Reitske Meganck

Factorial Validity and Measurement Invariance of the 20-Item Toronto Alexithymia Scale in Clinical and Nonclinical Samples

The most widely used instrument to measure alexithymia is the 20-item Toronto Alexithymia Scale (TAS-20). However, different factor structures have been found in different languages. This study tests six published factor models and metric invariance across clinical and nonclinical samples. It also investigated whether there is a method effect of the negatively keyed items. Second-order models with alexithymia as a higher order factor are tested. Confirmatory factor analyses showed that the original factor model with three factors—difficulty identifying feelings (DIF); difficulty describing feelings (DDF) and externally oriented thinking (EOT)—is the best fitting model. Partial measurement invariance across samples was illustrated but requires further study. A weakness of the model is the low internal consistency of the third factor. Because models with a method factor had a better fit, future reconsideration of the negatively formulated items seems necessary. No evidence was found for the second-order models.

Frequency of and subjective response to critical incidents in the prediction of PTSD in emergency personnel

In this study, the authors compared the respective contribution of an individuals subjective response and the frequency of exposure to critical incidents to the development of symptoms of posttraumatic stress disorder (PTSD) in a sample of 136 nurses and ambulance personnel working in military facilities. They found no relationship between the frequency of encountered critical incidents and the occurrence of PTSD symptoms. The subjective response to a stressor contributed to the development of PTSD symptoms and was most strongly associated with intrusion, partial eta squared =.23, and hyperarousal symptoms, partial eta squared =.16. Stressors that elicited the most intense affects within this population were those involving children and those where workers encountered limitations in supplies and resources.

Tinnitus Severity and the Relation to Depressive Symptoms A Critical Study

Objective. In this study, the authors investigated whether tinnitus severity is a problem related to depression. If so, the following 2 conditions should be fulfilled:first, there should be evidence for the presence of moderate to severe depressive symptomatology in a substantial group of tinnitus patients; second, there should be evidence of a substantial relationship between depressive symptoms and tinnitus severity. Study Design. Cross-sectional. Setting. Ear, Nose, and Throat (ENT) Department of the Ghent University Hospital. Subjects and Methods. In total, 136 consecutive help-seeking tinnitus patients were seen by a psychologist, an audiologist, and an ENT specialist. All patients filled in the Beck Depression Inventory II (BDI-II) and the Tinnitus Handicap Inventory (THI) and underwent psychoacoustic measurement. Results. Mean scores indicate the presence of no or minimal depressive symptoms. There was a positive correlation (P < .01) between the BDI-II and the THI. No correlations were found between psychoacoustic measures and the self-report questionnaires. Linear regression analysis was performed to examine the predictive role of the 3 components of depression (cognitive, somatic, and affective) in tinnitus severity. Results show that only the somatic depression subscale of the BDI-II significantly predicted tinnitus severity, which can be explained because of content overlap between the BDI-II and the THI. Conclusion. Tinnitus does not appear to be a problem related to depression. The authors did not find a substantial group of tinnitus patients with moderate to severe depressive symptoms. The relation between depressive symptoms and tinnitus severity seems to be an artifact of content overlap between the BDI-II and the THI.

Relationship Patterns in Alexithymia: A Study Using the Core Conflictual Relationship Theme Method

Background: Alexithymia is a disturbance in regulating affective states. Clinical observations suggest that alexithymic patients relate to others in a specific way. This paper explores whether specific relationship or transference patterns are typical of alexithymia. Sampling and Methods: Relationship patterns were assessed by means of the Core Conflictual Relationship Theme method, standard categories version. This method examines transference patterns and was applied to clinical interview data collected from a sample (n = 31) of mental health outpatients. Alexithymia was assessed by means of a score on the 20-item Toronto Alexithymia Scale corrected for the degree of depression (measured by the Beck Depression Inventory-II). Data were analysed by means of the leaps and bounds regression algorithm for selecting optimal subsets of indicators and by bootstrapping to determine 95% confidence intervals. Results: First, we observed that alexithymia can be meaningfully explained by typical wishes, typical subjective perceptions of how others respond and one’s own typical responses to others. This result indicates that the more marked a patient’s alexithymic traits are, the more probable it is that specific transference themes come to the fore. Second, a set of three core indicators of trait alexithymia was mapped: little concern about being good to others, a strong perception of others as cooperative, and weak levels of reacting to others and to conflict by means of somatic symptoms. Conclusion: Alexithymia is related to a double interpersonal indifference: not much is expected from others, nor is there a personal urge to fulfill the expectations of others. Moreover, in alexithymia somatic symptoms proved to be non-reactive to interpersonal situations. Implications for diagnosis and treatment are highlighted. Limitations of our study are that alexithymia was only assessed with a self-report measure and that conclusions are based only upon data from a heterogeneous mental health sample.

