DEVELOPMENT AND VALIDATION OF THE PISTANTHRO-PHOBIA SCALE: A MIXED-METHODS PSYCHOMETRIC STUDY

Abstract

Background. A socially and clinically significant phenomenon of pathological fear of trusting others following betrayal has not been adequately measured despite its great impact on interpersonal functioning and psychological well-being. The lack of a validated theory-driven instrument has limited the possibility of systematic research, beneficial clinical evaluation, and restrictive intervention development in relation to severe trust-related distress. Objective. This paper designed and psychometrically tested the Pistanthro-Phobia Scale (PPS), a bilingual, cross-cultural instrument, which is designed to represent the multidimensional concept of pathological fear of trust as a result of betrayal trauma.

Method. An integrated design involving qualitative and quantitative steps consisted of a sequential exploratory mixed-method design. Phase One relied on semi-structured interviews of 25 purposively recruited people who reported having challenges in developing or sustaining trust; thematic analysis in the six-phase procedure identified by Braun and Clarke produced an item pool. A pilot test was done with a refined 36 items, and a total of 39 items were subjected to expert content review (n=8) and pilot test (n=30). Phase Two tested the psychometric properties using Exploratory Factor Analysis (EFA; n=229) with principal axis factoring and Promax rotation, and Confirmatory Factor Analysis (CFA; n=291) in SmartPLS 4. The psychometric standards assessed construct validity, internal consistency, composite reliability, convergent validity, and discrimination validity.

Results. Qualitative analysis yielded twelve themes that informed item content and ensured conceptual breadth. EFA supported a coherent six-factor structure accounting for 65.6% of total variance: Psycho-social Impact (18.21%), Past Betrayal (12.34%), Severity/Impact (10.83%), Withdrawal Behaviors (9.74%), Cognitive Patterns (9.09%), and Impact on Daily Life (5.39%). Sampling adequacy (Kaiser–Meyer–Olkin = .948) and Bartlett’s test (χ² = 5765.35, p < .001) indicated excellent factorability. CFA produced acceptable-to-good fit (χ²/df = 2.15, CFI = .90, TLI = .88, RMSEA = .07, SRMR = .06). Subscales demonstrated strong internal consistency (Cronbach’s α = .81–.91), composite reliability (ρc = .81–.91), and adequate convergent validity (AVE = .50–.69). Discriminant validity was supported by Fornell–Larcker comparisons and HTMT ratios below .90; all standardized loadings exceeded .59 (p < .001). Conclusions. The Pistanthro-Phobia Scale is a psychometrically robust, theoretically grounded, and culturally adapted instrument that captures cognitive, emotional, behavioral, and functional dimensions of pathological mistrust. It provides researchers and clinicians with a comprehensive tool for screening, assessment, treatment planning, and outcome monitoring, such as well-being, social functioning, and quality of life. Future work should assess test–retest reliability, longitudinal predictive validity, clinical sensitivity, and wider cross-cultural generalizability.