Alexithymia in Anorexia Nervosa, More State Than Trait? A Multi‐Dimensional Assessment of Emotion Processing in Patients With Anorexia Nervosa, Recovered Patients and Healthy Controls

ABSTRACT Objective Alexithymia is implicated in both development and maintenance of Anorexia Nervosa (AN). It is unclear what defines alexithymia in AN. In this study, emotion processing related to alexithymia was examined. Method 40 patients with AN, 43 recovered (RC) patients and 35 matched healthy controls (HC) filled out questionnaires on eating disorder pathology (EDE‐Q), depression (CES‐D), alexithymia (TAS‐20), and emotion regulation (DERS). BMI was obtained. Behavioural (naming emotions, valence and intensity ratings) and physiological responses (heart rate and skin conductance) to emotional stimuli were assessed. Data were analysed for group differences, and controlled for effects of depression. Results Although high levels of negative affect, alexithymia and emotion regulation problems were found in self‐report questionnaires, the AN group was able to identify and name simple explicit emotions, and showed only subtle signs of reduced physiological responsiveness when viewing the emotion pictures. The RC group only showed differences to the healthy control group in self‐assessed alexithymia. Conclusions The present results give more evidence of alexithymia as a state than a trait feature in AN. Longitudinal studies are advised to gain more insight into how eating disorder behaviours versus alexithymia and emotion regulation change during the recovery process of AN.