Delphine Grynberg

Alexithymia and the processing of emotional facial expressions (EFEs) : systematic review, unanswered questions and further perspectives

Alexithymia is characterized by difficulties in identifying, differentiating and describing feelings. A high prevalence of alexithymia has often been observed in clinical disorders characterized by low social functioning. This review aims to assess the association between alexithymia and the ability to decode emotional facial expressions (EFEs) within clinical and healthy populations. More precisely, this review has four main objectives: (1) to assess if alexithymia is a better predictor of the ability to decode EFEs than the diagnosis of clinical disorder; (2) to assess the influence of comorbid factors (depression and anxiety disorder) on the ability to decode EFE; (3) to investigate if deficits in decoding EFEs are specific to some levels of processing or task types; (4) to investigate if the deficits are specific to particular EFEs. Twenty four studies (behavioural and neuroimaging) were identified through a computerized literature search of Psycinfo, PubMed, and Web of Science databases from 1990 to 2010. Data on methodology, clinical characteristics, and possible confounds were analyzed. The review revealed that: (1) alexithymia is associated with deficits in labelling EFEs among clinical disorders, (2) the level of depression and anxiety partially account for the decoding deficits, (3) alexithymia is associated with reduced perceptual abilities, and is likely to be associated with impaired semantic representations of emotional concepts, and (4) alexithymia is associated with neither specific EFEs nor a specific valence. These studies are discussed with respect to processes involved in the recognition of EFEs. Future directions for research on emotion perception are also discussed.

Personality-dependent effects of oxytocin: greater social benefits for high alexithymia scorers.

Originally known for its role in labor and lactation, oxytocin (OT) has recently been shown to facilitate social behaviour by improving socio-emotional abilities. However, whether OT is equally beneficial to all people, or whether is it particularly beneficial to less emotionally/socially competent (i.e., high alexithymia) individuals it is not yet known. We investigated the effects of OT on individuals of varying socio-emotional ability by randomly assigning sixty male students to receive either oxytocin (OT) or a placebo (PL), and had them perform the Reading the Mind in the Eyes test (RMET). Results showed that whereas the performance of lower alexithymia individuals was equally good in both OT and PL conditions, the performance of higher alexithymia people was better under OT than PL. These results suggest that the effects of OT are not only context-dependent-as recently shown-but also personality dependent. They also provide new insights into the remediation of socio-emotional deficits.

Dissociation between affective and cognitive empathy in alcoholism : a specific deficit for the emotional dimension.

BACKGROUND Emotional impairments constitute a crucial and widely described dimension of alcoholism, but several affective abilities are still to be thoroughly explored among alcohol-dependent patients. This is particularly true for empathy, which constitutes an essential emotional competence for interpersonal relations and has been shown to be highly impaired in various psychiatric states. The present study aimed at exploring empathic abilities in alcoholism, and notably the hypothesis of a differential deficit between emotional and cognitive empathy. METHODS Empathy abilities were evaluated among 30 recently detoxified inpatients diagnosed with alcohol dependence and 30 paired healthy controls, using highly validated questionnaires (Interpersonal Reactivity Index [J Pers Soc Psychol44:113] and Empathy Quotient [J Autism Dev Disord34:163]). Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures (i.e., depression, anxiety, interpersonal problems, and alexithymia). RESULTS When psychiatric comorbities are controlled for, alcoholism is not associated with a general empathy deficit, but rather with a dissociated pattern combining impaired emotional empathy and preserved cognitive one. Moreover, this emotional empathy deficit is not associated with depression or anxiety scores, but is negatively correlated with alexithymia and the severity of interpersonal problems. CONCLUSIONS At the theoretical level, this first observation of a specific deficit for emotional empathy in alcoholism, combined with the exact inverse pattern observed in other psychiatric populations, leads to a double-dissociation, which supports the notion that emotional and cognitive empathy are 2 distinct abilities. At the clinical level, this deficit calls for considering emotional empathy rehabilitation as a crucial concern in psychotherapy.

Perceiving one's body shapes empathy.

BACKGROUND Empathy is a basic human ability with affective and cognitive facets and high interindividual variability. Accurately detecting ones internal body signals (interoceptive sensitivity) strongly contributes to the awareness of oneself and is known to interact with emotional and cognitive processes. This study investigated whether interoceptive sensitivity (i.e., heartbeat perception task) shapes affective and cognitive empathy. METHODS Ninety-three participants were asked to report the valence of their feelings, as well as the degree of compassion, arousal, and distress they felt in response to pictures depicting other people in pain or in non-pain situations. Participants also had to estimate how painful the situation was. RESULTS Main results showed that greater interoceptive sensitivity enhanced the estimated degree of pain (cognitive empathy), as well as arousal and feelings of compassion (affective empathy), in response to painful pictures. CONCLUSIONS The accurate perception of bodily states and their representation shape both affective and cognitive empathy. This perception enables us to feel more compassion for another person and to evaluate the pain that they experience as being more intense.

