The present study examines the relationship of emotional awareness to anticipatory psychophysiological markers and performance on the Iowa Gambling Task (IGT). The IGT is a computerized card game that simulates real-life decisions through uncertainty of reward or punishment. The participant’s goal is to make advantageous card choices. Anticipatory somatic markers of physiological arousal, like electrodermal activity and heart rate, have been proposed to bias decisions in the IGT. The central hypothesis is that a participant’s emotional awareness is related to their ability to make advantageous decisions through biasing psychophysiological responses. The Toronto Alexithymia Scale was used to assess each participant’s emotional awareness. Less emotional awareness was associated with enhanced performance on the IGT. However, anticipatory physiological arousal (electrodermal activity and heart rate) and emotional awareness yielded no significant relationships. Findings suggest a need for further research on cognitive models, such as the expectancy valence model, in relation to decision-making.

Tyrimo tikslas – įvertinti aleksitiminių bruožų, socialinio palaikymo ir pablogėjusios nuotaikos sąsajas priklausomų nuo alkoholio bei depresiškų tiriamųjų grupėse. Tyrimo metodai. Aleksitiminiai asmenybės bruožai buvo tiriami naudojant 20-ties teiginių Toronto aleksitimijos skalę (TAS-20). Socialiniam palaikymui įvertinti buvo naudoti socialinio palaikymo klausimynas (SSQ)(Social Support Questionnaire and Duke Social Network Questionnaire were used to assess social support). Pablogėjusiai nuotaikai ir nerimastingumui nustatyti naudota A. S. Zigmondo ir R. P. Snaitho ligoninės nerimo ir depresijos skalė (HAD – angl. Hospital Anxiety and Depression Scale). Tyrime dalyvavo 177 asmenys (77 vyrai (43,5%) ir 100 moterų (56,5%), iš jų priklausomi nuo alkoholio - 91 asmuo, (51 vyras (56 %) ir 40 (44%) moterų) ir sergančių depresija asmenų grupė, kurioje buvo 86 asmenys, iš jų 26 vyrai (30,2%) ir 60 moterų (69,8 %). Aleksitimija yra išankstinis rizikos veiksnys, turintis reikšmės psichoaktyviųjų medžiagų vartojimo pradžiai, kadangi daugelis priklausomybę turinčių asmenų vartoja alkoholį ir vaistus, jog kompensuotų nesugebėjimą išreikšti ir valdyti emocijas. Aleksitimija susijusi su nerimu ir depresiškumu, neigiamai veikia gydymo rezultatus ir apsunkina sveikimo procesą. Rezultatai. Aleksitiminių bruožų pasireiškimas nesiskiria priklausomų nuo alkoholio ir depresiškų tiriamųjų grupėse. Labiau išreikšti aleksitiminiai bruožai tiesiogiai siejasi su ryškesniais pablogėjusios nuotaikos... [toliau žr. visą tekstą] / The aim of the study was to assess depressive features, social support and the deterioration of the interface depending on the mood and spirit with depression groups. Methods of study. alexithymia personality traits were tested using Toronto's Alexithymia Scale 20 propositions (TAS-20). Social Support Questionnaire (SSQ) and Duke Social Network Questionnaire were used to assess social support. In order to assess worsening mood and anxiety, A. S. Zigmond and R. P. Snaith’s Hospital Anxiety and Depression Scale (HAD) was employed. The study included 177 subjects (77 men (43.5%) and 100 women (56.5%) of their dependence on alcohol - 91 person (51 males (56%) and 40 (44%) women) and group of people, suffering from depression, which has 86 members, of which 26 were males (30.2%) and 60 women (69.8%). Alexithymia traits is an early risk factor values of psychoactive substance use beginning, whereas many people which are addicted to alcohol and drugs are using them to compensate the inability to describing and control their emotions. Alexithymia is associated with anxiety and depression, adversely affects treatment outcomes and complicates the recovery process. Results. Alexithymia traits features are the same in both groups, people addicted to alcohol and depressed people. The features, which are more significant, directly relates to the deterioration of the brighter mood indicators. Alcohol-dependent patients group experience less social support because of more expressed... [to full text]

Anorexia nervosa (AN) is a serious disorder with long-term consequences for those afflicted. No evidence-based care is available for adults with full or subthreshold AN. The thesis research investigated aspects of emotion and cognition relevant to the maintenance of AN that might inform psychological treatment. In addition, the effectiveness of a recent psychotherapy model of AN was investigated. Study I investigated alexithymia and emotional awareness and their associations with depression, anxiety, and perfectionism among patients with AN compared with a control group. The AN group exhibited the same level of emotional awareness as did the control group and the same level of alexithymia when controlling for depression and anxiety. Alexithymia and emotional awareness were not associated, despite representing an overlapping construct. The results of the present study indicate that those with AN can trust their emotional awareness. Study II explored implicit pro-thin and anti-fat attitudes (towards the self and others), striving for thinness (loosely corresponding to positive reinforcement), and avoidance of fatness (loosely corresponding to