Alexithymia, ambivalence over emotional expression, and eating attitudes

To clarify the relationships amongst alexithymia, emotional expression, and characteristics associated with eating psychopathology, 162 female undergraduate students completed questionnaire measures of alexithymia, emotional expressiveness, ambivalence over expression, eating psychopathology, and characteristics related to eating disorders. Despite the high frequency of alexithymia in eating disorders, when other variables were controlled alexithymia was not related to total EAT-26 (the measure of pathology), nor to two of the core aspects of eating pathology measured by EDI-2: body dissatisfaction and drive for thinness. Bulimia was directly predicted by difficulty identifying feelings, and negatively by difficulty describing feelings, both measured by TAS-20. The same bidirectional relations were observed for three characteristics of eating disorders: asceticism, impulse regulation, and perfectionism. Direct relationships with difficulty identifying feelings were found for ineffectiveness and interoceptive awareness. Ambivalence over emotional expression predicted ineffectiveness, interoceptive awareness, impulse regulation, maturity fears and perfectionism, but was not related to any of the measures of pathology. However, ambivalence over expressing anger predicted restrictive psychopathology. The results are discussed in relation to the origins and maintenance of eating-disordered attitudes and behaviours.