Factor structure and longitudinal invariance for the Chinese Mainland version of the Edinburgh postnatal depression scale during pregnancy

BACKGROUND

There are inconsistent results on the Edinburgh Postnatal Depression Scale's (EPDS) factor structure and longitudinal invariance among different cultures. Furthermore, limited relevant studies in Chinese pregnant women exist.

PURPOSE

To test the factor structure of the Chinese Mainland EPDS during pregnancy and conduct longitudinal invariance analyses.

METHODS

A national multi-centre cohort study was conducted among 1207 pregnant women selected consecutively by convenience sampling from five hospitals in Zhuhai, Taiyuan, Haidian, Changchun, and Shenzhen in China between August 2015 and October 2016. Depression was measured by the EPDS during gestational weeks 10-13, 15-18, 23-25, 30-32 and 36-37, respectively.s RESULTS: Three factors with eigenvalues nearly larger than 1.0 were optimal for the Chinese Mainland EPDS, labelled "anxiety," "anhedonia," and "depression," and contained items 3-5, 1-2, and 6-10, respectively. The confirmatory factor analysis results of standardized root mean square residual (SRMR) = 0.034, root mean square error of approximation (RMSEA) = 0.049, comparative fit index (CFI) = 0.968, Tucker-Lewis index (TLI) = 0.954, and χ2, p < 0.05 indicated good fit. For the longitudinal invariance tests, the configural invariance was met, with the CFI and TLI both higher than 0.90 and the RMSEA lower than 0.08 (CFI = 0.919, TLI = 0.908, and RMSEA = 0.034). The metric-, scalar-, and strict invariances were met.

CONCLUSIONS

The three-factor model of the Chinese Mainland EPDS is invariant in pregnancy, suggesting stability and comparability in identifying the women screened positive at different points during pregnancy and making the scale feasible to screen prenatal depression and anxiety simultaneously.

Psychometric properties of the Spanish version of the functionality appreciation scale

BACKGROUND

The Functionality Appreciation Scale is a 7-item measure of an individual's appreciation of his or her body for what it can do and is capable of doing. While this instrument has been increasingly used in intervention-based research, its psychometric properties have not been extensively studied in non-English-speaking populations. The psychometric properties of a novel Spanish translation of the FAS were examined.

METHODS

An online sample of 838 Spanish adults (mean age = 31.79 ± 11.95 years, 50.48% men) completed the Spanish FAS and validated measures of body appreciation, eating disorder symptomatology, intuitive eating, and life satisfaction.

RESULTS

Exploratory factor analysis supported a 1-dimensional factor structure of the FAS, which was further supported by confirmatory factor analysis (SBχ²(14) = 83.82, SBχ²normed = 1.48, robust RMSEA = 0.094 (90% CI = 0.074, 0.115), SRMR = 0.040, robust CFI = 0.946, robust TLI = 0.924). Invariance across genders was shown, and there were no significant differences according to gender (t(417) = 0.77, p =.444, d = 0.07). Construct validity was also supported through significant associations with the other measures of the study. Incremental validity was established in women. Thus, appreciation of functionality predicted life satisfaction over and above the variance accounted for by other body image and eating disorder-related measures (F(4, 399) = 18.86, p <.001, ΔR2 = 0.03).

CONCLUSIONS

These results support the psychometric properties of the Spanish FAS and demonstrate the importance of the appreciation of functionality in relation to a healthier body image and psychological wellbeing.

Academic grit scale for Chinese middle- and upper-grade primary school students: testing its factor structure and measurement invariance

The Academic Grit Scale (AGS) is a novel measure of academic-specific grit. However, its factor structure and measurement invariance have yet to be thoroughly supported. The present study tested the factor structure and measurement invariance of the AGS with a large sample of early adolescents (aged 9-14 years) from China (N = 1,894). The bifactor model showed that the AGS was predominately accounted for by the general factor rather than the domain-specific factors; the parallel model from the AGS's one-factor model showed good fit indices; thus, the AGS should be described as a univocal solution and reported as the total score. Gender and grade measurement invariance were supported at a scalar level, warranting further mean difference comparisons. In addition, academic grit was significantly associated with positive academic emotions and academic achievement, yielding evidence of good criteria-related validity. The current study contributes additional evidence to the construct validity of the Chinese version of the AGS among middle- and upper-grade primary school students in China.

Parental mental health and reporting of their child's behaviour: measurement invariance of the French version of the parental strengths and difficulties questionnaire

Symptomatic effects of mental disorders in parents could bias their reporting on their child's mental health. This study aimed to investigate the measurement invariance of the French version of the parental Strengths and Difficulties Questionnaire (SDQ) across parental mental health in a sample (N = 20,765) of parents of children aged 3 to 17 years in France. Confirmatory factor analysis (CFA) and Exploratory Structural Equation Modelling (ESEM) were used to evaluate the fit of three known alternative SDQ factor structures (five, three, or second-order factor structures). Invariance was tested across parental mental health (present anxiety and depressive symptoms, psychiatric history) and across socio-demographic characteristics (child's age, child's gender, parent's gender, parent's educational level). CFA models showed a poor fit, while all ESEM models achieved acceptable or good fit, with the five-factor model presenting the best fit. Invariance was observed for all characteristics tested, indicating that the SDQ can be used to study the links between parental mental health and their child's mental health without bias. However, ESEM showed that the hyperactivity/inattention and conduct problems dimensions were not well differentiated in the French version of the SDQ.

Illustrating psychometric tests, scales, and constructs: An R package for Item Pool Visualization

Researchers assessing psychological constructs have to understand and choose between several competing measures. Item Pool Visualization (IPV, Dantlgraber et al., 2019) was developed to offer a systematic and detailed portrayal of the actual content and internal balance of competing measures. To enable the use of IPV, we developed and present here the IPV R package. Its aim is to allow researchers to add IPV to their repertoire with minimal effort. Creating IPV charts from raw data requires two simple function calls, because the package streamlines model specification, model estimation, and chart creation. It improves IPV conceptually by introducing the aggregate center distance and the item overview chart. It provides many customization options and generates high-quality, vector-based PDF output. The workflow of the package is explained using a reproducible open data example from a personality assessment.

Psychometric properties of the Persian version of the cognitive emotion regulation questionnaire-short (CERQ-P-short): Reliability, validity, factor structure, treatment sensitivity, and measurement invariance

AIMS

This study aimed to examine the psychometric properties of a widely-used measure of emotion regulation, the short version of the Cognitive Emotion Regulation Questionnaire (CERQ-short), in the Persian language (CERQ-P-short) among Iranian populations.

METHODS

The CERQ-P-short was administered to 1825 participants (female = 974) including 436 adolescents, 834 adults from the general population, 45 patients each with generalized anxiety and obsessive-compulsive disorders, an additional 30 patients each with generalized anxiety and obsessive-compulsive disorders receiving treatment, 45 patients with substance use disorders (SUDs) and an additional 360 adult psychiatric patients. We tested reliability, factor structure, measurement invariance, convergent and discriminant validity, and treatment sensitivity (i.e., intervention response) by age, sex, and diagnostic group. The Depression Anxiety Stress Scale-21 was also administered.

RESULTS

Cronbach's alpha coefficient and test-retest coefficients suggested good reliability. Fit indices suggested that the 9-factor CERQ-P-Short model was good across groups. The CERQ-P-Short showed good measurement invariance in all four models (configural, metric, scalar, and strict) in all groups. Both adaptive and maladaptive cognitive emotion-regulation strategies demonstrated convergent and discriminant validity. Finally, treatment sensitivity of the CERQ-P-Short scale before and after the completion of treatment sessions was suggested for patients with generalized anxiety and obsessive-compulsive disorders.

