A two-year study by Johns Hopkins Medicine involving 1,453 adults with chronic pain has found that individuals with alexithymia—a difficulty identifying and expressing emotions—experienced greater disruption to daily life from pain over time.
The effect was mediated by increased psychological distress.
Published March 26 in the American Psychological Association journal, the study is among the first to examine how alexithymia affects pain outcomes longitudinally. Participants were assessed at baseline, one year, and two years using validated scales.
Key Findings
- Higher alexithymia at baseline predicted greater psychological distress (anxiety and depression) at one year.
- Increased distress at one year predicted greater pain interference (impact on daily functioning) at two years.
- Alexithymia did not significantly predict pain severity. Pain interference did not predict later alexithymia, suggesting that emotional processing difficulties are a risk factor rather than a consequence.
Background
Chronic pain affects 24.3% of U.S. adults, with 8.3% experiencing pain severe enough to limit daily activity. Alexithymia, a subclinical trait, has been linked to worse pain outcomes, but the causal direction was previously unclear.
Implications
Senior author Rachel Aaron, Ph.D., noted that the results support targeting psychological distress in chronic pain treatment, especially for patients with alexithymia.
The study was funded by multiple NIH grants and a Johns Hopkins Clinician Scientist Award. The authors report no conflicts of interest.