Adaptive and Maladaptive Influences of Alexithymia on Affective Disorders: Through Empathy and Emotion Regulation

Alexithymia—a personality trait characterized by difficulties in recognizing and verbalizing emotions—is associated with various affective disorders. This study examined the relationship between the cognitive and affective dimensions of alexithymia, the multidimensional facets of empathy, and their association with the risk of affective disorders. A total of 391 Japanese participants completed self-report questionnaires assessing alexithymia, empathy, emotion regulation, and symptoms related to affective disorders. The results revealed that cognitive alexithymia was associated with diminished cognitive empathy and heightened personal distress, which in turn predicted higher levels of affective disorders. In contrast, affective alexithymia was negatively associated with personal distress and affective symptoms, suggesting a potential adaptive role in reducing the risk of affective disorders symptoms. Furthermore, while reappraisal is generally regarded as an adaptive emotion regulation strategy, its effectiveness depends on the level of alexithymia. These findings highlight the complex nature of alexithymia and its interactions with empathy and emotion regulation. Rather than providing a perspective on alexithymia as a maladaptive trait, our results suggest that it may have both adaptive and maladaptive aspects. These findings emphasize considering individual differences in emotional processing when examining mental health outcomes and developing interventions.