TAS-20: Toronto Alexithymia Scale
The TAS-20 (Toronto Alexithymia Scale, 20-item) is a 20-item self-report questionnaire that measures alexithymia, a difficulty identifying and describing feelings with externally oriented thinking (Bagby, Parker & Taylor, 1994). Totals run 20–100, with 61 or higher conventionally classed as alexithymia and 52–60 as possible alexithymia.
TAS-20 Score Interpreter
Borderline range. Emotional processing difficulties may be present; further clinical evaluation is warranted.
20 items rated 1–5 (5 items reverse-scored). Higher scores = greater alexithymia. Three subscales: DIF, DDF, EOT.
| Total score | Interpretation |
|---|---|
| 61+ | AlexithymiaScore consistent with alexithymia: marked difficulty identifying and describing feelings and a tendency toward externally oriented thinking. |
| 52–60 | Possible alexithymiaBorderline range. Emotional processing difficulties may be present; further clinical evaluation is warranted. |
| 20–51 | Alexithymia unlikelyScore below the commonly used alexithymia threshold. Emotional processing within typical range on this measure. |
Bagby, Parker & Taylor (1994). Severity ranges per commonly used clinical convention. Educational reference only — not a diagnostic tool.
For reference only — not an assessment, diagnosis, or medical advice. This page provides scoring reference material; interpretation and clinical decisions rest with a qualified clinician.
The TAS-20 is a 20-item validated self-report measure of alexithymia, the inability to identify, describe, and distinguish feelings. Scores 20–100; cutoff ≥61 for alexithymia. Three subscales: DIF, DDF, EOT. Bagby, Parker & Taylor (1994).
What the TAS-20 measures
The Toronto Alexithymia Scale (TAS-20) was developed by R. Michael Bagby, James D. A. Parker, and Graeme J. Taylor (1994) to operationalize the construct of alexithymia, a term coined by Sifneos (1973) to describe a deficit in emotional awareness characterized by difficulty identifying feelings, difficulty describing feelings to others, and a tendency to focus on external rather than internal experiences.
The 20 items are rated on a 5-point Likert scale (1 = Strongly disagree, 5 = Strongly agree). Five items (4, 5, 10, 18, 19) are reverse-scored before summing. Total scores range from 20 to 100, with higher scores indicating greater alexithymia. The scale yields three subscale scores: DIF (Difficulty Identifying Feelings, 7 items), DDF (Difficulty Describing Feelings, 5 items), and EOT (Externally Oriented Thinking, 8 items).
The TAS-20 has been validated in over 50 countries and is widely used in research on trauma, somatic disorders, eating disorders, substance use, and psychosomatic medicine. Prevalence of alexithymia in the general population is estimated at approximately 10–15%. Elevated alexithymia is commonly observed in PTSD, autism spectrum, and somatic symptom disorders.
How to administer the TAS-20
The TAS-20 is a self-report questionnaire. Respondents rate 20 statements on a 5-point Likert scale (1 = Strongly disagree to 5 = Strongly agree). No clinician administration is required, though results should be interpreted within a broader clinical context.
Enter a TAS-20 total score (from a formally administered assessment) to see the corresponding interpretation and subscale context.
Score range: 20 (no alexithymia) to 100 (severe alexithymia)
TAS-20 scoring and interpretation
Bagby, Parker & Taylor (1994). Sum all 20 items after reverse-scoring items 4, 5, 10, 18 and 19, for a total of 20–100. By commonly used convention, a total of 61 or higher is classed as alexithymia, 52–60 as possible alexithymia, and 51 or lower as alexithymia unlikely; use the score interpreter above to look up a total. Prevalence of alexithymia (≥61) in the general population is approximately 10–15%.
TAS-20 subscale reference
For reference only. Formal TAS-20 administration required for clinical use.
TAS-20 Subscales: DIF, DDF, EOT
The TAS-20 yields three factor subscores reflecting distinct components of the alexithymia construct.
Difficulty Identifying Feelings
7 items. Assesses difficulty recognizing and distinguishing between emotions and bodily sensations of emotional arousal. The most clinically significant subscale for emotional dysregulation.
Difficulty Describing Feelings
5 items. Measures difficulty communicating feelings to other people. High DDF scores are associated with poor therapeutic alliance and limited responsiveness to emotion-focused therapies.
Externally Oriented Thinking
8 items. Reflects a tendency to focus on the external environment rather than inner experience. High EOT is linked to somatic preoccupation and difficulty with introspection and self-reflection.
