Login | Register

Quantitative Questions, Qualitative Answers: The Cultural Meaning of Externally Oriented Thinking in a Chinese Psychiatric Sample

Title:

Quantitative Questions, Qualitative Answers: The Cultural Meaning of Externally Oriented Thinking in a Chinese Psychiatric Sample

Chang, Jie (2019) Quantitative Questions, Qualitative Answers: The Cultural Meaning of Externally Oriented Thinking in a Chinese Psychiatric Sample. Masters thesis, Concordia University.

[thumbnail of Chang_MA_F2019.pdf]
Preview
Text (application/pdf)
Chang_MA_F2019.pdf - Accepted Version
Available under License Spectrum Terms of Access.
816kB

Abstract

Adaptive emotional norms are frequently assumed, and often go unexamined, when emotional constructs originating from the West are exported to other cultural contexts. The current study uses a mixed-methods design to examine alexithymia, whose underlying normative assumptions may be leading to over-pathologization and psychometric difficulties in cross-cultural usage. The externally oriented thinking (EOT) component of alexithymia, measured by the 20-Item Toronto Alexithymia Scale (TAS-20), shows well-recognized poor psychometric properties and potentially different but adaptive normative levels in non-English samples. In this two-part study, I first replicate and demonstrate past findings of poor internal consistency and weak model fit of the EOT subscale of the TAS-20 in a Chinese clinical sample (N = 276). To explain the quantitative observations, I then conduct a thematic analysis of audio-recorded interview responses using a subset of the sample (n = 23), who were administered the Toronto Structured Interview for Alexithymia. The qualitative results reveal that Chinese respondents demonstrated EOT tendencies such as organizing and analyzing experiences based on factual attributes, as well as engaging in more consideration of norms and less mentalization of feelings than normatively expected for Euro-Canadians. These findings provide explanations for EOT measurement issues from both task and conceptual levels. Integrating cultural emotion theories, I also consider the relative adaptiveness of EOT in service of specific cultural goals while challenging the appropriateness of its original ‘Western’ pathological assumptions. Implications of current findings for clinical practise, acculturative adjustment, and future empirical studies of attention to emotions are discussed.

Divisions:Concordia University > Faculty of Arts and Science > Psychology
Item Type:Thesis (Masters)
Authors:Chang, Jie
Institution:Concordia University
Degree Name:M.A.
Program:Psychology
Date:21 August 2019
Thesis Supervisor(s):Ryder, Andrew
Keywords:alexithymia, culture, emotions, externally oriented thinking
ID Code:985712
Deposited By: Jie Chang
Deposited On:05 Feb 2020 02:58
Last Modified:05 Feb 2020 02:58

References:

