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.     

Understanding alexithymia in female adolescents: The role of attachment style

Adults with alexithymia retrospectively report emotional difficulties with caregivers during childhood. However, the association between attachment style and alexithymic traits may be evident at an earlier stage than adulthood, i.e. during adolescence. Sixty school-based healthy females aged 9–18 years (mean 14.08, SD 2.71 years) participated in an Attachment Style Interview (ASI) and completed the Toronto Alexithymia Scale (TAS-20). Greater levels of alexithymia were exhibited by both anxious and avoidant insecurely attached groups compared to securely attached participants. Fear of separation (characteristic of anxious attachment style) predicted both overall alexithymia scores and the specific alexithymic trait of ‘difficulty identifying feelings’ (DIF). Constraints on closeness (an avoidant attachment attitude) predicted ‘difficulty describing feelings’ (DDF). Low felt attachment to primary caregiver was a predictor of ‘externally oriented thinking’ (EOT). These findings indicate that features of anxious and avoidant insecure attachment styles are differentially related to the separate facets of alexithymia in female adolescents. Specifically, the findings concerning fear of separation may reflect the adolescent struggle for autonomy and the resulting effects on the affect regulation system. Our results also suggest that the normative differentiation of the emotional and cognitive aspects of alexithymia may occur on a developmental trajectory.     

The five factor model of personality: Openness a distinct but related construct

It has been argued that the Openness (O) dimension from the five factor model (FFM) of personality may in fact be an associate of the ability domain more than the personality domain. This paper explores this hypothesis using a sample of 101 managers. Participants completed the NEO-FFI and a measure of ability assessing the construct as typical performance. This measure was an occupational specific measure of typical intellectual engagement (TIE), termed the “problem solving through challenge” PSC scale. A combination of LISREL CFA and hierarchical multiple linear regression (HMLR) indicated that in fact O was a distinct but related construct to the other four dimensions of the FFM (N, E, A and C), but that O was more strongly correlated with PSC than the other dimensions. These results are taken to indicate that O, while associated with personality, assesses something to do with problem solving as a personality trait. Further the results suggest that E linked O to the other personality scales.     

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.     

BRIEF REPORT

This study examined the different facets of emotional intelligence, alexithymia, and mood awareness. Undergraduate students (N = 129) completed the Trait Meta-Mood Scale (TMMS), the Toronto Alexithymia Scale (TAS-20), and the Mood Awareness Scale (MAS). A factor analysis revealed two dimensions, attention to and clarity of emotions, that cut across all three instruments. These two dimensions were differentially associated with personality, as measured by the neuroticism, extraversion, and openness to experience portions of the NEO-FFI, and with performance on an emotional Stroop task. We discuss the implications for the conceptualisation of broad constructs such as emotional intelligence and alexithymia, as well as the potential utility of more narrowly defined individual differences.     

Are alexithymia and Type D personality distinct or overlapping constructs? A confirmatory factor analysis of the Toronto alexithymia and Type D scales

Theoretically and conceptually the constructs of alexithymia and Type D personality share many common characteristics. Despite both measures being utilized widely in psychosomatic research, to-date no study has examined the constructs simultaneously. The present study was undertaken to determine if alexithymia and Type D personality are distinct or overlapping constructs. A cross-sectional sample of 1016 healthy participants completed the 20-item version of the Toronto alexithymia scale (TAS-20), and the Type D personality scale (DS14). Confirmatory factor analysis of the 14 items of the DS14, and 20 items of the TAS-20 was conducted. Based on the underlying theoretical structures of the DS14 and TAS-20 a five-factor model was examined (corresponding to the five subscales of the DS14 and TAS-20). The analysis revealed that the five factor model was an acceptable fit for the data (χ²/df = 4.7; CFI = .94, RMSEA = 0.06). These results provide evidence to suggest that alexithymia and Type D are distinct and separate constructs. However, future research should aim to replicate these findings in population and clinical samples.     

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.     

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.     

Different subgroups of high-scorers on the TAS-20 based on the big five personality traits

We investigated whether it was possible to obtain a consistent representation of the alexithymia trait by using the twenty-item Toronto Alexithymia Scale (TAS-20). TAS-20 and the NEO-Five Factor Inventory were administered to nonclinical participants (N = 2188). The results of hierarchical cluster analysis and a two-way analysis of variance indicated two subgroups with high scores on the TAS-20. One group had difficulty identifying feelings and high neuroticism; the other had a high externally oriented cognitive style and low openness to experience. These results suggest that the total score on the TAS-20 should not be considered a uni-dimensional measure of alexithymia.     

