title: Alexithymia in parents and adolescent anorexic daughters: comparing the responses to TSIA and TAS-20 scales.
abstract: BACKGROUND
  A growing body of literature has been focusing on individual alexithymia in anorexia nervosa, while there are only scarce and conflicting studies on alexithymia in the families of anorexic patients, despite the important role played by family dynamics in the development of the anorexic disorder, especially in adolescent patients. The aim of this study is to assess alexithymia in anorexic adolescent patients and in their parents using a multimethod measurement to gain more direct, in-depth knowledge of the problem.
  
  
  METHODS
  Forty-six subjects, anorexic adolescent patients and their parents, underwent the Toronto Alexithymia Scale (TAS-20) along with the Toronto Structured Interview for Alexithymia (TSIA), which represents the first comprehensive clinically structured interview focused specifically on assessing alexithymia. The use of latent trait Rasch analysis allowed a comparison of the two instruments' sensitivity and ability to detect the presence and intensity of alexithymic components in patients and parents.
  
  
  RESULTS
  Significant discordance was found between the two measures. The clinical instrument allowed detection of a greater level of alexithymia compared with the self-report, in particular in our adult parent sample. Moreover, a significant alexithymic gap emerged within families, particularly within parental couples, with noticeably more alexithymic fathers compared with the mothers.
  
  
  CONCLUSIONS
  The TSIA clinical interview may be a more sensitive instrument in detecting alexithymia, minimizing parents' negation tendency. Clinical questions have arisen on how useful it would be to give greater weight to family functioning (ie, alexithymic gap) in order to predict the possibility of establishing a therapeutic alliance, and thus the outcome of the anorexic adolescent.
authors.affiliation: Interdepartmental Center of Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Balottin
authors.affiliation: Childhood and Adolescence Neuropsychiatric Unit, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy.
authors.forename: Renata
authors.initials: R
authors.lastname: Nacinovich
authors.affiliation: Childhood and Adolescence Neuropsychiatric Unit, San Gerardo Hospital, University of Milan-Bicocca, Monza, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Bomba
authors.affiliation: Interdepartmental Center of Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Mannarini
keywords: Rasch model; Toronto Alexithymia Scale; Toronto Structured Interview for Alexithymia; adolescence; anorexia; family