Validation of perceived invalidation of emotion scale (PIES) in Iranian populations

Abstract

Background
The examination of the psychometric properties of the PIES in Eastern cultures has remained unexplored. The current study aims to explore the psychometric features of the PIES in Iranian populations.

Methods
A total of 2250 participants (clinical sample = 177, student samples = 1762, general population = 311) completed the following questionnaires: Perceived Invalidation of Emotion Scale (PIES), Childhood Trauma Questionnaire-Short form (CTQ-SF), Depression, Anxiety and Stress (DASS-2), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). The psychometric qualities of the PIES were examined using construct, convergent, discriminant, incremental, and predictive validities together with internal consistency and test–retest reliability.

Results
The results of exploratory and confirmatory factor analysis revealed that the PIES had a unifactorial structure. Support was found for internal consistency as well as for test–retest reliability. In addition, the PIES scores significantly predicted emotional distress over time and had positive correlations with emotional dysregulation, childhood traumas, anxiety, stress, and depression. The PIES was also found to discriminate the clinical from nonclinical populations. Finally, PIES demonstrated adequate incremental validity.

Conclusion
Despite the limitations of the current study and the need for additional research, the findings indicate that the PIES with unifactorial structure is a reliable and valid scale among Iranian populations.

Full text

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Discover Psychology
Brief Communication
Validation ofperceived invalidation ofemotion scale (PIES) inIranian
populations
MehdiRezaei1 · ZahraParipishbar1· SamanehKhazaei1
Received: 15 August 2024 / Accepted: 11 December 2024
© The Author(s) 2024 OPEN
Abstract
Background The examination of the psychometric properties of the PIES in Eastern cultures has remained unexplored.
The current study aims to explore the psychometric features of the PIES in Iranian populations.
Methods A total of 2250 participants (clinical sample = 177, student samples = 1762, general population = 311) completed
the following questionnaires: Perceived Invalidation of Emotion Scale (PIES), Childhood Trauma Questionnaire-Short form
(CTQ-SF), Depression, Anxiety and Stress (DASS-2), and the Diculties in Emotion Regulation Scale-16 (DERS-16). The
psychometric qualities of the PIES were examined using construct, convergent, discriminant, incremental, and predictive
validities together with internal consistency and test–retest reliability.
Results The results of exploratory and conrmatory factor analysis revealed that the PIES had a unifactorial structure.
Support was found for internal consistency as well as for test–retest reliability. In addition, the PIES scores signicantly
predicted emotional distress over time and had positive correlations with emotional dysregulation, childhood traumas,
anxiety, stress, and depression. The PIES was also found to discriminate the clinical from nonclinical populations. Finally,
PIES demonstrated adequate incremental validity.
Conclusion Despite the limitations of the current study and the need for additional research, the ndings indicate that
the PIES with unifactorial structure is a reliable and valid scale among Iranian populations.
Keywords Emotion invalidation· Psychometrics· Validity· Reliability
1 Introduction
Humans, similar to many other primates [1], live in groups and engage in social processes. One of the most important
sources of interpersonal process and social sharing is emotional expression. The evolutionary approach also suggests
that not only humans but also animals display facial emotions and specic emotional reactions [2]. However, humans
are especially sensitive and vulnerable to the facial expression of emotions and gestural cues made by other individuals
and utilize these signals as guides for their own actions [3]. A body of studies on the social sharing of emotion revealed
that motions are subject to talking in about 90% of the cases in adolescents, young adults, and adults [3–5].
A form of social sharing with a special focus on emotional experiences refers to emotional disclosure [6]. Negative
and positive emotions are shared similarly, where the more intense the emotional experience is, the higher the ten-
dency to conversation about that, and is associated with more emotion regulation eort [7]. Research demonstrated
that status that increases emotional experience heightens social sharing and transmission regardless of their valence
* Mehdi Rezaei, Mehdi.rezaei15@birjand.ac.ir | 1Department ofPsychology, Faculty ofEducational Sciences andPsychology, University
ofBirjand, Birjand, Iran.

