Alexithymia is associated with neural reactivity to masked emotional faces in adolescents who self-harm

Lauren A. Demers, Melinda Westlund Schreiner, Ruskin H Hunt, Bryon A Mueller, Bonnie Klimes-Dougan, Kathleen M Thomas, Kathryn R Cullen

Research output: Contribution to journalArticle

Abstract

Background: Non-suicidal self-injury (NSSI) is a major, trans-diagnostic mental health problem among adolescents. Alexithymia has been identified as a developmental risk factor for NSSI. Research on how alexithymia relates to the neurobiology of automatic emotion processing is only beginning to emerge. This study evaluates the relationship between alexithymic features and neural responses to automatic processing of emotional content in adolescents with NSSI. Methods: 25 female adolescents (ages 13–21) with a history of repeated engagement in NSSI completed the Toronto Alexithymia Scale and the Difficulties with Emotion Regulation Scale and underwent functional magnetic resonance imaging (fMRI) during a task in which participants were exposed to masked emotions. Results: One facet of alexithymia, limited internal emotion awareness or externally-oriented thinking (EOT), was related to differential reactivity to masked emotional faces in clusters in the right supramarginal gyrus and right inferior frontal gyrus. Follow-up assessment of regional reactivity revealed that greater EOT is associated with lower activation to masked happy faces but higher activation to masked fearful faces. Other facets of alexithymia did not show relationships with reactivity to masked emotional faces. Limitations: This is a cross-sectional and small sample that only includes females, which may attenuate generalizability of findings. Conclusions: We report neural correlates of multiple facets of alexithymia in adolescents with NSSI. Among adolescents who self-harm, those with higher levels of EOT may be less alert to subtle positively-valenced emotion cues. For this subset of adolescents with NSSI, interventions designed to enhance mental representation of emotional responses and attention to positive emotions may be appropriate.

Original languageEnglish (US)
Pages (from-to)253-261
Number of pages9
JournalJournal of Affective Disorders
Volume249
DOIs
StatePublished - Apr 15 2019

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Affective Symptoms
Emotions
Wounds and Injuries
Parietal Lobe
Neurobiology
Prefrontal Cortex
Cues
Mental Health
Magnetic Resonance Imaging
Research
Thinking

Keywords

  • Alexithymia
  • Masked faces
  • Non-suicidal self-injury (NSSI)
  • fMRI

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

Cite this

@article{d199cd5dede84891915501f71a68fa22,
title = "Alexithymia is associated with neural reactivity to masked emotional faces in adolescents who self-harm",
abstract = "Background: Non-suicidal self-injury (NSSI) is a major, trans-diagnostic mental health problem among adolescents. Alexithymia has been identified as a developmental risk factor for NSSI. Research on how alexithymia relates to the neurobiology of automatic emotion processing is only beginning to emerge. This study evaluates the relationship between alexithymic features and neural responses to automatic processing of emotional content in adolescents with NSSI. Methods: 25 female adolescents (ages 13–21) with a history of repeated engagement in NSSI completed the Toronto Alexithymia Scale and the Difficulties with Emotion Regulation Scale and underwent functional magnetic resonance imaging (fMRI) during a task in which participants were exposed to masked emotions. Results: One facet of alexithymia, limited internal emotion awareness or externally-oriented thinking (EOT), was related to differential reactivity to masked emotional faces in clusters in the right supramarginal gyrus and right inferior frontal gyrus. Follow-up assessment of regional reactivity revealed that greater EOT is associated with lower activation to masked happy faces but higher activation to masked fearful faces. Other facets of alexithymia did not show relationships with reactivity to masked emotional faces. Limitations: This is a cross-sectional and small sample that only includes females, which may attenuate generalizability of findings. Conclusions: We report neural correlates of multiple facets of alexithymia in adolescents with NSSI. Among adolescents who self-harm, those with higher levels of EOT may be less alert to subtle positively-valenced emotion cues. For this subset of adolescents with NSSI, interventions designed to enhance mental representation of emotional responses and attention to positive emotions may be appropriate.",
keywords = "Alexithymia, Masked faces, Non-suicidal self-injury (NSSI), fMRI",
author = "Demers, {Lauren A.} and Schreiner, {Melinda Westlund} and Hunt, {Ruskin H} and Mueller, {Bryon A} and Bonnie Klimes-Dougan and Thomas, {Kathleen M} and Cullen, {Kathryn R}",
year = "2019",
month = "4",
day = "15",
doi = "10.1016/j.jad.2019.02.038",
language = "English (US)",
volume = "249",
pages = "253--261",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier B.V.",

}

TY - JOUR

T1 - Alexithymia is associated with neural reactivity to masked emotional faces in adolescents who self-harm

AU - Demers, Lauren A.

