Abstract
This study had two aims. Firstly, the psychometric properties of the 20-item Toronto Alexithymia Scale (TAS-20) and the Alexithymia Questionnaire for Children (AQC) that measure the three dimensions of alexithymia (DIF, difficulty identifying feelings; DDF, difficulty describing feelings; EOT, externally-oriented thinking) were explored in various samples of children, adolescents or young adults to detect the best factor-structure and to examine if the Externally-Oriented Thinking (EOT) factor must be deleted or not. Secondly, the capacity for adolescents to distinguish between alexithymia and depression was studied using factorial analyses of items of self-report of alexithymia and depression scales. Four groups were examined (80 healthy children, 105 adolescents with various psychiatric disorders, 333 healthy older adolescents and 505 young adults recruited from universities). The first two groups filled out the AQC and the latter two the TAS-20. Confirmatory factorial analyses (CFA) showed that the two-factor model (DIF, DDF) provided acceptable fits and had significant advantages over the three-factor model (DIF, DDF, EOT). Low alpha coefficients for the EOT subscale were reported (range from 0.18–0.61). Except for the children sample, exploratory factorial analyses (EFA) were performed on the items of the TAS-20 or AQC without the EOT items and the Beck depression inventory-II (BDI-II) or the Zung Self-Rating Depression Scale (SDS). The items of the AQC and BDI-II or items of the TAS-20 and SDS loaded on separate factors with only a minor overlap suggesting that adolescents were able to differentiate alexithymia and depression when self-assessments were used. Alexithymia can be reliably assessed in adolescents using the TAS-20 or AQC without the eight items rating the EOT dimension.
Highlights
Alexithymia is not a diagnostic category included in any mental disorder but a multifaceted personality construct associated with various somatic or psychiatric disorders as well as nonclinical populations [1]
The following values were required for adequate fits: χ2/df ratio 5 and preferably 2; goodness-of-fit index (GFI) 0.85; adjusted goodness-of-fit index (AGFI) 0.80; comparative fit index (CFI) 0.9; root mean square error of approximation (RMSEA) 0.08
The following values were required for adequate fits: In boldface:χ2/df ratio 5 and preferably 2; GFI 0.85; AGFI 0.80; CFI 0.9; RMSEA 0.08
Summary
Alexithymia is not a diagnostic category included in any mental disorder but a multifaceted personality construct associated with various somatic or psychiatric disorders as well as nonclinical populations [1]. This personality construct is characterized by four main features: 1) difficulty identifying and distinguishing emotions from bodily sensations; 2) difficulty describing and verbalizing emotions; 3) poverty of fantasy life; 4) externally oriented thinking. Affect regulation and the quality of attachment are closely related and the exploration of alexithymia in adolescence or childhood and notably its relationships with the attachment style gives us the opportunity to examine the capacity to regulate emotion independently of reliance on the primary caregiver. Multivariate logistic regression analyses indicated that only alexithymia (and not dissociation or childhood maltreatment) was a significant predictor for non-suicidal self-injury [4]
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