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Conceptually, alexithymia is a key transdiagnostic risk factor for the development of numerous psychopathologies across the lifespan. However, to date, most alexithymia research has focused on adults, with adolescent work limited by a lack of validated age-appropriate assessment tools. Recently, the Perth Alexithymia Questionnaire (PAQ) was introduced to enhance the comprehensiveness of alexithymia assessments, but its psychometric properties have only been tested in adults. In this study, we address this by examining the psychometric properties of the PAQ in a sample of English-speaking high school students (N = 225, aged 11 to 18), and use the PAQ to further establish the structure of the alexithymia construct in adolescents. Confirmatory factor analysis revealed that all PAQ items conformed well to the expected factor structure, supporting that the PAQ was measuring a coherent multidimensional construct, consistent with the attention-appraisal model of alexithymia. All subscale and composite scores had good to excellent internal consistency (αrange =.83 to.95) and correlated in expected ways with other emotion measures. Together, these findings suggest that the multidimensional structure of the alexithymia construct manifests similarly in adolescents and adults, and that the PAQ is a valid and reliable measure of alexithymia in adolescents. KEY POINTS: What is already known about this topic: Alexithymia is an important transdiagnostic risk factor for the development and maintenance of a range of psychopathologies. To date, most work on alexithymia has been done in adults. There is a lack of validated alexithymia measures for adolescents. What this topic adds: In this study, we examine the validity and reliability of the Perth Alexithymia Questionnaire (PAQ) in adolescents, using the PAQ to explore the structure of the alexithymia construct in this age group. We find that the PAQ demonstrates strong validity and reliability in adolescents as a measure of the multidimensional alexithymia construct. Our data suggest that the PAQ will now enable detailed work on alexithymia to extend from adults to adolescents. [ABSTRACT FROM AUTHOR]

Background: Alexithymia is characterized by difficulties in describing feelings and physical sensations. Few studies have shown that there is a relation between alexithymia and dietary habits. Objectives: To determine the prevalence of alexithymia and its association with dietary patterns among a sample of communities in the Eastern Region of the Kingdom of Saudi Arabia. Materials and Methods: A cross-sectional study was conducted using a sample of 247 participants, were selected using convenience sampling. A well-organized and valid online questionnaire was administered, which covered variables related to socio-demographic data, anthropometric measurements, dietary patterns, and the Toronto Alexithymia Scale (TAS). Results: The prevalence of Alexithymia was found as 39.3%. Moreover, among the alexithymia and possible alexithymia groups, the majority eat pasta 1–4 times per week (70% and 67% respectively). Alexithemic participants eat fewer vegetables and fruits 46%), while the remaining eat more (70%), p =.001. Only 34% of the cases eat breakfast regularly (p =.005). Furthermore, the cases drink soft drinks and juices at meals more than controls in this study (p =.025). Conclusion: The present study provides further experimental evidence which supports existing literature that indicating the strong association between alexithymia and unhealthy dietary patterns. Also, Alexithymia prevalence in our study is (39.3%) ; because of the cultural impact of the Saudi environment due to the fact that the face of Saudi women is not revealed, and because the face is one of the main sources of expression of feelings, which makes females unable to express or read feelings well. [ABSTRACT FROM AUTHOR]

Alexithymia is an important transdiagnostic risk factor for emotion-based psychopathologies. However, it remains unclear whether alexithymia questionnaires actually measure alexithymia, or whether they measure emotional distress. Our aim here was to address this discriminant validity concern via exploratory factor analysis (EFA) of the 20-item Toronto Alexithymia Scale (TAS-20) and the Perth Alexithymia Questionnaire (PAQ). United States general community adults (N = 508) completed the TAS-20, PAQ, and the Depression Anxiety Stress Scales-21 (DASS-21). EFA was used to examine the latent dimensions underlying these measures' scores. Our EFA extracted two higher-order factors, an "alexithymia" factor and a "general distress" factor (i.e., depression, anxiety, stress). All PAQ scores loaded cleanly on the alexithymia factor, with no cross-loadings on the distress factor. However, for the TAS-20, Difficulty Identifying Feelings (DIF) facet scores cross-loaded highly on the distress factor. Our sample consisted of general community adults; future work in clinical settings will be useful. Our data indicate that the PAQ has good discriminant validity. However, the TAS-20 appears to have significant discriminant validity problems, in that much of the variance in its DIF facet reflects people's current levels of distress, rather than alexithymia. The TAS-20, which has traditionally been the most widely used alexithymia questionnaire, may therefore not be the optimal alexithymia tool. Our findings add to the body of evidence supporting the validity and utility of the PAQ and suggest that, moving forward, it is a superior option to the TAS-20 for alexithymia assessments. • Alexithymia is an important risk factor for psychopathology and is most commonly assessed with self-report questionnaires. • However, there is ongoing uncertainty about whether alexithymia questionnaires might actually measure distress. • We explored this issue by examining the discriminant validity of the TAS-20 and PAQ. • The PAQ had good discriminant validity against markers of distress, but the TAS-20 did not. • Our data suggest that the PAQ is preferable over the TAS-20 as an alexithymia measure in psychopathology research. [ABSTRACT FROM AUTHOR]

Abstract Background Alexithymia is the inability to identify and describe one’s own emotions. Adolescents who suffer from Restrictive Eating Disorders (REDs) show a higher prevalence of alexithymia than the general population. Methods The study explored the correlation between levels of alexithymia in mothers, fathers, and adolescents affected by REDs and patients’ ability to recognize their emotions. The study also aimed to evaluate if patients’ emotional distress can significantly impact the severity of their disorder and functioning measured by the Clinical Global Impression Scale - Severity (CGI-S) and the Children’s Global Assessment Scale (CGAS). We enrolled 67 families of adolescents affected by REDs. Parents and patients’ levels of alexithymia were assessed through the Toronto Alexithymia Scale (TAS-20). Spearman’s correlation shows a statistically significant correlation between mothers and patients’ levels of alexithymia. Results Our findings also suggest that fathers and mothers’ TAS scores correlate with each other. However, there is no statistically significant relationship between the influence of the TAS scores of fathers and sons/daughters. Conclusions In conclusion, mothers’ level of alexithymia could influence both fathers and patients’ difficulty in identifying and describing their own emotions. This relationship can be investigated further when considering externally oriented thinking. However, the severity of the disease and overall functioning do not appear to be affected by patients’ levels of alexithymia.