negative reinforcement). The AN and the control groups were found to have equally strong implicit pro-thin and striving for thinness attitudes. The AN group exhibited stronger implicit anti-fat and avoidance of fatness attitudes (loosely corresponding to negative reinforcement) than did the control group. There was no association between implicit and explicit measures. The results are in line with the over-evaluation of weight and shape as a core feature of eating disorders. Study III compared the effectiveness of Acceptance and Commitment Therapy (ACT) and treatment as usual (TAU) for adults with AN after day-care. Follow-up measures indicated no difference in improvement or deterioration between the two groups. The level of perfectionism was reduced in the ACT group relative to the TAU group. The study was compromised by a lower inflow of patients than anticipated and by a high drop-out rate, and thus fails to provide evidence of a difference between the two groups. The present thesis demonstrates that emotional awareness is intact in those with AN and that implicit attitudes concerning weight and shape reflect the explicit attitudes, although without association. The treatment study indicates that, when designing treatment, it is important to consider the ambivalence to treatment among those suffering from AN, which is reflected in the high drop-out rate in the present study.

Research in the last decades has shown that individuals with high degrees in the personality trait of alexithymia not only have difficulties in identifying and recognizing own feelings, but also show deficits in reading emotions from facial expressions of other people. Therefore, the current dissertation investigates the neural correlates of recognizing emotional facial expressions as a function of alexithymia. Initially, a theoretical introduction is given and existing findings from behavioral as well as structural and functional neuroimaging research are presented. Open questions are identified and addressed in one structural and two functional magnetic resonance imaging studies that were compiled into three original research articles. Study 1 examined the gray matter profile of high and low alexithymic individuals in selected brain regions relevant for processing emotional faces. In Study 2, functional neuroimaging was used to investigate the neural correlates of high alexithymic individuals\'' difficulties in labeling briefly presented (≤ 100 ms) facial expressions of emotion. Study 3 investigated neural activations as a function of alexithymia during the labeling of emotional facial expressions when these are presented with little temporal constraints (≥ 1 s). The results of these studies are summarized and integrated with the existing literature. Finally, open issues are discussed and ideas for further research are outlined.

Cette recherche porte sur l’impact et la caractérisation des difficultés socio-affectives dans l’anorexie mentale (AM). Les difficultés intéroceptives et introspectives, telles qu’appréhendées par des mesures d’alexithymie, pourraient être liées à la sévérité des tableaux cliniques des AM et impacter non seulement leur état somatique mais également leur fonctionnement interpersonnel. Par ailleurs l’alexithymie et l’évitement social sont des déficits retrouvés dans les troubles du spectre autistique. L’Institut de Psychiatrie de Londres a d’ailleurs proposé un modèle mettant en cause un partage d’endophénotypes entre ces troubles et l’anorexie mentale qui rendrait compte de leur chevauchement phénotypique. Le manque de flexibilité et de cohérence centrale font l’objet d’une littérature grandissante et semblent bien être commun aux deux pathologies. Des difficultés socio-affectives communes sont aussi discutées, mais encore peu étudiées. Un axe de notre travail a été d’étudier les liens entre l’alexithymie, les facteurs cliniques (e.g âge de début, durée d’évolution, nombre de rechutes, évolution de l’état globlal) et l’anxiété sociale en prenant en compte d’éventuels facteurs de confusion mis en cause dans la littérature (état nutritionnel,, affects anxio-dépressifs). Le deuxième axe de notre travail a porté sur la caractérisation du chevauchement existant entre les troubles du spectre autistique et l’anorexie mentale en comparant les profils socio-affectifs d‘anorexiques et de personnes atteintes du syndrome d’Asperger. Pour répondre au premier axe de recherche, nous avons réalisé deux études : une 1ère auprès de 60 patientes ; une 2ème auprès de 213 patients. Les sujets des deux études étaient des patients hospitalisés pour un épisode d’anorexie dans une unité spécialisée dans la prise en charge des troubles des conduites alimentaires. La première étude a porté sur une population homogène d’adolescentes anorexiques, malades depuis moins de 3 ans et toutes hospitalisées dans le même centre parisien. La participation à la deuxième étude a été proposée à tous les patients âgés de 13 à 65 ans hospitalisés pour un épisode d’anorexie au sein de 11 services spécialisés en France. Pour les deux études, nous avons utilisé les scores à des instruments psychométriques mesurant l’alexithymie (TAS-20 ou BVAQ), la symptomatologie alimentaire (EDI, ou EDE-Q et EAT) et les affects anxio-dépressifs (SCL-90 ou HAD). L’état