[The Alexithymia Questionnaire for Children (AQC): French translation and validation study in a convenience sample of 80 children]. / Le questionnaire d'alexithymie pour enfants (QAE): traduction française et étude de validation dans une population de 80 enfants « tout venant ¼.

INTRODUCTION: Alexithymia refers to a specific disturbance in psychic functioning characterized by a limited ability to identify and communicate one's feelings. Development of specific rating scales and notably the well-validated 20-item Toronto alexithymia Scale (TAS-20) have allowed the study of alexithymia in numerous samples of clinical or non-clinical subjects. Recently, Rieffe et al. [Pers and Individ Differ 40 (2006) 123-133] have developed an alexithymia questionnaire for children (AQC) basing on the TAS-20. The AQC comprised 20 items divided into three subscales: difficulty-identifying feelings (DIF), difficulty describing feelings (DDF) and externally-oriented thinking (EOT). Using a sample of 740 children and the Dutch version of the AQC the three-factor structure of alexithymia was found, using confirmatory factorial analysis, but the EOT factor showed low factor loadings and reliability. OBJECTIVE: The aim of the study was to present the French version of the AQC and to assess the psychometric properties of this version. METHODS: Eighty children recruited from a convenience sample were included in the study. There were 43 boys and 37 girls with a mean age of 11.81 (SD = 1.99, range: 9-16). The validity and the reliability of the AQC were studied using a confirmatory factorial analysis (CFA), the determination of the Cronbach alpha coefficient, and the calculation of the correlations between each item and the total score. RESULTS: Adequation parameters of the CFA showed that the 3-factor solution of the AQC was adequate (χ 2/df = 1.27, RMSEA = .039) although the EOT factor had low factor loadings. The Cronbach alpha coefficient was 0.64 and 15 items had significant correlations with the total score. CONCLUSION: The three-factor model of the AQC was reported for the French version of scale but the EOT factor had low validity. This result confirms the recent study using the Dutch version of the AQC. Moreover, several studies using foreign versions of the TAS-20 reported low reliability of the EOT factor. Thus, other studies are necessary to explore the reliability of the EOT factor of the French version of the AQC, and it's recommended to use only the total score of the AQC instead of the sub-scores.

[Incidence and risk factors of HCV infection in a cohort of intravenous drug users in the North and East of France]. / Incidence et facteurs de risque de la séroconversion au virus de l'hépatite C dans une cohorte d'usagers de drogue intraveineux du nord-est de la France.

BACKGROUND: In order to evaluate the incidence and risk factors of infection by hepatitis C virus (HCV) among intravenous drug users we conducted a prospective cohort study of HCV and HIV negative IVDU in the North and East of France. METHODS: Two hundred and thirty-one IVDU who had injected drug at least once in their lifetime and were negative for anti-HCV and anti-HIV were followed-up every three months over a 12-month period. Serum anti-HCV and anti-HIV antibodies were tested at inclusion in the study and at the end of the follow-up. Data on injection practices and behaviours were collected at inclusion and at each visit, and a test for anti-HCV antibodies was performed on a saliva sample. When this proved positive, an ELISA test for serum anti-HCV antibodies was carried out. RESULTS: Of the 231 participants included, 165 (71.4%) underwent a final HCV and HIV serum test. The incidence was nil for HIV infection and 9% (95% CI: 4.6-13.4) person-years for HCV infection. Among IVDU who injected at least once during the last 6 months HCV infection incidence was 11% (95% CI: 4.7-17.1) person-years. The multivariate analysis carried out on the inclusion data found female sex alone to be an independent predictive factor of HCV seroconversion. In a Cox proportional hazard multivariate analysis that took into account time-dependent exposures and covariates, we found that syringe and cotton sharing were, after adjusting for other covariates, the only independent predictive factors of HCV seroconversion: hazard ratio: 6.3 [corrected] (95% CI: 1.1-35.4; [corrected] p<0.05) and 16.4 (95% CI: 1.4-190.6; [corrected] p<0.05), respectively. CONCLUSION: The transmission of the HCV virus persists among French IVDU despite an ongoing national harm reduction program. Injecting material and cotton sharing are the two major determinants of transmission in this cohort.