Background: Alexithymia is the inability to identify and describe one's own emotions. Adolescents who suffer from Restrictive Eating Disorders (REDs) show a higher prevalence of alexithymia than the general population. Methods: The study explored the correlation between levels of alexithymia in mothers, fathers, and adolescents affected by REDs and patients' ability to recognize their emotions. The study also aimed to evaluate if patients' emotional distress can significantly impact the severity of their disorder and functioning measured by the Clinical Global Impression Scale - Severity (CGI-S) and the Children's Global Assessment Scale (CGAS). We enrolled 67 families of adolescents affected by REDs. Parents and patients' levels of alexithymia were assessed through the Toronto Alexithymia Scale (TAS-20). Spearman's correlation shows a statistically significant correlation between mothers and patients' levels of alexithymia. Results: Our findings also suggest that fathers and mothers' TAS scores correlate with each other. However, there is no statistically significant relationship between the influence of the TAS scores of fathers and sons/daughters. Conclusions: In conclusion, mothers' level of alexithymia could influence both fathers and patients' difficulty in identifying and describing their own emotions. This relationship can be investigated further when considering externally oriented thinking. However, the severity of the disease and overall functioning do not appear to be affected by patients' levels of alexithymia. [ABSTRACT FROM AUTHOR]

Yu-Chen Lin,1 Wei-Yang Lee2 1Department of Psychiatry, Veteran General Hospital-Taichung, Taichung, 407, Taiwan, Republic of China; 2Department of Psychiatry, Cheng Gung Memorial Hospital, Taoyuan City, 333, Taiwan, Republic of ChinaCorrespondence: Wei-Yang Lee, Department of Psychiatry, Cheng Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan District, Taoyuan City, 333, Taiwan, Republic of China, Tel +886 988067722, Email wayne2859750@gmail.comPurpose: Caregivers’ responses have an impact on children’s emotional and behavioral development. The inability of caregivers to perceive their own emotions affects their responses to children. This study aims to examine the relationship between a mother’s difficulties in emotional expression and children’s emotional and behavioral disorders.Patient and Methods: A total of 78 cases, aged between 3 and 15 years old, were included in this study. The mothers completed the Taiwan version of the “Toronto Alexithymia Scale” (TAS) and “Children’s Behavior Checklist” (CBCL) questionnaires, which served as research tools. TAS consists of three factors: difficulty in distinguishing emotions (Factor 1, F1), difficulty in expressing feelings (Factor 2, F2), and an externally oriented thinking style (Factor 3, F3). CBCL represents a child’s behavior profile. The Mann–Whitney test and correlation analyses were used for follow-up analysis.Results: Our analysis revealed that F1, F2, F3, and total scores of TAS (TAS-Total) correlate positively with the somatic complaint subscale of CBCL (F1: p = 0.003; F2: p = 0.002; F3: p = 0.034, TAS-Total p=0.002). Additionally, TAS-F1 was positively correlated with the internalizing problems subscale of CBCL (p = 0.020) and the withdrawn (WD) subscale of CBCL (p = 0.044). We also found a significant association between TAS-F1 and WD of CBCL in boys alone (p = 0.022). However, we observed a negative association between TAS-F3 and the social problems subscale of CBCL in boys alone (p = 0.038).Conclusion: Mothers with alexithymic features are more likely to have children who internalize emotions, leading to withdrawal and somatic expression. Boys tend to exhibit withdrawal traits associated with internalization. This study provides initial evidence of a partial correlation between maternal alexithymia and children’s emotional and behavioral disorders, emphasizing the importance of investigating caregivers’ emotional traits for a better understanding of children’s development in the future.Keywords: maternal alexithymia, childhood behavioral disturbance, external and internal problem, children’s behavior checklist, Toronto alexithymia scale

Background: Alexithymia study has been severely affected by the absence of psychometrically validated tests. Two tests stand out against all others: the Toronto Alexithymia Scale-20 (TAS-20) and the Perth Alexithymia Questionnaire (PAQ). The aim of this study was to adapt the PAQ questionnaire to a Spanish sample. Method: For that purpose, it was translated and revised to make both version match in meaning trough a backward translation procedure. The target construct was delimited through a battery of six tests measuring related to alexithymia constructs. The battery was administered to n = 762 (47.2% males), with a retest applied 30 days after with n = 117 subjects. Results: The confirmatory factor analyses showcased a better adjustment in the model that included affective valence as a factor. The exploratory analysis delivered a trifactorial structure. The questionnaire obtained an excellent internal consistency (Cronbach’s α = .955). Correlations with the related constructs confirmed all the hypotheses. Conclusions: Our results confirm our hypothesis: PAQ is a valid and reliable assessment tool for alexithymia. The adapted version performed well contrasted with questionnaires assessing emotional expression, regulation and appraisal as well as psychological distress and even the TAS-20. [ABSTRACT FROM AUTHOR]

Background: Alexithymia study has been severely affected by the absence of psychometrically validated tests. Two tests stand out against all others: the Toronto Alexithymia Scale-20 (TAS-20) and the Perth Alexithymia Questionnaire (PAQ). The aim of this study was to adapt the PAQ questionnaire to a Spanish sample. Method: For that purpose, it was translated and revised to make both version match in meaning trough a backward translation procedure. The target construct was delimited through a battery of six tests measuring related to alexithymia constructs. The battery was administered to n = 762 (47.2% males), with a retest applied 30 days after with n = 117 subjects. Results: The confirmatory factor analyses showcased a better adjustment in the model that included affective valence as a factor. The exploratory analysis delivered a trifactorial structure. The questionnaire obtained an excellent internal consistency (Cronbach’s α = .955). Correlations with the related constructs confirmed all the hypotheses. Conclusions: Our results confirm our hypothesis: PAQ is a valid and reliable assessment tool for alexithymia. The adapted version performed well contrasted with questionnaires assessing emotional expression, regulation and appraisal as well as psychological distress and even the TAS-20.

