Alexithymia is a personality trait characterized by difficulties in both identifying and verbally describing one's own emotional state, experiences, and externally oriented thinking. Although the core problem of alexithymia is thought to be deficits in the perception and recognition of internal psychological and somatic states, many studies have shown the presence of deficits in the recognition of external emotional stimuli with negative valence, especially others' emotional facial expressions such as anger. The processing of facial expressions is combined with gaze direction as social signals. They play an important role in understanding others' attention, intentions, and emotional states. However, only a paucity of studies has been conducted on how emotional deficits in alexithymia affect social attention such as gaze-induced orienting. Consequently, the aim of the current study was to elucidate social attention in alexithymia by using a gaze-cueing paradigm based on Posner's endogenous attentional task. Forty-one participants completed the Japanese version of the 20-item Toronto Alexithymia Scale (TAS-20), which has three sub-scales, namely, difficulty identifying feeling (DIF), difficulty describing feeling (DDF), and externally oriented feeling (EOT). Participants in the top and bottom 15 of the total TAS and subscale scores were categorized as the high and low group of each scale. In the gazecueing paradigm, gaze cue with facial expressions depicting angry, fearful, and neutral emotions are presented as cue stimulus. The gaze-cueing effect was calculated as cue-target congruency, that is, the difference of the reaction time between congruent and incongruent conditions. Results showed that the high DIF group displayed a smaller gaze-cueing effect in the angry face condition compared to that of the low DIF group. The results suggest weak enhancement of attentional processing induced by emotionally arousing and socially relevant stimuli in individuals with high alexithymia. In the case of clinical alexithymia, those attentional and emotional characteristics might lead to maladaptive behavior in social situations.
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