Journal of Autism and Developmental Disorders

, Volume 46, Issue 4, pp 1354–1367 | Cite as

Alexithymia in Adolescents with Autism Spectrum Disorder: Its Relationship to Internalising Difficulties, Sensory Modulation and Social Cognition

  • Bosiljka MilosavljevicEmail author
  • Virginia Carter Leno
  • Emily Simonoff
  • Gillian Baird
  • Andrew Pickles
  • Catherine R. G. Jones
  • Catherine Erskine
  • Tony Charman
  • Francesca Happé
Original Paper


Alexithymia is a personality trait frequently found in adults with autism spectrum disorder (ASD), and has been linked to impairments in emotion recognition and empathy. The presentation of alexithymia within ASD at younger ages remains unexplored, and was examined in the present study. Alexithymia rates were significantly elevated in ASD (55 %; 31/56 scoring above cut-off) versus non-ASD adolescents (16 %; 5/32 scoring above cut-off). Within individuals with ASD, alexithymia was associated with increased self-reported anxiety, parent-reported emotional difficulties, self-reported sensory processing atypicalities, and poorer emotion recognition, but was not associated with theory of mind ability. Overall, our results suggest that alexithymia is highly prevalent, and has selective cognitive correlates in young people with ASD.


Alexithymia Autism spectrum disorder Emotion recognition Theory of mind Anxiety Sensory processing 



We would like to thank the participants and their parents for taking the time to contribute to this study. The study was supported by the Medical Research Council. Furthermore, the authors acknowledge financial backing from the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre and Dementia Unit awarded to South London and Maudsley NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust. This paper presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the MRC, the NIHR or the Department of Health.


This study was funded by the Medical Research Council (Grant Number: G0400065).

Author Contributions

TC, FH, GB, ES and AP obtained funding for the study. FH, TC, ES, GB, AP and CRGJ all participated in the conceptualisation and design of the study. CRGJ was additionally responsible for data acquisition. BM and VCL were responsible data analysis and interpretation and drafted the manuscript. CE participated in data analysis and interpretation. All authors read, approved and provided feedback on the final manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the South East Multicentre Research Ethics Committee (REC) (05/MRE01/67).

Informed Consent

Written consent was obtained from all parents and informed consent from all participants.


