Alexithymia is characterized by impaired emotional awareness and alexithymic individuals demonstrate difficulty in describing and identifying their emotions. Although alexithymia was shown to be associated with masculinity, emotional intelligence and fear of intimacy, current literature is required to deeply investigate to understand nature of alexithymia and develop preventive strategies. In the present report, we aimed to observe the relationship between alexithymia, emotional intelligence, masculine behavior and fear of intimacy and to reveal basic impairments associated with emotional intelligence and masculinity dimensions which is impact on alexithymia. 98 males (N=98) age ranging from 18 to 58 (with mean age 27.13 ± 9.81) were recruited and subjected to TAS, MBS, EIS and FIS measures. Results gathered from collected data demonstrated that alexithymia has strong association with impaired emotional intelligence and high masculine behavior and fear of intimacy. In conclusion, alexthymia is multiple facet construct and shaped by various contributors.
Alexithymia is appeared as a problem in individuals in describing and identifying emotions in the self and in others and is characterized by impaired emotional awareness and communication abilities (Levant, 2001). Although DSM-V is not classified alexithymia as a mental disorder (APA, 2013), it has been associated with other psychiatric disorders including depression and anxiety (Marchesi, Brusamonti, & Maggini, 2000). Therefore, it is important to understand basic relationships between alexithymia and its contributors in terms of building prevention strategies. Moreover, alexithymia occurred in two separate forms which are clinical and normative alexithymia. Levant (2001) describes normative alexithymia as a gendered condition in which caring and vulnerable emotions repressed by men resulting in underdeveloped emotional expression. Furthermore, men with alexithymia demonstrate inability to verbalize their feelings and inability to distinguish between feelings and emotional states (Sifneos, 1973) indicating that emotional processes are also impaired in those individuals. On the other hand, emotional intelligence (EI) was defined as managing and controlling capability of one’s own and other people’s emotions (Mayer, 1997). Therefore, since prominent features of alexithymia included difficulties in describing one’s own feeling, a strong correlation is expected between alexithymia and impairment in EI levels. Indeed, a previous report demonstrated strong inverse correlation between alexithymia and emotional intelligence (Parker, Taylor, & Bagby, 2001). Moreover, authors reported significant negative correlation between the stress management and adaptability factors of EI and alexithymia indicating its association with maladaptive defense styles, vulnerability to stress and psychiatric illnesses. However, authors used BarOn Emotional Quotient Inventory (Bar-On, 1997), which considers emotional, social and personal dimensions of intelligence rather than focusing only on emotional dimensions of EI. Therefore, current literature is required to deeply investigate alexithymic tendencies considering subdimensions of EI rather than investigating other constructs (i.e social and personal). On the other hand, EI model developed by Schutte et al. differ from Bar-On model in numerous ways as Schutte integrated various dimensions of the individuals current state of emotional development (Schutte et al., 1998). Therefore, revealing the association between alexithymia and the dimensions of EI such as regulation of mood, use of feelings and appraisal of feelings will be helping us to understand how impairment in EI could result in alexithymia.
Keeping the information mentioned above in mind, one central norm in masculine behavior is the restriction of emotional expression. Masculinity is the set of attributes and behaviors associated with men which was varied by age, generation within family, cultural diversity, nationality and social class (Berger, Levant, McMillan, Kelleher, & Sellers, 2005; Levant et al., 2003; Levant, Majors, & Kelley, 1998). Previous research on alexithymia suggested that alexithymia is strongly influenced by traditional masculinity ideology (Levant et al., 1998). Moreover, empirical findings from a research demonstrated association between the endorsement of masculinity and alexithymia in men (Berger et al., 2005). Related to masculine gender roles, for instance, inhibited emotional, expressive and intimate changes were seen in men in which their willingness to form relationships was impaired. Moreover, fear of intimacy was described as “the inhibited capacity of an individual in terms of exchanging feelings and thoughts with another individual who is highly valued” (O’Neil, 1981). Therefore, restricted emotional, expressive and intimate changes may be leading to higher levels of masculinity providing evidences that it was associated with greater fear of intimacy levels. Although it was previously reported that men with increased level of alexithymia and fear of intimacy was associated with greater role in men masculinity (Fischer & Good, 1997), current literature is required to deeper investigation overall contribution of alexithymia levels on EI dimensions, fear of intimacy and masculinity levels to understand basic features of alexithymic individuals.
