do Espírito Santo Gonçalves Patrícia, de Tubino Scanavino Marco
Excessive Sexual Drive and Prevention of Negative Outcome Associated to Sexual Behavior Outpatient Unit, Institute of Psychiatry, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP 05403-010, Brazil.
Department of Psychiatry, St. Joseph's Health Care London and London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, Ontario N6A 4V2, Canada.
Sex Med. 2024 Sep 2;12(4):qfae050. doi: 10.1093/sexmed/qfae050. eCollection 2024 Aug.
Previous studies have provided initial evidence supporting the association between compulsive sexual behavior (CSB) and alexithymia, but these studies did not investigate the psychometric property of a measure of alexithymia in individuals with CSB, which is necessary.
This study investigated the factor analysis, reliability, and construct validity of the Toronto Alexithymia Scale (TAS) in men with CSB and control individuals.
This cross-sectional study included 418 participants (304 individuals with CSB and 114 control individuals) who underwent a semi-structured psychiatric interview and completed the following instruments: the Sexual Compulsivity Scale, Hypersexual Disorder Screening Inventory, Beck Anxiety Inventory, Beck Depression Inventory, TAS, and Barratt Impulsiveness Scale. The eligible participants were men 18 years of age or older who were literate and residing in Brazil. Individuals who met the diagnostic criteria for Goodman's criteria for sex addiction were subsequently assessed for the excessive sexual drive (International Classification of Diseases-Tenth Revision F52.7) criteria. Those who met this second criteria were considered individuals with CSB. Participants who did not reach this point were considered control individuals. We conducted factor analysis, reliability analysis (internal consistency and temporal stability), and discriminant and construct validity analyses.
The outcomes included the TAS total score and scores on TAS factors 1, 2, 3, and 4.
The extracted factors explained 44% of the variance in the TAS. Factor 1 explained 21%, but 3 items (items 2, 9, and 21) did not load onto this factor. The Cronbach's alpha was 0.83, and the reproducibility (intraclass correlation coefficient) was 0.70. The TAS can differentiate between individuals with CSB and control individuals. The different forms of validity were demonstrated through correlations between factors 1 to 4 and the total score, as well as with impulsivity, hypersexuality, sexual compulsivity, and depression. Surprisingly, anxiety was only weakly correlated with factors 1 and 2. Moreover, the TAS-4 score was not correlated with impulsivity.
The TAS can be used in clinical practice to identify men with difficulties in recognizing subjective experiences, and proper interventions can subsequently be provided to these patients to increase their treatment efficacy.
Various dimensions of alexithymia covary with other key psychopathological symptoms of CSB. This study examined a convenience sample. The results cannot be generalized to the broader population. Factors 3 and 4 presented low internal consistency (0.50).
In general, TAS presented good psychometric properties in a sample mainly composed of individuals with CSB.
以往研究已提供初步证据支持强迫性行为（CSB）与述情障碍之间的关联，但这些研究未调查述情障碍测量工具在患有CSB个体中的心理测量特性，而这是必要的。
本研究调查了多伦多述情障碍量表（TAS）在患有CSB的男性和对照个体中的因素分析、信度和结构效度。
这项横断面研究纳入了418名参与者（304名患有CSB的个体和114名对照个体），他们接受了半结构化精神科访谈并完成了以下工具：性强迫量表、性欲亢进障碍筛查量表、贝克焦虑量表、贝克抑郁量表、TAS和巴拉特冲动性量表。符合条件的参与者为18岁及以上、识字且居住在巴西的男性。符合古德曼性成瘾诊断标准的个体随后被评估是否符合过度性驱力（国际疾病分类第十版F52.7）标准。符合这第二个标准的个体被视为患有CSB的个体。未达到这一标准的参与者被视为对照个体。我们进行了因素分析、信度分析（内部一致性和时间稳定性）以及判别效度和结构效度分析。
提取的因素解释了TAS中44%的方差。因素1解释了21%，但有3个项目（项目2、9和21）未加载到该因素上。克朗巴哈α系数为0.83，再现性（组内相关系数）为0.70。TAS能够区分患有CSB的个体和对照个体。通过因素1至4与总分之间的相关性，以及与冲动性、性欲亢进、性强迫和抑郁之间的相关性，证明了不同形式的效度。令人惊讶的是，焦虑仅与因素1和2弱相关。此外，TAS-4得分与冲动性无关。
TAS可用于临床实践，以识别在识别主观体验方面存在困难的男性，随后可为这些患者提供适当干预，以提高其治疗效果。
述情障碍的各个维度与CSB的其他关键精神病理症状相关。本研究调查的是一个便利样本。结果不能推广到更广泛的人群。因素3和4的内部一致性较低（0.50）。
总体而言，TAS在一个主要由患有CSB的个体组成的样本中呈现出良好的心理测量特性。
