Towards a classification of alexithymia: primary, secondary and organic

Verso una classificazione dell’alessitimia in primaria, secondaria e organica

A. Messina, J.N. Beadle, S. Paradiso

1 General Medicine Trainers, Health Department of Sicily, Catania, Italy; 2 University of Iowa, Iowa CIty, USA; 3 Universidad “Diego Portales”, Santiago, Chile and 4 University of Hawaii at Manoa, Honolulu, USA



Emotion processing is essential for well-being and psychosocial adaptation. Alexithymia is widely viewed as an impairment in emotion processing that includes difficulty identifying and describing emotions. While there is a significant understanding of primary alexithymia, which is thought to be the result of developmental genetic and familial factors, secondary and organic alexithymia are beginning to be focus of research.

Method and results

The present review of the literature suggests the importance of differentiating between primary and secondary alexithymia, and the organic subtype of secondary alexithymia. Secondary alexithymia is thought to be a consequence of psychological stress, chronic disease, or organic processes (e.g. brain trauma or stroke) that occur after childhood (whereas primary alexithymia is a developmental phenomenon). Organic insults to the brain may bring about the organic form of alexithymia by altering cerebral structures involved in emotional processing (e.g. anterior cingulate cortex, frontostriatal networks, callosum corpus, right hemisphere cortex and amygdala). The usefulness of differentiating among alexithymia categories and their relationships with brain structures known to subserve emotional processing is discussed.


We propose that differentiating between primary, secondary and organic alexithymia may potentially serve to develop better treatments for alexithymia.

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