Therefore, to deeply investigate this phenomenon, in the present study, we have come up with following research questions: (1) How individuals with low and high levels of alexithymic tendencies have differed in EI, masculinity and fear of intimacy levels? (2) How alexithymia dimensions in men have demonstrated strong correlations with the dimensions of EI and masculinity in our subjects? (3) How other contributors such as relationship length influence on alexithymia levels?
Taking into account the previous studies, we hypothesized that men who have greater levels of alexithymia will be showing impairment in EI levels and elevated fear of intimacy and masculinity (Fischer & Good, 1997; Parker et al., 2001). Finally, this study will be helping to identify and describe the fundamentals about alexithymia and will be leading to help to alleviate symptomology of those individuals who have impaired emotional expressions.
Subjects and Design
Total sample size in our research consisted of 98 males (N=98) age ranging from 18 to 58 (with mean age 27.13 ± 9.81). Since alexithymia has gender specific characteristics, we only included men to prevent gender related biases. We utilized online survey strategy to administer standardized measures which was further subjected to quantitative data analysis. The survey link was spread through the male college students and men from the general population. The aim of experiment wasn’t told the participants however, their consent was gathered which confirms that participants voluntarily agreed on to participate this experiment.
Basically, demographic information including age, gender, relationship length and origin of culture was collected. Further, Toronto Alexithymia Scale (TAS), The Masculine Behavior Scale (MBS), Schutte’s Modified Emotional Intelligence Scale (EIS) and The Fear of Intimacy Scale (FIS) were subjected to participants in the survey respectively. Data was collected for further analysis.
Measures and Forms
Informed Consent Form (ICF)
ICF including the ethical statement that confirming voluntariness of participants and their right to be withdrawn from the study anytime was subjected. In addition, the statement demonstrating about the data collection and use will be based on according to research purposes was added in ICF.
Demographics form collected data related to age, gender, relationship length and origin of culture.
Toronto Alexithymia Scale (TAS)
The Turkish version of Toronto Alexithymia Scale (TAS) is 20-items containing psychometrically validated scale which is consisting of 3 subdimensions and measuring alexithymia levels in individuals (Güleç & Yenel, 2010). TAS is likert type scale in which its scoring is ranged between 1 (none) to 5 (always). Item numbers 4,5,10,18 and 19 were reverse scored. Three subdimensions of TAS are described as “difficulty identifying feeling (TASdif), difficulty describing feelings (TASddf), externally oriented thinking (TASeot)”. The cronbach’s α value for total TAS found as 0.78 whereas α values for subscales reported to be occurred between 0.58 and 0.80 in the Turkish version. In addition, scores less than 51 demonstrating low level of alexithymia, scores between 52 to 60 is appeared as intermediate level of alexithymia whereas scores equal or greater than 61 appeared as high level of alexithymia in its practices (Bagby, Parker, & Taylor, 1994).
The Masculine Behavior Scale (MBS)
The Masculine Behavior Scale (MBS) is 20-items questionnaire which measures masculinity levels in individuals (Snell, 1989). Since MBS did not have Turkish version, we translated MBS into Turkish language and further subjected to participants. MBS consisted of 4 subscales which are “success dedication, restrictive emotionality, inhibited affection and exaggerated self-reliance”. The cronbach’s α for each subscale was found as 0.62, 0.70, 0.65 and 0.48 in the validated scale (Snell, 1989). MBS was constructed using 5 point Likert scale from -2 (disagree) to +2 (agree) in which negative scores showed that subjects did not engage with masculine behaviors whereas higher positive scores indicated more masculine behaviors.
