title: The 20-Item Toronto Alexithymia Scale. IV. Reliability and factorial validity in different languages and cultures.
abstract: 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.
  
  
  METHODS
  Data from published articles as well as unpublished data from various countries were reviewed to determine whether the three-factor structure of the TAS-20 is replicable in different cultures by the method of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 (CFA), 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 CFA 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, University of Toronto and Mount Sinai Hospital, 600 University Avenue, M5G1X5, Toronto, Ontario, Canada. graeme.taylor@utornto.ca
authors.forename: Graeme J
authors.initials: GJ
authors.lastname: Taylor
authors.forename: R Michael
authors.initials: RM
authors.lastname: Bagby
authors.forename: James D A
authors.initials: JD
authors.lastname: Parker
mesh_terms: D000342:Affective Symptoms / Q000145:classification* / Q000175:diagnosis*; D003466:Cultural Characteristics; D006801:Humans; D007802:Language; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity