Alexithymia in primary ciliary dyskinesia.

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.

Alexithymia or general psychological distress? Discriminant validity of the Toronto Alexithymia Scale and the Perth Alexithymia Questionnaire.

BACKGROUND: 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). METHOD: 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. RESULTS: 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. LIMITATIONS: Our sample consisted of general community adults; future work in clinical settings will be useful. CONCLUSIONS: 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.

The impact of family alexithymia on the severity of restrictive eating disorders in adolescent patients.

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.

Alexithymia prevalence among patients with chronic dermatological diseases in a tertiary hospital, Saudi Arabia.

Introduction: Alexithymia is a psychological condition characterized by difficulty in identifying and expressing one's emotions, and it has been associated with several physical and mental health disorders. Aim: To determine the prevalence of alexithymia among patients with a range of chronic dermatological diseases in a Saudi public hospital. Material and methods: 477 patients who were over 14 years old and affected by one of the following chronic skin conditions: psoriasis, atopic dermatitis, acne, alopecia areata, vitiligo, hidradenitis suppurativa, pemphigus vulgaris, chronic urticaria were included in this study. Alexithymia was assessed in these patients by using the Toronto Alexithymia Scale (TAS) which is a widely used, reliable and valid measure of this construct. Results: Prevalence of alexithymia among chronic dermatological disease patients ranges from 14.8% to 71.4%, with an overall occurrence of 43%. The highest prevalence of alexithymia was found in hidradenitis suppurativa (71.4%) and the lowest in acne (14.8%). Overall, the alexithymia cases were predominantly male (51.7%). The distribution of male and female cases with alexithymia varied among patients with different types of chronic skin diseases, with the highest male prevalence in psoriasis (58.7%) and the highest female prevalence in pemphigus vulgaris (66.7%). Conclusions: Alexithymia is prevalent among patients with chronic dermatological diseases and dermatologists' awareness of how to identify and address alexithymia among their patients can play a vital role in improving treatment adherence and outcomes.

Correlation Analyses Between Childhood Behavioral Disturbance and Maternal Alexithymia: An Observational Study.

Purpose: 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.

Análisis factorial confirmatorio dela escala de alexitimia de toronto de20 ítems en pacientes españoles contrastorno por uso de sustancias / Confirmatory factor analysis of 20-item toronto alexithymia scale in spanish patients with substance use disorder

La alexitimia es altamente prevalente en pacientes con trastorno por uso de sustancias (TUS) y ha sido relacionado conla patogénesis y la evolución del TUS. Sin embargo, el instrumento más frecuentemente usado para la medición de laalexitimia (la Escala de Alexitimia de Toronto de 20 ítems- TAS-20) ha sido poco estudiado en cuanto a sus propiedades psicométricas en pacientes con TUS. Solamente cincoestudios han evaluado las características psicométricas de laTAS-20 en pacientes con TUS y ninguno en población española con TUS. Por lo anterior, se realizó un análisis factorialconfirmatorio y de fiabilidad en una muestra de pacientesespañoles con TUS (n=126; 75,4% hombres; edad media de43,7±14,6 años). El análisis factorial confirmatorio se realizóconsiderando que la TAS-20 tiene una estructura de tres factores (Dificultad para Identificar Sentimientos [DIF]; Dificultad para Describir Sentimientos [DDF]; Pensamiento Orientado hacia lo Externo [EOT]). En general, la TAS-20 tiene unaspropiedades psicométricas adecuadas en pacientes españolescon TUS. Sin embargo, el modelo clásico de tres factores dela TAS-20 se ajusta solo moderadamente bien en pacientesespañoles con TUS, siendo los factores DIF y DDF los constructos fiables y válidos, mientras que el factor EOT necesitamás investigación y debe analizarse con cautela en pacientescon adicciones. (AU)