  1. Abell, F., Happé, F., & Frith, U. (2000). Do triangles play tricks? Attribution of mental states to animated shapes in normal and abnormal development. Cognitive Development, 15, 1–16. doi: 10.1016/S0885-2014(00)00014-9.CrossRefGoogle Scholar
  2. American Psychological Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
  3. Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994a). The twenty-item Toronto Alexithymia scale—I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32. doi: 10.1016/0022-3999(94)90005-1.CrossRefPubMedGoogle Scholar
  4. Bagby, R. M., Taylor, G. J., & Parker, J. D. A. (1994b). The twenty-item Toronto Alexithymia scale—II. Convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38, 33–40. doi: 10.1016/0022-3999(94)90006-X.CrossRefPubMedGoogle Scholar
  5. Baird, G., Simonoff, E., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., et al. (2006). Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: The Special Needs and Autism Project (SNAP). Lancet, 368, 210–215. doi: 10.1016/s0140-6736(06)69041-7.CrossRefPubMedGoogle Scholar
  6. Bankier, B., Aigner, M., & Bach, M. (2001). Alexithymia in DSM-IV disorder: Comparative evaluation of somatoform disorder, panic disorder, obsessive-compulsive disorder, and depression. Psychosomatics, 42, 235–240. doi: 10.1176/appi.psy.42.3.235.CrossRefPubMedGoogle Scholar
  7. Baranek, G. T., David, F. J., Poe, M. D., Stone, W. L., & Watson, L. R. (2006). Sensory Experiences Questionnaire: Discriminating sensory features in young children with autism, developmental delays, and typical development. Journal of Child Psychology and Psychiatry and Allied Disciplines, 47, 591–601. doi: 10.1111/j.1469-7610.2005.01546.x.CrossRefGoogle Scholar
  8. Baron-Cohen, S. (1989). The autistic child’s theory of mind: A case of specific developmental delay. Journal of Child Psychology and Psychiatry and Allied Disciplines, 30, 285–297.CrossRefGoogle Scholar
  9. Berthoz, S., Artiges, E., Poline, J. E., Rouquette, S., Consoli, S. M., & Martinot, J. L. (2002). Effect of impaired recognition and expression of emotions on frontocingulate cortices: An fMRI study of men with alexithymia. The American Journal of Psychiatry, 159, 961–967.CrossRefPubMedGoogle Scholar
  10. Berthoz, S., Consoli, S., Perez-Diaz, F., & Jouvent, R. (1999). Alexithymia and anxiety: Compounded relationships? A psychometric study. European Psychiatry, 14, 372–378.CrossRefPubMedGoogle Scholar
  11. Berthoz, S., & Hill, E. L. (2005). The validity of using self-reports to assess emotion regulation abilities in adults with autism spectrum disorder. European Psychiatry: The Journal of the Association of European Psychiatrists, 20, 291–298. doi: 10.1016/j.eurpsy.2004.06.013.CrossRefGoogle Scholar
  12. Berthoz, S., Lalanne, C., Crane, L., & Hill, E. L. (2013). Investigating emotional impairments in adults with autism spectrum disorders and the broader autism phenotype. Psychiatry Research, 208, 257–264. doi: 10.1016/j.psychres.2013.05.014.CrossRefPubMedGoogle Scholar
  13. Bird, G., & Cook, R. (2013). Mixed emotions: The contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry, 3, e285. doi: 10.1038/tp.2013.61.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Bird, G., Silani, G., Brindley, R., White, S., Frith, U., & Singer, T. (2010). Empathic brain responses in insula are modulated by levels of alexithymia but not autism. Brain, 133, 1515–1525. doi: 10.1093/brain/awq060.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Bird, G., & Viding, E. (2014). The self to other model of empathy: Providing a new framework for understanding empathy impairments in psychopathy, autism, and alexithymia. Neuroscience and Biobehavioral Reviews, 47, 520–532. doi: 10.1016/j.neubiorev.2014.09.021.CrossRefPubMedGoogle Scholar
  16. Birleson, P. (1981). The validity of depressive disorder in childhood and the development of a self-rating scale: A research report. Journal of Child Psychology and Psychiatry and Allied Disciplines, 22, 73–88.CrossRefGoogle Scholar
  17. Birleson, P., Hudson, I., Buchanan, D. G., & Wolff, S. (1987). Clinical evaluation of a self-rating scale for depressive disorder in childhood (Depression Self-Rating Scale). Journal of Child Psychology and Psychiatry and Allied Disciplines, 28, 43–60.CrossRefGoogle Scholar