CONCLUSIONS

While the present study has some limitations, it represents a significant contribution because it supports CERQ-P-Short scales usefulness, validity, and reliability in the general population and among psychiatric patients. The results of the current study can be beneficial to the both clinicians and researchers.

Factor structure and measurement invariance of the Weight-Related Abuse Questionnaire (WRAQ)

Weight-related abuse is defined as verbal or physical maltreatment specific to one's weight. The Weight-Related Abuse Questionnaire (WRAQ) is an instrument specifically designed to measure weight-related abuse. The main goal of this research was to study the factor structure and measurement invariance of the Spanish version of the WRAQ in a non-clinical and a clinical sample. The clinical sample included 150 participants with obesity (60 % women) from the Hospital de Valme (Sevilla, Spain). The non-clinical sample included 301 students (79 % women) from the Spanish Open University (UNED). Scales to measure weight self-stigma and fear of gaining weight were used to analyze the convergent validity of the WRAQ. A confirmatory factor analysis showed that a two-factor model (verbal and physical abuse) was an acceptable fit for the data in both the clinical and non-clinical samples. Multigroup Confirmatory Factor Analysis revealed scalar measurement invariance by sample and gender. Cronbach's alpha coefficients and composite reliability for both samples were found to be good, with values ranging from 0.83 to 0.96. Fear of gaining weight was correlated to verbal (r = 0.36, p < .01) and physical (r = 0.12, p < .05) abuse, and weight self-stigma was also related to physical (r = 0.21, p < .01) and verbal (r = 0.41, p < .01) abuse. These results suggest that the WRAQ can be used in clinical and non-clinical samples to assess verbal and physical abuse in both men and women.

Validation of a Latin-American Spanish version of the Body Esteem Scale for Adolescents and Adults (BESAA-LA) in Colombian and Nicaraguan adults

BACKGROUND

Body dissatisfaction (BD) is a growing concern in Latin America; reliable and culturally appropriate scales are necessary to support body image research in Spanish speaking Latin American countries. We sought to validate a Latin-American Spanish version of the Body Esteem Scale for Adolescents and Adults (BESAA; Mendelson et al. 2001).

METHODS

The BESAA was translated, culturally adapted, and validated in a sample of adults in Colombia (N = 525, 65% women, Mage 24.4, SD = 9.28). We assessed factor structure (using confirmatory factor analysis (CFA), exploratory factor analysis (EFA) and exploratory structural equation model (ESEM)), internal reliability (using Cronbach's alpha and omega), validity (using the Body Appreciation Scale BAS and Sociocultural Attitudes Towards Appearance Questionnaire SATAQ), test-retest stability in a small subsample (N = 84, using Intraclass correlations ICC) and measurement invariance across gender. To evaluate the generalizability of the scale, we assessed reliability, validity, and factor structure in a second sample from rural Nicaragua (N = 102, 73% women, Mage 22.2, SD = 4.72), and assessed measurement invariance across Nicaraguan and Colombian participants.

RESULTS

The scale showed good internal reliability and validity in both samples, and there was evidence of adequate test-retest stability in the Colombian sample. EFA showed a three-factor structure with subscales we labelled 'appearance-positive', 'appearance-negative' and 'weight', that was confirmed using CFA and ESEM in the Colombian sample. Measurement invariance was confirmed across the Colombian and Nicaraguan samples, and across gender within the Colombian sample.

CONCLUSION

The Latin-American Spanish version of the BESAA (BESAA-LA) appears to be a psychometrically sound measure with good reliability, validity and invariance across gender and countries. These results support the use of this scale to measure body satisfaction/dissatisfaction in Latin American adult populations.

Separating Behaviours and Adverse Consequences in the Problem Gambling Severity Index (PGSI): A Confirmatory Factor Analysis and Rasch Analysis

The Problem Gambling Severity Index (PGSI) is considered the "gold standard" for measuring problem gambling. The PGSI provides a single score summed across nine items. The nine items of the PGSI comprise two subdomains: problematic behaviours and adverse consequences. The aim of the present study was to compare evidence of a one-factor structure to evidence of a two-factor structure representing the two subdomains. With a sample of 1,251 bettors, we conducted confirmatory factor analyses and Rasch analyses to assess evidence supporting the one-factor and the two-factor structures. In addition, stochastic search variable selection was conducted with the total PGSI score, PGSI behaviour score, and PGSI adverse consequences score as separate outcomes to examine whether information is lost when collapsing the two subdomains into a single factor. Overall, there was stronger support of a two-factor structure than a one-factor structure. However, the two-factors were highly correlated with one another and shared most predictors except for one. We recommend continued use of the one-factor structure of the PGSI unless one aims to better understand the relationship between problematic behaviours and adverse consequences.

Factor structure of the Oxford Shoulder Score: secondary analyses of the UK FROST and PROFHER trial populations

AIMS

Frozen shoulder and proximal humeral fracture can cause pain, stiffness and loss of function. The impact of these symptoms on patients can be measured using the comprehensively validated, 12-item Oxford Shoulder Score (OSS). Evidence suggests that pain and function may have a differential impact on patients' experience of shoulder conditions, and this may be important for clinical management. We therefore explored the factor structure of the OSS within the UK FROST and PROFHER trial populations.

METHODS

We performed exploratory factor analysis (EFA), followed by confirmatory factor analysis (CFA), on baseline UK FROST data from 490 of the 503 trial participants. Data at 6 months post-randomisation were used for 228 of the 250 participants for the PROFHER trial.

RESULTS

UK FROST factor extraction results, using Velicer's Minimum Average Partial and Horn's Parallel Analysis tests, suggested a unifactorial solution, but two factors were weakly indicated by the less reliable 'Kaiser's eigenvalue > 1' and scree tests. We explored this further using EFA. Eight items (2 to 7, 9 and 10) loaded onto a 'Function' factor, three on a 'Pain' factor (1, 8 and 12) and item 11 cross-loaded. However, one- and two-factor models were rejected in CFA. Factor extraction of PROFHER data at 6 months demonstrated a single first-order factor solution, which was also subsequently rejected in CFA.

CONCLUSION

Insufficient evidence was found, within the constraints of the data available, to support the use of 'Pain' and 'Function' sub-scales of the OSS in either patient population.

An investigation into the factor structure of the Health of the Nation Outcome Scales for People with Learning Disabilities

BACKGROUND

The Health of the Nation Outcome Scales for People with Learning Disabilities (HoNOS-LD) is one of the most used outcome measures in learning disability services in the United Kingdom. There is relatively little known of the psychometric properties of the scales.

METHOD

A data set of HoNOS-LD scales from 571 people with learning disabilities was randomly split into two halves. Exploratory Mokken analysis was applied to the first dataset, and confirmatory scale factor analysis was applied to the second dataset to test the fit of scale structures.

RESULTS

Two-factor and three-factor solutions were explored in the Mokken analysis, with the three-factor option having somewhat better characteristics. One-factor, three-factor and seven-factor solutions were explored using confirmatory factor analysis; a three-factor solution with items 8, 16, 17 and 18 used separately offers the best characteristics.

CONCLUSIONS

The HoNOS-LD is best conceptualised as consisting of three scales, accounting for 14 items that can be labelled as 'Cognitive and Physical Functioning', 'Behaviour and Mood Disturbances' and 'Functional Difficulties'.

