Does Alexithymia, Not Autism, Drive Emotion Recognition Challenges? A Nuanced Look
Friday, April 25, 2025.
A new study published in Development and Psychopathology (Standiford & Hsu, 2025) offers a surprising twist on a long-assumed narrative: that difficulty reading emotional expressions—a hallmark often associated with autism—may actually owe more to alexithymia than to autistic traits themselves.
It’s a sharp, compelling insight. But like most compelling insights, it risks being a little too neat.
Let’s dive into what they found, why it matters, and where we need to tread carefully.
A Quick Primer: Autism, Alexithymia, and Anime
First, a little background. Autism spectrum disorder (ASD) has long been linked to challenges in recognizing others’ emotions, particularly from facial expressions (Harms, Martin, & Wallace, 2010).
Meanwhile, alexithymia—a trait characterized by difficulties identifying and describing one’s own emotions—frequently co-occurs with autism (Kinnaird, Stewart, & Tchanturia, 2019), but is distinct.
Standiford and Hsu (2025) took a fresh approach: instead of lumping emotion recognition struggles under the autism umbrella, they asked whether alexithymia might actually be the real driver.
They recruited 247 adults with varying levels of autistic traits and had them complete standardized measures of autistic traits (AQ-10) and alexithymia (TAS-20), alongside an emotion recognition task using both human and anime-style faces.
At first glance, as expected, those higher in autistic traits struggled more with reading human emotional expressions.
But when researchers controlled for alexithymia? The link between autistic traits and poor emotion recognition disappeared.
Alexithymia, not autism, stood alone as the better predictor of difficulty.
And anime faces? People high in autistic traits actually recognized those exaggerated emotions just as well as anyone else.
Why This Matters
The study highlights a long-overdue distinction.
For years, emotional recognition difficulties have been casually attributed to "autism," shaping how society—and sometimes even therapists—perceive the emotional lives of autistic folks.
If alexithymia, not autism, explains these challenges, it reframes the narrative entirely. It suggests:
Autism might not inherently involve emotional blindness.
Emotional education or therapy for autistic individuals might be more effective if it specifically targets alexithymia.
Some emotional competencies in autistic individuals may have been systematically underestimated.
This aligns with growing research pointing toward a "double-empathy problem" (Milton, 2012)—the idea that communication breakdowns between autistic and non-autistic people are mutual, not a one-way autistic deficit.
In short: this study hints that many autistic souls may actually perceive emotions just fine—provided they're not also struggling with alexithymia.
But Slow Down: A Nuanced Critique
While Standiford and Hsu (2025) add important nuance, their conclusions should be handled with care. Here's why:
Trait vs. Diagnosis Problem
Participants were not clinically diagnosed with autism.
They were simply folks showing higher or lower autistic traits on a short screener (the AQ-10). This is not the same as autism diagnosis, which is a complex clinical determination involving behavior, development, and context.
Without a formally diagnosed autistic sample, we can't assume that findings generalize to people with autism spectrum disorder as currently understood clinically (Lord et al., 2020).
Alexithymia and Autism Are Often Entangled
Alexithymia and autism frequently do co-occur.
Some research suggests that the very social communication challenges of autism—difficulty interpreting subtle cues, atypical emotional expression—might, over time, lead to alexithymia-like adaptations (Poquérusse et al., 2018).
In other words, alexithymia might not always be a separate co-occurring condition; it might emerge in autistic individuals because of chronic social disconnect.
By statistically "controlling" for alexithymia, you might actually be removing an intrinsic feature of how autism can unfold in real life.
Thus, saying "it’s not autism, it’s alexithymia" risks oversimplifying a more dynamic developmental relationship.
Anime Faces Aren't a Neutral Comparator
The study's use of anime faces was creative—and probably needed, given the gaps in existing research tools.
But anime faces are exaggerated by design. They're built to externalize emotions in a hyper-readable, often idealized way (Napier, 2005).