Adolescent Psychopathy and the Five Factor Model: Domain and Facet Analysis

Given the consideration of callousness as a specifier for Conduct Disorder in the DSM-V, it seems imperative that researchers continue to investigate this personality style in adolescents to determine both its applicability and utility. The present study examined the Youth Psychopathic traits Inventory (YPI; Andershed et al. 2002) and the Interpersonal Adjective Scale Revised-Big 5 (IASR-B5; Trapnell and Wiggins 1990a, b) psychopathy scales in relation to the Five Factor Model (FFM) of personality. Using a sample of adolescent offenders (N = 145), the YPI and IASR-B5 psychopathy scales showed adequate reliability and strong inverse bivariate relations with the FFM domains of Agreeableness (−A) and Conscientiousness (−C). Multivariate analyses, at the facet level, revealed that Tendermindedness (−A) and Assertiveness (+E) explained the association between FFM facets and the YPI, whereas Altruism (−A), Modesty (−A), Straightforwardness (−A), Assertiveness (+E), Warmth (−E), and Deliberation (+C) all uniquely contributed to the IASR-B5 psychopathy scale. Both measures were linked with general and violent recidivism. The authors discuss the implications of these findings in terms of the use of personality to help describe conduct problem youth and the need for future research in this important area.     

Is Alexithymia Related to Colon Cancer? A Survey of Patients Undergoing a Screening Colonoscopy Examination

The current study examined whether alexithymia is involved in colon cancer as has been found in breast and uterine cancer research. The TAS-20 was administered before examination to patients who underwent colon cancer screening. Histological data were obtained from the biopsies. Gender, age, education, smoking and drinking habits, and personal and family histories of neoplastic colonic disease were controlled for in the analysis. Both adenoma and adenocarcinoma patients had higher TAS-20 scores than negative cases, and both high and intermediate levels of alexithymia were implicated. Difficulty identifying feelings and externally oriented thinking were the most prominent facets related to the disease process.     

Alexithymie bei Neurodermitis

Background

The study shows correlations between atopic dermatitis (AD) and alexithymia. Furthermore it examines their influences on skin-related quality of life.

Patients and methods

A total of 62 adult AD patients were compared with a control group (n=62) of skin healthy persons. Alexithymia (Toronto Alexithymia Scale-20, TAS-20) and impairment of the skin-related quality of life (Dermatology Life Quality Index, DLQI) were assessed as well as duration, severity [patients?? self-evaluation based on scoring of atopic dermatitis (SCORAD)] and onset of AD.

Results

The prevalence of alexithymia (TAS-20 ??61) in AD patients was 22.6% (control group 4.9%). Problems with identifying feelings (TAS-20 scale) and also the severity of AD were significant predictors for the impairment of skin-related quality of life.

Conclusions

Atopic dermatitis patients showed a prevalence of alexithymia (22.6%) similar to diseases found in the field of psychosomatic and psychiatric patients (Leweke & Bausch 2009). From a psychotherapeutic point of view the study may provide a further reason for the observance of mental features in AD treatment. A possible indication for a specific psychotherapy in atopic dermatitis is discussed.     

A meta‐analysis of psychopathy‐, antisocial PD‐ and FFM associations

This research meta‐analytically summarizes the relationships of the Five‐Factor Model (FFM) with psychopathy and Antisocial Personality Disorder (APD). Effect sizes of the associations between psychopathy, APD and the FFM were compiled from 26 independent samples (N = 6913) for psychopathy and 57 independent samples (N = 16 424) for APD. The results revealed predominantly points of similarity and some differences in the FFM associations of both disorders. Symptoms of psychopathy and APD were negatively associated with Conscientiousness and Agreeableness facets and positively with scores on Angry–Hostility (N2), Impulsiveness (N5), Excitement Seeking (E5) and negatively with Warmth (E1). Only psychopathy had a small negative association with Anxiety (N1) and was characterized by stronger negative associations with Agreeableness and Straightforwardness (A2), Compliance (A4) and Modesty (A5) compared to APD. The moderator analyses showed that sample type, use of the NEO‐PI‐R and APD instrument moderated the APD FFM associations, while psychopathy instrument and age group were moderators in the psychopathy MA. Implications of this research for the assessment of APD and psychopathy relying on dimensional models of personality pathology are discussed. Copyright © 2009 John Wiley & Sons, Ltd.     

A confirmatory factor analytic investigation of the TAS-20: corroboration of a five-factor model and suggestions for improvement

Alexithymia represents an individual difference dimension characterized by difficulties identifying emotions, difficulties describing emotions, and a utilitarian approach to thinking. The Toronto Alexithymia Scale-20 (TAS-20; Bagby, Parker, & Taylor, 1994) is a frequently used inventory to measure alexithymia, and although several studies have examined the factor structure of the TAS-20, a number of issues remain unresolved. Specifically, the severely unbalanced item-keyed nature of the TAS-20 has been suggested to limit the interpretation of the substantive Externally Oriented Thinking (EOT) factor. Further, it has also been suggested that the EOT factor may be better represented by 2 oblique factors. A review of the TAS-20 confirmatory factory analysis (CFA) literature has suggested that some improvement in CFA strategies could possibly be afforded by using a nested factors modeling approach. Based on a sample of 355 participants, we demonstrated that the TAS-20 was better represented by a nested factors model with 5 substantive factors. A novel, latent variable approach to estimating internal consistency reliability revealed that the subscales within the TAS-20 were associated with unacceptably low levels of reliability independently of the global alexithymia factor. Although there was some CFA evidence to suggest the plausibility of a negatively keyed factor, a thorough examination of the items in question offered an alternative interpretation. Further development of the TAS-20']s Externally Oriented Thinking subscale is encouraged.     

