The criterion validity of the Toronto Alexithymia Scale (TAS) was assessed by administering the scale to 46 patients referred to a behavioral medicine outpatient clinic. Clinical ratings derived from observed interviews served as the criterion. TAS scores were significantly higher for the group of patients identified by two out of three raters as "alexithymic" than for the group identified as "nonalexithymic." On the basis of these findings, preliminary TAS cutoff scores were suggested. The results from this study and from previous investigations assessing the reliability and construct validity of the TAS indicate that it is currently the psychometrically best-validated measure of alexithymia. Further refinement and cross-validation with other clinical samples are recommended.

Specific coping styles are associated with varied risk of burnout in ED staff across several different types of hospitals in a regional network. Coping style intervention may reduce burnout, while leading to improvement in staff well-being and patient outcomes. Further studies should focus on building and sustaining task-oriented coping, along with alternatives to emotion-oriented coping.

Twenty patients with inflammatory bowel disease and twenty psychoneurotic patients were studied to assess differences in psychopathology, verbal expression and fantasy formation. The method combined clinical observation, self-assessment questionnaires and quantified projective tests. The psychoneurotic patients showed a higher level of psychopathology, were more verbally expressive, more able to verbalize emotion, and better able to modulate their emotions. Differences in fantasy formation were found. The results provide partial support for the concept of alexithymia (pensée opératoire), a cluster of cognitive traits which have been reported in many psychosomatic patients.

Previous studies have shown that measurement of verbal affective expression is influenced by the method used for obtaining speech samples, thereby supporting a situation-dependent, or state concept of alexithymia. In this study monadic speech samples obtained from 20 psychoneurotic and 20 psychosomatic patients, using selected thematic apperception test (TAT) cards, were examined using different methods of content analysis. Although no differences were found with the Gottschalk-Gleser anxiety, hostility outward and hope scales, the psychosomatic patients had a more limited emotional vocabulary than the psychoneurotic patients as measured by an ‘affect vocabulary score’ (AVS). In contrast to the Gottschalk-Gleser scores (GGS), the AVS correlated with measures of fantasizing ability and would appear to be a more valid method of measuring alexithymia. The findings also supported a trait concept rather than a state concept of alexithymia.

Psychopathology and verbal expression were investigated in 20 psychoneurotic patients and 20 psychosomatic patients (10 patients with ulcerative colitis and 10 patients with Crohn’s disease). The Crohn’s disease patients showed as much psychopathology as the psychoneurotic patients, but the ulcerative colitis patients showed significantly less psychopathology. However, the Crohn’s disease and ulcerative colitis patients showed a similar reduction in verbal-emotional expression (alexithymia), when they were compared separately with the psychoneurotic patients. It was concluded that alexithymic characteristics are independent from other forms of psychopathology and may be more important in the pathogenesis of psychosomatic disorder.