Alexithymia is an important mental health construct, but there is continuing debate regarding its definition and measurement. We attempt to resolve this definitional uncertainty in two ways. Firstly, we trace the development of the alexithymia construct, focusing particularly on what we call the Toronto and Amsterdam models, and examine a body of empirical research that shows strong support for the hypothesis that alexithymia consists of three components (difficulty identifying feelings, difficulty describing feelings, and externally orientated thinking). Based on these components, we formulate an alternate theoretical model of alexithymia, the attention-appraisal model of alexithymia, that aligns alexithymia theory with recent advances in the broader emotion regulation field. Secondly, we examine the construct\u27s latent structure by factor analysing data from multiple psychometric measures administered to a community sample (N = 368). Our results suggest statistical support for our model, rather than the Toronto or Amsterdam models. We end by discussing how our model accounts for several unresolved issues within the alexithymia field, including the construct\u27s relation to imaginal capacities and emotional reactivity, whether alexithymia is a deficit or a defence, how it might be addressed in psychiatric treatment, and the discordance that has existed between alexithymia theory and alexithymia measurement. Ethical statement Ethics approval for this project was granted by the Edith Cowan University Human Research Ethics Committee. The guidelines of this committee were followed. All participants provided informed consent for their data to be used

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The 20-item Toronto Alexithymia Scale (TAS-20) is a self-report questionnaire designed to measure the three components of alexithymia; difficulty identifying feelings in the self (DIF), difficulty describing feelings (DDF), and externally orientated thinking (EOT). We examined the scale's psychometric properties in Australian nonclinical (N=428) and psychiatric (N=156) samples. In terms of factorial validity, confirmatory factor analyses found the traditional 3-factor correlated model (DIF, DDF, EOT) to be the best and most parsimonious solution, but it did not reach adequate levels of goodness-of-fit in either sample. Several EOT items loaded poorly on their intended factor, and a reverse-scored item method factor was present; the factor structure of the scale was invariant across both samples. A higher-order factor model (with a single higher-order factor) was slightly inferior to the correlated models, but still tenable. The total scale score and DIF and DDF subscales displayed sound internal consistency, but the EOT subscale did not. We conclude that the TAS-20 has, for the most part, adequate psychometric properties, though interpretation should focus only on the total scale score and DIF and DDF subscales; we recommend the EOT subscale score not be used. Implications for clinical use and future revision of the scale are discussed.

The Emotion Regulation Questionnaire (ERQ) is a 10-item self-report measure of two emotion regulation strategies; cognitive reappraisal and expressive suppression. It is a widely used measure of emotion regulation, however, its factor structure has rarely been examined outside of university student samples, and some authors have recently questioned its factorial validity in general community samples. In this study, we examine the psychometric properties of the ERQ (original English version) in three Australian general community samples (Ns = 300, 400, 348). Confirmatory factor analyses in each sample demonstrated that the traditional 2-factor model (comprised of cognitive reappraisal and expressive suppression factors) was replicable and an excellent fit to the data. In all samples, ERQ cognitive reappraisal (α = .89-.90) and expressive suppression (α = .76-.80) scores had acceptable to excellent levels of internal consistency reliability. As expected, cognitive reappraisal scores were significantly negatively correlated with psychological distress and alexithymia, whereas expressive suppression scores were significantly positively correlated with psychological distress and alexithymia. We conclude that, similar to previous findings in student samples, the ERQ has strong psychometric properties in general community samples and can therefore be used confidently regardless of participants' student status.

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