global des patients, l’anxiété et l’évitement social ont été évalués lors d’entretiens semi-structurés (respectivement Morgan et Russell, LSAS). De ces deux études, il ressort que l’alexithymie semble jouer un rôle péjorant, non seulement sur les symptômes alimentaires, mais également sur l’évitement social. L’impact de l’alexithymie existe au-delà de l’effet de l’état nutritionnel et des affects dysphoriques. Le fonctionnement alexithymique semble par ailleurs influencer négativement l’évolution de l’état clinique des personnes ayant nécessité une hospitalisation pour anorexie mentale dans une unité spécialisée. Pour répondre à notre deuxième axe de recherche, nous avons réalisé une étude psychométrique comparative auprès de 15 personnes présentant un Syndrome d’Asperger, 15 anorexiques et deux groupes de témoins appariés à chaque groupe clinique. Nous avons utilisé des entretiens semi-structurés pour confirmer les diagnostics du Syndrome d’Asperger et d’AM (ADOS et MINI). Les participants ont complété des échelles d’alexithymie (BVAQ), de traits autistiques (AQ), d’empathie (IRI, EQ), de dépression (BDI) ainsi que de symptomatologie alimentaire (EAT). Cette étude comparative montre que les anorexiques se rapprochent des personnes souffrant du Syndrome d’Asperger en ce qui concerne l’alexithymie et certains traits autistiques, notamment cognitifs. (...) / This work concerns the impact and the nature of socio-affective difficulties in Anorexia Nervosa (AN). Interoceptive and introspective difficulties, as apprehended by measures of alexithymia, could be linked to the severity of clinical profiles among AN patients, and have an impact not only on their somatic state but also on their interpersonal functioning.Alongside, alexithymia and social avoidance are deficits that are encountered in disorders in the autistic spectrum. The London Institute of Psychiatry has indeed proposed a model involving shared endophenotypes between these disorders and AN, thus concluding to a phenotype overlap. The lack of flexibility and central coherence among these patients are issues that are being increasingly broached in the literature, and these features do indeed appear common to both pathologies. Socio-affective difficulties are also widely discussed in this respect, but as yet there have been few studies. Our first line of research was the study of the links between alexithymia, clinical factors (such as age at onset, duration of illness, number of relapses, evolution of global state), and social anxiety, taking into account any possible confounders highlighted in the literature (nutritional state, anxious-depressive affects). The second line of research was an exploration of the overlap between disorders in the autism spectrum and AN, by way of a comparison of the socio-affective profiles of AN patients and patients with Asperger's syndrome. To address the first line of research two studies were conducted. The first involved 60 female patients, and the second included 213 male and female patients. The patients in both of these studies were hospitalised for an episode of anorexia in units specialised in the care of eating disorders. The first study explored a homogenous population of anorexic adolescent girls with an illness duration of three years or more, all hospitalised in the same facility in Paris. Participation in the second study was proposed to all patents aged between 13 and 65 years hospitalised for an episode of anorexia across 11 specialised units in France. For both studies the scores used were derived from psychometric measures of alexithymia (TAS-20 or BVAQ), eating disorder symptoms (EDI or EDE-Q and EAT), and anxious-depressive affects (SCL-90 or HAD). Global state, anxiety and social avoidance were assessed in the course of semi-structured interviews (GOAS and LSAS respectively). From these studies it emerged that alexithymia appears to have an aggravating role, not only on eating symptoms, but also on social avoidance. The impact of alexithymia extends beyond that of the nutritional state and dysphoric affects. Alexithymic functioning also appears to have a negative impact on the evolution of clinical state among individuals having required hospitalisation in a unit specialised in AN. To explore the second line of research we performed a comparative psychometric study on 15 individuals presenting Asperger's syndrome, 15 anorexic patients, and two control groups matched to the two clinical groups. Semi-structured interviews were used to confirm the diagnoses of Asperger's Syndrome and AN (ADOS and MINI). The participants completed the scales for alexithymia (BVAQ), autistic traits (AQ), empathy (IRI,EQ), depression (BDI) and eating symptoms (EAT). This comparative study showed that AN subjects exhibited similarities with Asperger subjects for alexithymia and certain autistic traits, in particular cognitive. In contrast, important differences were observed for social skills, with anorexics exhibiting more empathy and greater concern for others that the patients with a disorder in the autism spectrum. From a clinical point of view in the field of the care of AN, this research shows the value of developing new approaches centred on the recognition of emotional states and the improvement of social skills. (...)