Psychometric properties of the Depression, Anxiety, and Stress Scale (DASS-21) among different Chinese populations: A cross-sectional and longitudinal analysis

Given that there is limited evidence concerning the psychometric properties of DASS-21 when applied to primary school students, the present study undertook a comprehensive exploration of the psychometric evidence supporting the use of the DASS-21 within this demographic. The research comprised three studies. In Study 1, the basic psychometric properties of internal consistency and construct validity were examined. A total of 3138 primary school students from three provinces in mainland China participated. The internal reliability of the overall scale was 0.93, and for all the subscales, it was higher than 0.80. Construct validity was partially supported. Both exploratory and confirmatory factor analyses upheld the factorial validity of the original three-factor structure. While convergent validity was established, the results showed unsatisfactory discriminant validity. The bifactor model showed that DASS-21 raw scores predominantly indicated the general factor, evidenced by the high explained common variance and omega-hierarchical values. However, the contributions from the three specific factors were minimal, with their omega hierarchical values all below 0.15. In Study 2, a longitudinal design was adopted, tracking 1366 primary school students from Southwest China over a three-month interval. The results further confirmed that the DASS-21 exhibited scalar time-invariance. The latent mean analysis showed that there were no statistically significant differences in the latent means of depression, anxiety, and stress between Time 1 and Time 2. In Study 3, which included 364 college students and 483 enterprise workers, the results demonstrated that the DASS-21 had measurement invariance across different populations. The latent mean analysis further confirmed that, in terms of the latent mean of all three subscales, both college students and enterprise workers had significantly higher scores than primary school students. Overall, the findings indicated that the DASS-21 is a suitable tool for screening schoolchildren for general psychological distress, but it is not suitable for discerning distinct negative mood state disorders.

The eleven-item Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-11): Cross-cultural psychometric evaluation across 42 countries

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is an instrument to screen substance-use-related health risks. However, little is known whether the ASSIST could be further shortened while remaining psychometrically sound across different countries, languages, gender identities, and sexual-orientation-based groups. The study aimed to validate a shortened 11-item ASSIST (ASSIST-11). Using the International Sex Survey data, 82,243 participants (M age = 32.39 years) across 42 countries and 26 languages completed questions from the ASSIST-11 regarding gender identity, sexual orientation, and other information. Confirmatory factor analysis (CFA) and multigroup CFA (MGCFA) evaluated the ASSIST-11's structure and tested measurement invariance across groups. Cronbach's α and McDonald's ω were used to examine the internal consistency. Cohen's d and independent t-tests were used to examine known-group validity. The ASSIST-11 was unidimensional across countries, languages, age groups, gender identities (i.e., men, women, and gender-diverse individuals), and sexual orientations (i.e., heterosexual and sexual minority individuals). Cronbach's α was 0.63 and McDonald's ω was 0.68 for the ASSIST-11. Known-group validity was supported by Cohen's d (range between 0.23 and 0.40) with significant differences (p-values<0.001). The ASSIST-11 is a modified instrument with a unidimensional factor structure across different languages, age groups, countries, gender identities, and sexual orientations. The low internal consistency of the ASSIST-11 might be acceptable as it assesses a broad concept (i.e., use of several different substances). Healthcare providers and researchers may use the ASSIST-11 to quickly assess substance-use information from general populations and evaluate the need to follow up with more detailed questions about substance use.

Measurement invariance and latent mean differences of the morbid curiosity scale (MCS) across the United States and China

In recent years, there has been a growing body of research focusing on morbid curiosity. However, the development of measurement tools has been slow, with only two scales available. Compared to the unidimensional scale of Curiosity About Morbid Events (CAME) proposed by Zuckerman and Little (1986), the recently developed four-factor Morbid Curiosity Scale (MCS) by Scrivner (2021) demonstrates a stable factor structure and good reliability and validity. As the time since the development of this scale is relatively short, its measurement properties have not been widely evaluated. Therefore, this study used exploratory and confirmatory factor analyses to validate the factor structure of the MCS in the Chinese cultural context, and the results supported the four-factor structure of the MCS. Additionally, we established partial scalar invariance of the MCS between Chinese (N = 663) and American (N = 330) cultures, and further analyzed cultural differences in morbid curiosity using latent mean comparison. The results revealed that Chinese individuals had a lower motivation for understanding the minds of dangerous people. This study validated the four-factor Morbid Curiosity Scale across different cultures for the first time, promoting the generalizability of the four-factor MCS and suggesting its potential for use in a wide range of cultural backgrounds. These findings contribute to enriching cross-cultural research on morbid curiosity and its associated psychological factors.

Psychometric properties of the Spanish version of the academic help seeking scale in a sample of adults

Although academic help-seeking is an important variable in the academic context, as it is related to academic achievement, college adjustment and teacher support, among other variables, no instruments evaluate it in the Spanish adult population. The main goal of the current study was to develop an adaptation of the Academic Help-Seeking Scale for the Spanish adult population with suitable psychometric properties. The sample consisted of 536 adults with an average age of 24.98 (SD = 8.55). The exploratory factor analysis in the first half of the sample suggested that only one factor was underlying the data, and the confirmatory factor analysis in the second half showed that the factor structure replicated in a different sample. The results suggest that this adaptation has appropriate psychometric properties, and adequate reliability and convergent validity. We also found the expected relationships with gender and academic achievement. Therefore, this instrument may be useful for researchers and education professionals who need to assess this behaviour in adults so that they can help them improve their academic performance. The study also contributes to a better understanding of academic help-seeking as an adaptative learning strategy and the variables it is related to.

A factor analytic comparison of three commonly used depression scales (HAMD, MADRS, BDI) in a large sample of depressed inpatients

BACKGROUND

Quantifying depression mainly relies on the use of depression scales, and understanding their factor structure is crucial for evaluating their validity.

METHODS

This post-hoc analysis utilized prospectively collected data from a naturalistic study of 1014 inpatients with major depression. Confirmatory and exploratory factor analyses were performed to test the psychometric abilities of the Hamilton Depression Rating Scale, the Montgomery Asberg Depression Rating Scale, and the self-rated Beck Depression Inventory. A combined factor analysis was also conducted including all items of all scales.

RESULTS

All three scales showed good to very good internal consistency. The HAMD-17 had four factors: an "anxiety" factor, a "depression" factor, an "insomnia" factor, and a "somatic" factor. The MADRS also had four factors: a "sadness" factor, a neurovegetative factor, a "detachment" factor and a "negative thoughts" factor, while the BDI had three factors: a "negative attitude towards self" factor, a "performance impairment" factor, and a "somatic" factor. The combined factor analysis suggested that self-ratings might reflect a distinct illness dimension within major depression.

CONCLUSIONS

The factors obtained in this study are comparable to those found in previous research. Self and clinician ratings are complementary and not redundant, highlighting the importance of using multiple measures to quantify depression.

A Reevaluation of the Factor Structure, Reliability, and Validity of the Spiritual Well-Being Questionnaire (SWBQ)

The 20-item Gomez and Fisher (Personal Individ Differ 35:1975-1991, 2003) Spiritual Well-Being Questionnaire (SWBQ) is a widely used measure of spiritual well-being. Its theoretical model is a higher-order model with primary factors for personal, communal, environmental, and transcendental well-being, and a secondary global spiritual well-being factor. The current study, conducted in Australia, reevaluated the factor structure of the SWBQ. Unlike previous studies, the current study also used exploratory structural equation modeling (ESEM) to examine the factor structure of the SWBQ and selected the preferred model using not only global model fit values, but also the clarity, reliabilities, and validities of the factors in the models. A total of 227 adults (males = 63; females = 164; M age = 26.1 years; SD = 5.2 years) completed the SWBQ. Based on the model selection criteria applied in the study, the ESEM model with four group factors was selected as the preferred model. However, there was also adequate support for the proposed theoretical higher-order model and the first-order oblique model with the four well-being factors. Concerning our preferred model, its factors showed reasonable clarity for factor loadings and (omega) reliabilities. However, only the communal domain scale was supported empirically for external validity. The implications of the findings for the theoretical model, the use of the SWBQ, and future studies are discussed. In this respect, there are three potential models (theorized higher-order model, 4-factor first-order oblique model, and the ESEM model proposed in this study) that warrant further detailed investigation with a larger, more representative population and additional validation measures.