Background: Chronic low back pain is an exceptionally predominant and exorbitant musculoskeletal pain syndrome. Low Back Pain is the primary cause of movement restriction and records for 33% of all worker's compensation claims. Utilizing the customary characterization framework, Low back pain is additionally arranged by its duration of onset like acute (<6 weeks), sub-acute (6 weeks-12 weeks), and chronic (>12 weeks). Usually, people who have back pain experience acute occurrence of pain, which heals on their own in roughly 3 months. Individuals with alexithymia will in general show lower empathy with others' beliefs, feelings, and desires maybe in light of their absence of information on their own enthusiastic experience. This absence of sympathy may likewise add to the higher rates of relational issues reported by people with alexithymia. Oswestry Low Back Pain Disability questionnaire is an important tool to evaluate functional disability. Therefore, in this study, the association between alexithymia and functional disability in chronic low back pain was discussed. Aim: The study aims to evaluate the correlation between alexithymia and functional disability among IT professionals with chronic low back pain. Materials and Methods: This study involves 246 IT professionals between ages 25-50 years of male and female genders in Bangalore were taken based on inclusion and exclusion criteria. The online survey was performed by using google forms. Outcome Measures: Nordic Musculoskeletal Questionnaire (NMQ), Toronto Alexithymia Scale (TAS-20), and Oswestry Low Back Pain Disability Questionnaire (ODI) were used. Result: A POSITIVE correlation is observed in both cases where the relationship is very weak. T-test for dependent means between those with CLBP and without CLBP the result implies that there is a significant difference between the individuals with CLBP and without CLBP in both the tests. The t-value of alexithymia shows 15.6960 and Oswestry shows -4.7784. the p-value for alexithymia is 0.001 which is significant and the p-value for Oswestry is <0.00001 which is significant. Conclusion: There is a significant difference between alexithymia and functional disability among individuals with CLBP and without CLBP. There is a positive correlation seen in CLBP and without low back pain. [ABSTRACT FROM AUTHOR]

Objective: This study evaluated patients' body perception, self-esteem, and personality traits during the preoperative and postoperative periods of septorhinoplasty. Based on these evaluations, we may provide patient selection recommendations for septorhinoplasty applicants. Methods: In this cross-sectional questionnaire study, 86 patients who underwent primary septorhinoplasty in the Department of Otolaryngology at Bilecik Training and Research Hospital were included between March 2023 and 2024. The same surgeon performed all operations. The preoperative Rhinoplasty Outcome Evaluation (ROE) Questionnaire, Rosenberg Self-Esteem Scale (RSES), Body Perception Scale (BPS), Toronto Alexithymia Scale (TAS), and TEMPS-A Temperament Scale in the preoperative period and ROE, RSES, and BPS in the postoperative period were applied. Results: Fifty-four female and 32 male patients participated in our study. The mean age was 24.0 ± 0.6 years. While there was no significant difference in the BPS and RSES scores between the preoperative and postoperative periods, the total ROE score was significantly higher in the postoperative than in the preoperative period. Postoperative ROE scores were positively correlated with RSES and hyperthymic temperament. In contrast, it was negatively correlated with depressive temperament, cyclothymic temperament, anxious temperament, BPS total score, TAS total score, and TAS emotion recognition and expression subscale scores. In the group with alexithymia features separated according to the TAS cutoff score, preoperative and postoperative ROE results were significantly lower, whereas depressive, cyclothymic, irritable, and anxious personality traits and total BPS scores were higher. However, the postoperative RSBE scores were lower in this group. Conclusion: This is the first study to evaluate self-esteem, body image, alexithymia, and personality traits in septorhinoplasty patients. Appropriate patient selection is essential for success and patient satisfaction in aesthetic operations such as septorhinoplasty. Performing BPS, TEMPS-A, and TAS may help evaluate psychological factors. [ABSTRACT FROM AUTHOR]

Abstract Background Lebanon is passing through an economic crisis leading to a decreased monthly income within a couple and more couple’s dissatisfaction. Furthermore, many studies postulate that the different types of attachment styles affect the romantic relationship experienced between adults. The main objectives of our study were to (1) validate the Toronto Alexithymia Scale (TAS) and Couple Satisfaction Index-4 (CSI-4) scales, and (2) assess the association between attachment styles and couple satisfaction and evaluate the mediating role of alexithymia in these associations. Methods This cross-sectional study involved 445 Lebanese participants (April–May 2021). A confirmatory factor analysis (CFA) was carried out using SPSS AMOS v.24 on the couple satisfaction index and Toronto alexithymia scales’ items. A linear regression was conducted, taking the couple satisfaction index as the dependent variable. Results The CFA results of the CSI-4 scale indicated an excellent fit (χ2/df = 3.845/2 = 1.92, TLI = 0.992, RMSEA = 0.046 [95% CI 0.001–0.115] (pclose = 0.436) and CFI = 0.998). The CFA of the TAS indicated a good/acceptable fit (χ2/df = 422.31/132 = 3.2, TLI = 0.89, RMSEA = 0.07 [95% CI 0.063–0.078] (pclose

