Can't Name It, Can't Log Off: Alexithymia and Problematic Internet-Related Behaviors: A Systematic Review and Meta-Analysis.

Alexithymia has been proposed as a ransdiagnostic vulnerability for behavioral addictions, but its role in problematic Internet-related behaviors (PIB) has not been quantified across phenotypes and populations. We conducted a preregistered systematic review and meta-analysis following Preferred Reporting Items for Systematic reviews and Meta-Analyses. Major databases were searched in October 2025 for studies reporting quantitative associations between alexithymia and PIB (problematic Internet, smartphone, social media, gaming use, or cyberbullying). Risk of bias was appraised with Joanna Briggs Institute tools. Random-effects models pooled correlations and standardized regression coefficients; three-level and robust-variance models accounted for multiple effects per study and examined moderators and adjustment for internalizing symptoms. Eighty-three studies met inclusion criteria; 78 independent samples (N = 42,478; 369 effect sizes total, comprising 302 zero-order correlations and 67 standardized regression coefficients) contributed to the meta-analysis. The pooled correlation between alexithymia and PIB was r = 0.36 (95% confidence interval 0.34-0.38; I2 = 77.6%). Associations were stronger for addictive-use PIB (r = 0.37) than for cyberbullying (r = 0.29), broadly comparable across world regions, and tended to be larger in adults than adolescents. In multivariable models, coefficients attenuated from about β = 0.37 to β = 0.18 after controlling for depression, anxiety, and other internalizing symptoms, but remained statistically significant. Sensitivity and publication-bias analyses indicated that the association was robust. Alexithymia shows a moderate association with PIB across age groups, partly via shared variance with internalizing psychopathology but also through unique pathways. Longitudinal and mechanistic studies should test whether targeting emotional awareness can help prevent or reduce PIB.