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This study used a multimethod approach to evaluate the relationship of alexithymia (as measured by the 20-item Toronto Alexithymia Scale and the 30-item Emotion Awareness Questionnaire), psychosocial development (assessed with the Measure of Psychosocial Development), and risk behavior (as measured by the Youth Comprehensive Risk Assessment) in 67 adolescents (85% from rural communities) in a rural residential treatment facility. Results revealed that both measures of alexithymia demonstrated good internal consistency and convergent validity. The EAQ-30 demonstrated stronger convergent validity over the TAS-20 with psychosocial measures of shame, inferiority, and role confusion and was more robust in differentiating risk behavior among males and females. Adolescent females scored higher on measures of alexithymia than males and demonstrated significantly more shame, diminished bodily awareness, and risk to self; whereas, males demonstrated significantly more risk to others. Overall, this study contributes to the current literature of alexithymia, provides further support for the validity of the alexithymia construct with adolescents, and sheds light on the importance of emotional awareness and expression in adolescent psychosocial development. Although exploratory, this study also increases clinical understanding of how risk behavior develops and manifests differently in male and female adolescents, specifically with regard to shame and diminished bodily awareness.

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This is an electronic version of an article published in Residential Treatment for Children & Youth, Vol. 28 Issue 4, p. 327-344. Residential Treatment for Children & Youth is available online at: DOI: 10.1080/0886571X.2011.625284