Alexithymia is highly prevalent in patients with substance use disorders (SUDs) and has been implied in SUD pathogenesis and treatment outcomes. However, the psychometric properties of the most-used instrument for evaluating alexithymia (the 20-item Toronto Alexithymia Scale, TAS-20) have been scarcely studied in relation to SUD patients. Specifically, only five psychometric studies have been performed with samples of SUD patients, and no studies have focused exclusively on Spanish patients with SUDs. Therefore, the aim of the present study was to examine the internal accuracy and reliability of the TAS-20 with a sample of Spanish SUD patients (n = 126; 75.4% male; mean age 43.7 ± 14.6 years). A reliability analysis and a confirmatory factor analysis were executed, considering that TAS-20 has a three-factor structure (difficulty identifying feelings [DIF]; difficulty describing feelings [DDF]; externally oriented thinking [EOT]). The results indicated that TAS- 20’s psychometric properties are acceptable for assessing alexithymia in Spanish patients with SUDs. However, the three-factor model of TAS-20 was found to fit only moderately well with the patient sample, with DIF and DDF being the most reliable and valid constructs. In contrast, the EOT factor needs further research and should be cautiously analyzed in the context of patients with addictions. [ABSTRACT FROM AUTHOR]

Introduction: Alexithymia has been the focus of much recent research in relation to emotional regulation and eating problems amongst psychological disorders. It is dealing with difficulties in processing, expressing, and awareness of emotion. Body image has also been researched, especially amongst women, and its relation emotion. Objective: The aim of this exploratory study is to examine the presence of alexithymia and how this is related to body image amongst a group of female Saudi University students. Methods: 152 Arabic female students from a local University participated in the study. The Toronto Alexithymia Scale-20 (TAS-20 Arabic), the Therapeutic Alexithymia scale (PTA Scale) short scale, body image scale, and figure body image scale were all used in the study. Results: The results showed that there is significant correlation between TAS and body image scale. Further, results showed that body image scale is best predictor of alexithymia in regression analysis. Discussion: Alexithymia has not been studied in university students in KSA. We also explored its relationship to body image and found there is a significant correlation. Alexithymia is present and needs much research in this sample and beyond, in both clinical and non-clinical groups. Conclusion: This is the first study in an Arabic population to show the alexithymia is prevalent amongst this sample and it is significantly related to poor body image. Further studies are suggested to explore further psychological variables related to body image and eating problems, as well as on clinical samples is indicated.

Objective: Psychometric properties of 20‐item Toronto Alexithymia Scale (TAS‐20) have been widely analyzed, but the validity and psychometric qualities of the TAS‐20 in populations with personality disorders are still poorly understood. The aim of the current study was to analyze the factor structure and validity of TAS‐20. Method: Data were extracted from a multisite clinical sample of patients with personality disorders or personality‐related problems referred to specialist mental health services in Norway. Results: With one exception, TAS‐20 revealed acceptable psychometric properties. Variations of TAS‐20 are associated with other clinical measures of distress and severity. Anxiety disorders, borderline, and avoidant personality disorders were all highly related to levels of TAS‐20. The TAS‐20 also revealed unique variance not accounted for by subjective distress, symptom disorders, or dysfunctional personality traits. Conclusion: The TAS‐20 is a relevant instrument for use in assessment of personality disorders, but one subscale should be improved. [ABSTRACT FROM AUTHOR]

Objective: Recent evidence suggests that alexithymic deficits in emotional processing may also affect physical health, and alexithymia may also be associated with organic disorders. The emotional well-being of patients with primary ciliary dyskinesia (PCD) is often negatively affected by uncertainty about the prognosis, lack of ongoing medical care, and lack of symptom control. This study aims to evaluate the frequency of alexithymia and its possible impact on the management of childhood PCD., Materials and Methods: Subjects were recruited from patients with PCD and healthy volunteers aged 8-18 years. The questionnaire included sociodemographic characteristics and self-report scales. Data were compared between patient and control groups., Results: In the >14 years of age group, the total Toronto Alexithymia Scale (TAS-20) score was significantly higher in the patients (56.60 ± 13.01) compared to the control group (46.47 ± 7.50) (p = .007). There were 6 (30) patients with a TAS-20 score ≥61. There was a significant correlation between TAS-20 and Pediatric Quality of Life (PedsQL) score (child), but no correlation between TAS-20 and Kovacs Children Depression Inventory (CDI) and PedsQL score (parents). The TAS-20 score was significantly higher in patients with bronchiectasis (p = .035), nasal polyps (p = .045), and siblings with PCD (p = .001). Furthermore, the TAS-20 score had a significant negative correlation with pulmonary function tests., Conclusion: Although this study is based on limited data from a single center and cannot be generalized to all PCD patient communities, our results show that PCD patients are more likely to have alexithymia compared to healthy controls and highlight the need to evaluate for alexithymia in patients with PCD. It is important for pediatric pulmonologists to have a thorough knowledge of the alexithymic features associated with PCD and to refer patients to pediatric psychiatry when necessary, especially in patients who are noncompliant with treatment protocols., (© 2024 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.)

