Applying Bifactor Statistical Indices in the Evaluation of Psychological Measures

Death anxiety as general factor to fear of cancer recurrence

OBJECTIVE

Fear of cancer recurrence or progress is strongly related to death anxiety in cancer patients, but due to lack of conceptualization and measurement methods, the relationship was not analyzed quantitatively before. The aim of the present study was to investigate the conceptual relationship of both constructs, with death anxiety expected to be the general construct.

METHODS

Cancer patients (N=121) participated in an online study. They provided information on socio-demographical, medical and psychological measures including death anxiety (DADDS-G) and fear of cancer recurrence or progression (FoP-Q-SF). Relation of constructs was assessed using a two-step process: Confirming individual construct structure with CFA, including correlation of constructs and modification of measurement model, followed by structural equation modeling and comparison of structure models for best model fit.

RESULTS

The measurement model was modified to include three residual correlations within and between constructs. Comparison of structure models supported a bifactor structure with death anxiety as general factor and fear of recurrence or progression as group factor: SBχ² (173)=207.74 (p<.05), SB=1.538, relative χ² =1.2, rRMSEA=0.05[.01,0.07] (p>.05), SRMR=0.07, CFI=0.94, AIC=7543.60.

CONCLUSIONS

Death anxiety can be interpreted as general factor to fear of cancer recurrence or progression. Psychological interventions to reduce emotional burden of cancer patients need to focus additionally on existential threat and individual fears regarding death anxiety. This article is protected by copyright. All rights reserved.

The Quality of Life for Children with Autism Spectrum Disorder Scale: Factor Analysis, MIMIC Modeling, and Cut-Off Score Analysis

Our purpose in this study was to further examine the psychometric properties of the Quality of Life for Children with Autism Spectrum Disorder (QOLASD-C) scale. We first investigated the factor structure and the internal consistency of the scale. The bifactor model showed good fit and strong reliability. Second, we used multiple-indicators multiple-causes (MIMIC) modeling to examine the associations between demographic variables and the QOLASD-C dimensions. Results showed differences on overall QOL based on age, race/ethnicity, and autism spectrum disorder severity, but no relationships with gender. All demographic variables were associated with one or all three subscales (i.e., interpersonal relationships, self-determination, emotional well-being) of the QOLASD-C. Third, an optimal cut-off score of 37 was identified. Implications for research and practice are discussed.

The factor structure of attention-deficit/hyperactivity disorder in schoolchildren

BACKGROUND

Most studies support a bifactor model of childhood ADHD with two specific factors. However, several studies have not compared this model with a bifactor model with three specific factors, few have tested the actual strength of the factors, and none have examined whether "talks excessively" should be treated as a hyperactivity versus impulsivity symptom in children with ADHD.

AIMS

To examine the factor structure of ADHD symptoms and evaluate the relative strength of potential factors.

METHODS

Parent-reports on the ADHD-Rating Scale (ADHD-RS-IV) were collected for 2044 schoolchildren from the general population and 147 children with ADHD from a clinical sample. Single-, two- and three-(correlated and bi-)factor models were tested using confirmatory factor analysis.

RESULTS

Most models had a satisfactory fit. However, a correlated three-factor model where "talks excessively" was included as an indicator of impulsivity, and especially a bifactor model with one strong, well-defined general and two/three (ICD-10 defined) weak specific factors fit the data slightly better than the remaining models.

CONCLUSIONS

The factor structure is best characterized by a bifactor model with a strong general factor and two/three weaker specific factors. Therefore, we suggest emphasizing the ADHD-RS-IV total score rather than the subscale scores in clinical practice.

Psychometric Evaluation of the Korean Version of the Functional Assessment of Chronic Illness Therapy-Fatigue

BACKGROUND

The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) instrument is a fatigue measure widely used on patients with cancer worldwide. The psychometric quality of the Korean version of the FACIT-Fatigue instrument has never been systematically evaluated.

PURPOSE

The purpose of this study was to assess the reliability and validity of the Korean version of the FACIT-Fatigue instrument.

METHODS

This study used data collected from 170 patients with cancer and 120 healthy individuals. Internal consistency reliability was analyzed using Cronbach's α and item-total correlation. Construct validity was analyzed using confirmatory factor analysis, and known-group validity was tested using t tests. Convergent validity was analyzed using Pearson's correlation with pain and functional limitations. Predictive validity was analyzed using receiver operating characteristic curves.

RESULTS

The Cronbach's α was .93 for the reliability evaluation, and the item-total correlation ranged from .27 to .84. In the construct validity evaluation, the bifactor model showed good fit (Q = 1.93, comparative fit index = .97, Tucker-Lewis index = .96, root mean square error of approximation = .05), indicating using the instrument's total score to be more appropriate than using the subscale scores (explained common variance = .76, ω = .95, ωH = .85, ωH/ω = .89). The group of patients with cancer showed significantly higher fatigue than the healthy subject group, showing known-group validity (t = -10.40, p < .05). Fatigue showed significant and strong correlations with functional limitations and pain (all ps < .001). The area under the curve was .81 (cutoff point = 40, Youden's index: 0.47, sensitivity: 77.60%, specificity: 73.04%), verifying that the instrument is predictive of higher fatigue severity in patients with cancer.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

The Korean version of the FACIT-Fatigue instrument was shown to be reliable and valid. Its construct validity supports the use of the total scale score rather than the subscale scores.

Validation of the mental health continuum-short form: The bifactor model of emotional, social, and psychological well-being

The Mental Health Continuum-Short Form (MHC-SF) is aimed at measuring the three dimensions of mental health; emotional, social, and psychological well-being. The purpose of the current study was to evaluate the psychometric properties of the MHC-SF within the context of Singapore and Australia. A total of 299 Singaporeans or permanent residents (59.2% female; mean age = 24.26, SD = 6.13) and 258 Australians or permanent residents (69% female; mean age = 23.95, SD = 8.66) completed the study. Confirmatory factor analyses were used to assess the structural validity of the MHC-SF. Internal consistency reliability was assessed via the Cronbach’s α and MacDonald’s ω reliability coefficients. Concurrent validity was examined against the World Health Organisation-Five Well-Being Index, discriminant validity using the Hospital Anxiety and Depression Scale, and criterion validity using a self-rated question of “Please rate your averaged level of mental health over the past month”, all via Pearson’s correlations. A bifactor model of the MHC-SF, where each item loaded on a general factor and simultaneously on their respective uncorrelated group factors, yielded the best fit to the data across both samples. Further investigations demonstrated that the general well-being factor accounted for majority of variances of the MHC-SF. Internal consistency reliability, concurrent validity, discriminant validity, and criterion validity were all demonstrated. In conclusion, the current study provided support for the bifactor model of MHC-SF and demonstrated evidence of good psychometrics across both samples. The results highlighted the unidimensionality of the measure, suggesting that it is more informative to interpret the aggregated score than scores of independent factors standalone.