  18. Bowler, D. M. (1992). “Theory of mind” in Asperger’s syndrome. Journal of Child Psychology and Psychiatry and Allied Disciplines, 33, 877–893.CrossRefGoogle Scholar
  19. Brown, C., Tollefson, N., Dunn, W., Cromwell, R., & Filion, D. (2001). The adult sensory profile: Measuring patterns of sensory processing. The American Journal of Occupational Therapy, 55, 75–82.CrossRefPubMedGoogle Scholar
  20. Charman, T., Jones, C. R., Pickles, A., Simonoff, E., Baird, G., & Happe, F. (2011). Defining the cognitive phenotype of autism. Brain Research, 1380, 10–21. doi: 10.1016/j.brainres.2010.10.075.CrossRefPubMedGoogle Scholar
  21. Cohen, J. (1973). Eta-squared and partial eta-squared in fixed factor ANOVA designs. Educational and Psychological Measurement, 33, 107–112. doi: 10.1177/001316447303300111.CrossRefGoogle Scholar
  22. Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33, 427–433.CrossRefPubMedGoogle Scholar
  23. Cook, R., Brewer, R., Shah, P., & Bird, G. (2013). Alexithymia, not autism, predicts poor recognition of emotional facial expressions. Psychological Science, 24, 723–732. doi: 10.1177/0956797612463582.CrossRefPubMedGoogle Scholar
  24. Cox, B. J., Swinson, R. P., Shulman, I. D., & Bourdeau, D. (1995). Alexithymia in panic disorder and social phobia. Comprehensive Psychiatry, 36, 195–198. doi: 10.1016/0010-440X(95)90081-6.CrossRefPubMedGoogle Scholar
  25. Crane, L., Goddard, L., & Pring, L. (2009). Sensory processing in adults with autism spectrum disorders. Autism, 13, 215–228. doi: 10.1177/1362361309103794.CrossRefPubMedGoogle Scholar
  26. De la Marche, W., Steyaert, J., & Noens, I. (2012). Atypical sensory processing in adolescents with an autism spectrum disorder and their non-affected siblings. Research in Autism Spectrum Disorders, 6, 639–645. doi: 10.1016/j.rasd.2011.09.014.CrossRefGoogle Scholar
  27. de Waal, F. B. (2008). Putting the altruism back into altruism: The evolution of empathy. Annual Review of Psychology, 59, 279–300. doi: 10.1146/annurev.psych.59.103006.093625.CrossRefPubMedGoogle Scholar
  28. Dunn, W. (1997). The impact of sensory processing abilities on the daily lives of young children and their families: A conceptual model. Infants and Young Children, 9, 23–35.CrossRefGoogle Scholar
  29. Dunn, W. (2001). The sensations of everyday life: Empirical, theoretical, and pragmatic considerations. The American Journal of Occupational Therapy, 55, 608–620.CrossRefPubMedGoogle Scholar
  30. Dunn, W., Myles, B. S., & Orr, S. (2002). Sensory processing issues associated with Asperger syndrome: A preliminary investigation. The American Journal of Occupational Therapy, 56, 97–102.CrossRefPubMedGoogle Scholar
  31. Eastwood, J. D., Cavaliere, C., Fahlman, S. A., & Eastwood, A. E. (2007). A desire for desires: Boredom and its relation to alexithymia. Personality and Individual Differences, 42, 1035–1045. doi: 10.1016/j.paid.2006.08.027.CrossRefGoogle Scholar
  32. Eastwood, J. D., Frischen, A., Fenske, M. J., & Smilek, D. (2012). The unengaged mind: Defining boredom in terms of attention. Perspectives on Psychological Science, 7, 482–495. doi: 10.1177/1745691612456044.CrossRefPubMedGoogle Scholar
  33. Ekman, P., & Friesen, W. V. (1976). Pictures of facial affect. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  34. Ernst, J., Boker, H., Hattenschwiler, J., Schupbach, D., Northoff, G., Seifritz, E., et al. (2014). The association of interoceptive awareness and alexithymia with neurotransmitter concentrations in insula and anterior cingulate. Social, Cognitive and Affective Neuroscience, 9, 857–863. doi: 10.1093/scan/nst058.CrossRefGoogle Scholar
  35. Friedlander, L., Lumley, M. A., Farchione, T., & Doyal, G. (1997). Testing the alexithymia hypothesis: Physiological and subjective responses during relaxation and stress. The Journal of Nervous and Mental Disease, 185, 233–239.CrossRefPubMedGoogle Scholar
  36. Goodman, R., Ford, T., Simmons, H., Gatward, R., & Meltzer, H. (2000). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. The British Journal of Psychiatry, 177, 534–539.CrossRefPubMedGoogle Scholar
