Reducing alexithymia and increasing interoceptive awareness: A randomized controlled trial comparing mindfulness with dyadic socio-emotional app-based practice.

Background: Emotion processing deficits of alexithymia are a transdiagnostic risk factor. While such deficits are malleable, the differential efficacy of brief scalable digital mental trainings remains understudied.

Methods: This randomized controlled trial probed the efficacy of mindfulness-based (MB) and partner-based socio-emotional Affect Dyad (SE) practice, both supported by weekly coaching sessions, in reducing alexithymia in 285 adult participants. We investigated the predictive role of interoceptive awareness assessed a) before and after daily practice, b) in ecological momentary assessment (EMA) before and after the intervention, and c) weekly during the 10-week intervention.

Results: Both interventions reduced emotion processing difficulties on the Toronto Alexithymia Scale (TAS-20). Similarly, both interventions improved interoceptive awareness immediately after daily practice and after the intervention period, yet SE outperformed MB training in EMA assessments. Further, only Dyad practice led to increases in body listening and self-regulatory aspects of the Multidimensional Assessment of Interoceptive Awareness (MAIA) over time, with the latter explaining a decrease in alexithymia.

Limitations: Given the subclinical study sample, findings are limited in their generalizability to clinical samples.

Conclusions: Findings suggest that app-based socio-emotional and mindfulness-based practices, supported by online coaching sessions, are effective in reducing emotion processing deficits. Dyad training showed advantages on some measures of body awareness, which predicted observed changes in alexithymia. This highlights the potential of using app-based dyadic approaches in the development of emotion awareness and regulation.