This week for Take-a-Test Tuesday we’re taking the online alexithymia questionnaire.
Alexithymia refers to people who have difficulty identifying and describing emotions as well as differentiating between physical and emotional sensations. It’s not a formal diagnosis, but a way of describing a common set of experiences related to emotional dysfunction.
Some descriptions of alexithymia also include impoverished imagination and a tendency toward externally oriented (concrete) thinking. I found it interesting that both studies I cite below omitted these last two characteristics. Many of you who commented on the emotional dysfunction post last week questioned the inclusion of impoverished imagination, saying that you personally felt the opposite was true. I have to agree with this. My imagination is, if anything, overactive. Perhaps there is an autistic subtype of alexithymia?
Alexithymia is extremely common in autistic individuals. About 50% of people diagnosed with ASD have severe alexithymia, however nearly all people on the spectrum experience it to some degree. Among the general population, about 10% fit the alexithymia profile and parents of autistic children are more likely to be alexithymic than parents of nonautistic children.
When it comes to social communication, the line between autistic traits and alexithymic traits is blurry. Two recent studies (Bird et al, 2010 and Silani et al, 2008) suggest that alexithymia, not ASD, is responsible for impaired affective empathy.
The 2008 study looked at brain activity in autistic and nonautistic people with and without alexithymia. It found a correlation between a person’s level of alexithymia, brain activity in one of the regions believed to be responsible for identifying one’s own emotions, and scores on an empathy questionnaire. This was true of both the autistic and nonautistic participants, suggesting that impaired processing of emotion, not autism, is the source of impaired affective empathy.
The brain uses the same neural pathways for perceiving and interpreting our own emotions as well as the emotions of others, so it makes sense that if we cannot process our emotions easily, we’ll also struggle to process emotions demonstrated by others..
One question that remains unanswered is why autism and alexithymia occur together so frequently.
Many commenters on last week’s post recognized themselves in my description of my own emotional dysfunction, so I thought it would be interesting to take the Online Alexithymia Questionnaire. While not a clinically recognized measure of alexithymia, it is based on commonly used clinical screening questionnaires.
Pros and Cons of the Online Alexithymia Questionnaire
- Provides subscale scores with cutoffs
- Overall score is presented on a simple visual “severity” scale
- Includes questions phrased as self-observation (I feel . . .) and other observation (People tell me . . .)
- Not clinically tested or validated
- Unclear how cutoffs were derived
- Includes questions on topics that are not a part of generally accepted alexithymia definition
Taking the Test
The alexithymia questionnaires used in clinical research (TAS-20, BVAQ) aren’t available online, so I took the Online Alexithymia Questionnaire (OAQ-G2).
Take the test here. There are 37 questions. You have to answer at least 20 to get a result, meaning you can skip any you find overly invasive. The answers for each question become “grayed out” once you make a selection but you can go back and change your answer if you want to.
Scoring the Test
When you’re satisfied with your answers, click the “Evaluate Test” button and you’ll be given an overall score as well as 7 subscale scores. Here are mine:
Test Results: 141 Points.
Alexithymia: You show high alexithymic traits.
Difficulty Identifying Feelings: 23 Points <15 – 18> high alexithymic traits
Difficulty Describing Feelings: 17 Points <10 – 12> high alexithymic traits
Vicarious Interpretation of Feelings: 13 Points <8 – 9> high alexithymic traits
Externally-Oriented Thinking: 29 Points <18 – 21> high alexithymic traits
Restricted Imaginative Processes: 19 Points <18 – 21> some alexithymic traits
Problematic Interpersonal Relationships: 29 Points <15 – 18> high alexithymic traits
Sexual Difficulties and Disinterest: 11 Points <10 – 12> some alexithymic traits
The subscale scores in parentheses appear to be equivalent to the yellow area on the slider bar, meaning “some alexithymic traits.” A score below the range in parentheses indicates the absence of alexithymic traits (green area) and a score above indicates high alexithymic traits (orange area).
Keep in mind that the last two subscales, problematic interpersonal relationships and sexual difficulties/disinterest, aren’t specifically part of the formal definition of alexithymia. It’s possible that the sexual difficulties subscale could be impacted by whether a person is in a long-term relationship and feels comfortable with their partner. Also, externally-oriented thinking and restricted imaginative processes are not always included in clinical definitions of alexithymia. The first three subscales are the best gauge of the core deficits of alexithymia.
I was surprised by my score on externally oriented thinking. This item refers to a tendency to think in concrete, nonintrospective terms. I don’t view concrete and nonintrospective as synonymous, but that could be my autistic brain.
I think in concrete terms, but I also spend a lot of time examining my thoughts and feelings. I might spend more time on the latter because I have to consciously “check-in” with my feelings to identify them. However, neurotypical people may be spending more time considering their feelings as part of decision making or social interaction. My introspection usually tends toward “what the heck is going on?”
The Bottom Line
The Online Alexithymia Questionnaire is the only freely available alexithymia test. Although not scientifically validated, it appears to be a reasonable “amatuer” measure of alexithymic traits and a useful starting point for better understanding how you process emotions.