Enhancing emotion expression (3E): A novel virtual reality tool for improving alexithymia and its psychological outcomes from a multi-dimensional perspective

Background: Alexithymia is characterized by an impaired ability in emotion awareness, expression, and regulation, associated with deficits in social and mental functioning. This study aims to develop a tool for addressing alexithymia and its psychological outcomes.

Method: In this paper, 102 subjects were recruited to investigate the relationship between alexithymia and psychological outcomes, along with the mediating role of emotion awareness, expression, and regulation. Based on these findings, we propose an Enhanced Emotion Expression (3E) system, an interactive VR platform that integrates emotion arousal, mindfulness, open-ended questions, and metaphor, designed to equip users with effective emotional management skills. We present the system's design and implementation, as well as user studies.

Results: We demonstrate the mediating role of emotion awareness, expression and regulation in the relationship between alexithymia and psychological outcomes (anxiety: 95 % CI = 0.002-0.189; depression: 95 % CI = 0.002-0.164). Furthermore, our findings indicate that the proposed 3E system can effectively guide users in becoming aware of, expressing, and regulating their emotions (ts = -2.185-2.860, Ps = 0.009-0.04), thus alleviating alexithymia, anxiety, and depression (ts = 2.404-3.775, Ps = 0.003-0.043).

Limitations: The limitations of this study include the use of self-reports, the lack of investigation into other mediating variables, a small sample size, and the absence of long-term follow-up.

Conclusions: We have developed intervention strategies to address alexithymia and proposed an innovative 3E system. This system provides an effective tool for mitigating alexithymia and its adverse psychological outcomes.