(2010) reported lower fit for this model, and good fit for a model in which the contra-indicative items were allowed
to cross load onto a residual factor. Kooiman, Spinhoven, and Trijsburg (2002) found a 2-factor structure in four
samples, and reviewing the TAS-20 literature, stated that although most authors concluded that the 3-factor struc-
ture could be replicated, the fit was troublesome: in all studies half of the EOT items had very low factor loadings.
Parker et al. (2003) found excellent fit for a 3-factor structure in a large Canadian sample, ( N51933 normals;
GFI5.98, AGFI 5.98, CFI 5.97; RMSR 5.05, RMSEA 5.06). Finally, Taylor, Bagby, and Parker (2003) presented fit
indices for a 3-factor structure of 24 studies with translations of the TAS-20. The results of the large population
study ( N51933) have been reanalyzed by Gignac et al. (2007) resulting in a lower fit (CFI 5.88), whereas the stan-
dards used in the 24 studies mentioned were mild: χ2/df,5, GFI$.85, AGFI $.80, RMSR #.10, RMSEA ,.08,
and TLI $.80.Gignac et al. (2007) , and Reise, Bonifay, and Haviland. (2013) who analyzed the TAS-20 came to the
conclusion that the TAS-20 general factor accounts for too much variance, leaving too little for subscales3.
Meganck et al. (2008) measuring various models, came to the conclusion that the original 3-factor model and
4-factor model both had good fit. Mu¨ller et al. (2003) , found good fit for several different models (2, 3, & 4 factors)
in their clinical sample, but were unable to find any good factor structure in their non-clinical sample. Richards
et al. (2005) presented principal component results (EOT & DDT items loading on the factor for DIF), and low fit in
a confirmative factor analysis.
Bagby et al. (1994a) reported for two samples the following correlations between subscales: DIF/DDF (.72 &
.65), DIF/EOT (.32 & .10), DDF/EOT (.50 & .36). Most findings are comparable ( Thorberg et al., 2010; Henry
et al., 2006; Meganck et al., 2008; Besharat, 2008; Culhane et al., 2009 ). Some studies reported overall lower esti-
mates ( Haviland & Reise, 1996b; Zech et al., 1999; Vorst & Bermond, 2001 ), and some higher ( Simonsson-Sarnecki
et al., 2000; Loas et al., 2001; Parker et al., 2003; Mu ¨ller et al., 2003; Parker et al., 2010 ).
Criterion/Predictive
Bagby et al. (1994b) reported correlations, among others, indicating that the TAS-20 and its three factors are all
negatively related to both Psychological Mindedness Scale (TAS-20 /C0.68, DIF /C0.44, DDF /C0.51, EOT /C0.54), and
the Need for Cognition Scale (TAS-20 /C0.55 DIF . /C0.40, DDF /C0.36, EOT /C0.44). The authors further reported correla-
tions with the NEO Personality Inventory (NEO-PI). Of the correlations between TAS-20 and NEO-PI facets,
Openness ( /C0.49) and Neuroticism (.27) were significant. The TAS-20 has been very successful (PubMed presents,
as per November 2013, 389 articles in response to ‘TAS-20’, and 531 in response to ‘Toronto alexithymia scale
20’), too much to be discussed. Various studies indicate discriminant, and convergent validity, (for review:
Taylor et al., 1997, 2000 ;Taylor and Bagby, 2000 ; and Lumley et al., 2007 ). The predictive validity of the TAS-20
was also demonstrated in a recent study by Bollinger and Howe (2011) , indicating that the prevalence of alexithy-
mia is higher among circumcised men as compared with genitally intact men.
Location
Bagby, R.M., Parker, J.D.A. & Taylor, G.J. (1994a). The twenty-item Toronto alexithymia scale-I. Item selection
and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23/C032.
Results and Comments
The TAS-20 appears to have adequate reliability. Although the concurrent validities with the M-BIQ, TSIA,
OAS, and BVAQ varied between low and moderate, those with the BVAQ-COG were high. Also the specificity
and selectivity of the TAS-20 to the M-BIQ and vice versa reached satisfactory levels. As for the factor structure,
most studies present three factors, but two, and four factor structures have also been described; this, together
with high correlations between subscales, compromises interpretation of subscale scores. Finally, publications
with the TAS-20 indicate discriminant and convergent validity.
However, the TAS-20 does not measure all alexithymia facets, three items refer to ill-understood bodily experi-
ences, the numbers of items per subscale are not fully balanced, and the scale is not balanced for indicative and
contra-indicative items. In fact, only five items are negatively keyed, while four of these are part of the subscale
EOT. These negatively keyed items tend to reduce the fit of factor models, internal consistency, and tend to form
a scale by themselves ( Gignac et al., 2007; Meganck et al., 2008; Mattila et al., 2010 ). Finally, on face validity, the
EOT items fall in two groups: pragmatic thinking (PR) and importance of emotions (IM). Meganck et al. (2008)
3Bagby, Taylor, Parker, Quilty, and Parker (2007) have reacted to the criticism of Gignac et al. (2007) by stating that the factor model on which
their conclusion was based, was not theoretically substantiated, but this is beside the point. Substantiated or not, Gignac’s analysis indicates
that there is too little variance left for the TAS20 subscales for meaningful diagnostic differentiation.242 9. MEASURES OF ALEXITHYMIA
III. EMOTION REGULATION