### INTRODUCTION

^{1}

^{2}The term alexithymia (derived from the Greek a=lack, lexis=word and thymos=mood) was introduced by Sifneos

^{3}to indicate a cognitive-affective disturbance that affects the way individuals regulate their emotions.

^{2}

^{4}This personality construct has been conceptualized to comprise multiple facets including: 1) difficulty identifying and distinguishing emotions from bodily sensations; 2) difficulty describing and verbalizing emotions; 3) poverty of fantasy life; 4) externally oriented thinking style; and 5) poor empathizing.

^{5}

^{2}in fact, it is hypothesized that this personality constructs is one of several factors that contribute to various physical and mental health problems including undifferentiated negative moods such as depression and anxiety, compulsive or addictive behaviors, heightened or prolonged, physiological arousal, physical symptoms, and potentially somatic disease.

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^{7}

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^{10}

^{11}

^{10}Particularly some researches have shown an association between alexithymia and behavioral problems in adolescents. Much of the existing adolescent alexithymia research, that has been conducted with the 20-Item Toronto Alexithymia Scale,

^{12}

^{13}showed associations between this construct and dissociative tendencies,

^{14}Eating Behavior Disorders,

^{15}Post-Traumatic Stress Disorder,

^{16}Emotional Intelligence,

^{17}and Abuse.

^{18}

^{8}developed a Dutch-language self-report measure of alexithymia for children and adolescent, by rewording the items from the original TAS-20 scale to make them adequate to a preadolescent population, because in its present form the TAS-20 may not be suitable for use with adolescents.

^{10}

^{10}demonstrating that the use of the TAS-20 with teenage respondents is not recommended without appropriate adaptation, this study aims to investigate the psychometric properties of an adapted Italian version of the TAS-20 in an adolescent population.

### METHODS

### Participants and procedure

^{2}=0.283, p=0.594) and age (t=-0.53, df=506, p=0.593).

### Instrument

^{13}is a self-report measure of alexithymia. It consists of three subscales: Difficulty identifying feeling (7 items; e.g., "I am often confused about what emotion I am feeling"); Difficulty describing feelings (5 items; e.g., "It is difficult for me to find the right words for my feelings"); and Externally oriented-thinking (8 items; e.g., "I prefer talking to people about their daily activities rather than their feelings"). Cut-off scores are as follow: ≤50=no alexithymia, 51-60=borderline alexithymia, and ≥61=alexithymia. The Italian reliability, construct, and criterion validity of scores on the TAS-20 have been well established in various samples of adults.

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### Data analyses

^{21}Principal axis factoring was selected as the method of factor extraction. An oblique rotation method (promax criterion) was selected to obtain a simple structure since there was no theoretical assumption suggesting that the factors were independent from each other.

^{22}The eigenvalues derived from the actual data were compared to the eigenvalues derived from the random data. Factors were retained as long as the ith eigenvalue from the actual data was greater than the ith eigenvalue from the random data.

^{23}Both Kaiser's

^{24}criterion and the scree test

^{25}were checked for agreement. Salience was detected applying the following three criteria: 1) a factor loading of at least 0.3 on the primary factor, ensuring a high degree of association between the item and the factor, 2) when an item was loading simultaneously on two factors, a difference of 0.3 between loading on the primary factor and loading on other factors, ensuring that each item could be considered salient to one factor, 3) a minimum of three items for each factor, so ensuring meaningful interpretation of stable factors.

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^{27}

^{28}To statistically evaluate the closeness of the hypothetical model to the empirical data, multiple goodness-of-fit indexes were used, including the ratio of the chi-square to degrees of freedom (χ

^{2}/df), the Non-Normed Fit Index (NNFI), the Comparative Fit Index (CFI), the Standardized Root Mean Square Residual (SRMR), and the Root Mean Square Error of Approximation (RMSEA). NNFI and CFI values of 0.95 or greater and SRMR and RMSEA values of 0.05 or less are interpreted as evidence of models that fit well.

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### RESULTS

### Item analysis

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^{31}Based on these findings, the principal axis factoring method was chosen for exploratory factor analyses, and Maximum Likelihood robust estimation procedures were applied for confirmatory factor analyses.

### Exploratory factor analysis

^{32}A sample of 12.7 subjects per item ensured that reliable factors would emerge from the factor analysis.

^{33}Both results, thus, suggest that items were appropriate for proceeding with factor analysis.

^{25}scree test is considered a more reliable indicator of the number of factors to be extracted because it draws on the relative values of the eigenvalues and so is not sensitive to the number of variables in the analysis.

^{34}Cattell

^{25}recommended that the number of factors to be extracted is the number of eigenvalues that lie well above the scree slope and is a more reliable test for the number of factors in cases where there is a clear and easily interpretable scree slope. The eigenvalue greater than one criterion suggested extracting seven factors, accounting for 35.63% of the total variance. Inspection of the scree plot suggested a solution of up to four factors.

### Confirmatory factor analysis

^{2}(32, n=254)=54.22; p=0.008; χ

^{2}/df=1.69; NNFI=0.92; CFI=0.95; SRMR=0.05; RMSEA= 0.05; 90% confidence interval=0.027-0.078 (Table 5). All manifest variables loaded significantly (p<0.05) on their hypothesized latent factors. Figure 2 presents the standardized parameter estimates.

### DISCUSSION

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^{10}

^{11}we found that only two of the three factors of alexithymia (Difficulty identifying feelings, Difficulty describing feelings) had good psychometric properties. These two factors seem to represent the core of alexithymia in young adolescents. Instead the Externally oriented thinking subscale obtained a low internal consistency: these data are similar to findings published in different languages.

^{1}We suppose that the Externally oriented thinking subscale is composed of items which are hard to understand for an adolescent (for instance, "I can feel close to someone, even in moments of silence", "I find examination of my feelings useful in solving personal problems", or "Looking for hidden meanings in movies or plays distracts from their enjoyment"). Yet, some items of this factor are strongly associated to the normal adult experience: e.g., it is improbable that adolescents look for a meaning in movies or cartoons.

^{10}that "applying adult scoring norms to adolescent respondents might lead to systematic overidentification of alexithymia in this population" (pp. 805-806). For this reason, a new version of TAS-20 for young adolescents that includes items adequate to their cognitive and emotional development, and to their own life experiences should be sought.