Cross-cultural validation and measurement invariance of the Perth Alexithymia Questionnaire (PAQ): a study in Iran and the USA

ABSTRACT Objective Alexithymia is a trait defined by difficulty in identifying and describing feelings, as well as externally oriented thinking. It is an important transdiagnostic risk factor for a range of psychopathologies, and therefore its assessment is of substantial interest. Recently, the Perth Alexithymia Questionnaire (PAQ) was developed to try to enable more comprehensive assessments of alexithymia. To date, no studies have examined the PAQ’s psychometric properties among adolescents, and few have examined non-Western populations. Method To address these gaps, here we examined the psychometric properties of the PAQ among three samples of Iranian adolescents (N = 557, 53% female, Mage = 14.94, SD = 1.29), Iranian adults (N = 926, 62% female, Mage = 32.52, SD = 9.65) and American adults (N = 242, 40% female, Mage = 40.69, SD = 11.91). Results Confirmatory factor analysis supported the intended five-factor model (that distinguished between different facets of alexithymia across positive and negative emotions) within all three samples. This five-factor model was invariant across genders, ages and cultural groups. Furthermore, the PAQ subscales showed good internal consistency, test–retest reliability and concurrent validity. Conclusions Overall, the present findings indicate that PAQ has strong psychometric properties among both Middle Eastern and Western samples, and functions similarly across adults and adolescents. The PAQ therefore appears to be a useful tool for comprehensively operationalising alexithymia across a diverse range of populations. Key Points What is already known about this topic: Heightened alexithymia contributes to the development and maintenance of numerous forms of psychopathology. The assessment of alexithymia has been limited as it primarily focuses only on negative emotions. The Perth Alexithymia Questionnaire (PAQ) was recently developed to provide an integrated and valence-sensitive assessment of alexithymia. What this topic adds: The PAQ can be used to measure alexithymia in both adults and adolescents. The intended five-factor structure of the PAQ, which distinguishes between different facets of alexithymia across positive and negative emotions, was supported. The intended factor structure of the PAQ was found to be invariant in terms of gender, age, and cultural groups.