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Although there is evidence for the role of environmental and neurological factors, the role and influence of genetic factors for developing alexithymia is still unclear.
A single large scale Danish study suggested that genetic factors contributed noticeably to the development of alexithymia.
Also, a study examining alexithymia in subjects with obsessive-compulsive disorder found higher alexithymia levels associated with the Val/Val allele of the Rs4680 polymorphism in the gene that encodes Catechol-O-methyltransferase (COMT), an enzyme which degrades catecholamine neurotransmitters such as dopamine.
These links are tentative, and further research will be needed to clarify how these genes relate to the neurological anomalies found in the brains of people with alexithymia.
In general, these individuals can, but not always, seem oriented toward things and even treat themselves as robots.The first language of an infant is nonverbal facial expressions.The parent's emotional state is important for determining how any child might develop.Some individuals working for organizations in which control of emotions is the norm might show alexithymic-like behavior but not be alexithymic.However, over time the lack of self-expressions can become routine and they may find it harder to identify with others.
In a study, a large group of alexithymic individuals completed the 64-item Inventory of Interpersonal Problems (IIP-64) which found that "two interpersonal problems are significantly and stably related to alexithymia: cold/distant and non-assertive social functioning.