The 20-Item Toronto Alexithymia Scale - IV. Reliability and factorial validity in different languages and cultures

Objective: The aim of this paper was to review findings from studies that have evaluated the reliability and factorial validity of the 20-item Toronto Alexithymia Scale (TAS-20) in different languages and cultures. Method: Data from published articles as well as unpublished data from various countries were reviewed to determine whether the three-factor structure of the TAS-20 is replicable in different cultures by the method of confirmatory factor analysis (CIA), and whether the scale and its three-factor scales show internal reliability in these cultures. Results: The TAS-20 has been translated adequately into 18 different languages and evaluated by CIA in 19 different countries. There is strong support for the generalizability of the three-factor structure of the scale across languages and cultures. In addition, the full-scale TAS-20 and the first two factors show adequate to good internal reliability for most of the translations. In most cultures where English is not the primary language, however, the third factor lacks internal reliability; this might be due to cultural differences or a response bias to the several negatively keyed items on this factor. Conclusion: The findings support the use of the TAS-20 in cross-cultural research, and suggest that alexithymia may be a universal trait that transcends cultural differences. (C) 2003 Elsevier Inc. All rights reserved.