Clinical significance of novel 8-factor model of DSM-5 PTSD in national VA PTSD residential treatment data: Internally- v. externally-cued intrusions

BACKGROUND

Intrusion symptoms are a core defining feature of posttraumatic stress disorder (PTSD). It was recently proposed that intrusions may be comprised of two distinct underlying processes: internally-cued intrusions (e.g., trauma-related memories), and externally-cued intrusions (e.g., reactivity to trauma-related cues in one's environment). This is the first study to examine the functional correlates of these two intrusion clusters.

METHODS

Participants included 7460 veterans discharged from 40 Veterans Affairs PTSD residential programs across the United States in fiscal years 2018 through 2020. Latent network modeling and structural equation modeling were used to assess the fit of an 8-factor model of PTSD symptoms, which were assessed using the PTSD Checklist for DSM-5 (PCL-5) PTSD symptoms at admission, and its association with symptoms of depression and generalized anxiety, and emotional and physical functioning.

RESULTS

The 8-factor model, with separate intrusion factors, showed superior model fit to the DSM-5 4-factor, 5-factor dysphoric arousal, 6-factor anhedonia, and 7-factor hybrid models of PTSD. Internally-cued intrusions were uniquely associated with dysphoric arousal, decreased avoidance, and worse physical health functioning; whereas, externally-cued intrusions were uniquely associated with greater avoidance, anxious arousal, negative affect, increased generalized anxiety symptoms, and worse emotional functioning.

LIMITATIONS

Limitations include the cross-sectional design and use of self-report measures.

CONCLUSIONS

Findings provide initial support for the clinical utility of a novel 8-factor model of PCL-5 PTSD symptoms, which distinguishes internally- and externally-cued intrusions. These separate intrusion symptom clusters may offer greater specificity and utility in informing the prognosis of and tailored interventions for PTSD.

Psychometric properties of the Sinhala version of the Swanson, Nolan, and Pelham rating scale (SNAP-IV) Parent Form in healthy children and children with ADHD

OBJECTIVE

The present study aimed to translate and adapt the Parent Form of the MTA Version of the Swanson, Nolan, and Pelham ADHD/ODD rating scale (SNAP-IV) into Sinhala and examine its psychometric properties.

METHOD

The MTA version of the SNAP-IV was translated into the Sinhala language by adhering to the WHO translation and adaptational process. The final Sinhala SNAP-IV (S-SNAP-IV) was administered to parents of 412 healthy children and adolescents (age: 6-18 years), and 272 children and adolescents with ADHD (age: 4-19 years). Internal consistency and factor structure of the S-SNAP-IV were determined in each sample.

RESULTS

Conforming to that of the original English version, the S-SNAP-IV showed a three-factor structure (inattention, hyperactivity/impulsivity, and oppositional defiant disorder) in each sample, except for three item deviations (10,11, and 13) in the healthy sample. The S-SNAP-IV showed excellent internal consistency in the total sample (Cronbach's alpha = 0.97), healthy sample (Cronbach's alpha = 0.90), and the clinical sample (Cronbach's alpha = 0.94). The S-SNAP-IV also showed good discriminative validity: Only 1.5% of the healthy sample exceeded the cut-off scores in any domain, whereas all newly diagnosed, unmedicated children were S-SNAP-IV positive in at least one domain.

CONCLUSIONS

The findings suggest that the three-factor model fits the S-SNAP-IV, and it clearly distinguishes children with ADHD from non-ADHD children. We conclude that the S-SNAP-IV possesses satisfactory psychometric properties-consistent with the MTA English version and its translations into other languages-making it a reliable and valid instrument for screening children with ADHD.

Factor structure of the Young Positive Schema Questionnaire in an eating disorder sample

PURPOSE

The Young Positive Schema Questionnaire (YPSQ) measures early adaptive schemas (EAS) which could be used to develop positive psychology and schema-based interventions to benefit the treatment of eating disorders (EDs).

METHODS

The present study investigated the factor structure of the YPSQ in a sample of 826 participants (18-73 years; n = 753 women) with ED symptomatology (e.g., restricting, binging, and purging). The sample was randomly split into two groups for exploratory and confirmatory factor analyses. Full sample analysis using Pearson correlations was conducted to explore convergent validity of the new YSPQ factor structure with ED symptomatology, emotional regulation, and cognitive flexibility.

RESULTS

A nine-factor model was found, demonstrating good fit indices and internal consistency (α = 0.77-0.92). The YPSQ showed an inverse relationship to ED symptomatology and emotional suppression, and a positive relationship with cognitive flexibility and emotion reappraisal.

CONCLUSION

Further research is needed to explore the clinical benefits of the YPSQ to identify EAS deficits in individuals with EDs to improve treatment outcomes.

LEVEL OF EVIDENCE

Level V, descriptive study.

Adaptive depends on context: An examination of the Intuitive Eating Scale-2 in an eating disorder sample

Though there is a robust literature base linking intuitive eating (IE) to better psychological health and reduced eating pathology, little is known about the psychometric properties of IES-2 measurement or how IE relates to eating psychopathology within eating disorder clinical samples. Importantly, some seemingly adaptive eating behaviors in non-clinical populations could conceivably result from disordered eating within clinical eating disorder populations (e.g., not eating when not hungry because of distorted hunger-fullness cues, furthering restriction). This study examined the factor structure, psychometric properties, and correlates of the Intuitive Eating Scale-2 (IES-2) in a transdiagnostic eating disorder sample (N = 224). Participants at an eating disorder specialty treatment center completed the IES-2 upon assessment, along with other symptomology measures. A confirmatory factor analysis was performed, finding a poor model fit in this transdiagnostic sample, CFI = 0.889, TLI = 0.869, RMSEA = 0.095, TLI = 0.869, and SRMR = 0.099. Through exploratory factor analysis, we identified a factor solution for the measure that can be used transdiagnostically in this population, with revised scoring and modifications. As expected, the IES-2 demonstrated construct validity, with higher IE being associated with lower eating pathology (r = -0.36, p < .01), lower clinical impairment (r = -0.26, p < .01), lower body image dissatisfaction (r = -0.39, p < .05), and lower depressive symptoms (r = -0.20, p < .01), supporting construct validity. As anticipated, IES-2 was not related to emotion regulation, supporting discriminant validity. This study suggests that the IES-2 does not perform as expected in a transdiagnostic clinical eating disorder population, and instead, a revised scored 21-item IES-2 is suggested, with interpretation of only the total score and two subscales.

Psychometric properties of the eating disorder examination questionnaire: Factor analysis and measurement invariance by race/ethnicity and gender

OBJECTIVE

The Eating Disorder Examination Questionnaire (EDE-Q) was originally validated in non-Hispanic White women and has become widely used as an assessment tool for research on eating pathology in college students. However, the original factor structure has generally failed to replicate across various samples, especially among diverse populations. The current study examined the factor structure and measurement invariance of the EDE-Q in a large sample of racially/ethnically diverse college men and women.

METHOD

Participants included a diverse sample of men and women from two universities (N = 1981). Exploratory factory analysis (EFA) was conducted to examine the factor structure of the EDE-Q, followed by confirmatory factor analysis (CFA) to verify the factor structure, and establish the configural model. Furthermore, we explored the measurement invariance of the configural model by gender (i.e., men, women) and race/ethnicity (i.e., White, Black, Asian, Hispanic, and multiracial).

