Toronto Alexithymia Scale (TAS-20)

Abstract

The Toronto Alexithymia Scale (TAS-20) is the most widely utilized 20-item self-report questionnaire designed to measure the personality construct of alexithymia. Developed by R. Michael Bagby, James D. A. Parker, and Graeme J. Taylor in 1994, the scale assesses core facets of alexithymia, including difficulty identifying and describing feelings, and an externally oriented thinking style. The TAS-20 employs a 5-point Likert scale and is recognized for its robust psychometric properties, serving as a critical screening tool in clinical assessment and research settings related to psychosomatic medicine and emotional processing deficits.

Keywords

Alexithymia, TAS-20, Toronto Alexithymia Scale, emotional processing, psychosomatic research, affective deficits, self-report, psychological assessment.

Authors

R. Michael Bagby, James D. A. Parker, Graeme J. Taylor.

Purpose

The primary purpose of the TAS-20 is to provide a standardized, quantifiable assessment of the severity and manifestation of alexithymia in individuals. Although the scale is not intended as a standalone diagnostic instrument, it serves as an essential screening tool to identify individuals exhibiting high levels of this construct, which is often considered a risk factor for various physical and mental health issues, including depression, anxiety, and chronic pain.

In clinical and research contexts, the TAS-20 is used for several critical functions:

• Assessment: Quantifying the degree of difficulty an individual faces in emotional identification, description, and introspection.
• Treatment Planning: Guiding therapeutic interventions, particularly those focused on emotional regulation and insight-oriented therapies.
• Monitoring Progress: Tracking changes in alexithymic characteristics over the course of treatment, although it is noted that the scale may not be sensitive to very small, subtle changes over short periods.

Construct

The scale measures alexithymia, a multidimensional personality construct characterized by fundamental deficits in emotional awareness and the cognitive processing of feelings. The original conceptualization, which the TAS-20 is built upon, defines alexithymia through three core factors, which are consistently reflected in the scale’s factor structure.

These core features of the construct are:

• Difficulty Identifying Feelings (DIF): Trouble distinguishing between emotional states (e.g., sadness, anger) and the accompanying bodily sensations of emotional arousal.
• Difficulty Describing Feelings (DDF): Inability to articulate or communicate one’s feelings clearly to others.
• Externally Oriented Thinking (EOT): A tendency to focus excessively on concrete, external events and details rather than engaging in internal psychological reflection or fantasy life.

Validity

The TAS-20 has demonstrated strong evidence of validity across numerous cross-cultural and clinical studies since its introduction. Its construct validity is supported by its consistent three-factor structure (DIF, DDF, EOT) in diverse populations. Furthermore, studies have established robust discriminant validity, confirming that the TAS-20 measures a construct distinct from related concepts such as depression and anxiety, despite frequent clinical comorbidity.

The scale also exhibits excellent convergent validity, showing high correlation with other established measures of emotional processing deficits and relevant clinical outcomes, reinforcing its standing as a reliable measure of the alexithymia construct in both research and clinical application.

Reliability

The psychometric evaluation of the TAS-20 confirms its high reliability. The scale exhibits strong internal consistency, typically yielding Cronbach’s alpha coefficients that are consistently high across various samples, indicating that the 20 items consistently measure the same underlying trait of alexithymia.

Additionally, the TAS-20 possesses satisfactory test-retest reliability. This temporal stability ensures that the scores reflect a relatively consistent personality characteristic rather than transient emotional states, making it suitable for longitudinal studies and reliable clinical assessment.

Factor Analysis

The TAS-20 is structured around three distinct, yet correlated, factors which were identified through principal components analysis and subsequent confirmatory factor analysis (CFA) during its development and cross-validation (Bagby, Parker, & Taylor, 1994). This robust three-factor model is considered the definitive structure, superseding the single-factor model found in earlier iterations of the Toronto Alexithymia Scale.

The three factors and their corresponding items are:

1. Difficulty Identifying Feelings (DIF): Items 1, 3, 6, 7, 9, 13, 14.
2. Difficulty Describing Feelings (DDF): Items 2, 4(R), 11, 12, 17.
3. Externally Oriented Thinking (EOT): Items 5(R), 8, 10(R), 15, 16, 18(R), 19(R), 20.