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[8, 9]. Emotional sharing and disclosure also elicit empathic/supportive processes and boost feelings of unity, prosocial
behavior, consolidation of social ties, social integration, emotional fusion, and validation [3, 5, 10].
Several theories emphasize the importance of validation and emotional connection in the mental health and thera-
peutic process in children, adolescents, and young adults. For example, Rogers emphasized unconditional positive regard.
He proposed that validation (e.g., empathy and accurate reection) is a key to both normal development and treatment
of individuals with emotional distress [11]. Kohut argued that mirroring and empathic failures are often unavoidable
elements of the therapeutic relationship [12]. Ginott [13] also argued strongly about validating and its advantages. In
particular, Ginott proposed that validating and understanding the child’s emotional experiences serves as an opponent
process to contempt, derogation, criticism, and disapproval of the child [13]. Indeed, validation is dened as legitimizing
the other individuals, accepting the other individuals, and providing approval or support to the other [14]. According
to Linehan [15], validation occurs when a therapist is able to convey to the patient that their emotions and eects are
understandable or his/her responses make sense and are understandable. In other words, validation is a procedure by
which an individual encourages another person to accept and understand their own emotional and private experience
by not trying to change the emotion and inner experience [16].
Emotional validation (EV) generally occurs when someone communicates and expresses nonjudgmental reference
(acceptance), understanding, and legitimacy in reaction to another individual’s emotion or emotional perspective [15,
16]. When emotional validation is provided, one is better able to recognize, identify, and control emotions and emotional
responses, resulting in emotional regulation [15], emotional self-ecacy [17], mental well-being [18], lower stress levels,
and better academic performance [19].
Even though group rituals and emotional sharing may increase the likelihood of survival through cooperation and
communication, other people are not always supportive of shared emotions as well as behaviors and may even con-
stitute a threat within a group by invalidating other members [20]. Thus, emotions may be invalidated by one’s close
family, friends, and other social connections. Emotional invalidation (EI) as a challenge to successful and adaptive emo-
tion regulation, occurring when an individual expresses that another individual’s emotions and private experiences
are inaccurate or unacceptable [15]. In other words, EI is dened as interactions during which an individual’s expressed
emotions or aective experiences are met with a reaction (verbal or nonverbal) from another person that is perceived
by the individual as implying that their emotions or private experiences are unacceptable, inappropriate, unacceptable,
inaccurate, or should be concealed [21]. Thus, children may experience EI directly through punitive and minimizing state-
ments (such as punishing and blaming a child for experiencing negative emotions) and indirectly by observing parents’
distress in reaction to their emotional expression.
Emotional invalidation has been identied as a major factor in the psycho-social functioning of people. For example, a
large body of evidence demonstrates that young adults and adolescents who perceive higher levels of EI are at increased
risk of BPD [22], depression [23], PTSD [24], emotion dysregulation [23, 25], and emotional distress [26, 27]. Additionally,
studies have demonstrated that when adults and young adults (ranging from 18 to 31 years) perceive their emotions
as continuously invalidated, they tend to engage in higher levels of suppression and develop more fear of emotions
[28], together with increased daily negative aective and stress [29]. Recently, Brandao and colleagues suggested that
perceived EI in current interpersonal interactions is directly associated with more depressive symptoms and indirectly
associated with it through emotional dysregulation in adults and young adults (ranging from 18 to 65 years) [30]. One
who has experienced stressful and adverse events may not share their private experience (e.g., emotions and feelings)
due to a fear of being blamed or unacceptance [15, 21, 29]. On the contrary, Parents’ supportive/validating responses to
young adults’ negative emotions are associated with their emotional expression and regulation [16].
The biopsychosocial theory postulates EI arises in the presence of an invalidating environment (IE). According to this
model, IEs are comprised of four key components: oversimplication of problem-solving, misattribution, discouraging
of negative emotional expression, and communications of inaccuracy. This kind of familial environment, in combination
with other vulnerability components of the child forms a "poorness of t" between the child and his/her context, result-
ing in emotional dysregulation (Linehan, 1993). A recent meta-analysis has also conrmed these four components of IEs
by reviewing 77 studies [31]. Accordingly, existent instruments measure childhood invalidation retrospectively such as
the Invalidation Childhood Environment Scale [32], and Parental Acceptance-Questionnaire/General Invalidation [33].
Invalidation tends to be also assessed in medical contexts such as the Illness Invalidation Inventory [34]. Additionally,
the Socialization of Emotions Scale [35] was developed to assess childhood EI which is not feasible to adapt for use with
adults. Thus, a measure for assessing present perceived EI in adults and young adults was lacking [30]. Meanwhile, the
ndings of Elzy and Karver demonstrated that the objective existence of emotionally invalidation behaviors (invalidat-
ing behaviors) may not be the same as the experienced perception of EI across individuals (perceptions of invalidation),

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highlighting the need to test how EI is operationally assessed [36]. Finally, the Perceived Emotion Invalidation (PIES) [21]
was developed to assess current levels of perceived EI in adults and young adults. The PIES is a very recent instrument
and for this reason, additional psychometric information is needed. On the other hand, so far, the factor structure of
the PIES has not yet been tested with a clinical sample. The PIES consists of 10 items and demonstrated higher levels
of internal consistency (alpha = 0.93 and 0.94) in dierent non-clinical samples. To our knowledge, only one study has
established the psychometric qualities of the PIES. The validation of the Portuguese version, with 234 adults, revealed
high reliability (alpha = 0.90) and validity. Factor analyses indicated a unidimensional and a good convergent validity
by correlating positively with depression, anxiety and stress symptoms, emotion communication, and suppression [37].
1.1 Present study
Although the original and Portuguese versions of PIES have demonstrated promising results, additional studies are
warranted to investigate the psychometric qualities of the PIES in other cultures, especially in Eastern cultures such as
Persian (Iran). Emotional invalidation is a transcultural phenomenon that people in all cultures may experience. Some
studies have also shown that emotional invalidation is experienced in clinical and non-clinical individuals in Iranian
populations [26, 38] but there is no valid instrument to measure it. On the other hand, childhood trauma and an invali-
dating environment as the main factors of emotional invalidation have been reported in Iran. In this regard, the target
populations of this study were general, student, and clinical populations. The ndings of Rezaei etal. [38] and Ghazanfari
etal. [39] indicated that emotional invalidation predicts depression symptoms in the Iranian clinical population. Similarly,
Mohammadkhani etal. [26] demonstrated that emotional invalidation related to emotional distress in Iranian students.
In general, according to the ndings of Mirzaei etal. [40], the prevalence of mental disorders has increased over the last
two decades in Iranian populations. Therefore, it seems necessary to measure emotional invalidation as one of the cor-
relates of mental disorders in Iran. In this regard, the only valid instrument to measure emotional invalidation in Iran is
the Leahy Emotional Schemas Scale (LESS) [41]. The LESS has only a scale (two items) for the measurement of emotional
validation. Therefore, a scale with more items is needed to measure emotion more accurately.
Introducing an assessment instrument into Persian study and clinical practice would contribute to the progress of
knowledge regarding the impact and consequences of EI. Further, so far, the factor analysis of the PIES has not yet been
tested with a clinical sample. Thus, the present study aimed to (a) examine the unidimensional structure of the PIES using
principal component analysis (PCA) and conrmatory factor analysis (CFA) for non-clinal and clinical samples respectively;
(b) explore the convergent validity with psychological maltreatment, emotional dysregulation, depression, depression,
anxiety, and stress as well as discriminant validity (the between-sample dierences regarding EI); (c) investigate the
incremental and predictive validity for non-clinal populations; and (d) inspect the internal consistency and test–retest
reliability of the Persian version of the PIES for both samples. It was hypothesized that the Persian version of the PIES has
adequate psychometric properties for clinical and non-clinical samples. We also hypothesized that EI would be positively
associated with psychological maltreatment, emotional dysregulation, depression, depression, anxiety, and stress.
2 Methods
2.1 Participants
Three samples of participants were recruited. The non-clinical college student sample (sample 1) included 1613
undergraduate and postgraduate students: 1115 (%69.1) women and 495 (%30.9) men, mean age = 22.87, SD = 5.21,
range: 18 to 46). The student sample was recruited from nine universities in the north (University of Tehran, Tehran),
south (Shahid Chamran University, Ahvaz), west (Razi University, Kermanshah; Azarbaijan Shahid Madani University,
Tabriz; Bu-Ali Sina University, Hamadan), east (University of Birjand and Bozorgmehr University, South Khorasan),
and center (Yazd University, Yazd; University of Isfahan, Isfahan) of Iran via convenience sampling. The majority of
subjects (n = 1392; 86.3%) were single, and a minority were married (n = 221; 13.7%). In terms of ethnicity, 1177 stu-
dents (73%) identified themselves as Pars, 182 (11.3%) as Turkish, 117 (7.3%) as Kurd, 49 (3.0%) as Lur, and 88 (5.5%)
as other ethnicities (e.g., Arab, Bakhtiari, Turkmen, and Baloch).
Sample 2 (n = 338) was drawn from the general population located in Western (Bijar, Kurdistan) and Eastern Iran
(Birjand). They were also selected via the convenience sampling method. Twenty-seven individuals had missing data

