Psychometric properties of the Toronto Alexithymia Scale (TAS-20) in Brazil

Assessing the impact of a community-based psychodrama intervention on mental health promotion of adolescents and young adults in Mozambique: A mixed-methods study

Background

While mental health is an emerging issue in low-income countries, its promotion remains poor, with little context-oriented evidence available. Here we aimed to assess the impact and acceptability/feasibility of a community-based psychodrama intervention involving both adolescents and young adults (AYA) living with HIV (AYALHIV) and without HIV (AYAHIV-).

Methods

We used a mixed-methods approach, where the quantitative part was based on pre/post questionnaires and the qualitative one on content analysis of semi-structured interviews. Trained community health care workers delivered psychodrama sessions involving AYAs aged 15-24 years once a week between July and August 2023 in Beira, Mozambique. The baseline assessment involved a sociodemographic and three mental health questionnaires: the Mental Health Knowledge Schedule (MAKS), Community Attitudes toward People with Mental Illness (CAMI27), and the Toronto Alexithymia Scale (TAS). We repeated all questionnaires after the intervention and conducted semi-structured interviews.

Results

We enrolled 354 AYAs (50.8% female, 45.5% AYALHIV) at baseline; 315 (89.0%) attended the sessions, with a mean participation rate of 94.4%. Overall, 281 (89.2%) completed the post-intervention assessment. MAKS score improved from 44.5 (95% confidence interval (CI) = 44.0-45.0) to 47.1 (95% CI = 46.4-47.7, P < 0.001). Total CAMI27 score showed no significant variation (P = 0.855). Total TAS score decreased from 57.3 (95% CI = 56.1-58.5) to 54.3 (95% CI = 53.0-55.6, P < 0.001). We found no statistically significant interactions between time and sex, age, or HIV serostatus in all questionnaires. For the qualitative part of the study, we analysed 37 semi-structured interviews (43.2% with females, 40.5% with AYALHIV). We identified four areas of intervention impact: peer-to-peer support (30.3%), social empowerment (24.7%), resilience (23.0%), and emotional skills (21.9%). Regarding acceptability/feasibility, perceived scalability (37.2%) and affective attitude (34.5%) were the sub-areas most frequently retrieved in the SSIs.

Conclusions

The community-based psychodrama intervention proved to be an effective tool in AYAs' mental health promotion, increasing knowledge and improving emotional awareness through group experience and interpersonal learning. The intervention also showed good acceptability and feasibility in the context of our study.

Relationship between emotional divorce and alexithymia among married women in Saudi Arabia

BACKGROUND

Emotional divorce occurs when a couple continues to live together due to necessity and coercion but they do not have a positive or constructive relationship, which negatively affects the stability of married life. Due to the low social acceptance of a formal divorce in the Saudi society, emotional divorce is common in several families. The rigidity of feelings and emotions within the family and the inability to express them may indicate the presence of alexithymia, which could result in the collapse of the family system and place the people involved at risk of mental health problems such as depression. Therefore, it is important to determine the prevalence of emotional divorce among married women in Saudi Arabia and to examine the relationship between emotional divorce and alexithymia.

METHODS

Data were collected from 305 married women in Saudi Arabia (Mage = 33.24 years; SDage = 4.87 years), using the Emotional Divorce Scale and the Alexithymia Scale.

RESULTS

Results revealed that 78.36% of the participants experienced moderate to severe levels of emotional divorce. Working women, those who had been married for more than ten years, and those with five or more children exhibited a higher incidence of emotional divorce as compared to their counterparts. A linear regression analysis indicated that alexithymia was significantly associated with emotional divorce in this sample.

CONCLUSION

These results suggest the need for examining the negative consequences of emotional divorce on the family and society. Additionally, it is important to educate young individuals of marriageable age about the nature of married life, and ways to deal with problems that occur. Finally, couples should be encouraged to express their positive and negative emotions with their spouse to build the marital relationship, and achieve compatibility and marital satisfaction.