Incidence and risk factors of HCV and HIV infections in a cohort of intravenous drug users in the North and East of France.

In order to evaluate the incidence and risk factors of infection by hepatitis C virus (HCV) among injecting drug users (IDUs), we conducted a prospective cohort study of HCV- and human immunodeficiency virus (HIV)-negative IDUs in the North and East of France. A total of 231 HCV and HIV IDUs who had injected drugs at least once in their lifetime were followed up every 3 months over a 12-month period. Serum anti-HCV and anti-HIV were tested at inclusion in the study and at the end of the follow-up. Data on injecting practices were collected at inclusion and at each visit. Of the 231 participants included, 165 (71.4%) underwent a final HCV and HIV serum test. The incidence was nil for HIV infection and 9/100 person-years (95% CI 4.6-13.4) for HCV infection. In a multivariable analysis, we found that syringe and cotton sharing were the only independent predictive factors of HCV seroconversion.

Anhedonia, alexithymia and locus of control in unipolar major depressive disorders.

The relationship between anhedonia, alexithymia and locus of control was studied in a group of healthy subjects (n = 56) and in a group of unipolar major depressives (n = 59). These dimensions were rated using the Physical Anhedonia Scale (PAS), the Toronto Alexithymia Scale (TAS) and the Internal Powerful others and Chance Scale. The unipolar major depressives were divided into two subgroups using the endogenomorphic subscale of the Hamilton Depression Rating Scale. There are respectively 25 and 17 depressives in the nonendogenomorphic (NENDO) and endogenomorphic (ENDO) subgroups. The unipolar major depressives were significantly more anhedonic, alexithymic and externalized than the controls. In the ENDO group the PAS and TAS Feelings scores were positively correlated suggesting that a third variable of emotional deficit could characterize endogenomorphic depression. In the NENDO group the PAS, TAS Daydreaming, Powerful others and Chance scores were positively correlated. In nonendogenomorphic depression anhedonia could be related to a poverty of imagery and could be interpreted as a consequence of external causes.

Is alexithymia a negative factor for maintaining abstinence? A follow-up study.

The prevalence of alexithymia in 46 inpatients with alcohol abuse or dependence was 67.4%. Pretreatment characteristics predicting outcome at 15 months were determined. At the 15-month time point, 67.4% of patients met criteria for abuse or alcohol dependence and 32.6% were abstinent. In patients who relapsed, the total score for the 20-item Toronto Alexithymia Scale (TAS-20) and the score for the TAS-20-feelings factor were significantly higher than in subjects who were abstinent, even when depressive symptoms were taken into account. Stepwise multiple linear regression showed that the TAS-20-feelings factor significantly predicted abstinence. The results may suggest that alexithymia predicted poor outcome in alcoholic inpatients.

Anhedonia and alexithymia: distinct or overlapping constructs.

The aim was to examine the relationship between alexithymia, anhedonia, and capacity for displeasure in a group of 133 healthy subjects using principal components analysis. A correlation matrix comprised of items from both the Communication and Identification scale of the 20-item Toronto Alexithymia Scale and the Physical Pleasure-Displeasure Scale yielded a four-factor solution (one Communication-Identification, two Pleasure, and one Displeasure factor) with no overlap of the significant factor loadings for the items from each scale. Moreover, there were no positive significant correlations between the Communication and Identification Scales and the Physical Anhedonia Scale. Our findings support the view that physical anhedonia is a construct distinct and separate from alexithymia.

[Locus of control in alcoholics: comparative study of 64 alcoholics vs 50 hospitalized patients and 50 normal controls]. / Le lieu de contrôle chez les alcooliques: étude comparative de 64 alcooliques versus 50 témoins hospitalisés et 57 sujets sains.