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on > 10% of the items and were therefore excluded from the study. As such, the number of the general population
sample was 311. The participants were primarily female (n = 216, 69.5%), Pars (n = 236, 75.9%), and married (n = 226,
72.7%), with a mean age of 32.99 (SD = 10.54). Also, 144 (46.3%) subjects completed high school, 132 (42.4%) com-
pleted college, and 35 (11.33%) held a bachelor’s degree or higher (See Table1).
Sample 3 (n = 177) was drawn from adults receiving outpatient psychiatric care at three facilities (Counseling Center
of University of Birjand, Hamrah, and Rah-E-No,) in Eastern Iran (Birjand). The outpatients met DSM-V criteria for
bipolar/unipolar depression (n = 49), anxiety disorders (n = 53), OCD (n = 29), borderline personality disorder (n = 24),
and other personality disorders (n = 22). Participants were primarily female (n = 130, 73.4%) and Pars (n = 119, 67.2%)
%), with a mean age of 32.92 (SD = 6.02). Subjects were recruited for participation and completed the PIES in person.
Sample 4 included 161 psychology, counseling, and physical education students from the University of Birjand
who completed the three questionnaires (DERS-16, DASS-21, and PIES) in two Phases (with an interval of 5 weeks).
Twelve students had missing data on > 10% of the items and were excluded from the study. Thus, the number of
subjects in sample 4 was 149. Their demographic characteristics are reported in Table1.
For exploratory factor analysis and incremental validity, sample 1 data were used, for confirmatory factor analysis,
samples 2 and 3 data were utilized, and to determine predictive validity and test–retest reliability, sample 4 data
were employed. In order to determine the internal consistency and item-test correlation, all samples were used. All
participants (samples 1, 2, 3, and 4) were studied in accordance with the 1989 revision of the Helsinki Declaration.
Table 1 Demographic characteristics and mean of PIES in study samples
Demographic characteristics Sample 1 (n = 1613) Sample 2 (n = 311) Sample 3 (n = 177) Sample 4 (n = 149)
Total PIES (Mean ± SD) 22.63 (8.33) 21.03 (8.29) 38.44 (5.51) 21.15 (6.13)
Age (Mean ± SD) 22.87 (5.21) 32.99 (10.54) 32.92 (6.02) 24.03 (6.52)
Gender
Female 1115 (69.1%) 216 (69.5%) 130 (73.4%) 104 (69.8%)
Male 498 (30.9%) 95 (30.5%) 26 (26.6%) 45 (30.2%)
Ethnicity
Pars 1177 (73.0%) 236 (75.9%) 119 (67.2%) 103 (69.1%)
Turkish 182 (11.3%) 52 (16.7%) 21 (11.9%) 18 (12.1%)
Kurd 117 (7.3%) 23 (7.4%) 20 (11.3%) 7 (4.7%)
Lur 49 (3.0%) – 5 (2.8%) 6 (4.0%)
Other ethnicities (Arab, Bakhtiari, Turkmen, and Baloch) 88 (5.5%) – 12 (6.8%) 15 (10.1%)
Marital status –
Single 1392 (86.3%) 85 (27.3%) 153 (67.2%) 125 (83.9%)
Married 221 (13.7%) 226 (72.7%) 58 (32.77%) 24 (16.1%)
University or city
University of Tehran/Tehran 202 (12.5%) – – –
University of Birjand/ Birjand 238 (14.8%) 182 (58.5%) 177 (100%) 149 (100%)
Bozorgmehr University/Ghaen 163 (10.1%) – – –
Yazd University/Yazd 170 (10.5) – – –
Azarbaijan Shahid Madani University/Tabriz 184 (11.4%) – – –
Razi University/Kermanshah 155 (9.6%) – – –
Bu-Ali Sina University/Hamadan 172 (10.7%) – – –
University of Isfahan/Isfahan 182 (11.3%) – – –
Shahid Chamran University/Ahvaz 147 (9.1%) – – –
Bijar city – 129 (41.5%) – –