RESULTS

EFA and CFA results suggested a three-factor, 10-item measure best fit the data, reflecting Dietary Restraint, Preoccupation and Eating Concern, and Shape/Weight Overvaluation. This measure achieved strict invariance by gender and race/ethnicity, indicating that mean comparisons across groups are meaningful. Women, relative to men, reported higher scores for all subscales. Significant differences across race/ethnicity emerged for Dietary Restraint and Shape/Weight Overvaluation in which Hispanic individuals endorsed the highest means compared to other racial/ethnic groups.

DISCUSSION

The three-factor, 10-item measure is a brief, valid, and reliable measure of eating disorder psychopathology for U.S. college students.

The assessment of Intolerance of uncertainty in youth: An examination of the Intolerance of Uncertainty Scale-Revised in Italian nonclinical boys and girls

Intolerance of Uncertainty (IU) is a transdiagnostic factor involved in several psychological disorders. Adolescence is characterized by elevated uncertainty and psychopathological vulnerability, but insufficient attention has been paid to IU at this age. This study aimed to investigate the factor structure and psychometric properties of the Intolerance of Uncertainty Scale-Revised (IUS-R) in Italian preadolescents and adolescents. 862 Italian students (57.3% girls) aged 11-17 (M = 14.8 ± 1.91) completed the IUS-R and measures of internalizing and externalizing symptoms, and psychological well-being. To test the factor structure of the IUS-R, one-factor, two-factor, and bifactor models were compared; measurement invariance, reliability, and validity were also addressed. Results showed that the bifactor model outperformed alternative factor models, and a general factor was needed to model the IUS-R. Bifactor model indices supported using the total score to assess IU reliably. Configural and metric invariance by age and sex were fully supported, while the IUS-R achieved partial scalar invariance. Significant correlations emerged for the IUS-R total score with psychopathological constructs, while no relationships with psychological well-being were found. Compared to adult normative data, higher total IUS-R scores were detected, suggesting that IU may be a phase-specific characteristic of adolescence. Our findings support using the IUS-R to measure IU across the lifespan. The recommended use of the total score and its associations with psychopathological dimensions highlight the transdiagnostic nature of IU in adolescence. Therefore, including IU when implementing interventions to prevent maladaptive outcomes in teenagers would be beneficial.

The Social Safeness and Pleasure Scale (SSPS): a psychometric evaluation of the Swedish version in a non-clinical sample and two clinical samples with eating disorders or borderline personality disorder

BACKGROUND

Social safeness and pleasure refer to the extent to which people experience their world as safe, warm, and soothing. Difficulties in achieving social safeness have been identified as a transdiagnostic vulnerability factor for developing and maintaining psychopathology and for feeling less contentment and self-compassion. The study aim was to evaluate the psychometric properties of the Swedish version of the Social Safeness and Pleasure Scale (SSPS).

METHODS

The SSPS was evaluated in a non-clinical sample of 407 participants. The internal consistency and test-retest reliability of the SSPS were explored and a confirmatory factor analysis was performed. Convergent validity was studied based on the assumption of negative correlations with the personality traits detachment and mistrust, derived from the Swedish Universities Scale of Personality. Divergent validity was studied based on the assumption of no or small correlations with impulsiveness and adventure-seeking-personality traits not assumed to be related to social safeness. Validity was also investigated by comparing the SSPS results in the non-clinical sample with those in two clinical groups of patients diagnosed with either borderline personality disorder (BPD; n = 58) or eating disorders (n = 103), recruited from two psychiatric outpatient clinics.

RESULTS

Confirmatory factor analysis confirmed a one-factor structure. Cronbach's alpha was 0.95 and test-retest reliability was 0.92. Validity was supported by moderate to strong negative correlations between the SSPS and the detachment and mistrust scales and no or small correlations with the impulsiveness and adventure-seeking scales in a personality questionnaire. Finally, we found significantly lower mean values on the SSPS in the clinical groups compared with the non-clinical group, with the lowest mean in the BPD sample.

CONCLUSIONS

The results showed good to excellent psychometric properties for the Swedish version of the SSPS, supporting its use in both clinical practice and research. Future research could use the SSPS when evaluating interventions aimed at improving the ability to develop social safeness, such as compassion-focused therapy or radically open dialectical behavior therapy, interventions that may be particularly important in BPD patients.

Executive functions in mono- and bilingual children: Factor structure and relations with fluid intelligence

The effects of bilingualism on executive functions (EFs) and intelligence are still controversially discussed. Most studies have focused on performance differences without considering the underlying structure of cognitive abilities. Thus, we examined whether the structure of EFs and the relations of EFs with intelligence differ between mono- and bilingual children. A total of 240 elementary school children (mean age = 8 years 6 months; 133 monolinguals and 95 bilinguals) performed two tasks measuring working memory, inhibition, cognitive flexibility, and fluid intelligence, respectively. Confirmatory factor analyses showed that one common EF factor provided the best fit to the data in both language groups, indicating that bilingualism is not associated with differences in the EF structure at this age. Moreover, there were no latent performance differences in either EFs or intelligence between mono- and bilingual children. However, we found a stronger relation between a common EF factor and fluid intelligence in bilingual children as compared with monolingual children, implying a closer coupling of EFs and intelligence abilities in bilingual children. This contributes to explaining the previous heterogeneous findings on the task level because more closely coupled cognitive functioning can be slightly beneficial for some tasks and irrelevant or even slightly obstructive for others.

The clinical perfectionism questionnaire: psychometric properties of the Italian version in patients with eating disorders

BACKGROUND

Problematic perfectionism has been traditionally conceptualized as a multidimensional construct, and specific instruments have been developed to capture its various dimensions. However, the Clinical Perfectionism Questionnaire (CPQ) was recently designed to measure a unidimensional construct called "clinical perfectionism", but the questionnaire has not yet been validated in Italian.

AIM

This study aimed to propose the Italian version of the CPQ and examine its psychometric properties.

METHODS

The CPQ was translated into Italian using translation and back-translation procedures. Then, it was administered to 188 Italian-speaking patients with eating disorders and 126 non-eating disorder group (excluded if the Italian version of the Eating Attitudes Test-26 was ≥ 20). The clinical group also completed the Italian versions of the Frost Multidimensional Perfectionism Scale (FMPS), the Eating Disorder Examination Questionnaire (EDE-Q), and the Brief Symptom Inventory (BSI).

RESULTS

Confirmatory factor analysis revealed a good fit for the bifactor structure of the 10-item version. Internal consistency was high for the general clinical perfectionism factor, and test-retest reliability was good. Convergent validity was acceptable for the general clinical perfectionism and 'overvaluation of striving' group factors. The CPQ showed significantly higher scores in patients with eating disorders than in the non-eating disorder group.

CONCLUSIONS

Overall, the study demonstrated the good psychometric properties of the Italian version of the CPQ, and validated its use in Italian-speaking patients with eating disorders. Although further research is required, the CPQ has promising evidence as a reliable and valid measure of clinical perfectionism in its Italian version.

LEVEL OF EVIDENCE

Level V, Descriptive study.

Factor structure and item response of psychosis symptoms among Kenyan adults

BACKGROUND

The aim of this study was to evaluate the construct validity of the psychosis module of the Mini International Neuropsychiatric Interview version 7.0.2 (MINI-7).

METHOD

We utilized data collected from 2738 participants with a primary psychotic or bipolar disorder. Participants were drawn from two Kenyan sites of a large multi-center neuropsychiatric genetic study. The factor structure of the MINI-7 psychosis items were explored using confirmatory factor analyses (CFA) and Item Response Theory approach, for the full sample and by gender.