Bagby, M. R., Taylor, G. J., Parker, J. D. A., & Dickens, S. E. (2006). The development of the Toronto structured interview for Alexithymia: Item selection, factor structure, reliability and concurrent validity. Psychotherapy and Psychosomatics, 75, 25–39. doi:10.1159/000089224
Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994). The twenty-item Toronto Alexithymia scale—I. Item selection and cross-validation of the factor structure. Journal of Psychosomatic Research, 38, 23–32. doi:10.1016/0022-3999(94)90005-1
Bagby, R. M., Taylor, G. J., & Ryan, D. (1986). Toronto Alexithymia Scale: Relationship with personality and psychopathology measures. Psychotherapy and Psychosomatics, 45, 207–215.
Bagby, R.M., Taylor, G.T., Dickens, S.E., & Parker, J.D.A. (2005). The Toronto Structured Interview for Alexithymia (TSIA) (version 1, October 2005): Administration and scoring guidelines. Unpublished manuscript.
Boiger, M., Ceulemans, E., De Leersnyder, J., Uchida, Y., Norasakkunkit, V., & Mesquita, B. (2018). Beyond essentialism: Cultural differences in emotions revisited. Emotion, 12, 1142–1162. doi:10.1037/emo0000390
Bond, M. H. (Ed.). (1986). The Psychology of the Chinese people. New York, USA: Oxford University Press.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101. doi:10.1191/1478088706qp063oa
Brown, T. A. (2015). Confirmatory factor analysis for applied research. New York, USA: The Guilford Press.
Bressi, C., Taylor, G., Parker, J., Bressi, S., Brambilla, V., Aguglia, E., … Invernizzi, G. (1996). Cross validation of the factor structure of the 20-item Toronto Alexithymia Scale: An Italian multicenter study. Journal of Psychosomatic Research, 41, 551–559. doi:10.1016/S0022-3999(96)00228-0
Caretti, V., Porcelli, P., Solano, L., Schimmenti, A., Bagby, R. M., & Taylor, G. J. (2011). Reliability and validity of the Toronto Structured Interview for Alexithymia in a mixed clinical and nonclinical sample from Italy. Psychiatry Research, 187, 432–436. doi:10.1016/j.psychres.2011.02.015
Chen, J. M., Kim, H. S., Mojaverian, T., & Morling, B. (2012). Culture and social support provision: Who gives what and why. Personality and Social Psychology Bulletin, 38, 3–13. doi:10.1177/0146167211427309
Chen, J., Xu, T., Jing, J., & Chan, R. C. K. (2011). Alexithymia and emotional regulation: A cluster analytical approach. BMC Psychiatry, 11, 2–7. doi:10.1186/1471-244X-11-33
Chentsova-Dutton, Y. E., & Tsai, J. L. (2010). Self-focused attention and emotional reactivity: The role of culture. Journal of Personality and Social Psychology, 98, 507–519. doi:10.1037/a0018534
Choi, E., Chentsova-Dutton, Y., & Parrott, W. G. (2016). The effectiveness of somatization in communicating distress in Korean and American cultural contexts. Frontiers in Psychology, 7, 1–17. doi:10.3389/fpsyg.2016.00383
Chow, P. I., & Berenbaum, H. (2012). Perceived utility of emotion: The structure and construct validity of the Perceived Affect Utility Scale in a cross-ethnic sample. Cultural Diversity and Ethnic Minority Psychology, 18, 55–63. doi:10.1037/a0026711
Clarke, V., Braun, V., & Hayfield, N. (2015). Thematic analysis. In J.A. Smith (Ed.), Qualitative psychology: A practical guide to research methods, 3rd edition (pp. 222-248). United Kingdom: Sage.
Coffey, E., Berenbaum, H., & Kerns, J. (2003). The dimensions of emotional intelligence, alexithymia, and mood awareness: Associations with personality and performance on an emotional stroop task. Cognition & Emotion, 17, 671–679. doi:10.1080/02699930302304
De Gucht, V., & Heiser, W. (2003). Alexithymia and somatisation: A quantitative review of the literature. Journal of Psychosomatic Research, 54, 425–434. doi:10.1016/S0022-3999(02)00467-1
Dere, J., Falk, C. F., & Ryder, A. G. (2012a). Unpacking cultural differences in alexithymia: The role of cultural values among Euro-Canadian and Chinese-Canadian students. Journal of Cross-Cultural Psychology, 43, 1297–1312. doi:10.1177/0022022111430254