  37. Grynberg, D., & Pollatos, O. (2015). Alexithymia modulates the experience of the rubber hand illusion. Frontiers in Human Neuroscience, 9, 357. doi: 10.3389/fnhum.2015.00357.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Happé, F. (1994). An advanced test of theory of mind: Understanding of story characters’ thoughts and feelings by able autistic, mentally handicapped, and normal children and adults. Journal of Autism and Developmental Disorders, 24, 129–154. doi: 10.1007/BF02172093.CrossRefPubMedGoogle Scholar
  39. Heaton, P., Reichenbacher, L., Sauter, D., Allen, R., Scott, S., & Hill, E. (2012). Measuring the effects of alexithymia on perception of emotional vocalizations in autistic spectrum disorder and typical development. Psychological Medicine, 42, 2453–2459. doi: 10.1017/S0033291712000621.CrossRefPubMedGoogle Scholar
  40. Herbert, B. M., Herbert, C., & Pollatos, O. (2011). On the relationship between interoceptive awareness and alexithymia: Is interoceptive awareness related to emotional awareness? Journal of Personality, 79, 1149–1175. doi: 10.1111/j.1467-6494.2011.00717.x.CrossRefPubMedGoogle Scholar
  41. Hill, E., Berthoz, S., & Frith, U. (2004). Brief report: Cognitive processing of own emotions in individuals with autistic spectrum disorder and in their relatives. Journal of Autism and Developmental Disorders, 34, 229–235.CrossRefPubMedGoogle Scholar
  42. Hirstein, W., Iversen, P., & Ramachandran, V. S. (2001). Autonomic responses of autistic children to people and objects. Proceedings Biological Sciences/The Royal Society, 268, 1883–1888. doi: 10.1098/rspb.2001.1724.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Hollocks, M. J., Jones, C. R., Pickles, A., Baird, G., Happé, F., Charman, T., et al. (2014). The association between social cognition and executive functioning and symptoms of anxiety and depression in adolescents with autism spectrum disorders. Autism Research, 7, 216–228. doi: 10.1002/aur.1361.CrossRefPubMedGoogle Scholar
  44. Honkalampi, K., Hintikka, J., Tanskanen, A., Lehtonen, J., & Viinamaki, H. (2000). Depression is strongly associated with alexithymia in the general population. Journal of Psychosomatic Research, 48, 99–104.CrossRefPubMedGoogle Scholar
  45. Jones, C. R., Pickles, A., Falcaro, M., Marsden, A. J., Happé, F., Scott, S. K., et al. (2011). A multimodal approach to emotion recognition ability in autism spectrum disorders. Journal of Child Psychology and Psychiatry and Allied Disciplines, 52, 275–285. doi: 10.1111/j.1469-7610.2010.02328.x.CrossRefGoogle Scholar
  46. Kano, M., Hamaguchi, T., Itoh, M., Yanai, K., & Fukudo, S. (2007). Correlation between alexithymia and hypersensitivity to visceral stimulation in human. Pain, 132, 252–263. doi: 10.1016/j.pain.2007.01.032.CrossRefPubMedGoogle Scholar
  47. Karukivi, M., Hautala, L., Kaleva, O., Haapasalo-Pesu, K. M., Liuksila, P. R., Joukamaa, M., et al. (2010). Alexithymia is associated with anxiety among adolescents. Journal of Affective Disorders, 125, 383–387. doi: 10.1016/j.jad.2010.02.126.CrossRefPubMedGoogle Scholar
  48. Karukivi, M., Vahlberg, T., Pölönen, T., Filppu, T., & Saarijärvi, S. (2014). Does alexithymia expose to mental disorder symptoms in late adolescence? A 4-year follow-up study. General Hospital Psychiatry, 36, 748–752. doi: 10.1016/j.genhosppsych.2014.09.012.CrossRefPubMedGoogle Scholar
  49. Katz, J., Martin, A. L., Page, M. G., & Calleri, V. (2009). Alexithymia and fear of pain independently predict heat pain intensity ratings among undergraduate university students. Pain Research & Management, 14, 299–305.Google Scholar
  50. Kern, J. K., Garver, C. R., Carmody, T., Andrews, A. A., Trivedi, M. H., & Mehta, J. A. (2007). Examining sensory quadrants in autism. Research in Autism Spectrum Disorders, 1, 185–193. doi: 10.1016/j.rasd.2006.09.002.CrossRefGoogle Scholar
  51. Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4, 117–132. doi: 10.1177/1362361300004002002.CrossRefGoogle Scholar
  52. Knight, R. G., Waal-Manning, H. J., & Spears, G. F. (1983). Some norms and reliability data for the State-Trait Anxiety Inventory and the Zung Self-Rating Depression scale. The British Journal of Clinical Psychology, 22, 245–249.CrossRefPubMedGoogle Scholar
  53. Le Couteur, A., Rutter, M., Lord, C., Rios, P., Robertson, S., Holdgrafer, M., et al. (1989). Autism diagnostic interview: A standardized investigator-based instrument. Journal of Autism and Developmental Disorders, 19, 363–387.CrossRefPubMedGoogle Scholar
