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Effect of experience information on emotional word processing in alexithymia
Journal of Affective Disorders 259 (2019) 251–258
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Research paper
Effect of experience information on emotional word processing in alexithymia Yao Zhaoa, Xuan Yanga, Zhu Xiangrub,c,
T
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a
School of Humanities, Xidian University, Xi'an 710126, China Institute of Cognition, Brain and Health, Henan University, Kaifeng, 475004, China c Institute of Psychology and Behavior, Henan University, Kaifeng, 475004, China b
A R T I C LE I N FO
A B S T R A C T
Keywords: Alexithymia Emotion words Valence Experience information Selective deficits
Background: Alexithymia is an at-risk personality trait that is associated with deficits in processing emotional words. However, little is known about whether the effect of emotional valence (neutral, positive, and negative) on word processing in alexithymia is related to individual differences in sensorimotor or affective information processing that is associated with alexithymia and experience information (sensorimotor vs. affective) that is denoted by words. Methods: The present study performed two experiments to explore this issue. In Experiment 1, we orthogonally manipulated experience information that was denoted by neutral words. In Experiment 2, we orthogonally manipulated experience information that was denoted by valenced words (i.e., positive and negative). We asked two groups of healthy individuals with high scores (high alexithymic [HA] group) or low scores (low alexithymic [LA] group) on the 20-item Toronto-Alexithymia-Scale to complete a lexical decision task. Results: The results showed that emotional word processing in the HA group was modulated by a joint effect of valence and experience information, indicating that selective deficits in the processing of neutral and negative words were loaded more by sensorimotor information and that selective deficits in the processing of positive words were loaded more by affective experience compared with the LA group. Conclusion: These findings shed a new light on emotional word processing in alexithymia and suggest that alexithymic deficits in the processing of emotional words should not be considered as being simply related to general or specific valence but rather related to experience information that is denoted by the meanings of words.
1. Introduction Alexithymia refers to difficulties in identifying, describing, and introspecting about one's own emotional experience (Sifneos,1973). Alexithymia is understood as a personality trait, the severity of which varies across general populations (Taylor et al., 1999). Previous studies showed that alexithymia is associated with impairments in the ability to perceive and recognize emotional stimuli (for review, see Donges et al., 2014; Donges and Suslow, 2017) and hypersensitivity to sensorimotor information from the external world and the avoidance of affective experience from one's own internal world (Kashdan et al., 2015; Nook et al., 2015). However, emotional words (e.g., happy, honor), unlike faces or pictures, are symbolic stimuli that can be learned and understood through different types of experience information (e.g., sensorimotor vs. affective) that is denoted by words (Vigliocco et al., 2009).
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An important issue is whether alexithymic impairments in emotional word processing are related to deficits in the perception of experience information as a function of the meaning of words. Previous studies linked alexithymia to problems in emotional word processing, indicating that alexithymic individuals recalled fewer emotional words compared with neutral words in memory tasks (Luminet et al., 2006). Alexithymic individuals also exhibited lower affective priming effect of emotional words (Goerlich et al., 2011) and used fewer emotional words when asked to define and describe a battery of emotional words and situations (Wotschack and KlannDelius, 2013). Alexithymia may also differentially influence the processing of positive words compared with negative words (Donges and Suslow, 2017; Meltzer and Nielson, 2010; Donges et al., 2014; Brandt et al., 2011). For example, Meltzer and Nielson (2010) found that alexithymic individuals recalled fewer negative words than non-
Corresponding authors. E-mail addresses: [email protected] (Z. Yao), [email protected] (X. Zhu).
https://doi.org/10.1016/j.jad.2019.08.068 Received 3 June 2019; Received in revised form 16 August 2019; Accepted 19 August 2019 Available online 20 August 2019 0165-0327/ © 2019 Elsevier B.V. All rights reserved.
Journal of Affective Disorders 259 (2019) 251–258
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between valenced and neutral concrete words in a lexical decision task. Sheikh and Titone (2013) used eye-movement measures of natural reading and found an interaction between valence and concreteness with regard to gaze duration. The processing of valenced words was faster than neutral words when the words were abstract. Overall, the interaction between valence and concreteness in emotional word processing indicates a joint facilitative effect of valence and affective experience information on the processing of valenced abstract words, but not on the processing of neutral abstract words or valenced and neutral concrete words (e.g., Kousta et al., 2011; Sheikh and Titone, 2013; Yao et al., 2016). Altogether, the existing literature suggests that the effect of valence on emotional word processing is modulated by experience information (i.e., concreteness) after controlling for other lexical variables. However, one unresolved issue is whether the influence of experience information on emotional word processing (neutral vs. valenced) depends on individual differences in sensorimotor or affective information processing in alexithymia. Based on perceptive differences in experience information that are observed in alexithymia (Kashdan et al., 2015; Nook et al., 2015) and the influence of experience information on emotional word processing (e.g., Kousta et al., 2011; Sheikh and Titone, 2013; Yao et al., 2016), we predicted that impairments in the processing of emotional words in alexithymic individuals are modulated by a joint effect of emotional valence (neutral, positive, negative) and experience information as a function of word concreteness (concrete, abstract). Previous studies suggested that the facilitative effect of affective experience on word processing is mainly limited to emotionally valenced words and absent for neutral words (e.g., Kousta et al., 2011; Yao and Wang, 2013; Wang and Yao, 2012). Thus, we conducted two separate experiments using a lexical decision task to explore this issue. In the present study, we orthogonally manipulated the word concreteness of neutral words in Experiment 1 and the word concreteness of valenced words (i.e., positive and negative) in Experiment 2 (in a high alexithymic (HA) group vs. a low alexithymic (LA) group). Concrete and abstract words represent more sensorimotor and affective experiential words, respectively. In Experiment 1, we expected that lexical decision latencies (i.e., response times) would be faster for neutral concrete words than for neutral abstract words in the LA group, which would be consistent with the finding of a processing advantage of concrete words (Paivio, 1986; Schwanenflugel et al., 1988; Barber et al., 2013; Zhang et al., 2014). In contrast, the HA group was expected to exhibit less pronounced processing differences between neutral concrete and abstract words because of an “impoverished imagination” ability (Taylor and Bagby, 2004; Vermeulen et al., 2006). In Experiment 2, we predicted that the influence of experience information on valenced words would be modulated by individual variations in alexithymia. Compared with valenced concrete words, valenced abstract words (by virtue of greater affective experience) might facilitate word processing in the LA group, but this facilitative effect might be attenuated or change in the HA group because of their limited capacity to experience affective information from their internal world (Kashdan et al., 2015; Nook et al., 2015) and their impoverished imagination ability (Taylor and Bagby, 2004; Vermeulen et al., 2006).
alexithymic individuals but exhibited no difference in the recall of positive words. Studies of lexical decision priming reported differential effects of positive and negative words on affective priming in alexithymia (Suslow et al., 2001; Suslow, 1998). These studies suggest that alexithymic individuals automatically evaluate the emotional meaning of a word and access the valence information of a word but exhibit differential processing engagement or distraction when presented with emotional words with different valence, even when the task does not specifically require participants to pay attention to valence information of stimuli (Donges et al., 2014; Donges and Suslow, 2017). Recent studies provided evidence that the effect of valence on emotional word processing is influenced by two types of experience information as a function of the meanings of words (sensorimotor vs. affective; Vigliocco et al., 2009, 2014; Kousta et al., 2011). Alexithymia has also been associated with hypersensitivity to sensorimotor information from the external world and the avoidance of affective experience information from one's own internal world (Kashdan et al., 2015; Nook et al., 2015). Few studies have explicitly examined whether alexithymic deficits in emotional word processing are associated with differences in experience information that is denoted by words. Embodied theories of cognition have sought to explain the role of experience information in emotional word processing. These theories hypothesize that knowledge, including word representations, is grounded in experiential information (Barsalou, 2008). With regard to words, Vigliocco et al. (2009) proposed that acquiring and processing the emotional meaning of words involve two types of experience information. One type of experience information is sensorimotor information, consisting of sensorimotor representations of sensory events (e.g., vision) and actions (e.g., movements) in the external world. Another type of experience information is affective information, consisting of affective representations of states in one's inner world (e.g., positive and negative affect). A series of studies showed that words with high concreteness were more associated with sensorimotor information than words with low concreteness (Vigliocco et al., 2009, 2014; Kousta et al., 2011). Concrete words tend to comprise more sensorimotor information than abstract words, whereas abstract words tend to comprise more affective experiential information than concrete words. Studies of language have shown that concrete word (i.e., specific objects or events; e.g., baby, corpse) is processed more rapidly than abstract words (i.e., more general or complex concepts; e.g., honor, revenge) (Paivio, 1986; Schwanenflugel et al., 1988; Barber et al., 2013; Zhang et al., 2014). However, a large-scale regression analysis of thousands of words showed, counterintuitively, that abstract words were processed faster than concrete words, and this advantage for abstract words only occurred with emotionally valenced (i.e., positive and negative) words but not with neutral words (Kousta et al., 2011). Based on differences in experience information between concrete and abstract words, recent studies suggested that the effect of valence on emotional word processing is influenced by experience information as a function of word concreteness1 after controlling for a larger number of lexical variables (e.g., word frequency, arousal, and familiarity, among others) (Yao et al., 2016; Ferré and Sánchez-casas, 2014; Yao and Wang, 2014; Palazova et al., 2013; Sheikh and Titone, 2013; Yao and Wang, 2013; Newcombe et al., 2012; Wang and Yao, 2012; Tse and Altarriba, 2009). For example, Palazova et al. (2013) found that participants responded more slowly to valenced (positive and negative) words than to neutral abstract words, whereas no difference was found
2. Experiment 1: Effect of experience information on neutral word processing in alexithymia 2.1. Methods 2.1.1. Participants Seven hundred seventy-six (776) students from Henan University were recruited to complete in the Chinese version of the TorontoAlexithymia Scale (TAS-20; Bagby et al., 2004; Chinese version: Zhu et al., 2007). A total of 716 valid questionnaires were completed by the students and returned. The TAS-20 is the most widely used measure of this personality trait and includes 20 items. Each item is rated on a 5-
1
Note here, as a relatively new dimension, experience information denoted by words is an aspect of semantic representation for words, but the subjective ratings for it have not be collected by current published database, so the type of experience information usually borrowed concreteness ratings in most of the recent literature in the field (Newcombe et al., 2012; Ferré and Sánchez-casas, 2014; Sheikh and Titone, 2013) 252
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pressing the “Z” and “M” keys on the keyboard (assignment of the two keys to response categories was counterbalanced across participants). All 160 stimuli were shown in four blocks of 40 trials each. Each block contained 10 NeuC words, 10 NeuA words, and 20 pseudowords. The order of word presentation in each block and the order of the blocks was randomized for each participant. Each trial began with a fixation point presented for 500 ms, followed by presentation of the string for 2000 ms or until a response was given. The inter-trial interval was 800–1200 ms. Prior to the experiment trials, each participant performed 12 practice trials (these words did not appear in the formal experiment) to prove that they had completely understood the trial procedure. All experiments were programmed using E-Prime 2.0 (Psychology Software Tools Inc., Sharpsburg, PA).
