Alexithymia and ill-being and well-being: The role of emotion regulation

Alexithymia is an important risk factor for psychopathology. However, it is not yet clear why. Here, we examine alexithymia's relationship with both ill-being and well-being outcomes and test whether emotion regulation patterns are a key mechanism explaining these links. Based on contemporary affective science frameworks, we predicted that people high (vs. low) in alexithymia would more frequently use maladaptive emotion regulation strategies that involve disengaging from negative emotions and less frequently use adaptive strategies that involve engaging with negative emotions. We also predicted that emotion regulation strategy choice should, in turn, statistically mediate relationships between alexithymia and ill- and well-being. We conducted two cross-sectional survey studies with mediation modeling, one exploratory (N = 427) and one preregistered (N = 600). In both studies, results indicated that (a) alexithymia is associated with higher ill-being and lower well-being, (b) alexithymia is associated with greater use of maladaptive disengagement emotion regulation strategies and less use of adaptive engagement strategies, and (c) the relationships between alexithymia and ill- and well-being outcomes are statistically partially explained by this profile of emotion regulation. Conceptually, these findings are well aligned with the attention-appraisal model of alexithymia and process model of emotion regulation, empirically supporting the claim that interactions between alexithymia and emotion regulation have important implications for people's ill-being and well-being. Clinically, these findings highlight the importance of targeting both alexithymia and emotion regulation patterns in treatment to help facilitate desirable affective outcomes. Our findings suggest that such work may help reduce ill-being and enhance well-being. (PsycInfo Database Record (c) 2026 APA, all rights reserved).