Loneliness and Poor Sleep Track With Emotion-Recognition Difficulty in Chinese Teens

A large school-based survey of 7,964 Chinese adolescents has found that loneliness and poor sleep quality are associated with higher levels of alexithymia, a difficulty in identifying and describing emotions, while psychological resilience and perceived social support show inverse associations with the trait. The cross-sectional study, published in BMC Psychology, measured alexithymia with the Chinese version of the Perth Alexithymia Questionnaire and reported a mean total PAQ score of 80.52 with a standard deviation of 26.43.

One descriptive detail from the results stands out: adolescents reported greater difficulties in identifying and describing negative emotions than positive emotions. This pattern indicates that the reported difficulty was not uniform across emotional valence, with adolescents describing greater difficulties with negative emotions than positive ones.

Poor sleep quality, indexed by higher B-PSQI scores, was also positively associated with alexithymia, with a coefficient of 0.099 and a confidence interval of 0.826 to 1.290. In contrast, psychological resilience carried a coefficient of −0.162 with a confidence interval of −0.531 to −0.400, and perceived social support a coefficient of −0.058 with a confidence interval of −0.569 to −0.248, both indicating that higher scores on these protective factors tracked with lower alexithymia scores.

The final regression model explained 23.9 percent of the variance in alexithymia scores.

Beyond the four main correlates, the adjusted analysis also flagged associations with several background variables: gender, grade level, boarding status, and smoking were each associated with alexithymia after adjustment. These demographic and behavioral links add context but, like the main findings, cannot be read as causal effects given the study design.

The authors are careful about interpretation. Their conclusion states that loneliness and poor sleep quality were associated with higher alexithymia scores, whereas psychological resilience and perceived social support showed inverse associations, and they describe these as potentially modifiable correlates that may warrant consideration in future longitudinal and intervention research. In other words, the study identifies patterns worth testing, not proven targets for treatment.

That caution matters because a cross-sectional survey captures a single moment in time. Adolescents who feel lonelier may also struggle more to name their emotions, or the direction could run the other way, or both relationships could reflect shared underlying causes. Only longitudinal follow-up or controlled intervention studies can establish whether improving sleep, social support, or resilience would actually change alexithymia levels.

The study’s scope is also worth keeping in view: the participants were secondary school students in six Chinese provinces and autonomous regions surveyed over a three-month window in early 2024, so the findings describe that population and setting rather than adolescents globally. Alexithymia is described in the paper as a significant psychological risk factor during adolescence, and the authors note that a comprehensive understanding of its modifiable correlates in the Chinese adolescent population had remained limited, which motivated the survey.

For researchers, the practical takeaway is a ranked map of candidate factors: loneliness emerged with the largest coefficient, resilience and social support pointed in the protective direction, and sleep quality added an independent positive association after full adjustment. For the public, the honest summary is simpler: in this large sample of Chinese teenagers, kids reporting more loneliness and worse sleep also reported more trouble identifying and describing their emotions, and those reporting more resilience and support reported less. Whether strengthening the protective factors would reduce alexithymia is precisely the question the authors say future longitudinal and intervention research needs to answer.

Subject of Research: Cross-sectional associations between loneliness, resilience, social support, sleep quality and alexithymia among Chinese adolescents

Article Title: Associations of loneliness, psychological resilience, social support, and sleep quality with alexithymia among 7,964 Chinese adolescents: a cross-sectional study

Article References: Li, S., Chong, X., Wang, Y., Guo, Y., Sun, Y., Guo, F., Zheng, Y., Mu, F., Liu, M., Zhang, Y., Wang, J., & Liu, Y. (2026). Associations of loneliness, psychological resilience, social support, and sleep quality with alexithymia among 7,964 Chinese adolescents: a cross-sectional study. BMC Psychology. https://doi.org/10.1186/s40359-026-05885-5

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05885-5

Keywords: alexithymia, adolescents, loneliness, sleep quality, psychological resilience, social support, cross-sectional study, China, mental health, BMC Psychology, Associations, psychological