point scale, ranging from 5 (strongly agree) to 1 (strongly disagree), with total scores ranging from 20 to 100. We selected a cutoff score of ≥60 for the HA group, reflecting the top quartile score. We selected a cutoff score of ≤40 for the LA group, reflecting the bottom quartile score. We sought to obtain a sample with as large a variance in alexithymia as possible (Scarpazza et al., 2014). All participants satisfied the following exclusion criteria: (a) no history of substance abuse and psychiatric diseases (e.g., alcohol, schizophrenia); (b) no participant was found to score in the range indicating serious depression (i.e., exclusion of participants who scored >10 as measured using the Beck Depression Inventory, BDI; Beck et al., 1996) or high anxiety (exclusion of participants who scored >55 as measured using the State-Trait Anxiety Inventory, STAI; Spielberger et al., 1983). The final sample consisted of 70 participants (34 participated in Experiment 1 and 35 participated in Experiment 2) who scored higher than 60 on the TAS-20 in the HA group (mean = 65.76; SD = 2.43) and 70 participants (35 participated in Experiment 1 and 35 participated in Experiment 2) who scored lower than 40 on the TAS-20 in the LA group (mean = 34.33; SD = 2.74). All participants were Chinese native speakers and reported normal or corrected-to-normal vision. All participants were right-handed according to the Edinburgh Handedness Inventory (mean score 86.7 ± 28, Oldfield, 1971). More demographic data of HA and LA groups in Experiment 1 is presented in Table 1. Written informed consents were obtained from all the participants and ¥20 was presented for their participation. The study was approved by the local Ethics Committee of Henan University (HUSOM-2018102).
2.2. Results We excluded from the analyses mean response times (RTs) above or below 2.5 standard deviations from the mean, and only analyzed RTs for correct responses to target stimuli, because the accuracy for each trial in all conditions was high (98.2%, range: 97.9–99.8%) and did not differ across conditions. A multivariate analysis of variance (MANOVA) was conducted, with level of alexithymia (HA group vs. LA group) as the between-subjects factor and concreteness (concrete vs. abstract) as the within-subjects factor. The results revealed a significant main effect of level of alexithymia, F (1,67) = 4.09, p = .04, ηP2 = 0.06, with slower responses in the HA group (629.0 ± 8.2 ms) compared with the LA group (605.7 ± 8.1 ms). A main effect of concreteness was also found, F (1,67) = 17.95, p < .001, ηP2 = 0.21, in which responses to neutral concrete words (609.8 ± 5.9 ms) being faster than to neutral abstract words (625.0 ± 6.2 ms). A level of alexithymia × concreteness interaction was found, F (1,67) = 5.39, p = .02, ηP2 = 0.07. The simple effects analysis showed that response times to neutral concrete words were significant longer in the HA group compared with the LA group, F (1,67) = 7.28, p = .009, but no significant difference in response times to neutral abstract words was found between groups, F (1,67) = 1.46, p = .23. The Bonferroni post-hoc test indicated faster response times to neutral concrete words than to neutral abstract words in the LA group (t34 = −4.39, p < .001), whereas no significant difference in responses times was found between neutral concrete words and neutral abstract words in the HA group (t33 = −1.46, p = .15) (see Fig. 1).
2.1.2. Stimuli The 80 neutral words were selected from a database of 1100 Chinese two-character words (Yao et al., 2017). This database provides the mean ratings and standard deviations (SDs) for valence, arousal, concreteness, and so on for each word. Half of neutral words were concrete words (e.g., NeuC: table, rope) and half were abstract words (e.g., NeuA: rule, maintain). The two types of words differed significantly from each other in concreteness ratings, but were matched for valence, arousal, familiarity, frequency, and strokes (i.e., the number of strokes that are used to write Chinese characters). Pseudowords were based on the 80 original words and were generated by altering one random character within different real words. Table 2 shows a summary of Descriptive Statistics (mean and standard deviations) for six variables and t-test on each factor.
2.3. Discussion 2.1.3. Tasks and procedure The HA group and LA group performed the lexical decision task individually, respectively. Stimuli and instructions were presented in white letters (font: Song typeface, size: 36) over black background on a 21-in. monitor. Participants were asked to respond as quickly and accurately as possible whether each item was a word or a pseudoword by
Experiment 1 examined whether neutral concrete words and neutral abstract words were differentially affected by the level of alexithymia. The results suggested an advantage of neutral concrete words over neutral abstract words (i.e., a traditional effect of concreteness; Paivio, 1986; Schwanenflugel et al., 1988; Barber et al., 2013; Zhang et al., 2014) in the LA group that was absent in the HA group. This finding supports our hypothesis and is consistent with previous findings that the facilitative effect of affective experience on word processing was absent for both neutral abstract and concrete words (e.g., Kousta et al., 2011, Wang and Yao, 2012). In the LA group, the processing advantage of neutral concrete words suggested that the subjects responded faster because these words contained more sensorimotor information (Kousta et al., 2011; Vigliocco et al., 2014) and provided richer visual imagery (e.g., visual information in dual-coding theory; Paivio, 1986). Moreover, because of no functional effect of affective experience and less visual imagery that was available during the processing of neutral abstract words, the LA group responded slower to neutral abstract words. In contrast, no significant difference in response times was found between neutral concrete words and neutral abstract words in the HA group. This suggests that high alexithymic individuals appear to be unable to efficiently
Table 1 Demographic data of high alexithymic (HA) and low alexithymic (LA) groups.
Age (years) Education (years) TAS-20 (score) BDI STAI-S STAI-T
HA group (n = 34) (20 m/14f)
LA group (n = 35) (19 m/16f)
t
p
19.35 (0.74) 13.89 (0.50)
19.39 (1.12) 13.91 (0.67)
−0.14 −0.15
.89 .88
65.68 (5.42) 7.89 (3.17) 43.42 (3.74) 41.19 (4.73)
33.89 (6.64)⁎⁎⁎ 7.38 (4.29) 42.91 (5.57) 39.87 (6.07)
39.05 1.67 0.46 1.01
<.001 .10 .65 .32
⁎⁎⁎
Significant at p < .001 (two-tailed). Note. m = male, f = female. TAS-20 = 20-Item Toronto Alexithymia Scale; BDI = Beck Depression Inventory; STAI-S = State Anxiety Inventory; STAIT = Trait Anxiety Inventory. 253
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Table 2 Means of concreteness (1, abstract to 9, concrete), valence (1, negative to 9, positive), arousal (1, calming to 9, arousing), and familiarity (1, unfamiliar to 9, familiarity) etc. Variables
Valence
Arousal
Concreteness
Familiarity
Frequency
Strokes
NeuC words NeuA words t-test
4.95 ± 0.49 4.74 ± 0.45 t = 1.48, p = 0.14
4.68 ± .32 4.66 ± .59 t = 0.22 p = 0.83,
6.39 ± 0.50 3.63 ± 0.53 t = 24.42 p < .001,
5.76 ± 0.80 5.67 ± 0.57 t = 0.56 p = .57,
16.43 ± 23.05 27.39 ± 23.67 t = −1.72 p = .09,
17.93 ± 3.55 16.03 ± 4.30 t = 1.60, p = .11
Note. NeuC words = Neutral concrete words; NeuA words = Neutral abstract words.
utilize sensorimotor and visual information to facilitate the processing of neutral concrete words. This finding supports the notion that alexithymia is associated with a lower capacity to engage in fantasy and other imaginary activities (Taylor and Bagby, 2004; Vermeulen et al., 2006). Overall, the results of Experiment 1 indicated that sensorimotor and visual information played an important role in neutral word processing in both the LA and HA groups. Alexithymic deficits in neutral word processing are associated with an impoverished imagination ability, but this occurs independently of experience information that is denoted by neutral words.
