Background: The evaluation of alexithymic deficits has become increasingly desirable in health and psychopathology research. The purpose of this study was to calculate alexithymia cutoff scores for a recently developed self-report alexithymia questionnaire: the Bermond-Vorst Alexithymia Questionnaire Form B (BVAQ-B). Sampling: Three hundred subjects (47 eating-disordered patients and 253 healthy individuals) completed the BVAQ-B and the 20-item Toronto Alexithymia Scale (TAS-20). Methods: The TAS-20 was used as a gold standard for this research, with its previously established cutoff scores serving as diagnostic criteria for determining the presence or absence of alexithymia. The BVAQ-B cutoff score selection was based on the examination of psychometric data (i.e., the sensitivity and specificity of the BVAQ-B scores and receiver operating characteristic curve analyses) and of clinical data (i.e., BVAQ-B mean score of the control subjects, who were mostly nonalexithymic, and BVAQ-B mean score of a group of patients with eating disorders, the majority of whom were alexithymic). Results: This research found that the most appropriate BVAQ-B cutoff scores for determining the absence and presence of alexithymia were 43 and 53, respectively. Conclusion: In light of these findings, we believe that the BVAQ-B may also lend itself to a categorical evaluation of alexithymia, with these cutoff scores determining its absence or presence.

Insecure attachment and the inability to identify emotions have both been put forward as possible explanations for dysfunction of the emotional system in borderline personality disorder (BPD). This study aimed to test a model according to which the influence of attachment on the development of BPD in adolescence is mediated by alexithymia. Borderline severity was assessed by means of the Structured Interview for DSM-IV Personality Disorders. Attachment and alexithymia were measured respectively with the Relationship Styles Questionnaire and the Toronto Alexithymia Scale. Mediation analyses conducted on 105 participants (54 with BPD and 51 matched controls) suggest that the role of security and negative model of self (i.e., preoccupied and fearful attachment styles) in the development of BPD symptoms are mediated by alexithymia.

Several researchers point to disorganized attachment as a core feature of borderline personality disorder (BPD). However, recent studies suggest that specific internal working models (IWMs) of each parent combine to account for child outcomes and that a secure relationship with one parent can protect against the deleterious effects of an insecure relationship with the other parent. It was thus hypothesized that adolescents with BPD are more likely to be disorganized with both their parents, whereas non-clinical controls are more secure with at least one of their caregivers. Thirty-six adolescents with BPD and 30 control participants (aged 13–19) were included. Psychiatrist diagnosis was verified with the Structured Interview for DSM-IV Personality Disorders (SIDP-IV) and comorbidity was assessed using the Kiddie-SADS. Reported trauma was assessed with the Childhood Trauma Questionnaire (CTQ). Attachment IWMs of each parent were assessed with the Attachment Multiple Model Interview (AMMI), which enables separate coding for each attachment figure and in which disorganization is conceptualized as conflicting attachment strategies within a specific relationship. Results of a logistic regression analysis suggested that beyond insecure attachment, being disorganized not just with one but with both parents is particularly characteristic of adolescents with BPD. Conversely, belonging to the non-clinical group was predicted by higher security scores with the father and lower deactivation with the mother. Although higher levels of childhood abuse or neglect were reported by adolescents with BPD, the retained attachment dimensions predicted group membership over and above reported trauma. These findings have important implications for clinical intervention and highlight the protective role fathers may have.

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