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Is Normative Male Alexithymia Associated
with Relationship Satisfaction,
Fear of Intimacy and Communication Quality
Among Men in Relationships?
This study investigated the relationships between Normative Male Alexithymia
(NMA), Relationship Satisfaction, Fear of Intimacy, and Communication Quality
among men in relationships. NMA is the inability of men to put emotions into words
posited to result from traditional masculine role socialization, and reflected in the
endorsement of and conformity to traditional masculine norms (Levant et al., 2006).
Previous research has found a moderate, negative relationship between alexithymia
and relationship satisfaction (Humphreys, Wood, & Parker, 2009). It was hypothe-
sized that NMA would negatively correlate with Relationship Satisfaction and Com-
munication Quality but would positively correlate with Fear of Intimacy. A sample
of 175 men from university and community sources volunteered for the study. All
three hypotheses were supported by the findings. These findings set the stage for fu-
ture explorations into the effects of the results of masculine gender role socializa-
tion, such as Normative Male Alexithymia, on romantic relationships.
Keywords: normative male alexithymia, communication quality, fear of intimacy,
Alexithymia is a clinical condition that literally means “without words for emotions.”
This condition is more common among men than women. A meta-analysis of gender
differences in alexithymia based on 41 existing samples found consistently small dif-
EMILY N. KARAKIS* and RONALD F. LEVANT*
THE JOURNAL OF MEN’SSTUDIES, VOL. 20, NO. 3, FALL 2012, 179-186.
© 2012 by the Men’s Studies Press, LLC. All rights reserved. http://www.mensstudies.com
jms.2003.179/$15.00 • DOI: 10.3149/jms.2003.179 • ISSN/1060-8265 • e-ISSN/1933-0251
* The University of Akron.
This article reports on research conducted as a Senior Honors Thesis at The University of Akron by the first
author, under the supervision of the second author.
Correspondence concerning this article should be addressed to Emily Karakis, 2393 Burnham Rd., Fairlawn,
Ohio 44333. Email: firstname.lastname@example.org.
ferences in mean alexithymia between women and men, with men exhibiting higher lev-
els (Hedges’ d = .22; Levant, Hall, Williams, & Hasan, 2009). These gender differ-
ences are thought to be due to Normative Male Alexithymia (NMA), a gender-linked,
mild-to-moderate form of alexithymia. NMA is the inability of some men to put emo-
tions into words that is posited to result from traditional masculine gender role social-
ization, a key element of which is the restriction of emotional expression. Due to such
socialization, these men do not develop a vocabulary for many of their emotions, es-
pecially the vulnerable emotions, such as fear and sadness, that might make them ap-
pear “weak,” and the attachment emotions, such as affection and fondness, that might
make them appear “needy.” NMA is also associated with men’s endorsement of tradi-
tional masculinity ideology (Levant et al., 2006).
Although there is a large body of research on alexithymia, there is not much litera-
ture on the effect that it might have on romantic relationships. Our lives are affected by
the quality of our relationships, particularly our intimate relationships. Establishing
and maintaining these relationships requires an ability to recognize and empathize with
the emotions of our partner as well as the ability to share with them our own emotions
(Humphreys, Wood, & Parker, 2009). It is thus likely that the inability to identify and
verbally express emotions reflected in alexithymia in general and NMA in particular
might affect intimate relationships. The extant research in this area has found a mod-
erate negative correlation between alexithymia and both relationship and sexual satis-
faction (Humphreys, Wood, & Parker). Further, Talka (2008) investigated the
relationships between alexithymia, fear of intimacy, masculinity ideology, and dis-
missing attachment style, and found that alexithymia was a unique predictor of men’s
fear of intimacy. Talka also found that relationship satisfaction was a unique predictor
of fear of intimacy.
