Table 1

Results of systematic review of literature on the effect of mindfulness-based interventions on alexithymia

AuthorStudy typePopulation (N)Age and sexInterventionControlMeasuresTime measurements takenResults
Bornemann and Singer35 RCTVolunteers from the general public in Germany in good health and with no prior meditation experience. People with TAS20 scores of >60 were excluded
n=318
Mean=40.8 (9.3)
59% Female
Three mental training modules, each 3 months long, involving a 3-day silent retreat, 13 weeks of weekly 2-hour group sessions and 30 min of daily practice. The Presence module was about directing attention to the present moment, the Affect module about approaching difficult emotions with acceptance and the Perspective module about metacognition, observing thoughts and reframing experiences. There were three intervention groups: groups 1 and 2 did all three modules over 9 months but in a different order, group 3 did just the Affect module for 3 monthsNo trainingTAS20 and subscales1
Heartbeat perception task and ECG
Before the intervention and at 3, 6 and 9 months (after each module)Alexithymia decreased more in the intervention groups than the control group from T0 to T3 (p<0.001, d=−0.331) and T0 to T2 (p=0.026, d=−0.155) but not T0 to T1 (p=0.143, d=−0.166). The effect at T3 was significant for all TAS subscales. Post hoc tests showed that the decreases in TAS scores were caused by the Presence and Affect modules but not the Perspective module
Heartbeat perception accuracy increased more in the intervention groups than the control group from T0 to T3 (p=0.017, d=0.273) and T0 to T2 (p=0.020, d=0.173) but not T0 to T1 (p=0.220, d=0.111)
Change in heartbeat perception accuracy between T0 and T1 were negatively correlated with changes in TAS20 (p=0.002). The correlation was significant for those who had taken the Presence training but not for those who had taken the Affect training
de la Fuente Arias et al 36 RCTStudents from the University of Almeria with no experience of meditation or yoga
n=46
M=23.47 (6.34)
85% F
10 weekly 1.5-hour mindfulness/meditation training sessions adapted from the MBSR programme,21 combined with individual practiceWait-listTAS20 and subscales1
Social skills scale51
Before and after the interventionPre/post tests show significant changes in TAS20 in the intervention group (DIF p<0.001, DDF, EOT and Total TAS p<0.01). The size of the change was 20% decrease in DIF (d=0.32) and DDF (d=0.39), 22.2% in EOT (d=0.55) and 20.60% in total TAS (d=0.47). The control group’s TAS20 did not change significantly. The difference in TAS20 scores between the groups was not significant at baseline (p=0.321) or post intervention (t=0.600, p=0.552)
There were no significant differences in social skills in the experimental and control groups at baseline, but post intervention social skills were significantly higher (p≤0.001) in the experimental group and there was a significant pre/post increase in social skills in the experimental group (total social skills, p≤0.001)
Santarnecchi et al 37 RCT
and MRI study
Right-handed members of the public in Italy, with no prior meditation or mindfulness experience and in good physical and mental health
n=48
Intervention group: 31 (±4)
Control group: 30 (±4)
52% F
8-week MBSR programme21 involving weekly 2.5-hour group sessions and daily individual practiceWait-listTAS201
Penn State Worry Questionnaire52
State-Trait Anxiety Inventory53
Beck Depression Inventory II54
Mindfulness Attention Awareness Scale39
MRI scans measured grey matter volume and cortical thickness
Before and after the interventionThere was a significant reduction in TAS20 in the intervention group (p=0.004) and no significant change in the control group. There was no significant change in MAAS in either group
There was a significant negative correlation between alexithymia level and insula cluster thickness values (r=−0.712, p<0.01) in the intervention group post training
There were significant reductions in the intervention group in worry (p=0.012), state anxiety (p=0.031) and depression (p=0.046) but not in the control group
Viding et al 38 RCTAdult women attending any of 4 healthcare centres in Sweden with burnout/exhaustion symptoms, excluding individuals with drug or alcohol abuse or severe depression
n=48
M=53.8 (8.15)
100% F
A package of six cultural activities, including mindfulness (focused on breathing, body awareness and awareness of thoughts and feelings), dance, theatre, film and drawing, each delivered in two 90 min sessionsStandard care involving physiotherapyTAS20 and subscales1
Karolinska Exhaustion Disorder Scale55
Sense of Coherence56
Single item measure of self-rated health
Baseline, 3 months (the length of the programme) and 6 months (follow-up)There was a significantly greater decrease in the intervention group compared with the control group in total TAS (p=0.007), DDF (p=0.004) and DIF (p=0.051) at 6 months relative to baseline
There was a significant decrease in exhaustion and self-reported health (p≤0.001) in the intervention group compared with the control group, but not in sense of coherence
  • MAAS, Mindful Attention Awareness Scale; MBSR, Mindfulness-Based Stress Reduction; RCT, randomised controlled trial; TAS20, 20-item Toronto Alexithymia Scale; DIF, Difficulty Identifying Feelings subscale of the TAS20; DDF, Difficulty Describing Feelings subscale of the TAS20; EOT, Externally Orientated Thinking subscale of the TAS20.