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2.2 Measures
2.2.1 Perceived invalidation ofemotion scale
The PIES is a 10-item self-report measure that currently assesses the perceived invalidation in adults. Participants rate
each item on a 5 (Almost never; 0–10%) to 5 (Almost always; 91–100%) Likert-type scale. An example item is “Others make
me feel that my emotions are unimportant.” The original version of PIES demonstrated higher levels of internal consist-
ency (α = 0.93 and 0.94), good test–retest reliability (r = 0.67, p < 0.01), and concurrent validity (CMIN/DF = 1.98, NFI = 0.97,
CFI = 0.98, RMSEA = 0.056) in dierent non-clinical samples. The PIES has also indicated good divergent, incremental, and
predictive validity among community and student participants.
2.2.2 Depression, anxiety, andstress
The DASS is a 21-item self-report measure that assesses the three related negative emotional states of depression, anxiety,
and stress. The DASS includes 7 items from each of the 3 factors. This measure assesses the prevalence of psychological
distress (depression, anxiety, and stress symptoms) over the past weeks. All of the items are rated using a 4-point Likert
scale (From 0 = did not apply to me at all to 3 = applied to me very much, or most of the time). Scores for each of the three
subscales were calculated by summing up the responses of relevant items, where the maximum sum for each subscale is
21; higher scores represent higher psychological distress. The DASS-21 has also demonstrated good internal consistency
(Depression: α = 0.91; anxiety: α = 0.81; stress: α = 89) and convergent validity (correlation coecient of DASS depression
and anxiety subscale with BDI and BAI were 0.81 and 0.74 respectively) [42]. The Persian version of DASS has demon-
strated good internal consistency (Depression: α = 0.93; anxiety: α = 0.79; stress: α = 91), test–retest reliability (ranging
from 0.74 to 0.89), and concurrent validity (SRMR = 0.047, TLI = 0.91, CFI = 0.92, RMSEA = 0.078) [43]. In our sample, internal
consistency scores were also good (Depression: α = 0.89; anxiety: α = 0.93; stress: α = 0.85).
2.2.3 Childhood trauma questionnaire‑short form
The CTQ-SF is a 28-item self-administered questionnaire that assesses child abuse and neglect. The CTQ-SF also yields a
total score (childhood maltreatment) and scores for ve factors retrospectively measuring ve components of childhood
traumas: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN).
It is recommended to be used from the age of twelve [44]. All 28 items are constructed as statements beginning with the
phrase ‘When I was growing up…’ and they are scored on a ve-point Likert scale from “never true” (= 1) to “very often
true” (= 5). Each subscale is represented by 5 items with the scores ranging from 5 to 25, after reversing 7 items. Higher
scores on the instrument indicate higher levels of reported childhood trauma. Three items are also designed to meas-
ure minimization/denial. The scoring of the M/D subscale is dierent, since only the highest positive scores (very often
true = 5) are scored, and it can vary from 0 to 3. In other words, anything less is scored a 0; a total of one [1] or greater
indicates the potential underreporting of childhood maltreatment (false negatives). The CTQ-SF has shown acceptable
internal consistency (EA = 0.84–0.89; PA = 0.83–0.86; SA = 0.92–0.95; EN = 0.85–0.91; PN = 0.61–0.78) and construct valid-
ity (RMSEA = 0.05–0.06) in clinical and community samples (Bernstein etal., 2003). The Persian version of CTQ-SF has
acceptable psychometric properties [45]. In the current study, estimates of test score reliability (Cronbach’s alpha) were
good (EA = 0.88, PA = 0.84, SA = 0.76, EN = 0.80, PN = 0.81, CTQ-SF total scores = 0.91).
2.2.4 Difficulties inemotion regulation scale‑16
The DERS-16 is a 16-item self-report measure assessing individuals’ typical levels of diculties in emotion regulation.
Participants rate items on a 5-point Likert-type scale ranging from 5 (Almost never; 0–10%) to 5 (Almost always; 91–100%),
where higher scores indicate greater levels of diculties in emotion regulation. Factor analysis supports a ve-factor
(non-acceptance of emotional responses, diculty engaging in goal-directed behavior, impulse control diculties, lim-
ited access to emotion regulation strategies, lack of emotional clarity) structure, and it has revealed excellent internal
consistency (α = 0.92 and 0.94), plus good test–retest reliability (ρI = 0.85; p < 0.001), convergent validity, and discriminant