  54. Leekam, S. R., Nieto, C., Libby, S. J., Wing, L., & Gould, J. (2007). Describing the sensory abnormalities of children and adults with autism. Journal of Autism and Developmental Disorders, 37, 894–910. doi: 10.1007/s10803-006-0218-7.CrossRefPubMedGoogle Scholar
  55. Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., et al. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36, 849–861. doi: 10.1007/s10803-006-0123-0.CrossRefPubMedGoogle Scholar
  56. Lockwood, P. L., Bird, G., Bridge, M., & Viding, E. (2013). Dissecting empathy: High levels of psychopathic and autistic traits are characterized by difficulties in different social information processing domains. Frontiers in Human Neuroscience, 7, 760. doi: 10.3389/fnhum.2013.00760.CrossRefPubMedPubMedCentralGoogle Scholar
  57. Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223.CrossRefPubMedGoogle Scholar
  58. Lyvers, M., Duric, N., & Thorberg, F. A. (2014). Caffeine use and alexithymia in university students. Journal of Psychoactive Drugs, 46, 340–346. doi: 10.1080/02791072.2014.942043.CrossRefPubMedGoogle Scholar
  59. Marchesi, C., Brusamonti, E., & Maggini, C. (2000). Are alexithymia, depression, and anxiety distinct constructs in affective disorders? Journal of Psychosomatic Research, 49, 43–49. doi: 10.1016/S0022-3999(00)00084-2.CrossRefPubMedGoogle Scholar
  60. Marchesi, C., Fonto, S., Balista, C., Cimmino, C., & Maggini, C. (2005). Relationship between alexithymia and panic disorder: A longitudinal study to answer an open question. Psychotherapy and Psychosomatics, 74, 56–60. doi: 10.1159/000082028.CrossRefPubMedGoogle Scholar
  61. Mattila, M. L., Hurtig, T., Haapsamo, H., Jussila, K., Kuusikko-Gauffin, S., Kielinen, M., et al. (2010). Comorbid psychiatric disorders associated with Asperger syndrome/high-functioning autism: A community- and clinic-based study. Journal of Autism and Developmental Disorders, 40, 1080–1093. doi: 10.1007/s10803-010-0958-2.CrossRefPubMedGoogle Scholar
  62. Mazefsky, C. A., Kao, J., & Oswald, D. P. (2011). Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Research in Autism Spectrum Disorders, 5, 164–174. doi: 10.1016/j.rasd.2010.03.006.CrossRefPubMedPubMedCentralGoogle Scholar
  63. Miller, L. J., Anzalone, M. E., Lane, S. J., Cermak, S. A., & Osten, E. T. (2007). Concept evolution in sensory integration: A proposed nosology for diagnosis. American Journal of Occupational Therapy, 61, 135–140. doi: 10.5014/ajot.61.2.135.CrossRefPubMedGoogle Scholar
  64. Montebarocci, O., Surcinelli, P., Rossi, N., & Baldaro, B. (2011). Alexithymia, verbal ability and emotion recognition. The Psychiatric Quarterly, 82, 245–252. doi: 10.1007/s11126-010-9166-7.CrossRefPubMedGoogle Scholar
  65. Moriguchi, Y., Ohnishi, T., Lane, R. D., Maeda, M., Mori, T., Nemoto, K., et al. (2006). Impaired self-awareness and theory of mind: An fMRI study of mentalizing in alexithymia. NeuroImage, 32, 1472–1482. doi: 10.1016/j.neuroimage.2006.04.186.CrossRefPubMedGoogle Scholar
  66. Muris, P. (2007). Normal and abnormal fear and anxiety in children and adolescents. Burlington, MA: Elsevier.CrossRefGoogle Scholar
  67. Neumann, S. A., Sollers, J. J., Thayer, J. F., & Waldstein, S. R. (2004). Alexithymia predicts attenuated autonomic reactivity, but prolonged recovery to anger recall in young women. International Journal of Psychophysiology, 53, 183–195. doi: 10.1016/j.ijpsycho.2004.03.008.CrossRefPubMedGoogle Scholar
  68. Nyklicek, I., & Vingerhoets, A. J. (2000). Alexithymia is associated with low tolerance to experimental painful stimulation. Pain, 85, 471–475.CrossRefPubMedGoogle Scholar
  69. Pandey, R., & Mandal, M. K. (1997). Processing of facial expressions of emotion and alexithymia. The British Journal of Clinical Psychology, 36, 631–633.CrossRefPubMedGoogle Scholar
  70. Parker, J. D. A., Taylor, G. J., & Bagby, R. M. (2003). The 20-Item Toronto Alexithymia Scale. Journal of Psychosomatic Research, 55, 269–275. doi: 10.1016/s0022-3999(02)00578-0.CrossRefPubMedGoogle Scholar
  71. Preston, S. D., & de Waal, F. B. (2002). Empathy: Its ultimate and proximate bases. The Behavioral and Brain Sciences, 25, 1–72.PubMedGoogle Scholar
  72. Prkachin, G. C., Casey, C., & Prkachin, K. M. (2009). Alexithymia and perception of facial expressions of emotion. Personality and Individual Differences, 46, 412–417. doi: 10.1016/j.paid.2008.11.010.CrossRefGoogle Scholar
