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Alexithymia in the German general population

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Abstract

The Toronto-Alexithymia-Scale (TAS-20) is used worldwide as a valid measurement of alexithymia. Until now, population-based standardization and cut-off values of the German TAS-20 version have not been available. This study provides these by means of a representative German sample and by investigating the factorial structure of the TAS-20. Data were generated from a representative random sample of the German general population (1,859 subjects aged between 20 and 69). The TAS-20 sum score was normally distributed. The mean value was 49.5 (SD = 9.3) in men and 48.2 (SD = 9.2) in women. Divorce, single and low social status were associated with enhanced sum scores. Ten percent of the population exceeded the TAS-20 sum score threshold of ≥61. The 66th percentile reached 53 for men and 52 for women. Factor analysis identified three factors that match the scales of the English original version. An additional fourth factor (“importance of emotional introspection”) was extracted. Total explanation of variance by these four factors was 52.27%. The sum score of the German TAS-20 version is suited for the standardized measure of alexithymia. For selecting alexithymic individuals in experimental studies, the cut-off ≥61 is possibly too restrictive. Therefore, we propose the 66th percentile for the identification of high alexithymics. The TAS-20 sum score is associated with important socio-demographic variables. The factorial structure is reliable; the fourth factor (“importance of emotional introspection”) provides differentiation of content and allows for enhanced explanation of variance.

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References

  1. Bach M, Bach D, de Zwaan M, Serim M, Böhmer F (1996) Validierung der deutschen Version der 20-item Toronto-Alexithymie-Skala bei Normalpersonen und psychiatrischen Patienten. Psychother Psychosom Med Psychol 46:23–28

    PubMed  CAS  Google Scholar 

  2. Bach M, de Zwaan M, Ackard D, Nutzinger DO, Mitchell JE (1994) Alexithymia—Relationship to personality-disorders. Compr Psychiatry 35:239–243

    Article  PubMed  CAS  Google Scholar 

  3. Bagby RM, Taylor GJ (1997) Measurement and validation of the alexithymia construct. In: Taylor GJ, Bagby RM, Parker JDA (eds) Disorders of affect regulation: Alexithymia in medical and psychiatric illness. Cambridge, Cambridge University Press, pp 46–66

    Google Scholar 

  4. Bagby M, Taylor G (1997) Measurement and validation of the alexithymia construct. In: Taylor GJ, Bagby RM, Parker JDA (eds) Disorders of affect regulation. Cambridge, University Press

  5. Bagby RM, Taylor GJ, Atkinson L (1988) Alexithymia: a comparative study of three self-report-measures. Psychosom Res 32:107–116

    Article  CAS  Google Scholar 

  6. Bagby RM, Taylor GJ, Parker JD (1994) The twenty-item Toronto Alexithymia Scale-II. Convergent, discriminant, and concurrent validity. J Psychosom Res 38:33–40

    Article  PubMed  CAS  Google Scholar 

  7. Costa PT, McCrae PR (1995) Theories of personality and psychopathology: approaches derived from philosophy and psychology. In: Kaplan H, Sadock B (eds) Comprehensive textbook of psychiatry. Baltimore, Williams & Wilkins, pp 507–519

    Google Scholar 

  8. Cox BJ, Kuch K, Parker JD, Shulman ID, Evans RJ (1994) Alexithymia in somatoform disorder patients with chronic pain. J Psychosom Res 38:523–527

    Article  PubMed  CAS  Google Scholar 

  9. Franke GH (1995) SCL-90-R. Die symptom-checkliste von derogatis—Deutsche version. Beltz, Weinheim

    Google Scholar 

  10. Franz M, Schaefer R, Schneider C (2003) Psychophysiological response patterns of high and low alexithymics under mental and emotional load conditions. J Psychophysiol 17:203–213

    Article  Google Scholar 

  11. Franz M, Schaefer R, Schneider C (2004) Visual event related potentials in subjects with alexithymia: modified processing of emotional aversive information. Am J Psychiatry 161:728–735

    Article  PubMed  Google Scholar 

  12. Franz M, Schneider C, Schafer R (2001) Reliability testing of the German version of TAS-20-validity and factorial structure. Psychother Psychosom Med Psychol 51:90–91

