®Alexithymia · Emotional Awareness
Perth Alexithymia Questionnaire
A 24-item validated measure of alexithymia: difficulty identifying and describing one's own emotions, and a tendency toward externally oriented thinking. Freely available and used here in place of the TAS-20. Alexithymia is significantly more common in autistic and ADHD individuals.
Please read each statement below and choose the answer that best fits your experiences.
This is a screening questionnaire, not a diagnosis. It was developed for research and produces a score that indicates whether a fuller assessment may be worth pursuing. A score cannot tell you whether you are alexithymic. Only a qualified clinician working with your full history can do that.
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Who the PAQ is for
The PAQ is designed for adults who want to understand how they process emotions: particularly those who find it difficult to identify what they are feeling, describe emotions to others, or notice emotional states in their body before they become overwhelming.
Alexithymia is significantly more common in autistic and ADHD individuals than in the general population, and it is frequently a hidden factor in why therapy feels frustrating or ineffective. Many people who score high on the PAQ have spent years being told they are emotionally unavailable or hard to read: when the more accurate picture is that their emotional processing works differently, not deficiently.
The PAQ is not a diagnostic tool and does not produce a clinical diagnosis. It is a self-report measure: a structured way to get a clearer picture of your own emotional processing style, which you can bring into therapy or simply use to understand yourself better.
How to read your PAQ score
The PAQ measures alexithymia across five subscales. Each captures a distinct aspect of how you relate to emotions:
Positive Difficulty Identifying Feelings (P-DIF)
How hard it is to identify positive emotions: happiness, excitement, contentment. High scores here often show up as a muted or flat experience of good things, even when life is going well.
Negative Difficulty Identifying Feelings (N-DIF)
How hard it is to identify negative emotions: anxiety, sadness, anger. This is the subscale most associated with the classic alexithymia presentation: knowing something is wrong but not being able to name what.
Positive Difficulty Describing Feelings (P-DDF)
How hard it is to put positive emotional states into words for others. High scores here often look like being perceived as reserved or hard to read, even when you are not.
Negative Difficulty Describing Feelings (N-DDF)
How hard it is to describe negative emotional states to others. This is frequently what brings people to therapy: a sense that they cannot explain what is happening inside them, even when they want to.
Externally Oriented Thinking (EOT)
A tendency to focus on external events and concrete facts rather than internal emotional experience. High EOT scores often correlate with difficulty using emotions as information: the body signals something, but the signal does not translate into meaning.
Total scores range from 24 to 168. Higher scores indicate greater alexithymia. The PAQ does not have a single clinical cutoff: what matters more than the total is the subscale pattern, which tells you where the difficulty lives. Reference values are from a general-population sample (Preece et al., 2018). Scores for autistic adults tend to run higher, so these ranges describe where you sit relative to the general population, not whether something is wrong. A therapist familiar with alexithymia can help you interpret your results in context.