orthogonal higher factors involved in alexithymia that were called ‘Affective’ (AFF) and ‘Cognitive’ (COG).
Bagby et al. (2009) tested seven models, although the model preferred by Bermond et al. (2007) was not included,
two of their models came close. A 5-factor hierarchical model in which IDEN, VERB, and ANA nested under one
higher order factor, and EMO and FAN under another correlating higher-order factor, and a 5-factor hierarchical
model in which IDEN, VERB are nested under one higher order factor, and ANA, EMO & FAN under another
correlating higher-order factor. The data indicated good fit for both models in three out of five samples and in
the pooled sample, whereas there was, according to the norms as used by ( Bagby et al., 1994a, and Taylor et al.,
2003 ) acceptable fit in all samples5. These results provide confirmation for the original model. Moreover, the two
dimensions in the emotional experience have also been theoretically substantiated ( Bermond, 2008 ).
Types of alexithymia: Since there are two orthogonal higher factors or alexithymia dimensions incorporated into
BVAQ scores, interpretation of the BVAQ-40-item sum scores is senseless. The BVAQ provides two sum scores:
BVAQ-COG and BVAQ-AFF, making four extreme types identifiable, three of which have reduced capacities in
one or both alexithymia dimensions. Alexithymia types were predicted on base of the neuropsychology of emo-
tions ( Bermond, 1997 ) and called type I (alexithymia as described by Nemiah and Sifneos; severe reductions in
both AFF and COG), type II alexithymia (severe reductions in COG together with at least normal AFF capabili-
ties), type III, the opposite of type II (severe reductions in AFF together with at least normal COG capacities).
Finally, the type scoring favorable on both BVAQ dimensions was called lexithym ( Bermond et al., 2007 ). Since
the two higher order factors interact with one another in their relations with other constructs, the four extreme
groups have very different personality traits, as is indicated by Moormann et al. (2008) . The idea of various types
of alexithymia has been challenged ( Bagby et al., 2009; Mattila et al., 2010 ). In short, the arguments come down to
the fact that alexithymia and the two alexithymia dimensions are dimensional latent traits; not categorical, and
for this reason the four extreme groups should not be called types, it is thus, a debate about language, not a sci-
entific debate nor a debate about alexithymia.6
In the Dutch sample the correlations between subscales varied for the 40-item version between .02 (EMO/
IDEN) and .43 (VERB/ANA), mean .20. Comparable, but somewhat lower, correlations were found in the
Belgian (mean .14) and English (mean .20) samples ( Vorst & Bermond, 2001 ).Morera et al. (2005) reported com-
parable figures, Mu¨ller et al. (2003) higher figures. Correlations between subscales have also been reported for
the BVAQ-B form ( Zech et al., 1999; Deborde, Berthoz, Perdereau, Coros, & Jeammet 2004, 2007; Berthoz et al.,
2007; and Sauvage & Loas, 2006 ). Although there is more variance in these figures, the mean scores are fully com-
parable (ranging from .39 VERB/ANA, to .09 IDEN/EMO). The figures for VERB/ANA and VERB/IDEN are rel-
atively high, in all studies mentioned, however, the mean correlations still explain less than 17% of the variance.
The correlations between the two higher order factors in the Bermond et al. (2007) study ranged over the seven
samples between .06 and .27, mean .15; Deborde et al. (2004) reported (.06).
Criterion/Predictive
Although the number of BVAQ publications is less compared to the TAS-20, BVAQ scores have also been
related to an extensive array of other constructs. Many of these studies either related the other construct with
specific BVAQ subscales, the BVAQ alexithymia dimensions COG & AFF, or one of the alexithymia types. For
instance, BVAQ-AFF is positively related to schizoid personality disorder, COG is positively related with
avoidant-personality traits, whereas both COG and AFF are both negatively related to schizotypal personality
disorder ( De Rick & Vanheule, 2007 ). Dissociative-proneness correlates negatively with subscale IDEN and posi-
tively with FAN ( Elzinga, Bermond, & van Dyck 2002 ). Autism as well as childhood sexual abuse are associated
5It should be noted that in Bagby’s et al. (2009) study a less demanding model produced better fit, but that is the logical consequence of being
less demanding.
6The arguments boil down to the idea that alexithymia is a dimensional latent trait ( Mattila et al., 2010 ). The BVAQ authors agree with the
idea of dimensionality, proposing two more or less normally distributed higher order factors. Combinations of selections out these dimensions
could be referred to as ‘types’ as ( Bagby et al., 2009 ). However, playing with the word type, Bagby et al self-contradictory change to a
categorical instead of dimensional view of alexithymia: ‘To infer variants or types, one must use subjects as the variable and identify if these
subjects sort into meaningful “clusters” ’ (Bagby et al., ibid). One either adheres to a dimensional or a categorical view of a construct. They
further state that if there are two subtypes (in the meaning of dimensions) of alexithymia, this should result in two types of clusters
(categories) in a cluster analysis, where certain types of clusters should correspond with distinctions on the first dimension and the other
types of cluster with the second. This makes no sense. If one were to distinguish people based on wealth and height, one cannot expect to find
clusters that correspond with either poor or wealthy and tall or short people. As the cluster-analysis performed by Bagby et al. is groundless,
the results are meaningless.245 SELF-RATING SCALES
III. EMOTION REGULATION