Confirmatory factor analysis of 20-item toronto alexithymia scale in spanish patients with substance use disorder

Abstract

Alexithymia is highly prevalent in patients with substance use disorders (SUDs) and has been implied in SUD pathogenesis and treatment outcomes. However, the psychometric properties of the most-used instrument for evaluating alexithymia (the 20-item Toronto Alexithymia Scale, TAS-20) have been scarcely studied in relation to SUD patients. Specifically, only five psychometric studies have been performed with samples of SUD patients, and no studies have focused exclusively on Spanish patients with SUDs. Therefore, the aim of the present study was to examine the internal accuracy and reliability of the TAS-20 with a sample of Spanish SUD patients (n = 126; 75.4% male; mean age 43.7 ± 14.6 years). A reliability analysis and a confirmatory factor analysis were executed, considering that TAS-20 has a three-factor structure (difficulty identifying feelings [DIF]; difficulty describing feelings [DDF]; externally oriented thinking [EOT]). The results indicated that TAS-20’s psychometric properties are acceptable for assessing alexithymia in Spanish patients with SUDs. However, the three-factor model of TAS-20 was found to fit only moderately well with the patient sample, with DIF and DDF being the most reliable and valid constructs. In contrast, the EOT factor needs further research and should be cautiously analyzed in the context of patients with addictions.