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. 2025 Jul 1;13(1):687.
doi: 10.1186/s40359-025-03028-w.

Does the Chinese version of 20-item Toronto alexithymia scale (TAS-20-C) measure alexithymia in Chinese young adolescents? Evidence from confirmatory factor analysis, network analysis, and latent profile analysis

Yuhan Ni  1 , Shuanghu Fang  2
Affiliations

Does the Chinese version of 20-item Toronto alexithymia scale (TAS-20-C) measure alexithymia in Chinese young adolescents? Evidence from confirmatory factor analysis, network analysis, and latent profile analysis

Yuhan Ni et al. BMC Psychol. .

Abstract

The 20-item Toronto Alexithymia Scale (TAS-20) is a measure of three components of alexithymia: difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT). Although TAS-20 is being increasingly used to measure the alexithymia construct, ongoing controversies remain regarding its internal structure and cross-cultural and cross-group applicability. This study evaluated the psychometric properties of the Chinese version of TAS-20 (TAS-20-C) among 1,355 Chinese young adolescents (mean age = 13.13; SD = 1.00; 52.6% boys) through multiple analytic approaches (i.e., confirmatory factor analysis, network analysis, and latent profile analysis). The confirmatory factor analysis showed reasonable goodness-of-fit for the bi-factorial model with three-dimensional structure and a negatively keyed item factor. However, the results derived from all analytic approaches suggested several items with poor psychometric properties (items 5, 10, 16, 18, 19, 20 from EOT and item 12 from DDF), including poor factor loading on their intended factor, low connectivity and predictability in the item network, and insufficient discrimination across heterogeneous groups. These issues could be attributed to an overabundance of negatively keyed items, translation biases, and the poor readability of certain items. The findings highlight the need for targeted revisions to both the wording and the content for these items, and offer insights into higher priority interventions aimed at improving alexithymia.

Keywords: Alexithymia; Confirmatory factor analysis; Latent profile analysis; Network analysis; Psychometric properties; TAS-20; Young adolescents.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the Ethical Committee of Anhui Normal University with the approval code of AHNU-ET2024034 (approval date 3/7/2024). All procedures are in accordance with the ethical standards of the institution, the committee and the Declaration of Helsinki. Written informed consent was obtained from all parents/or legal guardian. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The confirmatory factor analysis models for TAS-20-C. GA = global alexithymia; DIF = difficulty identifying feelings; DDF = difficulty describing feelings; EOT = externally oriented thinking; Neg. = negatively keyed factor (i.e., method factor); EOT1 = lack of importance of emotions (i.e., IM); EOT2 = pragmatic thinking (i.e., PR). Model 1: oblique three-factor model; Model 2: higher order model; Model 3: bifactor model; Model 4: bifactor model with method factor; Model 5: bifactor model with method factor and two oblique EOT factors. The item error terms were omitted from the models for space and clarity
Fig. 2
Fig. 2
The TAS-20-C network in Chinese young adolescent sample (N = 1,355). Each node represents an item from the TAS-20-C. Each edge represents the unique association within the items after controlling for other nodes. DIF = difficulty identifying feelings; DDF = difficulty describing feelings; EOT = externally oriented thinking
Fig. 3
Fig. 3
The conditional mean score on items of TAS-20-C across four latent classes (N = 1,355). DIF = difficulty identifying feelings; DDF = difficulty describing feelings; EOT = externally oriented thinking
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