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Alexithymia in Autism & ADHD (Quick Read)
Part of the Topic Index: Clinical Practice · Risk Assessment
A real gap between having an emotion and being able to name it, distinct from avoidance or guardedness. See the Glossary definition of Alexithymia for a plain-language overview.
The Numbers
TAS-20-measured alexithymia: ~10-13% in the general population, ~50% in autistic adults (some studies up to 63%). Also elevated in ADHD, depression (~50%), and PTSD (~53%).
Not the Same as Autism
Roughly half of autistic adults don't have it. It's a trait distinct from the diagnosis. Don't assume emotional unavailability in an autistic client who has none, or miss it in a non-autistic client who does.
The Brain Research
Insula-prefrontal connectivity differences correlate with alexithymia severity more than with autism status itself, during emotional processing tasks, supporting a reframe where alexithymia itself drives some emotion-processing differences.
Why It Matters for Risk Assessment
A client with significant alexithymia may not be minimizing on a screening tool. They may be unable to label the internal state being asked about. Add behavioral/somatic anchors (sleep, appetite, functioning) alongside direct emotional questions.
If you are having thoughts of suicide, please reach out: call or text 988 (Suicide & Crisis Lifeline).
Well wishes. 🙏
Mx. Love C. Dialogos, LMFT · Buddhist Chaplain Licensed Marriage and Family Therapist | Buddhist Chaplain Pronouns: They/Them
Explore Topics: #alexithymia #autism #ADHD #neurodivergent #riskassessment
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Written by
Mx. Love C. Dialogos, LMFT
Mx. Love C. Dialogos, LMFT, is a licensed marriage and family therapist and Buddhist chaplain practicing by telehealth in 13 states. Their clinical writing has appeared in Psychotherapy Networker.
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