The relationship between insecure attachment and alexithymia: A meta-analysis

Alexithymia is a personality trait with its primary characteristic being a deficiency in handling emotions. Previous literature has found inconsistent findings on the relationship between insecure attachment and alexithymia. Therefore, this study adopted a three-level random-effect meta-analysis approach with the goal of understanding the underlying mechanism between insecure attachment and alexithymia based on the 415 effects from 67 studies. As shown in our findings, insecure attachment was significantly and positively correlated to alexithymia (r = 0.306; 95% CI: 0.286, 0.325; p < 0.0001). Furthermore, the moderator analysis demonstrated that category of insecure attachment (F(4, 399) = 5.896; p < 0.001), measurement of insecure attachment (F(13, 397) = 2.074; p = 0.015), and facet of alexithymia (F(4, 406) = 26.218; p < 0.001) showed significant moderating effects. In terms of different categories of attachment, individuals with anxious attachment could show more severe alexithymia than those with preoccupied attachment. As for diverse measurements of attachment, the moderating effect of the Experiences in Close Relationship (ECR) on the relationship between insecure attachment and alexithymia is the most significant, followed by the Attachment Style Questionnaire (ASQ), then the Relationship Style Questionnaire (RSQ), with the Relationship Questionnaire (RQ) being the least. Regarding various facets of alexithymia, the significance of their moderating effect is, in descending order, externally oriented thinking, general alexithymia, and difficulty describing feelings. Overall, this review confirms the aggravating effect of insecure attachment on alexithymia, providing a feasible gateway to prevent emotional management impairments, that is, reducing the likelihood of high-level alexithymia by averting individuals from developing insecure attachment.