Dere, J., Falk, C. F., & Ryder, A. G. (2012b). Unpacking Cultural Differences in Alexithymia: The Role of Cultural Values Among Euro-Canadian and Chinese-Canadian Students. Journal of Cross-Cultural Psychology, 43, 1297–1312. doi:10.1177/0022022111430254
Dere, J., Tang, Q., Zhu, X., Cai, L., Yao, S., & Ryder, A. G. (2013). The cultural shaping of alexithymia: Values and externally oriented thinking in a Chinese clinical sample. Comprehensive Psychiatry, 54, 362–368. doi:10.1016/j.comppsych.2012.10.013
Dilley, P. (2010). Analyzing qualitative data. Theory Into Practice, 39, 124–130. doi:10.1207/s15430421tip3903
Dion, K. L. (1996). Ethnolinguistic correlates of alexithymia: Toward a cultural perspective. Journal of Psychosomatic Research, 41, 531–539. doi:10.1016/S0022-3999(96)00295-4
Doan, S. N., & Wang, Q. (2010). Maternal discussions of mental states and behaviors: Relations to emotion situation knowledge in European American and immigrant Chinese children. Child Development, 81, 1490–1503. doi:10.1111/j.1467-8624.2010.01487.x
Gendron, M. (2017). Revisitng diversity: Cultural variation reveals the constructed nature of emotion perception. Current Opinions in Psychology, 17, 145–150. doi:10.1016/j.copsyc.2017.07.014.Revisiting
Gendron, M., Roberson, D., van der Vyver, J. M., & Barrett, L. F. (2014). Perceptions of emotion from facial expressions are not culturally universal: Evidence from a remote culture. Emotion, 14, 251–262. doi:10.1037/a0036052
Grabe, H. J., Löbel, S., Dittrich, D., Bagby, R. M., Taylor, G. J., Quilty, L. C., … Rufer, M. (2009). The German version of the Toronto Structured Interview for Alexithymia: factor structure, reliability, and concurrent validity in a psychiatric patient sample. Comprehensive Psychiatry, 50, 424–430. doi:10.1016/j.comppsych.2008.11.008
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. doi:10.1080/10705519909540118
Joukamaa, M., Kokkonen, P., Veijola, J., Läksy, K., Karvonen, J. T., Jokelainen, J., & Järvelin, M. riitta. (2003). Social situation of expectant mothers and alexithymia 31 years later in their offspring: A prospective study. Psychosomatic Medicine, 65, 307–312. doi:10.1097/01.PSY.0000030389.53353.BC
Jurist, E. L. (2005). Mentalized affectivity. Psychoanalytic Psychology, 22, 426–444. doi:10.1037/0736-9735.22.3.426
Keefer, K. V., Taylor, G. J., Parker, J. D. A., Inslegers, R., & Bagby, R. M. (2015). Measurement equivalence of the Toronto Structured Interview for Alexithymia across language, gender, and clinical status. Psychiatry Research, 228, 760–764. doi:10.1016/j.psychres.2015.04.044
Kim, D., Pan, Y., & Park, H. S. (1998). High- versus low-context culture: A comparison of Chinese, Korean and American cultures. Psychology and Marketing, 15, 507–521.
Kim, H. S. & Lawrie, S. I (2019). Culture and motivation. In D. Cohen and S. Kitayama (Eds.), Handbook of cultural psychology (pp. 268-291). New York: the Guildford Press.
Kirmayer, L. J. (1987). Languages of suffering healing: Alexithymia as a social and cultural process. Transcultural Psychiatry, 24, 119–136. doi:10.1177/136346158702400204
Kitayama, S., Mesquita, B., & Karasawa, M. (2006). Cultural affordances and emotional experience: Socially engaging and disengaging emotions in Japan and the United States. Journal of Personality and Social Psychology, 91, 890–903. doi:10.1037/0022-3514.91.5.890
Kline, R. B. (2011). Principles and practice of structural equation modeling – 3rd edition. New York, USA: The Guilford Press.
Kooiman, C. G., Spinhoven, P., & Trijsburg, R. W. (2002). The assessment of alexithymia: A critical review of the literature and a psychometric study of the Toronto Alexithymia Scale-20. Journal of Psychosomatic Research, 53, 1083–1090. doi:10.1016/S0022-3999(02)00348-3
Lane, R. D., Ahern, G. L., Schwartz, G. E., & Kaszniak, A. W. (2002). Is alexithymia the emotional equivalent of blindsight? Biological Psychiatry, 42, 834–844. doi:10.1016/s0006-3223(97)00050-4
Leys, C., Klein, O., Dominicy, Y., & Ley, C. (2018). Detecting multivariate outliers: Use a robust variant of the Mahalanobis distance. Journal of Experimental Social Psychology, 74, 150–156. doi:10.1016/j.jesp.2017.09.011