Psychometric properties
In its development studies, the TAS-20 showed good internal consistency and test-retest reliability and a three-factor structure (DIF, DDF, EOT) that was replicated by confirmatory factor analysis in clinical and nonclinical samples (Bagby, Parker & Taylor, 1994). Convergent and discriminant validity were supported by the expected pattern of correlations with NEO Personality Inventory scales, psychological mindedness and need for cognition, and concurrent validity by positive correlations with observer ratings of alexithymia in behavioural medicine outpatients (Bagby, Taylor & Parker, 1994). A 25-year review concluded that the preponderance of evidence supports the scale's reliability and validity (Bagby, Parker & Taylor, 2020).
Limitations
- Not a diagnosis. Alexithymia is a personality trait, not a DSM or ICD diagnosis; the TAS-20 measures it on a continuum.
- Cutoffs are a convention. The ≥61 and 52–60 ranges are commonly used conventions rather than cutoffs validated against a criterion standard.
- Weak EOT subscale. A critical review found the Externally Oriented Thinking subscale unreliable in practically all studies, and in some patient samples DIF and DDF collapsed into a single factor (Kooiman et al., 2002).
- Self-report paradox. People with limited emotional awareness are asked to rate their own awareness; a critical review recommended using it in combination with other measures (Kooiman et al., 2002).
Measuring emotional processing in HiBoop
HiBoop does not offer the TAS-20; this page is reference material. For emotion regulation, HiBoop offers the ERQ, with automated scoring and tracking over time.
HiBoop does not offer this scale. This page is reference material.This library is an academic and clinical reference. A scale described here is not necessarily offered in HiBoop; each page says whether it is.
Frequently Asked Questions
What does a TAS-20 score of 61 or higher mean?
A total score of 61 or above is commonly used to classify alexithymia — difficulty identifying, describing, and distinguishing feelings from bodily sensations. Scores in the 52–60 range are considered a possible or borderline alexithymia zone. These cutoffs are widely applied in research and clinical settings as a commonly used clinical convention.
Is the TAS-20 self-report or clinician-administered?
The TAS-20 is a self-report questionnaire. Respondents rate 20 statements on a 5-point Likert scale (1 = Strongly disagree to 5 = Strongly agree). Five items are reverse-scored before summing. No clinician administration is required, though results should be interpreted within a broader clinical context.
Can the TAS-20 provide a diagnosis of alexithymia?
No. Alexithymia is a personality trait or construct, not a standalone psychiatric diagnosis in DSM or ICD classification systems. The TAS-20 quantifies the degree of alexithymia on a continuum; elevated scores indicate a characteristic pattern of emotional processing difficulty that warrants clinical attention, but a score alone does not constitute a diagnosis.
How is the TAS-20 scored?
Sum all 20 item responses (each rated 1–5). Items 4, 5, 10, 18, and 19 are reverse-scored before summing. Total scores range from 20 to 100. The three factor subscales — DIF (Difficulty Identifying Feelings, 7 items), DDF (Difficulty Describing Feelings, 5 items), and EOT (Externally Oriented Thinking, 8 items) — are summed separately to provide a subscale profile.
Bill this assessment
The TAS-20: Toronto Alexithymia Scale qualifies for reimbursement under these CPT codes (US).
Measurement-based care in practice
For clinicians
HiBoop does not offer this scale. For the scales it does offer, HiBoop automates delivery, scoring and longitudinal tracking across your patient panel.
For individuals
This page is a clinical reference, not a diagnostic tool. If you have concerns about your own symptoms, bring this information to a qualified mental health professional.
References
- 1.Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto Alexithymia Scale--I. Item selection and cross-validation of the factor structure. J Psychosom Res. 1994;38(1):23-32.View source
- 2.Bagby RM, Taylor GJ, Parker JD. The Twenty-item Toronto Alexithymia Scale--II. Convergent, discriminant, and concurrent validity. J Psychosom Res. 1994;38(1):33-40.View source
- 3.Bagby RM, Parker JDA, Taylor GJ. Twenty-five years with the 20-item Toronto Alexithymia Scale. J Psychosom Res. 2020;131:109940.View source
- 4.Kooiman CG, Spinhoven P, Trijsburg RW. The assessment of alexithymia: a critical review of the literature and a psychometric study of the Toronto Alexithymia Scale-20. J Psychosom Res. 2002;53(6):1083-90.View source
Last reviewed: Jun 3, 2026
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