Alexithymia in chronic urticaria patients

Alexithymia has been described as an important dimension in several medical and psychiatric diseases. Chronic urticaria (CU) is a chronic condition, in which treatment is difficult. Our aim is to determine the prevalence of alexithymia traits in patients with CU, and to identify the relationships between alexithymia and psychological variables and quality-of-life dimensions. Fifty-five sequential CU patients in a faculty ambulatory specialized consultation, with an average age of 44.92, were compared with 31 healthy volunteers. Both groups were studied by means of validated scales for alexithymia (Toronto Alexithymia Scale [TAS-20]), attachment (Adult Attachment Scale-R [AAS-R]), psychopathology (Brief Symptom Inventory [BSI]), personality dimensions (The NEO Five-Factor inventory [NEO-FFI]) and quality of life (Short Form-36 [SF-36]). The classification of CU reactions was obtained from the patient's history, physical examination, laboratory assessment and histopathologic findings. All the patients were under treatment with sedating H1-antihistamines, non-sedating H1-antihistamines combination of H1 and H2 blocker, 2 H1-antihistamines and 3 H1-antihistamines. High traits of alexithymia were found on CU patients (56.9%) as well as high symptom rates of anxiety. Alexithymia traits were significantly positively correlated with insecure attachment styles, with psychopathological symptoms, and with the defense mechanism turn against self. We also reported a significant negative correlation between alexithymia traits and the dimensions of quality of life. Insecure attachment styles were positively correlated with psychopathological symptoms and negatively correlated with quality of life. We did not find significant statistical correlations between alexithymia and clinical variables. CU patients present serious difficulty in dealing with emotion arousal. There is strong evidence of a psychosomatic specificity in CU, with marked alexithymic traits.     

Development of a Short Form of the Abridged Big Five-Dimensional Circumplex Model to Aid with the Organization of Personality Traits

Although there has been widespread consensus on the use of the Five-Factor Model (FFM) of general personality functioning in personality research, there are various, diverse models of the lower order traits of the FFM domains. Given the usefulness of these finer grained traits, it is imperative to integrate facets proposed across a variety of models and eventually reach consensus on the lower level traits of the FFM. Due to its depth and coverage, the Abridged Big Five-Dimensional Circumplex (AB5C) model potentially provides a useful framework for organizing various faceted models due to its conceptual organization and inclusiveness. The only measure of this model—the IPIP–AB5C—has shown promise, but is limited by its length (i.e., 485 items). This study developed an abbreviated version of the IPIP–AB5C using an iterative process including item response theory methods. The shorter version maintained key features of the long form including a factor structure that matched the full form as well as facets that correlated in expected ways with other FFM measures. Building on this support, the short form was used to contextualize and organize the facets from 2 commonly used measures.     

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.     

The relationships between problematic internet use,alexithymia levels and attachment characteristics in a sample of adolescents in a high school,Turkey

The aim of this study is to investigate the relationships between attachment characteristics, alexithymia and problematic internet use (PIU) in adolescents. The study was performed on 444 high school students (66% female and 34% male). Internet Addiction Test (IAT), Toronto Alexithymia Scale (TAS-20) and Short Form of the Inventory of Parent and Peer Attachment (s-IPPA) scales were used. The adolescents who scored ≥50 on IAT were considered as the PIU group and <50 were considered as control group. There was a moderate positive relationship between TAS-20 and IAT scores (r = .441), and a moderate negative relationship between TAS-20 and s-IPPA scores (r = ?.392), and a negative weak relationship between IAT and s-IPPA scores (r = ?.208). S-IPPA scores were significantly lower in the PIU group compared to the controls (p < .001). TAS-20 scores of the PIU group were significantly higher compared to the controls (p < .05). Logistic regression analysis indicated that s-IPPA scores and TAS-20 significantly predict the PIU development (p < .05). The results indicate that alexithymia increases the risk of PIU and higher attachment quality is a protective factor for both alexithymia and PIU. These results suggest that it is important to focus on the insecure attachment patterns and alexithymic characteristics when studying adolescents with PIU.     

The emotional deficits associated with the Dark Triad traits: Cognitive empathy,affective empathy,and alexithymia

Volunteers (N = 322) in an online survey revealed the complex correlational patterns between the Dark Triad traits and two forms of “emotional deficiencies” (i.e., limited empathy and alexithymia) overall and in each sex. Each Dark Triad trait was associated with a unique pattern of emotional deficits. Psychopathy was correlated with limited overall empathy, difficulty describing feelings, and externally oriented thinking. Narcissism was associated with limited affective empathy and difficulty identifying feelings, whereas Machiavellianism was associated with externally oriented thinking. The Dark Triad mediated sex differences in empathy and externally oriented thinking. Structural Equation Modeling suggests that the differential facets of alexithymia predict different forms of limited empathy that in turn predict specific Dark Triad traits. Results are discussed using an evolutionary paradigm.     

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.