Establishing the theoretical components of alexithymia via factor analysis: Introduction and validation of the attention-appraisal model of alexithymia

Alexithymia is an important mental health construct, but there is continuing debate regarding its definition and measurement. We attempt to resolve this definitional uncertainty in two ways. Firstly, we trace the development of the alexithymia construct, focusing particularly on what we call the Toronto and Amsterdam models, and examine a body of empirical research that shows strong support for the hypothesis that alexithymia consists of three components (difficulty identifying feelings, difficulty describing feelings, and externally orientated thinking). Based on these components, we formulate an alternate theoretical model of alexithymia, the attention-appraisal model of alexithymia, that aligns alexithymia theory with recent advances in the broader emotion regulation field. Secondly, we examine the construct's latent structure by factor analysing data from multiple psychometric measures administered to a community sample (N = 368). Our results suggest statistical support for our model, rather than the Toronto or Amsterdam models. We end by discussing how our model accounts for several unresolved issues within the alexithymia field, including the construct's relation to imaginal capacities and emotional reactivity, whether alexithymia is a deficit or a defence, how it might be addressed in psychiatric treatment, and the discordance that has existed between alexithymia theory and alexithymia measurement. Ethics approval for this project was granted by the Edith Cowan University Human Research Ethics Committee. The guidelines of this committee were followed. All participants provided informed consent for their data to be used.