# Minimal Impact of Sensation‐Related Items on the Association Between Alexithymia and Self‐Report Measures of Interoception

## TL;DR

The study finds that removing sensation-related items from a questionnaire reduces the link between alexithymia and interoception measures, suggesting measurement overlap.

## Contribution

The study demonstrates that removing specific items from alexithymia questionnaires reduces spurious associations with interoception measures.

## Key findings

- Removing sensation-related items from the TAS-20 reduced associations with interoceptive accuracy and attention.
- The effect was specific to sensation-related items, not random item removal.
- Alexithymia and interoception remained related after item removal, but associations were weaker.

## Abstract

Evidence suggests a relationship between alexithymia and self‐report measures of interoception. As measures of alexithymia often include items that may pick up on interoceptive difficulty, however, it is possible that previously reported associations are driven by a lack of independence of measurement. Here, we explored the effect of removing sensation‐related items from the Toronto Alexithymia Questionnaire (TAS‐20) on the association between the TAS‐20 and self‐report measures of interoceptive accuracy (Studies 1 and 2; N = 330 and N = 476, respectively) and attention (Study 2). In both studies, removal of sensation‐related items significantly reduced associations between the self‐report measures of interoception and alexithymia. This effect was specific to the removal of sensation‐related items (removing a random set of items did not result in a reduction in the size of the association). Importantly, relationships between alexithymia and self‐reported interoception remained after item removal. Although effects were modest, it is recommended that future studies exploring relationships with self‐report measures of interoception—particularly in relation to constructs where sensation‐related items may broadly feature—should implement sensitivity analyses or employ alternative instruments that exclude sensation‐related items, to ensure associations are not driven by a lack of independence of measurement.