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Both alcohol misuse and the externally oriented thinking (EOT) facet of alexithmia are associated with deficits in facial emotion recognition and emotional empathy. The aim of the present study was to investigate whether EOT mediates the association of drinking with these deficits, and to test the hypothesis that impaired facial emotion recognition mediates the relationship between EOT and low emotional empathy, in a nonclinical sample. The sample consisted of 161 men and women who completed an online survey that included the Alcohol Use Disorders Identification Test (AUDIT), Depression Anxiety Stress Scales, Interpersonal Reactivity Index (IRI), Reading the Mind in the Eyes Test (RMET), and Toronto Alexithymia Scale (TAS-20). In addition to replicating associations between TAS-20 and other measures, EOT was found to mediate relationships between potential alcohol misuse (as indexed by AUDIT) and facial emotion recognition (as indexed by RMET) as well as emotional empathy (as indexed by the corresponding subscale of the IRI) after controlling for mood and demographic variables. The negative relationship between EOT and emotional empathy was mediated by impaired facial emotion recognition. Present findings point to a likely role of the EOT trait in the reported associations of alcohol misuse with both poor emotion recognition and low emotional empathy, and a mediating role of poor emotion recognition in the relationship of EOT to the latter.

Alexithymia in Relation to Alcohol Use, Emotion Recognition, and Empathy: The Role of Externally Oriented Thinking