Succeeding at reading anime emotions doesn’t necessarily mean emotion recognition is intact; it may just mean the stimulus was easier to decode for everyone.
Moreover, validation of the anime stimuli was informal, as Standiford himself acknowledges. We don’t know if the exaggerated emotions were truly comparable across human and anime faces.
The result? The study might be telling us more about the power of stylization than about internal emotional processing.
Self-Report Limitations
Both autistic traits and alexithymia were measured using self-report scales. Self-awareness of emotional deficits, particularly in alexithymia, is notoriously unreliable (Bagby, Parker, & Taylor, 1994).
People who have trouble identifying their own emotions might not accurately report those struggles on a survey. Thus, self-reported alexithymia might underestimate—or overestimate—the real scope of emotional difficulties.
Moving Forward: What We Should Actually Say
The real insight here isn't that "autism doesn’t cause emotional recognition deficits." It's that some emotional processing difficulties historically attributed to autism may be better explained—or at least heavily mediated—by co-occurring alexithymia.
That’s an important refinement, not a refutation.
It opens the door for much more nuanced interventions:
Alexithymia-Focused Therapies, like emotion identification training, may help both autistic and non-autistic souls struggling with emotional awareness (Kinnaird et al., 2019).
More Stylized Emotional Cues (like those found in anime or cartoon therapy tools) might scaffold emotion recognition training.
Avoiding Assumptions that autistic folks are emotionally disconnected or incapable of empathy—a stereotype increasingly challenged by modern research (Brewer et al., 2016).
As with much of science, the truth here is subtler than the headline.
Autistic folks may struggle with emotion recognition. They may also excel at it.
They may face added hurdles if alexithymia is part of the picture. And they deserve therapies, tools, and respect grounded in this richer complexity—not in worn-out caricatures.
Be Well, Stay Kind, and Godspeed.
REFERENCES:
Bagby, R. M., Parker, J. D., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale—II. Convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38(1), 33–40. https://doi.org/10.1016/0022-3999(94)90006-X
Brewer, R., Biotti, F., Catmur, C., Press, C., Happé, F., Cook, R., & Bird, G. (2016). Can neurotypical individuals read autistic facial expressions? Atypical production of emotional facial expressions in autism spectrum disorders. Autism Research, 9(2), 262–271. https://doi.org/10.1002/aur.1508
Harms, M. B., Martin, A., & Wallace, G. L. (2010). Facial emotion recognition in autism spectrum disorders: A review of behavioral and neuroimaging studies. Neuropsychology Review, 20(3), 290–322. https://doi.org/10.1007/s11065-010-9138-6
Kinnaird, E., Stewart, C., & Tchanturia, K. (2019). Investigating alexithymia in autism: A systematic review and meta-analysis. European Psychiatry, 55, 80–89. https://doi.org/10.1016/j.eurpsy.2018.09.004
Lord, C., Charman, T., Havdahl, A., Carbone, P., Anagnostou, E., Boyd, B., ... & McCauley, J. B. (2020). The Lancet Commission on the future of care and clinical research in autism. The Lancet, 395(10242), 1125–1170. https://doi.org/10.1016/S0140-6736(20)30247-2
Milton, D. (2012). On the ontological status of autism: The 'double empathy problem'. Disability & Society, 27(6), 883–887. https://doi.org/10.1080/09687599.2012.710008
Napier, S. J. (2005). Anime from Akira to Howl's Moving Castle: Experiencing contemporary Japanese animation. Palgrave Macmillan.
Poquérusse, J., Pastore, L., Dellantonio, S., & Esposito, G. (2018). Alexithymia and autism spectrum disorder: A complex relationship. Frontiers in Psychology, 9, 1196. https://doi.org/10.3389/fpsyg.2018.01196
Standiford, B., & Hsu, K. (2025). Autistic traits, alexithymia, and emotion recognition of human and anime faces. Development and Psychopathology. Advance online publication. https://doi.org/10.xxxx/devpsychopathology.xxxx