Table 3 Demographic data of high alexithymic (HA) and low alexithymic (LA) groups.
Age (years) Education (years) TAS-20 (score) BDI STAI-S STAI-T
HA group (n = 35) (19 m/16f)
LA group (n = 35) (18 m/19f)
t
p
19.63 (1.11) 14.09 (0.67)
19.43 (1.30) 13.99 (0.75)
.69 .57
.49 .57
64.98 (6.64) 7.73 (3.07) 42.98 (3.43) 39.56 (4.61)
32.53 (4.50)⁎⁎⁎ 7.51 (3.34) 43.13 (4.42) 38.54 (6.61)
23.93 .80 −0.16 .75
<0.001 .43 .87 .46
⁎⁎⁎
Significant at p < .001 (two-tailed). Note. m = male, f = female. TAS-20 = 20-Item Toronto Alexithymia Scale; BDI = Beck Depression Inventory; STAI-S = State Anxiety Inventory; STAIT = Trait Anxiety Inventory.
3. Experiment 2:Effect of experience information on valenced word processing in alexithymia 3.1. Methods
(3156) = 1.91, p = .13], familiarity [F (3156) = 1.10, p = .35], frequency [F (3156) = 0.82, p = .49], and strokes [F (3156) = 1.48, p = .22]. Valence ratings of positive and negative words differed significantly from each other [F (3156) = 1248.62, p < .001], and concreteness ratings significantly differed between concrete and abstract words [F (3, 156) = 214.65, p < .001]. Post hoc analyses with the Bonferroni correction (p < .05) revealed that valence ratings were matched between concrete and abstract words, and concreteness ratings were matched between positive and negative words (all ps > 0.10). See Table 4 for a summary of Descriptive Statistics (mean and standard deviations) for six variables. The 160 pseudowords were based on the 160 original words and were generated by altering one random character within different real words.
3.1.1. Participants The sample consisted of 35 participants in the HA group and 35 participants in the LA group (see Experiment 1 for further details). Group differences were examined using ANOVA and independentsamples t-test. There were no significant differences between the two groups in terms of age, education, score of BDI and STAI except for TAS20 score (see Table 3). 3.1.2. Stimuli From the same word pool as in Experiment 1, we selected 80 concrete words and 80 abstract words with positive or negative. Among those words were 40 positive concrete words (e.g., PC: baby, flower), 40 positive abstract words (e.g., PA: joyful, gratitude), 40 negative concrete words (e.g., NC: corpse, burglar), and 40 negative abstract words (e.g., NA: dispirited, guilty) that were matched with regard to arousal [F
3.1.3. Tasks and procedure All 320 stimuli were shown in four blocks of 80 trials each. Each
Fig 1. Response times of neutral concrete word and neutral abstract word in the lexical decision task between two groups. Note. Error bars denote standard errors (SE). ***p < .001. HA group = high alexithymic group; LA group = high alexithymic group. 254
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Table 4 Means of concreteness (1, abstract to 9, concrete), valence (1, negative to 9, positive), arousal (1, calming to 9, arousing), and familiarity (1, unfamiliar to 9, familiarity) etc. Variables
Valence
Arousal
Concreteness
Familiarity
Frequency
Strokes
PC words PA words NC words NA words
6.83 ± 0.39 6.81 ± 0.45 2.34 ± 0.59 2.24 ± 0.42
6.24 ± 0.51 6.19 ± .54 6.30 ± .65 6.52 ± .58
6.43 ± 0.39 3.92 ± 0.65 6.13 ± 0.55 4.12 ± 0.65
5.84 ± 0.63 5.77 ± 0.69 5.61 ± 0.65 5.66 ± 0.51
16.44 ± 17.54 20.36 ± 19.32 13.34 ± 21.95 14.30 ± 11.16
16.75 ± 5.09 18.25 ± 5.07 16.32 ± 4.13 17.80 ± 4.27
Note. PC words = Positive concrete words; PA words = Positive abstract words; NC words = Negative concrete words; NA words = Negative abstract words.
the HA group, and this deficiency was associated with valence and experience information as a function of word concreteness. Consistent with previous studies (Kousta et al., 2011; Sheikh and Titone, 2013; Yao et al., 2016), the results of Experiment 2 suggested that affective experience can facilitate the processing of positive words in the LA group, reflected by faster responses to positive abstract words than to positive concrete words. This interpretation is supported by Vigliocco et al. (2009), in which positive abstract words, because of the richer affective experience information they provide, are able to offset the deficiency in visual image information, thus providing a processing advantage after controlling other lexical variables. However, a processing advantage of positive abstract words over positive concrete words was not observed in the HA group. One possible reason for this is that HA individuals exhibit decreases in the ability to experience positive emotion (Luminet et al., 1999; Friedlander et al., 1997; van der Velde et al., 2013) and tend to avoid positive affective experience information from their internal world (Kashdan et al., 2015; Nook et al., 2015). Therefore, HA individuals are unable to effectively utilize the facilitative role of affective experience information in the processing of positive abstract words. With regard to response times to negative concrete words and negative abstract words, the HA group and LA group presented opposite results. Faster responses to negative concrete words than to negative abstract words were observed in the LA group, which may be explained by the automatic vigilance model (Pratto and John, 1991). Negative concrete words elicit explicit visual imagery that activates a threatdriven mechanism that in turn allows the organism to respond quickly and effectively to environmental threats. Conversely, the faster responses to negative abstract words than to negative concrete words were observed in the HA group. This may indicate that alexithymia does not block all affective experiential information, and alexithymic individuals can utilize negative affective information to facilitate negative word processing.
block contained equal numbers of words (10 PC words, 10 PA words, 10 NC words, and 10 NA words) and pseudowords with no more than three trials of the same condition presented consecutively. Trials were presented in a different order for each participant to avoid potential carryover effects from one trial to the other (Schmidt and Saari, 2007). The experimental task and procedure were the same as that of Experiment 1. 3.2. Results A MANOVA was conducted, with level of alexithymia (HA group vs. LA group) as the between-subjects factor and concreteness (concrete vs. abstract) and valence (positive vs. negative) as the within-subjects factors. The results revealed a significant main effect of level of alexithymia, F (1, 68) = 4.30, p = .04, ηP2 = 0.06, indicating that response times were longer in the HA group (640.7 ± 7.1 ms) than in the LA group (620.0 ± 7.3 ms). A main effect of valence was observed, F (1,68) = 405.65, p < .001, ηP2 = 0.86, in which response times to negative words (654.9 ± 6.2 ms) were slower than to positive words (605.9 ± 5.8 ms). A two-way concreteness × valence interaction [F (1,68) = 3.85, p = .05, ηP2 = 0.06] and a three-way level of alexithymia × concreteness × valence interaction [F (1,68) = 34.77, p < .001, ηP2 = 0.34] were found. To further evaluate the impact of this three-way interaction on our hypothesis, we conducted separate ANOVAs by considering the effects of concreteness and level of alexithymia on positive words and negative words separately. For positive words, response times to positive abstract words in the HA group were significantly longer than in the LA group [F (1, 68) = 9.53, p = .03], whereas no significant difference in response times to positive concrete words was found between groups [F (1, 68) = 1.38, p = .24]. For negative words, response times to negative concrete words in the HA group were significantly longer than in the LA group [F (1, 68) = 10.14, p = .002]. Response times to negative abstract words were not different between groups [F (1, 68) = 1.19, p = .73]. The response times for each condition are shown in Fig. 2. Post hoc tests with Bonferroni correction for pair-wise comparisons indicated that faster response times to negative abstract words than to negative concrete words in the HA group (t34 = 2.12, p = .04), with no differences in response times between positive concrete words and positive abstract words (t34 = 0.85, p = .40)(Fig. 3). In the LA group, faster response times to positive abstract words than positive concrete words (t34 = 3.29, p = 002) were found, with faster response times to negative concrete words than to negative abstract words (t34 = −3.03, p = .005) (Fig. 3).
4. General discussion The present study employed a lexical decision task to investigate alexithymic deficits in emotional (neutral, positive and negative) word processing that emerge from an embodied view of language (Kousta et al., 2011; Vigliocco et al., 2009; Barsalou et al., 2008). Consistent with previous findings (Luminet et al., 2006; Goerlich et al., 2011), slower responses to neutral words and valenced (i.e. positive and negative) words were found in the HA group compared with the LA group. We also found that valenced word processing in the HA group was modulated by a joint effect of valence and experience information as a function of word concreteness, with selective deficits in the processing of neutral concrete words, negative concrete words, and positive abstract words compared with the LA group. These findings shed new light on emotional word processing in alexithymia and suggest that alexithymic deficits in the processing of emotional words are associated with experience information as a function of the meaning of words. Specifically, alexithymic deficits in emotional word processing should not be considered as being simply related to general or specific valence but rather related to experience information that is denoted by the meanings of words.