Irritability and Emotional Impulsivity as Core Feature of ADHD and ODD in Children

The categorical approach of diagnosing mental disorders entails the problem of frequently occurring comorbidities, suggesting a more parsimonious structure of psychopathology. In this study, we therefore aim to assess how affective dysregulation (AD) is associated with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) in children. To assess AD in children aged 8–12 years (n = 391), we employed the parent version of a newly constructed parent rating scale. Following item reduction, we conducted exploratory and confirmatory factor analyses to establish a factorial structure of AD. One core dimension was identified, comprising irritability and emotional impulsivity, and two smaller dimensions, comprising positive emotionality and exuberance. Subsequently, we examined five different latent factor models – a unidimensional model, a first-order correlated factor model, a second-order correlated factor model, a traditional bifactor model, and a bifactor S-1 model, in which the first-order factor AD-Irritability/Emotional Impulsivity (II) was modeled as the general reference factor. A bifactor S-1 model with the a priori defined general reference domain AD-II provided the best fit to our data and was straightforward to interpret. This model showed excellent model fit and no anomalous factor loadings. This still held true, when comparing it to bifactor S-1 models with ADHD/ODD-related reference factors. Differential correlations with emotion regulation skills and the established Parent Proxy Anger Scale validate the interpretation of the different dimensions. Our results suggest that irritability/emotional impulsivity might be a common core feature of ADHD and ODD.

Separate but Related: Dimensions of Healthcare Provider Social Support in Day-Treatment Oncology Units

Social support by healthcare providers has been increasingly investigated during the past decade, but studies have made different choices concerning its measurement. To evaluate how social support from a healthcare provider impacts the perceived quality of care and patient outcomes, reliable and valid instruments capable of measuring specific aspects of the construct are needed. In study 1, we tested the factor structure and the psychometric properties of a new Healthcare Provider Social Support measure (HPSS) for oncology settings. One-hundred-sixty-two patients (89 females; M age = 58.97, SD age = 13.28) from religious and government-operated hospitals completed the HPSS during day treatment. We modeled the HPSS factor structure to represent four related aspects: Emotional, Informational, Appraisal, and Instrumental social support. Study 2 preliminarily assessed the concurrent validity of the HPSS with patient perceptions of the patient-doctor relationship. Sixty-nine patients (40 females; M age = 53.67, SD age = 13.74) completed the HPPS with scales assessing perceived doctor-patient communication and patient trust in the healthcare provider. Study 1, using Exploratory Structural Equation Modeling, showed that a bifactor model had an excellent fit. The analysis supported the use of subscale scores, which were more tenable than a single total score in terms of bifactor model indices. This conclusion was also supported by greater scalability of the subscales in a Mokken Scale Analysis. Oncology patients treated in the religious hospital perceived greater Emotional, Informational, and Instrumental social support from their healthcare provider than those treated in government-operated. Study 2 showed that patient ratings of healthcare provider social support, except Instrumental, were positively correlated with better doctor communication skills and greater trust in the physician. Multiple regression analyses showed that Informational and Emotional support provided a unique contribution to building trust in the physician, controlling for the doctor's communication skills. The study results showed that the four social support ratings were reliable and valid, sharpening the distinction between functional components in the formal healthcare system.

Psychometric Properties of the Chinese Translated Athlete Burnout Questionnaire: Evidence From Chinese Collegiate Athletes and Elite Athletes

The purpose of the study was to translate the athlete burnout questionnaire (ABQ) into Simplified Chinese and examine its psychometric properties in Chinese collegiate athletes and elite athletes. Firstly, the factor structure, internal consistency reliability and nomological validity of the Chinese translated ABQ was examined in a sample of Chinese collegiate athletes (n = 214, 58.9% females). Secondly, abovementioned psychometric properties were examined in a sample of Chinese elite athletes (n = 505, 52.7% females). Finally, measurement invariance of the Chinese translated ABQ was examined across the two samples. It was found that the 12-item three-correlated-factors model outperformed the one factor model and bi-factor model in collegiate athlete sample whereas the 12-item bi-factor model best represented the factor structure of the Chinese translated ABQ in elite athlete sample. Satisfactory internal consistency reliabilities of the Chinese translated ABQ were evidenced in the two samples. Nomological validity was also supported by the results of the two samples that the three subscales of the ABQ were significantly associated with its theoretically related variables. Results of multiple-group confirmatory factor analysis revealed that weak measurement invariance of the Chinese translated ABQ (three-correlated-factors model) was evidenced across the two samples. Collectively, results of this study indicated that the 12-item Chinese translated ABQ could be used for measuring burnout of Chinese collegiate and elite athletes. Significance and implication of the current study as well as recommendations for future study were discussed.

Exploring the need for external input through the prism of social, material and sensation seeking input

External input is any kind of physical stimulation created by an individual's surroundings that can be detected by the senses. The present research established a novel conceptualization of this construct by investigating it in relation to the needs for material, social and sensation seeking input, and by testing whether these needs predict psychological functioning during long- and short-term input deprivation. It was established that the three needs constitute different dimensions of an overarching construct (i.e. need for external input). The research also suggested that the needs for social and sensation seeking input are negatively linked to people's experiences of long-term input deprivation (i.e. COVID-19 restrictions), and that the need for material input may negatively predict the experiences of short-term input deprivation (i.e. sitting in a chair without doing anything else but thinking). Overall, this research indicates that the needs for social, material and sensation seeking input may have fundamental implications for experiences and actions in a range of different contexts.

Exploring the need for external input through the prism of social, material and sensation seeking input

External input is any kind of physical stimulation created by an individual's surroundings that can be detected by the senses. The present research established a novel conceptualization of this construct by investigating it in relation to the needs for material, social and sensation seeking input, and by testing whether these needs predict psychological functioning during long- and short-term input deprivation. It was established that the three needs constitute different dimensions of an overarching construct (i.e. need for external input). The research also suggested that the needs for social and sensation seeking input are negatively linked to people's experiences of long-term input deprivation (i.e. COVID-19 restrictions), and that the need for material input may negatively predict the experiences of short-term input deprivation (i.e. sitting in a chair without doing anything else but thinking). Overall, this research indicates that the needs for social, material and sensation seeking input may have fundamental implications for experiences and actions in a range of different contexts.

Factor Structure of the KABC-II at Ages 5 and 6: Is It Valid in a Clinical Sample?

The factor structure of the German edition of the KABC-II for ages 5 and 6 was examined in a clinical sample. Participants were 450 children ages 5 and 6 who had been assessed due to various behavioral, emotional, or developmental disorders in five Centers for Social Pediatrics (SPCs). Confirmatory factor analyses of the standard test structure including core subtests of the Cattell-Horn-Carroll model and of the Luria model were conducted using maximum likelihood estimation. Several modified structures derived from CHC ability classifications were evaluated. Second-order factor structures corresponding to the standard test structure of the KABC-II demonstrated an adequate global fit for both theoretical models and were superior to unidimensional models. The fit of bifactor models was comparable to second-order models. In all subtests, the general factor accounted for more variance than group factors (broad abilities). However, in more than half of the subtests, unique variance explained the largest portion of the variance. The scale Learning/Glr showed a lack of convergent validity. At age 6, a model omitting subtest Rover significantly improved the fit. In the combined sample of 5- and 6-year-old children, both second-order and bifactor models with nine subtests demonstrated excellent fit.

