Psychometric evaluation of the preference to avoid self-experiences (PASE) scale : cross-cultural validity and associations with complex PTSD and dissociation in an international female sample

Abstract

Objectives: This study aims to validate the English version of the Preference to Avoid Self-Experiences (PASE) scale, which assesses the tendency and preference to disengage from internal states (e.g., emotions, thoughts, and memories)—a cognitive process hypothesized to play a central role in trauma-related psychopathology. We evaluated the scale's psychometric properties and associations with post-traumatic stress disorder (PTSD), complex PTSD (CPTSD), dissociation, and disturbances in self-organization (DSO) within an international female sample. Method: Data were collected from N = 995 female mental health service users across more than 25 countries. Participants completed validated self-report measures assessing PASE, childhood trauma, PTSD/CPTSD and dissociative symptoms, and experiential avoidance. Psychometric validation and analyses included exploratory and confirmatory factor analyses, internal consistency, convergent and discriminant validity, Rasch modeling, item reduction, measurement invariance testing, and multiple hierarchical regressions. Results: The 19-item PASE emerged as a single-factor structure and demonstrated good model fit: (Formula presented) ; CFI = 0.989; TLI = 0.988; RMSEA = 0.080 (90 % CI [0.074, 0.085]); SRMR = 0.058. Item fit statistics from the Partial credit model supported scale functioning (infit = 0.71–1.16, outfit = 0.70–1.32). Measurement invariance testing across Western and non-Western indicated equivalence (CFI = 0.989, TLI = 0.987, RMSEA = 0.082, SRMR = 0.064). PASE was significantly associated with PTSD (Formula presented), dissociation (Formula presented), and DSO (Formula presented) symptoms, controlling for childhood trauma, experiential avoidance, and demographic variables and it emerged as the strongest predictor in all models. Conclusion: The PASE Scale is a psychometrically valid and theoretically grounded tool that captures a distinct form and tendency of avoidance. Its associations with trauma-related symptoms emphasize its clinical and conceptual relevance for research and intervention targeting trauma-related psychopathology.