Restricted accessResearch articleFirst published online 2026
Alexithymia and ergonomic health in academic work environments: Associations with physical activity,musculoskeletal discomfort,posture,and fatigue among university students
Alexithymia, defined as difficulty identifying and expressing emotions, has been linked to poor health behaviors and psychosomatic complaints. Evidence on its relationship with physical activity, musculoskeletal problems, posture, and fatigue in university students remains limited.
Objective
This study examined associations between alexithymia, physical activity, musculoskeletal complaints, posture, and fatigue in young adults.
Methods
A cross-sectional study was conducted with 176 university students (59.1% female, mean age 21.3 ± 1.7 years). Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20), physical activity with the International Physical Activity Questionnaire–Short Form (IPAQ-SF), musculoskeletal complaints with the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), posture with the New York Posture Rating Chart (NYPRC), and fatigue with the Checklist Individual Strength Questionnaire (CIS). Group comparisons were made by alexithymia status, and associations were analyzed with Spearman's correlation.
Results
Students with alexithymia (n = 29) reported lower physical activity (p = 0.012) and greater fatigue (p = 0.023). No significant differences emerged for musculoskeletal complaints or posture. TAS scores correlated positively with fatigue (r = 0.431, p < 0.001) and negatively with physical activity (r = –0.187, p < 0.05) and posture (r = –0.150, p < 0.05).
Conclusions
Alexithymia is associated with reduced physical activity and increased fatigue, and showed a weak negative correlation with posture in university students. These results underscore the need for interventions addressing emotional regulation and physical activity to support ergonomic health and academic outcomes in young adults.
IskricACenitiAKBergmansY, et al.Alexithymia and self-harm: a review of nonsuicidal self-injury, suicidal ideation, and suicide attempts. Psychiatry Res2020; 288: 112920.
2.
TesioVDi TellaMGhiggiaA, et al.Alexithymia and depression affect quality of life in patients with chronic pain: a study on 205 patients with fibromyalgia. Front Psychol2018; 9: 442.
3.
Martínez-SánchezFAto-GarcíaMOrtiz-SoriaB. Alexithymia—state or trait?Span J Psychol2003; 6: 51–59.
4.
LaneRDLeeSReidelR, et al.Impaired verbal and nonverbal emotion recognition in alexithymia. Psychosom Med1996; 58: 203–210.
5.
ŞahinH. Peptik ülser ve aleksitimi. Türk Psikiyatri Dergisi1991; 2: 25–30.
6.
Martinez-SanchezFAto-GarciaMAdamEC, et al.Stability in alexithymia levels: a longitudinal analysis on various emotional answers. Pers Individ Dif1998; 24: 767–772.
7.
KurtaranMBaktırSAbanozEŞ, et al.Üniversite öğrencilerinde ağrı, aleksitimi, emosyonel durum ve yaşam kalitesinin değerlendirilmesi. Sakarya Tıp Dergisi2019; 9: 433–441.
8.
ObbariusNFischerFLieglG, et al.A modified version of the transactional stress concept according to Lazarus and Folkman was confirmed in a psychosomatic inpatient sample. Front Psychol2021; 12: 584333.
9.
HerbertBMHerbertCPollatosO. On the relationship between interoceptive awareness and alexithymia: is interoceptive awareness related to emotional awareness?J Pers2011; 79: 1149–1175.
10.
KandolaAAshdown-FranksGHendrikseJ, et al.Physical activity and depression: towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev2019; 107: 525–539.
11.
CaiSWangHZhangYH, et al.Could physical activity promote indicators of physical and psychological health among children and adolescents? An umbrella review of meta-analyses of randomized controlled trials. World J Pediatr2025; 21: 159–173.
12.
KooimanCGBolkJHRooijmansHGM, et al.Alexithymia does not predict the persistence of medically unexplained physical symptoms. Psychosom Med2004; 66: 224–232.
13.
TaylorGJ. Recent developments in alexithymia theory and research. Can J Psychiatry2000; 45: 134–142.
14.
LeclercAChastangJFNiedhammerI, et al.Incidence of shoulder pain in repetitive work. Occup Environ Med2004; 61: 39.
15.
BonettiFCurtiSMattioliS, et al.Effectiveness of a’Global Postural Reeducation’program for persistent low back pain: a non-randomized controlled trial. BMC Musculoskelet Disord2010; 11: 285.
16.
DaelNMortillaroMSchererKR. Emotion expression in body action and posture. Emotion2012; 12: 1085–1101.
17.
SchmeichelBJ. Attention control, memory updating, and emotion regulation temporarily reduce the capacity for executive control. J Exp Psychol Gen2007; 136: 241–255.
18.