RESULTS

The CFA revealed that a 1-factor model provided adequate fit for the MINI-7 psychosis items for the full sample (x2 = 397.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.90) as well as for the female (x2 = 185.16.92, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.93; TLI = 0.91) and male groups (x2 = 242.09, df = 35, p < .0001; RMSEA = 0.06; CFI = 0.92; TLI = 0.89). Item thresholds for the full sample, and female and male groups were highest for 'odd beliefs' (-1.42, -1.33, and -1.51 respectively) and lowest for 'visual hallucinations' (-0.03, -0.04, and -0.01 respectively).

LIMITATIONS

Our study used a hospital-based population, which may have excluded patients with milder psychotic symptoms. Findings may therefore not be generalizable to the community setting.

CONCLUSIONS

Our findings indicate good construct validity of the MINI-7 psychosis module, and provides support for use of the tool in diagnosing psychotic disorders in clinical settings in Kenya.

Psychometric properties of the Utrecht Work Engagement Scale for Students (UWES-S) in the Taiwanese context

Academic engagement in recent years has become the focus of determining student learning and achievement. However,despite this growing awareness that has revolutionized academic policies and educational approaches, literature on engagement in the academic context is still in its infancy. This study seeks to remedy this through the confirmation of the Utrecht Work Engagement Scale for Students' (UWES-S) promising psychometric properties and by providing empirical evidence on the relationship between academic engagement, personality traits, and social media addiction, a determinant that has yet to be explored. Our findings indicate that of the five personality traits analyzed, agreeableness had the strongest negative correlation with academic engagement, and perhaps equally as striking is the positive, albeit insignificant, association between social media and academic engagement. Furthermore, the most informative and least informative items for academic engagement were identified using IRT analysis. Finally, this study also addresses several gaps in the literature by determining that the one-factor construct of the UWES-S is an adequate measure of academic engagement compared to its three-factor counterpart and by demonstrating the measurement invariance of the UWES-S across gender, class year, and academic major in our sample of Taiwanese undergraduates.

Symptom dimensions stability over time in recent onset psychosis: A prospective study

BACKGROUND

The factorial structure of schizophrenia symptoms has been much debated but little is known on its degree of unicity, specificity as well as its dynamic over time. Symptom differentiation is a phenomenon according to which patients' symptoms could differentiate from one another during illness to form more independent, distinct dimensions. On the contrary, symptom dedifferentiation is an increase in the correlations between those symptoms over time. The goal of this study was to investigate symptom differentiation or dedifferentiation over time in recent onset psychosis using the Positive and Negative Syndrome Scale.

METHODS

A confirmatory factor analysis model based on the consensus five-factor model of the Positive and Negative Syndrome Scale for schizophrenia was estimated on seven different time points over a three-year period. A general factor capturing common variance between every symptom was also included. Explained common variance was computed for the general factor and each specific factor.

RESULTS

Three hundred and sixty-two recent onset psychosis patients were assessed. Results showed no evidence for either symptom differentiation or dedifferentiation over time. Specific symptoms accounted for >70 % of the variance suggesting a high degree of specificity of the symptomatology.

CONCLUSIONS

Overall, this study adds support for a highly multidimensional approach to clinical symptom assessment with an explicit focus on depression. The premise behind the staging approach being inherently one-dimensional, implications for further research is discussed.

Factor structure, measurement invariance, and concurrent validity of the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder scale-7 in a Norwegian psychiatric outpatient sample

OBJECTIVE

The aim of this study was to test factor structure, measurement invariance, and concurrent validity of the nine item Patient Health Questionnaire-9 (PHQ-9) and the seven item Generalized Anxiety Disorder scale-7 (GAD-7) in a heterogeneous outpatient sample.

METHOD

Outpatients completed the PHQ-9, GAD-7, and the Working Social Adjustment Scale (WSAS) before starting treatment. Study design was cross-sectional, with convenience sampling. The total sample consisted of 831 participants (61% women).

RESULTS

Both PHQ-9 and GAD-7 demonstrated better fit statistics with two-factor and bifactor solutions consisting of a cognitive and somatic factor. Omega hierarchical was .78 for PHQ-9 and .81 for GAD-7. Both instruments achieved scalar invariance across gender, diagnosis, and comorbidity. However, the somatic factors demonstrated poor discriminant validity. These factors are not well separatable and risks being too similar if used together. The general factors of both instruments were most associated with functional impairment, although PHQ-9 demonstrated a stronger association with WSAS (γ = .74, r² = .62) than GAD-7 (γ = .54, r² = .32). Using latent mean difference, women and patients with comorbidity had significantly higher scores of both depression and anxiety.

CONCLUSION

This study shows that the PHQ-9 and GAD-7 may be used as one-dimensional instruments in clinical settings. Tests for measurement invariance supported that both measures are understood and interpreted comparably across gender and diagnostic subgroups.

Tic disorders and premonitory urges: validation of the Spanish-language version of the Premonitory Urge for Tics Scale in children and adolescents

INTRODUCTION

Most people with persistent tics report an unpleasant sensation (premonitory urge) before the tic. In recent years, interest in these sensory phenomena has increased due to their important role in behavioural therapy. However, instruments for assessing these sensations remain scarce. Among the available instruments, the Premonitory Urge for Tics Scale (PUTS) is the most widely used.

METHODS

We examined the psychometric properties and factor structure of the Spanish-language version of the PUTS in a sample of 72 children and adolescents with Tourette syndrome or persistent tic disorders. We analysed data from the total sample and by age group (children up to 10 years old and children/adolescents over 10).

RESULTS

The PUTS presented good internal consistency and moderate correlations between items on the scale (except for item 1). Divergent validity was good, test-retest reliability was adequate, and a bifactorial structure was identified (one dimension related to mental phenomena reported in obsessive-compulsive disorder, and another related to the quality and frequency of premonitory urges). These results were replicated in both age groups, with lower divergent validity and test-retest reliability in the younger group.

CONCLUSIONS

The Spanish-language version of the PUTS is a valid, reliable tool for assessing premonitory urges in both children and adolescents, especially after the age of 10.

Factor structure of ten psychoactive substance addictions and behavioural addictions

Over the past two decades, many problematic/excessive behaviours have increasingly been conceptualized as addictions due to their similarity with more traditional psychoactive substance addictions. The primary aim of the present study was to simultaneously examine the factor structure of three psychoactive substance addictions (alcohol use, cigarette smoking, and substance use) and seven behavioural addictions (sex, social media use, shopping, exercise, online gambling, internet gaming, and internet use), using exploratory factor analysis (EFA; N = 481) and confirmatory factor analysis (CFA; N = 487). A total of 968 participants completed an online survey including ten psychometric scales assessing the ten different potentially addictive behaviours. EFA supported a two-factor solution, with different factors for the psychoactive substance and behavioural addictions (excluding exercise addiction). CFA supported the two-factor model in a separate sample. There was good support for the concurrent and discriminant validities of the CFA latent factors and the reliability of the behavioural latent factor in the two-factor CFA model. While there was support for the concurrent and discriminant validities of the psychoactive substance latent factor, there was insufficient support for its reliability. The taxonomic, theoretical, and clinical implications of the findings are discussed.

The psychometric properties of the grazing questionnaire in an obesity sample with and without binge eating disorder

BACKGROUND

Despite being the first validated measure of grazing, the Grazing Questionnaire (GQ) has not been investigated among individuals with obesity. Therefore, the current study aimed to examine the psychometric properties of the GQ in an obesity sample.

METHODS

Participants (N = 259) were recruited from community and clinical settings in Australia. The sample comprised adults with normal weight (n = 77) and obesity (n = 182). A portion of individuals with obesity (n = 102) had binge eating disorder (BED). Data from the obesity group was examined to establish the factor structure, validity, and reliability of the GQ. A one-way ANOVA with planned contrasts was conducted to compare scores on the GQ across groups.