Tinnitus severity and its association with cognitive and somatic anxiety: a critical study

Tinnitus has been defined as a phantom auditory perception. Research indicates the necessity to make a distinction between the physical symptom and the subjective severity of the tinnitus symptom, since especially the latter seems to vary among patients. The relationship between tinnitus severity and psychological variables has been well established. Anxiety is considered to be an important variable for understanding the differences in the subjective tinnitus severity. Although many studies confirm the relationship between anxiety and tinnitus severity, most studies do not take the possibility of shared method variance and content overlap between questionnaires into account. Furthermore, anxiety is a broad concept and contains both a cognitive and somatic dimension. Research including both dimensions of anxiety in tinnitus population is rare. According to us two conditions must be fulfilled before theorization on the relation is useful: (1) the presence of clinically relevant cognitive and/or somatic anxiety, (2) evidence of a substantial or “real” relationship. In our sample, almost 60% reported more than average cognitive anxiety and 40.8% reported clinical relevant somatic anxiety. After controlling for content overlap between the questionnaires used, the relation between tinnitus severity and cognitive and somatic anxiety remains significant. Two hypothetical models concerning this relationship that deserve future research attention are described.

Alexithymia, social detachment and cognitive processing

Using lexical content analysis (linguistic inquiry and word count), the hypotheses that social detachment and impaired cognitive processing are typical for alexithymia are investigated. Based on clinical interviews with 32 outpatients (mixed diagnoses), we found support for the hypotheses for the externally oriented thinking facet of alexithymia only.

The Observer Alexithymia Scale: A Reliable and Valid Alternative for Alexithymia Measurement?

In this study, we evaluated the reliability and validity of the Dutch version of the Observer Alexithymia Scale (OAS; Haviland, Warren, & Riggs, 2000) while addressing shortcomings of earlier research. Internal consistency and test–retest reliability were found to be adequate, whereas interrater reliability was insufficient. The original five-factor model (Distant, Uninsightful, Somatizing, Humorless, Rigid) with item parcels showed excellent fit, indicating adequate translation. Alternative models were tested to overcome problems with the parcel method, and all showed poor fit. OAS total scores correlated .23 with the 20-item Toronto Alexithymia Scale (Bagby, Parker, & Taylor, 1994; Bagby, Taylor, & Parker, 1994) and .50 with the Toronto Structured Interview for Alexithymia (Bagby, Taylor, Parker, & Dickens, 2006). These problematic results on validity compromise the use of the OAS as an alexithymia measure.

Psychoanalytic Single Cases Published in ISI-Ranked Journals: The Construction of an Online Archive

nique (e.g. music therapy, bodypacking, wilderness therapy, etc. were not included), (3) the case study is either the focus of the article or an illustrative vignette of sufficient size (more than 50% of the publication or longer than five pages), (4) the case study is written in English, French, or German, and (5) the case study presents an original analysis of therapeutic data. Four hundred and fifty-three cases were selected according to these criteria. The full text of 8 cases could not be obtained. The full texts of the remaining 445 articles were screened with the Inventory of Basic Information in Single Cases (IBISC), an ad hoc constructed inventory that assesses the presence of basic information on research method, patient, therapist, and therapy. The IBISC, the IBISC manual, and the full results of the screening are available at www.singlecasearchive.com. What follows is a concise overview of salient results of the screening.

Reliability and factor structure in an adolescent sample of the Dutch 20-item Toronto Alexithymia Scale.

This study investigated the psychometric properties of the 20-item Toronto Alexithymia Scale (TAS–20) in an adolescent sample (N = 406, ages 12 to 17). This is rarely done even though the TAS–20 is used in adolescent research. Five published factor models were tested. For good fitting models, a second-order model with alexithymia as a higher-order factor and metric invariance across sex and age groups was tested. Confirmatory factor analyses showed that the original three-factor model and a four-factor model provided acceptable fit. Both models were invariant across sex, but not across age. Second-order models did not provide good fit. Reliability was good for the “Difficulty identifying feelings” subscale and acceptable for the “Difficulty describing feelings” subscale, but not for the “Externally oriented thinking” subscale. Measuring alexithymia with the TAS–20 in adolescents thus seems problematic, especially in younger age groups.

Interpersonal problems and cognitive characteristics of interpersonal representations in Alexithymia: a study using a self-report and interview-based measure of Alexithymia

Abstract In this study, associations between alexithymia, interpersonal problems, and cognitive-structural aspects of internal interpersonal representations were examined. Alexithymia was measured using the Toronto Structured Interview for Alexithymia (TSIA) and the 20-item Toronto Alexithymia Scale (TAS-20). To measure interpersonal problems, the dominance and affiliation dimension scores of the Inventory of Interpersonal Problems were used, and cognitive-structural characteristics of interpersonal representations were measured using the Social Cognition and Object Relations Scale (SCORS). As hypothesized, alexithymia was related to cold and withdrawn, but not to dominant or submissive, interpersonal functioning. In terms of the SCORS, alexithymia was negatively related to complexity of interpersonal representations, both in TAT and in interview narratives, indicating a link between alexithymia and mentalization. However, alexithymia was related only to the dimension of social causality when this dimension was scored on TAT narratives. Overall, the TSIA provides the most consistent and stable results after controlling for negative affectivity.