Further research on the impact of alexithymia and NMA on relationships is quite im-
portant, as relationship quality has been show to affect men’s physical and psycholog-
ical well-being (Barnett, Davidson, & Marshall, 1991; Barnett, Marshall, & Pleck,
The purpose of the current study is to examine the relationships between Normative
Male Alexithymia and three relationship variables: Relationship Satisfaction, Com-
munication Quality, and Fear of Intimacy. This combination of variables has not pre-
viously been studied. The first hypothesis is that scores on the Normative Male
Alexithymia Scale (NMAS) will positively correlate with scores on the Fear of Intimacy
Scale. The second hypothesis is that scores on the NMAS will correlate negatively with
scores on the measure of communication quality (the Dyadic Adjustment Scale [DAS]
subscale, Affectional Expression). The third and final hypothesis is that scores on the
NMAS will correlate negatively with scores on the measure of relationship satisfaction
(the DAS subscale, Dyadic Satisfaction).
Participants, 175 adult men in romantic relationships, were recruited from multiple
sources, including a large research university in the Midwest and internet message
KARAKIS & LEVANT
boards that appealed to men of traditional male occupations. Participants were asked
to indicate which group of ages they fit within (18-25, 26-35, 36-45, 46-55, and 56+).
Overall, ages spanned the full range from the 18-25 to the 56+ groups, the median was
in the 26-35 age group, and the mode was in the 18-25 age group. All participants were
involved in a relationship that included dating and living separately (43.4%), dating
and living together (12.6%), engaged (5.1%), and married (38.9%). Participants were
asked which group of relationship lengths they fit within (less than one year, 1-2 years,
3-5 years, 6-10 years, 11-20 years, 21-30 years, and 30+ years). Overall relationship
lengths spanned the full range from the less than 1 year to the 30 + years groups, the
median was the 6-10 years and the mode was the less than one year groups. The vast
majority of participants listed their ethnicity as Caucasian (91.4%); however some par-
ticipants reported their ethnicity as African American (3.4%), Asian (2.9%), Hispanic
(.6%), and Other (1.1%). With regard to children, 38.9 percent reported having children
while 60.6 percent reported having no children and 1 declined to answer. Participants
were given one of two options for compensation in exchange for their participation in
this survey: University students could receive extra credit for certain courses; other
participants were given the opportunity to be entered into a raffle for a $100 gift card
to Best Buy.
Participants completed a 96-item survey that included a Demographic Form, the Nor-
mative Male Alexithymia Scale, the Fear of Intimacy Scale, and the Dyadic Adjust-
ment Scale. The study was completed using an online survey utility at the participant’s
convenience. Analyses were completed using PASW Statistics 18. All aspects of the
study complied with campus IRB procedures that include an informed consent and a
Demographic form. This form, developed for the present study, assessed: gender,
age, relationship status, relationship length, ethnicity, and whether or not the participant
Normative Male Alexithymia Scale (NMAS). The NMAS (Levant et al., 2006) con-
sists of 20 items to which participants respond using a Likert-based format (1= strongly
disagree to 7 = strongly agree). Sample items include, “I have difficulty expressing
my innermost feelings” and “I don’t like to talk with others about my feelings.” Ex-
ploratory and confirmatory factor indicated that the NMAS consisted of a single 20-
item factor. Scores on the NMAS displayed very good internal consistency (α= .92 for
men), and test-retest reliability (r =.91 for men) over a 1 - 2 month period. Results of
analyses of gender differences, relations of the NMAS with other instruments, and its
incremental validity in predicting traditional masculinity ideology (using the Male Role
Norms Inventory) provide evidence supporting the validity of the scale. After recoding
reverse-worded items, a total NMAS score is obtained through the averaging of scores
on all 20 items. Higher scores indicate greater Normative Male Alexithymia. The co-
efficient alpha for the present study was .85.
NORMATIVE MALE ALEXITHYMIA
Fear of Intimacy Scale (FIS). The FIS (Descutner & Thelen, 1991) consists of Part
A, which assesses current relationships, and Part B, which assesses past relationships.
Participants respond to both parts using a Likert-type format (1 = not at all character-
istic of me to 5 = extremely characteristic of me). Part A consists of 30 items. Instruc-
tions to participants were: “In each statement, “0” refers to the person you are currently
in a relationship with.” Sample items include, “I would feel comfortable telling my ex-
periences, even sad ones, to 0” and “I would not be nervous about being spontaneous
with 0.” Part B consists of 5 items. The instructions asked participants to respond to the
items with regard to past relationships. Sample items from part B include, “I have shied
away from opportunities to be close to someone” and “I have held back my feelings in
previous relationships.” A total FIS score is obtained through the averaging of scores
on all 35 items. Higher scores indicate a greater fear of intimacy. This scale was found
to have excellent internal consistency demonstrated by an alpha coefficient of .93. Fac-
tor analysis also showed that there was the presence of one primary factor that ac-
counted for 32.5 percent of the variance (Descutner & Thelen, 1991). The coefficient
alpha for the present study was .93.
