HPA system activity in alexithymia: a cortisol awakening response study

Abstract

Objectives: Alexithymia is a personality trait characterized by difficulties in identifying, describing and communicating one's own emotions. It is also associated with several stress-related psychiatric disorders. The aim of the study was to examine the cortisol awakening response (CAR) as a measure of HPA-system function in a community based sample of psychologically and physically healthy adults with alexithymia.

Methods: Fourty-one high alexithymic individuals and thirty-seven low alexithymic subjects, well-controlled regarding gender, age and sociodemographic status, provided three saliva cortisol samples each day for three consecutive days for the calculation of mean CAR. Participants filled out questionnaires on alexithymia (TAS-20, BVAQ) and interpersonal reactivity (IRI) prior to cortisol assessment.

Results: The mean CAR of three sampling days was significantly lower in the alexithymic group in comparison to control participants. Additionally there was a negative correlation between CAR and perceived stress, which points to lower CAR in alexithymia accompanied by higher perceived stress in socio-emotional situations. CAR was negatively correlated with age in the alexithymic group, indicating to alterations in HPA system over longer time to stress exposure.

Conclusion: Alexithymic individuals have a lower CAR. Hence the results of the present study indicate that certain aspects of personality modulate HPA-system functioning.

Keywords: Alexithymia; Cortisol; Cortisol awakening response; HPA; Personality; Stress.