Feeling physical pain while depressed: The effect of alexithymia.

BACKGROUND: In the literature, depression and alexithymia are associated with greater pain perception. It is unknown whether depression and alexithymia have additive effects on perceived pain. METHODS: The present study examined 152 participants (96 women, 56 men). Participants completed the 20-item Toronto Alexithymia Scale, the Hamilton Depression Rating Scale, the Brief Pain Inventory, and the NEO Personality Inventory. There were 49 participants in the active phase of depression with either definite (n = 15) or no alexithymia (n = 34). One hundred three participants showed no depression with either definite (n = 14) or no alexithymia (n = 89). RESULTS: Pain severity showed a small but significant relationship with alexithymia and depression. Pain was greater among without alexithymia individuals who were depressed and among with alexithymia individuals who were not depressed. Individuals with combined presence of depression and alexithymia did not report greater pain than participants with either condition alone. Alexithymia, depression, and pain were significantly correlated with greater neuroticism. CONCLUSIONS: We did not find a summative effect of depression and alexithymia on perceived pain. One interpretation of this result is that neuroticism (a shared personality factor in both depression and alexithymia) may be partially responsible for the effect on pain.

Lifetime Physical Activity and White Matter Hyperintensities in Cognitively Intact Adults.

BACKGROUND: White matter hyperintensities (WMHs) observed on magnetic resonance images are associated with depression and increase the risk of stroke, dementia, and death. The association between physical activity and WMHs has been inconsistently reported in the literature, perhaps because studies did not account for a lifetime of physical activity or depression. OBJECTIVES: The aim of this study was to determine the extent to which a lifetime of leisure-time physical activity is associated with less WMHs while accounting for depression. METHODS: Face-to-face interviews were conducted with the Lifetime Total Physical Activity Questionnaire, where the metabolic equivalent of task hours per week per year was calculated. Cognitively intact participants also underwent magnetic resonance imaging, where WMHs as a percentage of intracranial volume was obtained. Hierarchical multiple linear regression was performed to compare WMHs in a more active group with a group with no psychiatric history (n = 20, mean age = 62.2 years), with a less active group with no psychiatric history (n = 13, mean age = 64.0 years), and a less active group with history of late-onset depression (n = 14, mean age = 62.8 years). RESULTS: There was not a statistically significant difference in WMHlg10 between the more and less active groups without a psychiatric history (b = .09, p > .05) or between the more active group without a psychiatric history and the less active group with a history of depression (b = .01, p > .05). The model was predictive of WMHlg10, explaining an adjusted 15% of the variance in WMHs (p = .041). DISCUSSION: A lifetime of leisure-time physical activity was not associated with WMHs when accounting for depression.

An Initial Study of Alexithymia and Its Relationship With Cognitive Abilities Among Mild Cognitive Impairment, Mild Alzheimer's Disease, and Healthy Volunteers.

The present study examined the degree to which alexithymia is greater in mild Alzheimer's disease (AD) and mild cognitive impairment (MCI) relative to healthy volunteers (healthy comparison [HC]), and investigated relationships between alexithymia and cognition. Eighty-five participants (MCI = 30, AD = 21, HC = 34) underwent a comprehensive neuropsychological examination and completed the 20-item Toronto Alexithymia Scale (TAS-20). Relative to HC, MCI and AD reported greater alexithymia total scores and higher scores on the TAS factor difficulty in identifying feelings (DIF). The remaining two factors, difficulty in describing feelings (DDF) and externally oriented thinking showed no significant group differences. In MCI, TAS-20 and DIF were negatively correlated with working and long-term verbal memory. In AD, TAS-20 was negatively correlated with general cognition, attention, memory, and visual spatial constructive and executive abilities. Also in AD, DIF was negatively correlated with general cognition, memory, and executive abilities. The correlation between DIF and long-term verbal memory in both MCI and AD suggests a potential common mechanism for alexithymia in these neurocognitive disorders. Declines in verbal memory may hinder a patient's ability to recall an association between a given sensation and the episodic experience of that sensation, thus leading to difficulty identifying feelings, as measured by the DIF factor of the TAS-20.

Longitudinal assessment of clinical risk factors for depression in schizophrenia spectrum disorders.

