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

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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.

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Notes

  1. Some authors disagree with respect to how alexithymia should be defined, positing that difficulty fantasising or reduced emotional reactivity might also be components of the construct (e.g., Vorst and Bermond 2001). Most empirical work has, however, suggested that the latent structure of the construct is comprised of only DIF, DDF and EOT (for a review, see Preece et al. 2017). We, hence, follow this empirically informed three-component definition when defining alexithymia in this paper. These are the three components that the TAS-20 is designed to assess (Bagby et al. 1994), and this is how alexithymia is defined within the attention-appraisal model of alexithymia (Preece et al. 2017).

  2. In one of these studies, Gignac et al. (2007), the 4-factor correlated model was assessed as part of a bifactor model, with a general alexithymia factor also included in the model loading on all the items.

  3. Some undergraduate students were included in the nonclinical sample in order to (1) increase the size of the sample and (2) make the distribution of age and gender in the nonclinical sample closer to that of the psychiatric sample.

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Acknowledgements

We would like to thank Fremantle Hospital in Western Australia for the use of their site for data collection.

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  1. Psychology Department, School of Arts and Humanities, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Australia

    David Preece, Rodrigo Becerra, Ken Robinson & Justine Dandy

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  1. David Preece
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Correspondence to David Preece.

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David Preece, Rodrigo Becerra, Ken Robinson and Justine Dandy declares that they have no conflict of interest.

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This study was approved by ethics committes from the South Metropolitan Health Service and Edith Cowan University. Informed consent was obtained from all individual participants.

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Preece, D., Becerra, R., Robinson, K. et al. Assessing Alexithymia: Psychometric Properties and Factorial Invariance of the 20-Item Toronto Alexithymia Scale in Nonclinical and Psychiatric Samples. J Psychopathol Behav Assess 40, 276–287 (2018). https://doi.org/10.1007/s10862-017-9634-6

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