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Объектом исследования явилось счастье, психологическое благополучие. Предметом исследования стала связь счастья и психологического благополучия с алекситимией и пищевым поведением. Магистерская диссертация состоит из введения, двух глав, заключения, списка литературы (60 источников). Объем магистерской диссертации 68 страниц, на которых размещены 13 таблиц. Во введении раскрывается актуальность проблемы исследования, разработанность проблематики, ставятся цель и задачи исследования, определяются объект и предмет исследования, формулируются основная и дополнительные гипотезы, указываются методы и эмпирическая база, а также этапы проведения исследования, научная новизна, теоретическая и практическая значимость работы. Первая глава включает в себя обзор иностранной и отечественной литературы по теме счастья, психологического благополучия, алекситимии и пищевого поведения. Представлены разделы, посвященные исследованию связи счастья и психологического благополучия с алекситимией и пищевым поведением. Выводы по первой главе представляют собой итоги по изучению теоретического материала. Вторая глава посвящена эмпирической части исследования. В ней представлено описание организации и методов проведенного исследования и результатов, полученных по всем использованным методикам: Обновленный Оксфордский опросник счастья (Oxford Happiness Inventory), Шкала психологического благополучия К. Рифф, методика «Торонтская шкала алекситимии», Голландский опросник пищевого поведения DEBQ. Также в главе представлен корреляционный и факторный анализ результатов исследования. Выводы по главе 2 включают в себя основные результаты эмпирического исследования. В заключении в обобщенном виде изложены результаты теоретической и эмпирической частей работы, а также выводы по выдвинутым гипотезам, обоснована практическая значимость исследования и описаны возможные перспективы дальнейшей разработки данной проблематики. / The object of the study was happiness, psychological well-being. The subject of the study was the relationship of happiness and psychological well-being with alexithymia and eating behavior. The master's thesis consists of an introduction, two chapters, a conclusion, a list of references (60 sources). The volume of the master's thesis is 68 pages, which contain 13 tables. The introduction reveals the relevance of the research problem, the development of the problem, sets the goal and objectives of the study, defines the object and subject of the study, formulates the main and additional hypotheses, indicates the methods and empirical base, as well as the stages of the study, scientific novelty, theoretical and practical significance of the work. The first chapter includes a review of foreign and domestic literature on the topic of happiness, psychological well-being, alexithymia and eating behavior. Sections devoted to the study of the relationship of happiness and psychological well-being with alexithymia and eating behavior are presented. The conclusions on the first chapter are the results of the study of theoretical material. The second chapter is devoted to the empirical part of the study. It presents a description of the organization and methods of the study and the results obtained for all the methods used: the updated Oxford Happiness Inventory, the K. Riff Psychological Well-Being Scale, the Toronto Alexithymia Scale, the Dutch DEBQ Eating Behavior Questionnaire. The chapter also presents a correlation and factor analysis of the results of the study. Chapter 2's conclusions include the main findings of the empirical study. In the conclusion, the results of the theoretical and empirical parts of the work are summarized, as well as conclusions on the hypotheses put forward, the practical significance of the study is substantiated, and possible prospects for further development of this issue are described.

