Assessing Alexithymia across Asian and Western Cultures: Psychometric Properties of the Perth Alexithymia Questionnaire and Toronto Alexithymia Scale-20 in Singaporean and Australian Samples

Abstract

Alexithymia refers to difficulties identifying feelings (DIF), describing feelings (DDF), and externally orientated thinking (EOT). Originally conceptualized by American psychiatrists, some researchers have since questioned the validity and application of this construct in Asian cultures. However, to date, there is little empirical work formally assessing the invariance of alexithymia across Asian and Western cultures. The present study aimed to help address this gap, by examining the psychometric properties and measurement invariance of two alexithymia measures, the Perth Alexithymia Questionnaire (PAQ) and Toronto Alexithymia Scale-20 (TAS-20), across samples from Singapore (n = 434) or Australia (n = 489). The same theoretically congruent factor structure was supported across both samples; this structure was fully invariant across samples for the PAQ, and partially invariant for the TAS-20. Both measures had good internal consistency and concurrent validity across samples, except the TAS-20 EOT subscale which had low internal consistency and factor loadings in both samples. The Singaporean sample reported higher DIF and DDF for positive emotions than the Australian sample. Overall, our results support the cross-cultural validity and application of the alexithymia construct. The PAQ and TAS-20 both appear to have good utility in this respect, though the PAQ may provide a more detailed facet-level profile.

Acknowledgments

We would like to thank the participants for taking out time to complete this study. Data used in this study will be made available upon request by contacting the first author.

Disclosure statement

The author(s) declared no potential conflicts of interest regarding the research, authorship, and/or publication of this study.

Notes

1 Some authors argue that there is a fourth component of alexithymia: difficulty fantasizing (For a review, Taylor & Bagby, 2021). However, others disagree that it is a component (e.g., Preece et al., 2017, 2020), or refer to it as a more peripheral component (e.g., Watters et al., 2019), because past research has found that difficulty fantasizing does not cohere statistically with DIF, DDF, and EOT (Haviland et al., 1991; Preece et al., 2017; Taylor et al., 1985). Consequently, the most commonly used psychometric measures of alexithymia do not include difficulty fantasising (e.g., TAS-20; Bagby et al., 1994), meaning in practice that the majority of existing alexithymia research has not operationalised it within the construct. As neither of the measures that are the focus of this article include difficulties fantasising, we focus in this paper on the three components of alexithymia that are common to all theoretical models: DIF, DDF, and EOT.

2 A robust WLS estimator, WLSM, was used when conducting measurement invariance for the DASS-21 instead of the Satorra-Bentler robust ML estimator (because the DASS-21 is responded to on a shorter 4-point Likert scale).

Additional information

Funding

This research was supported by the Research Training Program scholarship awarded to the first author by the University of Western Australia.