Schutte’s Revised Emotional Intelligence Scale (EIS)
The Turkish version of Shutte’s Revised Emotional Intelligence Scale (Tatar, Tok, & Saltukoğlu, 2011) is psychometrically validated 5 point Likert Scale and consisted of 41 items which were scored from 1 (completely agree) to 5 (completely disagree). EIS consisted of three factors which are “optimism/regulation of mood (EISo/rm), use of feelings (Euof) and appraisal of feelings (Eaof)”. The cronbach’s α values for total EIS, optimism/regulation of mood, use of feelings and appraisal of feelings are found as 0.82, 0.75, 0.39 and 0.76 in Turkish sample (Tatar et al., 2011). Item numbers 3, 4, 6, 8, 10, 12, 13, 14, 17, 20, 22, 23, 24, 25, 26, 28, 34, 35, 39, 40, 41 are reverse scored.
The Fear of Intimacy Scale (FIS)
The Fear of Intimacy Scale (FIS) is 35-items containing psychometrically validated scale which is measuring dating relationships. Items on Likert type scale in FIS scored from 1 (not at all characteristics of me) to 5 (extremely characteristics of me) and item numbers 3, 6, 7, 8, 10, 14, 17, 18, 19, 21, 22, 25, 27, 29 and 30 are reverse scored. Participants with higher scores reports briefer relationships (Descutner & Thelen, 1991). Cronbach’s α value for total FIS was found as .85 (Descutner & Thelen, 1991).
Data gathered from measures were further subjected to IBM SPSS program for statistical analysis. Internal reliability analysis demonstrating cronbach’s α belonging to TAS, MBS, EIS and FIS and subscale dimensions were evaluated. Kruskal Wallis analysis was used to analyze the differences between all groups and Mann Whitney U test was used to analyze significant differences between two groups. Spearman’s correlation analysis was used to analyze correlation between alexithymia dimensions and the dimensions of EI and masculinity in our subjects. p<.05 was accepted as significant at 95% confidence interval. Microsoft Excel program was used to draw representing graphs.
In order to analyze cronbach’s α values indicating scale reliability we compared our results with the previously validated scales’ α values. According to table 1, except from TASdif, TASeot and EISo/rm, all scales and their subdimensions showed higher α values indicating that data we collected have good consistency.
Table 1: Comparison of cronbach’s α values between original scales and scale data obtained from 98 individuals.
|Scale||α value in validated scale||Cronbach’s α||Number of items|
|TAS (Güleç & Yenel, 2010)||.78||.782||20|
|MBS (Snell, 1989)||Not mentioned||.818||20|
|EIS (Tatar et al., 2011)||.82||.865||41|
|FIS (Serafini & Adams, 2002)||.85||.902||35|
TAS categorizes alexithymia levels into three categories based on scoring from the scales. Therefore, considering score categorization, we divided our sample into three groups and next compared differences in masculine behavior, emotional intelligence and fear of intimacy levels between low and high alexithymia group. Kruskal Wallis analysis showed that there are statistical differences existed between three groups for MBS, EIS and FIS (table not shown, p<.000 for EIS and FIS, p=.032 for MBS).
To analyze masculine behavior on different level of alexithymic groups, we draw a bar graph and applied Mann Whitney U test. According to results, statistical significant differences were seen in masculinity levels of low and high alexithymia group (p=.046) (see figure 1). As expected, high alexithymic group showed significantly showed more masculine behaviors in comparison to low alexithymic group.
We further evaluated emotional intelligence and fear of intimacy levels between low and high levels of alexithymia demonstrating groups and applied Mann Whitney U test. As demonstrated in figure 2 and 3, high alexithymic group demonstrated significantly lower EI and higher FIS levels (p=.000 in both cases).
We next assessed the differences among MBS subscales. Mann Whitney U test results revealed that success dedication, restrictive emotionality and inhibited affection subdimension significantly differed between low and high alexithymia groups (p=.011 for success dedication, p=.001 for restrictive emotionality, p=.004 for inhibited affection) whereas no statistical differences were seen in exaggerated self-reliance subdimension (p>.725) indicating emotional processes are impaired in individuals demonstrating higher alexithymia (see figure 4).