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validity in clinical and community samples [46]. The Persian version of DERS-16 has also demonstrated adequate internal
consistency (α = 0.71 and 0.91), good test–retest reliability (r12 = 0.74 to 0.94; ρI = 0.92; p < 0.001), and good concurrent
validity [47].
2.3 Procedure
Once permission was received from the developers, the original/English version of the PIES was translated into Persian/
Farsi by three bilingual psychologists. According to Gudmundsson (2009) and Byrne [48], the following phases were fol-
lowed: (1) a parallel translation of the original version for Persian was performed independently by the second author
and a bilingual psychologist (associate professor). All psychologists were familiar with the purpose of the PIES and uent
in Persian and English; (2) all translated versions were reviewed and a consensual version was obtained. Five assistant
or associate professors of psychology who were familiar with childhood traumas and emotional invalidation and were
native in Persian reviewed the translated version to ensure the content validity and uency of the questions. The back-
translation into English was also conducted by an independent associate professor of clinical psychology, who was uent
in Persian and English; (3) a pilot study of the Persian version was conducted with students (men = 6, women = 6) and the
general population (n = 12, men = 6, women = 6) to obtain feedback about the comprehensibility and clarity of questions.
(4) Finally, feedback and comments from pilot subjects were taken into consideration [48, 49].
The data were collected between December 2023 and April 2024. The data collection from the college student sample
(sample 1) occurred through a web link directing the students to the study website. Indeed, students were invited to
participate in the investigation using advertisements, whereby a web link directed the students to the study website.
For this purpose, the link of the questionnaire was placed on the virtual networks (Telegram, Eitaa, and Instagram) of
the mentioned universities and it was advertised once a week for 20 days. The rst page of the study website described
the aim of the study as follows: ‘‘Examining the psychometric properties of the Persian (Iranian) version of the Perceived
Emotional Invalidation Scale’’. Students were directed to the next page if they consented to participate in the study. The
second page asked about demographic characteristics and then other questionnaire items (PEIS, CTQ-SF, DASS, and
DERS-16) were displayed in order. If the participants did not answer an item, the next item would not be shown to them.
In other words, there was an item to answer on each page.
The data collection from the general population (sample 2), conducted by the rst and second authors and two M.Sc.
psychologists was done from a population of visitors in health centers (Bijar and Birjand center), cultural house (cultural
house of Amir), and parks of Bijar and Birjand, Iran. The data collection from the clinical sample (sample 3) was performed
by the second and third authors (assistant professors of psychology), at three facilities (Hamrah, Rah-E-No, and Counseling
Center of the University of Birjand) in Birjand, Iran. In this regard, the rst and second authors approached the clients and
illustrated the aim of the investigation. They then instructed the clients about the PIES and asked them to ll it. Finally,
data collection from sample 4 was conducted by the second and third authors in ve dierent classrooms.
Participants (samples 2, 3, and 4) were recruited for participation and completed the questionnaires in person, using
paper-and-pencil measures. The necessary explanations for completing the questionnaires were provided to the par-
ticipants. The researcher was also available to the participants at the time of completing the questionnaires. Individuals
(samples 2, 3, and 4) who consented to participate rst provided written informed consent and were then requested
to ll in the questionnaires. The current investigation was also conducted under a master’s project in psychology and
was approved by the scientic committee of the School of Psychology of the University of Birjand. Table1 reports the
demographic characteristics of the study samples.
2.4 Statistical analysis
Statistical analyses were conducted using SPSS version 26 and AMOS (version 24.0, IBM SPSS, Inc. in Chicago, IL). Initial
data screening (Sample 1) demonstrated that distributions of the PIES items were acceptable in terms of skewness (< 2.0;
range − 0.04_1.28) and kurtosis (< 2.0; range − 1.04_0.99). Principal component analysis (PCA), using direct Oblimin rota-
tion, was conducted on the student sample to test the factor structure (construct validity) of the 10 items of the PIES.
Parallel analysis was employed to determine the number of factors or principal components to retain in the initial step of
exploratory factor analysis. Parallel analysis indicated a unidimensional solution to the data. The Bartlett’s test of spheric-
ity and Kaiser–Meyer–Olkin (KMO) test were performed to examine the adequacy of the PCA. Pattern factor loadings of
0.40 or higher (> 0.40) were considered meaningful and were chosen [50].

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After initial data screening and conrmation of normal distributions (Sample 2: skewness < 0.2.0, range 0.21–1.40;
kurtosis < 2.0, range − 1.25–0.71; Sample 3: M = 0.58, SD = 0.89, range − 1.07 to –0.16; kurtosis < 2.0, range − 1.07–0.87),
conrmatory factor analysis (CFA) was conducted using a maximum likelihood estimation (MLE) method, to examine
the unidimensional structure of the PIES items on the general population (Sample 2) and clinical (Sample 3) samples.
Goodness-of-t indices were evaluated against the following criteria: the X2/df statistic (with values < 5 indicating good
t), the goodness-of-t index (GFI), Incremental Fit Index (IFI), the Bentler comparative t index (CFI) (in three cases
with ≥ 0.90 indicating acceptable t), the root mean square error of approximation (RMSEA; with values value ≤ 0.08
indicating adequate t), and residual (SRMR; with values value ≤ 0.08 indicating good t) [51, 52]. The convergent valid-
ity was examined using the Pearson correlation coecient. Discriminative validity was tested using the Kruskal–Wallis
test among three samples. Hierarchical regression was employed to test the incremental validity of PIES. Finally, the
reliability was estimated by internal consistency (Cronbach’s alpha and McDonald’s Omega) and test–retest reliability. A
signicance level of 0.05 was used.
3 Results
3.1 Construct validity: principal component analysis (PCA)
In order to examine the factor structure of the Persian PIES, scores of the student sample (N = 1613) were analyzed through
exploratory factor analysis (EFA) using oblique rotation. The Bartlett’s test of sphericity (χ2 (45) = 8469.05, p < 0.0001) and
Kaiser–Meyer–Olkin measure of sampling adequacy (KMO = 0.937) for the Persian PIES indicated that factor analyses
were appropriate. Additionally, results of the Scree test (See Fig.1) [53] and a parallel analysis indicated a unidimensional
solution which accounted for 55.62% of the variance (eigenvalues of 5.56) (see Fig.1). The item loadings also ranged
from 0.66 (item 1) to 0.84 (item 5).
3.2 Construct validity: confirmatory factor analysis (CFA)
We examined the t of the unidimensional structure of Persian PIES through CFAs using maximum likelihood estima-
tion. The CFAs were computed for the Persian PIES with the general population (n = 311) and clinical (n = 177) samples.
The Persian PIES measurement model yielded good t with the data in general population (χ2 = 102.33 p < 0.001, χ2/
df (35) = 2.92, GFI = 94, CFI = 0.95; TLI = 0.94; SRMR = 0.059, RMSEA = 0.079 (90%: 0.05–0.06). The item loadings ranged from
0.42 (item 2) to 0.81 (items 5 and 10), all well above acceptable levels (see Fig.2).
Consistent with the results for general population, the Persian PIES yielded acceptable t with the data in clinical
sample (χ2 (35) = 101.16, p < 0.001; χ2/df = 2.89, GFI = 0.93, CFI = 0.96; IFI = 0.96; SRMR = 0.05, RMSEA = 0.077) where the
item loadings ranged from 0.49 (item 2) to 0.86 (items 5 and 10) (see Fig.3).
Fig. 1 Scree plot for the num-
ber of factors

