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

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. To address these gaps, here we examined the psychometric properties of the PAQ among three samples of Iranian adolescents (<i>N</i> = 557, 53% female, M_age = 14.94, SD = 1.29), Iranian adults (<i>N</i> = 926, 62% female, M_age = 32.52, SD = 9.65) and American adults (<i>N</i> = 242, 40% female, M_age = 40.69, SD = 11.91). 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. 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. <b>What is already known about this topic:</b>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. 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. <b>What this topic adds:</b>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. 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.

述情障碍（alexithymia）是一种以难以识别和描述情绪，以及外倾性思维为特征的人格特质。它是多种精神病理状态的重要跨诊断风险因素，因此对其评估具有重要研究价值。近年来，研究者开发了珀斯述情障碍问卷（Perth Alexithymia Questionnaire, PAQ）以实现对述情障碍的更全面评估。迄今为止，尚无研究考察青少年群体中PAQ的心理测量学属性，针对非西方人群的相关研究也较为匮乏。

为填补这一研究空白，本研究对三个样本的PAQ心理测量学属性进行了考察：伊朗青少年样本（*N* = 557，女性占比53%，平均年龄*M*_age = 14.94，标准差*SD* = 1.29）、伊朗成人样本（*N* = 926，女性占比62%，平均年龄*M*_age = 32.52，标准差*SD* = 9.65）以及美国成人样本（*N* = 242，女性占比40%，平均年龄*M*_age = 40.69，标准差*SD* = 11.91）。验证性因素分析（confirmatory factor analysis）结果显示，三个样本中均支持PAQ预设的五因素模型——该模型区分了正负性情绪下不同维度的述情障碍。该五因素模型在性别、年龄及文化群体间均具有测量不变性。此外，PAQ各分量表表现出良好的内部一致性、重测信度与效标关联效度。

综上，本研究结果表明，PAQ在中东与西方人群样本中均具备优异的心理测量学属性，且在成人与青少年群体中功能表现一致。因此，PAQ可作为一款实用工具，实现在多样化人群中对述情障碍进行全面的操作化评估。

**当前领域已知研究共识：**
述情障碍水平升高会促进多种精神障碍的发生与维持。现有述情障碍评估手段存在局限，因其仅聚焦于负性情绪维度。珀斯述情障碍问卷（PAQ）为近年开发的评估工具，旨在实现对述情障碍的整合性、效价敏感性评估。述情障碍水平升高会促进多种精神障碍的发生与维持。现有述情障碍评估手段存在局限，因其仅聚焦于负性情绪维度。珀斯述情障碍问卷（PAQ）为近年开发的评估工具，旨在实现对述情障碍的整合性、效价敏感性评估。

**本研究新增贡献：**
PAQ可用于成人与青少年群体的述情障碍评估。PAQ预设的五因素结构（区分正负性情绪下不同维度的述情障碍）得到了实证支持。PAQ的预设因素结构在性别、年龄与文化群体间均具备测量不变性。PAQ可用于成人与青少年群体的述情障碍评估。PAQ预设的五因素结构（区分正负性情绪下不同维度的述情障碍）得到了实证支持。PAQ的预设因素结构在性别、年龄与文化群体间均具备测量不变性。