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Aphantasia and alexithymia predict complex PTSD symptoms

DOI: 10.31234/osf.io/kj5d3
Ale, E., & Burns, E. J. (n.d.). Aphantasia and alexithymia predict complex ptsd symptoms. doi:10.31234/osf.io/kj5d3

Abstract

Aphantasia is characterised by a complete, or almost complete, absence of visual imagery. Prior work has hinted that these individuals may experience qualitative alterations in posttraumatic stress disorder symptoms (PTSD) in contrast to neurotypicals. However, higher levels of alexithymia (i.e., difficulties identifying one’s own emotions) and trauma exposure have been linked to PTSD and possibly aphantasia. We therefore wondered if aphantasia would be associated with the most widely used PTSD symptom measures (i.e., the PTSD Checklist for DSM-5: PCL-5; and the International Trauma Questionnaire: ITQ) when alexithymia, trauma levels, sex at birth and age were considered. We replicated prior work in finding alexithymia positively predicts symptoms across all PTSD and complex PTSD measures, their subscales, and their related functional impairments. By contrast, aphantasia was not clearly linked to PTSD symptoms in global PCL-5 or ITQ scores, nor in any of the PCL-5 subscales. Despite this, aphantasia was associated with a reduction in the ITQ’s re-experiencing of traumatic events subscale, and an increase in complex PTSD symptoms, i.e., disturbances in self-organization and its related functional impairments, negative self-concepts, and difficulties in interpersonal relationships. Given their elevated levels of complex PTSD symptoms, those with aphantasia may require greater support than is currently considered. Moreover, these findings support suggestions that the disturbances in self-organisation associated with complex PTSD may be partially distinct from the core symptoms of PTSD.

Authors

  • Emmanual Ale1
  • Edwin James Burns1

Understanding Aphantasia and Its Connection to PTSD

Overview/Introduction

Aphantasia is a condition where individuals are unable to visualize images in their mind. This research explores how aphantasia might influence symptoms of posttraumatic stress disorder (PTSD), a mental health condition triggered by traumatic events. PTSD often involves reliving traumatic experiences through vivid mental imagery, which is challenging for those with aphantasia. The study also examines the role of alexithymia, a condition where individuals struggle to identify and express emotions, and its potential link to PTSD.

Methodology

  • Participants: 192 individuals were recruited, including 75 with aphantasia and 117 neurotypicals (people with typical visual imagery abilities).
  • Tools Used:
  • Vividness of Visual Imagery Questionnaire (VVIQ): Assessed participants' ability to visualize.
  • Toronto Alexithymia Scale (TAS-20): Measured difficulties in identifying and expressing emotions.
  • Life Event Checklist (LEC-5): Evaluated exposure to traumatic events.
  • PTSD Checklist for DSM-5 (PCL-5) and International Trauma Questionnaire (ITQ): Assessed PTSD symptoms.
  • Analysis: The study used statistical methods to explore the relationships between aphantasia, alexithymia, and PTSD symptoms, considering factors like trauma exposure, age, and sex.

Key Findings

  • Aphantasia and PTSD: Aphantasia was not significantly linked to overall PTSD symptoms. However, individuals with aphantasia reported fewer instances of re-experiencing traumatic events but showed increased symptoms related to complex PTSD, such as difficulties in self-organization and interpersonal relationships.
  • Alexithymia: Strongly predicted higher levels of PTSD and complex PTSD symptoms across all measures.
  • Complex PTSD: Those with aphantasia exhibited more complex PTSD symptoms, suggesting they might need more support than currently provided.

Implications

  • Support Needs: People with aphantasia may require tailored support for complex PTSD symptoms, focusing on interpersonal relationships and self-concept.
  • Diagnostic Considerations: Current PTSD diagnostic tools may need adjustments to account for the unique experiences of individuals with aphantasia.
  • Future Research: Further studies could explore the interaction between aphantasia and alexithymia in larger samples to better understand their combined impact on PTSD.

Limitations

  • Sample Size: The study's sample size may not have been large enough to detect subtle differences in PTSD symptom experiences among those with aphantasia.
  • Trauma Types: The study did not differentiate between types of trauma, which could affect PTSD symptoms differently in those with aphantasia.
In summary, while aphantasia might reduce the re-experiencing of traumatic events, it appears to increase complex PTSD symptoms. This highlights the need for specialized support for indivi...