An Examination of the Topology and Measurement of the Alexithymia Construct Using Network Analysis

ABSTRACT

There is some ongoing controversy surrounding the definition and measurement of the alexithymia construct. Whereas most researchers describe 4 components comprising the construct (difficulty identifying feelings, difficulty describing feelings, restricted fantasizing, and externally oriented thinking), some include a 5th component, which is defined as “reduced experiencing of emotional feelings.” This study examined the topology and measurement of alexithymia using the method of network analysis with data from a heterogeneous multilanguage sample (N = 1,696) that had completed the Bermond–Vorst Alexithymia Questionnaire (BVAQ; Vorst & Bermond, 2001). The BVAQ includes an Emotionalizing subscale for assessing the purported 5th component; we compared the network analyses conducted both with and without the Emotionalizing items. The results revealed strong associations between Emotionalizing and Analyzing (externally oriented thinking) items, but Emotionalizing items had almost as many negative as positive connections with items assessing the other components of the construct. A comparison of communities identified by modularity analyses of the 2 networks failed to support emotionalizing as a distinct component of the construct. In addition, network metrics revealed that Fantasizing items were particularly weak within both networks, suggesting that reduced fantasizing might be a peripheral component of the alexithymia construct. Implications for the measurement and treatment of alexithymia are discussed.

Acknowledgments

The authors thank our colleagues in Belgium, France, Germany, and Portugal, who made available their data for this study.

Funding

This research was supported by a Joseph-Armand Bombardier Doctoral Scholarship awarded to Carolyn A. Watters by the Social Sciences and Humanities Research Council of Canada (Grant 767–2012–1272).

Notes

¹ Nemiah et al. (1976) noted that an impoverished fantasy life and externally oriented thinking style correspond to the concept of pensée opératoire (operative thinking) described by Marty and de M'Uzan (1963).

² Because the BVAQ is a copyrighted instrument, and at the request of the developers, we have paraphrased all of the items we cite.

³ Taylor (2012) published a case report of a 31-year-old male alexithymic patient, which illustrates the application of the various psychotherapeutic techniques.