  73. Reker, M., Ohrmann, P., Rauch, A. V., Kugel, H., Bauer, J., Dannlowski, U., et al. (2010). Individual differences in alexithymia and brain response to masked emotion faces. Cortex, 46, 658–667. doi: 10.1016/j.cortex.2009.05.008.CrossRefPubMedGoogle Scholar
  74. Rutter, M., Bailey, A., & Lord, C. (2003). Social Communication Questionnaire (SCQ). Los Angeles, CA: Western Psychological Services.Google Scholar
  75. Salminen, J. K., Saarijarvi, S., Aarela, E., Toikka, T., & Kauhanen, J. (1999). Prevalence of alexithymia and its association with sociodemographic variables in the general population of Finland. Journal of Psychosomatic Research, 46, 75–82.CrossRefPubMedGoogle Scholar
  76. Shamay-Tsoory, S. G., Aharon-Peretz, J., & Perry, D. (2009). Two systems for empathy: A double dissociation between emotional and cognitive empathy in inferior frontal gyrus versus ventromedial prefrontal lesions. Brain, 132, 617–627. doi: 10.1093/brain/awn279.CrossRefPubMedGoogle Scholar
  77. Sifneos, P. E. (1973). The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22, 255–262.CrossRefPubMedGoogle Scholar
  78. Simonoff, E., Pickles, A., Charman, T., Chandler, A., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 921–929. doi: 10.1097/CHI.0b013e318179964f.CrossRefPubMedGoogle Scholar
  79. Spielberger, C. D. (1973). State-trait anxiety inventory for children: Preliminary manual. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  80. StataCorp. (2009). Statistical software: Release 11.0. College Station: Stata Corporation.Google Scholar
  81. Tager-Flusberg, H. (2010). The origins of social impairments in autism spectrum disorder: Studies of infants at risk. Neural Networks, 23, 1072–1076. doi: 10.1016/j.neunet.2010.07.008.CrossRefPubMedPubMedCentralGoogle Scholar
  82. Taylor, G. J. (2000). Recent developments in alexithymia theory and research. Canadian Journal of Psychiatry, 45, 134–142.PubMedGoogle Scholar
  83. Taylor, G. J., Bagby, R. M., & Parker, J. D. (1991). The alexithymia construct: A potential paradigm for psychosomatic medicine. Psychosomatics, 32, 153–164.CrossRefPubMedGoogle Scholar
  84. Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (1999). Disorders of affect regulation: Alexithymia in medical and psychiatric illness. Cambridge: Cambridge University Press.Google Scholar
  85. Tomchek, S. D., & Dunn, W. (2007). Sensory processing in children with and without autism: A comparative study using the short sensory profile. The American Journal of Occupational Therapy, 61, 190–200.CrossRefPubMedGoogle Scholar
  86. Tomchek, S. D., Huebner, R. A., & Dunn, W. (2014). Patterns of sensory processing in children with an autism spectrum disorder. Research in Autism Spectrum Disorders, 8, 1214–1224. doi: 10.1016/j.rasd.2014.06.006.CrossRefGoogle Scholar
  87. Uljarevic, M., & Hamilton, A. (2013). Recognition of emotions in autism: A formal meta-analysis. Journal of Autism and Developmental Disorders, 43, 1517–1526. doi: 10.1007/s10803-012-1695-5.CrossRefPubMedGoogle Scholar
  88. Wastell, C. A., & Taylor, A. J. (2002). Alexithymic mentalising: Theory of mind and social adaptation. Social Behavior and Personality, 30, 141–148. doi: 10.2224/sbp.2002.30.2.141.CrossRefGoogle Scholar
  89. Wechsler, D. (1999). The Wechsler abbreviated scale of intelligence. San Antonio, TX: The Psychological Corporation.Google Scholar
  90. White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29, 216–229. doi: 10.1016/j.cpr.2009.01.003.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Bosiljka Milosavljevic
    • 1
    Email author
  • Virginia Carter Leno
    • 2
  • Emily Simonoff
    • 2
  • Gillian Baird
    • 3
  • Andrew Pickles
    • 4
  • Catherine R. G. Jones
    • 5
  • Catherine Erskine
    • 6
  • Tony Charman
    • 1
  • Francesca Happé
    • 7
  1. 1.Department of Psychology, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  2. 2.Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  3. 3.Newcomen CentreGuy’s and St. Thomas’ NHS Foundation TrustLondonUK
  4. 4.Department of Biostatistics, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  5. 5.School of PsychologyCardiff UniversityCardiffUK
  6. 6.EcorysBirminghamUK
  7. 7.MRC SDGP Research Centre, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK

Personalised recommendations