ArticlesAffect Regulation in Alexithymia An Ethological Study of Displacement Behavior during Psychiatric InterviewsTROISI, ALFONSO M.D.1; BELSANTI, SERGIO M.D.1; BUCCI, ANNA ROSARIA M.D.1; MOSCO, CRISTINA M.D.2; SINTI, FABIOLA M.D.1; VERUCCI, MONICA M.D.1Author Information 1 Department of Psychiatry, University of Rome Tor Vergata, via Guattani 14, 00161 Rome, Italy. Send reprint requests to Dr. Troisi. 2 Department of Genetics, University of Rome La Sapienza, Italy. The Journal of Nervous & Mental Disease: January 2000 - Volume 188 - Issue 1 - p 13-18 Buy Abstract Displacement activities (i.e., self-directed behaviors such as self-touching, scratching, and self-grooming) are a reliable ethological indicator of increased emotional and physiological arousal throughout the phylogenetic scale. We hypothesized that, in alexithymic individuals, the failure to regulate cognitively distressing emotions might result in increased displacement behavior. The nonverbal behavior of 30 patients with depressive or anxiety disorders was video-recorded during psychiatric interviews and analyzed using an ethological scoring system. Before being interviewed, each patient completed the Twenty-Item Toronto Alexithymia Scale (TAS-20), the Beck Depression Inventory (BDI), and the state form of the State-Trait Anxiety Index (STAI-S). Ethological data confirmed the hypothesis of the study. The patients with more pronounced alexithymic features showed a significantly higher frequency of displacement activities during interviews. At the same time, these patients reported levels of self-rated anxiety and depression equivalent to those reported by nonalexithymic patients. Such a dissociation between cognitive appraisal of emotion and nonverbal behavior reflecting increased emotional arousal supports the view that alexithymia implies a failure to elevate emotions from a preconceptual level of organization to the conceptual level of mental representations. © 2000 Lippincott Williams & Wilkins, Inc.