Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Haviland, M. G. Search for Related Content PubMed Citation Articles by Haviland, M. G. Other Personality Disorders Tests

The Validity of the California Q-Set Alexithymia Prototype

Received November 25, 1997; revised March 19, 1998; accepted April 2, 1998. From the Department of Psychiatry, Loma Linda University School of Medicine, Loma Linda, California. Address reprint requests to Dr. Haviland, Department of Psychiatry, Loma Linda University School of Medicine, Post Office Box 1007, Loma Linda, CA 92354–1007. e-mail:haviland{at}ix.netcom.com

ABSTRACT

The author examined the validity of the California Q-set Alexithymia Prototype (CAQ-AP), an observer- and self-report measure of the alexithymia construct. Alexithymia similarity scores (based on observer reports) were correlated with scores on several relevant self-report scales in a sample of 155 undergraduate college students. Alexithymia was positively correlated with neuroticism, depression, and anxiety; and negatively with extraversion, openness, and emotional expression. These correlations were statistically significant (P<0.05) and in the expected direction. The CAQ-AP has passed its second validity check and, again, can be recommended as an observer measure of the alexithymia construct.

Key Words: Brief Report • Alexithymia • California Q-Set

The California Q-set Alexithymia Prototype (CAQ-AP)¹ is a reliable, consensual description of the alexithymia construct² and a potentially useful observer- and self-report measure. To construct the CAQ-AP, 13 professional judges described the prototypical alexithymic person by using 100 personality descriptors (items) that ostensibly cover the domain of personality. Descriptors were printed on small index cards, and each judge sorted them into a forced, nine-category distribution (9=most characteristic of an alexithymic person, 1=most uncharacteristic). Individual item scores were summed, ranked, and converted to the original nine-point distribution (this is the CAQ-AP). Examples of most characteristic items in the prototype are "is emotionally bland; has flattened affect" and "anxiety and tension find outlet in bodily symptoms." Among the least characteristic are "engages in personal fantasy and daydreams, fictional speculations" and "has insight into own motives and behavior." To rate alexithymia, observers describe their targets (people can describe themselves, however) by using the same 100 personality descriptors. To compare individual sorts with the CAQ-AP, sorts 1) can be correlated, and r is used as a similarity index or 2) can be compared item-by-item (items are arranged by direction and magnitude of difference).³

In its first validity test,¹ the CAQ-AP was correlated with two theoretical constructs, overcontrol and ego-resiliency,⁴ for which CAQ-set prototypes were available. Alexithymic individuals are contained and inflexible; thus, as expected, alexithymia was positively related to overcontrol (r=0.45) and negatively related to ego-resiliency (r=-0.70). Item-level analyses, however, suggested that alexithymia is a unique personality construct and not adequately explained by overcontrol and ego-resiliency.

Observer alexithymia reports are particularly important, because alexithymic people may not be well equipped to rate themselves.^2,5 The most psychometrically sound and popular alexithymia measure, however, is the self-report Twenty-Item Toronto Alexithymia Scale (TAS-20)⁶; it is used most commonly by itself, despite the recommendation that it be used with observer measures.² The CAQ-AP is a more flexible tool in that it may be used by clinicians and laypersons as an observer report and by patients as a self-report.^7,8

The primary purpose of the present study, done in 1997, is to encourage use of the CAQ-AP by conducting a second test of its validity. CAQ-AP similarity scores (observer ratings) will be correlated with self-ratings of the "Big Five" personality factors (neuroticism, extraversion, openness, agreeableness, and conscientiousness)^9,10 and with self-ratings of depression, anxiety, and emotional expression. Alexithymic people can be described in five-factor terms as a combination of neurotic, introverted, and closed to experience; and studies of alexithymia and other personality dimensions suggest that alexithymia similarity scores will be positively correlated (in the low-to-moderate range) with neuroticism, depression, and anxiety; and negatively (in the low-to-moderate range) with extraversion, openness, and emotional expression.^2,11

