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A common approach to investigating item bias in achievement tests considers sociodemographic factors like gender and ethnicity in DIF analyses. This study examines math anxiety as a potential source of DIF using PISA 2022 Mathematics Literacy adaptive test items. Six item groups were formed based on stage levels and testlets, including only multiple-choice items with binary scoring. Respondents were split into low- and high-anxiety groups using median Math Anxiety Index scores. Five DIF detection methods were applied; items flagged by three or more methods were identified as DIF. Results indicated that 20–37.5% of items exhibited DIF, predominantly non-uniform, mainly at low-medium stages. Findings highlight math anxiety as a potentially important psychological source of DIF beyond traditional sociodemographic variables.