3.3. Discussion In Experiment 2, we examined whether the processing of valenced words in alexithymic individuals is modulated by a joint effect of valence and word concreteness in a lexical decision task. The results suggested that HA individuals exhibited slower responses to positive abstract words and negative concrete words compared with LA individuals, whereas no differences in response times to positive concrete words and negative abstract words were found between groups. These findings indicated a selective deficiency in valenced word processing in 255
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Fig 2. Response times of four types of words for two groups during the lexical decision task. Note. Error bars denote standard errors (SE). *p < .05. **p < .005. HA group = high alexithymic group; LA group = high alexithymic group.
Faster responses to positive abstract words than to positive concrete words were found in the LA group. This is consistent with previous findings that suggested richer affective experiential information that is conferred by positive abstract words can capture more attention and thus facilitate positive abstract word processing in a lexical decision task (Kousta et al., 2011; Yao et al., 2016; Ferré and Sánchez-casas, 2014; Yao and Wang, 2013, 2014; Palazova et al., 2013; Newcombe et al., 2012). For example, Yao and Wang (2013, 2014) used a lexical decision priming task and found that positive abstract words facilitated activation from primes to targets in the semantic network because of more affective associations between positive abstract prime-target word pairs, thus leading to an obvious affective priming effect. According to Vigliocco et al. (2009), with the aid of more affective experience, positive abstract words are able to offset the deficiency in visual image information, resulting in a processing advantage of positive abstract words. In contrast, a processing advantage of positive abstract words was not observed in the HA group, indicating a reduction of the availability and acquisition of affective experiential information that is conferred by positive abstract words in alexithymia. A previous study showed that HA individuals experience positive emotional situations with less pleasure (Friedlander et al., 1997) and present a lower capacity to experience pleasure (Luminet et al., 1999, 2006; van der Velde et al., 2013). van der Velde et al. (2013) conducted a meta-analysis of 15 neuroimaging studies of emotion processing in alexithymia and found that positive stimuli elicited lower activation in the right insula and precuneus, suggesting a reduction of emotional awareness in alexithymia with regard to positive affect. Consequently, the facilitative effect of affective experience on the processing of positive words was absent in the HA group. Our results also showed that the influence of experience information on negative word processing in the LA group was different from the HA group. Individuals in the LA group responded to negative concrete words faster than to negative abstract words, which is consistent with previous studies that examined the relationship between valence and experience information in word processing in a lexical decision task (e.g., Yao et al., 2016; Kousta et al., 2011; Palazova et al., 2013). A possible reason for this result is that negative concrete words elicit an explicit visual image that activates a threat-driven mechanism, which allows the individual to respond quickly and effectively to environmental threats. According to the automatic vigilance model (Pratto and
Previous studies suggested no functional effect of experience information on neutral word processing (Kousta et al., 2011). Therefore, in the present study, we first examined the ways in which neutral concrete words and neutral abstract words are processed according to different levels of alexithymia (HA and LA) in Experiment 1. Faster responses to neutral concrete words than to neutral abstract words were observed in the LA group, which is consistent with previous findings of an advantage of neutral concrete words (e.g., Wang and Yao, 2012; Yao et al., 2013; Kousta et al., 2011). According to the dual coding theory (Paivio, 1986), neutral concrete words are represented in both verbal and mental imagery systems, whereas neutral abstract words are mainly represented in the verbal system. The availability of two representational systems for neutral concrete words thus facilitates word processing and induces faster responses. However, no significant difference in response times was found between neutral concrete words and neutral abstract words in the HA group, indicating that the contribution of visual imagery information to the processing of neutral concrete words was absent in HA individuals. One possible explanation for this result is that HA individuals have a lower ability to engage in fantasy and other imaginary activities (Taylor and Bagby, 2004; Vermeulen et al., 2006). Thus, they are unable to efficiently utilize visual imagery information to facilitate the processing of neutral concrete words. Moreover, no significant facilitative effect of sensorimotor information on the processing of neutral concrete words was found in the HA group, suggesting that although alexithymia tends to amplify sensorimotor, tactile, nociceptive, and acoustic stimulus information (Sheikh and Titone, 2013), alexithymic individuals may be unable to amplify or effectively utilize sensorimotor symbolic stimulus information, such as neutral words. Based on the facilitative effect of affective experiential information on emotionally valenced (i.e., positive and negative) words (Kousta et al., 2011), Experiment 2 examined whether the processing of valenced words in alexithymia is modulated by a joint effect of emotional valence and experience information. The results indicated a significant interactive effect of valence, experience information, and level of alexithymia. An advantage of positive abstract words over positive concrete words and an advantage of negative concrete words over negative abstract words with regard to response times were observed in the LA group. In the HA group, an advantage of negative abstract words over negative concrete words was found, with no difference between positive abstract words and positive concrete words. 256
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Fig 3. Group differences in response times between positive concrete and positive abstract words (Fig.3a), and group differences in response times between negative words concrete and negative abstract words (Fig.3b). Error bars denote standard errors (SE). Note. Error bars denote standard errors (SE). *p < .05. **p ≤ 0.005. HA group = high alexithymic group; LA group = high alexithymic group.
experience to facilitate the processing of negative words. Previous studies showed that HA individuals are able to easily perceive negative emotional situations (Lumiet et al.,1999) and they even appear to perceive negative emotions better than LA individuals (Franz et al., 2004).
John, 1991), negative objects or events capture an organism's attention to a greater extent than positive and neutral objects or events, thus eliciting a powerful physiological, behavioral, and emotional response. This may be an evolutionary adaptation that allows the organism to respond quickly and effectively to environmental threats, thus highlighting the overriding significance of negative stimuli for survival. Negative concrete words may be similar to biologically relevant threats in LA individuals. However, such an effect of negative concrete words was not observed in the HA group, in contrast to the advantage of negative abstract words. This suggests that HA individuals do not utilize an avoidance strategy to cope with threatening visual stimuli and rather present a greater tendency to experience negative emotion. Alexithymia may not prevent the processing of all affective experience information, but alexithymic individuals may effectively utilize negative affective
5. Limitations and conclusions One potential limitation of the present study is that all of the participants were chosen from a nonclinical sample of young adults, which may limit our ability to generalize the findings. Although alexithymia is viewed as a continuous personality trait in both clinical and nonclinical populations, with people differing in their ability to perceive and recognize emotional stimuli, the degree of alexithymic deficits can differ 257
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in different populations (Donges and Suslow, 2017; Pollatos and Gramann, 2011). Therefore, future studies should select a representative clinical sample of alexithymic individuals to investigate the relationship between alexithymic deficits in emotional word processing and experience information that is denoted by words. Another limitation is that the present results indicate that selective deficits in emotional word processing in alexithymia are associated with the word's experience information only at the behavioral level. Therefore, future studies should utilize more direct measurement methods, such as functional magnetic resonance imaging and event-related potentials, to verify the present findings and shed more light on associated brain networks that underlie the relationship between alexithymia and emotional word processing. In conclusion, the present results extend previous findings that suggest that alexithymic individuals utilize an avoidance strategy to cope with emotion stimuli through their avoidance of affective experience from their own internal world (Kashdan et al., 2015; Nook et al., 2015). Nonetheless, not all emotional stimuli are avoided by alexithymic individuals. Specifically, they exhibit the selective avoidance of positive words with more affective experience from their own internal world but not negative words with more affective experience.
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CRediT authorship contribution statement Yao Zhao: Conceptualization, Resources, Writing - original draft, Writing - review & editing. Xuan Yang: Software, Data curation. Zhu Xiangru: Writing - original draft, Writing - review & editing. Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acknowledgment This research was supported by grants from the National Natural Science Foundation of China (grant# 31600885) and the Fundamental Research Funds for the Central Universities (20101196146, 20106186449, 20101194941) to Zhao Yao and Yang Xuan (20101186246). This research was also supported by grants from the Higher Education Reform Project of Xidian universityto Zhao Yao (20901190006) and Yang Xuan (20901190029). Supplementary materials Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.jad.2019.08.068. References Bagby, R.M., Parker, J.D.A., Taylor, G.J., 2004. The twenty-item Toronto Alexithymia Scale-I. J. Psychosom. Res. 38, 33–40. Barsalou, L.W., 2008. Grounded cognition. Annu. Rev. Psychol. 59, 617–645. Barber, H., Otten, L., Kousta, S., Vigliocco, G., 2013. Concreteness in word processing: ERP and behavioral effects in a lexical decision task. Brain Lang. 125 (1), 47–53. Beck, A.T., Steer, R.A., Brown, G.K., 1996. Beck depression inventory-II. San Antonio 78 (2), 490–498. Brandt, L., Pintzinger, N.M., Tran, U.S., 2011. Abnormalities in automatic processing of illnessrelated stimuli in self-rated alexithymia. PloS one 10 (6), e0129905. Donges, U.S., Kersting, A., Suslow, T., 2014. Alexithymia and perception of emotional information: a review of experimental psychological findings. Univ. Psychol. 13 (2), 745–756. Donges, U.S., Suslow, T., 2017. Alexithymia and automatic processing of emotional stimuli: a systematic review. Rev. Neurosci. 28 (3), 247–264. Ferré, P., Sánchez-casas, R., 2014. Affective priming in a lexical decision task: is there an effect of words' concreteness? Psicológica 35, 117–138. Franz, M., Schaefer, R., Schneider, C., Sitte, W., Bachor, J., 2004. Visual event-related potentials in subjects with alexithymia: modified processing of emotional aversive information? Am.
