Assessing reliability and validity of the Farsi version of the Toronto Alexithymia Scale in a sample of substance-using patients

The aim of this study was to estimate reliability and factorial validity of the Farsi version of the Toronto Alexithymia Scale-20 (TAS-20) for 321 substance-abusing patients (187 men and 134 women). All were asked to complete the Farsi version of the Toronto Alexithymia Scale-20, the Emotional Intelligence Scale, and The Mental Health Inventory. Analysis supported the internal consistency, test-retest reliability, concurrent validity, and three-factor structure of the Farsi version of the TAS-20 for substance users. The factors are similar to the three reported previously and were labeled as Difficulty Identifying Feelings, Difficulty Describing Feelings, and Externally oriented Thinking. These results provide evidence for applicability of the TAS-20 and its cross-cultural validity.     

Comparison of 26-item and 20-item versions of the Toronto Alexithymia Scale for psychiatric outpatients

This study compared the 20-item revised Toronto Alexithymia Scale with the 26-item version for 257 psychiatric outpatients. Scores on the 20-item version significantly correlated with those on the 26-item inventory even when controlled for depressed mood. Furthermore, the 20-item scale showed greater internal consistency. Factor analysis for both versions indicated three subfactors but the factors in the TAS-20 accounted for greater common variance (92%) than for the factors in the TAS-26 (78%). The total variance accounted for by these factors on the TAS-20 (45%) was also greater than for the TAS-26 (38%).     

Gastroesophageal reflux disease: alexithymia and attachment style

Alexithymia and its relation with attachment style were evaluated in a group of 69 patients (men, M age = 46.4 yr., SD = 12.6; women, M age = 44.2 yr., SD = 14.4) affected by Gastroesophageal Reflux Disease. Two self-evaluation questionnaires were used for psychological evaluation, the 20 item Toronto Alexithymia Scale (TAS-20) and the Attachment Style Questionnaire (ASQ). The TAS-20 analysis showed that the clinical sample taken as a whole did not score in the alexithymic range. The inverse correlations between the Confidence ASQ subscale and the Difficulty Communicating Feelings TAS-20 subscale showed that communication of emotions could develop more easily within the framework of a relational context characterized by safety and confidence. In this group of patients this was represented by the referent caregiver.     

Psychometric properties of a revised Spanish 20-item Toronto Alexithymia Scale adaptation in multiple sclerosis patients

There have been a small number of investigations of alexithymia in multiple sclerosis (MS) using the 20-item Toronto Alexithymia Scale (TAS-20). However, the TAS-20 factor structure has not yet been evaluated in a MS patient sample, and earlier Spanish translations of this instrument require some improvement. We aimed to evaluate the factorial validity and reliability of an improved Spanish translation of the TAS-20 (the TAS-20-S). The TAS-20-S was completed by 221 MS patients. Confirmatory factor analysis was used to compare the fit of six different factor models. Internal consistency and retest reliability coefficients were also computed. The correlated three-factor model and the higher-order factor model made up of Difficulty Identifying Feelings, Difficulty Describing Feelings, and Externally Oriented Thinking achieved the best fit. Alpha coefficients ranged between .87 and .67; mean inter-item correlations ranged between .48 and .20; and retest correlations after 6 months ranged between .61 and .52. A high degree of alexithymia was present in 18.1% of the sample. Reliability and the traditional three-factor structure were demonstrated for the TAS-20-S, which can now be recommended for assessing an aspect of emotional processing in MS patients.     

Factorial validity of the 20-item Toronto Alexithymia Scale

The 20-item Toronto Alexithymia Scale (TAS-20) was developed in previous research to measure a general dimension of alexithymia with three inter correlated factors. These three factors reflect distinct facets of the alexithymia construct: (1) difficulty identifying feelings and distinguishing them from the bodily sensations of emotion, (2) difficulty describing feelings to others, and (3) an externally orientated style of thinking. This study tested the three-factor model for the TAS-20, using confirmatory factor analysis, in separate samples of young adults from Germany, Canada, and the United States. The previously established three-factor model was found to be replicable in all three samples. In addition, the full TAS-20 and its three factors demonstrated adequate internal reliability in all three samples. Although evaluation of the convergent, discriminant, and criterion validity of the TAS-20 is required in diverse cultural groups, the present results provide evidence for the factorial validity and internal reliability of the TAS-20.     

20‐Item Toronto Alexithymia Scale: Do difficulties describing feelings assess proneness to shame instead of difficulties symbolizing emotions?