Examining the psychometric properties of the Chinese Behavioral Regulation in Exercise Questionnaire-3: A bi-factor approach

The Behavioral Regulation in Exercise Questionnaire (BREQ) was revised to its third iteration (BREQ-3) and has been widely used to measure different types of exercise motivation, including amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation. However, the Chinese version has not been similarly revised. The aim of this study was to develop and examine the psychometric properties of the Chinese BREQ-3 using alternative structural equation models. Specifically, this study aimed to translate the English BREQ-3 into Chinese to examine the best representation of the factor configuration of Chinese BREQ-3, measurement invariance for the best-fitted model, and the concurrent validity evidence and reliability for the Chinese BREQ-3. Undergraduate students (N = 825) from mainland China completed a battery of online questionnaires. After including two general motivation factors (controlled motivation and autonomous motivation), we discovered that the majority of items on the identified regulation, integrated regulation, and intrinsic motivation subscales no longer loaded on or had very low loadings on their specific factors, implying that these items essentially represent a unidimensional construct. Invariance testing supported the comparison between latent factor means across gender based on the bi-factor exploratory structural equation model (BESEM). Concurrent validity evidence was found for amotivation, controlled motivation, and autonomous motivation. The hierarchical omega, explained common variance (ECV), item explained common variance (I_ECV), and percentage of uncontaminated correlations (PUC) indicated that the external regulation and introjected regulation subscales had a multidimensional structure, while the identified regulation, integrated regulation, and intrinsic motivation subscales had a unidimensional structure (autonomous motivation). We advocate calculating amotivation, external regulation, introjected regulation, and a single autonomous motivation (excluding item 19) score when utilizing the Chinese BREQ-3.

Validity Evidence of Brazilian Portuguese Version of the Professional Fulfillment Index

PURPOSE

The questionnaire "Professional Fulfillment Index" (PFI) was validated to assess emotional exhaustion, interpersonal disengagement, and professional achievement among physicians. This study presents the process of cross-cultural adaptation of the PFI to the Brazilian context.

DESIGN

Analytical cross-sectional study carried out between July and October 2020. Settings: For conceptual equivalence, a panel of experts was constituted who conducted analyzes on the translation and back-translation processes from English to Brazilian Portuguese.

SUBJECTS

For the operational equivalence, 432 physicians in the field of Occupational Medicine were invited.

MEASURES

They answered the PFI in an online platform. Analysis: Both exploratory and confirmatory factor analysis were performed to seek evidence of the hypothesized structure of PFI item responses. Reliability was assessed using three indicators.

RESULTS

The Brazilian version can be considered similar to the original. Most of participants were female (57.6%) and mean age 49.6 years-SD 14.0. The mean time since graduation was 18.5 years-SD 9.67. Most of them had a full-time job (88.0%) and were trained through post-graduation courses 83.8%. The most frequent job task was to perform worker´s clinical evaluations (84.9%). Exploratory and confirmatory analyzes showed the adequacy of the items in measuring the instrument's construct, with stability for use in other populations and samples.

CONCLUSION

The PFI was developed to evaluate positive and negative aspects of physicians' role and performance. The process described in this article was the first cross-cultural adaptation of the questionnaire. The PFI can help in mapping potential risk situations for negative impacts on physicians' occupational well-being and performance at work, in order to propose interventions that reduce exhaustion and expand professional fulfillment.

Joint Modeling of Response Accuracy and Time in Between-Item Multidimensional Tests Based on Bi-Factor Model

With the popularity of computer-based testing (CBT), it is easier to collect item response times (RTs) in psychological and educational assessments. RTs can provide an important source of information for respondents and tests. To make full use of RTs, the researchers have invested substantial effort in developing statistical models of RTs. Most of the proposed models posit a unidimensional latent speed to account for RTs in tests. In psychological and educational tests, many tests are multidimensional, either deliberately or inadvertently. There may be general effects in between-item multidimensional tests. However, currently there exists no RT model that considers the general effects to analyze between-item multidimensional test RT data. Also, there is no joint hierarchical model that integrates RT and response accuracy (RA) for evaluating the general effects of between-item multidimensional tests. Therefore, a bi-factor joint hierarchical model using between-item multidimensional test is proposed in this study. The simulation indicated that the Hamiltonian Monte Carlo (HMC) algorithm works well in parameter recovery. Meanwhile, the information criteria showed that the bi-factor hierarchical model (BFHM) is the best fit model. This means that it is necessary to take into consideration the general effects (general latent trait) and the multidimensionality of the RT in between-item multidimensional tests.

Examining the Structure and Validity of Self-Report Measures of DSM-5 Alternative Model for Personality Disorders Criterion A

The Level of Personality Functioning Scale (LPFS) operationalizes Criterion A of the DSM-5 Alternative Model for Personality Disorders. Despite progress in LPFS measurement development and validation, there is a lack of research, and some disagreement, concerning structural, convergent, and incremental validity of LPFS self-report measures. The present study aimed to compare the LPFS Self-Report, LPFS Self-Report of Criterion A, and LPFS Brief Form. Internal structure was assessed through principal component analyses, factor analyses, and bifactor analyses of unidimensionality. Associations with both pathological and basic personality characteristics among the LPFS measures were explored. Incremental validity of LPFS severity in predicting pathological personality outcomes controlling for basic personality traits, and the reverse, were examined. Results suggest a unidimensional structure robustly associated with other pathological personality assessments. LPFS severity and basic personality traits mutually offered unique explanatory power. We discuss the implications of assessing personality pathology using LPFS self-report measures.

Calibration of the Dutch EyeQ to Measure Vision Related Quality of Life in Patients With Exudative Retinal Diseases

Purpose

This study aims to develop an item-bank to measure vision-related quality of life (Vr-QoL) and subsequently calibrate this set of items.

Methods

Three Vr-QoL instruments were searched for suitable items to be added in the EyeQ. Patients who received antivascular endothelial growth factor treatment for various retinal diseases involving macular edema were included in the study and completed the 47-item EyeQ. Item response theory (IRT) was used to calibrate the EyeQ items, which was performed multiple times in subsets as a novel approach, containing 80% of the data. Differential item functioning (DIF) was evaluated for various variables.

Results

Responses of 704 patients were used in analysis. One item violated the local independence IRT-assumption and showed a high percentage of missing values, after which this item was deleted from the item-bank. The data of the five subsets fitted the graded response model adequately, and no DIF was detected for items between subsets, after which mean item parameters were calculated. Item fit statistics were found to be good. DIF was detected for gender, age, and administration mode by the patient (independently vs. with help), this involved three items, which all showed negligible impact on total scores.

Conclusions

Because of separate calibrations of the EyeQ in multiple subsets, a high robustness of item parameters is expected.

Translational Relevance

The calibrated EyeQ can now be used for the assessment of Vr-QoL in patients suffering from exudative retinal diseases and is promising for use as a computer adaptive test.

Development and Calibration of the PREMIUM Item Bank for Measuring Respect and Dignity for Patients with Severe Mental Illness

Most patient-reported experience measures (PREMs) are paper-based, leading to a high burden for patients and care providers. The aim of this study was to (1) calibrate an item bank to measure patients’ experience of respect and dignity for adult patients with serious mental illnesses and (2) develop computerized adaptive testing (CAT) to improve the use of this PREM in routine practice. Patients with schizophrenia, bipolar disorder, and major depressive disorder were enrolled in this multicenter and cross-sectional study. Psychometric analyses were based on classical test and item response theories and included evaluations of unidimensionality, local independence, and monotonicity; calibration and evaluation of model fit; analyses of differential item functioning (DIF); testing of external validity; and finally, CAT development. A total of 458 patients participated in the study. Of the 24 items, 2 highly inter-correlated items were deleted. Factor analysis showed that the remaining items met the unidimensional assumption (RMSEA = 0.054, CFI = 0.988, TLI = 0.986). DIF analyses revealed no biases by sex, age, care setting, or diagnosis. External validity testing has generally supported our assumptions. CAT showed satisfactory accuracy and precision. This work provides a more accurate and flexible measure of patients’ experience of respect and dignity than that obtained from standard questionnaires.

