{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T18:28:14Z","timestamp":1774031294131,"version":"3.50.1"},"reference-count":89,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:00:00Z","timestamp":1773964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Alexithymia, a difficulty in processing and expressing emotions, is associated with socio-emotional challenges and altered autonomic responses. This raises the question of whether cognitive (CA) and affective (AA) alexithymia can be differentiated based on parasympathetic and sympathetic indices. This study explores the reactivity of CA and AA individuals to social and non-social emotional stimuli. Participants, categorized as non-alexithymic (NA), CA, or AA based on the Toronto Alexithymia Scale and Bermond-Vorst Alexithymia Questionnaire, completed assessments on empathy, social phobia, depression, and anxiety. They viewed images from the International Affective Picture System (IAPS), varying in emotional (unpleasant, neutral, and pleasant) and social (with humans, without humans) content, and evaluated them at the end of the experiment. Heart rate variability (HRV) and facial infrared thermal imaging (fITI) were recorded during image presentation. Psychometric analysis revealed higher social phobia avoidance and depression scores in CA compared to AA, and higher trait anxiety in CA compared to both AA and NA. CA and NA participants scored higher on empathic personal distress than AA. At the autonomic level, NA participants exhibited increased HF-HRV and decreased LF-HRV in response to emotional social stimuli, whereas CA and AA groups displayed no HRV modulation. Thermal responses revealed decreased nose temperature for non-social stimuli in CA, while AA showed the opposite pattern. HRV and fITI measures highlight distinct autonomic reactivity to socio-emotional stimulation and thus effectively differentiate cognitive and affective alexithymia. These physiological findings reinforce the psychometric distinction between CA and AA, suggesting tailored interventions for alexithymic disorders.<\/jats:p>","DOI":"10.1371\/journal.pone.0341921","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T17:38:17Z","timestamp":1774028297000},"page":"e0341921","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differentiated impact of social and non-social content in Alexithymia: A facial thermal infrared imaging study"],"prefix":"10.1371","volume":"21","author":[{"given":"Lucas","family":"De Zorzi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9570-0920","authenticated-orcid":true,"given":"Eduardo S.","family":"Mart\u00ednez-Vel\u00e1zquez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacques","family":"Honor\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrique","family":"Sequeira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,3,20]]},"reference":[{"key":"pone.0341921.ref001","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.neuropsychologia.2013.12.006","article-title":"Distinct associations of insula and cingulate volume with the cognitive and affective dimensions of alexithymia","volume":"53","author":"KS Goerlich-Dobre","year":"2014","journal-title":"Neuropsychologia"},{"issue":"2","key":"pone.0341921.ref002","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1159\/000286529","article-title":"The prevalence of \u201calexithymic\u201d characteristics in psychosomatic patients","volume":"22","author":"PE Sifneos","year":"1973","journal-title":"Psychother Psychosom"},{"issue":"8","key":"pone.0341921.ref003","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1016\/j.neubiorev.2013.07.008","article-title":"Neural correlates of alexithymia: a meta-analysis of emotion processing studies","volume":"37","author":"J van der Velde","year":"2013","journal-title":"Neurosci Biobehav Rev"},{"issue":"8","key":"pone.0341921.ref004","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.paid.2010.07.013","article-title":"Alexithymia in the interpersonal domain: A general deficit of empathy?","volume":"49","author":"D Grynberg","year":"2010","journal-title":"Personality and Individual Differences"},{"issue":"3","key":"pone.0341921.ref005","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.ijpsycho.2009.11.004","article-title":"The cognitive and affective alexithymia dimensions in the regulation of sympathetic responses","volume":"75","author":"B Bermond","year":"2010","journal-title":"Int J Psychophysiol"},{"issue":"2","key":"pone.0341921.ref006","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1006\/brcg.1997.0900","article-title":"Alexithymia: a right hemisphere dysfunction specific to recognition of certain facial expressions?","volume":"34","author":"M Jessimer","year":"1997","journal-title":"Brain Cogn"},{"issue":"3","key":"pone.0341921.ref007","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S0191-8869(00)00033-7","article-title":"Validity and reliability of the Bermond\u2013Vorst Alexithymia Questionnaire","volume":"30","author":"HCM Vorst","year":"2001","journal-title":"Personality and Individual Differences"},{"key":"pone.0341921.ref008","doi-asserted-by":"crossref","first-page":"1615612","DOI":"10.3389\/fpsyg.2025.1615612","article-title":"Exploring alexithymia with the French Perth alexithymia questionnaire: latent structure, profiles, and links with affective outcomes","volume":"16","author":"C Fantini-Hauwel","year":"2025","journal-title":"Front Psychol"},{"key":"pone.0341921.ref009","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.jad.2023.11.038","article-title":"Subscales of alexithymia show unique pathways through reappraisal and suppression to anxiety, depression and stress","volume":"347","author":"KP Morie","year":"2024","journal-title":"J Affect Disord"},{"key":"pone.0341921.ref010","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.paid.2018.05.011","article-title":"The psychometric assessment of alexithymia: Development and validation of the Perth Alexithymia Questionnaire","volume":"132","author":"D Preece","year":"2018","journal-title":"Personality and Individual Differences"},{"issue":"6","key":"pone.0341921.ref011","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1111\/jopy.12563","article-title":"What is alexithymia? 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