Prevalence of alexithymia and its association with social media addiction among medical students in Pakistan: a cross-sectional study

Alexithymia, defined as difficulty in identifying, describing, and expressing emotions, has gained increasing attention in populations exposed to high psychological and academic stress. Medical students represent a particularly vulnerable group due to intensive coursework, emotionally challenging clinical exposure, and the early requirement to adopt professional roles. Existing studies suggest an association between alexithymia and digital use; however, there is limited evidence in Pakistan. This study aims to determine the prevalence of alexithymia among medical students and examine its association with demographic, behavioral, and particularly social media addiction. A cross-sectional analytical study was conducted among undergraduate medical students across multiple medical colleges in Pakistan (n = 417). Data were collected using a self-administered online questionnaire comprising demographic variables, the Toronto Alexithymia Scale (TAS-20), and the Bergen Social Media Addiction Scale (BSMAS). Descriptive statistics were calculated, and associations were assessed using chi-square tests and binary logistic regression analysis. The prevalence of alexithymia was 29.7% (95% CI: 25-34%), with 28.8% classified as possible alexithymia. TAS-20 scores showed a moderate positive correlation with BSMAS scores (r = 0.36, p < 0.001). In multivariable analysis, moderate (aOR = 2.10, 95% CI: 1.25-3.53) and high social media addiction (aOR = 4.31, 95% CI: 2.35-7.90) were significantly associated with alexithymia. Physical activity ≥ 3 times per week was also associated with higher odds of alexithymia (aOR = 2.74, 95% CI: 1.26-5.97). Alexithymia is prevalent among medical students in Pakistan and has a strong association with social media addiction. This may indicate a potential relationship between social media use and emotional processing difficulties. For the stated results, screening, counseling, and emotional skill training is recommended.