BACKGROUND: During initial assessment of individuals with schizophrenia and related disorders (schizophrenia spectrum disorders [SSDs]), clinicians tend to pay greater attention to psychotic symptoms than mood symptoms, including depression. Depression is reported to influence the course of SSDs, but not much is known about the risk factors for depression in SSDs. In the present study, we examined clinical predictors of depression in SSDs. METHODS: The sample included 71 patients with SSDs followed in a modified Assertive Community Treatment program, the Community Support Network of Springfield, Illinois. The study design was naturalistic, prospective, and longitudinal (mean follow-up = 8.3 years; SD = 7.3). The GENMOD procedure appropriate for repeated measures analysis with dichotomous outcome variables followed longitudinally was computed. RESULTS: Rates of depression ranged from 18% to 41% over the differing assessment periods. Schizophrenia and schizoaffective disorder did not vary by depression rate. Depression independent of SSD diagnosis was associated with greater hospitalization rates. Clinical variables predict- ing depression were auditory hallucinations, delusions, poor insight, and poor judgment. CONCLUSIONS: Psychotic symptoms in the course of SSDs are risk factors for depression. As a consequence, the mental status examination of patients with SSDs with active psychosis should include assessment of mood changes. Further research is warranted to determine if treatment of depression among patients with SSDs may reduce their rates of hospitalization.

Social adaptive functioning, apathy, and nondysphoric depression among nursing home-dwelling very old adults.

BACKGROUND: Apathetic and subsyndromal depressive conditions are common in the oldest old. This study examined whether nondysphoric depression (NDD), a clinical condition characterized by ideational and vegetative but no emotional symptoms of depression, belongs to the apathetic presentations of late-life depression. Rates of NDD, dysphoric depression (DD), apathy, and social functional impairment were examined in a sample of nondemented very old (mean age 87.5 years, SD = 7.7) nursing home residents. It was hypothesized that individuals with NDD show greater apathy and greater social functional impairment relative to DD and nondepressed individuals. METHODS: Social functioning was measured using the Social-Adaptive Functioning Evaluation (SAFE) and apathy was measured using the global apathy rating on the Scale for the Assessment of Negative Symptoms (SANS). RESULTS: The rates of DD (50.0%) and NDD (27.4%) were quite high. Participants with DD reported greater apathy than those with NDD (and nondepressed individuals). NDD and DD subjects showed greater social functional impairment relative to the comparison group. There was no difference in social functioning between DD and NDD individuals. CONCLUSIONS: The present data are inconsistent with the view that NDD among the oldest old is an apathetic form of depression. NDD involves social functional impairment. Limitations include rather selected population of nursing home residents that may have included individuals with early dementia, lack of data on prior depressive episodes, and apathy assessment not validated on the specific population.

Alexithymia, emotional empathy, and self-regulation in anorexia nervosa.

BACKGROUND: Individuals with anorexia nervosa (AN) who are starved have poor awareness (alexithymia), reduced understanding of others' mental states (cognitive empathy), and difficulty regulating personal emotions (self-regulation). Despite its important role in social interaction, sympathy for others (emotional empathy) has not been measured in AN. Furthermore, it is unknown how restoring weight affects the relationship among alexithymia, empathy, and self-regulation in AN. METHODS: Women with AN were tested longitudinally during their starvation period (N = 26) and after weight was restored (N = 20) and compared with 16 age-matched healthy women. Alexithymia, empathy, and self-regulation were assessed with the Toronto Alexithymia Scale, the Interpersonal Reactivity Index, and items measuring self-regulation from the Minnesota Multiphasic Personality Inventory-2, respectively. RESULTS: Relative to comparison participants, individuals with AN during both starvation and weight restoration reported greater alexithymia and emotional empathy in one domain, personal distress (vicarious negative arousal to others' suffering). Among AN participants, personal distress was positively correlated with alexithymia and negatively correlated with self-regulation, when accounting for depression. CONCLUSIONS: High levels of alexithymia and personal distress may be persistent features of AN because they do not resolve upon weight restoration. Greater personal distress in AN may be a function of poor emotional awareness and regulation.

Modifiable risk factors for depressed mood among farmers.

