Increasing affective distance - leftward prism adaptation amplifies alexithymia in healthy females

Laura Culicetto¹Massimo Mucciardi²Chiara Lucifora³Alessandra Falzone²Francesco Tomaiuolo⁴Angelo Quartarone¹Carmelo Mario Vicario²Selene Schintu^5,6*

• ¹IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
• ²Universita degli Studi di Messina Dipartimento di Scienze cognitive Psicologiche Pedagogiche e degli Studi Culturali, Messina, Italy
• ³Universita degli Studi di Bologna Dipartimento di Filosofia e Comunicazione, Bologna, Italy
• ⁴Universita degli Studi di Messina Dipartimento di Medicina Clinica e Sperimentale, Messina, Italy
• ⁵National Institute of Neurological Disorders and Stroke (NIH), Bethesda, United States
• ⁶Universita degli Studi di Trento Centro Interdipartimentale Mente/Cervello, Rovereto, Italy

Emotional processing is linked with spatial attention, which prioritizes emotional stimuli over neutral ones. The interconnection between spatial and emotional processing may rely on the overlap between the networks underpinning such cognitive functions. Recent evidence has indeed identified a link between the rightward visuospatial bias exhibited by healthy individuals and the challenge in understanding emotional states, so-called alexithymia. However, while spatial attention has been manipulated by prism adaptation (PA), a well-known sensorimotor training, whether this is possible with emotional processing has never been investigated. Ninety-five participants completed alexithymia questionnaires, Toronto Alexithymia Scale (TAS-20) and Perth Alexithymia Questionnaire (PAQ), before and after a single session of either leftward or rightward deviating PA. While both males and females showed the expected sensorimotor aftereffect solely leftward PA modulated alexithymia scores, and it did so only for women. The results indicate that leftward PA not only affects visuospatial performance, but also emotional processing, particularly in how individuals perceive and interpret emotional proximity and distance. Alexithymia may be, therefore, metaphorically linked to impaired perception of emotional closeness and remoteness. These findings suggest that PA may modulate emotional capacities in a sex-dependent manner, offering insights into its therapeutic potential while also highlighting the need for caution as prolonged PA-based interventions may affect emotional well-being.