A hallmark of alexithymia is the difficulty putting emotional states into words which has to be differentiated from problems to communicate emotion to others. Shame proneness is a personality trait that is expected to be closely related to a reduced emotional self-disclosure in social interactions. The present investigation was conducted to examine construct validity of the Difficulties Describing Feelings scale of the 20-Item Toronto Alexithymia Scale (TAS-20). The TAS-20 was administered to 68 subjects (30 psychiatric inpatients and 38 normals) along with the Levels of Emotional Awareness Scale (LEAS), a direct measure of the ability to express feelings verbally, and the Shame-Guilt-Scale. Difficulties Describing Feelings was associated with shame assessing scales but not with guilt assessing scales or the LEAS. Thus, in view of our data one should be cautious in interpreting scores from the TAS-20 scale Difficulties Describing Feelings as indices of a difficulty to symbolize one's emotions. Instead, this TAS-20 scale seems to evaluate aspects of social shame.     

Alexithymia and sociocultural factors in a Japanese sample: a study with the Rorschach

We reexamined the Japanese version of the 20-item Toronto Alexithymia Scale, a self-report sc ale for measuring alexithymic characteristics, by comparing the scores on three factors and the total scores with variables of the Rorschach in a sample of 40 (originally 48) Japanese college students. Based on prior studies, our aims were to further validate the 20-item Toronto Alexithymia Scale by comparing its scores with those on a projective technique. We also investigated whether sociocultural factors, such as repression of hostility. are associated with scores on the 20-item Toronto Alexithymia Scale (especially Factor 3). None of the seven Rorschach Alexithymia Variables were significantly related to the factors and total scores of the 20-item Toronto Alexithymia Scale. However, scores for Factor 1 (difficulty identifying feelings) of the 20-item Toronto Alexithymia Scale correlated positively with scores on Sum C' (reserved responses to emotional stimuli) and Adj es (stimulus demand), suggesting that individuals who score high for Factor 1 experience gloomy, depressive feelings but in constricted ways. Scores for Factor 3 (externally oriented thinking) correlated positively with the D scores (stress tolerance) and negatively with m (situational stress) responses, suggesting that Factor 3 may reflect a psychological defense that enhances stress tolerance. There was a nonsignificant negative correlation between Factor 1 and Factor 3 scores, but, unlike our hypothesis. Factor 3 was neither related to AG (aggression) nor S (space responses reflecting oppositional tendency), indices of aggression or hostility in the Rorschach Comprehensive System. It may be that the 20-item Toronto Alexithymia Scale and the Rorschach measure quite different aspects of personality, but further research is necessary.     

Alexithymia and interpersonal problems: A study of natural language use

The concept of alexithymia refers to difficulties in experiencing, verbalizing and regulating emotions. The relationship between alexithymia and interpersonal style is investigated by means of lexical content analysis. It is hypothesized that alexithymia is related to less frequent and less varied use of communication words and references to others. Alexithymia was measured with the 20-item Toronto Alexithymia Scale and the Toronto Structured Interview for Alexithymia. The Clinical Diagnostic Interview was administered to 50 psychiatric inpatients, transcribed verbatim, and computer-analysed with the Linguistic Inquiry and Word Count-dictionary. Results showed that alexithymia is related to a less complex vocabulary for communication words. Contradictory results for some subscales of the TAS-20 and the TSIA however compromise their construct validity.     

TAS-20 alexithymia in obesity, and its links to personality

We studied the association between alexithymia (20-item Toronto Alexithymia Scale, TAS-20) and obesity, and also assessed the construct validity of the TAS-20 in terms of personality dimensions in obese patients. The TAS-20 and its subscales were analysed for their correlations with the NEO Personality Inventory - Revised (NEO PI-R) in an obese sample of 259 patients. Obesity was associated with higher scores on the TAS-20 than a Swedish reference sample. Obese men furthermore scored higher on Externally Oriented Thinking than the obese women. TAS-20 scores correlated with elevated Neuroticism and lower levels of Extraversion and Openness, in agreement with most previous research, but also somewhat unexpectedly with lower Conscientiousness and for women also with lower Agreeableness. The TAS-20 subscales showed divergent associations with personality variables, largely in accordance with previous findings. The associations were more prominent for the women, and some gender-specific patterns not previously reported were also revealed.     

The Toronto Alexithymia Scale (TAS-20): A measure of general psychological distress

The Toronto Alexithymia Scale (Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale-I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32.) is the most commonly used measure of Alexithymia (= difficulties identifying and describing one’s own feelings). Sixty-three persons (34 psychiatric inpatients, 29 healthy controls) first filled in the TAS-20 and were then interviewed about their interpersonal relationships. Two raters coded the emotional experiences that the participants reported during these interviews. Contrary to expectations, participants with higher TAS-20 scores reported more emotions (particularly negative ones), and more different emotions, questioning the validity of the TAS-20 as a measure of Alexithymia. Based on correlation patterns and a joint factor analysis with two well-established measures of psychopathology, it is concluded that the TAS-20 assesses a general psychological distress factor.     

