title: Emotional awareness deficits in inpatients of a psychosomatic ward: a comparison of two different measures of alexithymia.
abstract: OBJECTIVE
  The TAS 20 has demonstrated strong psychometric properties in a broad variety of studies in healthy populations. Much less work has been done in clinical contexts exploring the validity of the TAS 20 as a measure of the cognitive processing of emotions. The TAS 20, a self-report scale, tends to correlate with self-reported negative affect, but in a clinical context it is important to be able to differentiate between negative affect and the cognitive processing of emotion. We therefore used the TAS 20 and a performance measure, the Levels of Emotional Awareness Scale (LEAS), which in previous studies demonstrated no overlap with measures of negative affect, to explore the ability of the two measures to detect deficits in emotional awareness in a clinical sample.
  
  
  METHODS
  Data from inpatients of a psychosomatic ward were collected at onset (N = 394) and at the end of multimodal psychodynamic treatment (N = 249). The sample consisted of six diagnostic groups (depression; anxiety and compulsive-obsessive disorders, adjustment disorders, somatoform disorders, psychological factors related to somatic disorders, eating disorders). Changes in the TAS 20 and LEAS were compared at the two time points controlling for the effects of gender, age, educational level, and associations with self-reported negative affect.
  
  
  RESULTS
  In contrast to the LEAS, the TAS 20 correlated with negative affect at the onset and the end of treatment. The scores of the TAS 20 decreased with treatment in all diagnostic groups but the change in the TAS 20 was not statistically significant when negative affect was controlled. In contrast, LEAS scores increased with treatment in the groups with somatoform disorders and psychological factors related to somatic disorders, and this change was independent of negative affect.
  
  
  CONCLUSIONS
  The LEAS captured a change in emotional awareness due to treatment, whereas the TAS 20 captured a change in negative affect. The LEAS appears to be a more specific measure of change in emotional awareness in clinical contexts than the TAS 20.
authors.affiliation: Department of Psychosomatics and Psychotherapy, University of Cologne, Josef-Stelzmann-Str. 9, D-50931 Köln, Germany. claudia.subic-wrana@uk-koeln.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Subic-Wrana
authors.forename: Susanne
authors.initials: S
authors.lastname: Bruder
authors.forename: Walther
authors.initials: W
authors.lastname: Thomas
authors.forename: Richard D
authors.initials: RD
authors.lastname: Lane
authors.forename: Karl
authors.initials: K
authors.lastname: Köhle
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis* / Q000523:psychology; D001364:Awareness; D004644:Emotions; D005260:Female; D006757:Hospital Units; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011581:Psychological Tests; D011611:Psychosomatic Medicine; D012647:Self-Assessment