Author: Charlotte Hedberg Affiliation: Stockholm School of Theology- University College Stockholm The inner revolution  A pilot study of Existential health in relation to mystical experience. The aim of the pilot study is to investigate five individuals self-rated health in relation to the existential aspects in secular contexts. Intensive experiences often lead to a new way of looking at life and a new orientation in life. The study builds on five qualitative interviews and theories of mysticism, existential health as well as alexithymia. The empiric material is analyzed through Pahnkes nine typologies for mystical experience aswell as the existential health facets stated in WHOQOL-SRPB.  The study found that all of the participants had experienced an increased self-rated existential health after their mystical experiences. The conclusion of the study states that mystical experiences has been positively affecting self-rated existential health in all eight existential health facets stated in WHOQOL-SRPB.  The results are discussed by adding theories of alexythymia and the role of interpretation.

Le trouble comportemental en sommeil paradoxal (TCSP) est caractérisé par des rêves intenses et une perte de l’atonie musculaire normalement présente au cours du sommeil paradoxal qui permet l’apparition de comportements oniriques isomorphiques au contenu des rêves. Quelques chercheurs ont étudié le contenu des rêves des patients atteints du TCSP, plusieurs ont trouvé une plus grande présence de thèmes menaçants et agressifs, d’autres ont obtenu des résultats plus mitigés. Ces études comportent des failles méthodologiques importantes, comme l’absence d’un groupe contrôle ou l’inclusion de patients consommant une médication psychoactive. La présence de rêves à caractère dysphorique a été associée, dans d’autres populations, à une psychopathologie marquée et à des difficultés émotionnelles, et cette association, quoiqu’inexplorée pourrait aussi être présente chez patients ayant un TCSP. La raison pour laquelle ces patients font des rêves plus dysphoriques est encore largement inconnue, de même qu’une partie des mécanismes qui génèrent les comportements oniriques. Le but du premier article de cette thèse était de mesurer l’alexithymie et la détresse des cauchemars chez les patients atteints du TCSP par rapport à des contrôles. Les résultats indiquent que les patients souffrent davantage d’alexithymie, et particulièrement d’une difficulté à identifier leurs émotions et qu’elle corrélait avec la détresse due aux cauchemars. Le second article estimait, à l'aide d'un questionnaire validé, la présence de rêves, la diversité des thèmes des rêves chez les patients et examinait leurs thèmes au cours de leur vie. Les patients rapportaient beaucoup plus de cauchemars et plus de thèmes à caractère menaçant, comme des agressions, des catastrophes, et des rêves où le rêveur a peu de contrôle. Le troisième article avait pour objectif de clarifier les écarts dans les résultats des études sur les rêves des patients, c'est-à-dire déterminer si l'agressivité rapportée par ces patients est vraiment une différence au niveau du contenu des rêves, ou s'il s'agit plutôt d'un problème dû à la détresse liée aux rêves. Un second objectif était de mesurer le degré de corrélation entre les comportements à l’éveil, comme les comportements miroirs, et les comportements oniriques chez les patients. L’article démontre que les patients ressentaient une plus grande détresse à l'éveil en lien avec leurs expériences oniriques et que leurs rêves étaient plus dysphoriques et contenaient plus d'anxiété. De plus, leurs résultats au questionnaire de comportements miroirs corrélaient avec la sévérité de leurs comportements oniriques, ce qui suggère que le système de neurones miroirs pourrait avoir une influence sur les manifestations de ces comportements chez les patients. Globalement, ces résultats suggèrent que des difficultés au niveau de la régulation émotionnelle pourraient expliquer à la fois les symptômes émotionnels à l’éveil et les difficultés nocturnes des patients. Nous suggérons qu'un déficit au niveau des régions régulatrices frontales pourrait être à la base des différentes difficultés éprouvées par les patients. De plus, il est possible que des anomalies au niveau du système de neurones miroirs aient à la fois un impact sur la capacité des patients à réguler leurs émotions, mais aussi sur les manifestations de comportements oniriques. / REM sleep behavior disorder (RBD) is a parasomnia characterized by vivid dreams and loss of muscle atonia usually present during REM sleep that allows the appearance of dream-enacting behaviors that are isomorphic to dream content. Several studies have examined the content of RBD patients’ dreams, many found a greater presence of threatening and aggressive themes, others obtained mixed results. Most studies had significant methodological shortcomings, such as a lack of a control group or the inclusion of patients taking psychoactive medication. Still, the presence of dysphoric dreams is associated with