Alexithymia is highly prevalent in patients withsubstance use disorders (SUDs) and has been implied inSUD pathogenesis and treatment outcomes. However, thepsychometric properties of the most-used instrument forevaluating alexithymia (the 20-item Toronto AlexithymiaScale, TAS-20) have been scarcely studied in relation toSUD patients. Specifically, only five psychometric studieshave been performed with samples of SUD patients, andno studies have focused exclusively on Spanish patientswith SUDs. Therefore, the aim of the present study was toexamine the internal accuracy and reliability of the TAS20 with a sample of Spanish SUD patients (n = 126; 75.4%male; mean age 43.7 ± 14.6 years). A reliability analysis and aconfirmatory factor analysis were executed, considering thatTAS-20 has a three-factor structure (difficulty identifyingfeelings [DIF]; difficulty describing feelings [DDF]; externallyoriented thinking [EOT]). The results indicated that TAS20’s psychometric properties are acceptable for assessingalexithymia in Spanish patients with SUDs. However,the three-factor model of TAS-20 was found to fit onlymoderately well with the patient sample, with DIF and DDFbeing the most reliable and valid constructs. In contrast, theEOT factor needs further research and should be cautiouslyanalyzed in the context of patients with addictions. (AU)

Are dietary pattern associated with alexithymia in Saudi adults?

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.

Couple's Satisfaction among Lebanese adults: validation of the Toronto Alexithymia Scale and Couple Satisfaction Index-4 scales, association with attachment styles and mediating role of alexithymia.

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.

Psychometric evaluation of the Norwegian Toronto Alexithymia Scale (TAS-20) in a multisite clinical sample of patients with personality disorders and personality problems.

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.

Can alexithymia be assessed through an interview in adolescents? The Toronto Structured Interview for Alexithymia: Reliability, concurrent validity, discriminant validity, and relationships with emotional-behavioral symptoms.

Alexithymia is connected to adolescents' psychopathology, but the current methods of assessment present limitations. The Toronto Structured Interview for Alexithymia (TSIA) was developed to overcome the limits of the main used self-rating scale in adults, but no studies investigated its feasibility with adolescents. This study involved 95 community adolescents aged 12-19 years. Adolescents were assessed with the TSIA, the 20-item Toronto Alexithymia Scale (TAS-20), the Verbal Comprehension Index of the WISC-IV for verbal skills, and the Child Behavior Checklist and Youth Self Report for emotional-behavioral symptoms. The aims were to investigate the TSIA internal consistency, concurrent validity with the TAS-20, discriminant validity with participants' verbal skills, and relationships with emotional-behavioral symptoms. TSIA showed good internal consistency, concurrent validity with the TAS-20 (except for factor DDF), and independence by participants' verbal skills, but few relationships with emotional-behavioral symptoms. In conclusion, TSIA showed some good psychometric proprieties but little convergence with research findings obtained with the TAS-20, suggesting the need for further research to check the feasibility of using the TSIA with adolescents. Meanwhile, a precautionary multi-method assessment of alexithymia is recommended.

Variance Composition, Reliability, Validity, and Measurement Invariance of the Toronto Alexithymia Scale-20 in Nonclinical Samples.

The present study extended prior work on the Toronto Alexithymia Scale-20 (TAS-20). The TAS-20 total scale score is commonly used in research in the psychology of men and masculinities and in clinical practice, but most published confirmatory factor analyses (CFA's) do not support this use. Using a sample of 913 men and women, variance composition was assessed, and model-based dimensionality and reliability coefficients were calculated, finding evidence for unidimensionality, which supports the use of the total scale raw score but not that of the subscales, although the model fit was less than desired. Convergent and concurrent evidence was found for the validity of the TAS-20 in men as a unidimensional scale (N = 505) by examining relationships with latent variables of several constructs in the nomological network. An assessment of measurement invariance by gender (men, women) found evidence for metric invariance, indicating that cisgender men and women understand the scale in the same way. It is recommended that the TAS-20 scale developers follow recommended procedures to trim composite measurement scales to improve the psychometric properties (i.e., model fit) of the TAS.