The Bifactor Structure of the Emotion Expression Scale for Children in a Sample of School-Aged Portuguese Children

The Emotion Expression Scale for Children (EESC) is a 16-item self-report questionnaire assessing children's difficulties in emotion expression (i.e., poor emotion awareness and reluctance to express emotions). Considering the inconsistent findings regarding its factorial structure and dimensionality, this study aims to explore the factor structure and psychometric properties of the EESC in a sample of 286 Portuguese children (8-12 years). Three competing models were analyzed through confirmatory factor analysis (correlated two-factor model, one-factor model, and bifactor model). The bifactor model provided a better fit than the competing models, and the results suggested a strong general factor of "difficulties in emotion expression." The validity of the EESC was also indicated by its positive correlations with variables assessing child anxiety, depression, and behavioral avoidance and its negative correlation with mindfulness skills. The EESC is a valid measure of children's difficulties in emotion expression and the use of its total score is recommended.

New complementary perspectives for inpatient physical function assessment: matched clinician-report and patient-report short form measures from the PROMIS adult physical function item bank

Purpose

To develop two item content-matched, precise, score-level targeted inpatient physical function (PF) short form (SF) measures: one clinician-reported, one patient-reported. Items were derived from PROMIS PF bank content; scores are reported on the PROMIS PF T-score metric.

Methods

The PROMIS PF item bank was reviewed for content measuring lower-level PF status (T-scores 10–50) with high item set score-level reliability (≥ 0.90). Selected patient-reported (PR) items were also edited to function as clinician-reported (CR) items. Items were reviewed by clinicians and field tested; responses were assessed for meeting PROMIS measure development standards. New CR and PR items were calibrated using patient responses to the original PROMIS PF items as anchoring data. SFs were constructed, based on content and precision.

Results

Nine PROMIS PF items were candidates for CR and PR inpatient PF assessment; three new items were written to extend content coverage. An inpatient sample (N = 515; 55.1% female; mean age = 66.2 years) completed 12 PR items and was assessed by physical therapists (using 12 CR items). Analyses indicated item sets met expected measure development standards. Twelve new CR and three new PR items were linked to the PROMIS PF metric (raw score r = 0.73 and 0.90, respectively). A 5-item CR SF measure was constructed; score-level reliabilities were ≥ 0.90 for T-scores 13–45. A 5-item PR SF measure was assembled, mirroring CR SF content.

Conclusions

Two item content-matched SFs have been developed for clinician and patient reporting and are an effective, efficient means of assessing inpatient PF and offer complementary perspectives.

Validity of the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) in Patients With Dizziness

HYPOTHESIS

The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) will be a valid and reliable combined measure of depression and anxiety in people with vertigo and dizziness.

BACKGROUND

Co-occurrence of depressive, anxiety, and somatic symptoms are common. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7) measure symptoms of depression and anxiety respectively, although measuring them separately may be suboptimal in people who have illness-related distress. There is some evidence that these scales can be combined in long-term conditions resulting in the PHQ-ADS, but validity is yet to be determined in people with vertigo and dizziness.

METHODS

Two separate datasets from a tertiary vestibular clinic were analyzed where the PHQ-ADS was completed at initial clinical assessment (n = 624) and while on a waiting list (n = 185). A cross-sectional design was used to examine the factor structure (confirmatory factor analysis), internal consistency (omega index), and construct validity (Pearson correlation coefficient) of the PHQ-ADS. Construct validity was determined against the dizziness handicap inventory (DHI).

RESULTS

A bi-factor PHQ-ADS model had good fit to the data (χ2 = 397.163, 249.763; comparative fit index [CFI] = 0.954, 0.919; Tucker-Lewis index [TLI] = 0.938, 0.892; root mean squared error of approximation [RMSEA] = 0.076, 0.098). The general distress factor explained 81 to 85% of the common variance between items. There were moderate to large significant positive correlations between the PHQ-ADS and DHI.

CONCLUSION

The PHQ-ADS appears to have good structural validity in patients with vertigo and dizziness. Clinicians and researchers can use this scale where a composite psychological measure is desired.

Measuring the transformative utopian impulse for planetary health in the age of the Anthropocene: a multi-study scale development and validation

BACKGROUND

Transformative utopian impulse for planetary health is people's propensity to have thoughts and engage in actions of which the purpose is to transform the current society into a better one in the future by addressing existing global issues. We aimed to develop a well-validated scale that can measure the transformative utopian impulse for planetary health and uncover its role in societal transformation.

METHODS

We developed a scale to measure the transformative utopian impulse for planetary health across 11 studies with 6248 participants from the USA (from the MTurk database) and the UK (from the Prolifico.co database). Participants were eligible take part in the studies if they completed the consent form. Participants who did not pass the seriousness check or did not accurately answer all instructed response items were excluded from statistical analyses. We used exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) to determine the factor structure of the Transformative Utopian Impulse for Planetary Health Scale (TUIPHS). Then we analysed the TUIPHS' nomological network (ie, the relationships between TUIPHS and various constructs ranging from personality traits and values to economic, social, and political attitudes and beliefs). We then examined the scale's incremental predictive validity by testing whether it predicts various attitudes and behaviours relevant to social change beyond scales that measure competing constructs (this part of the study is registered at OSF Registries [https://osf.io/ztj2f]). Finally, we examined the TUIPHS' longitudinal predictive validity by probing whether it predicts people's future support for social change.

FINDINGS

Data were collected between Oct 8, 2018, and July 6, 2020. We established that TUIPHS has a four-factor structure and can also be scored as a single general factor, indicating that it captures an overarching theoretical construct (ie, the transformative utopian impulse for planetary health). We then showed that the scale is related to various specific individual difference measures that capture diverse aspects of people's propensity to actively engage in thoughts and actions oriented toward the betterment of society. Moreover, TUIPHS predicted, above and beyond 20 competing scales highly correlated (r ≥0·50) with it, a series of 19 self-reported behavioural and attitudinal constructs pertaining to social change. Finally, participants' past TUIPHS scores predicted their support, a few months later, for social movements that aim to build a more just and resilient society than in the current day.

INTERPRETATION

This research lays the groundwork for future theoretical and empirical research into the psychological and behavioural processes attached to the transformative utopian impulse for planetary health as a source of transformative social change toward a better way of being and living.

FUNDING

The London School of Economics and Political Science.

Development and Validation of a Multidimensional Population-Based Healthy Aging Scale: Results From the China Health and Retirement Longitudinal Study

Background

The World Health Organization proposed a multidimensional concept of healthy aging in 2015; there was limited evidence about how the concept was constructed and measured. The current study aims to develop a health aging scale (HAS) following the WHO framework and validate it using data from the China Health and Retirement Longitudinal Study (CHARLS).

