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Perth Alexithymia Questionnaire - Short Form (PAQ-S)


What it is​

The PAQ-S is a brief 6-item self-report measure of alexithymia — a trait characterised by difficulty identifying and describing one's own emotions, and a tendency toward externally oriented thinking. Alexithymia is a transdiagnostic risk factor associated with a range of psychological difficulties, including depression, anxiety, PTSD, eating disorders, and somatic complaints.

The PAQ-S is a shortened version of the 24-item Perth Alexithymia Questionnaire (PAQ), developed by Preece and colleagues. Unlike most other alexithymia measures, the PAQ and PAQ-S assess alexithymia across both negative and positive emotions, capturing the full breadth of the construct. The PAQ-S is well suited to clinical settings where brevity is important.

How is it used​

  • Suitable for adults and adolescents
  • Takes approximately 2–3 minutes to complete
  • Provides a single total alexithymia score
  • Best interpreted by comparing an individual's score to normative data rather than applying a binary cut-off
  • Freely available from the scale authors for research and clinical use with appropriate citation

The PAQ-S covers three core dimensions of alexithymia:

  • Difficulty identifying feelings (DIF) — trouble recognising and labelling one's own emotional states
  • Difficulty describing feelings (DDF) — difficulty communicating emotions to others
  • Externally oriented thinking (EOT) — a tendency to focus on external events rather than inner emotional experience

What do the scores mean?​

Items are rated on a 7-point scale, with higher scores indicating greater alexithymia. The PAQ-S provides a total score as a marker of overall alexithymia level.

Alexithymia is a dimensional construct, normally distributed in the general population. Rather than categorical labels, scores are best interpreted relative to normative samples:

  • Scores close to the normative mean indicate an average level of alexithymia
  • Scores approximately 1 SD above the mean indicate an elevated level
  • Scores approximately 2 SD above the mean indicate a high level, associated with clinically significant difficulties in emotional awareness and processing

The PAQ-S demonstrates strong reliability and validity, including good internal consistency and convergent validity with established alexithymia measures.

Developer​

The PAQ-S was developed by David A. Preece, James J. Gross, and colleagues at the University of Western Australia.

References:

Preece, D. A., Becerra, R., Robinson, K., & Gross, J. J. (2023). The Perth Alexithymia Questionnaire-Short Form (PAQ-S): A 6-item measure of alexithymia. Personality and Individual Differences, 204, 112044.

Preece, D. A., Becerra, R., Robinson, K., Dandy, J., & Allan, A. (2018). The psychometric assessment of alexithymia: Development and validation of the Perth Alexithymia Questionnaire. Personality and Individual Differences, 132, 32–44.