AU - Schreiner, Melinda Westlund

AU - Hunt, Ruskin H

AU - Mueller, Bryon A

AU - Klimes-Dougan, Bonnie

AU - Thomas, Kathleen M

AU - Cullen, Kathryn R

PY - 2019/4/15

Y1 - 2019/4/15

N2 - Background: Non-suicidal self-injury (NSSI) is a major, trans-diagnostic mental health problem among adolescents. Alexithymia has been identified as a developmental risk factor for NSSI. Research on how alexithymia relates to the neurobiology of automatic emotion processing is only beginning to emerge. This study evaluates the relationship between alexithymic features and neural responses to automatic processing of emotional content in adolescents with NSSI. Methods: 25 female adolescents (ages 13–21) with a history of repeated engagement in NSSI completed the Toronto Alexithymia Scale and the Difficulties with Emotion Regulation Scale and underwent functional magnetic resonance imaging (fMRI) during a task in which participants were exposed to masked emotions. Results: One facet of alexithymia, limited internal emotion awareness or externally-oriented thinking (EOT), was related to differential reactivity to masked emotional faces in clusters in the right supramarginal gyrus and right inferior frontal gyrus. Follow-up assessment of regional reactivity revealed that greater EOT is associated with lower activation to masked happy faces but higher activation to masked fearful faces. Other facets of alexithymia did not show relationships with reactivity to masked emotional faces. Limitations: This is a cross-sectional and small sample that only includes females, which may attenuate generalizability of findings. Conclusions: We report neural correlates of multiple facets of alexithymia in adolescents with NSSI. Among adolescents who self-harm, those with higher levels of EOT may be less alert to subtle positively-valenced emotion cues. For this subset of adolescents with NSSI, interventions designed to enhance mental representation of emotional responses and attention to positive emotions may be appropriate.

AB - Background: Non-suicidal self-injury (NSSI) is a major, trans-diagnostic mental health problem among adolescents. Alexithymia has been identified as a developmental risk factor for NSSI. Research on how alexithymia relates to the neurobiology of automatic emotion processing is only beginning to emerge. This study evaluates the relationship between alexithymic features and neural responses to automatic processing of emotional content in adolescents with NSSI. Methods: 25 female adolescents (ages 13–21) with a history of repeated engagement in NSSI completed the Toronto Alexithymia Scale and the Difficulties with Emotion Regulation Scale and underwent functional magnetic resonance imaging (fMRI) during a task in which participants were exposed to masked emotions. Results: One facet of alexithymia, limited internal emotion awareness or externally-oriented thinking (EOT), was related to differential reactivity to masked emotional faces in clusters in the right supramarginal gyrus and right inferior frontal gyrus. Follow-up assessment of regional reactivity revealed that greater EOT is associated with lower activation to masked happy faces but higher activation to masked fearful faces. Other facets of alexithymia did not show relationships with reactivity to masked emotional faces. Limitations: This is a cross-sectional and small sample that only includes females, which may attenuate generalizability of findings. Conclusions: We report neural correlates of multiple facets of alexithymia in adolescents with NSSI. Among adolescents who self-harm, those with higher levels of EOT may be less alert to subtle positively-valenced emotion cues. For this subset of adolescents with NSSI, interventions designed to enhance mental representation of emotional responses and attention to positive emotions may be appropriate.

KW - Alexithymia

KW - Masked faces

KW - Non-suicidal self-injury (NSSI)

KW - fMRI

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U2 - 10.1016/j.jad.2019.02.038

DO - 10.1016/j.jad.2019.02.038

M3 - Article

VL - 249

SP - 253

EP - 261

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -