Alexithymic characteristics have been observed in antisocial personality disorder (APD). On the other hand, aggression is a particular problem commonly observed in personality disorders, especially in APD. We investigated the alexithymic features and aggression levels in outpatients diagnosed with APD in a military hospital setting.

71 male subjects diagnosed with APD and 81 sex and age matched normal subjects with no known medical or psychiatric disorder were assessed with an assessment battery using a sociodemographic data form, APD section of SCID-II, the Toronto Alexithymia Scale (TAS)-20 items, and Aggression Questionnaire.

The subjects with APD have showed significantly higher rates of unemployment, lower educational and socioeconomic status. The APD group also displayed significantly higher scores on alexithymia and aggression than control group. APD subjects with higher scores of aggression revealed significantly higher scores of alexithymia.

Use of action to express emotions, a commonly observed feature of APD, was once considered to be a part of alexithymia. The subjects with APD may have less developed cognitive skills which lead to a failure in communicating their feelings. This may result in immature methods of communicating distress. Our study indicate that alexithymia may contribute to aggressive behavior in patients with APD. To draw a more definitive conclusion on this issue, larger community based studies that compares APD subjects with sociodemographically matched patient control groups are necessary.