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3.3 Reliability
Reliability data for the Persian PIES are outlined in Table2. According to Hunsley & Mash [54] guideline (0.70 < α < 0.79 = ade-
quate; 0.80 < α < 0.89 = good; and 0.90 ⩽ α = excellent internal), analyses of Cronbach’s alpha and McDonald’s Omega
revealed good internal consistency for the Persian PIES in dierent samples (α = 0.89–0.91). Test–retest reliability was
examined on a subsample of 149 college students (45 men, 104 women) over a 5-week interval and was found to be
good (r12 = 0.63 p < 0.0001). Finally, item-test correlations (r it; the correlations among items and the total score of scale)
were found to be good (ranging from 0.42 to 0.79, p < 0.001), indicating that the PIES is homogeneous and all items
should be retained (See Table2).
3.4 Convergent validity
To assess convergent validity, we examined the relationship between the Persian PIES and the diculties in emotion
regulation scale-16 (DERS-16), depression, anxiety and stress (DASS-21), and childhood trauma questionnaire-short
form (CTQ-SF) among the student and general population samples (Samples 1, 2, and 4) at the same time. In the three
samples, the Persian PIES showed a positive signicant correlation with measures of DERS-16 (ranged from 0.48 to 0.59,
p < 0.001), DASS-21 (ranged from 0.53 to 0.60, p < 0.001), and CTQ-SF (r = 0.40 and 0.52, p < 0.00) (see Table3).
3.5 Discriminant validity
In order to determine and examine the discriminant validity of the Persian PIES, scores of three samples of clinical, general
population, and students (samples 2, 3, and 4) were compared using one-way Kruskal–Wallis. The result of Kruskal–Wallis
indicated that there were dierences among the three groups (Kruskal–Wallis H(2) = 312.95, p = 0.0001). Mann–Whitney
U test revealed that the general population student (Mann–Whitney U = 3386.50, Z = − 16.13, p = 0.0001) and student
Fig.2 factor structure of
Persian PIES in the general
population (sample 2; df
(55–20) = 35)
Fig. 3 factor structure of Per-
sian PIES in the clinical sample
(sample 3; df (55–20) = 35)
Table 2 Means, standard
deviations, McDonald’s
Omega, Cronbach’s α, Item-
Test Correlations, and Test–
Retest Reliability Coecients
for the Persian PIES
α = Cronbach’s alpha; rit = item-test correlation; r12 = test–retest coecient
Reliability Sample 1 (n = 1613) Sample 2 (n = 311) Sample 3 (n = 177) Sample 4 (n = 149)
McDonald’s Omega 0.91 0.90 0.90 0.89
α 0.91 0.90 0.90 0.89
Rang of rit 0.54–0.78 0.42–0.74 0.49–0.79 0.54–0.79
r12 – – – 0.63

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(Mann–Whitney U = 561.50, Z = −14.90, p = 0.0001) scored signicantly lower on the PIES than the clinical sample, while
there was no signicant dierence between general population and student samples (Mann–Whitney U = 21,231.0,
Z = –1.45, p = 0.146).
3.6 Incremental validity
Incremental validity was examined on a sample of 1613 college students (Sample 1) and the general population (Sam-
ple 2). Hierarchical regression analysis was conducted to test whether PIES would predict outcomes beyond what can
be accounted for by childhood traumas (physical, sexual, and emotional abuse; physical and emotional neglect). Two
independent hierarchical regression analyses examined emotional distress (i.e., the total score of DASS-21) and emo-
tional dysregulation (i.e., a total score of DERS-16) as criterion variables separately. The ve components of childhood
traumas: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), physical neglect (PN), and
perceived emotion invalidation (PIES) were predictor variables in the regression models. The components of childhood
traumas were entered at Step 1, while the PIES was entered at Step 2. The components of childhood traumas signicantly
predicted outcome variables (DASS-21 and DERS-16) at Step 1. The addition of PIES to the model (Step 2) enhanced the
proportion of predicted variance to 17% in emotional distress (multiple R = 0.57, R2 = 0.32, F (1, 1610) = 395.08, p < 0.0001)
and 15% in emotional dysregulation (multiple R = 0.50, R2 = 0.25, F (1, 1610) = 317.38, p < 0.0001) in sample 1 (student
sample). Another Hierarchical regression revealed that addition of PIES to the model (Step 2) elevated the proportion
of predicted variance to 24% in emotional distress (multiple R = 0.62, R2 = 0.34, F (1, 308) = 119.96, p < 0.0001) and 19% in
emotional dysregulation (multiple R = 0.53, R2 = 0.28, F (1, 308) = 83.27, p < 0.0001) (See Table4) in sample 2 (general popu-
lation) (See Table4). Tolerance (ranging from 0.34 to 0.81) and VIF (ranging from 1.22 to 2.93) for both samples indicated
that there was no multiple collinearity.
3.7 Predictive validity
Predictive validity was examined on a subsample of 149 college students. In this regard, two other hierarchical regression
analyses were conducted to test the ability of the Persian PIES as a predictive variable, for predicting changes in emotional
distress (DASS-21 in time 2) and diculties in emotion regulation (i.e., total score of DERS-16 in time 2) over a 5-week
interval. The Time 1 scores for the emotional distress (DASS-21 in time 1) and diculties in emotion regulation (DERS-16
in time 1) were entered in Step 1, and the Time 1 score for the Persian PIES was entered in Step 2. Results showed that
high currently perceived invalidation predicted increased emotional distress (Step 1_DASS-21 time 1: β = 0.86, SE = 0.11,
Table 3 Correlation between
PIES and measures of
emotion dysregulation
(DERS-16), childhood trauma
questionnaire-short form
(CTQ-SF), and emotional
distress (DASS-21)
All coecients are signicant at p < 0.001
Measures Sample 1 (Stu-
dents; n = 1613) Sample 2 (Gen-
eral population) Sample 4 (Stu-
dents; n = 149)
Emotional abuse 0.40 0.52 –
Sexual abuse 0.15 0. 31 –
Physical abuse 0.24 0.47 –
Emotional neglect 0.37 0.34 –
Physical neglect 0.33 0.43 –
Total CTQ-SF 0.40 0.52 –
Depression 0.49 0.56 0.56
Anxiety 0.46 0.55 0.51
Stress 0.48 0.52 0.54
Total DASS-21 0.53 0.61 0.60
Non-acceptance of emotional responses 0.42 0.49 0.44
Diculty engaging in goal-directed behavior 0.33 0.53 0.41
Impulse control diculties 0.36 0.49 0.42
Limited access to emotion regulation strategies 0.48 0.60 0.51
Lack of emotional clarity 0.41 0.41 0.42
Total DERS-16 0.48 0.59 0.52

