Alexithymia and interpersonal problems: A study of natural language use Reitske Meganck * , Stijn Vanheule, Ruth Inslegers, Mattias Desmet Ghent University, Department of Psychoanalysis and Clinical Consulting, H. Dunantlaan 2, B-9000 Ghent, Belgium article info Article history: Received 31 March 2009 Received in revised form 16 July 2009 Accepted 6 August 2009 Available online 27 August 2009 Keywords: Alexithymia Interpersonal problems TAS-20 TSIA abstract The concept of alexithymia refers to difficulties in experiencing, verbalizing and regulating emotions. The relationship between alexithymia and interpersonal style is investigated by means of lexical content analysis. It is hypothesized that alexithymia is related to less frequent and less varied use of communi- cation words and references to others. Alexithymia was measured with the 20-item Toronto Alexithymia Scale and the Toronto Structured Interview for Alexithymia. The Clinical Diagnostic Interview was admin- istered to 50 psychiatric inpatients, transcribed verbatim, and computer-analysed with the Linguistic Inquiry and Word Count-dictionary. Results showed that alexithymia is related to a less complex vocab- ulary for communication words. Contradictory results for some subscales of the TAS-20 and the TSIA however compromise their construct validity. Ó 2009 Elsevier Ltd. All rights reserved. 1. Introduction The concept of alexithymia was introduced in the 70s (Nemiah & Sifneos, 1970; Sifneos, 1973) and refers to difficulties in experi- encing, verbalizing and regulating emotions. Nowadays alexithy- mia is defined as consisting of four dimensions: (1) difficulty identifying feelings and distinguishing between feelings and the bodily sensations of emotional arousal, (2) difficulty describing feelings to other people, (3) constricted imaginal processes, and (4) a stimulus-bound, externally orientated cognitive style (Taylor, Bagby, & Parker, 1997). These characteristics are understood by Taylor and colleagues to reflect ‘‘deficits both in the cognitive- experiential domain of emotion response systems and at the level of interpersonal regulation of emotions” (p. 30). In this context, the authors suggest that alexithymic individuals communicate emo- tional distress to others poorly and as a result fail to enlist others for help or comfort. Problems with close, affectively invested relationships already became clear in the early clinical observations of alexithymia (Marty & de M’Uzan, 1963; Nemiah & Sifneos, 1970). With the ab- sence of transference and the slow-moving development of the therapeutic relation, Marty and de M’Uzan (1963) use the term ‘‘relation blanche” to characterize the interaction with these pa- tients. Furthermore, this interpersonal style was not limited to the therapeutic relation; in terms of object relations these patients were described as lacking libidinal affect. Moreover, they seemed to be uninterested and unemotional towards significant others (Marty, de M’Uzan, & David, 1963; McDougall, 1984). More recent research suggests that their relationships are marked by discom- fort, avoidance, and a distance taking attitude (Vanheule, Inslegers, Meganck, Ooms, & Desmet, in press). Indeed, an investigation of the association between alexithymia (20-item Toronto Alexithy- mia Scale, TAS-20; Bagby, Parker, & Taylor, 1994) and interpersonal problems (Inventory of Interpersonal Problems, IIP; Horowitz, Al- den, Wiggins, & Pincus, 2000) found that alexithymia is character- ized by a cold and socially avoidant interpersonal style (Spitzer, Siebel-Jürges, Barnow, Grabe, & Freyberger, 2005; Vanheule, Des- met, Meganck, & Bogaerts, 2007). Research with children and ado- lescents shows that those with a lower level of emotional competence (a characteristic of alexithymia) display less help- seeking behaviour with respect to family, friends, and profession- als (Ciarrochi & Deane, 2001). Adult attachment studies indicate that a dismissing attachment style is related to a higher level of alexithymia (Scheidt et al., 1999), while child attachment studies found that an insecure and disorganized attachment style is asso- ciated with a developmental delay in the acquisition of mentaliz- ing language (Lemche, Klann-Delius, Koch, & Joraschky, 2004). To date both clinical observations and theoretical descriptions of alexithymia suggest a link between alexithymia and an interper- sonal style that is characterized by a lack of investment in others. However, the studies that provide evidence for this association fre- quently operationalize both alexithymia and interpersonal styles by means of (self-report) questionnaires. This method can give rise to artificially high correlations due to content overlap and shared method variance (Meyer et al., 2001). In this study, we investigate the link between alexithymia and interpersonal style by means of interview data and lexical content analysis. The rationale behind lexical content analysis is that the lexical choices people make as they speak or write reveal what they have on their mind or are concerned with, irrespective of the intentions they have while communicating (Pennebaker, Mehl, & Niederhoffer, 2003). As we 0191-8869/$ - see front matter Ó 2009 Elsevier Ltd. All rights reserved. doi:10.1016/j.paid.2009.08.005 * Corresponding author. Tel.: +32(0)9/2649110; fax: +32 9 264 64 88. E-mail address: Reitske.Meganck@UGent.be (R. Meganck). Personality and Individual Differences 47 (2009) 990–995 Contents lists available at ScienceDirect Personality and Individual Differences journal homepage: www.elsevier.com/locate/paid