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Journal of Affective Disorders journal homepage: www.elsevier.com/locate/jad
Research paper
Effect of experience information on emotional word processing in alexithymia Yao Zhaoa, Xuan Yanga, Zhu Xiangrub,c,
T
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a
School of Humanities, Xidian University, Xi'an 710126, China Institute of Cognition, Brain and Health, Henan University, Kaifeng, 475004, China c Institute of Psychology and Behavior, Henan University, Kaifeng, 475004, China b
A R T I C LE I N FO
A B S T R A C T
Keywords: Alexithymia Emotion words Valence Experience information Selective deficits
Background: Alexithymia is an at-risk personality trait that is associated with deficits in processing emotional words. However, little is known about whether the effect of emotional valence (neutral, positive, and negative) on word processing in alexithymia is related to individual differences in sensorimotor or affective information processing that is associated with alexithymia and experience information (sensorimotor vs. affective) that is denoted by words. Methods: The present study performed two experiments to explore this issue. In Experiment 1, we orthogonally manipulated experience information that was denoted by neutral words. In Experiment 2, we orthogonally manipulated experience information that was denoted by valenced words (i.e., positive and negative). We asked two groups of healthy individuals with high scores (high alexithymic [HA] group) or low scores (low alexithymic [LA] group) on the 20-item Toronto-Alexithymia-Scale to complete a lexical decision task. Results: The results showed that emotional word processing in the HA group was modulated by a joint effect of valence and experience information, indicating that selective deficits in the processing of neutral and negative words were loaded more by sensorimotor information and that selective deficits in the processing of positive words were loaded more by affective experience compared with the LA group. Conclusion: These findings shed a new light on emotional word processing in alexithymia and suggest that alexithymic deficits in the processing of emotional words should not be considered as being simply related to general or specific valence but rather related to experience information that is denoted by the meanings of words.
1. Introduction Alexithymia refers to difficulties in identifying, describing, and introspecting about one's own emotional experience (Sifneos,1973). Alexithymia is understood as a personality trait, the severity of which varies across general populations (Taylor et al., 1999). Previous studies showed that alexithymia is associated with impairments in the ability to perceive and recognize emotional stimuli (for review, see Donges et al., 2014; Donges and Suslow, 2017) and hypersensitivity to sensorimotor information from the external world and the avoidance of affective experience from one's own internal world (Kashdan et al., 2015; Nook et al., 2015). However, emotional words (e.g., happy, honor), unlike faces or pictures, are symbolic stimuli that can be learned and understood through different types of experience information (e.g., sensorimotor vs. affective) that is denoted by words (Vigliocco et al., 2009).
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An important issue is whether alexithymic impairments in emotional word processing are related to deficits in the perception of experience information as a function of the meaning of words. Previous studies linked alexithymia to problems in emotional word processing, indicating that alexithymic individuals recalled fewer emotional words compared with neutral words in memory tasks (Luminet et al., 2006). Alexithymic individuals also exhibited lower affective priming effect of emotional words (Goerlich et al., 2011) and used fewer emotional words when asked to define and describe a battery of emotional words and situations (Wotschack and KlannDelius, 2013). Alexithymia may also differentially influence the processing of positive words compared with negative words (Donges and Suslow, 2017; Meltzer and Nielson, 2010; Donges et al., 2014; Brandt et al., 2011). For example, Meltzer and Nielson (2010) found that alexithymic individuals recalled fewer negative words than non-
Corresponding authors. E-mail addresses: [email protected] (Z. Yao), [email protected] (X. Zhu).
https://doi.org/10.1016/j.jad.2019.08.068 Received 3 June 2019; Received in revised form 16 August 2019; Accepted 19 August 2019 Available online 20 August 2019 0165-0327/ © 2019 Elsevier B.V. All rights reserved.
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between valenced and neutral concrete words in a lexical decision task. Sheikh and Titone (2013) used eye-movement measures of natural reading and found an interaction between valence and concreteness with regard to gaze duration. The processing of valenced words was faster than neutral words when the words were abstract. Overall, the interaction between valence and concreteness in emotional word processing indicates a joint facilitative effect of valence and affective experience information on the processing of valenced abstract words, but not on the processing of neutral abstract words or valenced and neutral concrete words (e.g., Kousta et al., 2011; Sheikh and Titone, 2013; Yao et al., 2016). Altogether, the existing literature suggests that the effect of valence on emotional word processing is modulated by experience information (i.e., concreteness) after controlling for other lexical variables. However, one unresolved issue is whether the influence of experience information on emotional word processing (neutral vs. valenced) depends on individual differences in sensorimotor or affective information processing in alexithymia. Based on perceptive differences in experience information that are observed in alexithymia (Kashdan et al., 2015; Nook et al., 2015) and the influence of experience information on emotional word processing (e.g., Kousta et al., 2011; Sheikh and Titone, 2013; Yao et al., 2016), we predicted that impairments in the processing of emotional words in alexithymic individuals are modulated by a joint effect of emotional valence (neutral, positive, negative) and experience information as a function of word concreteness (concrete, abstract). Previous studies suggested that the facilitative effect of affective experience on word processing is mainly limited to emotionally valenced words and absent for neutral words (e.g., Kousta et al., 2011; Yao and Wang, 2013; Wang and Yao, 2012). Thus, we conducted two separate experiments using a lexical decision task to explore this issue. In the present study, we orthogonally manipulated the word concreteness of neutral words in Experiment 1 and the word concreteness of valenced words (i.e., positive and negative) in Experiment 2 (in a high alexithymic (HA) group vs. a low alexithymic (LA) group). Concrete and abstract words represent more sensorimotor and affective experiential words, respectively. In Experiment 1, we expected that lexical decision latencies (i.e., response times) would be faster for neutral concrete words than for neutral abstract words in the LA group, which would be consistent with the finding of a processing advantage of concrete words (Paivio, 1986; Schwanenflugel et al., 1988; Barber et al., 2013; Zhang et al., 2014). In contrast, the HA group was expected to exhibit less pronounced processing differences between neutral concrete and abstract words because of an “impoverished imagination” ability (Taylor and Bagby, 2004; Vermeulen et al., 2006). In Experiment 2, we predicted that the influence of experience information on valenced words would be modulated by individual variations in alexithymia. Compared with valenced concrete words, valenced abstract words (by virtue of greater affective experience) might facilitate word processing in the LA group, but this facilitative effect might be attenuated or change in the HA group because of their limited capacity to experience affective information from their internal world (Kashdan et al., 2015; Nook et al., 2015) and their impoverished imagination ability (Taylor and Bagby, 2004; Vermeulen et al., 2006).
alexithymic individuals but exhibited no difference in the recall of positive words. Studies of lexical decision priming reported differential effects of positive and negative words on affective priming in alexithymia (Suslow et al., 2001; Suslow, 1998). These studies suggest that alexithymic individuals automatically evaluate the emotional meaning of a word and access the valence information of a word but exhibit differential processing engagement or distraction when presented with emotional words with different valence, even when the task does not specifically require participants to pay attention to valence information of stimuli (Donges et al., 2014; Donges and Suslow, 2017). Recent studies provided evidence that the effect of valence on emotional word processing is influenced by two types of experience information as a function of the meanings of words (sensorimotor vs. affective; Vigliocco et al., 2009, 2014; Kousta et al., 2011). Alexithymia has also been associated with hypersensitivity to sensorimotor information from the external world and the avoidance of affective experience information from one's own internal world (Kashdan et al., 2015; Nook et al., 2015). Few studies have explicitly examined whether alexithymic deficits in emotional word processing are associated with differences in experience information that is denoted by words. Embodied theories of cognition have sought to explain the role of experience information in emotional word processing. These theories hypothesize that knowledge, including word representations, is grounded in experiential information (Barsalou, 2008). With regard to words, Vigliocco et al. (2009) proposed that acquiring and processing the emotional meaning of words involve two types of experience information. One type of experience information is sensorimotor information, consisting of sensorimotor representations of sensory events (e.g., vision) and actions (e.g., movements) in the external world. Another type of experience information is affective information, consisting of affective representations of states in one's inner world (e.g., positive and negative affect). A series of studies showed that words with high concreteness were more associated with sensorimotor information than words with low concreteness (Vigliocco et al., 2009, 2014; Kousta et al., 2011). Concrete words tend to comprise more sensorimotor information than abstract words, whereas abstract words tend to comprise more affective experiential information than concrete words. Studies of language have shown that concrete word (i.e., specific objects or events; e.g., baby, corpse) is processed more rapidly than abstract words (i.e., more general or complex concepts; e.g., honor, revenge) (Paivio, 1986; Schwanenflugel et al., 1988; Barber et al., 2013; Zhang et al., 2014). However, a large-scale regression analysis of thousands of words showed, counterintuitively, that abstract words were processed faster than concrete words, and this advantage for abstract words only occurred with emotionally valenced (i.e., positive and negative) words but not with neutral words (Kousta et al., 2011). Based on differences in experience information between concrete and abstract words, recent studies suggested that the effect of valence on emotional word processing is influenced by experience information as a function of word concreteness1 after controlling for a larger number of lexical variables (e.g., word frequency, arousal, and familiarity, among others) (Yao et al., 2016; Ferré and Sánchez-casas, 2014; Yao and Wang, 2014; Palazova et al., 2013; Sheikh and Titone, 2013; Yao and Wang, 2013; Newcombe et al., 2012; Wang and Yao, 2012; Tse and Altarriba, 2009). For example, Palazova et al. (2013) found that participants responded more slowly to valenced (positive and negative) words than to neutral abstract words, whereas no difference was found
2. Experiment 1: Effect of experience information on neutral word processing in alexithymia 2.1. Methods 2.1.1. Participants Seven hundred seventy-six (776) students from Henan University were recruited to complete in the Chinese version of the TorontoAlexithymia Scale (TAS-20; Bagby et al., 2004; Chinese version: Zhu et al., 2007). A total of 716 valid questionnaires were completed by the students and returned. The TAS-20 is the most widely used measure of this personality trait and includes 20 items. Each item is rated on a 5-
1
Note here, as a relatively new dimension, experience information denoted by words is an aspect of semantic representation for words, but the subjective ratings for it have not be collected by current published database, so the type of experience information usually borrowed concreteness ratings in most of the recent literature in the field (Newcombe et al., 2012; Ferré and Sánchez-casas, 2014; Sheikh and Titone, 2013) 252
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pressing the “Z” and “M” keys on the keyboard (assignment of the two keys to response categories was counterbalanced across participants). All 160 stimuli were shown in four blocks of 40 trials each. Each block contained 10 NeuC words, 10 NeuA words, and 20 pseudowords. The order of word presentation in each block and the order of the blocks was randomized for each participant. Each trial began with a fixation point presented for 500 ms, followed by presentation of the string for 2000 ms or until a response was given. The inter-trial interval was 800–1200 ms. Prior to the experiment trials, each participant performed 12 practice trials (these words did not appear in the formal experiment) to prove that they had completely understood the trial procedure. All experiments were programmed using E-Prime 2.0 (Psychology Software Tools Inc., Sharpsburg, PA).