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t = 20.58, R = 0.86, R2 = 0.74, p = 0 0.0001; Step 2_PIES time 1: β = 0.19, SE = 0.13, t = 15.80, R = 0.88, R2 = 0.77, ΔR2 = 0.03, p = 0
0.0001) and emotional dysregulation (Step 1_DERS-16 time 1: β = 0.77, SE = 0.36, t = 14.71, R = 0.77, R2 = 0.60, p = 0.0001;
Step 2_ PIES time 1: β = 0.26, SE = 0.10, t = 4.47, R = 0.80, R2 = 0.64, ΔR2 = 0.05, p = 0 0.0001), when DASS-21 and DERS-16
Time 1 scores were controlled.
4 Discussion
To the best of the authors’ knowledge, the present study is the rst to examine the psychometric qualities of the PIES in
an Eastern culture. The validity and reliability of the Persian PIES were tested in three dierent samples (students, general
population, and clinical) and ndings provided early evidence for acceptable psychometric properties of the Persian PIES.
In line with the original version of the PIES [21], a unifactorial solution was obtained that explained 55.62% of the variance.
Indeed, results from the exploratory factor analysis (EFA) led to a unidimensional structure and then a unifactorial
solution of the Persian PIES was conrmed through the conrmatory factor analysis (CFA). In other words, the CFA results
demonstrated that the unifactorial structure model of the Persian PIES provided a good t with the data in the two dif-
ferent samples (general population, clinical sample). Previously, to our knowledge, only one study had tested the factor
structure of the PIES using non-clinical adults [30]. These results were in line with the original version [21], showing a
unidimensional solution. This nding is also in line with the Portuguese version (Brandao etal., 2023) which obtained
a unidimensional model of the PIES. Contrary to our ndings, item 2 (“When I share how I’m feeling, others want me to
get over it or accept it and move on”) was removed in the Portuguese version since it had a low factor loading (factor
loading = 0.22) and lower discrimination (α1 > 0.40). In sum, the results of the principal component and conrmatory
factor analyses conrmed the construct validity of the Persian PIES. Thus, PIES has a comparable structure in Iranian,
Portuguese, and original versions.
The current study revealed the good internal consistency reliability (Cronbach’s alpha; ranging from 0.89 to 0.91) of
the PIES. The test–retest reliability (r12 = 0.63) of the Persian PIES over a 5-week interval was also found to be acceptable
in the non-clinical sample. These ndings are comparable with ndings from previous studies [30], suggesting good
internal consistency and test–retest reliability for the Portuguese PIES or the original version of PIES [21]. In other words,
the current test–retest correlation coecients were found to be similar to Zielinski & Veilleux [21] as well as Brandao etal.
[30]. Therefore, our ndings provide additional support for the robustness of the PIES in clinical on non-clinical adults.
The convergent validity of the Persian PIES was supported in the present study through its positive signicant cor-
relations with the CTQ-SF, the DESR-16, and the DASS-21. In other words, the relationship between PIES and the three
scales (CTQ-SF, DESR-16, and DASS-21) was investigated in order to examine the convergent validity. As expected, the
PIES was positively correlated with childhood trauma (CTQ-SF) in both student and general populations (Samples 1 and
2), especially with emotional abuse and neglect subscale. This nding is consistent with Linehan’s biopsychosocial theory
[15] and some research [22, 24, 30] demonstrating the relationship between adverse childhood events and emotional
invalidation. Linehan [15] proposed that children raised in invalidating environments (IEs) will catch the message that
their emotions and feelings are defective and eventually begin to self-invalidate. Similarly, Wetphal and colleagues [24]
Table 4 Hierarchical
regressions predicting
emotion dysregulation (DERS-
16) and emotional distress
(DASS-21) through childhood
traumas and emotional
invalidation (n = 1613)
* p < 0.01
Outcome variables Sample 1 (n = 1613) Sample 2 (n = 311)
SE β t SE β t
Predicting DASS-21; Step 1 R2 = 0.16* R2 = 14*
Childhood trauma 0.02 .39 17.34* 0.05 0.37 7.19*
Predicting DASS-21; Step 2 ΔR2 = 0.17* ΔR2 = 24*
Childhood trauma 0.02 0.22 9.87* 0.04 0.15 3.12*
PIES 0.03 0.44 19.87* 0.08 0.53 10.95*
Predicting DERS-16; Step 1 R2 = 0.11 R2 = 0.09*
Childhood trauma 0.02 0.31 13.33* 0.06 0.29 5.41*
Predicting DERS-16; Step 2: ΔR2 = 0.15 ΔR2 = 0.19*
Childhood trauma 0.02 0.15 6.31* 0.05 0.09 1.72
PIES 0.04 0.42 17.81* 0.10 0.48 9.12*