Items designated with (R) are reverse-scored, meaning that disagreement with these statements contributes to a higher overall score of alexithymia.

Instrument

Test Type: Self-report Psychological test/Questionnaire

Format: 20 items rated on a 5-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree).

Language Available: English (Original), widely translated (e.g., Farsi, Dutch, French, etc.).

Population Group: Clinical and Non-clinical populations.

Age Group: Adolescents and Adults.

Population Details: Used extensively in psychiatric, psychosomatic, and general population research. The total score ranges from 20 to 100, with higher scores indicating a greater degree of alexithymia (a score above 61 is often used as a clinical cut-off).

Test Methodology: The scale is scored by summing the item scores after adjusting for reverse-scored items. Subscale scores for DIF, DDF, and EOT can also be calculated.

Keywords

DIF, DDF, EOT, emotional intelligence, psychosomatics, self-report measure, psychological assessment, personality scale, emotional awareness.

Authors

Author ORCID Identifier: Unknown/Not provided

Affiliation Email addresses: Unknown/Not provided

Correspondence Address: Unknown/Not provided

Permissions & Fee and Test Year

The TAS-20 was developed and published in 1994 by Bagby, Parker, and Taylor. It is widely considered a standard instrument in psychological research and is generally available for non-commercial academic use, often without charge, though formal licensing or permission may be required for large-scale clinical application or commercial purposes.

The instrument itself can be located online via several academic resources, including http://contextualscience.org/TAS_Measure. A related instrument, the Alexithymia Questionnaire for Children, is also available. The original PDF for the Alexithymia Questionnaire for Children can be downloaded here: http://www.focusonemotions.nl/files/Alex%20Kids%20UK.pdf

Reference’s

The following references document the scale’s development, psychometric properties, and subsequent validation studies:

• Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia Scale (TAS-20): I. Item selection and psychometric properties. Journal of Psychosomatic Research, 38, 23-32.
• Bagby, R. M., Taylor, G. J., & Parker, J. D. A. (1994). The Twenty-Item Toronto Alexithymia Scale II. Convergent discriminant, and concurrent validity. Journal of Psychosomatic Research, 38, 33–40.
• Parker, J. D. A., Taylor, G. J., & Bagby, R. M. (2001). The Toronto Alexithymia Scale (TAS-20): 20 years after. Journal of Psychosomatic Research, 50, 643-656.
• Taylor, G. J., Ryan, D., & Bagby, R. M. (1985). Toward the development of a new self-report alexithymia scale. Psychotherapy & Psychosomatics, 44, 191–199.
• Taylor, G. J. (1994). Alexithymia: concept, measurement, and implications for psychopathology. New York: Guilford Press.
• Zimmermann, G., Rossier, J., Meyer de Stadelhofen, F., & Gaillard, F. (2005). Alexithymia Assessment and Relations with Dimensions of Personality. European Journal of Psychological Assessment, 21(1), 23-33.
• 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.
• Besharat, M. A., Rostami, R., Pourhosein, R., & Mirzamani, M. (2006). Assessing reliability and validity of Farsi Version of the Toronto Alexithymia Scale-20 in a sample of opioid substance use disordered patients. Iranian Journal of Psychiatry, 1, 133- 139.

Items of the Toronto Alexithymia Scales (TAS 20)

1. I am often confused about what emotion I am feeling

2. It is difficult for me to find the right words for my feelings

3. I have physical sensations that even doctors don’t understand

4. I am able to describe my feelings easily(R)

5. I prefer to analyze problems rather than just describe them (R)

6. When I am upset‚ I don’t know if I am sad‚ frightened‚ or angry

7. I am often puzzled by sensations in my body

8. I prefer to just let things happen rather than to understand why they turned out that way

9. I have feelings that I can’t quite identify

10. Being in touch with emotions is essential (R)

11. I find it hard to describe how I feel about people

12. People tell me to describe my feelings more

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 their daily activities rather than their feelings

16. I prefer to watch “light” entertainment shows rather than psychological dramas

17. It’s difficult for me to reveal my innermost feelings‚ even to close friends

18. I can feel close to someone‚ even in moments of silence (R)

19. I find examination of my feelings useful in solving personal problems (R)

20. Looking for hidden meanings in movies or plays distracts from their enjoyment