Methods

A total of 13,233 adults aged ≥ 45 years old from the CHARLS included in current study. Based on the WHO framework, 37 self-reported indicators were used to determine healthy aging. Exploratory factor analysis and second-order and bi-factor modeling, as well as psychometric coefficients, were used to examine the structure of healthy aging. To assess concurrent validity of the HAS, regression analyses were used to examine the associations of HAS and its subscales with sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction in Wave 1. The predictive validity of HAS and subscales was assessed by their associations with mortality in Wave 2 follow-up using Cox regressions.

Results

The general HAS and its five subscales were generated according to bi-factor modeling [CFI = 0.949; TLI = 0.942; SRMSR = 0.030; and RMSEA = 0.033 (95% CI, 0.032–0.034)] and psychometric coefficients (ω = 0.903; ωH = 0.692; ECV = 0.459). The general HAS presented solid evidence of concurrent validity with various sociodemographic characteristics, health conditions, healthcare utilization and life satisfaction; and predictive validity with mortality.

Conclusions

The population-based multidimensional healthy aging scale and its subscales can be used to monitor the trajectories of general healthy aging and its subdomains to support the development of healthy aging policies and interventions.

Factor structure, reliability, inter-rater agreement and convergent validity of the parent and child Italian versions of the paediatric quality of life inventory multidimensional fatigue scale for children and adolescents in paediatric inpatients with obesity and their parents

OBJECTIVE

This study aimed to examine the factor structure, reliability, inter-rater agreement and convergent validity of the child and parent Italian versions of the paediatric quality of life inventory multidimensional fatigue scale (PedsQL-MFS) in paediatric inpatients with obesity and one of their parents.

METHODS

100 pairs of children/adolescents (64% female, mean age = 15.34) with obesity and one of their parents completed the PedsQL-MFS and the Child Behaviour Checklist (CBCL) or the Youth Self Report.

RESULTS

Confirmatory Factor Analysis indicated that the three correlated first-order factors model corresponding to the published subscales demonstrated acceptable fit and achieved strict invariance across parent and child informants. Bifactor Analysis supported the multidimensionality and the reliability of the total and subscale scores as multidimensional composites. Parent-child agreement was low with latent means higher for parent reports. PedsQL-MFS total scores were strongly correlated with Somatic Complaints scores on the CBCL, and moderately associated with anxiety, depression, social problems and school problems.

CONCLUSIONS

Total scores of the child and parent Italian versions of the PedsQL-MFS demonstrated good reliability and convergent validity in paediatric inpatients with obesity and their parents, and are complementary rather than interchangeable.

LEVEL OF EVIDENCE

No level of evidence.

A New Story on the Multidimensionality of the MSPSS: Validity of the Internal Structure through Bifactor ESEM

The internal structure of the Multidimensional Scale of Perceived Social Support (MSPSS) in adolescents has been evaluated with some factorial analysis methodologies but not with bifactor exploratory structural equation modeling (ESEM), and possibly the inconsistency in the internal structure was dependent on these approaches. The objective of the study was to update evidence regarding its internal structure of MSPSS, by means of a detailed examination of its multidimensionality The participants were 460 adolescents from an educational institution in the Callao region, Lima, Peru. The structure was modeled using unidimensional, three-factor and bifactor models with confirmatory factor analysis (CFA) and ESEM approaches. The models showed good levels of fit, with the exception of the unidimensional model; however, the multidimensionality indicators supported the superiority of the bifactor ESEM. In contrast, the general factor was not strong enough, and the interfactorial correlations were substantially lower. It is concluded that the MSPSS can be interpreted by independent but moderately correlated factors, and there is possible systematic variance that potentially prevented the identification of a general factor.

Development of the Japanese Version of the State Self-Compassion Scale (SSCS-J)

Research in the U.S. developed and validated the State Self-Compassion Scale (SSCS), which measures self-compassionate reactions toward a specific negative event. The current study is aimed at developing the Japanese version of the State Self-Compassion Scale (SSCS-J) and extending previous findings in the U.S. by showing measurement invariance across sexes and demonstrating the construct validity of this scale. Across two studies (n = 596 in Study 1, n = 474 in Study 2), the bifactor exploratory structural equation modeling representation of the SSCS-J showed excellent fit in which a single global factor (i.e., self-compassion) and most of the specific factors (six subscales) were well defined. Study 1 further provided evidence for the measurement invariance across sexes. The SSCS-J was related with higher trait self-compassion and lower fear of and negative beliefs about self-compassion. In Study 2, participants who were instructed to be self-compassionate reported higher scores in the SSCS-J relative to those in the control condition. These results attest to the replicability of the factor structure of the SSCS in Japan and provide further evidence for the construct validity of this scale.

Distilling vector space model scores for the assessment of constructed responses with bifactor Inbuilt Rubric method and latent variables

In this paper, we highlight the importance of distilling the computational assessments of constructed responses to validate the indicators/proxies of constructs/trins using an empirical illustration in automated summary evaluation. We present the validation of the Inbuilt Rubric (IR) method that maps rubrics into vector spaces for concepts’ assessment. Specifically, we improved and validated its scores’ performance using latent variables, a common approach in psychometrics. We also validated a new hierarchical vector space, namely a bifactor IR. 205 Spanish undergraduate students produced 615 summaries of three different texts that were evaluated by human raters and different versions of the IR method using latent semantic analysis (LSA). The computational scores were validated using multiple linear regressions and different latent variable models like CFAs or SEMs. Convergent and discriminant validity was found for the IR scores using human rater scores as validity criteria. While this study was conducted in the Spanish language, the proposed scheme is language-independent and applicable to any language. We highlight four main conclusions: (1) Accurate performance can be observed in topic-detection tasks without hundreds/thousands of pre-scored samples required in supervised models. (2) Convergent/discriminant validity can be improved using measurement models for computational scores as they adjust for measurement errors. (3) Nouns embedded in fragments of instructional text can be an affordable alternative to use the IR method. (4) Hierarchical models, like the bifactor IR, can increase the validity of computational assessments evaluating general and specific knowledge in vector space models. R code is provided to apply the classic and bifactor IR method.

Psychometric evaluation of fear of COVID-19 Scale (FCV-19S) among Chinese primary and middle schoolteachers, and their students

Utilizing a large-scale cross-sectional survey, the present study tested the advanced psychometric properties of Fear of COVID-19 Scale (FCV-19S) in specific populations (i.e., primary and middle schoolteachers, and their students). The present study also examined the association between perceived fear of COVID-19 and psychological distress among home-room teachers (i.e., teachers who teach all their students in one classroom all day) and their students. The results among participants (11,134 teachers and 4,335 students) indicated good internal reliability of FCV-19S and excellent factorial validity with a two-factor structure utilizing these specific populations. Furthermore, the multilevel analysis showed that home-room teachers' psychological distress, but not fear of COVID-19, was positively associated with their students. In sum, the FCV-19S is a useful tool to assess the fear of COVID-19 on potentially vulnerable populations (i.e., primary/middle schoolteachers and their students). Future studies are encouraged to use the present study's findings to investigate possible underlying mechanisms for developing effective coping strategies and interventions.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02471-3.

Intuitive eating Scale-2: Factor structure and associations with disordered eating, impulsivity and quality of life in adolescents with overweight/obesity

OBJECTIVE

The Intuitive Eating Scale-2 (IES-2) has been shown to be a valid tool to assess the capability of eating in reaction to natural hunger/satiety cues. However, its factor structure seems to differ in function of cultural/socioeconomic backgrounds, and its psychometric properties among the adolescents with overweight/obesity (BMI-for-age percentile >85th) have not been examined yet. Thus, this study aims to 1) investigating the factorial structure/psychometric properties of IES-2 in adolescents with overweight/obesity; and 2) exploring the associations between impulsivity, quality of life disordered and intuitive eating.