BACKGROUND: Risk for depression among farmers is not fully understood. DSM-IV considers sadness or depressed mood a critical symptom of depression. The aim of this study was to examine risk factors for depressed mood among farmers using a longitudinal study design. METHODS: Participants were principal farm operators in the Iowa Certified Safe Farm study. We identified risk factors for depressed mood by calculating relative risks (RR) using the generalized estimating equations method. RESULTS: In the multivariate model, pesticide exposure (RR = 1.26; 95% CI: 1.04 to 1.53), having an additional job off the farm (RR = 1.32; 95% CI: 1.08 to 1.62), stress (RR = 3.09; 95% CI: 2.55 to 3.75), and previous injury (RR = 1.41; 95% CI: 1.05 to 1.89) prospectively increased the risk of depressed mood. CONCLUSIONS: Consistent with earlier non-longitudinal studies, the results of this study suggest that reducing pesticide exposure, stress, and injury may reduce the risk of depression in the farm setting.

Lifetime romantic attachment style and social adaptation in late-onset depression.

BACKGROUND: Measuring social adjustment (including attachment style and current social adaptation) in late-life depression may support planning secondary prevention, rehabilitation, and treatment. Insecure attachment style is a risk factor for developing new depression, and social adjustment may constitute a problem after symptoms abatement. Few studies have examined attachment style and social adjustment in late-onset depression. DESIGN: Subjects 50 years of age and older with early-onset (n = 35), late-onset DSM-IV unipolar depression (n = 38), and never-depressed volunteers (n = 47) were assessed with a widely used measure of attachment style (the Experiences in Close Relationship Scale). Social adjustment was measured using the Social Adjustment Scale. RESULTS: Both early-onset and late-onset patients with depression showed greater insecure attachment and poorer social adaptation compared with never-depressed volunteers. No difference was found between early-onset and late-onset patients with depression on attachment style or social adjustment. There were no significant differences between late-life depression in remission or current on attachment or social adaptation. CONCLUSION: Insecure attachment style may be a risk factor for late-life depression irrespective of the age of onset. Social maladaptation may persist among individuals with late-life depression in remission.

Mirror neuron function, psychosis, and empathy in schizophrenia.

Processing of social and emotional information has been shown to be disturbed in schizophrenia. The biological underpinnings of these abnormalities may be explained by an abnormally functioning mirror neuron system. Yet the relationship between mirror neuron system activity in schizophrenia, as measured using an electroencephalography (EEG) paradigm, and socio-emotional functioning has not been assessed. The present research measured empathy and mirror neuron activity using an established EEG paradigm assessing the integrity of the Mu rhythm (8-13Hz) suppression over the sensorimotor cortex during observed and actual hand movement in 16 schizophrenia-spectrum disorder (SSD) participants (n=8 actively psychotic and n=8 in residual illness phase) and 16 age- and gender-matched healthy comparison participants. Actively psychotic SSD participants showed significantly greater mu suppression over the sensorimotor cortex of the left hemisphere than residual phase SSD and healthy comparison individuals. The latter two groups showed similar levels of mu suppression. Greater left-sided mu suppression was positively correlated with psychotic symptoms (i.e., greater mu suppression/mirror neuron activity was highest among subjects with the greater severity of psychotic symptoms). SSD subjects tended to have significantly higher levels of Personal Distress (as measured by the Interpersonal Reactivity Index) than healthy participants. The present study suggests that abnormal mirror neuron activity may exist among patients with schizophrenia during the active (psychotic) phase of the illness, and correlates with severity of psychosis.

Effects of age-related differences in empathy on social economic decision-making.

BACKGROUND: The ways in which aging affects social economic decision-making is a central issue in the psychology of aging. To examine age-related differences in social economic decision-making as a function of empathy, 80 healthy volunteers participated in the Repeated Fixed Opponent Ultimatum Game (UG-R). Previous economic decision-making research has shown that in younger adults empathy is associated with prosocial behavior. The effects of empathy on older adult social economic decision-making are not well understood. METHODS: On each of 20 consecutive trials in the UG-R, one player ("Proposer") splits $10 with another player ("Responder") who chooses either to accept (whereby both receive the proposed division) or reject (whereby neither receives anything). Trait cognitive and emotional empathy were measured using the Interpersonal Reactivity Index. RESULTS: UG-R data were examined as a function of age and cognitive empathy. For "unfair" offers (i.e. offers less than $5), older Responders with high cognitive empathy showed less prosocial behavior and obtained greater payoffs than younger Responders with high cognitive empathy. CONCLUSIONS: High levels of cognitive empathy may differentially affect economic decision-making behavior in younger and older adults. For older adults, high cognitive empathy may play a role in obtaining high financial payoffs while for younger adults it may instead be involved in facilitating social relationships.

Trait empathy as a predictor of individual differences in perceived loneliness.

