Alexithymia and drinking in young adults: The role of alcohol-related intrusive thoughts

• Alexithymia is associated with heavier alcohol use in college students.
• Intrusive alcohol-related thoughts link alexithymia to heavier drinking.
• Findings are similar to those reported in alcohol dependent patients.
• Alexithymia is related to anxiety and frontal lobe dysfunction.

Alexithymia refers to difficulties identifying and describing emotions, an externalised thinking style and a lack of imagination. Alexithymia has been linked to heavier drinking in community samples and is strongly associated with alcohol use disorders. Among patients undergoing treatment for alcohol dependence, alexithymia is associated with more intrusive thoughts about drinking. The present research asked whether this may also be the case in a non-clinical sample of social drinkers and whether such intrusive thoughts mediate the relationship between alexithymia and drinking. Participants were 113 university undergraduates aged 18–30 years who completed self-report indices of alexithymia (Toronto Alexithymia Scale-20, or TAS-20), drinking behavior (Alcohol Use Disorders Identification Test, or AUDIT), anxiety (Beck Anxiety Inventory, or BAI), sensitivity to punishment (SP scale of the Sensitivity to Punishment and Sensitivity to Reward scale), frontal lobe dysfunction (Frontal Systems Behavior Scale, or FrSBe), and intrusive thoughts about drinking (the Cognitive-Emotional Preoccupation with alcohol or CEP scale of the Temptation and Restraint Inventory). As predicted TAS-20 scores were significantly positively correlated with scores on AUDIT, CEP, BAI, SP, and FrSBe scales. CEP mediated the association between TAS-20 and AUDIT. Similar to those with alcohol dependence, alexithymic characteristics are related to intrusive thoughts about drinking which may significantly influence drinking behavior even in a non-clinical sample of young adults at university.