METHODS

A total of 202 Portuguese adolescents (124 girls; 78 boys; 12-19 years) under weight-loss treatment with a mean BMI z-score of 2.41 (SD = 0.75) participated in this study. The IES-2 factor structure was explored by confirmatory factor analysis and bifactor models. Test-retest reliability analyses were performed over 6 months (n = 41) and associations between the variables under study were explored.

RESULTS

Confirmatory factor analyses with posthoc modifications resulted in a bifactor model with acceptable fit supporting one general factor (intuitive eating) and three specific factors (IES-2 subscales). The "Unconditional Permission to Eat" subscale could not be replicated in this sample. Test-retest reliability analyses suggested good temporal stability. Intuitive eating scores were negatively associated with grazing eating behavior and impulsivity (negative urgency) and positively linked to quality of life.

CONCLUSIONS

An adjusted version of IES-2 can be an appropriate measure for assessing intuitive eating levels in adolescents with overweight/obesity. Research on intuitive eating has the potential to enhance pediatric weight-loss interventions.

Social anxiety and rumination in the context of the revised reinforcement sensitivity theory and the mediation model of social anxiety

The aim of this study was to examine the relationship between temperament, ruminative thought style and social anxiety using latent variable modeling. Before examining the integrated model that specifies the relations between the constructs, relevant measurement issues were examined. The study was conducted on a heterogeneous sample from the general population that included 1,029 participants (62.1% female) aged 19 to 79. The findings show that the Behavioural Inhibition System is the most important vulnerability factor for the development of social anxiety, and it has both a direct effect and an indirect one through the ruminative thought style. Also, Freeze has an additional contribution to the increased experience of social anxiety. The Behavioural Approach System has complex effects on social anxiety ? with a direct protective effect, and indirectly ? with a facilitation of the ruminative thought style. Thus, BAS can also act as a risk factor. The findings support the revised Reinforcement Sensitivity Theory and provide a basis for the extension of the Kimbrel?s Mediation Model of Social Anxiety.

Psychometric Properties of a Cultural Adapted Version of the Assessment of Identity Development in Adolescence in Panama

The Assessment of Identity Development in Adolescence (AIDA) is a self-report instrument to detect pathological development of Identity. In Panamá, psychometric instruments for assessment of psychopathology in adolescence are lacking. Our aim was to develop a valid and reliable version of the AIDA Inventory for Panamanian Population. AIDA was adapted to Spanish considering cultural aspects of Panamanian population. Two pilot tests were performed prior to main test to assess item-total correlation at subscale, primary scale and total scale levels and internal consistency at subscale level. A mixed sample of students and PD patients (N = 315) completed the AIDA inventory, the "Strength and Difficulties Questionnaire" and "Defense Style Questionnaire-40." AIDA was retested in a sub sample from school population (n = 98). The Structured Clinical Interview for Axis II Disorders was used for diagnosis of personality disorders in the patient sample (n = 25). Psychometric properties were tested to assess internal consistency, reliability, factorial validity, convergent validity, and criterion validity. AIDA Panama showed excellent internal consistency for the total scale Identity Diffusion with Cronbach's α:0.94 and a retest reliability of 0.84. A Bifactorial CFA was modeled to assess the dimensionality of the inventory. The proportion between OmegaH and Omega at total scales 96% of the variance is explained by a general factor. Furthermore, the Explained Common Variance for the General Factor is 73% supporting unidimensionality. In line with theory, AIDA total scale showed a high positive correlation (r = 0.67) with Total Difficulties scale and high positive correlation (r = 0.71) with Immature Defense scale. The AIDA total score differed highly significant (p = 0.000) between the patient sample and the students with a large effect size (d = 1.02).

CONCLUSION

The adaptation and validation of AIDA for Panamanian adolescent population was successful with good psychometric properties and significant correlations with related psychopathological constructs. AIDA showed high clinical validity by providing a valid discrimination between the school sample and a diagnosed PD sample, in line with the assumption that impaired identity functioning is at the core of personality disorders, especially in adolescence.

The development and preliminary validation of a brief scale of emotional distress in young people using combined classical test theory and item response theory approaches: The Brief Emotional Distress Scale for Youth (BEDSY)

Reliable, valid, and brief measures are important for identifying young people in community contexts who experience mental health problems. This paper reports the development and preliminary validation of the Brief Emotional Distress Scale for Youth (BEDSY), a measure based on anxiety and depression symptoms that load strongly upon the general construct of emotional distress. Participants, aged 11-17 years, included 2663 from a community population and 281 referred anxious youth. From a pool of 20 items, eight were selected for the final scale using methods from classical test theory, followed by item response theory (IRT). The final eight items met the pre-specified criteria for skewness and kurtosis, item-total correlations, IRT characteristics, and discrimination between referred vs. community samples. Exploratory structural equation modeling for a bi-factor model indicated that 81% of total variance was explained by the general emotional distress factor. The 8-item BEDSY showed strong internal consistency, good construct validity, and acceptable sensitivity and specificity in discriminating between a community sample vs anxious youth, and between youth with and without high levels of depressive symptoms. As such the scale has strong potential as a brief screen for identifying emotionally distressed young people in community contexts.

Italian version of the Occupational Depression Inventory: Validity, reliability, and associations with health, economic, and work-life characteristics

BACKGROUND

The Occupational Depression Inventory (ODI) reflects a new approach to job-related distress centered on work-attributed depressive symptoms. The instrument was developed with reference to the characterization of major depression found in the Diagnostic and statistical manual of mental disorders, fifth edition. The ODI has been validated in English, French, and Spanish. This study (a) investigated the psychometric and structural properties of the ODI's Italian version and (b) inquired into the nomological network of occupational depression.

METHODS

A convenience sample of 963 employed individuals was recruited in Italy (69.9% female; mean age = 40.433). We notably relied on exploratory structural equation modeling bifactor analysis, common-practice confirmatory factor analysis, and Mokken scale analysis to examine our dataset.

RESULTS

Our analyses indicated that the Italian version of the ODI meets the requirements for essential unidimensionality, thus justifying the use of the instrument's total score. The ODI's reliability was excellent. Measurement invariance held across sexes, age groups, and occupations. Occupational depression was negatively associated with general wellbeing and positively associated with a 12-month history of depressive disorder, current antidepressant intake, 12-month sick leave, 6-month physical assault at work, 6-month verbal abuse at work, lack of money for leisure activities, and financial strain in the household.

CONCLUSIONS

The ODI's Italian version exhibits robust psychometric and structural properties, suggesting that the instrument can be fruitfully used for addressing job-related distress in Italian-speaking populations. Furthermore, the present study relates occupational depression to important health, economic, and work-life characteristics, including past depressive episodes, antidepressant medication, sickness-related absenteeism, workplace violence, and economic stress.