Alexithymia modulates the experience of the rubber hand illusion

Alexithymia is associated with lower awareness of emotional and non-emotional internal bodily signals. However, evidence suggesting that alexithymia modulates body awareness at an external level is scarce. This study aimed to investigate whether alexithymia is associated with disrupted multisensory integration by using the rubber hand illusion task. Fifty healthy individuals completed the Toronto Alexithymia Scale and underwent the rubber hand illusion measure. In this measure, one watches a rubber hand being stroked synchronously or asynchronously with one’s own hand, which is hidden from view. Compared to the asynchronous stimulation, the synchronous stimulation results in the illusion that the rubber hand and the participant’s hand are closer together than they really are and that the rubber hand belongs to them. Results revealed that higher levels of alexithymia are associated with a lower ownership illusion over the rubber hand. In conclusion, our findings demonstrate that high alexithymia scorers integrate two simultaneous sensory and proprioceptive events into a single experience (lower multisensory integration) to a lesser extent than low alexithymia scorers. Higher susceptibility to the illusion in high alexithymia scorers may indicate that alexithymia is associated with an abnormal focus of one’s own body.

Evidence for a cognitive bias of interpretation toward threat in individuals with a Type D personality

Biological and behavioral mediators link Type D personality with a poor prognosis in heart disease. However, the mediator role of cognitive biases is still unknown. This study tested whether Type D individuals exhibit an interpretative bias for ambiguous social situations. For this aim we examined Type D and non-Type D individuals’ evaluations of written social situations that varied in terms of situations’ clarity (clear, ambiguous) and social judgment (neutral, negative). A convenience sample of 42 young, healthy adults rated each situation in relation to the difficulty of formulating a verbal response, anticipated distress, and perceived threat, and they completed the Type D personality scale (DS14; Denollet, 2005). Results showed an interpretation bias among Type D individuals, as they rated ambiguous or neutral situations as significantly more distressing compared to non-Type D individuals. Only clearly negative situations were rated similarly by Type D and non-Type D individuals. The discussion suggests that this interpretation bias in Type D individuals would increase their vulnerability to perceived stress.

The body language : The spontaneous influence of congruent bodily arousal on the awareness of emotional words

Nowadays, the idea of a reciprocal influence of physiological and psychological processes seems to be widely accepted. For instance, current theories of embodied emotion suggest that knowledge about an emotion concept involves simulations of bodily experienced emotional states relevant to the concept. In line with this framework, the present study investigated whether actual levels of physiological arousal interact with the processing of emotional words. Participants performed 2 blocks of an attentional blink task, once after a cycling session (increased arousal) and once after a relaxation session (reduced arousal). Concretely, participants were instructed to detect and report 2 target words (T1 and T2) presented among a series of nonword distractors. T1 and T2 were either neutral, high arousal, or low arousal words. Results revealed that increased physiological arousal led to improved reports of high arousal T2 words, whereas reduced physiological arousal led to improved reports of low arousal T2 words. Neutral T2 remained unaffected by the arousing conditions. These findings emphasize that actual levels of physiological arousal modulate the cognitive access to arousal (in-)congruent emotional concepts and suggest a direct grounding of emotion knowledge in our bodily systems of arousal.

Amplification of Attentional Blink by Distress Related Facial Expressions: Relationships with Alexithymia and Affectivity

The present studies aimed to analyse the modulatory effect of distressing facial expressions on attention processing. The attentional blink (AB) paradigm is one of the most widely used paradigms for studying temporal attention, and is increasingly applied to study the temporal dynamics of emotion processing. The aims of this study were to investigate how identifying fear and pain facial expressions (Study 1) and fear and anger facial expressions (Study 2) would influence the detection of subsequent stimuli presented within short time intervals, and to assess the moderating influence of alexithymia and affectivity on this effect. It has been suggested that high alexithymia scorers need more attentional resources to process distressing facial expressions and that negative affectivity increases the AB. We showed that fear, anger and pain produced an AB and that alexithymia moderated it such that difficulty in describing feelings (Study 1) and externally oriented thinking (Study 2) were associated with higher interference after the processing of fear and anger at short time presentations. These studies provide evidence that distressing facial expressions modulate the attentional processing at short time intervals and that alexithymia influences the early attentional processing of fear and anger expressions. Controlling for state affect did not change these conclusions.

Pain and Empathy: The Effect of Self-Oriented Feelings on the Detection of Painful Facial Expressions

Background Painful facial expressions have been shown to trigger affective responses among observers. However, there is so far no clear indication about the self- or other-oriented nature of these feelings. The purpose of this study was to assess whether facial expressions of pain are unconsciously associated with other-oriented feelings (empathic concern) or with self-oriented feelings (personal distress). Method 70 participants took part in a priming paradigm in which ambiguous facial expressions of pain were primed by words related to empathic concern, distress, negative or by neutral words. It was hypothesized that empathic concern or distress-related words might facilitate the detection of pain in ambiguous facial expressions of pain, independently of a mere effect of prime (i.e., neutral words) or an effect of valence congruency (negative primes). Results The results showed an effect of prime on the detection and on the reaction time to answer “pain” when confronted to ambiguous facial expressions of pain. More specifically, the detection of pain was higher and faster when preceded by distress primes relative to either neutral or negative primes. Conclusion The present study suggests that painful expressions are unconsciously related to self-oriented feelings of distress and that their threat value might account for this effect. These findings thus shed new light on the automatic relationship between painful expressions and the affective components of empathy.

Posttraumatic Symptoms and Thought Control Strategies Among Aging Hidden Jewish Children

This study examined the severity of posttraumatic stress disorder (PTSD) symptoms and the coping strategies of 51 aging hidden children (28 women and 23 men) 65 years after the Holocaust. Results indicated a positive relation between age and PTSD symptoms that was fully mediated by sense of danger and education. Regression analyses showed that lower educational level (β = −.32) and more reappraisals (β = .38) were associated with severity of PTSD symptoms. Reappraisal also predicted intrusions (β = .36) and arousal (β = .37).