Loneliness has been shown to be inversely correlated with empathy in younger adults. The present study extends previous research by investigating the association between empathy and loneliness across the adult lifespan and examining the role of relevant demographic and personality factors. 110 community-dwelling adults (18 to 81 years old) completed the UCLA Loneliness Scale and the Empathy Quotient. Empathy scores were inversely associated with rated loneliness and predicted 8.7% of variance in loneliness scores after accounting for sex, age, relationship status, education, and neuroticism. The Social Skills factor of the Empathy Quotient was the strongest predictor of the association between perceived empathy and loneliness. Previous research is extended by the finding that rated loneliness was inversely associated with empathy scores across the adult lifespan. Underlying this relationship may be negative perceptions of personal social proclivity as a function of difficulty in understanding the mental states of others and high trait neuroticism.

Alexithymia in oncologic disease: association with cancer invasion and hemoglobin levels.

BACKGROUND: The literature suggests that alexithymia is the result of individual differences and/or biological mechanisms. Both individual differences and disease mechanisms may play a role among individuals with medical or surgical conditions. The relative weight of clinical and individual differences factors related to alexithymia has not been studied in patients with cancer. The purpose of this study was to examine the extent to which individual differences in perceived stress and biological markers of illness severity are associated with alexithymia among patients with cancer. METHODS: Treated oncologic outpatients (N = 37) were assessed using the 20-item Toronto Alexithymia Scale and Perceived Stress Scale. Alexithymia was examined in relation to perceived stress, tumor staging, and hemoglobin levels. RESULTS: Among the patients studied, 34.2% endorsed the established cutoff score (≥61) for alexithymia. Higher alexithymia scores were found in patients with more advanced stages of cancer invasion. Alexithymia correlated directly with perceived stress and indirectly with hemoglobin levels. Hemoglobin levels and cancer invasion significantly correlated with alexithymia when controlling for perceived stress. CONCLUSIONS: A significant component of alexithymia in cancer patients may be construed as acquired. But awareness of health status influencing perceived stress might partially mediate the role of cancer invasion and hemoglobin on alexithymia.

Cognition and nondysphoric depression among adoptees at high risk for psychopathology.

BACKGROUND: Association between poor cognition and symptom clusters including depressive ideation (eg, guilt) and vegetative symptoms in the absence of dysphoria (nondysphoric depression [NDD]) has been suggested in the elderly. The current study examined associations between NDD and premorbid and concurrent cognitive functioning in younger adults at high risk for psychopathology. Nondysphoric depression and depressed subjects were expected to show poorer premorbid and current cognition than nondepressed participants. METHOD: Subjects were adoptees enrolled in the Iowa Adoption Study [Yates W, Cadoret R, Troughton E. The Iowa adoption studies: methods and results. On the way to individuality: methodological issues in behavioral genetics. In: LaBuda M, Grigorenko E, (Eds), Editor. 1999, Commack (NY): Nova Science Publishers, Inc. p. 95-121]. Nondysphoric depression subjects were compared with nondepressed comparison subjects and with subjects with dysphoric depression (DD) on measures of premorbid cognition (estimated by standardized school achievement test scores) and concurrent cognition (intelligence, attention, memory, and executive abilities). RESULTS: Nondysphoric depression and DD showed lower premorbid cognition and executive functioning, whereas DD showed lower verbal and performance IQ compared to nondepressed subjects. The size of the comparison between NDD and nondepressed subjects for premorbid cognition was double that between DD and nondepressed subjects. No significant differences in cognition were found between NDD and DD. These effects were no longer significant after controlling for premorbid cognition. CONCLUSIONS: Poorer premorbid cognition and executive functions in NDD (and the absence of current cognitive differences compared with DD) suggest that NDD may be a condition of clinical interest. Because poor cognition is a known correlate of alexithymia, these results (including their magnitude) are consistent with the view that NDD may be a paradoxical presentation of depression in persons with limited ability to be aware and to verbally-report emotions.

Beyond alcoholism: Wernicke-Korsakoff syndrome in patients with psychiatric disorders.

