Although authors slavishly include references to Marty and de M’Uzan (1963) , Nemiah and Sifneos (1970a),
and Sifneos (1973) , almost no-one takes the trouble to read these classics, as is indicated by the fact that for more
than 30 years, references contained the wrong page numbers for Marty and de M’Uzan’s (1963) publication.
Furthermore, while referring to Sifneos (1973) , all authors present either one of two translations for alexithymia
from the Greek: alexis 5not reading, thymos 5mood/emotion, or a 5lack, lexis 5word, thymos 5mood/
emotion). However, the translation Sifneos (1973) gave is: ‘from the Greek alexi 5not working, thymos 5mood/
emotion’.8
The high number of alexithymia scales, with low concurrent validities, have robbed the construct of its import.
Although this is mainly due to ignoring the founding fathers of the construct, it is also the result of the idea that
the content of a construct can change in response to the research results ( Taylor et al., 1997 , p.58), or can be
extended by incorporating other constructs (e.g., Rieffe et al., 2007 ). Although there is something to say for these
views, it results in a Babylonian confusion of tongues. Furthermore, a redefinition of a construct on basis of
research results can only be made if the results are obtained by a scale that measures the original construct reli-
ably and fully. Since there is debate about the measurement, all changes in the definition of the construct are
premature.
Another source of confusion can be found in the history of alexithymia measures that reveals two very differ-
ent approaches. The early measures were made by clinical professionals, and the items were directly related to
the original descriptions of the construct (e.g., Sifneos, 1973 ; Apfel & Sifneos, 1979). However, these authors did
not bother much about the psychometric properties of their scales. Subsequently, measures have been developed
by laying too much trust on psychometric analyses, and not enough on content validity. Items sets were formed,
analyzed with advanced statistical methods, and only those items fulfilling pre-established psychometric require-
ments were selected for the final scale. However, initial sets often contained items referring to constructs
assumed to be related to alexithymia that were sometimes simply taken from scales measuring such other con-
structs (for instance, Taylor et al., 1985 ). Since many of these proxy items survived the selection procedure, the
final measure contained items, and/or factors that were not part of the original descriptions of the alexithymia
construct, resulting in re-descriptions, sometimes even redefinitions of alexithymia, and, thus, in a watering
down of the construct.
There is only one-way to solve these problems: we need general agreement about the alexithymia construct,
only then will it survive and have a future. This means acceptance of the description as presented by Nemiah
and Sifneos, not because these authors introduced the term alexithymia, but since they based their construct on
clinical observations, and the facets distracted out of these observations, should be the starting point of all alex-
ithymia scales. Moreover, it is, for the time being, the only thing we can agree on. Measurement scales should,
thus, cover all facets as mentioned by these authors, nothing less and nothing more. In short, the future of the
alexithymia construct lies in the past.
Acknowledgement
The authors are indebted to Merel Agenant, Lily Menco, Charlotte Ornstein, and Linde van Vlijmen for ordering the literature data, and to
various members of the alexithymia network, who sent us suggestions and information.
References
Apfel, R. J., & Sifneos, P. E. (1997). Alexithymia: concept and measurement. Psychotherapy and psychosomatics ,32, 180/C0190.
Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994a). The twenty-item Toronto alexithymia scale-I. Item selection and cross-validation of the
factor structure. Journal of psychosomatic Research ,38,2 3/C032.
Bagby, R. M., Quilty, L. C., Taylor, G. J., Grabe, H. J., Luminet, O., Verissimo, R., et al. (2009). Are there subtypes of alexithymia? Personality
and Individual Differences ,47, 413/C0418.
Bagby, R. M., Taylor, G. J., & Atkinson, L. (1988). Alexithymia: A comparative study of three self-report measures. Journal of Psychosomatic
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Bagby, R. M., Taylor, G. J., Dickens, S. E., & Parker, J. D. A. (2009). The Toronto Structured Interview for Alexithymia: Administration and
Scoring Guidelines, version 2. Unpublished manual .
8The first mentioned translations were given later for instance Apfel and Sifneos (1979) (‘alexithymia’, literally without words for feelings).252 9. MEASURES OF ALEXITHYMIA
III. EMOTION REGULATION