Assessing Alexithymia: Psychometric Properties and Factorial Invariance of the 20-Item Toronto Alexithymia Scale in Nonclinical and Psychiatric Samples

Abstract

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 associations between alexithymia, non‐suicidal self‐injury, and risky drinking: The moderating roles of experiential avoidance and biological sex

“…Whereas, women who reported a combination of high levels of externally orientated thinking but low levels of experiential avoidance were more likely to have engaged in risky drinking. However, consistent with previous research (Preece, Becerra, Robinson, & Dandy, ), the reliability of the externally orientated thinking subscale was poor in the current sample and results should be interpreted with caution.…”

Bullying and alexithymia: Are there differences between traditional, cyber, combined bullies, and nonbullies in reading their own emotions?

“…We were not able to take into account the potential effects of variables, which have also been shown to be associated with alexithymia, such as eating disorder, substance use disorder, or depression (Marchesi, Ossola, Tonna, & De Panfilis, 2014). Lastly, although alexithymia among young people can be reliably measured with the Toronto Alexithymia Scale without using the externally oriented thinking subscale (Loas et al, 2017;Preece et al, 2017), more research is needed that also considers this key component of alexithymia with a reliable subscale for young people.…”

“…As recommended by past research (Loas, Braun, Delhaye, & Linkowski, ; Preece et al, ), alexithymia was measured by a sum score from two subscales (1) difficulties identifying one's own feelings (seven items) and (2) difficulties in describing one's own feelings (five items) of the Toronto Alexithymia Scale (Bagby, Parker, & Taylor, ), with answer options ranging from “ strongly disagree ” to “ strongly agree .” High scores indicated high alexithymia. Reliabilities were good for the whole sample ( α = 0.89), and the German ( α = 0.88) and Thai subsamples ( α = 0.89) separately.…”

“…Alexithymia is comprised of difficulties interpreting and describing emotions, and externally-oriented thinking (Preece, Becerra, Robinson, & Dandy, 2017;Sifneos, 1973). These individuals have more interpersonal problems, uncontrolled emotional responses, and higher levels of anger and aggressive behaviour than those without alexithymia (Keltikangas-Järvinen, 1982;Konrath, Novin, & Li, 2012).…”

Orthorexic tendencies are linked with difficulties with emotion identification and regulation

“…Indeed, while it is estimated that as many as 77% of female patients with AN have alexithymia 3 [45], and while this relationship is maintained even after controlling for nutritional status [46], findings are mixed as to whether alexithymia remains after controlling for general depression and anxiety, in both AN and BN (see 7 for review). Because being able to accurately identify emotions is an important first step to being able to regulate them [47,48], exploring alexithymia is required to fully understand possible emotional processing deficits in individuals with orthorexic tendencies.…”