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Alexithymia refers to a cluster of emotion processing weaknesses. Etiological theories suggest frontal lobe impairment, which implicates corresponding executive dysfunction. Although some studies have identified cognitive deficits in alexithymia, no study has systematically investigated executive functioning in this population while simultaneously deconstructing alexithymia and related constructs into empirically-derived dimensions. In this study, 104 adults completed self-report measures of alexithymia, emotional intelligence, and mood awareness as well as an ecologically-sensitive measure of discrete executive functions in daily life. Principal components analysis revealed two latent alexithymia factors: emotional clarity (EC) and emotional monitoring (EM). Analyses revealed that low-EC participants performed worse than high-EC participants across multiple executive function domains, including behavioral initiation/inhibition, set-shifting, self-monitoring, working memory, error recognition, and ability to plan and organize. No relationship was found between EM and patterns of cognitive performance. These data highlight the need to decompose alexithymia into discrete facets and suggest that executive dysfunction is related to lack of emotional clarity specifically rather than alexithymia broadly.

Emotional regulation and the impact of dysfunctional emotional systems on one’s mental and physical health have been of recent interest among researchers. Alexithymia, a personality construct first defined by Sifneos (1973), is used to classify those who have difficulty perceiving and processing emotions. Salient characteristics that define the alexithymic population include difficulty identifying feelings and distinguishing among bodily sensations of arousal, difficulty describing feelings to others, constricted imaginal processes, and a stimulus-bound, externally orientated cognitive style (see Luminet, Bagby, Wagner, Taylor, & Parker, 1999 for a discussion of how alexithymia relates to the Five-Factor Model of personality). With 10% of the general population estimated to be alexithymic (Fukunishi et al., 1999 and Taylor et al., 1997), researchers are finding vulnerability for a variety of somatic syndromes such as hypertension, diabetes, chronic pain, and obesity (Kauhanen, Kaplan, Cohen, Julkunen, & Salonen, 1996) as well as psychiatric disorders (Luminet and Rimé, 2004 and Taylor et al., 1997) in alexithymic individuals. Past research employing neuroscientific techniques has implicated frontal lobe dysfunction in the alexithymia trait. Human brain lesion studies indicate a decrease in emotional expressivity after frontal lobe damage, with more recent neuroimaging studies suggesting particular roles of the anterior cingulate (Lane et al., 1998) and prefrontal cortices (Bermond, Vorst, & Moormann, 2006). Although a model of frontal lobe brain functioning in alexithymia is emerging, it is problematic that most studies to date have largely ignored the cognitive deficits concomitant with frontal lobe dysfunction. Cognitive functions of the frontal lobe, the so-called executive functions, include cognitive flexibility, decision making, inhibitory control, planning and organization, self-monitoring, abstract reasoning, sustained and selective attention, and working memory (for review, see Roth, Randolph, Koven, & Isquith, 2006). While some studies reveal neuropsychological indices of executive dysfunction in conjunction with alexithymia in specific clinical populations, such as individuals with traumatic brain injury ( Henry, Phillips, Crawford, Theodorou, & Summers, 2006), human immunodeficiency virus ( Bogdanova, Díaz-Santos, & Cronin-Golomb, 2010), Parkinson’s disease ( Costa, Peppe, Carlesimo, Salamone, & Caltragirone, 2007), and heroin addiction ( Huang, Zhu, Yao, & Zhou, 2005), very few studies have investigated patterns of cognitive functioning and alexithymia in non-clinical samples. One such study by Xiong-Zhao, Xiao-Yan, and Ying (2006) reported that level of alexithymia was negatively correlated with performance on the Wisconsin Card Sorting Test (WCST). While these data certainly suggest some executive dysfunction in alexithymia, neuropsychological measures such as the WCST index multiple executive functions simultaneously. It remains unclear which specific aspects of executive function are implicated in alexithymia and whether any performance-based neuropsychological deficits translate beyond the laboratory to self-reported real-life cognitive difficulties. Clinical assessment of executive functions has historically been challenging because of their dynamic nature (Stuss & Alexander, 2000). The structured format of the typical assessment context may not place sufficiently high demands on executive functioning (Holmes-Bernstein & Waber, 1990) such that adults may score within normal limits on performance-based measures despite reports of severe executive dysfunction in everyday life (Eslinger and Damasio, 1985, Goldstein et al., 1993 and Meyers et al., 1992). Since current performance-based tests are constructed to assess individual components of executive functions over short periods of time, they may fail to capture the integrated, multidimensional, relativistic, priority-based decision-making that is demanded in real world situations (Goldberg and Podell, 2000 and Shallice and Burgess, 1991). Using our current knowledge of neuropsychological correlates of executive functioning, further research is needed to explore executive functioning in alexithymic individuals in non-clinical samples. However, the multidimensionality of the alexithymia construct can make data interpretation complicated, and it has been noted that there is considerable overlap of alexithymia with the related constructs of emotional intelligence and mood awareness (Coffey, Berenbaum, & Kerns, 2003). Indeed, past factor analytic research has suggested that different facets of alexithymia have unique cognitive and emotion processing correlates (Coffey et al., 2003). However, no study to date has examined the relationships between specific facets of alexithymia and patterns of everyday executive functioning. To address this gap, this study uses empirically-derived facets of alexithymia and an ecologically-sensitive, broadband measure of executive dysfunction in a non-clinical sample of young adults. Given the finding by Xiong-Zhao and colleagues (2006) of diminished performance by alexithymic individuals on the WCST, it is expected that individuals who score higher on dimensions of alexithymia will report difficulty in daily life with executive functions needed for this task, including set-shifting, behavioral inhibition, error monitoring, and working memory.