Psychometric Assessment of the Mental Health Continuum-Short Form in Athletes: A Bifactor Modeling Approach

Aim: A recent mental health in sport consensus statement advocates Keyes’ two continua model with an associated Mental Health Continuum (MHC) instrument to assess mental health in athletes. However, there remains statistically inconsistent usage of the MHC in athletes, so further exploration of the MHC’s psychometric factors is required. Methods: Athletes (N = 1,097) aged 32.63 (SD = 11.16) comprising 603 females (55.7%) and 478 males (44.3%), completed the 14-item MHC-Short Form, alongside validated measures of anxiety and depression. Five confirmatory factor analytic and bifactor models were developed based on extant research and theory. Results: Overall, a bifactor structure with a “general” positive mental health factor, and three specific factors (“hedonic well-being,” “social well-being,” and “psychological well-being”) fitted the data well and was deemed the superior model. Conclusion: A bifactor model of the MHC-Short Form is recommended comprising a composite score alongside specific factors of hedonic, social, and psychological well-being.

Comparing Informants for Mental Health Screening at the Preschool Level

Universal screening for mental health in preschools provides the opportunity for early identification and early intervention, but guidance regarding which informants to use is needed. Preschoolers' (N = 535) parent and teacher reports across two screening forms were analyzed to determine similarities and discrepancies for classification results and screener scores. The analyses also examined if an additional rater provided incrementally valid information to the prediction of longitudinal kindergarten outcomes. Parents' and teachers' screening scores were significantly correlated across forms by rater and across raters. However, categorical classification results indicated that teachers were more likely than parents to rate preschoolers in at-risk ranges across forms. Finally, hierarchical regression analyses revealed teacher ratings were predictive of kindergarten social-emotional, cognitive, and academic outcomes, and that the addition of parent ratings did not significantly improve prediction of outcomes. Implications are discussed in the context of multiple raters within multiple-gating screening procedures.

Validation and measurement invariance of the Occupational Depression Inventory in South Africa

This study aimed to validate the recently developed Occupational Depression Inventory (ODI) in South Africa. A total of 327 employees (60% female) participated in the study. Bifactor exploratory structural equation modeling analysis indicated that the ODI can be considered essentially unidimensional. The ODI displayed strong scalability (e.g., scale-level H = 0.657). No monotonicity violation was detected. The reliability of the instrument, as indexed by Cronbach's alpha, McDonald's omega-total, Guttman's λ2, and the Molenaar-Sijtsma statistic, was highly satisfactory. Measurement invariance was observed across age groups, sexes, and ethnicities, as well as between our sample and the ODI's original validation sample. As expected, the ODI showed both a degree of convergent validity and a degree of discriminant validity vis-à-vis a measure of "cause-neutral" depressive symptoms. Moreover, the ODI manifested substantial associations, in the anticipated directions, with measures of work engagement, job satisfaction, and life satisfaction. Overall, the ODI exhibited excellent structural and psychometric properties within the South African context. Consistent with previous research, this study suggests that occupational health specialists can confidently rely on the ODI to investigate job-related distress.

Review of the Internal Structure, Psychometric Properties, and Measurement Invariance of the Work-Related Rumination Scale - Spanish Version

Background: The aim of the current study was to examine the internal structure and assess the psychometric properties of the Work-Related Rumination Scale (WRRS) – Spanish version in a Puerto Rican sample of workers. This instrument is a 15-item questionnaire, which has three factors, affective rumination, problem-solving pondering, and detachment. This measure is used in the occupational health psychology context; however, there is little evidence of its psychometric properties.

Materials and Methods: A total sample of 4,100 from five different study samples was used in this cross-sectional study design in which the WRRS was used. We conducted confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) to examine the internal structure of the Work-Related Rumination Scale. Measurement invariance across sex and age was examined.

Results: The three-factor model was supported; however, four items were eliminated due to their cross-loadings and factorial complexity. This 11-item Spanish version of the WRRS was invariant across sex and age. Reliability of the three-factors of WRRS were within the range of 0.74 to 0.87 using Cronbach’s alpha and McDonald’s omega. Correlations between the three factors were as expected as well as with other established measures.

Conclusion: The results suggest that the WRRS-Spanish version appears to be a reliable and valid instrument to measure work-related rumination using its three factors. Comparison across sex and age appear to be useful in occupational health psychology research setting since results suggest that the WRRS is invariant regarding those variables.

Análisis psicométrico del Cuestionario de Regulación Conductual de las Emociones en universitarios peruanos

La presente investigación tuvo como objetivo traducir e identificar las propiedades psicométricas del Behavioral Emotion Regulation Questionnaire (BERQ) en 315 universitarios de Lima, Perú, entre los 16 y 44 años (Medad = 21.31; DE edad = 3.39; 59.7 % hombres). Para la evaluación se aplicó el BERQ y el Inventario Multicultural de Depresión Estado Rasgo (IMUDER), y las evidencias de validez de la estructura interna se obtuvieron por medio de un análisis factorial confirmatorio y un modelamiento exploratorio de ecuaciones estructurales, mientras que las evidencias de validez en relación con otras variables se obtuvieron a través de un análisis de regresión lineal. Los resultados indican que la estructura pentafactorial se replica en la muestra peruana, que las estrategias adaptativas predicen significativamente el eutrés, y que las estrategias desadaptativas predicen el distrés; además, los valores de confiabilidad fueron aceptables. Al final se discuten aspectos teóricos y prácticos de los hallazgos y la importancia de continuar brindando evidencia para su utilización en diferentes poblaciones y contextos, teniendo en cuenta que esta la primera vez que se analiza una versión en español del BERQ.

Development and validation of the Body Compassion Questionnaire

Background

The associations between compassion, self-compassion, and body image are well established. However, there is not yet a compassion-informed measure of body compassion that can be applied to any aspect of one’s body.

Method

Items for The Body Compassion Questionnaire (BCQ) were derived from an earlier expressive writing study on self-compassion in body image. In study 1, the BCQ was completed by 728 men and women; with factor analysis, Rasch analysis, content and concurrent validation and reliability assessed. Study 2 compared BCQ scores with investigator-based ratings of spontaneous expressions of body compassion through writing in female undergraduates as well as an existing measure of body compassion. Study 3 examined the associations between BCQ scores, and the emotions expressed in a structured body image writing task. It also examined the relative predictive ability of the BCQ versus self-compassion in predicting eating pathology.

Results

A bi-factor structure was identified, with an overall BCQ score and three subscales: body kindness, common humanity, and motivated action. The BCQ and its subscales had good validity and reliability and Rasch analysis showed the item fit was invariant across a range of demographic characteristics. Spontaneous expressions of body compassion showed positive associations with body kindness. Overall BCQ scores and body kindness were also inversely related to negative emotions expressed in relation to body image. The BCQ was a better predictor of eating disorder symptoms than was self-compassion.

Conclusions

The BCQ is the first measure of body compassion that is aligned with theoretical aspects of self-compassion, and which includes aspects of both the first and second psychologies of compassion. It also highlights its potential use as a process measure of body compassion in models of eating disorder symptomology, mood and wellbeing as well as an outcome measure for compassion-based interventions in eating disorders and body image.

Neural correlates of extinguished threat recall underlying the commonality between pediatric anxiety and irritability

BACKGROUND

Anxiety and irritability frequently co-occur in youth and are mediated by aberrant threat responses. However, empirical evidence on neural mechanisms underlying this co-occurrence is limited. To address this, we apply data-driven latent phenotyping to data from a prior report of a well-validated threat extinction recall fMRI paradigm.

