Alexithymia and Impaired Mentalization: Evidence from Self-, Informant-, and Meta-Perception Ratings on the 20-Item Toronto Alexithymia Scale

Alexithymia is a trait-like deficit in the cognitive processing of emotions, characterized by difficulty identifying and describing feelings, externally oriented thinking, and limited imaginal capacity. It reflects a deficit in emotional intelligence, specifically in the intrapersonal ability to understand and manage one’s own emotional states and to similarly recognize how others might view them. Emotional intelligence has been conceptualized as a distinct form of intelligence that involves emotion-related mental abilities and meets standard psychometric criteria for inclusion within the broader taxonomy of human intelligences. Increasingly, alexithymia is also understood as a failure of affect-focused mentalization, or the ability to perceive emotions in oneself and others as intentional states. This study examined alexithymia using a multi-informant approach to assess intrapersonal and interpersonal emotional awareness. A sample of 211 university students and their informants completed the Toronto Alexithymia Scale (TAS-20), an informant version (TAS-20-IF), and a novel meta-perception version (TAS-20-Meta). Two hypotheses were tested and supported: (1) participants underestimated their alexithymia traits relative to informant ratings and (2) self- and meta-perception ratings were more strongly correlated than either was with informant ratings. These findings support the view that alexithymia reflects deficits in both affective mentalization and a specific domain of human intelligence.