RESULTS

Confirmatory factor analysis revealed that the 2-factor model of the GQ was the best model fit for individuals with obesity. The GQ demonstrated high internal consistency, test-retest reliability over 3 months, and convergent and divergent validity. As hypothesised, the obesity group had significantly higher scores on the GQ than the normal weight group, while the obesity with BED group had significantly higher scores than the obesity without BED group.

CONCLUSION

This was the first study to investigate the psychometric properties of the GQ in an obesity sample. Overall, findings indicated that the GQ is a psychometrically sound measure of grazing among individuals with obesity. These findings provide further support for two distinct subtypes of grazing and highlight the importance of increased assessment and management of grazing behaviours for individuals with obesity and eating disorders. Maintaining a healthy weight is one of the greatest challenges for individuals with obesity. Certain eating patterns such as grazing may contribute to difficulties in weight management. Grazing is the repetitive and unplanned eating of small amounts of food that is not related to feeling hungry. Researchers and clinicians often use self-report questionnaires to measure grazing. However, the first validated questionnaire of grazing has not been investigated among individuals with obesity. Therefore, the goal of this study was to examine and validate the Grazing Questionnaire in individuals with obesity. Overall, our results showed that the Grazing Questionnaire is a valid and reliable self-report measure of grazing in individuals with obesity. Similar to previous research, we found that there are two subtypes of grazing. The first subtype involves continuous, unplanned eating. The second subtype is associated with a sense of loss of control over eating. We also found that people with obesity and binge eating disorder graze more than people with obesity that do not have binge eating disorder, while both groups graze more than individuals with normal weight. We recommend that clinicians routinely assess and treat unhelpful grazing patterns when working with individuals with obesity and eating disorders.

Psychometric properties of a Farsi translation of the Functionality Appreciation Scale (FAS) in Iranian adolescents

The 7-item Functionality Appreciation Scale (FAS; Alleva et al., 2017) measures an individual's appreciation of their body for what it can do and is capable of doing (i.e., functionality appreciation). However, few studies have assessed the psychometric properties of the FAS in non-English speaking populations and in younger age groups. Here, we examined the psychometric properties of a novel Farsi translation of the FAS in Iranian adolescent girls and boys. A sample of 828 Iranian adolescents completed the FAS alongside the Rosenberg Self-Esteem Scale and the Beck Depression Inventory-II. Participants were randomly split into a first split-half for exploratory factor analysis (EFA) or a second split-half for confirmatory factor analysis (CFA). The EFA broadly supported a 1-dimensional model of FAS scores, although one item had low item-factor loadings. The CFA indicated that both the 6- and 7-item models had adequate fit. In further analyses, we found that the 7-item unidimensional model was invariant across gender and that higher FAS scores were significantly associated with higher self-esteem and lower depressive symptoms, indicative of convergent validity. These results provide evidence that the Farsi translation of the FAS is reliable and valid for use in Iranian adolescent girls and boys.

Psychometric properties and factor structure of the Kessler-10 among Ethiopian adults

BACKGROUND

Many common mental disorders are underdiagnosed and undertreated in low-resource countries. The ten-item Kessler Psychological Distress Scale (K10) is a brief screening tool widely used to assess psychological distress. We evaluated the K10's performance in an Ethiopian population by assessing internal consistency and construct validity through factor structure.

METHODS

K10 survey responses and sociodemographic data were collected from 1928 adults, including patients and caregivers from a general medical setting, who served as controls of a large epidemiological study.

RESULTS

The K10 had good internal consistency, with a Cronbach's alpha of 0.83. Results from exploratory factor analyses showed that the K10 had a two-factor solution that accounted for approximately 66% of the variance. Confirmatory factor analyses demonstrated that a unidimensional model with correlated errors, informed by a theoretical model, was the best fitting model for the setting (comparative fit index of 0.90 and root mean square error of approximation of 0.10).

LIMITATIONS

We did not assess the K10's test-retest reliability or its criterion validity (i.e., agreement with a reference measure).

CONCLUSIONS

Based on internal consistency and construct validity, the K10 can effectively assess psychological distress among Ethiopian adults for population-based research and potentially clinical screening, consistent with previous findings in this setting. Further studies are needed to test its criterion validity against a reference measure of psychological distress.

Hindi Adaptation and Psychometric Validation of the Affiliate Stigma Scale

BACKGROUND

The Affiliate Stigma Scale (ASS) is a widely used tool to measure affiliate stigma in the caregivers of individuals with various types of mental illnesses. However, the Hindi adaptation of this scale with evident psychometric properties is not available. This study aimed to adapt the ASS in the Hindi language and, further, to validate it in the Indian setting.

METHODS

Translation and back-translation methods were used to translate the original items of the ASS to the Hindi language. After completion of translations and linguistic adaptation process, the Hindi translated version of the ASS, WHO Quality of Life-BREF (WHOQOL-BREF), General Health Questionnaire-12 (GHQ-12), and Hospital Anxiety and Depression Scale (HADS) were administered to 140 caregivers of persons with mental illness. Purposive sampling method was adopted. The age range of the participants was 17-60 years. Psychometric properties, as well as the factor structures of the scale, were evaluated.

RESULTS

The Hindi version of the ASS has adequate internal consistencies (r = 0.87-0.93) and test-retest reliability (r = 0.78, P < 0.001). The concurrent validity of this scale was also high, as the correlation coefficients among the Hindi version of the ASS, WHOQOL-BREF, GHQ-12, and HADS were ranging from 0.23 to 0.35. The exploratory factor analysis revealed three underlying factors, namely, cognition, affect, and behavior.

CONCLUSIONS

The Hindi version of the ASS is a reliable and valid psychometric tool to measure affiliate stigma in caregivers of patients with mental illness.

Development and validation of the Health Education Adherence Scale for Stroke Patients: a cross-sectional study

Background

Due to the lack of health education adherence assessment tools for stroke patients, the assessment of health education adherence in this population is insufficient, which hinders the prevention and rehabilitation of stroke. This study aims to develop and validate a Health Education Adherence Scale for Stroke Patients (HEAS-SP).

Methods

A cross-sectional design with a purposive sampling method was used for this study. Six hundred and fifty-four eligible participants completed the demographic questionnaire and the HEAS-SP. The data collection lasted for 7 months, from March 1stto September 30th in 2019. Item analysis and exploratory and confirmatory factor analysis were employed to develop and validate the HEAS-SP.

Results

The item analysis, exploratory and confirmatory factor analysis resulted in a 20-item HEAS-SP with 4 domains: medication adherence, diet adherence, rehabilitation exercise adherence, and healthy lifestyle adherence. The four-domain model demonstrated acceptable model fit indexes and the 20-item HEAS-SP demonstrated acceptable reliability and validity.

Conclusion

The 20-item HEAS-SP was shown to have acceptable reliability and validity for assessing health education adherence with respect to diet, medication, rehabilitation exercise and healthy lifestyle in stroke patients, making it a potential basis for developing targeted interventions for stroke patients.

Psychometric Properties of the Korean version of the Emotion Regulation Questionnaire (K-ERQ) in a Clinical Sample

OBJECTIVE

The Emotion Regulation Questionnaire (ERQ) is one of the widely used instruments to assess emotion regulation skills in many countries, including Korea. However, its psychometric properties have not been validated within this population. Also, the ERQ has increasingly been used in studies with psychiatric patients despite a general lack of validation in clinical settings. Therefore, the present study aimed to investigate the psychometric properties of the Korean version of the ERQ (K-ERQ) using a clinical sample in Korea.