Background: Lebanon is passing through an economic crisis leading to a decreased monthly income within a couple and more couple's dissatisfaction. Furthermore, many studies postulate that the different types of attachment styles affect the romantic relationship experienced between adults. The main objectives of our study were to (1) validate the Toronto Alexithymia Scale (TAS) and Couple Satisfaction Index-4 (CSI-4) scales, and (2) assess the association between attachment styles and couple satisfaction and evaluate the mediating role of alexithymia in these associations. Methods: This cross-sectional study involved 445 Lebanese participants (April–May 2021). A confirmatory factor analysis (CFA) was carried out using SPSS AMOS v.24 on the couple satisfaction index and Toronto alexithymia scales' items. A linear regression was conducted, taking the couple satisfaction index as the dependent variable. Results: The CFA results of the CSI-4 scale indicated an excellent fit (χ2/df = 3.845/2 = 1.92, TLI = 0.992, RMSEA = 0.046 [95% CI 0.001–0.115] (pclose = 0.436) and CFI = 0.998). The CFA of the TAS indicated a good/acceptable fit (χ2/df = 422.31/132 = 3.2, TLI = 0.89, RMSEA = 0.07 [95% CI 0.063–0.078] (pclose < 0.001) and CFI = 0.91) (items 4 and 8 were removed due to low factor loading (< 0.4)). Being married and higher secure attachment style were significantly associated with more couple satisfaction, whereas older age, higher household crowding index, more alexithymia and mode depression were significantly associated with less couple satisfaction. In addition, alexithymia mediated the association between secure attachment style and couple satisfaction, between preoccupied attachment style and couple satisfaction and between dismissing attachment style and couple satisfaction. Conclusion: Couple's satisfaction is positively associated with secure attachment style. In addition, alexithymia plays a mediating role between couple's satisfaction and attachment styles. Upcoming studies should determine if other mental illnesses play a mediating role between attachment style and couple satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Alexithymia is a personality trait that affects the emotional regulation. It has been found associated especially with pain disorders. It is a personality construct which is characterised by inability to experience and describe feelings, making an alexithymia patient suffer from mental clouding. Therefore, it is important to diagnose patients with alexithymia in dental clinics since it may adversely affect the doctor patient relationship and treatment outcome. Aim: To find the prevalence of alexithymia and to find any difference in alexithymia traits between children with Traumatic Dental Injury (TDI) and those without it. Materials and Methods: This cross-sectional study was conducted on 10-19 years old adolescents reporting to K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India, from February 2018 to September 2018. A total of 420 participants were enrolled with 210 in each group (with TDI and without TDI). Toronto Alexithymia Scale (TAS-20) was used to identify alexithymia. Andreasen’s classification for TDI was used to classify the TDI. Chi-square was used to compare the non parametric data between the groups. Unpaired t-test was performed for the comparison of scores between groups for total TAS-20 score and as well as for the nine dimensions. Results: The prevalence of alexithymia was found to be 86.1% in children with TDI compared to 30.9% in children without TDI. The difference in prevalence of alexithymia between children with TDI and those without was statistically significant (p-value=0.0001). Children with TDI reported with significantly higher total TAS scores. However, difference with respect to gender was not statistically significant. Conclusion: The prevalence of alexithymia was found significantly higher in children with TDI. Also, the TAS-20 score and the individual domain scores were higher in children with TDI. Hence, alexithymia may be associated with TDI.

The aims of this study were to assess the factor structure, validity, and reliability of the Persian translation of the Toronto Alexithymia Scale-20 (TAS-20) and to examine different models of the TAS-20 in Iranian patients with various psychiatric disorders. Participants were 839 patients with psychiatric disorders, including obsessive-compulsive disorder (OCD) (n = 80), schizophrenia (n = 82), bipolar disorder (BD) (n = 100), alcohol dependence (n = 81), major depressive disorder (MDD) (n = 95), psychosomatic disorders (n = 92), anxiety disorders (n = 85), post-traumatic stress disorder (PTSD) (n = 90), attention deficit hyperactivity disorder (ADHD) (n = 55), and suicide attempts (n = 79). Results indicated that the three-factor TAS-16 fit the data well, after removing four items from the externally-oriented thinking (EOT) subscale. In addition, the total score and subscales had strong internal consistency and concurrent validity. An alternative three-factor model and a four-factor model, which both allow the reverse-coded EOT items to load on a separate factor, also had an acceptable fit. The results suggest that after deleting four items from the EOT subscale, the 16-item TAS is a reliable scale among Iranian psychiatric patients. Moreover, the alternative three-factor and four-factor structures may be appropriate to apply among Iranian patients. [ABSTRACT FROM AUTHOR]

Background/Aim: Blood pressure disorder can accompany mood and various psychosomatic disorders. One of the signs of emotional disorganization is alexithymia, which is defined as the impaired ability to experience and express emotions. The relationship of hypertension (HT) with alexithymia is well known, but few studies show the change in alexithymia status after blood pressure regulation. Our study aimed to evaluate the level of alexithymia caused by optimal medical treatment in newly diagnosed essential HT patients. Methods: Fifty-six essential HT patients (33 males, 23 females) diagnosed with 24-hour ambulatory blood pressure monitoring were included in this cross-sectional study. All participants filled the Toronto Alexithymia Scale (TAS-20) during diagnosis and when blood pressure was regulated with treatment. Results: The mean age of the study group was 50.7 (9.9) years. There were twenty-three (41.1%) females. As expected, the systolic and diastolic blood pressure values were significantly lower after treatment (144.41 (9.11) / 89.42 (9.31) mmHg vs. 122.75 (7.27) /74.96 (3.18) mmHg, P<0.001 for both). While TAS-DIF (difficulty identifying feelings) and TAS-EOT (externally oriented thinking) did not significantly change after treatment, a significant decrease was observed in TAS-DDF (difficulty describing feelings) (14.29 (3.51) vs 12.57 (3.06), P<0.01). Total TAS score, TAS-20, was also significantly decreased after treatment (55.67 (8.82) vs 52.35 (7.71), P=0.036). Conclusion: Our findings show that TAS-DDF, one of the subscales of alexithymia, can be improved by regulating blood pressure. We think that psychiatric and emotional states should be evaluated in the follow-up of HT. It is also essential to increase the awareness of patients about coping with stress and stress management. [ABSTRACT FROM AUTHOR]