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suggested that parental abuse and indierence were signicantly related to perceived emotional invalidation. Hope and
Chapman [22] also found that recalled experiences of childhood trauma, emotional invalidation, parental psychologi-
cal control, and BPD features were positively correlated. Thus, it can be stated that children exposed to environments
characterized by neglect or abuse would develop critical and negative attitudes toward their own emotions.
In addition, our ndings suggested that PIES is linked to DERS-16 and symptoms of depression, anxiety, and stress in
both student and general populations. These results align with the previous studies that have demonstrated emotional
invalidation to be a contributing factor to the development and persistence of emotional dysregulation [23, 25, 28, 37],
as well as a predictor of the severity of daily negative aect and emotional disorders [16, 26, 27, 29]. For example, Shenk
and Fruzzetti [16] demonstrated that participants who were exposed to invalidating responses experienced noticeably
higher levels of negative aect, heart rate, and skin conductance than participants who were exposed to validating
responses. Another study by Brandao and colleagues [37] found a direct correlation between higher levels of emotional
invalidation experienced and depressive symptoms in interpersonal interactions, as well as an indirect correlation through
challenges with emotion regulation. The relations of the PIES to the DERS-16 and the DASS-21 indicate that those who
experience emotional invalidation may have maladaptive emotion regulation strategies and engage in emotional dis-
tress and psychopathology. In summary, the invalidating environment can expectedly cause a child to acquire the belief
that feelings and emotions are unacceptable, shameful, and lack legitimacy. Hence, it is possible that adult emotion
dysregulation and psychopathology are inuenced by early invalidating environments [15].
Our ndings provide additional support for the robustness of the PIES; this is the rst study to provide evidence
that PIES has acceptable discriminant validity. The results of the current study revealed that, although there was no
signicant dierence between student and general populations, the PIES signicantly distinguished between clinical
and non-clinical populations. The patients’ scores were signicantly higher than those of the non-clinical populations.
This supports the hypothesis that emotional invalidation as assessed by the PIES is associated with psychopathology.
This study also expanded on the evidence for the incremental validity of the PIES and provided additional evidence
for its unique predictive eects. The results from the student and general populations (Samples 1 and 2) presented
here demonstrated that the PIES could consistently predict incremental variance in construct-relevant criteria beyond
childhood traumas (CTQ-SF) and diculties in emotion regulation (DERS-16). Incremental eects in terms of criterion
variance explained were found to be 0.15% to 24% in student and general populations. This nding is consistent with
the original version [21]. In a similar study, Westphal and colleagues [24] found that emotional invalidation predicts
emotional distress even after controlling for perceived parental abuse. Similarly, Schreiber and Veilleux [27] found that
perceived emotion invalidation predicted greater emotional distress above and beyond emotional reactivity, negative
aect, emotion dysregulation, cognitive and behavioral emotion regulation strategies, self-compassion, and experiential
avoidance. Another study found that childhood trauma related to psychopathology after controlling diculties regulat-
ing emotions [22]. Consequently, PIES is a relatively new instrument that can be used to measure emotional invalidation.
Finally, we found preliminary evidence indicating that higher levels of emotional invalidation (PIES) at time 1 are
associated with emotional distress (DASS-21) later at time 2 when controlling for time 1 DASS-21 and DERS-16. In other
words, the results of the present study provided support for the high predictive power of the PIES over and beyond the
DASS-21 and DERS-16 over a 5-week interval. Indeed, the predictive eect in terms of criterion variance explained was
found to be 0.03 to 0.05% in the student population. Thus, current emotional invalidation is clearly a signicant predictor
of future emotional distress. Contrary to our ndings, in the original version the PIES was only able to predict relatively
small increases (0.01%) in additional emotional distress at Time 2 when controlling for Time 1 emotional distress [21].
The present study had some strengths and limitations. Its strengths included three distinct and large sample sizes
(students, general population, and inpatient populations) from dierent ethnicities, comprehensive consideration of
language translation concerns, and appropriate statistical methods. Conversely, the limitations of this study were as
follows: First, the cross-sectional nature of the current study prevented it from reporting causal correlations. Secondly, a
convenience sampling method was used and not all measures could be included for all participants. So, its ndings may
not be generalized to the entire Iranian population. Further, the current investigation did not contain any instruments
that could be considered theoretically distinct from emotional invalidation. As a result, no evidence was provided to
support the divergent validity. In addition, the test–retest reliability of the PIES was only assessed in the student college
population. Also, the instruments used in the present study were self-report in format. Moreover, the current study did not
investigate the sensitivity of the PIES to treatment, so the ecacy of the instrument as a measure of therapeutic change
has not yet been determined. Additionally, the questionnaire was conducted online for the rst sample. Therefore, some
of the participants’ questions about the items have remained unanswered. Finally, the Iranian sample was not compared
to a reference sample from another context, suggesting future research should analyze measurement invariance across

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dierent samples for cross-cultural evidence. It is also suggested to conduct an exploratory test with the aim of more
than one factor in the Iranian population for further studies.
5 Conclusions
The Persian version of PIES demonstrated a unifactorial structure in a large student sample. Additionally, the unifactorial
structure of PIES was conrmed through CFA in both clinical and non-clinical samples. The reliability (internal consist-
ency and test-retest) of the PIES, as well as its convergent, discriminant, incremental, and predictive validity, were con-
rmed.Overall, the PIES, with its unifactorial structure, appears to be a valid measurement across the Iranian population.
Acknowledgements We would like to thank Ahamad Khamesan, Mohammad Hosein Salarifar, Hadi Samadieh, Hamid Amiri, and all study
participants for their kind participation
Author contributions All authors contributed to the study conception and design. Zahra Paripishbar and Mehdi Rezaei designed the study.
Zahra Paripishbar and Samaneh Khazaei managed the literature searches and analyses. Zahra Paripishbar and Mehdi Rezaei undertook the
statistical analysis, and Mehdi Rezaei wrote the rst draft of the manuscript. All authors contributed to and have approved the nal manuscript.
Data availability Data was provided within the manuscript.
Declarations
Competing interests The authors declare no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adapta-
tion, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source,
provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article
are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in
the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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