OBJECTIVE: Wernicke encephalopathy and Korsakoff syndrome (the combined disorder is named Wernicke-Korsakoff syndrome [WKS]) are preventable, life-threatening neuropsychiatric syndromes resulting from thiamine deficiency. WKS has historically been associated with alcoholism; more recently, it has been recognized in patients who have anorexia nervosa or have undergone bariatric surgery for obesity. However, patients with nutritional deficiencies of any origin are at risk for WKS. We present clinical histories and neuroimaging data on 2 young adults with underlying psychiatric disorders who became malnourished and developed WKS. METHODS: A young woman with bipolar disorder and somatization disorder was hospitalized for intractable vomiting. A young man with chronic paranoid schizophrenia developed delusions that food and water were harmful, and was hospitalized after subsisting for 4 months on soda pop. RESULTS: Acute, life-threatening Wernicke encephalopathy was confirmed in both patients by brain magnetic resonance imaging showing classic thalamic injury. The patients were left with persistent cognitive and physical disabilities that were consistent with Korsakoff syndrome. CONCLUSIONS: Failure to suspect a vitamin deficiency led to permanent cognitive and physical disabilities that may necessitate lifelong care for these patients. The neuropsychiatric consequences could have been prevented by prompt recognition of their thiamine deficiency.

Altered neural activity and emotions following right middle cerebral artery stroke.

Stroke of the right MCA is common. Such strokes often have consequences for emotional experience, but these can be subtle. In such cases diagnosis is difficult because emotional awareness (limiting reporting of emotional changes) may be affected. The present study sought to clarify the mechanisms of altered emotion experience after right MCA stroke. It was predicted that after right MCA stroke the anterior cingulate cortex (ACC), a brain region concerned with emotional awareness, would show reduced neural activity. Brain activity during presentation of emotional stimuli was measured in 6 patients with stable stroke, and in 12 age- and sex-matched nonlesion comparisons using positron emission tomography and the [(15)O]H(2)O autoradiographic method. MCA stroke was associated with weaker pleasant experience and decreased activity ipsilaterally in the ACC. Other regions involved in emotional processing including thalamus, dorsal and medial prefrontal cortex showed reduced activity ipsilaterally. Dorsal and medial prefrontal cortex, association visual cortex and cerebellum showed reduced activity contralaterally. Experience from unpleasant stimuli was unaltered and was associated with decreased activity only in the left midbrain. Right MCA stroke may reduce experience of pleasant emotions by altering brain activity in limbic and paralimbic regions distant from the area of direct damage, in addition to changes due to direct tissue damage to insula and basal ganglia. The knowledge acquired in this study begins to explain the mechanisms underlying emotional changes following right MCA stroke. Recognizing these changes may improve diagnoses, management and rehabilitation of right MCA stroke victims.

Transportation Physical Activity Earlier in Life and Areas of the Brain related to Dementia Later in Life.

INTRODUCTION: Efforts to preserve brain function may be most effective when administered before there are changes in the brain, which may occur decades before the onset of Alzheimer's disease symptoms. White matter hyperintensities (WMH), a cardiovascular disease biomarker, are areas of hyperintense signals scattered in the white matter of the brain evident on magnetic resonance images. WMH increase with age and are associated with a higher risk of dementia. The purpose of this study was to determine if there was an association between different domains and intensities of physical activity earlier in life and lower risk of dementia later in life as indicated by less WMH. METHODS: In this cross-sectional study, face-to-face interviews were conducted with the Lifetime Total Physical Activity Questionnaire. The metabolic equivalent of task (MET) hours/week/year of moderate (3.0-5.9 METs) and vigorous-intensity (≥6 METs) occupation, transportation, household and leisure-time physical activity was obtained across school-age (6-11), adolescence (12-18), young (19-39) and middle adulthood (40-64). WMH were calculated as the percent of intracranial volume in cognitively unimpaired middle (age 40-64) and older adults (age 65+). Simultaneous multiple linear regression determined associations between moderate and vigorous-intensity occupation, transportation, household and leisure-time physical activity across school-age, adolescence, young and middle adulthood with WMH. RESULTS: Greater moderate-intensity transportation physical activity during young (b= -.09, p=.008) and middle adulthood (b= -.14, p=.013) was associated with lower WMH in middle and older adulthood, explaining 28% (p=.003) to 29% (p=.002) of the variance in WMH (n=54). CONCLUSIONS: Changes to the physical environment that encourage walking, running or biking, such as sidewalks and bike paths, may be strategies to mitigate the age-related increases in WMH, areas of the brain associated with higher risk of dementia.

Cognitive and daily functioning in older adults with vegetative symptoms of depression.