As we saw differences in EI levels between high and low alexithymic groups, we further tested whether this differed in subdimensions of EI or not. Mann Whitney U test results revealed that all of the dimensions of EI (use of emotions, appraisal of emotions and optimism/regulation of mood) significantly differed between low and high alexithymia groups indicating distinct type of emotional impairments occurred in individuals in high alexithymia group (see figure 5, p=.000 for optimism/regulation of mood and appraisal for emotions and p=.004 for use of emotions).
We next assessed correlation between alexithymia, its dimensions and dimensions of EI and MBS. Spearman’s rho correlation test revealed that while higher alexithymia scores positively correlated with difficulty in identifying feelings, difficulty in describing feelings, restrictive emotionality, inhibited affection, it was negatively correlated with success dedication, optimism/regulation of mood, use of emotions and appraisal of emotions (see table 2, p<.05).In addition, subjects who have difficulty identifying feelings also showed difficulty describing feelings, restrictive emotionality, inhibited affection whereas difficulty in identifying feelings showed negative correlation (lower scores) in optimism/regulation of mood and appraisal of emotion subscales of EI (see table 2, p<.05).
Table 2: The Correlation Between Alexithymia, MBS and EI Dimensions
We next assessed the correlation between relationship length, FIS and TAS scores. Results on table 3 demonstrated that those who have higher relationship lengths scores lower on FIS and TAS indicating their ability to form potential relationship might be also impaired in alexithymia. However, this was not in significance levels (p>.05 in all cases)
Table 3: The Correlation Between Relationship Length, Alexithymia and Fear of Intimacy
The purpose of the current study was to examine the relationship between alexithymia, emotional intelligence, masculine behavior and fear of intimacy and to reveal basic impairments associated with alexithymia. In order to do this, we looked for answers following questions: (a) How individuals with different level of alexithymic tendencies have differed in EI, masculinity and fear of intimacy levels? (2) How alexithymia dimensions in men have demonstrated correlations with the dimensions of EI and masculinity in our subjects? (3) How relationship length influenced on alexithymia and fear of intimacy levels?
Firstly, we collected data from 98 males and assessed their alexithymia levels. Since alexithymia is gender specific condition (Levant, 2001), we did not include female subjects to our experiment. Furthermore, by separating alexithymia levels in our subjects, we made series of comparisons between low and high alexithymic tendencies, emotional intelligence, masculinity and fear of intimacy levels. Prior to this procedure, we assessed reliabilities from TAS, MBS, EIS and FIS by measuring cronbach’s α. Results showed that we have quite good α values in comparison to validated scales indicating data collected from scales are reliable (see table 1). Furthermore, we found that men with high levels of alexithymia demonstrated significantly lower scores on EIS and higher scores on MBS and FIS (see figure 1,2 and 3). In parallel to our results, Parker et al. (2001) demonstrated that limited capacity for empathizing with the emotional states of others and impaired emotional intelligence in high alexithymic individuals. Authors concluded that these impairment in emotional intelligence levels associated with maladaptive defense styles and therefore might be leading to psychiatric disorders. In addition, fear of intimacy was found as a predictor of men’s behavior towards seeking psychological help (Fischer & Good, 1997). Moreover, high alexithymic individuals was shown to have high levels of fear of intimacy in which authors concluded fear of intimacy is an important contributor affecting men’s ability to form a personal relationships (Fischer & Good, 1997). Therefore, centering alexithymia in the core of this research, the impairments shown in high alexithymic groups may play a role in the development of psychopathologies via impairment in emotional intelligence and increased fear of intimacy. Because of the mentioning characteristics of alexithymia, although it is not characterized mental disorder in DSM-V, one who have such tendencies should be taken into consideration by psychologists and clinicians due to alexithymia may increase development of other psychopathologies and comorbid psychiatric disorders.
