Amélioration de la mesure de l’alexithymie chez les adultes autistes : une investigation psychométrique de l’échelle d’alexithymie de Toronto à 20 items et génération d’un score de facteur général d’alexithymie à l’aide de la théorie de réponse à l’item
Titre original en anglais : Improving the measurement of alexithymia in autistic adults: a psychometric investigation of the 20-item Toronto Alexithymia Scale and generation of a general alexithymia factor score using item response theory
Williams, Z. J. & Gotham, K. (2021). Improving the measurement of alexithymia in autistic adults: a psychometric investigation of the 20-item Toronto Alexithymia Scale and generation of a general alexithymia factor score using item response theory. Molecular Autism, 12(1), 56-56. https://doi.org/10.1186/s13229-021-00463-5
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Résumé
CONTEXTE : L’alexithymie, un trait de personnalité caractérisé par des difficultés à interpréter les états émotionnels, est fréquemment élevée chez les adultes autistes, et un corpus croissant de littérature suggère que ce trait sous-tend plusieurs différences cognitives et émotionnelles auparavant attribuées à l’autisme. Bien que des questionnaires tels que l’échelle d’alexithymie de Toronto à 20 items (TAS-20) soient fréquemment utilisés pour mesurer l’alexithymie dans la population autiste, peu d’études ont examiné les propriétés psychométriques de ces questionnaires chez les adultes autistes, notamment l’existence d’un fonctionnement différentiel des items (I-DIF) entre les adultes autistes et les adultes de la population générale. MÉTHODES : Cette étude est une version révisée d’un article précédent qui a été rétracté en raison de préoccupations liées au droit d’auteur (Williams et Gotham dans Mol Autism 12:1-40). Nous avons mené une analyse psychométrique approfondie de la TAS-20 dans un large échantillon de 743 adultes autistes ayant des capacités cognitives préservées, recrutés à partir du vivier de participants SPARK de la Simons Foundation, et de 721 témoins de la population générale inscrits à une vaste étude psychologique internationale. La structure factorielle de la TAS-20 a été examinée au moyen d’une analyse factorielle confirmatoire, et la théorie de réponse à l’item a été utilisée pour générer un sous-ensemble d’items constituant de forts indicateurs d’un facteur d’« alexithymie générale ». Les corrélations entre l’alexithymie et d’autres résultats cliniques ont été utilisées pour évaluer la validité nomologique du nouveau score d’alexithymie dans l’échantillon SPARK. RÉSULTATS : La TAS-20 n’a pas présenté un ajustement de modèle adéquat dans les échantillons autiste ou de population générale. Une réduction empirique des items a été entreprise, aboutissant à un score de facteur général d’alexithymie à 8 items (GAFS-8, sans référence à « TAS » en raison du droit d’auteur) présentant de solides propriétés psychométriques et un I-DIF pratiquement négligeable entre les groupes diagnostiques. Les analyses corrélationnelles ont indiqué que les scores GAFS-8, dérivés de la TAS-20, prédisent de manière significative les niveaux de traits autistiques, les comportements répétitifs et les symptômes de dépression, même après contrôle du névrosisme en tant que trait. Le GAFS-8 n’a également présenté aucune diminution significative de validité nomologique par rapport à la TAS-20 complète chez les participants autistes. LIMITES : Les limites de l’étude actuelle comprennent un échantillon d’adultes autistes majoritairement féminin, diagnostiqué plus tardivement et très instruit ; des groupes cliniques et témoins issus d’études différentes avec des mesures variables ; l’administration de seulement 16 des items de la TAS-20 à l’échantillon non autiste ; et l’impossibilité de tester plusieurs autres caractéristiques psychométriques importantes du GAFS-8, notamment la sensibilité au changement et l’I-DIF lors d’administrations multiples. CONCLUSIONS : Ces résultats indiquent le potentiel du GAFS-8 pour mesurer de manière robuste l’alexithymie chez les adultes autistes et non autistes. Un calculateur de score en ligne gratuit a été créé afin de faciliter l’utilisation de scores de traits latents GAFS-8 référencés à des normes dans des applications de recherche (disponible à l’adresse https://asdmeasures.shinyapps.io/alexithymia ).
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