Validity of the Trait Emotional Intelligence Questionnaire (TEIQue) in a Brazilian Sample

The study of the relationship between reasoning and emotional processes is not new in Psychology. There are currently two main approaches to understanding the aspects related to these processes called emotional intelligence: the ability model and the trait model. This study focuses on the latter, analyzing the factor structure, reliability, and validity of the Trait Emotional Intelligence Questionnaire (TEIQue) in a Brazilian sample. 4314 adults with ages ranging from 18 to 60 years (M = 30.37; SD = 9.73) answered the TEIQue and other online instruments measuring emotional regulation, impulsiveness, alexithymia, loneliness, quality of life, positive and negative affect, personality traits, emotional perception, emotional understanding, and reasoning tests. The original four-factor structure of the TEIQue was replicated, Cronbach's alphas ranged from 0.60 to 0.89 for the facets, and from 0.76 to 0.90 for the factors and global score. The correlations followed theoretically expected directions, showing a stronger pattern for self-report measures than for performance tasks. Our results corroborated previous studies with the TEIQue, confirming the psychometric adequacy of the instrument in the Brazilian context. Future studies may focus on participants with lower levels of education and additional external criteria, such as career preferences, job performance, and health.

Empathy and the ability to experience one's own emotions modify the expression of blatant and subtle prejudice among young male adults

Prejudices can lead to discrimination, social exclusion, and violence particularly among young male adults. Previous findings suggest that the degree of holding prejudices is linked to low levels of empathy, while low levels of empathy have been associated with alexithymia, the inability to experience one's own feelings. We tested the hypothesis that the impact of a lack of empathy on reporting blatant and subtle prejudices is moderated by the inability to identify one's own feelings. In a sample of n = 136 young male adults aged 21 years (mean = 21.5 years; sd = 0.3), we conducted correlation and moderator analyses to determine possible relationships between prejudices, empathy, and alexithymia as assessed by self-report questionnaires. Prejudices were assessed by the Blatant and Subtle Prejudice Scale (BSPS), empathy was assessed by the German modified version of the Interpersonal Reactivity Index (IRI), and alexithymia by the 20-item Toronto Alexithymia Scale (TAS-20). Self-reported empathy levels were correlated with the strength of subtle and blatant prejudices. The moderation analyses revealed that the negative association between empathy and subtle prejudice increased with decreasing alexithymia. The negative association between empathy and blatant prejudice, on the other hand, was significant only for participants with low levels of alexithymia. These results suggest that empathy can limit the expression of blatant and to some degree also subtle prejudice when subjects are capable to identify their own feelings in a group of young males.

Twenty-five years with the 20-item Toronto Alexithymia Scale

OBJECTIVE

Twenty-five years ago, this journal published two articles reporting the development and initial validation of the 20-Item Toronto Alexithymia Scale (TAS-20). Since then the literature on alexithymia has burgeoned with the vast majority of this research using the TAS-20, including multiple language translations of the scale.

METHOD

In this article we review the psychometric literature evaluating various aspects of the reliability and validity of the TAS-20 and examine some of the controversies surrounding the scale and the construct it assesses. We reflect on the ways in which the TAS-20 has advanced the measurement of the construct and theory of alexithymia. We also discuss recent developments and some future directions for the measurement of alexithymia.

RESULTS

Although not without some controversy, the preponderance of the accumulated evidence over a 25-year period supports various aspects of the reliability and validity of the TAS-20, including findings from confirmatory factor analytic and convergent and discriminant validity studies which are consistent with Nemiah et al.'s (Nemiah et al., 1976 [3]) and Taylor and colleagues (Taylor et al., 1997 [9]) theoretical formulations and definition of the alexithymia construct.

CONCLUSIONS

Based on the accumulated empirical evidence of 25 years, we conclude that the TAS-20 is a reliable and valid instrument and accurately reflects and measures the construct as it was originally defined by Nemiah et al. Nemiah et al. (1976) [3] as composed of deficits in affect awareness and expression and pensée opératoire (operational thinking). Clinicians and researchers can use the TAS-20 to confidently measure alexithymia, the roots of which have foundations in psychosomatic medicine.