Chapter 2 56 effort on training, administration, scoring and interpreting. The pros and cons of which diagnostic instruments to administer should be weighed up by the clinician. To this end, we list several of the available instruments in the following section. We have grouped each instrument according to the ‘era’ of alexithymia in which it was developed, although in current practice, all are being used interchangeably. 5.1.1 Alexithymia 2.0 Below is a brief description of the most used measuring instruments. A more extensive list can be found in the review by Maes, Sabbe, Luyten, and Beukeleirs [97] in which they include some of the older questionnaires and measuring instruments, most of which are not, or hardly ever, used anymore, as well as some more broadly oriented diagnostic tests that include alexithymia as a subscale. Three types of instruments are distinguished within this domain: self-reporting questionnaires, observer rating scales and (semi-structured) interviews. As several self-reporting questionnaires, observer rating scales and interviews have been found to be only partly interrelated, it is commonly advised to use instruments from different categories when assessing alexithymia, as this helps to cover multiple aspects of the alexithymia concept. We will discuss the most used instruments of each category. Toronto Alexithymia Scale (TAS-20) The Toronto Alexithymia Scale (TAS-20) is by far the most widely used instrument to measure alexithymia [101-103]. The TAS-20 is a self-reporting questionnaire consisting of twenty items in which the respondent must indicate on a Likert scale to what extent he recognizes himself in the item. Factor analysis confirms that the test measures three characteristics of alexithymia: difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking. The fourth characteristic, lack of fantasizing is not included in the test. Also, there is no option to inspect results on the questionnaire at the level of the two higher order factors of the ‘Toronto model’. Although the questionnaire is considered to provide a valid measure of the concept when the total test score is used, there is criticism concerning the validity of the separate characteristics and their reliability in specific populations [54, 62]. For these reasons, Kooiman and colleagues [99] advised against the use of the TAS-20 for clinical purposes, especially when questionnaires are being considered an option to replace other, more extensive tests. Bermond-Vorst Alexithymia Questionnaire (BVAQ-40) A second self-reporting questionnaire is the Bermond-Vorst Alexithymia Questionnaire (BVAQ-40) [58]. The BVAQ is presumably the second most used alexithymia questionnaire in research and practice after the TAS- 20. In line with Vorst and Bermond’s model of alexithymia, the questionnaire is more extensive than
RkJQdWJsaXNoZXIy MjY0ODMw