OBSERVATION SCALES
Modified Beth Israel Questionnaire (M-BIQ)
(Taylor et al., 1997 )
Variable
As a measure of alexithymia, the M-BIQ was developed in order to improve on the psychometric properties of
the Beth Israel Questionnaire (BIQ; see below).
Description
The Beth Israel Questionnaire (BIQ) ( Sifneos, 1973 ) was the first alexithymia scale published. It was developed
to provide an alexithymia observation scale, which has to be filled out, using a dichotomous response format, by
attending therapists, based on knowledge s/he already has, or has obtained in a preceding interview. The BIQ
comprises 17 items of which eight refer to alexithymia (6 indicative and two contra-indicative). The core items
cover the following domains: verbalizing emotions, emotion expression, fantasy, and external thinking. All
reviewers ( Paulson, 1985; Sriram et al., 1988 ;Bretagne et al., 1992 ; and Linden et al., 1995 ), agreed that, under the
condition that the interview is structured and recorded, the BIQ has acceptable psychometric properties. Taylor
et al. (1997) have produced a Modified Beth Israel Questionnaire (M-BIQ). Adaptation was considered necessary
since studies that used separate interviews to rate the same patients reported low inter-rater reliabilities, indicat-
ing that the scores are influenced by the experience, bias, and style of the interviewer ( Taylor et al., 2000 ). The
M-BIQ items were first published in Taylor et al. (1997) , and psychometric data were added later by Bagby et al.
(1994b) . BIQ items were rewritten and four new items (referring to fantasy and dreaming) were added to the
original eight BIQ items. In addition, the rating scale was changed from a dichotomous to a 7-point Likert-type
format. The resulting 12-item questionnaire comprises six items pertaining to the ability to identify and verbally
communicate feelings (Affect Awareness /C0AA), and six items pertaining to imaginal activity and externally-
oriented thinking (Operatory Thinking /C0OT) ( Bagby et al., 1994b ).
All items have sufficient face validity.
Sample
The two Bagby et al. (1994b) samples comprised (1) 39 patients (14 males; 25 females, M536.62 years,
SD510.56) referred for assessment and possible treatment in the behavioral medicine out-patient clinic; and
(2) 85 undergraduate students (28 males; 55 females, M521.47 years. SD 55.24), respectively.
Reliability
Internal Consistency
Cronbach alpha coefficients reported by Fukunishi, Nakagawa, Nakamura, Kikuchi, and Takubo (1997) ranged
from .70 to .85 ( M5.79). Comparable alpha coefficients were reported (.90) by Haviland, Warren, Riggs, and
Nitch (2002) , as well as (.83) by Lumley, Gustavson, Partridge, and Labouvie-Vief (2005) , and (.85) by Meganck
et al. (2011) .
Test/C0Retest
Taylor et al. (2000) reported a test /C0retest reliability coefficient over a three-month interval of .71 for a college
student sample and .51 for a psychiatric outpatients’ sample.
Inter-Rater
Bagby et al. (1994b) reported significant inter-rater reliability coefficients among three clinicians who inter-
viewed 39 outpatients referred to a Behavioral Medicine Clinic (Kappa .51).
Validity
Convergent/Concurrent
Haviland et al. (2002) reported positive correlations between the M-BIQ and the Observation Alexithymia
Scale (OAS; Haviland et al., 2000 ; see section below on OAS) of .69, between the M-BIQ subscale AA and OAS of
.75, and between the M-BIQ subscale OT of .48, while the correlations between M-BIQ and OAS subscales varied232 9. MEASURES OF ALEXITHYMIA
III. EMOTION REGULATION