It is suggested in this paper that alexithymia may be a graded behavioral characteristic in much the same way as psychological dimensions are. Under this assumption every person would possess an alexithymic score, however low it could be, and the basis for distinguishing between diagnostic groups would thence be quantitative rather than qualitative. The measurement of alexithymia in any given individual poses two main problems: the nature of the underlying phenomenon and the instruments that should be used for its depiction. Whether alexithymia is a trait, a state, or both cannot be answered confidently at present. On the other hand, its quantitative assessment depends upon an interaction between phenomenon, observer and situation. Some data bearing on the application of the Beth Israel Alexithymic and Psychosomatic Questionnaire by informed and uninformed interviewers suggest the need for reliability studies of this instrument. Also advanced is the possibility that some aspects of the syndrome (reflected differently in the questionnaire items) might be easier to detect or more amenable to quantitative assessment, thus suggesting that some weighting of items is needed in order to obtain a total alexithymia score.

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