point scale, ranging from 5 (strongly agree) to 1 (strongly disagree), with total scores ranging from 20 to 100. We selected a cutoff score of ≥60 for the HA group, reflecting the top quartile score. We selected a cutoff score of ≤40 for the LA group, reflecting the bottom quartile score. We sought to obtain a sample with as large a variance in alexithymia as possible (Scarpazza et al., 2014). All participants satisfied the following exclusion criteria: (a) no history of substance abuse and psychiatric diseases (e.g., alcohol, schizophrenia); (b) no participant was found to score in the range indicating serious depression (i.e., exclusion of participants who scored >10 as measured using the Beck Depression Inventory, BDI; Beck et al., 1996) or high anxiety (exclusion of participants who scored >55 as measured using the State-Trait Anxiety Inventory, STAI; Spielberger et al., 1983). The final sample consisted of 70 participants (34 participated in Experiment 1 and 35 participated in Experiment 2) who scored higher than 60 on the TAS-20 in the HA group (mean = 65.76; SD = 2.43) and 70 participants (35 participated in Experiment 1 and 35 participated in Experiment 2) who scored lower than 40 on the TAS-20 in the LA group (mean = 34.33; SD = 2.74). All participants were Chinese native speakers and reported normal or corrected-to-normal vision. All participants were right-handed according to the Edinburgh Handedness Inventory (mean score 86.7 ± 28, Oldfield, 1971). More demographic data of HA and LA groups in Experiment 1 is presented in Table 1. Written informed consents were obtained from all the participants and ¥20 was presented for their participation. The study was approved by the local Ethics Committee of Henan University (HUSOM-2018102).
2.2. Results We excluded from the analyses mean response times (RTs) above or below 2.5 standard deviations from the mean, and only analyzed RTs for correct responses to target stimuli, because the accuracy for each trial in all conditions was high (98.2%, range: 97.9–99.8%) and did not differ across conditions. A multivariate analysis of variance (MANOVA) was conducted, with level of alexithymia (HA group vs. LA group) as the between-subjects factor and concreteness (concrete vs. abstract) as the within-subjects factor. The results revealed a significant main effect of level of alexithymia, F (1,67) = 4.09, p = .04, ηP2 = 0.06, with slower responses in the HA group (629.0 ± 8.2 ms) compared with the LA group (605.7 ± 8.1 ms). A main effect of concreteness was also found, F (1,67) = 17.95, p < .001, ηP2 = 0.21, in which responses to neutral concrete words (609.8 ± 5.9 ms) being faster than to neutral abstract words (625.0 ± 6.2 ms). A level of alexithymia × concreteness interaction was found, F (1,67) = 5.39, p = .02, ηP2 = 0.07. The simple effects analysis showed that response times to neutral concrete words were significant longer in the HA group compared with the LA group, F (1,67) = 7.28, p = .009, but no significant difference in response times to neutral abstract words was found between groups, F (1,67) = 1.46, p = .23. The Bonferroni post-hoc test indicated faster response times to neutral concrete words than to neutral abstract words in the LA group (t34 = −4.39, p < .001), whereas no significant difference in responses times was found between neutral concrete words and neutral abstract words in the HA group (t33 = −1.46, p = .15) (see Fig. 1).
2.1.2. Stimuli The 80 neutral words were selected from a database of 1100 Chinese two-character words (Yao et al., 2017). This database provides the mean ratings and standard deviations (SDs) for valence, arousal, concreteness, and so on for each word. Half of neutral words were concrete words (e.g., NeuC: table, rope) and half were abstract words (e.g., NeuA: rule, maintain). The two types of words differed significantly from each other in concreteness ratings, but were matched for valence, arousal, familiarity, frequency, and strokes (i.e., the number of strokes that are used to write Chinese characters). Pseudowords were based on the 80 original words and were generated by altering one random character within different real words. Table 2 shows a summary of Descriptive Statistics (mean and standard deviations) for six variables and t-test on each factor.
2.3. Discussion 2.1.3. Tasks and procedure The HA group and LA group performed the lexical decision task individually, respectively. Stimuli and instructions were presented in white letters (font: Song typeface, size: 36) over black background on a 21-in. monitor. Participants were asked to respond as quickly and accurately as possible whether each item was a word or a pseudoword by
Experiment 1 examined whether neutral concrete words and neutral abstract words were differentially affected by the level of alexithymia. The results suggested an advantage of neutral concrete words over neutral abstract words (i.e., a traditional effect of concreteness; Paivio, 1986; Schwanenflugel et al., 1988; Barber et al., 2013; Zhang et al., 2014) in the LA group that was absent in the HA group. This finding supports our hypothesis and is consistent with previous findings that the facilitative effect of affective experience on word processing was absent for both neutral abstract and concrete words (e.g., Kousta et al., 2011, Wang and Yao, 2012). In the LA group, the processing advantage of neutral concrete words suggested that the subjects responded faster because these words contained more sensorimotor information (Kousta et al., 2011; Vigliocco et al., 2014) and provided richer visual imagery (e.g., visual information in dual-coding theory; Paivio, 1986). Moreover, because of no functional effect of affective experience and less visual imagery that was available during the processing of neutral abstract words, the LA group responded slower to neutral abstract words. In contrast, no significant difference in response times was found between neutral concrete words and neutral abstract words in the HA group. This suggests that high alexithymic individuals appear to be unable to efficiently
Table 1 Demographic data of high alexithymic (HA) and low alexithymic (LA) groups.
Age (years) Education (years) TAS-20 (score) BDI STAI-S STAI-T
HA group (n = 34) (20 m/14f)
LA group (n = 35) (19 m/16f)
t
p
19.35 (0.74) 13.89 (0.50)
19.39 (1.12) 13.91 (0.67)
−0.14 −0.15
.89 .88
65.68 (5.42) 7.89 (3.17) 43.42 (3.74) 41.19 (4.73)
33.89 (6.64)⁎⁎⁎ 7.38 (4.29) 42.91 (5.57) 39.87 (6.07)
39.05 1.67 0.46 1.01
<.001 .10 .65 .32
⁎⁎⁎
Significant at p < .001 (two-tailed). Note. m = male, f = female. TAS-20 = 20-Item Toronto Alexithymia Scale; BDI = Beck Depression Inventory; STAI-S = State Anxiety Inventory; STAIT = Trait Anxiety Inventory. 253
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Table 2 Means of concreteness (1, abstract to 9, concrete), valence (1, negative to 9, positive), arousal (1, calming to 9, arousing), and familiarity (1, unfamiliar to 9, familiarity) etc. Variables
Valence
Arousal
Concreteness
Familiarity
Frequency
Strokes
NeuC words NeuA words t-test
4.95 ± 0.49 4.74 ± 0.45 t = 1.48, p = 0.14
4.68 ± .32 4.66 ± .59 t = 0.22 p = 0.83,
6.39 ± 0.50 3.63 ± 0.53 t = 24.42 p < .001,
5.76 ± 0.80 5.67 ± 0.57 t = 0.56 p = .57,
16.43 ± 23.05 27.39 ± 23.67 t = −1.72 p = .09,
17.93 ± 3.55 16.03 ± 4.30 t = 1.60, p = .11
Note. NeuC words = Neutral concrete words; NeuA words = Neutral abstract words.
utilize sensorimotor and visual information to facilitate the processing of neutral concrete words. This finding supports the notion that alexithymia is associated with a lower capacity to engage in fantasy and other imaginary activities (Taylor and Bagby, 2004; Vermeulen et al., 2006). Overall, the results of Experiment 1 indicated that sensorimotor and visual information played an important role in neutral word processing in both the LA and HA groups. Alexithymic deficits in neutral word processing are associated with an impoverished imagination ability, but this occurs independently of experience information that is denoted by neutral words.
