In plain language
People in treatment for drug and alcohol problems often say they struggle to identify and describe their own emotions — a difficulty psychologists call alexithymia. One long-standing theory holds that people use substances to manage emotions they cannot understand or handle. But do substance abusers actually have deficient emotional processing, or do they just believe they do? This study tested both possibilities in 40 newly abstinent residents of drug and alcohol treatment programs, comparing them with university students and community adult samples.
On the self-report questionnaire (the Toronto Alexithymia Scale), fully 50% of the treatment group qualified as alexithymic — far higher than rates in normal adults (4–18%) or psychiatric outpatients (12.5–33%). But when the same people completed a performance test (the Levels of Emotional Awareness Scale), which requires actually identifying and describing feelings in realistic scenarios, they performed just as well as a community adult sample, and just as well as university students once age, gender, and IQ were taken into account. Strikingly, self-reports and actual performance were unrelated in this group.
The findings suggest substance abusers believe they are worse at processing emotions than they really are. The authors propose two explanations — elevated negative mood inflating self-reported difficulties, or inaccurate beliefs that may sap motivation to engage with emotions — and suggest that treatment may work best by helping clients clarify feelings in the context of their everyday lives rather than teaching general knowledge about emotions.
Key findings
- 50% of newly abstinent substance abusers were classified as alexithymic on the self-report TAS-20 — considerably higher than rates in normal adult samples (4–18%) and psychiatric outpatient samples (12.5–33%).
- On the performance-based Levels of Emotional Awareness Scale (LEAS), the treatment group did not differ from a large community adult sample, for either men or women.
- The treatment group initially scored lower than university students on the LEAS, but this difference disappeared entirely after controlling for age, gender, and fluid and crystallized intelligence.
- Self-reported alexithymia was unrelated to actual LEAS performance within the substance abuse group — contrary to the link found in normal samples.
- Negative mood was associated with self-reported alexithymia (r = .35) but not with performance, and the treatment group reported far higher negative affect than a university normative sample.
- The authors suggest interventions should help substance users clarify feelings in the context of their own lives, rather than provide general information about emotions, since general emotion knowledge appears intact.
How to cite
APA
Lindsay, J., & Ciarrochi, J. (2009). Substance abusers report being more alexithymic than others but do not show emotional processing deficits on a performance measure of alexithymia. Addiction Research and Theory, 17(3), 315-321. https://doi.org/10.1080/16066350802472056
BibTeX
@article{lindsay2009substance,
author = {Lindsay, Julie and Ciarrochi, Joseph},
title = {Substance Abusers Report Being More Alexithymic Than Others but Do Not Show Emotional Processing Deficits on a Performance Measure of Alexithymia},
journal = {Addiction Research and Theory},
year = {2009},
volume = {17},
number = {3},
pages = {315--321},
doi = {10.1080/16066350802472056}
}
Related work
- All publications by Joseph Ciarrochi (searchable, with free PDFs)
- Process-Based Therapy & Idionomic Analysis
Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.