The relationship between alexithymia and dissociation: an updated systematic review (2020-2025)

Background: Alexithymia and dissociation present similarities between the possible contributing factors to their development and some of their traits: a history of trauma, in particular childhood trauma, and a state of compromised awareness and connectedness over one’s emotions and inner state. This systematic review aim was to update a previous study conducted on the relationship between alexithymia and dissociation: Reyno, Simmons and Kinley’s (2020) meta-analytic study, replicating its methodology, analyzing new literature published from 2020 to 2025. Methods: The review was conducted following PRISMA 2020 guidelines. Eligible studies were searched using the following databases: PubMed, Scopus and PsycINFO. Inclusion criteria required the reports to: present a sample with a mean age over 18 (adults), use the DES/DES II and TAS-20 scales for the assessment of dissociation and alexithymia and report the correlation between the scales’ scores. Studies mixing clinical and non-clinical samples were excluded. Results: Based on 10 studies (pooled sample size N= 2620), alexithymia and dissociation were significantly associated, with this being true in 9 on 10 studies. The distinction between clinical samples, young adults non-clinical samples and general population non-clinical samples brought different results when compared to Reyno’s et al. (2020) study outcome. Limitations: All the studies included were cross-sectional and the two psychological conditions were assessed with only self-report measurements. Also personal bias of the reviewer should be considered. Conclusions: The relationship between alexithymia and dissociation was confirmed as significant. The results of this review are in line with previous studies, specifically when investigated in association to behavioural addiction and compulsion, childhood trauma and PTSD symptomatology. This relationship should be studied further with other study designs rather than cross-sectional, and also considering different possible under-represented factors influencing the strength of their association.