The locus of control is a construct that consists of factors that influence and contribute to a person's belief concerning the extent and degree to which he or others can influence life events. The study had four purposes. They were to examine differences between psychiatric inpatients alcoholics and non alcoholics on the internal, chance and powerful others subscales of the French version of Levenson's scale, to evaluate differences on these scores between the alcoholics who accepted the alcohol program treatment proposed at the admission (hospitalization of 15 days with a directive and structured context) and those who refused this treatment, to assess the impact of treatment on the Levenson scale scores of the alcoholics, and finally to determine whether the Levenson scale scores differentiate between treatment successes and failures (evaluated at three months). 171 subjects were divided into three groups: 64 patients hospitalized in psychiatry for chronic alcoholism (ICD-10 criteria for alcohol dependency), 50 patients hospitalized in psychiatry for an other pathology (control group) and 57 healthy subjects (normal group). These subjects filled out the IPC (Internal, Powerful others, Chance) scale of Levenson, different from the I-E (Internal-External) Rotter's scale because it distinguishes two types of externality: one imprevisible, the chance, and the other previsible, the powerful others. The results showed that the alcoholics as the controls are more external than the healthy subjects (Chance and Powerful others subscales). They also showed that the alcoholics who refused the alcohol treatment program proposed at the admission were more internal than those who accepted. We also found that, during the treatment, the alcoholics' scores of Internality increased while their scores of externality (Chance and Powerful others) decreased. This decreasing was also found with the check inpatients. So these changes would have connections with an "hospitalization factor" and wouldn't be due to the alcohol treatment. As for the last purpose, there were no significant differences between the initial locus of control scores of the successes and those of the failures.

[Physical anhedonia and depression: distinct concepts? Study of the construct validity of these dimensions in a group of 224 normal subjects]. / Anhédonie physique et dépression : dimensions distinctes? Etude de la validité constructive de ces dimensions chez un groupe de 224 sujets sains.

The aim of the study was to precise the relationship between physical anhedonia and depression in healthy subjects. The construct validity of these two dimensions were determined using a principal components analysis. 224 normal subjects were recruited for the study. They filled out the abrigded version of the Beck Depression Inventory (BDI) and a physical pleasure scale (Fawcett Clark Pleasure Capacity Scale--FCPCS-PP). A principal components analyses following by a varimax rotation was done. The correlation matrix comprising items from both the BDI and the FCPCS-PP yielded a three-factor solution (two "pleasure" factors and one "depression factor") with no overlap of the significant factor loading for the items from each scale. The findings support the view that physical anhedonia is a construct that is distinct and separate from depression.

[External validity, reliability and basic score determination of the Toronto Alexithymia Scales (TAS and TAS-20) in a group of alcoholic patients]. / Etude de la validité externe, de la fidélité et détermination des notes seuils des échelles d'alexithymie de Toronto (TAS et TAS-20) chez un groupe de malades alcooliques.

The criterion validity of the Toronto Alexithymia Scales (TAS and TAS-20) was assessed by administering the scales to 47 alcoholic inpatients. The 47 subjects were inpatients meeting the Research Diagnostic Criteria for alcoholism. The subjects were assessed by two raters using the Beth Israël Questionnaire in the first week following their hospitalization. They filled out the TAS and one week later the TAS-20. Among the 47 alcoholics, 31 were alexithymic and 16 were non-alexithymic. The TAS and the TAS-20 scores of the alexithymics were significantly higher than that of the non alexithymics. The mean (sd) of the TAS in the alexithymics and the non alexithymics were respectively (m = 76.13, sd = 9.56; m = 64.2, sd = 13.88; t = 3.38, df = 45, p = 0.0015). The mean (sd) of the TAS-20 in the alexithymics and the non alexithymics were respectively (m = 54.1, sd = 8.81; m = 43.18, sd = 11.5; t = 3.62, df = 45, p = 0.0007). The one-week test-retest was r = 0.17, p < 0.001. On the basis of these findings, TAS and TAS-20 cutoff scores were suggested. A range of potential cutoff scores around the mean TAS or TAS-20 score were tested using four methods to assess the goodness of a diagnostic test (sensitivity, specificity, Younden's coefficient, positive predictive value). The best scores that maximizes the diagnostic validity of the TAS and TAS-20 in identifying alexithymic subjects were respectively 73 and 56. On the basis of the mean TAS and TAS-20 score for the non alexithymic group and the means that we have obtained with normal groups, scores of 64 and 44 were respectively selected as the cutoff level for the identification of non alexithymic subjects.

