Alexythymia and irony comprehension and their relations with depression, anxiety, general symptomatology and personality disorders: a comparison between clinical and non-clinical participants

Poor awareness of one’s own emotions and theory of mind appears to be a feature of many adult psychiatric conditions. In this study, we explored whether alexithymia and poor understanding of irony, both elements of the metacognitive system, were impaired in a clinical sample (n = 20) when compared to a non-clinical group (n = 35). We expected that both elements were impaired in the clinical group and explored whether they were correlated with personality disorder traits, global symptomatology, depression and anxiety. Finally, we sought to investigate whether alexithymia and difficulties in irony comprehension were related to each other. Results partially supported our hypotheses. Both emotional awareness and irony comprehension were impaired in the clinical vs. non-clinical sample. Alexithymia was related to personality disorder traits in both groups, and was linked with depression in the clinical group only. Irony understanding was not related to any elements of personality or symptoms, though time in reacting to irony vignettes was linked with cluster A and B traits in the clinical group only. Finally, the two elements were not significantly related to one another, except for a link between alexithymia and time spent in reacting to irony vignettes. With the caveat that the size of the clinical sample was small, results are consistent with the contention that many with psychiatric conditions experience metacognitive deficits which could be the target of intervention