When Words Fail: Investigating Alexithymia And Coping Strategies In Adolescent Mental Health

Introduction: Alexithymia, defined by difficulty identifying and verbalizing emotions, has emerged as a significant factor influencing emotional regulation and coping behaviors in youth. Adolescents with high levels of alexithymia may be at greater risk of psychological distress due to maladaptive coping mechanisms and reduced social support engagement. Materials and Methods: This cross-sectional study was conducted among 141 high school students aged 15-18 in Skopje, North Macedonia. Participants completed validated instruments including the Toronto Alexithymia Scale (TAS-20) and the Adolescent Coping Orientation for Problem Experiences (COPE-A). Statistical analyses included descriptive statistics, Pearson correlations, to examine associations between alexithymia and coping strategies. Results: The mean TAS-20 score suggested a high prevalence of alexithymic traits in the sample. Approximately 44% of adolescents in the sample scored above the clinical threshold for alexithymia (TAS-20 > 61), highlighting the prevalence of emotional processing difficulties in this population. Significant correlations were found between higher alexithymia and maladaptive emotion regulation strategies such as self-blame, rumination, and catastrophizing. Conversely, positive coping strategies like positive reappraisal and acceptance were negatively correlated with alexithymia levels. Participants with high alexithymia reported a greater tendency to engage in maladaptive coping behaviors. Discussion: Findings underscore alexithymia as a trait associated with emotion dysregulation and diminished coping flexibility in adolescents. The results highlight the interplay between poor emotional awareness and a tendency to adopt dysfunctional cognitive responses to stress, which may exacerbate vulnerability to psychological problems. Conclusion: Early identification of alexithymic traits and the promotion of emotional literacy and adaptive coping in adolescence are crucial. Preventive school-based programs focusing on emotional skill development and peer support may buffer the impact of alexithymia and enhance youth mental health outcomes.