Table 3 Demographic data of high alexithymic (HA) and low alexithymic (LA) groups.
Age (years) Education (years) TAS-20 (score) BDI STAI-S STAI-T
HA group (n = 35) (19 m/16f)
LA group (n = 35) (18 m/19f)
t
p
19.63 (1.11) 14.09 (0.67)
19.43 (1.30) 13.99 (0.75)
.69 .57
.49 .57
64.98 (6.64) 7.73 (3.07) 42.98 (3.43) 39.56 (4.61)
32.53 (4.50)⁎⁎⁎ 7.51 (3.34) 43.13 (4.42) 38.54 (6.61)
23.93 .80 −0.16 .75
<0.001 .43 .87 .46
⁎⁎⁎
Significant at p < .001 (two-tailed). Note. m = male, f = female. TAS-20 = 20-Item Toronto Alexithymia Scale; BDI = Beck Depression Inventory; STAI-S = State Anxiety Inventory; STAIT = Trait Anxiety Inventory.
3. Experiment 2:Effect of experience information on valenced word processing in alexithymia 3.1. Methods
(3156) = 1.91, p = .13], familiarity [F (3156) = 1.10, p = .35], frequency [F (3156) = 0.82, p = .49], and strokes [F (3156) = 1.48, p = .22]. Valence ratings of positive and negative words differed significantly from each other [F (3156) = 1248.62, p < .001], and concreteness ratings significantly differed between concrete and abstract words [F (3, 156) = 214.65, p < .001]. Post hoc analyses with the Bonferroni correction (p < .05) revealed that valence ratings were matched between concrete and abstract words, and concreteness ratings were matched between positive and negative words (all ps > 0.10). See Table 4 for a summary of Descriptive Statistics (mean and standard deviations) for six variables. The 160 pseudowords were based on the 160 original words and were generated by altering one random character within different real words.
3.1.1. Participants The sample consisted of 35 participants in the HA group and 35 participants in the LA group (see Experiment 1 for further details). Group differences were examined using ANOVA and independentsamples t-test. There were no significant differences between the two groups in terms of age, education, score of BDI and STAI except for TAS20 score (see Table 3). 3.1.2. Stimuli From the same word pool as in Experiment 1, we selected 80 concrete words and 80 abstract words with positive or negative. Among those words were 40 positive concrete words (e.g., PC: baby, flower), 40 positive abstract words (e.g., PA: joyful, gratitude), 40 negative concrete words (e.g., NC: corpse, burglar), and 40 negative abstract words (e.g., NA: dispirited, guilty) that were matched with regard to arousal [F
3.1.3. Tasks and procedure All 320 stimuli were shown in four blocks of 80 trials each. Each
Fig 1. Response times of neutral concrete word and neutral abstract word in the lexical decision task between two groups. Note. Error bars denote standard errors (SE). ***p < .001. HA group = high alexithymic group; LA group = high alexithymic group. 254
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Table 4 Means of concreteness (1, abstract to 9, concrete), valence (1, negative to 9, positive), arousal (1, calming to 9, arousing), and familiarity (1, unfamiliar to 9, familiarity) etc. Variables
Valence
Arousal
Concreteness
Familiarity
Frequency
Strokes
PC words PA words NC words NA words
6.83 ± 0.39 6.81 ± 0.45 2.34 ± 0.59 2.24 ± 0.42
6.24 ± 0.51 6.19 ± .54 6.30 ± .65 6.52 ± .58
6.43 ± 0.39 3.92 ± 0.65 6.13 ± 0.55 4.12 ± 0.65
5.84 ± 0.63 5.77 ± 0.69 5.61 ± 0.65 5.66 ± 0.51
16.44 ± 17.54 20.36 ± 19.32 13.34 ± 21.95 14.30 ± 11.16
16.75 ± 5.09 18.25 ± 5.07 16.32 ± 4.13 17.80 ± 4.27
Note. PC words = Positive concrete words; PA words = Positive abstract words; NC words = Negative concrete words; NA words = Negative abstract words.
the HA group, and this deficiency was associated with valence and experience information as a function of word concreteness. Consistent with previous studies (Kousta et al., 2011; Sheikh and Titone, 2013; Yao et al., 2016), the results of Experiment 2 suggested that affective experience can facilitate the processing of positive words in the LA group, reflected by faster responses to positive abstract words than to positive concrete words. This interpretation is supported by Vigliocco et al. (2009), in which positive abstract words, because of the richer affective experience information they provide, are able to offset the deficiency in visual image information, thus providing a processing advantage after controlling other lexical variables. However, a processing advantage of positive abstract words over positive concrete words was not observed in the HA group. One possible reason for this is that HA individuals exhibit decreases in the ability to experience positive emotion (Luminet et al., 1999; Friedlander et al., 1997; van der Velde et al., 2013) and tend to avoid positive affective experience information from their internal world (Kashdan et al., 2015; Nook et al., 2015). Therefore, HA individuals are unable to effectively utilize the facilitative role of affective experience information in the processing of positive abstract words. With regard to response times to negative concrete words and negative abstract words, the HA group and LA group presented opposite results. Faster responses to negative concrete words than to negative abstract words were observed in the LA group, which may be explained by the automatic vigilance model (Pratto and John, 1991). Negative concrete words elicit explicit visual imagery that activates a threatdriven mechanism that in turn allows the organism to respond quickly and effectively to environmental threats. Conversely, the faster responses to negative abstract words than to negative concrete words were observed in the HA group. This may indicate that alexithymia does not block all affective experiential information, and alexithymic individuals can utilize negative affective information to facilitate negative word processing.
block contained equal numbers of words (10 PC words, 10 PA words, 10 NC words, and 10 NA words) and pseudowords with no more than three trials of the same condition presented consecutively. Trials were presented in a different order for each participant to avoid potential carryover effects from one trial to the other (Schmidt and Saari, 2007). The experimental task and procedure were the same as that of Experiment 1. 3.2. Results A MANOVA was conducted, with level of alexithymia (HA group vs. LA group) as the between-subjects factor and concreteness (concrete vs. abstract) and valence (positive vs. negative) as the within-subjects factors. The results revealed a significant main effect of level of alexithymia, F (1, 68) = 4.30, p = .04, ηP2 = 0.06, indicating that response times were longer in the HA group (640.7 ± 7.1 ms) than in the LA group (620.0 ± 7.3 ms). A main effect of valence was observed, F (1,68) = 405.65, p < .001, ηP2 = 0.86, in which response times to negative words (654.9 ± 6.2 ms) were slower than to positive words (605.9 ± 5.8 ms). A two-way concreteness × valence interaction [F (1,68) = 3.85, p = .05, ηP2 = 0.06] and a three-way level of alexithymia × concreteness × valence interaction [F (1,68) = 34.77, p < .001, ηP2 = 0.34] were found. To further evaluate the impact of this three-way interaction on our hypothesis, we conducted separate ANOVAs by considering the effects of concreteness and level of alexithymia on positive words and negative words separately. For positive words, response times to positive abstract words in the HA group were significantly longer than in the LA group [F (1, 68) = 9.53, p = .03], whereas no significant difference in response times to positive concrete words was found between groups [F (1, 68) = 1.38, p = .24]. For negative words, response times to negative concrete words in the HA group were significantly longer than in the LA group [F (1, 68) = 10.14, p = .002]. Response times to negative abstract words were not different between groups [F (1, 68) = 1.19, p = .73]. The response times for each condition are shown in Fig. 2. Post hoc tests with Bonferroni correction for pair-wise comparisons indicated that faster response times to negative abstract words than to negative concrete words in the HA group (t34 = 2.12, p = .04), with no differences in response times between positive concrete words and positive abstract words (t34 = 0.85, p = .40)(Fig. 3). In the LA group, faster response times to positive abstract words than positive concrete words (t34 = 3.29, p = 002) were found, with faster response times to negative concrete words than to negative abstract words (t34 = −3.03, p = .005) (Fig. 3).
4. General discussion The present study employed a lexical decision task to investigate alexithymic deficits in emotional (neutral, positive and negative) word processing that emerge from an embodied view of language (Kousta et al., 2011; Vigliocco et al., 2009; Barsalou et al., 2008). Consistent with previous findings (Luminet et al., 2006; Goerlich et al., 2011), slower responses to neutral words and valenced (i.e. positive and negative) words were found in the HA group compared with the LA group. We also found that valenced word processing in the HA group was modulated by a joint effect of valence and experience information as a function of word concreteness, with selective deficits in the processing of neutral concrete words, negative concrete words, and positive abstract words compared with the LA group. These findings shed new light on emotional word processing in alexithymia and suggest that alexithymic deficits in the processing of emotional words are associated with experience information as a function of the meaning of words. Specifically, alexithymic deficits in emotional word processing should not be considered as being simply related to general or specific valence but rather related to experience information that is denoted by the meanings of words.
