David A Preece, James J Gross
It is now clear that emotions play a fundamental role in adaptation. However, some people rarely attend to their emotions and have difficulty identifying and describing their emotions when they do attend to them. This trait is referred to as alexithymia, a term first coined in the 1970s. Now, half a century later, we take stock of the field of alexithymia and offer our perspective on its current status and future prospects. Our aim is to provide a comprehensive review of alexithymia, integrating diverse streams of evidence through the lens of contemporary affective science. In the first section, we summarize the history and evolution of the alexithymia construct. In the second section, we prepare the ground for our conception of alexithymia by highlighting the foundational affective science constructs of emotion and emotion regulation. In the third section, we outline the attention-appraisal model of alexithymia, which maps the alexithymia construct within the contemporary field of affective science, and using this framework we explain the close links between alexithymia, emotion, and emotion regulation. In the fourth section, we employ our model to consider the antecedents and consequences of alexithymia, and show that alexithymia is an important transdiagnostic risk factor for a range of psychopathologies and other affective outcomes. In the final section, we consider promising future directions for the field of alexithymia.