Expanded question: What percentage of people with Autism Spectrum Disorder (ASD) have alexithymia?

Approximately 50% of people with Autism Spectrum Disorder (ASD) have alexithymia. This is supported by multiple studies, including a systematic review and meta-analysis which found that 49.93% of individuals with ASD exhibit alexithymia. Another study reported a similar prevalence, with 55% of adolescents with ASD scoring above the cut-off for alexithymia. These findings highlight the significant co-occurrence of alexithymia in the ASD population.[1-2]

References

1.
Investigating Alexithymia in Autism: A Systematic Review and Meta-Analysis.

Kinnaird E, Stewart C, Tchanturia K.

European Psychiatry : The Journal of the Association of European Psychiatrists. 2019;55:80-89. doi:10.1016/j.eurpsy.2018.09.004.

Leading Journal

Background: New research suggests that, rather than representing a core feature of autism spectrum disorder (ASD), emotional processing difficulties reflect co-occurring alexithymia. Autistic individuals with alexithymia could therefore represent a specific subgroup of autism who may benefit from tailored interventions. The aim of this systematic review and meta-analysis was to explore the nature and prevalence of alexithymia in autism using the Toronto Alexithymia Scale (TAS).

Methods: Online scientific databases were searched systematically for studies on ASD popu lations using the TAS. Meta-analyses were performed to evaluate differences in scores between the ASD and neurotypical groups, and to determine the prevalence of alexithymia in these populations.

Results: 15 articles comparing autistic and neurotypical (NT) groups were identified. Autistic people scored significantly higher on all scores compared to the NT group. There was also a higher prevalence of alexithymia in the ASD group (49.93% compared to 4.89%), with a significantly increased risk of alexithymia in autistic participants.

Conclusions: This review highlights that alexithymia is common, rather than universal, in ASD, supporting a growing body of evidence that co-occurring autism and alexithymia represents a specific subgroup in the ASD population that may have specific clinical needs. More research is needed to understand the nature and implications of co-occurring ASD and alexithymia.

2.
Alexithymia in Adolescents With Autism Spectrum Disorder: Its Relationship to Internalising Difficulties, Sensory Modulation and Social Cognition.

Milosavljevic B, Carter Leno V, Simonoff E, et al.

Journal of Autism and Developmental Disorders. 2016;46(4):1354-67. doi:10.1007/s10803-015-2670-8.

Alexithymia is a personality trait frequently found in adults with autism spectrum disorder (ASD), and has been linked to impairments in emotion recognition and empathy. The presentation of alexithymia within ASD at younger ages remains unexplored, and was examined in the present study. Alexithymia rates were significantly elevated in ASD (55%; 31/56 scoring above cut-off) versus non-ASD adolescents (16%; 5/32 scoring above cut-off). Within individuals with ASD, alexithymia was associated with increased self-reported anxiety, parent-reported emotional difficulties, self-reported sensory processing atypicalities, and poorer emotion recognition, but was not associated with theory of mind ability. Overall, our results suggest that alexithymia is highly prevalent, and has selective cognitive correlates in young people with ASD.