3.3. Discussion In Experiment 2, we examined whether the processing of valenced words in alexithymic individuals is modulated by a joint effect of valence and word concreteness in a lexical decision task. The results suggested that HA individuals exhibited slower responses to positive abstract words and negative concrete words compared with LA individuals, whereas no differences in response times to positive concrete words and negative abstract words were found between groups. These findings indicated a selective deficiency in valenced word processing in 255
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Fig 2. Response times of four types of words for two groups during the lexical decision task. Note. Error bars denote standard errors (SE). *p < .05. **p < .005. HA group = high alexithymic group; LA group = high alexithymic group.
Faster responses to positive abstract words than to positive concrete words were found in the LA group. This is consistent with previous findings that suggested richer affective experiential information that is conferred by positive abstract words can capture more attention and thus facilitate positive abstract word processing in a lexical decision task (Kousta et al., 2011; Yao et al., 2016; Ferré and Sánchez-casas, 2014; Yao and Wang, 2013, 2014; Palazova et al., 2013; Newcombe et al., 2012). For example, Yao and Wang (2013, 2014) used a lexical decision priming task and found that positive abstract words facilitated activation from primes to targets in the semantic network because of more affective associations between positive abstract prime-target word pairs, thus leading to an obvious affective priming effect. According to Vigliocco et al. (2009), with the aid of more affective experience, positive abstract words are able to offset the deficiency in visual image information, resulting in a processing advantage of positive abstract words. In contrast, a processing advantage of positive abstract words was not observed in the HA group, indicating a reduction of the availability and acquisition of affective experiential information that is conferred by positive abstract words in alexithymia. A previous study showed that HA individuals experience positive emotional situations with less pleasure (Friedlander et al., 1997) and present a lower capacity to experience pleasure (Luminet et al., 1999, 2006; van der Velde et al., 2013). van der Velde et al. (2013) conducted a meta-analysis of 15 neuroimaging studies of emotion processing in alexithymia and found that positive stimuli elicited lower activation in the right insula and precuneus, suggesting a reduction of emotional awareness in alexithymia with regard to positive affect. Consequently, the facilitative effect of affective experience on the processing of positive words was absent in the HA group. Our results also showed that the influence of experience information on negative word processing in the LA group was different from the HA group. Individuals in the LA group responded to negative concrete words faster than to negative abstract words, which is consistent with previous studies that examined the relationship between valence and experience information in word processing in a lexical decision task (e.g., Yao et al., 2016; Kousta et al., 2011; Palazova et al., 2013). A possible reason for this result is that negative concrete words elicit an explicit visual image that activates a threat-driven mechanism, which allows the individual to respond quickly and effectively to environmental threats. According to the automatic vigilance model (Pratto and
Previous studies suggested no functional effect of experience information on neutral word processing (Kousta et al., 2011). Therefore, in the present study, we first examined the ways in which neutral concrete words and neutral abstract words are processed according to different levels of alexithymia (HA and LA) in Experiment 1. Faster responses to neutral concrete words than to neutral abstract words were observed in the LA group, which is consistent with previous findings of an advantage of neutral concrete words (e.g., Wang and Yao, 2012; Yao et al., 2013; Kousta et al., 2011). According to the dual coding theory (Paivio, 1986), neutral concrete words are represented in both verbal and mental imagery systems, whereas neutral abstract words are mainly represented in the verbal system. The availability of two representational systems for neutral concrete words thus facilitates word processing and induces faster responses. However, no significant difference in response times was found between neutral concrete words and neutral abstract words in the HA group, indicating that the contribution of visual imagery information to the processing of neutral concrete words was absent in HA individuals. One possible explanation for this result is that HA individuals have a lower ability to engage in fantasy and other imaginary activities (Taylor and Bagby, 2004; Vermeulen et al., 2006). Thus, they are unable to efficiently utilize visual imagery information to facilitate the processing of neutral concrete words. Moreover, no significant facilitative effect of sensorimotor information on the processing of neutral concrete words was found in the HA group, suggesting that although alexithymia tends to amplify sensorimotor, tactile, nociceptive, and acoustic stimulus information (Sheikh and Titone, 2013), alexithymic individuals may be unable to amplify or effectively utilize sensorimotor symbolic stimulus information, such as neutral words. Based on the facilitative effect of affective experiential information on emotionally valenced (i.e., positive and negative) words (Kousta et al., 2011), Experiment 2 examined whether the processing of valenced words in alexithymia is modulated by a joint effect of emotional valence and experience information. The results indicated a significant interactive effect of valence, experience information, and level of alexithymia. An advantage of positive abstract words over positive concrete words and an advantage of negative concrete words over negative abstract words with regard to response times were observed in the LA group. In the HA group, an advantage of negative abstract words over negative concrete words was found, with no difference between positive abstract words and positive concrete words. 256
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Fig 3. Group differences in response times between positive concrete and positive abstract words (Fig.3a), and group differences in response times between negative words concrete and negative abstract words (Fig.3b). Error bars denote standard errors (SE). Note. Error bars denote standard errors (SE). *p < .05. **p ≤ 0.005. HA group = high alexithymic group; LA group = high alexithymic group.
experience to facilitate the processing of negative words. Previous studies showed that HA individuals are able to easily perceive negative emotional situations (Lumiet et al.,1999) and they even appear to perceive negative emotions better than LA individuals (Franz et al., 2004).
John, 1991), negative objects or events capture an organism's attention to a greater extent than positive and neutral objects or events, thus eliciting a powerful physiological, behavioral, and emotional response. This may be an evolutionary adaptation that allows the organism to respond quickly and effectively to environmental threats, thus highlighting the overriding significance of negative stimuli for survival. Negative concrete words may be similar to biologically relevant threats in LA individuals. However, such an effect of negative concrete words was not observed in the HA group, in contrast to the advantage of negative abstract words. This suggests that HA individuals do not utilize an avoidance strategy to cope with threatening visual stimuli and rather present a greater tendency to experience negative emotion. Alexithymia may not prevent the processing of all affective experience information, but alexithymic individuals may effectively utilize negative affective
5. Limitations and conclusions One potential limitation of the present study is that all of the participants were chosen from a nonclinical sample of young adults, which may limit our ability to generalize the findings. Although alexithymia is viewed as a continuous personality trait in both clinical and nonclinical populations, with people differing in their ability to perceive and recognize emotional stimuli, the degree of alexithymic deficits can differ 257
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in different populations (Donges and Suslow, 2017; Pollatos and Gramann, 2011). Therefore, future studies should select a representative clinical sample of alexithymic individuals to investigate the relationship between alexithymic deficits in emotional word processing and experience information that is denoted by words. Another limitation is that the present results indicate that selective deficits in emotional word processing in alexithymia are associated with the word's experience information only at the behavioral level. Therefore, future studies should utilize more direct measurement methods, such as functional magnetic resonance imaging and event-related potentials, to verify the present findings and shed more light on associated brain networks that underlie the relationship between alexithymia and emotional word processing. In conclusion, the present results extend previous findings that suggest that alexithymic individuals utilize an avoidance strategy to cope with emotion stimuli through their avoidance of affective experience from their own internal world (Kashdan et al., 2015; Nook et al., 2015). Nonetheless, not all emotional stimuli are avoided by alexithymic individuals. Specifically, they exhibit the selective avoidance of positive words with more affective experience from their own internal world but not negative words with more affective experience.
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CRediT authorship contribution statement Yao Zhao: Conceptualization, Resources, Writing - original draft, Writing - review & editing. Xuan Yang: Software, Data curation. Zhu Xiangru: Writing - original draft, Writing - review & editing. Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acknowledgment This research was supported by grants from the National Natural Science Foundation of China (grant# 31600885) and the Fundamental Research Funds for the Central Universities (20101196146, 20106186449, 20101194941) to Zhao Yao and Yang Xuan (20101186246). This research was also supported by grants from the Higher Education Reform Project of Xidian universityto Zhao Yao (20901190006) and Yang Xuan (20901190029). Supplementary materials Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.jad.2019.08.068. References Bagby, R.M., Parker, J.D.A., Taylor, G.J., 2004. The twenty-item Toronto Alexithymia Scale-I. J. Psychosom. Res. 38, 33–40. Barsalou, L.W., 2008. Grounded cognition. Annu. Rev. Psychol. 59, 617–645. Barber, H., Otten, L., Kousta, S., Vigliocco, G., 2013. Concreteness in word processing: ERP and behavioral effects in a lexical decision task. Brain Lang. 125 (1), 47–53. Beck, A.T., Steer, R.A., Brown, G.K., 1996. Beck depression inventory-II. San Antonio 78 (2), 490–498. Brandt, L., Pintzinger, N.M., Tran, U.S., 2011. Abnormalities in automatic processing of illnessrelated stimuli in self-rated alexithymia. PloS one 10 (6), e0129905. Donges, U.S., Kersting, A., Suslow, T., 2014. Alexithymia and perception of emotional information: a review of experimental psychological findings. Univ. Psychol. 13 (2), 745–756. Donges, U.S., Suslow, T., 2017. Alexithymia and automatic processing of emotional stimuli: a systematic review. Rev. Neurosci. 28 (3), 247–264. Ferré, P., Sánchez-casas, R., 2014. Affective priming in a lexical decision task: is there an effect of words' concreteness? Psicológica 35, 117–138. Franz, M., Schaefer, R., Schneider, C., Sitte, W., Bachor, J., 2004. Visual event-related potentials in subjects with alexithymia: modified processing of emotional aversive information? Am.
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