Elsevier

Psychiatry Research

Volume 178, Issue 3, 15 August 2010, Pages 565-567
Psychiatry Research

Brief report
A confirmatory factor analysis of the Toronto Alexithymia Scale (TAS-20) in an alcohol-dependent sample

https://doi.org/10.1016/j.psychres.2009.09.015Get rights and content

Abstract

Confirmatory factor analyses were conducted to evaluate the factorial validity of the Toronto Alexithymia Scale in an alcohol-dependent sample. Several factor models were examined, but all models were rejected given their poor fit. A revision of the TAS-20 in alcohol-dependent populations may be needed.

Introduction

Alexithymia refers to difficulty in identifying, differentiating and communicating feelings, a lack of imagination, and an externally oriented thinking style (Nemiah et al., 1976). The Toronto, Alexithymia Scale (TAS-20) (Bagby et al., 1994) is a reliable self-report measure of alexithymia. It consists of three factors: difficulties identifying feelings (DIF), difficulties describing feelings (DDF), and externally oriented thinking (EOT). Given the link between addiction and alexithymia, it is important to validate the TAS-20 in substance misuse samples (Thorberg et al., 2009). There have only been a few such studies. The TAS-20 confirmatory factor analyses (CFA) undertaken by Cleland et al. (2005) in a substance disorder sample indicated a marginal fit for the two-factor model (Loas et al., 1996, Kooiman et al., 2002) and the original three-factor model (Bagby et al., 1994). In a combined drug- and alcohol-dependent group, Besharat (2008) confirmed the three-factor model, but the psychometric properties of the TAS-20 were described as suboptimal. In a sample composed of a group with substance dependence and a group with eating disorders (Loas et al., 2001) the original three-factor structure was confirmed and was a superior fit than the two-factor model. In a psychiatric sample including alcohol abusers, a four-factor model consisting of DIF, DDF, pragmatic thinking, and lack of importance of emotions provided the best fit compared to the other models (Mueller et al., 2003). Given the lack of consistency in previous attempts to identify the TAS-20 factor structure in substance-dependent samples, and the lack of such research in groups with primary alcohol dependence, further studies of this type are warranted. This study aimed to establish the underlying factor structure of the TAS-20 in an alcohol-dependent sample.

Section snippets

Participants

Participants were undertaking outpatient cognitive behavioural therapy for alcohol dependence at a Brisbane hospital. A total of 210 participants (144 males) with a mean age of 38.17 years (S.D. = 10.82) diagnosed with alcohol dependence as assessed by Diagnostic and Statistical Manual of Mental Disorders, fourth edition, third revision (DSM-IV) criteria (American Psychiatric Association, 2000), Brief Michigan Alcoholism Screening Test (bMAST Pokorny et al., 1972), and the Alcohol Use Disorder

Means, S.D. and intercorrelations

The mean score for the TAS-20 was 53.82 (S.D. = 11.87), DIF 19.38 (S.D. = 6.23), DDF 14.11 (S.D. = 4.47), EOT 20.33 (S.D. = 4.42), bMAST 16.60 (S.D. = 8.27), and AUDIT 26.03 (S.D. = 9.80). Pearson's correlations between TAS-20 total score, DIF, DDF, and EOT were significant (r = 0.83; r = 0.87; and r = 0.63, respectively). The DIF scale was significantly correlated with DDF (r = 0.63) and EOT (r = 0.19) and DDF was significantly correlated with EOT (r = 0.43). The AUDIT was significantly correlated with TAS-20 (r = 

Discussion

The original three-factor model provided the most plausible theoretical explanation of the data compared with the other models. It had a significantly lower χ2 scores as well as a significant chi-square difference indicating a superior global fit. This result supports previous findings (Loas et al., 2001, Mueller et al., 2003, Cleland et al., 2005). DIF and DDF factor loadings were significant and higher than the recommended cut-off (Stevens, 1996), with the exception of DDF item 4 (Table 1).

References (28)

  • H.J. Grabe et al.

    The relationship between dimensions of alexithymia and dissociation

    Psychotherapy and Psychosomatics

    (2000)
  • G. Hawthorne et al.

    Imputing cross-sectional missing data: comparison of common techniques

    Australian and New Zealand Journal of Psychiatry

    (2005)
  • L.T. Hu et al.

    Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives

    Structural Equation Modelling

    (1999)
  • S. Kagan-Krieger et al.

    Paternal alcohol exposure and Turner syndrome

    Alcohol and Alcoholism

    (2002)
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