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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. En la esclerosis múltiple (EM) son escasas las investigaciones centradas en evaluar la alexitimia con la Escala de Alexitimia de Toronto (TAS-20). A pesar de ello, no se ha evaluado aún su estructura factorial en dicha población y, además, las anteriores traducciones al español necesitan modificaciones. Los objetivos del presente estudio fueron evaluar la validez factorial y la fiabilidad de una traducción mejorada en español de la TAS-20 (la TAS-20-S), la cual fue administrada en una muestra de 221 pacientes con EM. Se realizaron análisis factoriales confirmatorios para comparar el ajuste de seis modelos factoriales. También se calcularon coeficientes de consistencia interna y de fiabilidad test-retest. Los modelos trifactorial correlacionado y el de orden superior conformados por Dificultad en Identificar Sentimientos, Dificultad en Describir Sentimientos y Pensamiento Externamente Orientado lograron el mejor ajuste. Los coeficientes alfa oscilaron entre 0,87 y 0,67; las correlaciones medias inter-ítem entre 0,48 y 0,20; y las correlaciones test-retest tras 6 meses oscilaron entre 0,61 y 0,52. El 18,10% de la muestra presentó niveles elevados de alexitimia. La TAS-20-S presentó una adecuada fiabilidad así como la tradicional estructura trifactorial, por lo que su uso es ahora recomendable para evaluar un aspecto del procesamiento emocional en EM. Ministerio de Educación, Cultura y Deporte de España Programa FPU (Formación del Profesorado Universitario)

Background The purpose of the present study was to develop a Chinese translation of the 20-item Toronto Alexithymia Scale (TAS-20-C) and examine its reliability and factorial validity. Methods The original English version of the TAS-20 was first translated into Chinese and then backtranslated and modified until cross-language equivalence was established. This version was then completed by 870 undergraduate students and 179 clinical patients in China. Internal reliability, retest reliability, and factorial validity were evaluated. Results The TAS-20-C showed adequate internal and retest reliability in both samples. Average TAS-20-C scores in Chinese samples were slightly higher than, but comparable to, TAS-20 scores in English-speaking Canadian samples; as well, scores were higher in the clinical sample than in the student sample. Finally, confirmatory factor analysis supported the 3-factor structure of the TAS-20 in both samples. Conclusions The TAS-20-C is a promising instrument for reliable and valid measurement of alexithymia in China.

The reliability and validity of the Toronto Structured Interview for Alexithymia (TSIA) have been demonstrated in previous studies with English-speaking community and psychiatric samples and a German-speaking psychiatric sample. The aim of this study was to evaluate the psychometric properties of the TSIA in a mixed clinical and nonclinical sample from Italy. The original English version of the TSIA was translated into Italian and administered, along with the 20-item Toronto Alexithymia Scale (TAS-20), to 80 healthy subjects, 69 medical outpatients, and 62 psychiatric outpatients. Eighty-one videotaped interviews were used for assessing the interrater reliability. Confirmatory factor analysis supported the hierarchical, four-factor structure of the TSIA obtained in previous studies, with four lower-order factors nested within two higher-order latent factors. The TSIA also demonstrated internal and interrater reliability, and concurrent validity with the TAS-20. The results support the use of the TSIA to assess alexithymia especially when a multimethod approach to measurement is possible.