OBJECTIVES: In primary care 50-95% of patients with depression present with vegetative symptoms (VS). Based on the extant literature, older adults showing VS (but no dysphoria) may show functional impairment but this hypothesis has not been empirically tested. The goal of this study was to examine neurocognitive and daily functioning of elderly patients showing exclusively VS in comparison with patients presenting with VS and dysphoria. METHODS: Seven hundred and eighty-seven primary care patients received measures of neurocognition and daily functioning. Neurocognition was measured with the repeatable battery for the assessment of neuropsychological status (RBANS). Three groups were compared: (1) patients with two or more VS of depression without dysphoria (VS - D), (2) patients with at least one VS and dysphoria (VS + D), and (3) comparison patients without multiple VS or dysphoria. RESULTS: Nearly one third of the sample (31%) fell into the VS - D group, whereas 15% fell into the VS + D group. Both VS groups showed poorer neurocognition and activities of daily living than comparisons. Only one subtest of the RBANS (i.e., picture naming) showed a significant difference between VS + D and VS - D, and there was no significant difference on daily functioning. VS - D patients reported less frequent past history of depression and endorsed less anxiety compared to VS + D. CONCLUSIONS: Elderly patients presenting with clusters of VS with or without dysphoria show poorer neurocognitive and functional performance. Relative poorer cognition and daily functioning in VS - D are potential harbingers of further decline and consistent with under-reporting of sadness in older age.

A longitudinal study of transient epileptic amnesia.

OBJECTIVE: To study the underlying pathophysiology and the long-term prognosis of the syndrome of transient epileptic amnesia (STEA). BACKGROUND: STEA has been recently described as a distinct nosologic entity, in which memory impairment is the sole clinical manifestation of temporal lobe epilepsy. METHODS: Serial neuropsychologic examinations and electroencephalography (EEG) were performed on a patient with STEA, before and after treatment with antiepileptic drug for a 2-year study period. RESULTS: Initial neuropsychologic assessment revealed isolated mild-to-moderate impairment in anterograde verbal and visual memory. EEG showed intermittent sharp and spike discharges from both temporal regions, independently, consistent with an underlying seizure tendency. Treatment with extended-release carbamazepine 200 mg twice daily led to complete resolution of the memory difficulty, and the repeat neuropsychologic assessment and EEG were within normal limits. Two years after the treatment was initiated, the patient remained asymptomatic and a third neuropsychologic assessment was completely normal. CONCLUSIONS: The memory impairment in STEA does not originate from a progressive neurodegenerative mechanism, but rather from an underlying epileptic and therefore reversible etiology. When identified and treated, STEA carries no memory impairment at 2 years after diagnosis.

Alexithymia and aging: a neuropsychological perspective.

Consistent with the emotional changes associated with later life, higher alexithymia scores are widely reported in older adults, but their significance has not been fully examined. We posited that association between alexithymia and poorer neurocognition would support the deficit nature of alexithymia in later life. Widely used neurocognitive tests assessing the relative integrity of the left and right hemisphere functions were used to examine the extent to which alexithymia of older age is associated with poor left or right hemisphere functioning. Healthy community-dwelling volunteers (20 young and 20 elderly subjects) were studied with the 20-item Toronto Alexithymia Scale. Neurocognitive competence was assessed using a neuropsychological battery measuring attention, language, memory, visuospatial abilities, and executive functions. Neurocognitive abilities were strongly age-related and indirectly correlated with alexithymia. Alexithymia total score appeared to be uniquely predicted by Raven Matrices and Rey's Figure Recall. These results support the deficit hypothesis alexithymia of older age.

Association between alexithymia, neuroticism, and social desirability scores among Italian graduate students.

An inverse correlation between social desirability and alexithymia has been observed in undergraduate students in Japan and Australia. It is not clear how this association is influenced by the personality dimension of neuroticism. This study examined the association of scores on social desirability with those on alexithymia controlled for neuroticism, in a sample of 111 Italian graduate students, with age range of 24 to 58 years. Students completed the Eysenck Personality Questionnaire (short form) and the Toronto Alexithymia Scale-20 (TAS-20). Social desirability scores inversely correlated with TAS-20 total scores, neuroticism scores, and the TAS-20 subscale, Difficulty identifying feelings. Neuroticism directly correlated with TAS-20 total score, Difficulty identifying feelings, and Difficulty describing feelings. Students with higher alexithymia and neuroticism scores seem to present themselves in less socially desirable ways. The correlation of social desirability with alexithymia was moderated by higher neuroticism scores.