marked psychopathology and emotional regulation problems. Moreover, the reason why RBD patients have dysphoric dreams is largely unexplored, just as parts of the processes that generate the dream-enacting behaviors. The goal of the first article of this thesis was to measure alexithymia and nightmare distress among RBD patients compared to a control group. The results indicate that RBD patients suffer more from alexithymia, especially a greater difficulty in identifying their emotions and that this difficulty correlated with nightmare distress. The second article examined, using a validated questionnaire, the lifetime prevalences of patients’ typical dream themes, and estimated the presence of their dreams, nightmares and dream theme diversity. RBD patients reported significantly more nightmares than controls and more menacing themes, such as assaults, disasters, and where the dreamer lacks control. The third article was intended to clarify discrepancies in the results of studies on RBD dreams, that is, if the aggressiveness reported by patients is really a difference in dream content or rather a problem related to dream distress. A second objective was to measure the degree of correlations between waking-state behaviors such as mirror behaviors, and dream-enacting behaviours in RBD patients. RBD patients were found to have more dysphoric dreams, containing more anxiety. They were also feeling greater distress in reaction to their dream experiences than did controls. Moreover, their results on the mirror behavior questionnaire correlated with the severity of their dream-enacting behaviors, suggesting that the mirror neuron system could have an influence in the formation of these behaviors. Overall, these findings suggest that difficulties in emotional regulation could explain both patients’ daytime emotional symptoms (alexithymia, nightmare distress, depression, anxiety, fewer mirror behaviors) and nocturnal difficulties (nightmares and dysphoric dreams, threats in dreams). We suggest that a deficit in frontal regulatory regions could be the base of the different challenges faced by patients. More specifically, it is possible that abnormalities in the mirror neuron system have an impact on both patients' ability to regulate their emotions and the manifestation of dream-enacting behaviors.

[pt] A presente tese teve como objetivo estabelecer um quadro teórico e empírico para desenvolver programas de intervenção para a alexitimia, uma condição relacionada com prejuízos socioemocionais. A tese é composta por quatro artigos. O artigo 1 validou uma versão adaptada do Bermond–Vorst Alexithymia Questionnaire (BVAQ) para o português brasileiro, mostrando que o TAS-20 e o BVAQ-BR medem diferentes aspectos da alexitimia. O artigo 2 validou a escala de precisão interoceptiva (IAS) adaptada para o português brasileiro, destacando a correlação negativa entre a precisão interoceptiva e alexitimia, sintomas de TEA e síndromes disfóricas. Os artigos 1 e 2 forneceram ferramentas confiáveis para avaliar alexitimia e acurácia interoceptiva no Brasil, mostrando seus potenciais benefícios na identificação de fatores de risco para transtornos psiquiátricos. O artigo 3 realizou uma revisão sistemática do impacto das intervenções baseadas em DBT na alexitimia, indicando a eficácia de tais intervenções na melhoria das habilidades de processamento emocional, embora as intervenções que incorporam princípios de outros tratamentos tenham sido mais eficazes. Por fim, o Artigo 4 explorou a relação entre alexitimia e empatia, revelando os aspectos multifacetados dessa relação. A tese propõe uma estrutura robusta para facilitar o desenvolvimento de programas de intervenção para alexitimia. / [en] The current thesis aimed to establish a theoretical and empirical framework to develop intervention programs for alexithymia, a condition related to socio-emotional impairments. The thesis is comprised of four articles. Article 1 validated an adapted version of the Bermond–Vorst Alexithymia Questionnaire (BVAQ) for Brazilian Portuguese, showing that the TAS-20 and the BVAQ-BR measure different aspects of alexithymia. Article 2 validated the Interoceptive Accuracy Scale (IAS) adapted to Brazilian Portuguese, highlighting the negative correlation between interoceptive accuracy and alexithymia, and symptoms of ASD and dysphoric syndromes. Articles 1 and 2 provided reliable tools for assessing alexithymia and interoceptive accuracy in Brazil, showing their potential benefits in identifying risk factors for psychiatric disorders. Article 3 conducted a systematic review of the impact of DBT-based interventions on alexithymia, indicating the effectiveness of such interventions in improving emotional processing skills, although interventions incorporating principles from other treatments were more effective. Finally, Article 4 explored the relationship between alexithymia and empathy, revealing the multifaceted aspects of this relationship. The thesis proposes a robust framework to facilitate the development of intervention programs for alexithymia.