Prevalence of Alexithymia in Patients with Medically Unexplained Physical Symptoms: A Cross-sectional Study in Egypt.

BACKGROUND: There is a high incidence of alexithymia in people who report medically unexplained symptoms. There have been limited studies on the prevalence of alexithymia in patients with medically unexplained physical symptoms (MUPS) in various ethnic and cultural backgrounds. OBJECTIVE: This study aimed to estimate the prevalence of alexithymia in patients with MUPS and examine their socio-demographic data. METHODS: In this cross-sectional study, 196 patients with MUPS were recruited from tertiary care internal medicine and neuropsychiatry clinics during the first quarter of 2019. Patients completed a structured interview; socio-demographic and medical history data were collected. Somatic symptom severity was assessed using the Arabic version of the Patient Health Questionnaire (PHQ-15). Alexithymia was assessed using the Arabic version of the Toronto Alexithymia Scale. RESULTS: General fatigue was the most common complaint observed, followed by headache and dyspepsia. In addition, 73.5% of patients had a high Patient Health Questionnaire score, 17.9% had somatic symptoms of medium severity, while 8% and 0.5% had low and marginal somatic symptoms, respectively. Alexithymia was presented in 49.5%, 22.9% had no alexithymia, and 27.6% had borderline/intermediate alexithymia.A weak positive correlation (r<0.4) was found between somatic symptom severity and alexithymic psychopathology (r=0.277;p<0.05). Only the 'difficulty identifying feelings' dimension of alexithymic psychopathology was positively correlated with the severity of somatic symptoms (r=0.271;p<0.05). CONCLUSION: Alexithymia is associated with the development of MUPS.

Influence of Catechol-O-Methyltransferase Gene Polymorphism on the Correlation between Alexithymia and Hypervigilance to Pain.

The psychological characteristic of having difficulty expressing emotions, known as alexithymia, is associated with hypervigilance to pain and is considered one of the risk factors for chronic pain. The correlation between alexithymia and hypervigilance to pain can be observed even in healthy individuals. However, the factors influencing this correlation remain unknown. We explored the dopamine system, which is known to be involved in emotion and pain. The dopamine-degrading enzyme catechol-O-methyltransferase (COMT) has a genetic polymorphism known to influence dopamine metabolism in the prefrontal cortex. COMT polymorphism reportedly affects various aspects of pain and increases pain sensitivity in Met allele carriers. Therefore, we investigated whether the correlation between alexithymia and hypervigilance to pain is influenced by COMT polymorphism in healthy individuals. The results revealed a significant positive correlation between the "difficulty describing feelings" of the 20-item Toronto Alexithymia Scale and the "attention to changes in pain" of the pain vigilance and awareness questionnaire in COMT Met carriers but not in Val/Val individuals. This finding suggests that the correlation between alexithymia and hypervigilance to pain is influenced by COMT polymorphism.

Quality of Life and Psychological Impact in Patients with Atopic Dermatitis.

Atopic dermatitis (AD) is a dermatological disorder that affects patients' mental health and psychological state in complex ways. The importance of understanding the entire scope of this burden is well recognized, but there is limited comprehensive information about the resulting stress on adult patients with AD. This study aimed to determine the degree of psychological stress in patients with AD compared to healthy participants. A total of 352 adult patients participated in this cross-sectional study-174 with AD and 178 healthy participants. Demographic and clinical data were collected. Itch and sleep disturbance were assessed using a numeric rating scale and a visual analogue scale. The 20-item Toronto Alexithymia Scale (TAS-20) and Beck Depression Inventory (BDI) questionnaires were administered to assess the symptoms of alexithymia and depression. Quality of life (QOL) was assessed in AD patients using the Dermatology Quality Index. In our study, we found high TAS-20 and BDI scores among patients with AD. The prevalence of alexithymic personality features was 56.3% in patients with AD versus 21.3% in healthy controls (p < 0.001). Based on BDI scoring (BDI-21 > 13), depression was suspected in a significantly higher number of patients with AD than in the control group (56.9% (99/174) vs. 15.7% (28/178); p < 0.0001). Eczema Area and Severity Index (EASI) score did not show any significant correlations with psychological parameters. Among clinical parameters, only sleep disturbance was positively correlated with depression (R = 0.307, p < 0.005). Our data show that the severity index score as a representative factor of skin involvement has a limited role in predicting the effect of skin diseases on mental status. Screening and assessment for psychiatric disorders, QOL, and sleep disturbance in patients with atopic dermatitis cannot be neglected by physicians and they should be treated in clinical practice with the consideration of psychosomatic approaches.

