The relationship between alexithymia and self-harm: The mediating role of mindfulness

Norman, Hilary; Marzano, Lisa; Oskis, Andrea and Coulson, Mark. 2023. The relationship between alexithymia and self-harm: The mediating role of mindfulness. Current Psychology, 42(2), pp. 1516-1528. ISSN 1046-1310 [Article]

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Abstract or Description

Self-harm, defined as any act of self-injury, irrespective of motivation, is a phenomenon which can have serious consequences for the individual, as well as significant public health costs. Many correlational studies have established a significant association between self-harm and alexithymia, a cognitive deficit in emotion processing, characterised by a difficulty identifying and describing feelings and an externally orientated thinking style. The current study investigated whether this relationship is explained by low levels of dispositional mindfulness. An opportunity sample of 325 community-based adults completed an online survey measuring their history of self-harm, alexithymia (Toronto Alexithymia Scale) and mindfulness (Five Facets of Mindfulness Questionnaire). Alexithymia was significantly higher among participants with a history of self-harm, compared with participants with no history of self-harm. All mindfulness facets were significantly lower among participants with a history of self-harm except the facet Observe which was significantly higher in that group. A multiple mediation analysis found that the mindfulness facets Non-judge and Non-react were positive, significant mediators of the relationship between alexithymia and self-harm, but the facet Observe suppressed the relationship. The relationship between alexithymia and self-harm can be explained in part by deficits in mindfulness skills, particularly the ability to accept emotional experience without judgment or reaction. Conversely, the external orientation of alexithymia may itself be protective against self-harm, through the avoidance of excessive introspection. Thus, merely learning to observe inner experience, without the ability to understand and accept that experience, may have adverse consequences.

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This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use (, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:

Data Access Statement:

Data Availability: The datasets generated during and analysed during the current study are available from the corresponding author on reasonable request.


Self-harm, Alexithymia, Mindfulness, Mediation

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26 February 2021Accepted
4 March 2021Published Online
January 2023Published

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15 Dec 2022 12:25

Last Modified:

14 Mar 2023 17:14

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Yes, this version has been peer-reviewed.


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