OVER VIEW OF THE MEASURES
The Rorschach Alexithymia Scale (RAS; Porcelli & Mihura, 2010 ) is the only alexithymia projection measure
discussed in this chapter, since all other alexithymia projection measures have insufficient psychometric proper-
ties. Although the psychometric data for the RAS are very limited the existing data are promising. For those clini-
cians who use the Rorschach as a diagnostic instrument, the RAS can be used to estimate TAS-20 alexithymia
scores.
Observation scales: Observation scales are meant to be filled out by raters on the basis of the knowledge s/he
already has, or has obtained in either a preceding interview or preceding observation of behavior. This means
that the quality of observation scales is among other things, dependent on the expertise and skills of the rater.
The 8-item dichotomous scored observation measure, the Beth Israel Hospital Psychosomatic Questionnaire
(BIQ, Sifneos, 1973 ), is the oldest alexithymia but, but its research utility was later largely surpassed by the
26-item Toronto Alexithymia Scale (TAS-26; Taylor et al., 1985 ).
The Modified Beth Israel Questionnaire (M-BIQ; Taylor et al., 1997 ;Bagby, Taylor, & Parker 1994b ) latest BIQ
improvement. The main differences with the original BIQ are: four more items, and a 7-point Likert-type
response format, instead of the original dichotomous scoring.
The California Q-set Alexithymia Prototype (CAQ-AP; Haviland & Reise, 1996a) is an alexithymia observation
scale, based on the California Q-statements set. The measure is time consuming ( 645 minutes) and needs
expertise. In fact, the measure was meant to be used by professionals.
The Observation Alexithymia Scale (OAS; Haviland et al., 2000 ) is a brief observation scale, based on the
CAQ-AP, to be used by professionals as well as laymen. The main difference with the CAQ-AP is that the state-
ments are written in ordinary language, understandable by laymen.
The Toronto Structured Interview for Alexithymia (TSIA; Bagby et al., 2006 ), was, as its name indicates, meant
to structure the preceding interview as much as possible (including probes and prompts), thereby reducing the
importance of the factor expertise and skills of the interviewer.
Self-rating scales: The quality of self-rating scales is fully dependent on the quality of the items. It is for this
reason that we will describe the history of development of the scales, and sources of the items included in to
the scales.
The 20-item Toronto Alexithymia Scale (TAS-20; Bagby et al., 1994a) had two precursors; the, above mentioned
TAS-26, and the Toronto Alexithymia Scale Revised (TAS-R; Taylor, Bagby, & Parker 1992 ). The final scale covers
three subscales: Difficulty identifying feelings, Difficulty describing feelings, and Externally-oriented thinking.
Most of the relative recent alexithymia research has been done with the TAS-20.
The 40-item Bermond Vorst Alexithymia Questionnaire (BVAQ; Vorst & Bermond 2001 ) has also extensively
been used in research, although less than the TAS-20. The scale covers five subscales: Inability to differentiate
between emotions, Inability to verbalize emotions, Inability to analyze emotions, Inability to fantasize, and
Inability to experience emotions. Higher order factor analyses indicated that these five subscales are part of two
higher dimensions: an alexithymia cognitive factor and an alexithymia affective factor. Scores on the scale can be
analyzed on subscale level, and on the level of the two dimensions mentioned. Since the two dimensions are
orthogonal, the 40-item-sum-total score is without meaning.
The Psychological Treatment Inventory Alexithymia Scale (PTI-AS; Gori et al., 2012 ) is an extremely short scale
of only five items.
Measurement of alexithymia in adolescents and children: Although this category contains observation scales as well
as self-rating scales, we opted to group them together, since the measurement of alexithymia in children has
specific problems.
The Alexithymia Observation Scale for Children (AOSC; Fukunishi et al., 1998 ) is a 12-item observation scale
covering two subscales: Difficulty communicating to others and Difficulty relating to others, to be filled out on
base of observations of behavior.
The Toronto Alexithymia Scale for Children (TAS12; Heaven et al., 2010 ;Rieffe et al., 2010 ) is a 12-item self-rat-
ing scale, containing the 12 items of the TAS-20, concerning the subscales Difficulty identifying feelings and
Difficulty describing feelings. There are two versions one contains the original TAS items, the other contains the
same items but now rewritten in children’s language.
The Emotional Awareness Questionnaire (EAQ-30; Rieffe et al., 2008 ) is a 30-item self-rating scale covering six
subscales: Differentiating emotions, Verbal sharing emotions, Analyzing emotions, Not hiding emotions, Bodily
awareness, and Attending to others’ emotions. The first three subscales aim to measure the same domains as the
TAS-20, the other three aim to measure alexithymia related features.230 9. MEASURES OF ALEXITHYMIA
III. EMOTION REGULATION