Dyadic Adjustment Scale (DAS). The DAS (Spanier, 1976) assesses the quality of
marital and non-marital couple adjustment. The scale consists of 32 items in 7 sections,
each with a different response format. Five of the sections ask participants to respond
using different Likert-type formats (5 = always agree to 0 = always disagree; 0 = all
the time to 5 = never; 4 = every day to 0 = never; 4 = all of them to 0 = none of them;
and 0 = never to 5 = more often). The sixth section asks participants to answer using
yes (coded as 0) or no (coded as 1). And the seventh section consists of one item that
asks participants to select one of six statements (coded 0, 1, 2, 3, 4, or 5) that best de-
scribed how they felt about the future of their relationship. Factor analysis of the DAS
found four factors: Dyadic Consensus, Dyadic Cohesion, Dyadic Satisfaction, and Af-
fectional Expression. Evidence of reliability and construct validity was reported by
Spanier. After recoding reverse-worded items and translating categorical items into
their assigned codes, we scored them according to Spanier’s protocol to derive sub-
scale and total score scores. Higher scores on subscales and the total scale indicate
greater adjustment to the relationship.
Two hundred and forty six participants initially took part in the study. However, 71
participants were eliminated either because they were not eligible (being female or sin-
gle), they stopped answering questions halfway through the survey, or they provided
patterned responses (e.g., they checked all 1’s or all 5’s). Thus the final sample was
175, for a completion rate of 71.1 percent. There were missing values as some partic-
ipants declined to answer questions at random throughout the survey, which were
treated using ipsative mean substitution, which calculates the mean of individual par-
ticipant’s answers on scale items and substitutes missing values using this mean. De-
scriptive statistics and correlations for study variables are displayed in Table 1.
KARAKIS & LEVANT
NORMATIVE MALE ALEXITHYMIA
Means, Standard Deviations and Alphas of All Study Variables
Scale 1 2 3 4 5 6 7 8 9 10 11 12 MSDα
1. Age 2.11 1.39
2. Status .65** 2.39 1.38
3. Length .75** .77** 3.18 1.86
4. Ethnicity .11 .10 .13 2.91 .51
5. Children -.72** -.68** -.68** -.02 1.60 .49
6. NMAS -.06 .00 .00 .07 .07 3.67 1.09 .85
7. FIS .03 -.09 -.11 -.13 .00 .70** 2.31 .64 .93
8. DC .04 .12 .09 .02 .00 -.38** -.61** 3.46 .60 .94
9. AE -.16* -.20** -.23** .09 .20** -.36** -.48** .54** 3.64 .67 .88
10. DCo .01 .06 .11 .16* .06 -.36** -.67** .70** .49** 3.27 .79 .79
11. DS -.05 -.02 .00 .21** .10 -.39** -.52** .53** .34** .66** 3.84 .72 .88
12. DAS -.01 .05 .05 .12 .07 -.44** -.70** .91** .64** .90** .74** 2.18 .64 .70
Note. NMAS, Normative Male Alexithymia Scale; FIS, Fear of Intimacy Scale; DC, Dyadic Consensus; AE; Affectional Expression; DCo, Dyadic
Cohesion; DS, Dyadic Satisfaction; DAS, Dyadic Adjustment Scale.
*p< .05; **p< .01.
The first hypothesis, that scores on the NMAS would correlate positively with scores
on the FIS, was supported (r = .70, p< .01). The second hypothesis, that higher scores
on the NMAS would correlate negatively with scores on the measure of communica-
tion quality (DAS subscale, Affectional Expression), was supported (r= -.63, p < .01).