Objective: Behçet's Disease (BD) is an immunoinflammatory systemic disease. In young adults it seen as genital ulceration, uveitis and oral aphthae. In some patients, BD may affect the central nervous system and some psyschiatric symptoms may accompany this disease. There are few studies in the literature evaluating the relationship between BD and alexithymia. In this study, the relationship between BD and alexithymia is evaluated. Methods: Fifty patients diagnosed according to the International Study Group for Behçet's Disease diagnostic criteria and fifty age and gender-matched healthy individuals were included in the study. Turkish versions of Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Toronto Alexithymia Scale (TAS-20) were applied to the patients and controls. Results: According to TAS-20 scale, alexithymia was classified as: non-alexithymia, moderate and severe alexithymia. In the classification of TAS, there was a significant difference between the cases and the control group (p = 0.019).In patients with BD, alexithymia was 6 times higher than control group (OR = 6.139)(95% CI = 1,657-23.913). Conclusions: Behçet's disease is strongly associated with alexithymia. Recognizing of these psychiatric symptoms is important for management of BD patients. Psychotherapeutic interventions should planned by dermatologist. [ABSTRACT FROM AUTHOR]

AimThe development and assessment of the psychometric properties of the Polish-language version of the Toronto Alexithymia Scale (Bagby et al., 1994a, b) is described in this article. The aim of this study was to translate the TAS – 20 into Polish and establish the psychometric properties of this instrument evaluating alexithymia.Materials and MethodsData were collected via self-report measures from a total sample of 676 participants: a total of 180 participants (115 males and 65 females) diagnosed with alcohol dependence, and 496 control group (347 males and 149 females).ResultsConfirmatory factor analyses found the factor structure of the original English-language TAS 20 for the three subscales translated into Polish: Difficulty in Identifying Feeling (DIF); Difficulty in Describing Feeling (DDF); Externally Oriented Thinking (EOT). All three subscales showed good internal consistency in non-clinical group and two subscales, DIF and DDF in alcohol addict group. Several EOT items loaded poorly on their intended factor.ConclusionThe results from the present study indicate that the Polish version of the TAS - 20 is a reliable and valid measure of alexithymia with good levels of internal consistency, homogeneity, and construct validity. 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, especially in clinical groups.

Aim: The development and assessment of the psychometric properties of the Polish-language version of the Toronto Alexithymia Scale (Bagby et al., 1994a, b) is described in this article. The aim of this study was to translate the TAS – 20 into Polish and establish the psychometric properties of this instrument evaluating alexithymia. Materials and Methods: Data were collected via self-report measures from a total sample of 676 participants: a total of 180 participants (115 males and 65 females) diagnosed with alcohol dependence, and 496 control group (347 males and 149 females). Results: Confirmatory factor analyses found the factor structure of the original English-language TAS 20 for the three subscales translated into Polish: Difficulty in Identifying Feeling (DIF); Difficulty in Describing Feeling (DDF); Externally Oriented Thinking (EOT). All three subscales showed good internal consistency in non-clinical group and two subscales, DIF and DDF in alcohol addict group. Several EOT items loaded poorly on their intended factor. Conclusion: The results from the present study indicate that the Polish version of the TAS - 20 is a reliable and valid measure of alexithymia with good levels of internal consistency, homogeneity, and construct validity. 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, especially in clinical groups. [ABSTRACT FROM AUTHOR]

Background Recent studies have shown that people with high alexithymia scores have decreased interoceptive abilities, which can be associated with psychological and physical disorders. Early assessments of the alexithymia trait included the evaluation of these abilities through the dimension measuring the difficulty in identifying and distinguishing between feelings and bodily sensations (the 26-item Toronto Alexithymia Scale; TAS-26). The revised version of the TAS, the TAS-20, contains a three-factor solution that does not involve a dimension assessing interoceptive abilities. However, the three items allowing the evaluation of these abilities are still present in the TAS-20. In this context, we hypothesized that the 3 items which assess interoceptive abilities in the TAS-20 should constitute an independent factor. In addition to exploring the internal structure of the TAS-20, we examined its external validity by assessing the relationships between the new factors and self-reported measures of personality trait and psychological and physical health. Method Two online studies (N = 253 and N = 287) were performed. The participants completed the TAS-20 and a set of psychological questionnaires (e.g., anxiety, depression) and health questions (e.g., “Do you suffer from a somatic disorder?”). The structure of the TAS-20 was examined using exploratory factor analysis (EFA), followed by an investigation of the relationships between the resulting new factors and other psychological and health data using regressions. In both studies, EFA revealed a new structure of the questionnaire consisting of four dimensions: (1) difficulty in the awareness of feelings, (2) externally oriented thinking, (3) difficulty in interoceptive abilities, and (4) poor affective sharing. The first factor was positively associated with all self-reported psychological and personality trait measures while the third factor was associated more with somatic disorders and medication intake. Results Our results suggest the presence of a new latent factor in the assessment of alexithymia that reflects interoceptive abilities specifically related to health and personality trait outcomes. In accordance with the results and the literature, it seems important to include an assessment of interoceptive abilities when considering the evaluation of alexithymia. The next step would be to develop a valid measure of these abilities.

Background: Recent studies have shown that people with high alexithymia scores have decreased interoceptive abilities, which can be associated with psychological and physical disorders. Early assessments of the alexithymia trait included the evaluation of these abilities through the dimension measuring the difficulty in identifying and distinguishing between feelings and bodily sensations (the 26-item Toronto Alexithymia Scale; TAS-26). The revised version of the TAS, the TAS-20, contains a three-factor solution that does not involve a dimension assessing interoceptive abilities. However, the three items allowing the evaluation of these abilities are still present in the TAS-20. In this context, we hypothesized that the 3 items which assess interoceptive abilities in the TAS-20 should constitute an independent factor. In addition to exploring the internal structure of the TAS-20, we examined its external validity by assessing the relationships between the new factors and self-reported measures of personality trait and psychological and physical health. Method: Two online studies (N = 253 and N = 287) were performed. The participants completed the TAS-20 and a set of psychological questionnaires (e.g., anxiety, depression) and health questions (e.g., “Do you suffer from a somatic disorder?”). The structure of the TAS-20 was examined using exploratory factor analysis (EFA), followed by an investigation of the relationships between the resulting new factors and other psychological and health data using regressions. In both studies, EFA revealed a new structure of the questionnaire consisting of four dimensions: (1) difficulty in the awareness of feelings, (2) externally oriented thinking, (3) difficulty in interoceptive abilities, and (4) poor affective sharing. The first factor was positively associated with all self-reported psychological and personality trait measures while the third factor was associated more with somatic disorders and medication intake. Results: Our results suggest the presence of a new latent factor in the assessment of alexithymia that reflects interoceptive abilities specifically related to health and personality trait outcomes. In accordance with the results and the literature, it seems important to include an assessment of interoceptive abilities when considering the evaluation of alexithymia. The next step would be to develop a valid measure of these abilities. [ABSTRACT FROM AUTHOR]

