Development and Validation of Alexithymia Scale for Pakistani Population

Sifneos (1973) introduced the term alexithymia (a = lack, lexis = word, thymos = emotions; the term literally means being devoid of emotions). The construct of alexithymia was not formulated until mid-1970s. In the beginning, the core symptoms of alexithymia were found among people having psychosomatic etiology. Besides this, some theorists stressed that alexithymic person suffers from paucity of introspective awareness, imagination and fantasy (Bruch, 1973), whereas later theorists suggested alexithymia as a trait rather than state (Saarijarvi, Salminen, & Toikka, 2001). Alexithymia refers to difficulty in recognizing, communicating and distinguishing feelings from the related bodily sensations, restricted imagination, and lack of introspective awareness and low levels of empathy (Kerr, 2012). This disturbance affects a person's life in diverse aspects.Results of various studies reflect that alexithymia has both absolute and relative stability over various periods of time; moreover salient features of alexithymia are normally distributed in the general population in both men and women. It shows deficits in cognitive processing as well as regulation of emotions (De Gucht, 2003; Picardim, Toni, & Caroppo, 2005; Saarijarvi, Salminen, & Toikka, 2006; Salminen, Saarijarvi, Toikka, Kauhanen & Aarela, 2006). Since the past few years, the term alexithymia has refined theoretically. At present this construct incorporates these underlying features: 1) Experiencing difficulty in feelings identification and related bodily sensations, 2) Difficulty in expressing feelings. 3) Lack of introspective awareness, 4) Restricted imagination (Nemiah, Freyberger & Sifneos, 1976). The differences in dealing with emotions are evident across cultures Dion (1996) conducted a study upon Canadian students and explored that ethnic Chinese students scored higher on alexithymia than Anglo-Celtic and European ethno-cultural backgrounds. Furthermore, Le, Berenbaum and Raghavan (2002) reported difference in alexithymia between people belonging to Asian and Western cultures. They found that parents belonging to western cultures were more able to communicate positive emotions and display physical affection than the Asian parents. From these studies, it is depicted that the level of alexithymia varies in different cultures. The ability to communicate emotions is described as the central part of both men and women life (Bem, 1974). The evidence regarding gender differences in alexithymia is ambiguous. Some studies reported that men outscored women (Zaidi, Yaqoob & Malik, 2015; Mohsin, Buzdar, Mohsin, & Saleem, 2016), while some witnessed higher scores for women (Joukamaa et al., 2007; Kokkonen et al., 2001; Gunzelmann, Kupfer & Brahler, 2002), whereas some reported non-significant relation of alexithymia with gender (Karukivi, 2011; Sakkinen et al., 2007). Studies also reported that it was significantly correlated with age (Moriguchi et al., 2007; Bagby et al., 1994); while other researchers determined that it is not associated with age (Cohen, Auld, & Brooker, 1994; Pandey et al., 1996). The way of identifying, expressing and managing emotions differs among cultures due to differences in language, social and ethical values (Taylor, Baggby & Parker, 2003). Thus, several theorists recommended developing culturally relevant scale. Toronto Alexithymia Scale (TAS-20; Bagby, Parker, & Taylor, 1994) is the most widely used measure for alexithymia. Originally developed in English, it has been validated and translated in many cultures but after a series of researches, theorists explored that alexithymia was culturally bound measure, especially the third factor externally-oriented thinking (EOT) reported lack of reliability in cultures where English was not mother tongue. So, in order to accurately measure the alexithymia, it is required to have a test with cultural relevance (Cossette, Frasure-Smith, & Lesperance, 2001; Taylor, Baggby, & Parker, 2003). …