Description
In developing the TSIA Bagby et al. (2006) started with 60 interview questions, based on the TAS-26, TAS-20,
BIQ and other measures related to alexithymia. After a pilot study 43 items remained, and after an item selection
method much like that described for the TAS-20 (see section TAS-20), 24 items remained, six for each facet. These
facets are, with the exception of Imaginal processes (IMP, not measured by the TAS-20), comparable to those of
the TAS-20 and labeled: Identifying emotional feelings (DIF), Describing emotional feelings (DDF), and
Externally oriented thinking (EOT). These facets are part of two higher-order dimensions/subscales labeled:
Affect Awareness’ (AA 5DIF & DDF), and ‘Operative Thinking’ (OT 5EOT & IMP). All items have face validity
for their facet.
The TSIA manual provides guidelines for the administration (interview questions with probes and prompts).
Sample
The two samples in the Bagby et al. (2006) study comprised, (1) 136 normal adults from the general commu-
nity (41 males; 95 females; M532.3 years, SD59.78); and (2) 97 psychiatric outpatients (20 men; 77 women;
M532.9 years, SD511.9). Both samples were predominantly middle class and had at least a high school educa-
tion. Seven different raters were used, six had Masters degrees in clinical/counseling psychology, and one was a
research assistant with training and experience in diagnostic interviewing.
Reliability
Internal Consistency
Bagby et al. (2006) reported Cronbach alpha coefficients for the TSIA dimensions (AA & OT), and subscales, as
found in a community sample and a psychiatric outpatients sample, ranging from .70 to .88, with only one excep-
tion (community sample IMP .61). Grabe et al. (2009) ,Carretti et al. (2011) ,Meganck et al. (2011) , and Insleggers
et al. (2013) reported comparable findings.
Inter-Rater
Bagby et al. (2006) presented inter-rater reliabilities calculated by interclass correlation for the TSIA, the
higher-order factors AA and OT and the subscales for experts as well as non-expert. The expert results in the
patient sample for TSIA, AA, and OT were respectively .90, .86, and .93, whereas those for the subscales ranged
between .82 and .93. These coefficients were somewhat lower in the community sample (.73, .74, and .68, sub-
scales .71 to .84). The non-expert results were (clinical sample .83, .85 & .68, subscales .82 to .86; community sam-
ple .73, .75 & .68, subscales .69 to .75). Grabe et al. (2009) , and Carretti et al. (2011) in various patient groups
found interclass correlations comparable to those in the patient group of Bagby et al. (2006) , whereas Insleggers
et al. (2013) reported somewhat lower coefficients.
Validity
Convergent/Concurrent
Concurrent validity was established by correlations with the TAS-20: patient sample TSIA/TAS-20 (.68), TSIA-
AA/TAS-20 (.80), TSIA-OT/TAS-20 (.39), TSIA-DIF/TAS-20 (.77), TSIA-DDF/TAS-20 (.70), TSIA-EOT/TAS-20
(.55), and TSIA-IMP/TAS-20 (.11) ( Bagby et al., 2006 ). Of the correlations between TSIA and TAS-20 subscales we
mention only those claimed to measure the same construct: patient sample DIF/DIF (.63), DDF/DDF (.63), EOT/
EOT (.48). However, correlation coefficients in the community sample were lower TSIA/TAS-20 (.36), TSIA-AA/
TAS-20 (.42), TSIA-OT/TAS-20 (.20), TSIA-DIF/TAS-20 (.32), TSIA-DDF/TAS-20 (.42), TSIA-EOT/TAS-20 (.32),
TSIA-IMP/TAS-20 (.01), DIF/DIF (.29), DDF/DDF (.37), EOT/EOT (.47). Grabe et al. (2009) using psychiatric
inpatients, and Carretti et al. (2011) using a mixed group of healthy individuals, and psychiatric or medical out-
patients also presented correlations with the TAS-20 comparable to those of Bagby’s et al. community sample
(Grabe et al., ranging from .49 [TSIA] to .34 [IMP]), (Carretti et al., ranging from .53 [AA] to .05 [IMP]). Meganck
et al. (2011) reported a number of concurrent correlations found in a sample of psychiatric patients: TSIA/TAS-20
(.47), TSIA/OAS (.37), TSIA/Alexithymia (see Footnote 1) (.45), TSIA/M-BIQ (.76). The high correlation between
the TSIA and the M-BIQ was explained by the fact that the same rater completed both measures. Finally,
Inslegers et al. (2013) reported a correlation TSIA/TAS-20 (.34).
With the exception for the figures from Bagby’s et al. (2006) patient group, and the same rater TSIA/M-BIQ
correlation, all other correlations explain a maximum 28% of the variance indicating that these alexithymia scales238 9. MEASURES OF ALEXITHYMIA
III. EMOTION REGULATION