Highlights • Correlations between personality traits and speech features were observed. • Results suggest a speech task-dependent behaviour of the observed correlations. • A negative-skewed behaviour of F 0 distribution correlated with Sociability score. • Prosodic production correlated to both Alexithymia scores and Activity trait. • Voice quality correlated with Impulsive Sensation Seeking and Aggression-Hostility. Abstract Voice signal has been widely investigated to characterize mood and emotional states. A further interesting dimension could regard the personality traits. The relationship between personality traits and specific speech features is known, however this topic requires further investigation. Specifically, most studies are focused on perceived personality traits, without adopting dedicated personality tests. Moreover, the relationship among speaker personality traits and specific speech features have still to be clarified. In this study, a correlational analysis between some speech-related features and the personality traits, as described by the Zuckerman-Kuhlman model and the Toronto Alexithymia Scale, is performed. An experimental protocol, consisting of two structured speech tasks, was administered to eighteen healthy subjects. Speech features were estimated to describe fundamental frequency (F 0) and voice quality related features from whole speech recording and tilt-related features, describing F 0 dynamics at voiced segment level. Significant correlations among personality traits and speech features were observed using both feature sets. Interestingly, the adopted speech task was found to influence the obtained results. Specifically, no feature reports the same significant correlation in both adopted tasks. The impact of personality traits and speech production studies on the characterization of mental disorders and the estimation of emotional/mood state of the speaker are discussed. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) is often considered to be a disorder of memory as patients suffer from fragmented uncontrollable memories (intrusions) whilst experiencing difficulties in intentionally retrieving details of the traumatic event. Recent research suggests that trait-related deficits in the identification of emotional states (alexithymia) may impact emotional memory processes in a way that promotes intrusion formation in PTSD. Therefore, we investigated the influence of alexithymia on intrusive re-experiencing and emotional recognition memory in a prospective analog study. Twenty-six healthy participants took part in a laboratory experiment, which combined two independent paradigms. Participants were exposed to a traumatic film (first session) and completed an episodic memory task comprising neutral and emotional stimuli (second session). In between sessions, participants recorded intrusive memories of the film. Individuals with higher trait alexithymia (HTA) reported an increased number of intrusions on the day of film presentation. Moreover, analyses of memory performance revealed a negative correlation between alexithymia and emotional recognition memory. Further analyses suggest that reduced emotional recognition memory, as evident in individuals with HTA, may, in turn, be associated with enhanced intrusive re-experiencing. As such, the current findings provide first indications regarding the role of alexithymia in emotional learning and PTSD. Future studies should further investigate these associations as well as potential implications for the treatment of PTSD.

Background: Alexithymia and emotional awareness may be considered overlapping constructs and both have been shown to be related to psychological and emotional well-being. However, it is not clear how the constructs relate to each other empirically or if they may overlap more or less in different populations. The aim of this review was therefore to conduct a meta-analysis of correlations between the most commonly used measures of alexithymia (i.e., the self-report instrument Toronto Alexithymia Scale; TAS-20) and emotional awareness (i.e., the observer-rated instrument Level of Emotional Awareness Scale; LEAS) and to explore potential moderators of their relationship.Methods: Electronic databases were searched for studies published until the end of February 2018. Study samples were coded as medical conditions, psychiatric disorders and/or healthy controls and sample mean age and gender distribution were extracted. Correlations between the TAS-20 and the LEAS were subjected to a random effect of meta-analysis and moderators were explored in subgroup analyses and meta-regressions. Publication bias was considered.Results: 21 studies reporting on 28 independent samples on correlation analysis were included, encompassing a total of 2857 subjects (57% women). The aggregated correlation between TAS-20 and LEAS was r = −0.122 (95% CI [−0.180, −0.064]; Z = −4.092; p < 0.001), indicating a significant, but weak, negative relationship between the measures. Heterogeneity was moderate, but we found no indication of significant differences between patients with medical conditions, psychiatric disorders or healthy controls, nor that mean age or percentage of female subjects moderated the relationship. The overall estimate became somewhat weaker after adjusting for possible publication bias.Conclusions: Our results indicate that TAS-20 and LEAS measure different aspects of emotional functioning. The small overlap suggests that alexithymia and emotional awareness are distinct constructs of emotional well-being. Clinicians need to assess both aspects when considering treatment options for individual patients. Moreover, from the clinical standpoint, an easy reliable and valid way of measuring emotional awareness is still needed. More research should be focus on the differences between alexithymia and emotional awareness in specific conditions, but also how to integrate self-report instrument and observed based measures in a clinical situation.

Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation.Methods: The articles were selected from the main electronic databases (PsycInfo, Medline, PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect) using multiple combinations of relevant search terms (defined GI and liver diseases, articles in English, use of the Toronto scales [TAS] for alexithymia). The TAS was selected as inclusion criterion because it is the most widely used measure, thus allowing comparisons across studies.Results: Forty-eight studies met the inclusion criteria, of which 38 focused on GI disorders (27 on FGID and 11 on IBD) and 10 on liver diseases. Most studies (n = 30, 62%) were cross-sectional. The prevalence of alexithymia was higher in FGID (two third or more) than IBD and liver diseases (from one third to 50% of patients, consistent with other chronic non-GI diseases) than general population (10–15%). In functional disorders, alexithymia may be viewed as a primary driver for higher visceral perception, symptom reporting, health care use, symptom persistence, and negative treatment outcomes. Also, it has been found associated with psychological distress and specific GI-related forms of anxiety in predicting symptom severity as well as post-treatment outcomes and is associated with several psychological factors increasing the burden of disease and impairing levels of quality of life. A number of critical issues (small sample sizes, patients referred to secondary and tertiary care centers, cross-sectional study design, use of one single scale for alexithymia) constitutes a limitation to the generalization of findings.Conclusions: Alexithymia showed to play different roles in gastroenterology according to the clinical characteristics and the psychological burden of the various disorders, with main relevance in increasing subjective symptom perception and affecting negatively post-treatment outcomes.