METHODS

Subjects
The subjects were 155 undergraduate college students (84 women and 71 men) ranging in age from 17 to 29 years (mean=20, standard deviation=2) participating in the Riverside Accuracy Project at the University of California, Riverside.¹² Q-sort descriptions were provided by college acquaintances; all 155 subjects were rated by 1 acquaintance, and 108 were described by 2. For those described by two raters, the more reliable composite description was used (individual item scores were summed, ranked, and converted to the original nine-point distribution). Data on the psychological similarity (or dissimilarity) between the raters and subjects and on interjudge and judge–subject agreement are provided in the original report.¹²

Alexithymia Similarity Scores
Individual sorts were correlated with the CAQ-AP, and r was used as a similarity index. Scores can range from -1.00 (completely dissimilar) to +1.00 (completely similar).

Self-Reports
To measure the "Big Five" personality factors, depression, anxiety, and emotional expression, the following were used: the NEO Personality Inventory (NEO-PI),¹⁰ the Beck Depression Inventory (BDI),¹³ the NEO-PI anxiety facet score, and the emotional expression subscale of the Social Skills Inventory.¹⁴

Statistical Analyses
To compare mean differences, t-tests for independent samples were used. To evaluate the relationships among the observer and self-reports, correlation (r) was used. For all tests of statistical significance, alpha was set at 0.05.

RESULTS

Students' alexithymia similarity scores ranged from -0.61 to 0.21 (mean=-0.28, standard deviation=0.18); nine were positive. Average scores for women (-0.29) and men were similar (-0.26), and the difference was not statistically significant at the 0.05 level.

The most alexithymic student (alexithymia similarity score=0.21) was a 21-year-old woman with the highest BDI score (37) and relatively high scores for anxiety and neuroticism (both 90th percentile), and relatively low scores for extraversion, openness, and emotional expression (percentile range: 10–14). The least alexithymic student also was a 21-year-old woman with relatively high scores for anxiety and neuroticism (84th and 90th percentiles, respectively), but very high scores for extraversion (90th percentile) and openness (99th percentile), and low-to-mid-range scores for depression (BDI score=2) and emotional expression (62nd percentile).

The correlations between observer alexithymia reports and self-reports and among self-reports are shown in Table 1. As expected, alexithymia correlated positively with neuroticism, depression, and anxiety; and negatively with extraversion, openness, and emotional expression (P<0.05). The nonsignificant correlation between alexithymia and conscientiousness was expected, whereas the significant correlation with agreeableness was not.

View this table: [in this window] [in a new window]

TABLE 1.

DISCUSSION

The CAQ-AP performed impressively well in its first "real-life" test. Observers' alexithymia reports, albeit indirect, were correlated as expected with a wide variety of relevant constructs, as measured by conventional self-report inventories. This was a modest test, however; the most alexithymic student had a CAQ-AP similarity score of 0.21. Clearly, the validity of the CAQ-AP must be evaluated in samples in which the base rate of alexithymia is high. Moreover, reasonable correspondence between CAQ-AP similarity scores and scores on the self-report TAS-20 must be demonstrated.

The Q-sort method, however, is not without its drawbacks. It is a tedious procedure, particularly if judges must rate several people. Moreover, the question of whether using human judges, specifically lay judges, is an appropriate method to gather data on personality has been the subject of vigorous and, at times, acrimonious debate, despite impressive research that documents the method's validity.^15,16 Thus, it might be helpful to compare lay and professional sorts, and CAQ-AP scores with scores on the modified Twelve-Item Beth Israel Hospital Psychosomatic Questionnaire,² a promising, but not well studied, clinician-rated report.

Nevertheless, given available reliability and validity data, the strengths of the Q-sort method,^3,7,8 and the desirability of measuring alexithymia with observer reports,^2,5 it seems reasonable to recommend, again, the use of the CAQ-AP. Studies in which observer- and self-reports are used are rare, and important questions about alexithymia remain unanswered. We do not know, for example, whether alexithymia is a latent trait or a class or whether among people who are neurotic, introverted, and closed to experience (or among people who are overcontrolled and lacking ego-resiliency) some are alexithymic and others are not. Studies in which multiple measures are used might help answer these and other questions and allow more rigorous testing of the latest intriguing theories.⁵

ACKNOWLEDGMENTS

The author thanks David Funder and Michael Furr, University of California, Riverside, for their assistance with this study.

