Improving the measurement of alexithymia in autistic adults: a psychometric investigation of the 20-item Toronto Alexithymia Scale and generation of a general alexithymia factor score using item response theory.
Improving the measurement of alexithymia in autistic adults: a psychometric investigation of the 20-item Toronto Alexithymia Scale and generation of a general alexithymia factor score using item response theory.
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DOI：
10.1186/s13229-021-00463-5
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发表时间：
2021-08-10
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
述情障碍是一种以难以解释情绪状态为特征的人格特质，在自闭症成年人中普遍升高，越来越多的文献表明，这种特质是以前归因于自闭症的几种认知和情绪差异的基础。虽然问卷调查，如20项多伦多述情障碍量表（TAS-20）经常被用来衡量述情障碍的自闭症人群，很少有研究调查这些问卷的心理测量学特性的自闭症成年人，包括是否差异项目功能（I-DIF）之间存在自闭症和一般人群的成年人。这项研究是以前一篇文章的修订版，由于版权问题而被撤回（威廉姆斯和高谭在摩尔自闭症12：1-40）。我们对从西蒙斯基金会SPARK参与者库招募的743名有认知能力的自闭症成年人和参加大型国际心理研究的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进行了检查，项目反应理论用于生成一个子集的项目，是一个“一般述情障碍”因素的强指标。述情障碍和其他临床结果之间的相关性被用来评估SPARK样本中新的述情障碍评分的法理学有效性。TAS-20在自闭症患者或一般人群样本中均未表现出充分的模型拟合。经验驱动的项目减少进行，导致一个8项一般述情障碍因子评分（GAFS-8，与“TAS”不再引用由于版权）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，GAFS-8分数，来自TAS-20，有意义地预测自闭症的特质水平，重复行为，抑郁症状，即使在控制特质神经质。GAFS-8在自闭症受试者中的法则有效性也没有比完整的TAS-20有意义的降低。当前研究的局限性包括：自闭症成年人样本大多数为女性，后来被诊断，受过良好教育;临床组和对照组来自不同的研究，采用不同的测量方法;只有16个TAS-20项目被用于非自闭症样本;以及无法测试GAFS-8的其他几个重要的心理测量特征，包括对变化的敏感性和多次给药的I-DIF。这些结果表明，GAFS-8强大的潜力来衡量述情障碍在自闭症和非自闭症成年人。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正常参考的GAFS-8潜在特质分数（可在https：//asdmeasures.shinyapps.io/alexithymia获得）。在线版本包含补充材料，可通过10.1186/s13229-021-00463-5获得。
Alexithymia, a personality trait characterized by difficulties interpreting emotional states, is commonly elevated in autistic adults, and a growing body of literature suggests that this trait underlies several cognitive and emotional differences previously attributed to autism. Although questionnaires such as the 20-item Toronto Alexithymia Scale (TAS-20) are frequently used to measure alexithymia in the autistic population, few studies have investigated the psychometric properties of these questionnaires in autistic adults, including whether differential item functioning (I-DIF) exists between autistic and general population adults. This study is a revised version of a previous article that was retracted due to copyright concerns (Williams and Gotham in Mol Autism 12:1–40). We conducted an in-depth psychometric analysis of the TAS-20 in a large sample of 743 cognitively able autistic adults recruited from the Simons Foundation SPARK participant pool and 721 general population controls enrolled in a large international psychological study. The factor structure of the TAS-20 was examined using confirmatory factor analysis, and item response theory was used to generate a subset of the items that were strong indicators of a “general alexithymia” factor. Correlations between alexithymia and other clinical outcomes were used to assess the nomological validity of the new alexithymia score in the SPARK sample. The TAS-20 did not exhibit adequate model fit in either the autistic or general population samples. Empirically driven item reduction was undertaken, resulting in an 8-item general alexithymia factor score (GAFS-8, with “TAS” no longer referenced due to copyright) with sound psychometric properties and practically ignorable I-DIF between diagnostic groups. Correlational analyses indicated that GAFS-8 scores, as derived from the TAS-20, meaningfully predict autistic trait levels, repetitive behaviors, and depression symptoms, even after controlling for trait neuroticism. The GAFS-8 also presented no meaningful decrement in nomological validity over the full TAS-20 in autistic participants. Limitations of the current study include a sample of autistic adults that was majority female, later diagnosed, and well educated; clinical and control groups drawn from different studies with variable measures; only 16 of the TAS-20 items being administered to the non-autistic sample; and an inability to test several other important psychometric characteristics of the GAFS-8, including sensitivity to change and I-DIF across multiple administrations. These results indicate the potential of the GAFS-8 to robustly measure alexithymia in both autistic and non-autistic adults. A free online score calculator has been created to facilitate the use of norm-referenced GAFS-8 latent trait scores in research applications (available at https://asdmeasures.shinyapps.io/alexithymia). The online version contains supplementary material available at 10.1186/s13229-021-00463-5.
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