Alexithymia and insomnia

The purpose of the present study was (1) to investigate the association between insomnia and alexithymia, as measured by the Toronto Alexithymia Scale (TAS-20) and its subscales, and (2) to test if the TAS-20 and its subscales show the same correlational pattern with anxiety, depression and perfectionism in insomnia patients as has previously been found in non-clinical samples. A consecutive series of 259 insomnia patients were compared with a community sample. Although the insomnia patients scored significantly higher on the TAS-20, this difference disappeared when trait anxiety was controlled for, and was primarily due to patients who suffered from insomnia associated with another psychiatric disorder. All insomnia groups, however, showed elevated scores on the TAS-20 subscale Externally Oriented Thinking (EOT). The correlational analysis showed moderate to high correlations between the TAS-20 (and its subscales Difficulties Identifying Feelings and Difficulties Describing Feelings, although not the EOT) and measures of depression, anxiety and perfectionism, thus replicating a pattern from non-clinical samples. The results are discussed in terms of externally oriented thinking being an interesting dimension of alexithymia, which is (a) not confounded by negative emotion and standards of performance, and (b) shows generally elevated scores in insomnia patients.     

Factorial and cross-cultural validity of a Farsi version of the Anger Rumination Scale

This study aimed to examine factorial and cross-cultural validity of a Farsi version of the Anger Rumination Scale. 933 undergraduate students (388 men, 545 women) from the University of Tehran participated. The Farsi version of the Anger Rumination Scale, the Tehran Multidimensional Anger Scale, and the Mental Health Inventory were completed by all participants. Results supported the four-factor structure, convergent and discriminant validity, internal consistency, and test-retest reliability of the Farsi version of the Anger Rumination Scale. The factors found in the Farsi version of the Anger Rumination Scale are similar to the factors found in previous studies and were accordingly labeled as Angry Afterthoughts, Thoughts of Revenge, Angry Memories, and Understanding Causes. The results also provided evidence for applicability of the Farsi version of the Anger Rumination Scale and its cross-cultural validity.     

A Swedish translation of the 20-item Toronto Alexithymia Scale: cross-validation of the factor structure

The purpose of this study was to develop a new Swedish translation of the twenty-item Toronto Alexithymia Scale (TAS-20) and to examine if the theoretical structure that underlies the factor structure of the English version of the TAS-20 could be recovered in this Swedish translation of the instrument. A sample of 157 undergraduate students of psychology was tested. Using confirmatory factor analysis, the previously established three-factor TAS-20 model was found to be replicable in this sample. In addition, the Swedish translation of the TAS-20 showed adequate internal reliability. The present study also illustrates the importance of using back translation methodology when transposing psychometric instruments from one language to another.     

Alexithymia and automatic affective processing

According to recent theories of emotion evaluative information is activated automatically in the associative network on the observation of a stimulus. This study investigates the relationship between alexithymic personality dimensions and automatic affective facilitation effects. The 20-Item Toronto Alexithymia Scale (TAS-20) was administered to 32 subjects along with two sequential word–word priming tasks (a pronunciation and an evaluation task). The TAS-20 scale ‘Difficulties Describing Feelings’ showed a correlation with affective facilitation based on negative stimuli, whereas the scale ‘Externally Oriented Thinking’ as well as the TAS-20 sum score correlated with affective facilitation based on positive stimuli. Thus, some evidence was found that individuals with difficulties verbalizing their emotions are especially sensitive to the negative valence of stimuli at a pre-attentive level. It is argued that the scale ‘Difficulties Describing Feelings’ might assess aspects of social anxiety or shame. Individuals who report a pragmatic and externally oriented cognitive style seem to be characterized by a heightened perceptual sensitivity for positive information. Methodological problems in measuring affective priming effects are discussed. © 1998 John Wiley & Sons, Ltd.     

Parental bonding and personality disorder: the mediating role of alexithymia

This study explored whether alexithymic features mediate the effect of perceived adverse parenting during childhood on being diagnosed with a PD in adulthood. Two hundred sixty-five psychiatric outpatients were evaluated with the Toronto Alexithymia Scale (TAS-20), the Parental Bonding Instrument (PBI), the Structured Interview for DSM-IV Personality, the Structured Clinical Interview for DSM-IV Axis I Disorders, the Clinical Global Impression scale, and the Global Assessment of Functioning scale. The statistical model for mediation proposed by Baron and Kenny (1986) was employed to detect whether the TAS scores account for the relation between PBI scores and a PD diagnosis. The results indicated that although altered parental bonding (and specifically, excessive maternal protection) may enhance the risk of PD, its effect is completely mediated by the alexithymic feature Difficulty Describing Feelings to Others (DDF), after controlling for gender, age, educational level, type, severity and age of onset of Axis I disorders. Therefore, this study suggests that the presence of DDF accounts for the effect of maternal overprotection as a risk factor for PD.     

