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: X²(152)=724.548,p<.001; 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 (β=.33,p<.001), dissociation (β=.39,p<.001), and DSO (β=.43,p<.001) 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.

Commentary on paper：

A Critical Advancement in Understanding Trauma-Related Avoidance: A Positive Commentary on Lay et al. (2025)

The study by Lay and colleagues (2025) on the Psychometric Evaluation of the Preference to Avoid Self-Experiences (PASE) Scale represents a significant and timely advancement in the assessment of trauma-related psychopathology. By introducing and rigorously validating a scale that captures a distinct, preference-based form of cognitive avoidance, this paper makes several highly beneficial contributions to both research and clinical practice.

1. Refining the Conceptualization of Avoidance

The most profound benefit of this paper is its theoretical refinement of the avoidance construct. While existing measures often focus on overt behavioral avoidance or global “experiential avoidance,” the PASE uniquely targets the preference to disengage from internal states—thoughts, emotions, and memories. This shift from behavior to preference is clinically ingenious. It acknowledges that for many individuals, especially those with complex trauma histories, avoidance is not simply a reaction but a deeply ingrained, almost automatic coping strategy. By quantifying this preference, the study provides a more precise tool to understand why individuals disengage internally, moving beyond simply that they disengage. This conceptual clarity is a major benefit for models of Complex PTSD (CPTSD) and dissociation.

2. Methodological Rigor and Cross-Cultural Validity

The study’s methodological approach is a model of psychometric rigor. The use of a large, international female sample (N=995 from over 25 countries) is a particular strength. The authors do not merely perform basic factor analysis; they employ a comprehensive battery including Exploratory/Confirmatory Factor Analysis, Rasch modeling, and—crucially—measurement invariance testing across Western and non-Western cultures. The finding that the PASE scale demonstrates equivalence across these cultural contexts is immensely beneficial. It provides confidence that the scale measures the same underlying construct in different cultural groups, making it a robust tool for global research on trauma. This addresses a critical gap in the field, where many instruments are validated solely in WEIRD (Western, Educated, Industrialized, Rich, Democratic) populations.

3. Strong Predictive Power for Key Clinical Outcomes

The results clearly demonstrate the scale’s clinical utility. The PASE emerged as the strongest predictor of PTSD, dissociation, and Disturbances in Self-Organization (DSO) symptoms, even when controlling for childhood trauma and general experiential avoidance. This is a powerful finding. It suggests that the specific tendency to avoid self-referential internal experiences (the “preference to avoid the self”) is more centrally related to post-traumatic pathology than broader avoidance tendencies. For clinicians, this is highly beneficial: it pinpoints a specific, measurable cognitive process (the PASE) that may be a more potent treatment target than previously recognized. For a patient with CPTSD and dissociation, reducing the preference for self-avoidance might be a more fundamental goal than reducing a specific avoidant behavior.

4. Practical Implications for Intervention

Finally, the paper offers clear, actionable benefits for intervention. If a strong preference for avoiding self-experiences underpins CPTSD and dissociative symptoms, then therapeutic models must directly address this process. This research provides empirical justification for integrating techniques from third-wave cognitive behavioral therapies (e.g., Acceptance and Commitment Therapy’s focus on willingness to experience internal events) or trauma-focused treatments that deliberately promote self-reflection and emotional processing (e.g., components of Phase 2 trauma therapy). The PASE scale itself can be used clinically as a brief (19-item) screening tool to identify individuals with this high-risk cognitive style and to track changes in this preference over the course of treatment.

Conclusion

In summary, Lay et al. (2025) have not merely validated another scale; they have provided the field with a theoretically grounded, cross-culturally valid, and clinically predictive tool that captures a distinct and central mechanism in trauma-related suffering. The benefits are clear: enhanced theoretical precision, a robust instrument for global research, and a specific new target for clinical assessment and intervention. The PASE scale is a valuable addition to the psychometric toolkit, promising to deepen our understanding of how individuals relate to their internal world following trauma and how best to help them.

link: