Alexithymia and emotion regulation: An in-depth exploration of ultra-endurance running

Abstract

This thesis aims to explore the processes that underpin the motives for ultrarunning within an emotion regulation framework, for individuals who have difficulty with regulating emotions. We begin with an introduction to the research area where we review the current literature and explain the specific aims of this thesis. The subsequent chapters are written as four research papers that aim to explore the areas of interest outlined in the introduction.
Chapter 2 provides preliminary evidence for the anxiolytic effect of running an ultramarathon for those high in alexithymia. We used a quasi-experimental repeated measures design, measuring alexithymia and state anxiety two days before an ultramarathon event, and then state anxiety again two days post-race. We found that alexithymia significantly moderated the relationship between pre- and post-race anxiety, such that higher alexithymia attenuated the relationship between pre- and post-race anxiety. This provides initial support for ultramarathon running having an anxiolytic benefit for those high in alexithymia.
Chapter 3 focuses on the lived experiences of alexithymic ultramarathon runners. We aimed to form an in-depth understanding of the experience of training for, and completing, ultramarathons within an emotion regulation framework. Additionally, we aimed to explore the potential mechanisms that underpin the emotional benefits of ultrarunning for alexithymic individuals. We followed a phenomenological approach using semi-structured interviews to glean detailed qualitative data, which we analysed using reflexive thematic analysis. Themes developed centred around emotion regulation benefits not only from ultramarathon events, but from the training required for these events. Furthermore, the experience of pain and intense emotions was revealed to play a key role in this process. Surrounding themes included interpersonal benefits, symptoms of exercise dependence, and transfer of coping skills into everyday life. In summary, ultramarathon running provides an environment rich in experiences that are beneficial to those high in alexithymia, providing emotion regulation benefits that expand into everyday life.
Chapter 4 aimed to establish whether the intensity of the pain experienced during an ultramarathon is a mechanism that underlies the anxiolytic benefit of ultrarunning for individuals high in alexithymia. We tested this position using a quasi-experimental repeated measures design collecting data at three time points, three days pre-race, immediately post-race, and three days post-race. We measured alexithymia at Time 1, state anxiety at all three time points, and pain intensity during the ultramarathon (measured immediately post-race). We used a latent growth curve model within a multilevel modelling framework to analyse change in anxiety over time, whether any change in anxiety was predicted by alexithymia, and whether pain moderated this relationship. The results showed a significant decrease in anxiety over time, which was significantly predicted by alexithymia such that those high in alexithymia had a greater decrease in anxiety. The intensity of the pain experienced during the ultramarathon did not moderate the relationship between alexithymia and change in anxiety over time. The findings support the anxiolytic effect of an ultramarathon for those high in alexithymia. However, we did not find support for the intensity of pain as the mechanism behind this emotion regulation benefit of ultramarathons.
Chapter 5 delves into emotion regulation as the mechanism behind exercise dependence in alexithymic ultrarunners, and their subsequent willingness to experience pain. Within a cross-sectional design, we measured alexithymia, difficulties regulating emotions, anxiety when participating regularly in ultrarunning, anxiety when unable to participate in ultrarunning, exercise dependence, and willingness to experience pain in ultrarunning. We tested a multiple mediator model to examine the indirect association of alexithymia with willingness to experience pain. Alexithymia predicted difficulties regulating emotions, which was in turn positively associated with anxiety when unable to participate in ultrarunning (controlling for anxiety when participating regularly). Anxiety when unable to participate in ultrarunning then predicted exercise dependence, which was positively associated with willingness to experience pain. This model provides empirical evidence for ultrarunning serving an emotion regulation function upon which alexithymic individuals may be dependent, which likely explains why they are willing to subject themselves to the pain of an ultramarathon.
A general discussion follows where we summarise the findings and discuss applied and theoretical implications, and potential future research directions.

Date of Award	20 Jun 2025
Original language	English
Awarding Institution	Bangor University
Sponsors	Economic and Social Research Council (ESRC)
Supervisor	Tim Woodman (Supervisor) & Ross Roberts (Supervisor)