Objectives: The primary aim of this systematic review and meta-analysis was to estimate the strength of the relationship between alexithymia and facial expression recognition. Secondary aims were to determine if the strength of the relationship was moderated the type of stimuli (e.g., dynamic, static) used in the study, and whether studies excluded participants with mental health disorders.
Methods: Web of Science, PsycINFO, MEDLINE, and Scopus database searches were conducted on 21 st June 2024. Studies were included if they comprised participants aged between 16 and 65 years, included a validated measure of alexithymia, a forced choice facial expression recognition labelling task, and reported the relationship between these variables. Risk of bias was assessed using the AXIS tool.
Results: Twenty-four studies were included in a random effects meta-analysis revealing a significant, medium, negative relationship between alexithymia and overall facial expression recognition ability, r = -0.24, CI [-0.29, -0.18]. Small, negative relationships were observed for recognition of anger, disgust, fear, happiness, and sadness. The type of stimuli moderated the strength of the relationship, with significant negative relationships between alexithymia and recognition of static facial expressions observed, but no significant relationship observed for dynamic stimuli. Exclusion of participants with mental health disorders did not moderate the strength of the relationship.
Conclusions: Results indicate alexithymia is associated with a global deficit labelling static facial expressions, that does not appear to be attributable to comorbid mental health disorders. Further research is needed to clarify the relationship between alexithymia and recognition of dynamic facial expressions.
Keywords: Alexithymia; Emotion recognition; Facial expression; Mental health; Meta-analysis.
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