    Article  Google Scholar 

  13. Franz M, Schneider C, Schafer R, Schmitz N, Zweyer K (2001) Factoral structure and psychometric properties of the German version of the Toronto Alexithymia Scale (TAS-20) in psychosomatic patients. Psychother Psychosom Med Psychol 51:48–55

    Article  PubMed  CAS  Google Scholar 

  14. Fukunishi I, Nakagawa T, Nakamura H, Kikuchi M, Takubo M (1997) Is alexithymia a culture-bound construct? Validity and reliability of the Japanese versions of the 20-item Toronto Alexithymia Scale and modified Beth Israel Hospital. Psychosomatic Questionnaire. Psychol Rep 80:787–799

    CAS  Google Scholar 

  15. Guendel H, Ceballos-Baumann AO, von Rad M (2000) Aktuelle Perspektiven der Alexithymie. Nervenarzt 71:151–163

    Article  Google Scholar 

  16. Honkalampi K, Hintikka J, Tanskanen A, Lehtonen J, Viinamaki H (2000) Depression is strongly associated with alexithymia in the general population. J Psychosom Res 48:99–104

    Article  PubMed  CAS  Google Scholar 

  17. Horowitz LM, Rosenberg SE, Bartholomew K (1993) Interpersonal problems, attachment styles, and outcome in brief dynamic psychotherapy. J Consult Clin Psychol 61:549–560

    Article  PubMed  CAS  Google Scholar 

  18. Horowitz LM, Strauß B, Kordy H (1994) Inventar zur Erfassung interpersonaler Probleme—Deutsche version. Beltz, Weinheim

    Google Scholar 

  19. Joukamaa M, Miettunen J, Kokkonen P, Koskinen M, Julkunen J, Kauhanen J, Jokelainen J, Veijola J, Läksy K, Järvelin MR (2001) Psychometric properties of the Finnish 20-item Toronto Alexithymia Scale. Nord J Psychiatry 55:123–127

    Article  PubMed  CAS  Google Scholar 

  20. Kojima M, Frasure-Smith N, Lesperance F (2001) Alexithymia following myocardial infarction. Psychometric properties and correlates of the Toronto Alexithymia Scale. J Psychosom Res 51:487–495

    Article  PubMed  CAS  Google Scholar 

  21. Kokkonen P, Karvonen JT, Veijola J, Laksy K, Jokelainen J, Jarvelin MR, Joukamaa M (2001) Prevalence and sociodemographic correlates of Alexithymia in a population sample of young adults. Compr Psychiatry 42:471–476

    Article  PubMed  CAS  Google Scholar 

  22. Lane RD, Sechrest L, Riedel R (1998) Sociodemographic correlates of alexithymia. Compr Psychiatry 39:377–385

    Article  PubMed  CAS  Google Scholar 

  23. Larsen JK, Brand N, Bermond B, Hijman R (2003) Cognitive and emotional characteristics of alexithymia—A review of neurobiological studies. J Psychosom Res 54:533–541

    Article  PubMed  Google Scholar 

  24. Loas G, Corcas M, Stephan P, Pellet J, Bizouard P, Venisse JL, Perez- Diaz F, Guelfi JD, Flament M, Jeammet P (2001) Factorial structure of the 20-item Toronto Alexithymia Scale: confirmatory factorial analyses in nonclinical and clinical samples. J Psychosom Res 50:255–261

    Article  PubMed  CAS  Google Scholar 

  25. Loas G, Otmani O, Verrier A, Fremaux D, Marchand MP (1996) Factor analysis of the French version of the 20-item Toronto Alexithymia Scale (TAS-20). Psychopathology 29:139–144

    PubMed  CAS  Google Scholar 

  26. Martinez-Sanchez F (1996) The Spanish version of the Toronto Alexithymia Scale (TAS-20). Clin Salud 7:19–32

    Google Scholar 

  27. Müller J, Buhner M, Ellgring H (2003) Is there a reliable factorial structure in the 20-item Toronto Alexithymia Scale? A comparison of factor models in clinical and normal adult samples. J Psychosom Res 55:561–568

