title: Influencing factors of alexithymia in Chinese medical students: a cross-sectional study.
abstract: BACKGROUND
  A much higher prevalence of alexithymia has been reported in medical students compared with the general population, and alexithymia is a risk factor that increases vulnerability to mental disorders. Our aim was to evaluate the level of alexithymia in Chinese medical students and to explore its influencing factors.
  
  
  METHODS
  A cross-sectional study of 1,950 medical students at Shenyang Medical College was conducted in May 2014 to evaluate alexithymia in medical students using the Chinese version of the 20-item Toronto Alexithymia Scale (TAS-20). The reliability of the questionnaire was assessed by Cronbach's α coefficient and mean inter-item correlations. Confirmatory factor analysis (CFA) was used to evaluate construct validity. The relationships between alexithymia and influencing factors were examined using Student's t-test, analysis of variance, and multiple linear regression analysis. Statistical analysis was performed using SPSS 21.0.
  
  
  RESULTS
  Of the 1,950 medical students, 1,886 (96.7%) completed questionnaires. Overall, Cronbach's α coefficient of the TAS-20 questionnaire was 0.868. The results of CFA showed that the original three-factor structure produced an acceptable fit to the data. By univariate analysis, gender, grade (academic year of study), smoking behavior, alcohol use, physical activity, history of living with parents during childhood, and childhood trauma were influencing factors of TAS-20 scores (p < 0.05). Multiple linear regression analysis showed that gender, physical activity, grade, living with parents, and childhood trauma also had statistically significant association with total TAS-20 score (p < 0.05).
  
  
  CONCLUSIONS
  Gender, physical activity, grade, history of living with parents during childhood, and childhood trauma were all factors determining the level of alexithymia. To prevent alexithymia, it will be advisable to promote adequate physical activity and pay greater attention to male medical students and those who are in the final year of training.
authors.affiliation: School of Public Health, China Medical University, Shenyang, Liaoning Province, People's Republic of China.
authors.forename: Yaxin
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Research Center for Medical Education, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, Postal Code: 110122, People's Republic of China.
authors.forename: Ting
authors.initials: T
authors.lastname: Luo
authors.affiliation: School of Public Health, China Medical University, Shenyang, Liaoning Province, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Research Center for Medical Education, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning Province, Postal Code: 110122, People's Republic of China. qubo6666@163.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Qu
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000209:etiology* / Q000503:physiopathology*; D002681:China; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: 20-item Toronto Alexithymia Scale; Alexithymia; Influencing factors; Medical students