Alexithymia in patients with posttraumatic stress disorder: A meta-analysis

Posttraumatic stress disorder (PTSD) is a psychiatric condition resulting from one or more traumatic events, characterized by behavioural and emotional disturbances. Alexithymia, the difficulty in identifying and describing internal emotions, is a significant comorbidity that can exacerbate PTSD symptoms but is often understated. This study aimed to estimate the prevalence of alexithymia in PTSD patients and explore associated factors and potential moderators.

We conducted a systematic review of the literature, querying three databases for studies on alexithymia in adults with PTSD. Meta-analyses were performed to assess the prevalence of alexithymia and explore its moderators.

Thirty-six studies met the inclusion criteria. The pooled prevalence of alexithymia in PTSD patients was 53% (95% CI: 42-65%). The mean TAS score indicated a possible threshold for alexithymia (56.12, 95% CI: 50.77-61.48), with a significant difference in alexithymia scores between PTSD patients and trauma-exposed controls (SMD: 0.78, 95% CI: 0.22-1.34). PTSD severity was positively correlated with alexithymia, and alexithymia was significantly associated with dissociative symptoms.

Alexithymia is a frequent and impactful comorbidity in PTSD, complicating its clinical picture and therapeutic management. The introspective difficulties associated with alexithymia hinder the effectiveness of traditional therapies, and its influence on body-related symptoms suggests that integrating Mind-Body approaches may improve treatment outcomes. Given the significant overlap between alexithymia, dissociation, and trauma exposure, a more tailored, nuanced treatment is needed to enhance emotional regulation and self-awareness in PTSD patients.