The third hypothesis, that scores on the NMAS would correlate negatively with scores
on relationship satisfaction (DAS subscale, Dyadic Satisfaction), was supported (r = -
.39, p < .01)
Age was found to significantly correlate with relationship status (r = .65, p < .01), re-
lationship length (r = .75, p < .01), the presence of children (r = -.72, p < .01), and the
DAS subscale, Affectional Expression, (r = .16, p < .05). Relationship status was found
to significantly correlate with relationship length (r = .77, p < .01), the presence of chil-
dren (r = -.68, p < .01), and the DAS subscale, Affectional Expression, (r = -.20, p <
.01). Relationship length was found to significantly correlate with the presence of chil-
dren (r = -.68, p < .01), and the DAS subscale, Affectional Expression, (r = -.23, p <
.01). The presence of children was found to correlate significantly with the DAS sub-
scale, Affectional Expression, (r = .20, p < .01).
The present study investigated the relationships of NMA with different aspects of re-
lationship quality. Testing of the first hypothesis found that scores on the NMAS cor-
related positively with scores on the FIS, suggesting that men with higher degrees of
NMA will more greatly fear intimacy with their romantic partners. This could indicate
that men suffering from NMA, who lack the ability to identify and express their own
emotions, may also have difficulty relating to their partner’s intimate emotions and
therefore come to fear them.
Testing the second hypothesis found that scores on the NMAS correlated negatively
with scores on the measure of communication quality (DAS subscale, Affectional Ex-
pression). This implies that men with higher degrees of NMA are less likely to com-
municate effectively with their romantic partner. This could indicate that men suffering
from NMA may not have the necessary emotional vocabulary to have quality commu-
nication with their partner.
Finally, testing the third hypothesis found that scores on the NMAS correlated neg-
atively with scores on the measure of relationship satisfaction (the DAS subscale,
Dyadic Satisfaction). These results suggest that men suffering from NMA are less likely
to be satisfied in their current, intimate relationship. This could indicate that such men,
who have a diminished ability to identify and express the wide range of emotions that
occur in an intimate relationship, gain less satisfaction from relationships.
KARAKIS & LEVANT
Age, relationship status, relationship length, and Affectional Expression. Age,
relationship status, and relationship length were all found to be negatively correlated
with the DAS subscale, Affectional Expression (the measure of communication qual-
ity). This suggests that the older an individual, and the more committed and longer the
relationship is, the lower the quality of communication between the man and his inti-
mate partner. This suggests that the longer and more committed the relationship, the
lower the quality of communication. Perhaps when individuals are older and have been
in relationships for long periods of time, they find it less necessary to communicate in
order to make the relationship “work.” However, the present data do not allow us to fur-
ther evaluate this finding, which must therefore be left to future research.
Presence of children and Affectional Expression. The present study also found that
the presence of children in a relationship correlated positively with the DAS subscale,
Affectional Expression. This suggests that those couples with children are more likely
to have a better quality of communication with their partner. However, this finding
could be due to the specific characteristics of sample, and needs to be investigated fur-
ther in future research.
LIMITATIONS AND FUTURE RESEARCH
One major limitation of the study is that only correlational analyses were conducted.
Therefore, nothing can be determined about the cause and effect relationships of the
variables studied. This limitation can be surmounted in future research that uses an ex-
Another limitation is that although participants were drawn from many sources, the
majority came from a single university and were predominantly young, European
American, and middle class. Future research should attempt to replicate our findings
with a sample that is more diverse in terms of age, ethnicity, and social class. Finally,
the self-report nature of the surveys introduces the possibility of bias due to socially de-
sirable responding. A future study employing a multi-method design (including the in-
terviewing method) would strengthen evidence for these relationships. This study
initiates research on the effects that NMA may have on romantic relationships. Future
research might envision an experimental design to investigate the causal relationships
between NMA and relationship quality, seek a broader and more diverse sample, and
use a multi-method design. Future research might also investigate the satisfaction of the
partners of men suffering from NMA.
Couple and marital therapists might make use of these findings by assessing whether
the male partners in distressed couples suffer from NMA, by simply administering the
20-item NMAS. If so, there are examples in the literature of Alexithymia Reduction
Treatment (Levant, Halter, Hayden, & Williams, 2009) in the context of couples ther-
apy (Levant, 2003; Levant, & Silverstein, 2001).
NORMATIVE MALE ALEXITHYMIA
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