Looking at the Eyes Interferes With Facial Emotion Recognition in Alexithymia

Alexithymia refers to difficulties in identifying, differentiating, and describing feelings. This personality trait is highly prevalent in many psychiatric conditions and may drive associated social-emotional problems, including the ability to decode emotions in faces. This study probed alexithymic problems with identifying clear and ambiguous blends of emotions in faces and their underlying visual attention patterns. Using the Toronto Alexithymia Scale-20, students with high alexithymia (HA, n= 73) or low alexithymia (LA, n= 76) were enrolled in this study. Participants judged the mixture ratio of emotional expressions while their eye movements were recorded. Controlling for group differences in mood and anxiety, HA showed similar accuracy but a reduced viewing preference of facial eye regions compared to LA (p=.02). More attention to the eye regions was related to lower accuracy in HA (p=.02) but to slightly higher accuracy in LA (p=.07). The current findings point to a role of alexithymia in attentional avoidance of other people's eyes, similar to previous findings in autism spectrum disorder. Eye contact may be perceived as a greater emotional challenge by those with alexithymia, disrupting downstream processing of facial emotions.