Factor analysis of the French version of the 20-Item Toronto Alexithymia Scale (TAS-20).

A French version of the Toronto Alexithymia Scale-20 Items (TAS-20) was factor-analyzed on a sample of 263 university students and its factor solution analyzed along with the studies using the Canadian version. Our results show a two-factor solution where the items rating the difficulty to identify feelings and the items rating the difficulty to describe feelings constitute a sole factor contrary to the Canadian version. These data are reviewed in the context of previous research and offer two subscales for future investigations utilizing the TAS-20.

[Prevalence of alexithymia in a general population. Study in 183 "normal" subjects and in 263 students]. / Prévalence de l'alexithymie en population générale. Etude chez 183 sujets "tout venant" et chez 263 étudiants.

The prevalence of alexithymia has been studied in two groups of healthy subjects, 183 normals and 263 university students. In the normal group the alexithymia was rated using the Toronto Alexithymia Scale (TAS) and in the student group the alexithymia was rated using the revised version of the TAS (Twenty-items TAS or TAS-20). Using our cutoff scores (> or = 73 for the TAS, > or = 56 for the TAS-20), the prevalence in the normal group and the student group were respectively 23% and 17.1%.

[Factorial structure and internal consistency of the French version of the twenty-item Toronto Alexithymia Scale in a group of 183 healthy probands]. / Etude de la structure factorielle et de la cohérence interne de la version française de l'échelle d'alexithymie de Toronto à 20 items (TAS-20) chez un groupe de 183 sujets sains.

The factorial structure of the French version of the twenty-item Toronto Alexithymia Scale (TAS-20) was studied in a group of 183 healthy subjects. The TAS-20 represents the latest revised version of the TAS. His psychometric characteristics are clearly superior than the others alexithymia scales. Our subjects filled out the TAS whose 14 items are common with the TAS-20. We conducted our statistical analyses on these 14 items. A principal components analysis was carried out and yielded a two-factor solution where the items rating the ability to describe feelings and the items rating the ability to identify feelings constitute one sole factor. The second factor corresponds to the externally oriented factor. The internal consistency of the scale was also measured by the Cronbach alpha coefficient and by the correlation between each item and the total score. The value of the Cronbach alpha was 0.79 and the correlation between each item and the total score ranges from 0.19 (p < 0.05) to 0.69 (p < 0.001) with a mean of 0.52. Our results confirm a previous work on a group of 263 normal students which showed a two-factor solution of the TAS-20. The French version of the TAS-20 seems to be reliable and constitutes a useful instrument to study alexithymia in psychopathology.

[Evaluation of the subjective component of emotions in normal subjects: relation between anhedonia and the capacity to perceive unpleasant feelings in a population of 221 normal subjects]. / Evaluation de la composante subjective des émotions chez le sujet sain: rapport entre l'anhédonie et la capacité à éprouver du déplaisir dans une population de 221 sujets sains.

This work presents a study of 221 healthy subjects among whom we have assessed the capacity to feel pleasure or displeasure through two rating scales, the FCPCS-PP and the HDCS-PD. We have observed a significant correlation between the scores, which shows that the more pleasure the subject feels, the more displeasure he feels. These results seem to confirm the existence of an overall dimension of emotional experience.

[Operationalization of the "locus of control" concept: translation and first validation study of the Levenson control scale (IPC: the internal powerful others and chance scale)]. / Opérationnalisation du concept de "lieu de contrôle": traduction et première étude de validation de l'échelle de contrôle de Levenson (IPC: the internal powerful others and chance scale).

This work presents the study of validation of the French version of the Internal Powerful others and Chance Scale (IPC) of Levenson. A principal components analysis was carried out on a group of 134 healthy subjects. The Cronbach alpha coefficient and the correlation between the items and the total score of each sub-scale of the IPC were calculated. Our results were discussed in comparison with others studies.