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Preece DA, Petrova K, Mehta A, Sikka P, Gross JJ. Alexithymia or general psychological distress? Discriminant validity of the Toronto Alexithymia Scale and the Perth Alexithymia Questionnaire. J Affect Disord 2024; 352:140-145. [PMID: 38320659 DOI: 10.1016/j.jad.2024.01.271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/15/2024] [Accepted: 01/31/2024] [Indexed: 02/08/2024]
Abstract
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.
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Affiliation(s)
- David A Preece
- Curtin University, Curtin enAble Institute & School of Population Health, Perth, Australia; The University of Western Australia, School of Psychological Science, Perth, Australia.
| | - Kate Petrova
- Stanford University, Department of Psychology, Stanford, United States of America
| | - Ashish Mehta
- Stanford University, Department of Psychology, Stanford, United States of America
| | - Pilleriin Sikka
- Stanford University, Department of Psychology, Stanford, United States of America; University of Turku, Department of Psychology and Speech-Language Pathology, Finland; University of Turku, Turku Brain and Mind Center, Finland; University of Skövde, Department of Cognitive Neuroscience and Philosophy, Sweden
| | - James J Gross
- Stanford University, Department of Psychology, Stanford, United States of America
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Preece DA, Mehta A, Petrova K, Sikka P, Bjureberg J, Chen W, Becerra R, Allan A, Robinson K, Gross JJ. The Perth Alexithymia Questionnaire-Short Form (PAQ-S): A 6-item measure of alexithymia. J Affect Disord 2023; 325:493-501. [PMID: 36642314 DOI: 10.1016/j.jad.2023.01.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/21/2022] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND Alexithymia is a trait characterized by difficulties identifying feelings, difficulties describing feelings, and externally orientated thinking. It is widely regarded as an important transdiagnostic risk factor for a range of psychopathologies, including depressive and anxiety disorders. Whilst several well-validated psychometric measures of alexithymia exist, these are relatively lengthy, thus limiting their utility in time-pressured settings. In this paper, we address this gap by introducing and validating a brief 6-item version of the Perth Alexithymia Questionnaire, called the Perth Alexithymia Questionnaire-Short Form (PAQ-S). METHOD Across two studies with adult samples (Study 1 N = 508 United States community; Study 2 = 378 Australian college students), we examined the psychometric properties of the PAQ-S in terms of its factor structure, reliability, and concurrent/criterion validity. RESULTS In exploratory and confirmatory factor analyses, all PAQ-S items loaded well on a single general alexithymia factor. The PAQ-S total score had high reliability, and correlated as expected with the long-form of the PAQ, as well as other established markers of alexithymia, emotion regulation, and affective disorder symptoms. LIMITATIONS Our samples were general community or college student samples from two Western countries; future validation work in clinical samples and more diverse cultural groups is thus needed. CONCLUSIONS The PAQ-S retains the psychometric strengths of the PAQ. As such, the PAQ-S can be used as a quick, robust measure of overall alexithymia levels. The introduction of the PAQ-S hence enables valid assessments of alexithymia in a more diverse range of settings and research designs.
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Affiliation(s)
- David A Preece
- Curtin University, Curtin enAble Institute, Perth, Australia; Curtin University, School of Population Health, Perth, Australia; University of Western Australia, School of Psychological Science, Perth, Australia.
| | - Ashish Mehta
- Stanford University, Department of Psychology, Stanford, United States
| | - Kate Petrova
- Stanford University, Department of Psychology, Stanford, United States
| | - Pilleriin Sikka
- Stanford University, Department of Psychology, Stanford, United States; University of Turku, Department of Psychology and Speech-Language Pathology, Finland; University of Turku, Turku Brain and Mind Center, Finland; University of Skövde, Department of Cognitive Neuroscience and Philosophy, Sweden
| | - Johan Bjureberg
- Karolinska Institutet, Department of Clinical Neuroscience, Centre for Psychiatry Research, Sweden; Stockholm County Council, Stockholm Health Care Services, Stockholm, Sweden
| | - Wai Chen
- Curtin University, Curtin enAble Institute, Perth, Australia; Curtin University, Curtin Medical School, Perth, Australia; University of Western Australia, Graduate School of Education, Perth, Australia; University of Notre Dame Australia, School of Medicine, Perth, Australia; Murdoch University, Perth, Australia; Fiona Stanley Hospital, Mental Health Service, Perth, Australia
| | - Rodrigo Becerra
- University of Western Australia, School of Psychological Science, Perth, Australia
| | - Alfred Allan
- Edith Cowan University, School of Arts and Humanities, Perth, Australia
| | - Ken Robinson
- Edith Cowan University, School of Arts and Humanities, Perth, Australia
| | - James J Gross
- Stanford University, Department of Psychology, Stanford, United States
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Fynn DM, Preece DA, Gignac GE, Pestell CF, Allan A, Kraats CV, Green SL, Weinborn M, Becerra R. Assessing alexithymia in adults with acquired brain injury: Psychometric properties of the Perth Alexithymia Questionnaire. J Affect Disord 2022; 302:224-233. [PMID: 35092756 DOI: 10.1016/j.jad.2022.01.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/13/2022] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Alexithymia is a multidimensional personality trait comprised of difficulty identifying feelings, difficulty describing feelings, and externally orientated thinking. The assessment of alexithymia in people with acquired brain injury (ABI) is of clinical interest because alexithymia is linked to poor psychosocial functioning and community reintegration after ABI. To date, alexithymia measures have not been psychometrically investigated/validated in an ABI sample, restricting confident empirical work in this area. We aimed to fill this gap by assessing the psychometric properties of the Perth Alexithymia Questionnaire (PAQ) in adults with ABI and determining whether the alexithymia construct manifests similarly in ABI samples compared to the general community. METHODS The PAQ and Depression Anxiety Stress Scales-21 were administered to an ABI sample (N = 350) and a community sample (N = 1012). Factor structure, measurement invariance, internal consistency reliability, and concurrent/discriminant validity were explored. RESULTS Our confirmatory factor analysis of the PAQ supported the intended five-factor correlated model as the best solution, where items loaded well onto the five intended subscales. This factor structure was invariant across ABI and community samples. Good reliability and concurrent and discriminant validity were also established. LIMITATIONS The PAQ is a self-report measure and may be impacted by insight deficits known to occur after ABI. CONCLUSION Our data suggests that the PAQ has good validity and reliability as a measure of alexithymia. The latent structure of alexithymia manifests similarly in ABI and community samples. This study provides the first psychometric foundation for confident assessment of alexithymia in ABI.
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Affiliation(s)
- Danielle M Fynn
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | | | - Gilles E Gignac
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Carmela F Pestell
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | | | | | - Sarah L Green
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Michael Weinborn
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Rodrigo Becerra
- The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
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