AbdaliNNobaharMGhorbaniR. Evaluation of emotional intelligence, sleep quality, and fatigue among Iranian medical, nursing, and paramedical students: a cross-sectional study. Qatar Med J2019; 2019: 15.
19.
LiuYDuanLShenQ, et al.The mediating effect of internet addiction and the moderating effect of physical activity on the relationship between alexithymia and depression. Sci Rep2024; 14: 9781.
20.
BagbyRMParkerJDATaylorGJ. The twenty-item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. J Psychosom Res1994; 38: 23–32.
21.
GüleçHKöseSGüleçMY, et al.Reliability and factorial validity of the Turkish version of the 20-item Toronto alexithymia scale (TAS-20). Verus J2009; 19: 214–220.
22.
GüleçHYenelA. 20 Maddelik Toronto aleksitimi ölçeği Türkçe uyarlamasının kesme noktalarına göre psikometrik özellikleri. Klin Psikiyatr Derg2010; 13: 108–112.
23.
CraigCLMarshallALSjöströmM, et al.International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc2003; 35: 1381–1395.
24.
SaglamMArikanHSavciS, et al.International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills2010; 111: 278–284.
25.
SavcıSÖztürkMArıkanH, et al.Physical activity levels of university students. Arch Turk Soc Cardiol2006; 34: 166–172.
26.
ErdincOHotKOzkayaM. Turkish version of the Cornell Musculoskeletal Discomfort Questionnaire: cross-cultural adaptation and validation. Work2011; 39: 251–260.
27.
GüneşÜCeylanB. Akademisyen hemşirelerin bilgisayarlı çalışma ortamındaki ergonomik koşullarının ve buna bağlı ortaya çıkan kas-iskelet sistemi rahatsızlıklarının incelenmesi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi2016; 32: 61–74.
28.
JohnsonBLNelsonJK. Practical measurements for evaluation in physical education. Published online 1969.
29.
McRobertsLBCloudRMBlackCM. Evaluation of the New York Posture Rating Chart for assessing changes in postural alignment in a garment study. Cloth Text Res J2013; 31: 81–96.
30.
VercoulenJHMMSwaninkCMAFennisJFM, et al.Dimensional assessment of chronic fatigue syndrome. J Psychosom Res1994; 38: 383–392.
31.
ErginGYildirimY. A validity and reliability study of the Turkish Checklist Individual Strength (CIS) questionnaire in musculoskeletal physical therapy patients. Physiother Theory Pract2012; 28: 624–632.
32.
CohenJ. Statistical power analysis. Curr Dir Psychol Sci1992; 1: 98–101.
33.
Proença LopesCAlladoEEssadekA, et al.Occurrence of alexithymia and its association with sports practice from a sample of university students: results from a French cross-sectional study. Healthcare2022; 10: 788. MDPI.
34.
Proença LopesCAlladoEPousselM, et al.An association between alexithymia and the characteristics of sport practice: a multicenter, cross-sectional study. Healthcare (Basel)2022; 10: 432.
35.
TorlakMSUnuvarBSGercekH. Effect of aerobic exercise on the levels of pain, quality of life, and alexithymia in alexithymic individuals with chronic pain: a single-blinded randomized controlled trial. J Manipulative Physiol Ther2022; 45: 652–659.
36.
LiparotiM. Physical exercise and Alexithymia: risk or benefit?Form@re2022; 22: 235–241.
37.
YıldızŞApaydınZBErbahçeciF. The analyses of the relationship between physical activity, musculoskeletal system problems, sleep, and screen exposure time in university students during the distance learning process. J Basic Clin Health Sci2017; 7: 64–74.
38.
AaronRVFisherEADe La VegaR, et al.Alexithymia in individuals with chronic pain and its relation to pain intensity, physical interference, depression, and anxiety: a systematic review and meta-analysis. Pain2019; 160: 994–1006.
39.
MehlingWEDaubenmierJPriceCJ, et al.Self-reported interoceptive awareness in primary care patients with past or current low back pain. J Pain Res2013: 403–418. DOI: 10.2147/JPR.S42418.
40.
PollatosOHerbertBM. Alexithymia and body awareness. In: Alexithymia: advances in research, theory, and clinical practice. 2018, pp.321–334. 321. DOI: 10.1017/9781108241595.019.
41.
KolpakovaNVShestel’AI. The prevalence of alexithymia among medical university students: the relationship with somatic morbidity, unhealthy habits, and academic performance. Med Sci Educ Ural2021; 22: 128–131.
42.
KadanjiSAHoomanFKhabirL. Predicting academic burnout based on loneliness, distress tolerance, and alexithymia in students. Educ Res Med Sci2025; 14: e162750.
43.
YaşarABGündoğmuşİ. Relationship between alexithymia and sleep quality in university students. Psikiyatr Güncel Yaklaş2021; 13: 122–133.
