Purpose This study explores the relationship between alexithymia and prison populations, synthesising existing empirical research to identify trends, gaps and implications for rehabilitation. By analysing 32 studies, the research examines how trauma, mental health comorbidities and demographic factors influence the prevalence of alexithymia among offenders. It also evaluates potential treatment approaches beyond traditional psychotherapy, particularly in reducing recidivism. The study highlights the need for a more nuanced understanding of alexithymia-specific interventions within correctional systems. Ultimately, this study aims to contribute to the development of targeted rehabilitation strategies for offenders with alexithymia, improving mental health outcomes and reducing reoffending rates. Design/methodology/approach A systematic review methodology was used to analyse studies on alexithymia in prison populations. A comprehensive search was conducted via Google Scholar database, screening publications from 1972 to 2024 using the search terms: Alexithymia AND Prison OR Offender OR Inmate OR Prisoner. Inclusion criteria required studies to be empirical, prison-based and published in English. After screening 981 search results, 32 studies met the criteria. Data extraction focused on study aims, methodology, sample characteristics and findings. Thematic synthesis was conducted, categorising studies into five key areas: abuse/trauma, testing and treatment, comorbidities, demographics and type of crime. Findings The review identified a strong relationship between alexithymia and adverse childhood experiences, comorbid mental health conditions (e.g. depression, post-traumatic stress disorder and addiction) and aggression/impulsivity. Studies indicate that alexithymia contributes to emotional dysregulation, influencing offending behaviour, particularly among violent offenders. However, evidence regarding its role in psychopathy and non-violent crime remains inconsistent. Few studies have examined alexithymia among female or ethnically diverse prison populations. Treatment interventions, such as mindfulness, compassion-focused therapy and social problem-solving skills, show promise in reducing alexithymic traits. Overall, these findings emphasise the need for tailored interventions for incarcerated individuals with alexithymia. Research limitations/implications This review is limited by its reliance on English-language publications and studies indexed in Google Scholar, which may exclude relevant research. The heterogeneity of methodologies across studies also limits direct comparisons. Furthermore, most studies focus on male prisoners, leaving gaps in understanding alexithymia in female and minority populations. The findings suggest a need for further research on gender differences, psychopathology and non-violent offending. In addition, more longitudinal studies are required to assess whether treating alexithymia reduces recidivism. Addressing these gaps can improve psychological assessments and rehabilitative approaches for offenders with alexithymia. Practical implications The strong association between alexithymia and offending behaviour underscores the need for targeted rehabilitative interventions in prisons. Current rehabilitation programs may be ineffective for alexithymic individuals due to their emotional processing deficits. Screening for alexithymia in correctional settings could enhance treatment planning by identifying offenders who may struggle with traditional therapy. The effectiveness of interventions such as mindfulness, emotional regulation training and social problem-solving skills suggests that integrating these into prison rehabilitation programs may reduce aggression, impulsivity and recidivism. Addressing alexithymia in offenders could improve rehabilitation outcomes and contribute to a safer reintegration into society. Social implications Alexithymia’s association with trauma, poor mental health and aggression suggests broader societal consequences. Many incarcerated individuals have experienced childhood abuse and neglect, highlighting systemic failures in early intervention. Understanding alexithymia s role in offending behaviour could inform social policies addressing mental health disparities, particularly in marginalised communities. In addition, providing alexithymia-specific rehabilitation in prisons may reduce reoffending rates, benefiting both the justice system and society. Addressing alexithymia could also have implications for reducing prison violence and improving inmate well-being, ultimately contributing to more effective reintegration and reducing the long-term social costs of incarceration. Originality/value To the best of the author’s knowledge, this systematic review is the first to synthesise all existing empirical research on alexithymia in prison populations. By categorising findings into five key themes, it provides a comprehensive overview of how alexithymia interacts with trauma, comorbidities, demographics and offending behaviour. The review identifies critical research gaps, particularly regarding gender differences and the effectiveness of treatment interventions. Its findings emphasise the need for tailored rehabilitation approaches, offering valuable insights for psychologists, prison administrators and policymakers. By advancing our understanding of alexithymia in incarcerated individuals, this review contributes to improving mental health strategies and reducing recidivism.
Misu Kim (Sun,) studied this question.