Cross-validation of the 20-item Toronto Alexithymia Scale: Results from an Arabic multicenter study Fares Zine El Abiddine a , Hiten Dave b , Said Aldhafri c , Sofián El-Astal d , Fairouz Hemaid e , James D.A. Parker b, ⁎ a Department of Psychology, University of Sidi Bel Abbes, Algeria b Department of Psychology, Trent University, Canada c Department of Psychology, Sultan Qaboos University, Oman d Al Azhar University, Gaza, Palestine e United Nations Relief and Works Agency-, Gaza, Palestine abstract article info Article history: Received 13 December 2016 Received in revised form 28 February 2017 Accepted 8 March 2017 Available online xxxx The Toronto Alexithymia Scale (TAS-20) is a 20-item self-report scale assessing emotional and social competency impairments like difficulty identifying feelings (DIF), difficulty describing feelings (DDF) and externally-oriented thinking (EOT). Despite strong validity and predictive utility in North American and European samples, its valid- ity in Non-Western cultures is still in need of verification. An Arabic version of the TAS-20 was given to a sample (n = 2221) of young adults from 3 Arabic-speaking countries (Algeria, Gaza and Oman), as well as English speak- ing young adults from Canada (n = 2220). Confirmatory factory analysis indicated good fit of the data from both samples, suggesting that the alexithymia construct can be extended to Arabic populations. The Arabic sample scored significantly higher on the total TAS-20 as well as all subscales and in total TAS-20 scores. This trend was consistent for both men and women and suggests important cultural differences exist in the communication of emotional information. © 2017 Elsevier Ltd. All rights reserved. Keywords: TAS-20 Alexithymia Arabic 1. Introduction The construct of alexithymia has gained increasing attention from health care researchers and providers around the world, including countries where English is not the primary language. Initially conceived of as a primarily psychosomatic health issue(Silfneos, 1973), it is now widely understood as a multidimensional personality construct involv- ing difficulty identifying and discerning feelings and understanding physical sensations of emotional arousal (Taylor, Bagby, & Parker, 1997). Alexithymia also involves an impairment in being able to de- scribe one's feelings to other people and narrow imaginal processes, as well as a very superficial, externally-oriented cognitive style. This per- sonality construct has been linked with an array of health problems, such as problem gambling(Lumley & Roby, 1995), substance abuse and eating disorders (Taylor et al., 1997) and chronic diseases like type-II diabetes (Lemche, Chaban, & Lemche, 2014). It also contributes to other non-clinical lifestyle issues such as loneliness and impaired re- lationships (Humphreys, Wood, & Parker, 2009; Kokkonen, Karvonen, Veijola, & Laksy, 2001), poor nutrition and a sedentary lifestyle (Helmers & Mente, 1999). In light of the widespread health implications, it is important to determine if alexithymia is generalizable across different cultural groups. The twenty-item Toronto Alexithymia Scale (TAS-20) is the most widely used assessment tool for this construct. Despite some criticism that alexithymia may be culture-bound and only fits the worldview of North American and European societal norms (Loiselle & Cossette, 2001), translated versions of the scale show ad- equate-to-very good fit in a wide range of countries (Taylor, Bagby, & Parker, 2003). In order to further establish its cross-cultural utility, more transla- tions of the TAS-20 need to be assessed in Non-Western cultures. Specif- ically, validation should continue to be done in “collectivist” cultures where religious practices, views on gender, help-seeking, family values and personal success are different from more “individualistic” Western societies (Graham, Bradshaw, & Trew, 2010; Gunkel, Schlägel, & Engle, 2014). A good example of such a collectivist society is the Arabic culture (Graham et al., 2010). The TAS-20 has been validated in some Islamic countries like Iran (Besharat, 2007) and Turkey (Güleç et al., 2009), and higher scores on the measure have been linked to health problems like disordered eating (Celiken, Cumurcu, Koc, Etikan, & Yucel, 2008), Personality and Individual Differences 113 (2017) 219–222 ⁎ Corresponding author at: Department of Psychology, Trent University, Peterborough, Ontario K9J 7B8, Canada. E-mail address: jparker@trentu.ca (J.D.A. Parker). http://dx.doi.org/10.1016/j.paid.2017.03.017 0191-8869/© 2017 Elsevier Ltd. All rights reserved. Contents lists available at ScienceDirect Personality and Individual Differences journal homepage: www.elsevier.com/locate/paid