We observed significant differences in total MBS scores between high and low level of alexithymic individuals (see figure 1), we further tested the alterations in the median scores in the subdimensions of MBS. Subdimensions of MBS includes success dedication, restrictive emotionality, inhibited affection and exaggerated self-reliance. Snell (1989) reported that restrictive emotionality and inhibited affection were not highly characteristic behavior of women and men however, females showed more tendency than males while scale was developed. Furthermore, men who describe themselves as emotionally and affectively inhibited indicating more masculine behavior in males than females. Connecting Snell (1989) results to our data represented figure 4, men with high level of alexithymia in comparison to low levels significantly demonstrated more masculine behaviors by scoring higher on restrictive emotionality and inhibited affection subscales. Indeed, as alexithymic individuals had restrictive emotional expression (Sifneos, 1973), impairment in emotions and affectional processes may lead to be appeared as masculine behavior in individuals with alexithymia. Moreover, Snell (1989) proposed that masculine behavior tendencies are more likely associated in women than men for exaggerated self-reliance. Therefore, this dimension might the be the characteristics to women and since we used men as subjects, this could be the reason why we did not find significant result in exaggerated self-reliance dimension of MBS while comparing low and high level alexithymic individuals. On the other hand, people who have shown high alexithymic tendencies may have failed in success dedication, because they cannot describe themselves. Goal-oriented behaviors might have also been impaired in those who have higher alexithymia. This should also be proven in further research.
Furthermore, we tested how EIS subdimensions differed between high and low alexithymic groups. All of the dimensions of EIS was shown to differ significantly among two groups. Moreover, optimism/regulation of mood, use of regulation and appraisal of emotions dimensions was shown to be impaired in individuals with high levels of alexithymia (see figure 5). Previously, individuals who regulate their moods was shown to have higher emotional intelligence as well as lower tendency to develop mood disorders (Farb, Anderson, & Segal, 2012; Solanki & Lane, 2010). In addition, high alexithymic individuals showed impairmens in use and appraisal of their emotions which is strongly fit the characteristics of alexithymia. Therefore, it was expected that their relationships were also affected, and they demonstrated less relationship lengths since they scored on high in TAS (see table 3). This should be because they cannot evaluate and use their emotions appropriately which may be leading to broken relationships. The relationship length was also have negative correlation with FIS scores which may further be implicated alexithymia is not a construct occurred by one influencer, instead it is a construct with the combination of several contributors including fear of intimacy, masculinity and emotional intelligence. Therefore, rather thinking alexithymia as gendered condition, it is important to consider overall dimension of alexithymia that was shaped by multiple factors. Furthermore, TAS scores were positively correlated with difficulty in identifying feelings, difficulty in describing feelings, restrictive emotionality, inhibited affection and negatively correlated with success dedication, optimism/regulation of mood, use of emotions and appraisal of emotions (see table 2). This should also confirm multiple facets of alexithymia. In addition, men with difficulty in identifying feelings, also showed difficulty in describing feelings, restrictive emotionality, inhibited affection whereas difficulty in identifying feelings showed negative correlation (lower scores) in optimism/regulation of mood and appraisal of emotion subdimensions of EI. This could indicate that individuals who are unable to identify their feelings are impaired EI levels. Henceforth, alexithymia and emotional intelligence is strongly connected personality construct. On the other hand, we have some recommendations for psychologist and clinicians as well. First of all, they should consider alexithymia as multiple facet of construct while they treat individuals who have higher level of alexithymia. Secondly, rather than focusing on alexithymia tendencies alone, psychologists should consider to rebuilt emotional impairments by focusing on personal construct of alexithymic individuals. Therefore, their tendency to develop psychiatric disorder would be reduced and alexithymia related symptomology would be reduced.
This research has some limitations as well. In fact, we used non-clinical sample and worked with normative alexithymia. This experiment is required to be tested in clinical sample in order to gather deeper knowledge in identification of the nature of alexithymia. Since alexithymia is gendered condition, we only used male subjects in our experiment. However, alexithymia could be appeared as different form in females. This should also have required to be identified. In conclusion, we demonstrated that (1) alexithymia has association with impaired emotional intelligence, (2) alexithymia has strong correlation with masculine behavior and fear of intimacy, (3) alexithymic individuals have impairment in masculinity and emotional intelligence dimensions, (4) alexithymia is multiple facet construct.
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