    Article  PubMed  Google Scholar 

  28. Parker JDA, Bagby RM, Taylor GJ, Endler NS, Schmitz P (1993) Factorial validity of the 20-item Toronto Alexithymia Scale. Eur J Person 7:221–232

    Article  Google Scholar 

  29. Parker JDA, Shaughnessy PA, Wood LM, Majeski SA, Eastabrook JM (2005) Cross-cultural alexithymia: validity of the 20-item Toronto Alexithymia Scale in North American aboriginal populations. J Psychosom Res 58:83–88

    Article  PubMed  Google Scholar 

  30. Parker DA, Taylor GJ, Bagby MR (1993) Alexithymia and the recognition of facial expressions of emotion. Psychother Psychosom 59:197–202

    PubMed  CAS  Google Scholar 

  31. Parker JDA, Taylor GJ, Bagby RM (2003) The 20-item Toronto Alexithymia Scale-III. Reliability and factorial validity in a community population. J Psychosom Res 55:269–275

    Article  PubMed  Google Scholar 

  32. Ritz T, Kannapin O (2000) Zur Konstruktvalidität einer deutschen Fassung der Toronto Alexithymia Scale. Z Differ Diagn Psychol 21:49–64

    Google Scholar 

  33. Salminen JK, Saarijarvi S, Aarela E, Toikka T, Kauhanen J (1999) Prevalence of alexithymia and its association with sociodemographic variables in the general population of Finland. J Psychosom Res 46:75–82

    Article  PubMed  CAS  Google Scholar 

  34. Schäfer R, Schneider C, Sitte W, Franz M (2002) Validitätshinweise der Deutschen version der TAS-20. Psychother Psych Med 52:1–5

    Article  Google Scholar 

  35. Sifneos PE (1973) The prevalence of “alexithymic” characteristics in psychosomatic patients. Psychother Psychosom 22:255–262

    Article  PubMed  CAS  Google Scholar 

  36. Säkkinen P, Kaltiala-Heino R, Ranta K, Haataja R, Joukamaa M (2007) Psychometric properties of the 20-item Toronto Alexithymia Scale and prevalence of alexithymia in a Finnish adolescent population. Psychosomatics 48:154–161

    Article  PubMed  Google Scholar 

  37. Taylor GJ (2000) Recent developments in alexithymia theory and research. Can J Psychiatry 45:134–142

    PubMed  CAS  Google Scholar 

  38. Taylor GJ, Bagby RM (2000) An overview of the Alexithymia construct. In: Bar-On R, Parker JDA (eds) The handbook of emotional intelligence. San Francisco, Jossey-Bass, pp 40–67

    Google Scholar 

  39. Taylor GJ, Bagby RM (2004) New trends in alexithymia research. Psychother Psychosom 73:68–77

    Article  PubMed  Google Scholar 

  40. Taylor GJ, Bagby RM, Parker JDA (1993) Is alexithymia a non-neurotic personality dimension? A response to Rubino, Grasso, Sonnino & Pezzarossa. Br J Med Psychol 66:281–287

    PubMed  Google Scholar 

  41. Taylor GJ, Bagby RM, Parker JD (2003) The 20-item Toronto Alexithymia Scale, IV. Reliability and factorial validity in different languages and cultures. J Psychosom Res 55:277–283

    Article  PubMed  Google Scholar 

  42. Taylor GJ, Bagby RM, Ryan DP, Parker JDA, Doody KF, Keefe P (1988) Criterion validity of the Toronto Alexithymia Scale. Psychosom Med 50:500–509

    PubMed  CAS  Google Scholar 

  43. Zeitlin SB, McNally RJ (1993) Alexithymia and anxiety sensitivity in panic disorder and obsessive-compulsive disorder. Am J Psychiatry 150:658–660

    PubMed  CAS  Google Scholar 

Download references

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Correspondence to Matthias Franz MD.

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Franz, M., Popp, K., Schaefer, R. et al. Alexithymia in the German general population. Soc Psychiat Epidemiol 43, 54–62 (2008). https://doi.org/10.1007/s00127-007-0265-1

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