ORIGINAL RESEARCH The Role of Alexithymia and Coping Strategies in Eating Disorders: a Pilot Study Fiorenza Marchiol 1 & Barbara Penolazzi 1 & Corrado Cavallero 1 & Gian Luigi Luxardi 2 Received: 6 August 2019 /Revised: 6 August 2019 /Accepted: 5 December 2019 # Neuroscientia 2020 Abstract The majority of studies have found higher levels of alexithymia and a higher use of maladaptive coping strategies in individuals with eating disorders (ED). In this study, we consider the relationships between alexithymia and coping skills in different types of ED, in order to identify the specific role of these constructs in predicting dysfunctional eating symptoms. Thirty-four patients with anorexia nervosa (AN), 30 patients with bulimia nervosa (BN), 29 with binge eating disorder (BED) and 28 healthy control (HC) took part in the study. Eating Disorder Inventory-2 (EDI-2), Symptom Checklist-90-R (SCL-90-R), Toronto Alexithymia Scale (TAS-20) and Coping Inventory for Stressful Situation (CISS) were used to assess the constructs of interest. Patients with ED showed higher levels of alexithymia in comparison with HC. Moreover, they presented a higher use of Emotion oriented coping strategy than HC. Regression analysis showed that alexithymia difficult to identify feeling predicted the eating disorder risk in patients with AN, whereas the same risk was predicted by the Emotion oriented coping strategy in BED group. For AN group, the model remain significant also when controlling for anxiety and depression. Alexithymia appears to be a predictor of eating symptoms specifically in an AN group, whereas a high use of emotion-oriented coping strategy appears to be a predictor of ED specifically in BED patients. The present findings may orient various kinds of intervention specifically targeted to different levels of emotion processing. Keywords Anorexia . Bulimia . Binge eating disorder . Alexithymia . Coping . Emotional difficulties Introduction The term alexithymia literally means “lacking words for feel- ings” and is defined as a diminished capability to verbally describe and identify moods, as well as restricted imaginative capacities (Nemiah and Sifneos 1970; Sifneos 1973). The de- velopment of the self-administered Toronto Alexithymia Scale (TAS) (Taylor et al. 1985) and, in particular, of its 20- item form (TAS-20) (Bagby et al. 1994) has largely contrib- uted to the spreading of studies on alexithymia, providing a reliable and valid measure of the construct. Studies have shown that individuals with ED have higher total alexithymia scores as well as higher scores on two out of three subscales: (1) difficulties in identifying feelings and bodily sensations and (2) difficulties in describing feelings (Westwood et al. 2017; Nowakowski et al. 2013; Sifneos 1973; De Panfilis et al. 2003; Dingemans et al. 2017; Eizaguirre et al. 2004; Fernandes et al. 2017). The same results have been found in studies with non-clinical samples with disturbed eating (De Berardis et al. 2007; Nowakowski et al. 2013). As regards to various eating disorders, it seems that patients with anorexia nervosa (AN) present higher difficulty in describing feelings with respect to patients with bulimia nervosa (BN) (Nowakowski et al. 2013). In a recent meta-analyses, Westwood et al. (2017) found differences between all diag- nostic groups and HCs on the total TAS score with medium and large effect sizes. When the individual subscale scores of the TAS-20 were analysed, individuals with AN scored sig- nificantly higher on all subscales than HCs. Moreover, AN restrictive subtype and BN patients scored higher on the Difficulty Identifying Feelings and Difficulty Describing Feelings subscales. Due to lack of available data, it was not possible to examine TAS-20 subscale values in individuals with an AN purging type or BED (Westwood et al. 2017). Studies have generally not found differences between * Fiorenza Marchiol fiorenza_marchiol@yahoo.it 1 Department of Life Sciences, University of Trieste, Trieste, Italy 2 Center for Eating Disorders, ASL5 West Friuli, Pordenone, Italy Activitas Nervosa Superior https://doi.org/10.1007/s41470-019-00066-9