The relationship between self-harm and alexithymia: a systematic review and meta-analysis

Norman, Hilary, Oskis, Andrea ORCID:, Marzano, Lisa ORCID: and Coulson, Mark (2020) The relationship between self-harm and alexithymia: a systematic review and meta-analysis. Scandinavian Journal of Psychology . ISSN 0036-5564 [Article] (Published online first) (doi:10.1111/sjop.12668)

PDF - Published version (with publisher's formatting)
Available under License Creative Commons Attribution.

Download (492kB) | Preview
[img] PDF - Final accepted version (with author's formatting)
Restricted to Repository staff and depositor only

Download (917kB)


Self-harm, defined for the purpose of this review as any act of self-injury without explicit suicidal intent, is an increasing public health concern, with potential long-term implications for those who engage in it. Previous research has identified a correlational relationship between self-harm and alexithymia, an emotion processing deficit characterised by difficulties identifying and describing feelings, and an externally-orientated thinking style. Through a systematic search of the literature, the current review examines the association between alexithymia and self-harm. A meta-analysis based on 23 studies found a significant, positive relationship between self-harm and alexithymia, with a medium effect size (g = 0.57, 95% CI 0.45 to 0.71). All 23 studies used the Toronto Alexithymia Scale (TAS20) to measure alexithymia. The alexithymia subcomponents difficulty identifying feelings and difficulty describing feelings were significantly associated with self-harm, but there was no significant association between self-harm and externally-orientated thinking. The effect size of the relationship was significantly larger in adolescent samples compared with adult samples and in female compared with male samples. The definition of self-harm did not affect the effect size of the relationship between alexithymia and self-harm and the results are consistent with previous meta-analyses focused more narrowly on non-suicidal self-injury and, separately, suicidal behaviours. Heterogeneity between the included studies was high. The results support an affect regulation model of self-harm, in which self-harm is used to regulate an emotional experience that is poorly understood.

Item Type: Article
Keywords (uncontrolled): Arts and Humanities (miscellaneous), General Psychology, Developmental and Educational Psychology, General Medicine
Research Areas: A. > School of Science and Technology > Psychology > Applied Health Psychology group
Item ID: 30521
Notes on copyright: © 2020 The Authors. Scandinavian Journal of Psychology published by Scandinavian Psychological Associations and John Wiley & Sons Ltd
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in anymedium, provided the original work is properly cited.
Useful Links:
Depositing User: Lisa Marzano
Date Deposited: 24 Jun 2020 08:06
Last Modified: 21 Aug 2020 23:59

Actions (login required)

View Item View Item

Full text downloads (NB count will be zero if no full text documents are attached to the record)

Downloads per month over the past year