Luminet, O. Bagby, M. R. & Taylor, G. J. (Eds.). (2018). Alexithymia: Advances in research, theory and clinical practice. Great Britain: Cambridge University Press.
Luminet, O., Rimé, B., Bagby, R. M., & Taylor, G. J. (2004). A multimodal investigation of emotional responding in alexithymia. Cognition and Emotion, 18, 741–766. doi:10.1080/02699930341000275
Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98, 224–253. doi:10.1037/0033-295X.98.2.224
McHugh, M. L. (2012). Lessons in biostatistics interrater reliability: The kappa statistic. Biochemia Medica, 22, 276–282.
Meganck, R., Vanheule, S., & Desmet, M. (2008). Factorial validity and measurement invariance of the 20-Item Toronto Alexithymia Scale in clinical and nonclinical samples. Assessment, 15, 36–47. doi:10.1177/1073191107306140
Mesquita, B. (2001). Emotions in collectivist and individualist contexts. Journal of Personality and Social Psychology, 80, 68–74. doi:10.1037/0022-3514.80.1.68
Mesquita, B., Boiger, M., & De Leersnyder, J. (2017). Doing emotions: The role of culture in everyday emotions. European Review of Social Psychology, 28, 95–133. doi:10.1080/10463283.2017.1329107org/10.1080/10463283.2017.1329107
Mesquita, B., & Karasawa, M. (2002). Different emotional lives. Cognition and Emotion, 16, 127–141. doi:10.1080/0269993014000176
Müller, J., Bühner, M., & Ellgring, H. (2003). Is there a reliable factorial structure in the 20-item Toronto Alexithymia Scale? Journal of Psychosomatic Research, 55, 561–568. doi:10.1016/s0022-3999(03)00033-3
Palmieri, P. A., Boden, M. T., & Berenbaum, H. (2009). Measuring clarity of and attention to emotions. Journal of Personality Assessment, 91, 560–567. doi:10.1080/00223890903228539
Potter, S. H. (1988). The Cultural construction of emotion in rural Chinese social life. Ethos, 16, 181–208.
R Core Team (2017). R: A language and environment for statistical computing. Vienna Austria: R Foundation for Statistical Computing. Retrieved from https://www.R-project.org/.
Revelle, W. (2017). psych: Procedures for Personality and Psychological Research (1.7.8). Illinois, USA: Northwestern University. Retrieved from https://CRAN.R-project.org/package=psych.
Ryder, A. G., & Chentsova-Dutton, Y. E. (2012). Depression in cultural context: “Chinese somatization”, revisited. Psychiatric Clinics of North America, 35, 15–36. doi:10.1016/j.psc.2011.11.006
Ryder, A. G., Davis-Jewish, M. B., Hospital, G., Yang, J., Zhu, X., Yao, S., … Wong, M. (2008). The cultural shaping of depression: Somatic symptoms in China, psychological symptoms in North America? Psychological Association, 117, 300–313. doi:10.1037/0021-843X.117.2.300
Ryder, A. G., Sunohara, M., Dere, J. & Chentsova-Dutton, Y. E. (2018). The cultural shaping of alexithymia. In O. Luminet, M. R. Bagby & G. J. Taylor (Eds.), Alexithymia: Advances in research, theory and clinical practice (pp. 33-48). Great Britain: Cambridge University Press.
Ryder, A. G., Yang, J., Zhu, X., Yao, S., Yi, J., Heine, S. J., & Bagby, R. M. (2008). The Cultural Shaping of Depression: Somatic Symptoms in China, Psychological Symptoms in North America? Journal of Abnormal Psychology, 117, 300–313. doi:10.1037/0021-843X.117.2.300
Sekely, A, Bagby, M. R. & Porcelli, P. (2018). Assessment of the alexithymia construct. In O. Luminet, M. R. Bagby & G. J. Taylor (Eds.), Alexithymia: Advances in research, theory and clinical practice (pp. 17-32). Great Britain: Cambridge University Press.
Simonsson-Sarnecki, M., Lundh, L. G., Törestad, B., Bagby, R. M., Taylor, G., & Parker, J. (2000). A Swedish translation of the 20-item Toronto Alexithymia Scale: Cross-validation of the factor structure. Scandinavian Journal of Psychology, 41, 25–30. doi:10.1111/1467-9450.00167
Soto, J. A., Perez, C. R., Kim, Y.-H., Lee, E. A., & Minnick, M. R. (2011). Is expressive suppression always associated with poorer psychological functioning? A cross-cultural comparison between European Americans and Hong Kong Chinese. Emotion, 11, 1450–1455. doi:10.1037/a0023340
