Alexithymia in Autism & ADHD (Quick Read)

Part of the Topic Index: Clinical Practice · Risk Assessment

A real gap between having an emotion and being able to name it — not avoidance, not guardedness. See the Glossary definition of Alexithymia for a plain-language overview.

TAS-20-measured alexithymia: ~10-13% in the general population, ~50% in autistic adults (some studies up to 63%). Also elevated in ADHD, depression (~50%), and PTSD (~53%).

Roughly half of autistic adults don't have it. It's a distinct trait, not synonymous with the diagnosis — don't assume emotional unavailability in an autistic client who has none, or miss it in a non-autistic client who does.

Insula-prefrontal connectivity differences correlate with alexithymia severity more than with autism status itself, during emotional processing tasks — supporting a reframe where alexithymia, not autism per se, drives some emotion-processing differences.

A client with significant alexithymia may not be minimizing on a screening tool — they may genuinely be unable to label the internal state being asked about. Add behavioral/somatic anchors (sleep, appetite, functioning) alongside direct emotional questions.

If you are having thoughts of suicide, please reach out: call or text 988 (Suicide & Crisis Lifeline).

Well wishes. 🙏

Mx. Love C. Dialogos, LMFT · Buddhist Chaplain Licensed Marriage and Family Therapist | Buddhist Chaplain Pronouns: They/Them

Explore Topics: #alexithymia #autism #ADHD #neurodivergent #riskassessment