Improving the measurement of alexithymia in autistic adults: a psychometric investigation and refinement of the twenty-item Toronto Alexithymia Scale.
Improving the measurement of alexithymia in autistic adults: a psychometric investigation and refinement of the twenty-item Toronto Alexithymia Scale.
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DOI：
10.1186/s13229-021-00427-9
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发表时间：
2021-03-02
期刊：
影响因子：
6.2
通讯作者：
Gotham KO
中科院分区：
文献类型：
--
作者：
Williams ZJ;Gotham KO
述情障碍是一种人格特质，其特征是难以解释自己的情绪状态，通常在自闭症成年人中升高，越来越多的文献表明，这种特质是以前归因于自闭症的许多认知和情感差异的基础，例如面部情绪识别困难和同情心降低。虽然20项多伦多述情障碍量表（TAS-20）等问卷经常用于测量自闭症人群的述情障碍，但很少有研究试图确定这些问卷在自闭症成年人中的心理测量学特性，包括自闭症和普通人群成年人之间是否存在项目功能差异（I-DIF）。我们对从西蒙斯基金会SPARK参与者库招募的743名语言自闭症成年人和参加大型国际心理研究（人类企鹅项目）的721名普通人群对照的大样本进行了TAS-20的深入心理测量分析。TAS-20的因素结构采用验证性因素分析，项目反应理论用于进一步完善规模的基础上局部模型失配和I-DIF组之间。述情障碍和其他临床结果，如自闭症特征，焦虑和生活质量之间的相关性被用来评估修订后的述情障碍量表在SPARK样本的法理学有效性。TAS-20在自闭症患者或一般人群样本中均未表现出充分的全局模型拟合。经验驱动的项目减少进行，从而在一个八项一维规模（TAS-8）与健全的心理测量特性和诊断组之间的实际可比较的I-DIF。相关性分析表明，TAS-8评分有意义地预测自闭症特质水平，焦虑和抑郁症状，生活质量，即使在控制了特质神经质。当前研究的局限性包括：绝大多数自闭症成年人样本为女性，诊断较晚，受过良好教育;临床和对照组来自不同的研究，测量方法不同;无法测试TAS-8的其他几个重要心理测量特征，包括对变化的敏感性和多次给药的I-DIF。这些结果表明，TAS-8作为一个强大的心理测量工具，以测量自闭症和非自闭症成年人的述情障碍的潜力。已经创建了一个免费的在线分数计算器，以便于在研究应用中使用常模参考的TAS-8潜在特质分数（可在http：//asdmeasures.shinyapps.io/TAS8_Score获得）。
Alexithymia, a personality trait characterized by difficulties interpreting one’s own emotional states, is commonly elevated in autistic adults, and a growing body of literature suggests that this trait underlies a number of cognitive and emotional differences previously attributed to autism, such as difficulties in facial emotion recognition and reduced empathy. Although questionnaires such as the twenty-item Toronto Alexithymia Scale (TAS-20) are frequently used to measure alexithymia in the autistic population, few studies have attempted to determine the psychometric properties of these questionnaires in autistic adults, including whether differential item functioning (I-DIF) exists between autistic and general population adults. We conducted an in-depth psychometric analysis of the TAS-20 in a large sample of 743 verbal autistic adults recruited from the Simons Foundation SPARK participant pool and 721 general population controls enrolled in a large international psychological study (the Human Penguin Project). The factor structure of the TAS-20 was examined using confirmatory factor analysis, and item response theory was used to further refine the scale based on local model misfit and I-DIF between the groups. Correlations between alexithymia and other clinical outcomes such as autistic traits, anxiety, and quality-of-life were used to assess the nomological validity of the revised alexithymia scale in the SPARK sample. The TAS-20 did not exhibit adequate global model fit in either the autistic or general population samples. Empirically driven item reduction was undertaken, resulting in an eight-item unidimensional scale (TAS-8) with sound psychometric properties and practically ignorable I-DIF between diagnostic groups. Correlational analyses indicated that TAS-8 scores meaningfully predict autistic trait levels, anxiety and depression symptoms, and quality of life, even after controlling for trait neuroticism. Limitations of the current study include a sample of autistic adults that was overwhelmingly female, later-diagnosed, and well-educated; clinical and control groups drawn from different studies with variable measures; and an inability to test several other important psychometric characteristics of the TAS-8, including sensitivity to change and I-DIF across multiple administrations. These results indicate the potential of the TAS-8 as a psychometrically robust tool to measure alexithymia in both autistic and non-autistic adults. A free online score calculator has been created to facilitate the use of norm-referenced TAS-8 latent trait scores in research applications (available at http://asdmeasures.shinyapps.io/TAS8_Score).
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作者：
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