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. [ABSTRACT FROM AUTHOR]

Background: Alexithymia and emotional awareness may be considered overlapping constructs and both have been shown to be related to psychological and emotional well-being. However, it is not clear how the constructs relate to each other empirically or if they may overlap more or less in different populations. The aim of this review was therefore to conduct a meta-analysis of correlations between the most commonly used measures of alexithymia (i.e., the self-report instrument Toronto Alexithymia Scale; TAS-20) and emotional awareness (i.e., the observer-rated instrument Level of Emotional Awareness Scale; LEAS) and to explore potential moderators of their relationship. Methods: Electronic databases were searched for studies published until the end of February 2018. Study samples were coded as medical conditions, psychiatric disorders and/or healthy controls and sample mean age and gender distribution were extracted. Correlations between the TAS-20 and the LEAS were subjected to a random effect of meta-analysis and moderators were explored in subgroup analyses and meta-regressions. Publication bias was considered. Results: 21 studies reporting on 28 independent samples on correlation analysis were included, encompassing a total of 2857 subjects (57% women). The aggregated correlation between TAS-20 and LEAS was r = −0.122 (95% CI [−0.180, −0.064]; Z = −4.092; p < 0.001), indicating a significant, but weak, negative relationship between the measures. Heterogeneity was moderate, but we found no indication of significant differences between patients with medical conditions, psychiatric disorders or healthy controls, nor that mean age or percentage of female subjects moderated the relationship. The overall estimate became somewhat weaker after adjusting for possible publication bias. Conclusions: Our results indicate that TAS-20 and LEAS measure different aspects of emotional functioning. The small overlap suggests that alexithymia and emotional awareness are distinct constructs of emotional well-being. Clinicians need to assess both aspects when considering treatment options for individual patients. Moreover, from the clinical standpoint, an easy reliable and valid way of measuring emotional awareness is still needed. More research should be focus on the differences between alexithymia and emotional awareness in specific conditions, but also how to integrate self-report instrument and observed based measures in a clinical situation. [ABSTRACT FROM AUTHOR]

Background: Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation. Methods: The articles were selected from the main electronic databases (PsycInfo, Medline, PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect) using multiple combinations of relevant search terms (defined GI and liver diseases, articles in English, use of the Toronto scales [TAS] for alexithymia). The TAS was selected as inclusion criterion because it is the most widely used measure, thus allowing comparisons across studies. Results: Forty-eight studies met the inclusion criteria, of which 38 focused on GI disorders (27 on FGID and 11 on IBD) and 10 on liver diseases. Most studies (n = 30, 62%) were cross-sectional. The prevalence of alexithymia was higher in FGID (two third or more) than IBD and liver diseases (from one third to 50% of patients, consistent with other chronic non-GI diseases) than general population (10-15%). In functional disorders, alexithymia may be viewed as a primary driver for higher visceral perception, symptom reporting, health care use, symptom persistence, and negative treatment outcomes. Also, it has been found associated with psychological distress and specific GI-related forms of anxiety in predicting symptom severity as well as post-treatment outcomes and is associated with several psychological factors increasing the burden of disease and impairing levels of quality of life. A number of critical issues (small sample sizes, patients referred to secondary and tertiary care centers, cross-sectional study design, use of one single scale for alexithymia) constitutes a limitation to the generalization of findings. Conclusions: Alexithymia showed to play different roles in gastroenterology according to the clinical characteristics and the psychological burden of the various disorders, with main relevance in increasing subjective symptom perception and affecting negatively post-treatment outcomes. [ABSTRACT FROM AUTHOR]

Alexithymia is regarded as a predictor of many chronic physical and neurological diseases, but it has not yet been regarded in connection with different types of dizziness, especially postural phobic vertigo. Patients with alexithymia have difficulties in describing their feelings and sensations; especially, it touches upon the description of neurological symptoms.The authors examined 84 patients with postural phobic vertigo (PPV): in 14 patients, this disease developed as a result of Ménière’s disease (MD) (men—6, women—8, average age 42 ± 11 years); in 19 patients—as a result of benign paroxysmal positional vertigo (men—9, women—10, average age 49 ± 13 years); in 17 patients—after ischemic stroke in the posterior circulation (men—9, women—8, average age—59 ± 7 years); and in 34 patients with presbiataxia who did not tolerate stroke (men—21, women—13, average age—64 ± 12 years). Diagnosis of alexithymia was carried out with the help of the Toronto Alexithymia Scale (TAS) (Russian-language version). According to the results of TAS, 46 patients did not have alexithymia (A− group), 8 patients were in the border zone, and 30 patients corresponded the criteria of alexithymia (A+ group). Patients from the border zone were not evaluated. The patients were prescribed anti-anxiety treatment (beta-phenyl-gamma-aminobutyric acid hydrochloride 250 mg three times a day for 3 weeks). All patients from A− group noted a good effect of treatment, and only in two patients from A+ group, the positive effect was registered. The results of the research show that alexithymia is a predictor of a more severe course of postural phobic vertigo, which requires the development of special approaches to the treatment of this disorder in patients with such cognitive modality. Testing on alexithymia is advisable for all patients with PPV complaints. [ABSTRACT FROM AUTHOR]