Development and psychometric evaluation of an informant form of the 20-item Toronto alexithymia scale.

OBJECTIVE: The alexithymia personality construct encompasses difficulties identifying and describing feelings, restricted imaginal processes, and an externally oriented cognitive style. The construct was derived initially from observations of patients with classic psychosomatic diseases. The self-report 20-item Toronto Alexithymia Scale (TAS-20) is the most frequently used measure to assess alexithymia. A concern associated with the TAS-20 is whether individuals can accurately self-report difficulties identifying and describing feelings if they are deficient in those abilities. To address this issue, we sought to develop and validate an informant form (version) of the TAS-20, the 20-item Toronto Alexithymia Scale - Informant Form (TAS-20-IF). METHOD: We employed a three-phase methodological strategy. In the first phase, items from the TAS-20 were re-written into a third person version by a team of experts. In the second phase, the "traditional" three-factor structure was tested in the TAS-20-IF using confirmatory factor analysis in a large sample of young adults (N = 857). The third phase was conducted with another sample (N = 430) composed of "informants" (n = 215), who completed the TAS-20-IF, and "targets" (n = 215), who completed the TAS-20 (informants were nominated by the targets). RESULTS: The psychometric properties (items and scales) of both versions were adequate and the three-factor structure of the TAS-20-IF was supported; the correlation between the two versions was statistically significant and the factor structures were similar. CONCLUSION: Although further research is needed to replicate these findings, especially in clinical samples, the results support the reliability and validity of the TAS-20-IF.

Psychometric Properties and Configural Invariance of the Polish - Language Version of the 20-Item Toronto Alexithymia Scale in Non-clinical and Alcohol Addict Persons.

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.

Rates of Alexithymia and Its Association With Smartphone Addiction Among a Sample of University Students in Egypt.

INTRODUCTION: Alexithymia is characterized by difficulties in describing feelings. Many studies have shown that there is a relation between alexithymia and different types of addictions. Nowadays, smartphone addiction is proposed to be a global problem. The current study focuses on the rates of alexithymia and its association with smartphone addiction in an Egyptian university. MATERIALS AND METHODS: This is a cross-sectional study that was conducted in Ain Shams University. A sample of 200 university students was surveyed using Toronto Alexithymia Scale (TAS) and Smartphone Addiction Scale - Short Version (SAS-SV). RESULTS: The results showed that 44 students (22%) had alexithymia. It was also found that around one third of the sample (N=65, 32.5%) met the criteria of smartphone addiction. There was a strong association between alexithymia and smartphone addiction (OR=4.33, 95% CI 2.15-8.74, p= < 0.001). CONCLUSION: This study supports existing literature indicating the strong association between alexithymia and smartphone addiction.

Corticospinal inhibition and alexithymia in multiple sclerosis patients-An exploratory study.