Suh, E., Diener, E., Oishi, S., & Triandis, H. C. (1998). The shifting basis of life satisfaction judgments across cultures: Emotions versus norms. Journal of Personality & Social Psychology., 74, 482–493.
Sun, J., & Ryder, A. G. (2016). The Chinese experience of rapid modernization: Sociocultural changes, psychological consequences? Frontiers in Psychology, 7, 1–13. doi:10.3389/fpsyg.2016.00477
Taylor, G. J. (1984). Alexithymia: Concept, measurement, and implications for treatment. American Journal of Psychiatry, 141, 725–732. doi:10.1176/ajp.141.6.725
Taylor, G. J. (2018). History of alexithymia: The contributions of psychoanalysis. In O. Luminet, M. R. Bagby & G. J. Taylor (Eds.), Alexithymia: Advances in research, theory and clinical practice (pp. 1-16). Great Britain: Cambridge University Press.
Taylor, G. J., Bagby, R. M., & Parker, J. D. A. (2003). The 20-Item Toronto Alexithymia Scale: IV. Reliability and factorial validity in different languages and cultures. Journal of Psychosomatic Research, 55, 277–283. doi:10.1016/S0022-3999(02)00601-3
Triandis, H. C. (1989). The self and social behavior in differing cultural contexts. Psychological Review, 96, 506–520.
Triandis, H. C. (1993). Cross-cultural collectivism and individualism as cultural syndromes. Cross-Cultural Reserach, 27, 155–180. doi:10.1177/106939719302700301
Triandis, H. C., Bontempo, R., & Villareal, M. J. (1988). Individualism and collectivism : Cross-Cultural perspectives on self-ingroup relationships. Journal of Personality and Social Psychology, 54, 323–338.
Tsai, J. L., Clobert, M. (2019). Culture influences on emotion: Established patterns and emerging trends. In D. Cohen & S. Kitayama (Eds.), Handbook of cultural psychology (pp. 292-318). New York, USA: The Guilford Press.
Tsai, J. L., Knutson, B., & Fung, H. H. (2006). Cultural variation in affect valuation. Journal of Personality and Social Psychology, 90, 288–307. doi:10.1037/0022-3514.90.2.288
Tsai, J. L., Miao, F. F., Seppala, E., Fung, H. H., & Yeung, D. Y. (2007). Influence and Adjustment Goals: Sources of Cultural Differences in Ideal Affect. Journal of Personality and Social Psychology, 92, 1102–1117. doi:10.1037/0022-3514.92.6.1102
Tsai, J. L., Simeonova, D. I., & Watanabe, J. T. (2004). Somatic and social: Chinese Americans talk about emotion. Personality and Social Psychology Bulletin, 30, 1226–1238. doi:10.1177/0146167204264014
Vandenberg, R., & Lance, C. (2000). A Review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3, 4–70.
Vanheule, S., Meganck, R., & Desmet, M. (2011). Alexithymia, social detachment and cognitive processing. Psychiatry Research, 190, 49–51. doi:10.1016/j.psychres.2010.06.032
Wang, Q. (2001). “Did you have fun?” American and Chinese mother-child conversations about shared emotional experiences. Cognitive Development, 16, 693–715. doi:10.1017/cbo9781139522618.016
Yves Rosseel (2012). lavaan: An R Package for Structural Equation Modeling. Journal of Statistical Software, 48, 1-36. Retrieved from http://www.jstatsoft.org/v48/i02/.
Zhu, X., Yi, J., Yao, S., Ryder, A. G., Taylor, G. J., & Bagby, R. M. (2007). Cross-cultural validation of a Chinese translation of the 20-item Toronto Alexithymia Scale. Comprehensive Psychiatry, 48, 489–496. doi:10.1016/j.comppsych.2007.04.007
Zine El Abiddine, F., Dave, H., Aldhafri, S., El-Astal, S., Hemaid, F., & Parker, J. DA. (2017). Cross-validation of the 20-item Toronto Alexithymia Scale: Results from an Arabic multicenter study. Personality and Individual Differences, 113, 219–222. doi:10.1016/j.paid.2017.03.017
All items in Spectrum are protected by copyright, with all rights reserved. The use of items is governed by Spectrum's terms of access.

Repository Staff Only: item control page

Downloads per month over past year

Research related to the current document (at the CORE website)
- Research related to the current document (at the CORE website)
Back to top Back to top