REFERENCES

1. Haviland MG, Reise SP: A California Q-set alexithymia prototype and its relationship to ego-control and ego-resiliency. J Psychosom Res 1996; 41:597–608[Medline]
2. Taylor GJ, Bagby RM, Parker JDA: Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness. Cambridge, UK, Cambridge University Press, 1997
3. Block J: The Q-Sort Method in Personality Assessment and Psychiatric Research (reprint edition). Palo Alto, CA, Consulting Psychologists Press, 1961/1978
4. Block J: Some enduring and consequential structures of personality, in Further Explorations in Personality, edited by Rabin AI, Aronoff J, Barclay AM, et al. New York, Wiley, 1981, pp. 27–43
5. Lane RD, Ahern GL, Schwartz GE, et al: Is alexithymia the emotional equivalent of blindsight? Biol Psychiatry 1997; 42:834–844[Medline]
6. Bagby RM, Parker JDA, Taylor GJ: The Twenty-Item Toronto Alexithymia Scale—I. Item selection and cross-validation of the factor structure. J Psychosom Res 1994; 38:23–32[Medline]
7. Ozer DJ: The Q-sort method and the study of personality development, in Studying Lives Through Time: Personality and Development, edited by Funder DC, Parke RD, Tomlinson-Keasey C, et al. Washington DC, American Psychological Association, 1993, pp. 147–168
8. Caspi A, Block J, Block J, et al: A "common-language" version of the California Child Q-set for personality assessment. Psychol Assess 1992; 4:512–523
9. Goldberg LR: The structure of phenotypic personality traits. Am Psychol 1993; 48:26–34[Medline]
10. Costa PT Jr, McCrae RR: The NEO Personality Inventory Manual. Odessa, FL, Psychological Assessment Resources, 1985
11. Bagby RM, Taylor GJ, Parker JDA: The Twenty-Item Toronto Alexithymia Scale—II. Convergent, discriminant, and concurrent validity. J Psychosom Res 1994;38:33–40
12. Funder DC, Kolar DC, Blackman MC: Agreement among judges of personality: interpersonal relations, similarity, and acquaintanceship. J Pers Soc Psychol 1995; 69:656–672[Medline]
13. Beck AT, Steer RA: Beck Depression Inventory Manual. San Antonio, TX, The Psychological Corporation, 1987
14. Riggio RE: Assessment of basic social skills. J Pers Soc Psychol 1986; 51:649–660
15. Funder DC: Judgments as data for personality and developmental psychology: error versus accuracy, in Studying Lives Through Time: Personality and Development, edited by Funder DC, Parke RD, Tomlinson-Keasey C, et al. Washington DC, American Psychological Association, 1993, pp. 121–146
16. Funder DC: On the accuracy of personality judgment: a realistic approach. Psychol Rev 1995; 102:652–670[Medline]

This article has been cited by other articles:

				K. Honkalampi, J. Hintikka, E. Laukkanen, J. Lehtonen, and H. Viinamäki Alexithymia and Depression: A Prospective Study of Patients With Major Depressive Disorder Psychosomatics, June 1, 2001; 42(3): 229 - 234. [Abstract] [Full Text]

				R. D. Lane, L. Sechrest, R. Riedel, D. E. Shapiro, and A. W. Kaszniak Pervasive Emotion Recognition Deficit Common to Alexithymia and the Repressive Coping Style Psychosom Med, July 1, 2000; 62(4): 492 - 501. [Abstract] [Full Text] [PDF]

Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Articles & Searches Download to citation manager Citing Articles via HighWire Citing Articles via Google Scholar Articles by Haviland, M. G. Search for Related Content PubMed Citation Articles by Haviland, M. G. Other Personality Disorders Tests

Get information about faster international access.

Privacy Policy

Copyright © 1998 Academy of Psychosomatic Medicine. All rights reserved.

Home | Search | Current Issue | Past Issues | Subscribe | All APPI Journals | Help | Contact Us