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Aphantasia and alexithymia predict complex PTSD symptoms

DOI: 10.31234/osf.io/kj5d3
Ale, E., & Burns, E. J. (2024). 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

What This Study Is About

Researchers wanted to know if having aphantasia—the inability to picture things in your mind’s eye—changes how people experience post-traumatic stress disorder (PTSD). They also looked at alexithymia, which is a fancy word for having a hard time identifying or describing your own emotions.

How They Studied It

The team recruited 192 people: 75 with aphantasia and 117 "neurotypicals" (people who can visualize normally). Participants completed several detailed surveys about their mental imagery, their ability to understand their feelings, and their history of trauma. They also answered questions to see if they met the criteria for PTSD or Complex PTSD, which includes extra challenges like struggling with relationships or having a negative view of oneself.

What They Found

The results showed that aphantasia acts like a double-edged sword when it comes to trauma:
  • Fewer "Mental Movies": People with aphantasia reported significantly fewer visual flashbacks. Since they can't "see" the trauma again in their heads, they are less likely to be haunted by those scary, movie-like re-runs.
  • Higher Complex Symptoms: Surprisingly, people with aphantasia were *more* likely to report symptoms of Complex PTSD. They struggled more with "disturbances in self-organization," such as feeling bad about themselves or finding it hard to stay close to others.
  • The Emotion Factor: Alexithymia was a huge predictor of distress for everyone. If a person struggled to name their feelings, they were much more likely to have severe PTSD symptoms, regardless of whether they could visualize or not.

What This Might Mean

This suggests that while aphantasia might "protect" someone from visual flashbacks, it doesn't protect them from the emotional weight of trauma. Instead of seeing a "video" of a bad memory, the brain might process the hurt through a person's identity and relationships. This is a small study based on self-reports, so we can't say it "proves" a rule for everyone, but it *suggests* that doctors might need to look past visual symptoms to help aphantasic trauma survivors.

One Interesting Detail

Even though they didn't have visual flashbacks, people with aphantasia were more likely to say that their trauma symptoms actively interfered with their ability to function in daily life compared to those with a mind's eye!
This summary was generated by AI and may contain errors. Always refer to the original paper for accuracy.