OBJECTIVES: Alexithymia is a multicomponent personality construct that could occur in up to 53% of patients with multiple sclerosis (MS), with recent works proposing higher rates of alexithymia in progressive MS. Among the available models of alexithymia, some propose a deficient interhemispheric communication and an aberrant GABAergic transmission at its origin. However, no single study has addressed the underlying physiological mechanisms of alexithymia in MS. The aim of this work was to assess the relationship between GABAergic neurotransmission and alexithymia in progressive MS by means of transcranial magnetic stimulation (TMS). METHODS: Twelve patients with high alexithymia and fifteen patients with low alexithymia were included based on Toronto Alexithymia Scale (TAS). Sociodemographic, clinical and neuropsychological data were recorded. The following corticospinal excitability measures were obtained: resting motor threshold, cortical silent period (CSP which reflects cortical GABAergic function), and interhemispheric inhibition (i.e., GABAergic function mediated by interhemispheric fibers). RESULTS: No significant group differences were observed regarding sociodemographic, clinical or neuropsychological variables. Patients with high alexithymia scores exhibited shorter CSP than those with low alexithymia scores (81.87 ± 45.72 ms vs. 145.27 ± 77.26 ms, respectively, p < 0.05). A significant inverse correlation was also found between TAS scores and CSP duration (r = -0.59, p < 0.05). CONCLUSION: This study offers insights into the neurophysiological mechanisms of alexithymia in MS. Reduced GABAergic transmission, as reflected by short CSP, seems to be associated with alexithymia in this population. Future studies would benefit from a more comprehensive evaluation of cortical and interhemispheric mechanisms in MS patients with alexithymia.

Twenty-five years with the 20-item Toronto Alexithymia Scale.

OBJECTIVE: Twenty-five years ago, this journal published two articles reporting the development and initial validation of the 20-Item Toronto Alexithymia Scale (TAS-20). Since then the literature on alexithymia has burgeoned with the vast majority of this research using the TAS-20, including multiple language translations of the scale. METHOD: In this article we review the psychometric literature evaluating various aspects of the reliability and validity of the TAS-20 and examine some of the controversies surrounding the scale and the construct it assesses. We reflect on the ways in which the TAS-20 has advanced the measurement of the construct and theory of alexithymia. We also discuss recent developments and some future directions for the measurement of alexithymia. RESULTS: Although not without some controversy, the preponderance of the accumulated evidence over a 25-year period supports various aspects of the reliability and validity of the TAS-20, including findings from confirmatory factor analytic and convergent and discriminant validity studies which are consistent with Nemiah et al.'s (Nemiah et al., 1976 [3]) and Taylor and colleagues (Taylor et al., 1997 [9]) theoretical formulations and definition of the alexithymia construct. CONCLUSIONS: Based on the accumulated empirical evidence of 25 years, we conclude that the TAS-20 is a reliable and valid instrument and accurately reflects and measures the construct as it was originally defined by Nemiah et al. Nemiah et al. (1976) [3] as composed of deficits in affect awareness and expression and pensée opératoire (operational thinking). Clinicians and researchers can use the TAS-20 to confidently measure alexithymia, the roots of which have foundations in psychosomatic medicine.

Toronto Alexithymia Scale-20: Examining 18 Competing Factor Structure Solutions in a U.S. Sample and a Philippines Sample.

The Toronto Alexithymia Scale-20 is arguably the most utilized measure of alexithymia. Although a three-factor solution has been found by numerous studies, these findings are not universal. This article examined and compared 18 competing factor structures for the Toronto Alexithymia Scale-20, which included between one and four correlated latent factor structures, common methods models that accounts for negatively worded items, and bifactor models. Although the two-factor bifactor model with a common methods factor had the better model fit compared with the other 17 models examined, it still did not achieve the requisites of a good model fit across all model fit indices. Issues stemmed primarily from the externally oriented thinking factor and the negatively worded items. Post hoc analyses indicated that a two-factor bifactor model with the negatively worded items dropped achieved the requisites of a good model fit and can be treated as a unidimensional measure despite the presence of multidimensionality. Multiple-group analysis indicated that the factor loadings were invariant across U.S. and Philippines samples. After controlling for noninvariance at the item intercept level, the Philippines sample had a higher alexithymia general score compared with the U.S. sample.