Furthering the language hypothesis of alexithymia: an integrated review and meta-analysis

Ka Shu Lee*, Jennifer Murphy, Caroline Catmur, Geoffrey Bird, Hannah Hobson

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Alexithymia, including the inability to identify and express one's own feelings, is a subclinical condition responsible for some of the socioemotional symptoms seen across a range of psychiatric conditions. The language hypothesis of alexithymia posits a language-mediated disruption in the development of discrete emotion concepts from ambiguous affective states, exacerbating the risk of developing alexithymia in language-impaired individuals. To provide a critical evaluation, a systematic review and meta-analysis of 29 empirical studies of language functioning in alexithymia was performed. A modest association was found between alexithymia and multi-domain language deficits (r = −0.14), including structural language, pragmatics, and propensity to use emotional language. A more theoretically-relevant subsample analysis comparing alexithymia levels in language-impaired and typical individuals revealed larger effects, but a limited number of studies adopted this approach. A synthesis of 11 emotional granularity studies also found an association between alexithymia and reduced emotional granularity (r = −0.10). Language impairments seem to increase the risk of alexithymia. Heterogeneous samples and methods suggest the need for studies with improved alexithymia assessments.

Original languageEnglish
Article number104864
Number of pages23
JournalNeuroscience and biobehavioral reviews
Early online date8 Sept 2022
Publication statusPublished - Oct 2022

Bibliographical note

Funding Information:
GB was supported by the Baily Thomas Trust. The funding source was not involved in the conduct of the research and/or preparation of the article.

Publisher Copyright:
© 2022 The Authors


  • Alexithymia
  • Constructionist
  • Emotion
  • Emotional granularity
  • Language
  • Meta-analysis
  • Systematic review

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience


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