Validity issues in the assessment of alexithymia related to the developmental stages of emotional cognition and language

Abstract

ObjectiveWe examined developmental aspects of the emotional awareness of adolescents by evaluating their responses to a self-reported questionnaire based on the Toronto Alexithymia Scale-20 (TAS-20).MethodsThe items of the TAS-20 were modified to make them more understandable by adolescents, and nine new items related to a limited capacity for imagination were added. The Japanese Linguistic Ability Test and the multi-dimensional empathy scale for adolescents were administered to examine concurrent validity. Two hundred and two normative young adolescents and thirty-two adolescent patients with psychosomatic and/or behavioral problems participated in the study. Eighty junior high school students also participated in a separate examination of test-retest reliability.ResultsThirteen items were extracted after exploratory and confirmatory factor analyses, and four core factors were identified in the resulting scale: Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), Externally-Oriented Thinking (EOT) and Constricted Imaginal Capacities (CIC). Interestingly, scores on the multi-dimensional empathy scale correlated positively with DIF and DDF, but negatively with EOT and CIC. Higher DDF scores were associated with higher Japanese linguistic abilities. DIF/DDF scores were higher for females than males, irrespective of linguistic ability. Test-retest reliability coefficients were significant. The patient group showed significantly higher DIF scores than the normative students.ConclusionThe present findings indicated that subjective difficulties in identifying and describing feelings are associated with empathetic and linguistic abilities. The developmental aspect to emotional awareness herein described suggests that self-reported questionnaires for alexithymia must be carefully constructed and examined, even for adults.

Serotonin Transporter Gene Promoter Polymorphism and Alexithymia

“…Previous studies have shown gender differences in the allelic variation of 5-HTTLPR [24,48] . In a Japanese population, females showed significantly higher DIF scores than males [19,49] . The underlying biologic mechanism of alexithymia may therefore differ between the sexes.…”

Alexithymia as a Screening Index for Male Conscripts with Adjustment Disorder

“…Alexithymics have been found to be relatively lacking in the ability to empathize [2][3][4]; thus, they have greater difficulty adjusting to social situations, such as that of a group living arrangement, as in the military setting in Taiwan. Currently, the CHQ is used as the screening instrument for psychological distress in military conscripts [24][25][26]; however, the CHQ can only reflect psychological distress after the conscripts have already had problems adjusting to military life.…”

“…Since people with alexithymia are unable to identify their own feelings, they also have trouble identifying the emotional state of others, accordingly, alexithymics have been found to be relatively lacking in the ability to empathize [2][3][4]. However, the ability to empathize is an important component in building interpersonal relationships.…”

Parental bonding and personality characteristics of first episode intention to suicide or deliberate self-harm without a history of mental disorders

“…This phenomenon of living with extended families is also common in Taiwan. Furthermore, a Japanese study also found that adolescents with psychosomatic and/or behavioral problems scored significantly higher than normal adolescents on the DIF index [37], and the DIF dimension of alexithymia have found in numerous studies to be related to somatization [38-40]. …”