METHODS

Participants included 59 youth (28 anxiety disorder, 31 healthy volunteers; Mage=13.15 yrs) drawn from a transdiagnostic sample of 331 youth, in which bifactor analysis was conducted to derive latent factors representing shared vs. unique variance of dimensionally-assessed anxiety and irritability. Participants underwent threat conditioning and extinction. Approximately three weeks later, during extinction recall fMRI, participants made threat-safety discriminations under two task conditions: current threat appraisal and explicit recall of threat contingencies. Linear mixed-effects analyses examined associations of a "negative affectivity" factor reflecting shared anxiety and irritability variance with whole-brain activation and task-dependent amygdala connectivity.

RESULTS

During recall of threat-safety contingencies, higher negative affectivity was associated with greater prefrontal (ventrolateral/ventromedial, dorsolateral, orbitofrontal), motor, temporal, parietal, and occipital activation. During threat appraisal, higher negative affectivity was associated with greater amygdala-inferior parietal lobule connectivity to threat/safety ambiguity.

LIMITATIONS

Sample included only healthy youth and youth with anxiety disorders. Results may not generalize to other diagnoses for which anxiety and irritability are also common, and our negative affectivity factor should be interpreted as anxiety disorders with elevated irritability. Reliability of some subfactors was poor.

CONCLUSIONS

Aberrant amygdala-prefrontal-parietal circuitry during extinction recall of threat-safety stimuli may be a mechanism underlying the co-occurrence of pediatric anxiety and irritability.

A patient-reported experience measure for community pharmacy including development of a short-form: The perceived service quality scale

BACKGROUND

The perceived service quality scale (pSQS) is a patient-reported experience measure (PREM) previously developed for measuring perceived service quality (pSQ) in community pharmacies. While measuring pSQ is feasible, further psychometric evaluation of the pSQS is warranted. In addition, the length of the 20-item pSQS may lead to fatigue among patients. It remains to be determined whether a short form of the pSQS has acceptable psychometric properties.

OBJECTIVES

The aim of this study was to psychometrically test the pSQS with a specific focus on making scoring recommendations and developing a short form pSQS with acceptable psychometric properties.

METHODS

Participants were recruited either in community pharmacies or via an online panel to complete a questionnaire including the pSQS. Confirmatory factor analyses (CFA) were conducted using robust statistics, including tests of factorial invariance. Alternative models were tested including a bifactor model. Spearman's correlation was used to conduct test-retest analyses on responses obtained one month apart.

RESULTS

Data were analysed from 319 participants recruited in-store and 303 participants recruited online, 86 participants providing test-retest reliability. Tests of factorial invariance indicated that the pSQS is stable across settings. The most parsimonious and best-fitting solution was obtained with a 19-item bifactor model with 5 factors plus a "general" factor. Factor scores obtained from the "general" factor explained sufficient variance and are unlikely to be excessively biased in regression models. A short-form 6-item scale (pSQ-SF6) demonstrated acceptable psychometric properties and similar predictive capacity to the original pSQS for patient loyalty intentions. Test-retest analyses indicated acceptable reliability for pSQS and PSQ-SF6.

CONCLUSION

This study confirms that the pSQS has acceptable psychometric properties including temporal stability. It is recommended that a 19-item pSQS be used to obtain a comprehensive overview of patients' pSQ. The short-form pSQ-SF6 is suitable as a community pharmacy PREM.

Psychometric properties of the traditional Chinese version of the youth attitude to noise scale: a cross-sectional study in a large representative sample

OBJECTIVES

This study aimed to examine the psychometric properties of the traditional Chinese version of the Youth Attitude to Noise Scale (YANS) in a large representative sample.

DESIGN

Cross-sectional study.

SETTING

15 secondary schools in Hong Kong, China.

PARTICIPANTS

2842 adolescents aged 12-20 years participated in this study between April and July 2016.

METHODS

The standard forward-backward validation procedures were followed to obtain the traditional Chinese version of the YANS. Prior to the formal investigation, the YANS was evaluated by cognitive debriefing. The sample was randomly divided into two halves for exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs), respectively. The number of factors was determined by comparison data approach using EFAs, and the factor structure was confirmed by CFAs using the one-factor, four-factor and bifactor models. The scale's internal reliability, dimensionality and measurement invariance across gender and age groups were also examined.

RESULTS

EFAs (n=1338) showed that four factors were extracted, and CFAs (n=1337) demonstrated the bifactor model fitted better to the sample than the other models. Additionally, the traditional Chinese version of the YANS showed high reliability (ω=0.84), a general factor, scale multidimensionality, and gender and age invariance.

CONCLUSIONS

The findings of the current study indicate that the traditional Chinese version of the YANS is a feasible instrument to assess attitude to noise in Chinese adolescents, regardless of their gender and age. Given the presence of a general factor, the YANS is not merely multidimensional, and whether to use the total or subscale scores is recommended to rely on research objectives.

Identifying the most important workplace factors in predicting nurse mental health using machine learning techniques

OBJECTIVES

Nurses are at a high risk of developing mental health problems due to exposure to work environment risk factors. Previous research in this area has only examined a few factors within nurses' work environments, and those factors were not conceptualized with the goal of improving workplace mental health. The purpose of this study is to identify the most important work environment predictors of nurse mental health using a comprehensive and theoretically grounded measure based on the National Standard of Psychological Health and Safety in the Workplace.

METHODS

This is an exploratory cross-sectional survey study of nurses in British Columbia, Canada. For this study, responses from a convenience sample of 4029 actively working direct care nurses were analyzed using random forest regression methods. Key predictors include 13 work environment factors. Study outcomes include depression, anxiety, post-traumatic stress disorder (PTSD), burnout and life satisfaction.

RESULTS

Overall, healthier reports of work environment conditions were associated with better nurse mental health. More specifically balance, psychological protection and workload management were the most important predictors of depression, anxiety, PTSD and emotional exhaustion. While engagement, workload management, psychological protection and balance were the most important predictors of depersonalization, engagement was the most important predictor of personal accomplishment. Balance, psychological protection and engagement were the most important predictors of life satisfaction.

CONCLUSIONS

Routine assessment with standardized tools of nurses' work environment conditions and mental health is an important, evidence-based organizational intervention. This study suggests nurses' mental health is particularly influenced by worklife balance, psychological protection and workload management.

Measuring the Dark Core of Personality in German: Psychometric Properties, Measurement Invariance, Predictive Validity, and Self-Other Agreement

The Dark Factor of Personality (D)-the underlying disposition of aversive traits-has been shown to account for various ethically and socially aversive behaviors. Whereas previous findings support the reliability and validity of the original English item sets suggested to measure D, a thorough psychometric examination of their German translation is still pending. Using data from four different samples (total N > 33,000), this study comprehensively evaluates the German version of the D70, D35, and D16 with respect to (a) their factor structure, (b) measurement invariance across gender, (c) measurement equivalence with the original English item sets, (d) predictive validity for relevant outcomes across a six-month period, and (e) self-observer agreement. Results confirm the bifactor structure of the D70 and single-factor models for the D35 and the D16. Measurement invariance testing shows partial strict invariance across gender and language versions. Furthermore, predictive validity and a moderate degree of self-other agreement are supported. The German version of the D70 and its shorter versions thus allow for a psychometrically sound assessment of D.