The longitudinal mechanism of alexithymia and social cognition influencing depression: Based on cross-lagged panel...

Alexithymia and social cognitive deficits may be the risk factors of depression. Guided by the cognitive-development theory of emotional awareness, this study aims to construct an integrated framework to elucidate the dynamic relationships among alexithymia, social cognition and depression at the dimensional level.

A two-wave follow-up survey was conducted among 1651 college students. Participants completed measures assessing depression (CES-D), alexithymia (TAS-20), mentalization (MentS), and empathy (IRI-C). Data were analyzed using a combination of cross-sectional network analysis, cross-lagged panel network (CLPN) analysis, and structural equation modeling (SEM).

(1) Both contemporaneous networks showed that depressed affect, difficulty identifying feelings (DIF) and motivation to mentalize had the highest strength centrality. (2) CLPN analysis showed that DIF at baseline predicted increases in difficulty describing feelings (DDF) and depressed affect, decreases in self-oriented mentalization over time. DIF had the highest out-Expected Influence (out-EI = 1.284); DDF had the highest in-Expected Influence (in-EI = 1.224); personal distress exhibited the highest Bridge Expected Influence (BEI = 0.150). (3) SEM revealed that DIF not only directly affected depression (β = 0.559, p < 0.001), but also through three indirect pathways: through self-oriented mentalization and personal distress (β = 0.128, p < 0.001), through DDF and motivation to mentalize (β = 0.159, p< 0.001), and through single motivation to mentalize (β = -0.125, p < 0.001).

Difficulty identifying feelings is the core driver in the alexithymia-social cognition-depression network. The primary psychological mechanism involves difficulty identifying feelings eroding the capacity for self-oriented mentalization, which in turn fosters empathic personal distress, ultimately leading to depression.