Discriminant Validity of the 20-Item Toronto Alexithymia Scale and the Perth Alexithymia Questionnaire in Relation to Psychological Distress

Recent investigations have questioned whether the Toronto Alexithymia Scale (TAS-20) distinguishes alexithymia from general psychological distress, with some researchers positioning the Perth Alexithymia Questionnaire (PAQ) as demonstrating superior discriminant validity. We evaluated both instruments in a community sample enriched with participants having psychiatric diagnoses or a treatment history (N = 681). Participants completed the TAS-20, PAQ, and Depression Anxiety Stress Scales-21 (DASS-21). Both alexithymia measures showed moderate correlations with the DASS-21, suggesting related but distinct constructs. Item-level exploratory factor analysis revealed a clear separation between alexithymia and distress, with no meaningful cross-loadings for TAS-20 Difficulty Identifying Feelings (DIF) items, replicating prior item-level studies. At the subscale level, a two-factor solution supported distinct alexithymia and distress dimensions. In contrast to previous investigations, the TAS-20 DIF subscale loaded exclusively on the alexithymia factor with negligible loading on distress. These findings demonstrate that neither the TAS-20 nor the PAQ is compromised by distress, challenging recent claims of TAS-20 discriminant validity problems and underscoring the importance of replication across diverse samples and analytic methods.