Association between alexithymia, neuroticism, and social desirability scores among Italian graduate students

An inverse correlation between social desirability and alexithymia has been observed in undergraduate students in Japan and Australia. It is not clear how this association is influenced by the personality dimension of neuroticism. This study examined the association of scores on social desirability with those on alexithymia controlled for neuroticism, in a sample of 111 Italian graduate students, with age range of 24 to 58 years. Students completed the Eysenck Personality Questionnaire (short form) and the Toronto Alexithymia Scale-20 (TAS-20). Social desirability scores inversely correlated with TAS-20 total scores, neuroticism scores, and the TAS-20 subscale, Difficulty identifying feelings. Neuroticism directly correlated with TAS-20 total score, Difficulty identifying feelings, and Difficulty describing feelings. Students with higher alexithymia and neuroticism scores seem to present themselves in less socially desirable ways. The correlation of social desirability with alexithymia was moderated by higher neuroticism scores.     

Alexithymia in patients with major depressive disorder and comorbid cluster C personality disorders: a 6-month follow-up study.

The authors examined the association between alexithymia, cluster C personality disorders (CPD), and severity of depression among 121 outpatients with major depressive disorder (MDD) in a 6-month, follow-up study. Diagnosis of depression and CPD was confirmed by means of the Structured Clinical Interviews for DSM-III-R (SCID I and SCID II). Alexithymia was screened using the 20-item version of the Toronto Alexithymia Scale and severity of depression was assessed using the 21-item Beck Depression Inventory. Results indicated that alexithymic features are common in patients with MDD but often alleviated during recovery from depression. Moreover, comorbid CPD and severity of depression seemed to be associated with poorer recovery from alexithymia. The implications of these findings are discussed.     

Criterion validity of Bermond-Vorst Alexithymia Questionnaire-20 Form B: a study of 63 alcoholic subjects

The aim of the study was to set alexithymia cutoff scores on the 20-item Bermond-Vorst Alexithymia Questionnaire-20 Form B. Alexithymia is a clinical construct describing individuals who have difficulty identifying and reporting their specific emotions. 63 subjects meeting the DSM-IV criteria for alcohol dependence completed the questionnaire and the 20-item Toronto Alexithymia Scale. Using cutoff scores for the latter, subjects were divided into alexithymic and nonalexithymic subgroups. Taking into account the sensitivity, specificity, and predictive positive value, several potential Bermond-Vorst questionnaire scores were tested. Using the Younden formula (Sensitivity+ Specificity-1), score of 52 was the most appropriate cutoff score for the Bermond-Vorst-20 to indicate the presence of alexithymia in these male alcoholics.     

Alexithymia,memory of emotion,emotional awareness,and perfectionism

The Toronto Alexithymia Scale (TAS-20; R. M. Bagby, J. D. A. Parker, & G. J. Taylor, 1994) is a self-assessment instrument designed to measure deficits in meta-emotional functioning (e.g., difficulties in identifying and describing emotions). Four studies were carried out to examine the association between the TAS-20 and (a) performance measures of meta-emotional functioning (memory of emotion and emotional awareness; Studies 1-2) and (b) measures of perfectionistic standards that may possibly be involved in the self-assessment of abilities-difficulties (Studies 3-4). The TAS-20 failed to correlate in the predicted direction with the performance measures but showed sizable correlations with measures of perfectionism. Moreover, perfectionism was found to predict TAS-20 scores independent of depression, anxiety, and somatic complaints. The results are discussed in terms of the TAS-20 measuring primarily certain aspects of meta-emotional self-efficacy.     

Observation of couple interactions: Alexithymia and communication behaviors

Alexithymia is conceptualized as a deficit of the cognitive aspect of an emotional response. Alexithymia has been associated with various relational difficulties, but few studies have investigated couple relationships. The present study addresses the imperative need for the advancement of knowledge regarding the impact of alexithymia on couple relationships and, more specifically, on communication behaviors. One hundred and fifty participants (75 couples) completed the Toronto Alexithymia Scale (TAS-20) and their interactions in the laboratory were coded using the Interactional Dimensions Coding System (IDCS). Actor–partner effects were investigated using Multi-level analyses. For women, no relationship was found between self-alexithymia and communication behaviors for self or partner. For men, alexithymia was found to be associated with their own hostility, but also with their partner’s hostility, withdrawal and communication skills. The results are discussed through a social learning perspective.