Alexithymia questionnaire for children (ASC)

Abstract

The Alexithymia Questionnaire for Children (ASC) is a specialized psychological scale designed to measure the construct of alexithymia in younger populations. Developed by Rieffe, Oosterveld, and Meerum Terwogt in 2006, the ASC adapts the established adult alexithymia model to capture the nuances of emotional processing deficits in children and young adolescents. The instrument utilizes a 20-item self-report format and is structured around three core dimensions: difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. The ASC has demonstrated strong factorial validation and is widely used in developmental and clinical psychology research to explore the relationship between emotional regulation difficulties and various internalizing symptoms.

Keywords

Alexithymia, Children, Emotional competence, Internalizing symptoms, Emotional processing, Self-report questionnaire, Developmental psychology.

Authors

Rieffe, C., Oosterveld, P., Meerum Terwogt, M.

Purpose

The primary purpose of the ASC is to provide a reliable and valid measure of the core features of alexithymia specifically tailored for use with children and young adolescents. Before the ASC, most instruments were designed for adults, making them unsuitable for pediatric research due to cognitive and linguistic limitations. The ASC aims to fill this gap by assessing the characteristic difficulties experienced by children in recognizing, articulating, and processing their own emotional states.

Furthermore, the instrument serves as a critical tool for researchers investigating the developmental origins and clinical correlates of alexithymia, including its links to psychosomatic complaints, emotional competency, and various forms of psychopathology across different cultural contexts, as demonstrated by validation studies in Iranian samples.

Construct

The ASC measures the multidimensional construct of alexithymia. This construct refers to a deficit in emotional processing characterized by a lack of emotional self-awareness. The scale operationalizes this concept using three distinct, yet correlated, factors:

• Difficulty Identifying Feelings (DIF): The inability to distinguish between different emotions and between emotional arousal and bodily sensations.
• Difficulty Describing Feelings (DDF): The inability or reluctance to communicate feelings to others.
• Externally Oriented Thinking (EOT): A cognitive style characterized by a lack of introspection and a tendency to focus attention on external events rather than internal emotional experiences.

Validity

The initial validation study by Rieffe et al. (2006) established both factorial validation and concurrent validation for the ASC. The factor structure confirmed the theoretical three-factor model of alexithymia (DIF, DDF, EOT) as appropriate for children, demonstrating satisfactory model fit across samples.

Evidence for concurrent validity has been demonstrated through correlations with related measures. Studies show that higher ASC scores are significantly associated with increased physical complaints and difficulties in emotional competency. Furthermore, the ASC scores correlate positively with measures of mood disturbance and internalizing symptoms (e.g., anxiety and depression), supporting its utility in clinical screening and research contexts.

Reliability

The reliability of the ASC is generally reported as satisfactory for a self-report instrument used with children. The original validation study provided evidence of internal consistency (e.g., Cronbach’s alpha) for the total scale and its subscales. Subsequent cross-cultural studies have generally replicated these findings, suggesting that the scale consistently measures the intended constructs.

Factor Analysis

The development of the ASC was guided by rigorous factor analysis, which supported a three-factor structure mirroring the established structure of adult alexithymia measures. These factors are Difficulty identifying feelings, Difficulty describing feelings, and Externally oriented thinking. This structure confirms that alexithymia in children, like in adults, is a multifaceted construct, essential for accurate diagnostic and research applications.

Instrument

Test Type: Self-report psychological scale.

Format: 20 items, typically utilizing a 3-point Likert scale response format (e.g., “not true, a bit true, true” or “Not true, Sometimes true, Often true”).

Language Available: English, Dutch (original research), Persian/Iranian (validated sample).

Population Group: Children and young adolescents.

Age Group: Typically utilized with children from middle childhood through early adolescence.

Population Details: Used in both general population samples and clinical samples to assess emotional processing deficits.

Test Methodology: Respondents rate the extent to which each statement applies to them. Total scores and subscale scores are calculated, with higher scores indicating higher levels of alexithymia.

Keywords

Alexithymia, Child assessment, Emotional deficits, DIF, DDF, EOT, Psychometrics.

Authors

Author ORCID Identifier: N/A (Information not provided in source).

Affiliation Email addresses: [email protected] (Provided for co-author Nasiri in one reference).

Correspondence Address: N/A (Information not provided in source).

Permissions & Fee and Test Year

The ASC was first published and validated in 2006 by Rieffe, Oosterveld, and Meerum Terwogt. The instrument is frequently used in academic research. The original PDF of the scale in English can be downloaded here: http://www.focusonemotions.nl/files/Alex%20Kids%20UK.pdf

An additional PDF document referencing the instrument is available here: http://www.sid.ir/fa/VEWSSID/J_pdf/52813885804.pdf

Reference’s

Rieffe, C., Oosterveld, P., & Meerum Terwogt, M. (2006). An alexithymia questionnaire for children: Factorial and concurrent validation results. Personality and Individual Differences, 40, 123-133.

Nasiri, Habib., Latifian, Morteza., & Rieffe, C., 2009. Alexithymia and its Relationship with Physical Complaints and Emotional Competency in Children and Adolescents. Iranian Journal of Psychiatry and Clinical Psychology, 15(3); 248-257.

Rieffe, C., Oosterveld, P., Meerum Terwogt, M., Novin, S., Nasiri, H. & Latifian, M. (2010). Relationship between alexithymia, mood and internalizing symptoms in children and young adolescents: Evidence from an Iranian sample. Personality and Individual Differences, 48, 425-430.

Items of the Alexithymia questionnaire for children (ASC)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. I am often confused about the way I am feeling inside
2. I find it difficult to say how I feel inside
3. I feel things in my body that even doctors don’t understand
4. I can easily say how I feel inside
5. When I have a problem, I want to know where it comes from and not just talk about it
6. When I am upset, I don’t know if I am sad, scared or angry
7. I am often puzzled by things that I feel in my body
8. I’d rather wait and see what happens, instead of thinking about why things happen
9. Sometimes I can’t find the words to say how I feel inside
10. It is important to understand how you feel inside
11. I find it hard to say how I feel about other people
12. Other people tell me that I should talk more about how I feel inside
13. I don’t know what’s going on inside me
14. I often don’t know why I am angry
15. I prefer talking to people about everyday things, rather than about how they feel
16. I prefer watching funny television programmes, rather than films that tell a story about other people’s problems
17. It is difficult for me to say how I really feel inside, even to my best friend
18. I can feel close to someone, even when we are sitting still and not saying anything
19. Thinking about how I feel, helps me when I want to do something about my problems
20. When I have to concentrate on a film to understand the story, I enjoy the film much less