A scoping review of suicidality and alexithymia: The need to consider interoception

Background: Alexithymia is a problem of emotion regulation and for this reason alone may relate to suicidality. This article investigates the evidence for a direct relationship. It explores the possibility of an additional role for interoception in future research. Methods: A scoping review of peer-reviewed journal articles examining alexithymia and suicidality was undertaken, followed by a critical assessment of the overall state of the evidence base in relation to interoception. Results: The review identified 27 journal articles. The evidence base was heterogeneous, involving a variety of clinical and non-clinical samples, and displays mixed findings. The measurement of alexithymia (using the Toronto Alexithymia Scale) and management of confounding variables were identified as problematic in determining its relationship with suicidality. Limitations: The review was limited to published research in the English language. The review findings were not tested and refined by stakeholders. Some of the research studies cited in the critical assessment of interoception were themselves subject to the limitations of the Toronto Alexithymia Scale. Conclusion: The scoping review identified a collection of articles that were too diverse to permit a definitive answer to the research question. Interoception may provide a fruitful new avenue in understanding the relationship between emotion regulation and suicide.