METHODS

One hundred and ninety-three psychiatric patients completed a packet of self-report measures, including K-ERQ, K-BDI-II, K-ASI-3, PCL-5-K, AUDIT-K. Confirmatory factor analysis (CFA) was administered to investigate the factor structure of the K-ERQ, and internal reliability and validity were examined.

RESULTS

Results of the CFA supported the two-factor structure, but only after the removal of one item. The K-ERQ showed good internal consistency reliability, and its concurrent validity was also confirmed. Cognitive reappraisal was negatively correlated with depression and alcohol use disorder-related symptoms, and expressive suppression was positively correlated with depression, anxiety sensitivity, posttraumatic stress disorder (PTSD)-related symptoms and alcohol use disorder-related symptoms. Significant group differences were found in the use of emotion regulation strategies; patients with PTSD reported the higher level of cognitive reappraisal than patients with depressive disorders, bipolar disorders, and attention-deficit hyperactivity disorder.

CONCLUSION

The 9-itemed K-ERQ is a reliable and valid tool to assess the emotion regulation strategies in a Korean clinical sample. Our study also adds preliminary evidence on the usefulness of the ERQ in clinical settings.

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.

Does a unique co-occurring OCD and PTSD factor structure exist?: Examination of overlapping OCD and PTSD symptom clusters

OCD and PTSD share many commonalities, including phenotypic and functional overlap in symptoms. Specifically, both disorders are characterized by unwanted, intrusive, anxiety/distress-eliciting intrusive thoughts and evoking behaviors intended to control, neutralize, suppress, or outright avoid intrusive thoughts and associated anxiety/distress. Extant factor analytic research supports a model of PTSD at odds with current DSM-5 criteria, and no examination of the factor structure of comorbid OCD+PTSD currently exists despite the noted overlap in symptomatology and high rates of comorbidity. Using a sample of 4073 patients diagnosed with OCD and/or PTSD enrolled in intensive treatment programs for OCD or PTSD, multigroup confirmatory factor analysis (MGCFA) and measurement invariance tests were run to determine the best fitting model of OCD and PTSD symptoms in patients with OCD+PTSD. Four models were compared across patients with OCD, PTSD, and OCD+PTSD: DSM-5 and 7-factor hybrid PTSD models with OCD symptoms structured as either combined or comorbid constructs. The comorbid hybrid model proved the best fit, and both hybrid models evidenced better fit than DSM-5 models. The current study lends additional support for the hybrid model of PTSD and suggests that there is no existence of a unique factor structure of OCD and PTSD symptoms in individuals with the comorbid conditions.

Exploring the factor structure of the mini-ICF-APP in an inpatient clinical sample, according to the psychiatric diagnosis

INTRODUCTION

Psychosocial functioning is a key factor determining prognosis, severity, impairment and quality of life in people who have a mental disorder. The mini-ICF-APP was developed to provide a standardised classification of functioning and disability. However, despite its gaining popularity little is known about its structure and performance. This paper examines the structure of the mini-ICF-APP using factor analysis techniques.

MATERIALS AND METHODS

In a clinical sample of 3178 patients, with psychiatric diagnoses from several ICD-10 categories, we analysed internal consistency, item inter-correlations and the factorial structure of the data, with reference to ICD-10 diagnostic categories; Neurocognitive Disorders; Alcohol Use Disorders; Substance Use Disorders; Schizophrenia and Psychotic Disorders; Bipolar Disorder; Major Depressive Disorder; Anxiety Disorders; Personality Disorders; and Neurodevelopmental Disorders.

RESULTS

We found good internal consistency and item inter-correlations (Cronbach alpha=0.92) for the mini-ICF-APP. We were able to identify pivotal domains (flexibility, assertiveness and intimate relationships), which demonstrate sub-threshold influences on other domains. The factor analysis yielded a one-factor model as ideal for the whole sample and for all diagnostic categories. For some diagnostic categories the data suggested a two or three-factor model, however, with poorer fit indices.

CONCLUSIONS

The factor structure of the mini-ICF-APP appears to modify according to the main diagnosis. However, a one-factor model demonstrates better fit regardless of diagnostic category. Consequently, we consider the mini-ICF-APP to be a trans-diagnostic measurement instrument for the assessment and grading of psychosocial functioning. The use of the mini-ICF-APP sum score seems to best reflect the degree of impairment in an individual, even taking into account that affected domains may lead to sub-threshold effects on other domains.

Translation and psychometric evaluation of the Experience of Embodiment Scale in a Swedish community sample of young women and men

This report describes a Swedish translation and psychometric evaluation of the Experience of Embodiment Scale (EES; Piran, Teall, & Counsell, 2020), an instrument for assessing a wide range of positive and negative experiences of living in the body. A community sample (N = 545) of Swedish young women (56%) and men (M_age = 24.4; SD = 0.52) completed the Swedish translation of the EES. To explore its construct validity, participants also completed measures of body esteem, disordered eating, internalization of appearance ideals, drive for muscularity and leanness, body mass index, life satisfaction, self-esteem, and psychological distress. Exploratory factor analyses (performed separately for women and men) revealed structures of the Swedish EES similar to those displayed during the development and first evaluations of the scale in North America. However, among men, the factors of agency and sexual desire combined to form one factor. On total scale level, the Swedish EES showed good internal consistency (McDonald's ω = .95 for women; ω = .94 for men), convergent validity, and incremental validity. Overall, the present findings support the Swedish version of the EES and the EES's cross-national use to assess the construct of embodiment, as well as its use among men.

Developing and validating a measurement tool to self-report perceived barriers in substance use treatment: the substance use treatment barriers questionnaire (SUTBQ)

BACKGROUND

Substance using often cause a wide range of social, health, and psychological problems. This study aimed to develop and validate a questionnaire of barriers of treatment in substance users.

METHODS

In this cross-sectional study, the initial questionnaire was designed based on the evaluation of previous studies. The preliminary tool including 35 Likert-scaled items. After assuring the face validity of the questionnaire, 13 experts' opinions were obtained for assessing or improving the content validity. The reliability was investigated by internal consistency methods using Cronbach's alpha. For measuring the structural validity, the exploratory factor analysis was performed to determine the dimensionality of the questionnaire using principal components extraction and Varimax rotation.

RESULTS

The preliminary questionnaire consisted of 35 items. After completing the face validity and summarizing the experts' suggestions, 8 items were removed. By calculating the content validity ratio and coefficient, 11 questions were deleted. The internal consistency was calculated to be 0.84 using Cronbach's alpha. In the last stage and according to the results of the factor analysis, three factors fear of or unawareness of treatment, doubt or inefficiency, and social stigma were identified from the 10-items questionnaire, which explained 67.34% of the total variance.

CONCLUSION

Considering the necessity of using a validated tool for planning and evaluating effective interventions on people who use substance is inevitable. The Substance use Treatment Barriers Questionnaire is designed with 10 items and 3 dimensions, which has appropriate validity and reliability and can be used to determine the obstacles for treatment or factors that lead to discontinuing treatment.

Validating the Self-assessed Wisdom Scale (SAWS) in an Iranian Sample: Psychometric and Developmental Findings

This study aimed to investigate the validity and factor structure of the Self-Assessed Wisdom Scale (SAWS; Webster in J Adult Dev 10:13-22, 2003) in an Iranian population. Participants (235 male, 340 female) were recruited in Tehran, Iran and ranged in age from 17 to 88 years. Cronbach alpha's for the subscales ranged from .63 to .81, and their inter-correlations ranged from .42 to .53. Exploratory factor analysis extracted 5 factors that were similar with the original structure. Confirmatory factor analysis supported 5-factor model of the SAWS. The SAWS's total and subscale scores positively correlated with two other measures of wisdom (indicating convergent validity). The SAWS correlated weakly with age. Women scored higher in the SAWS subscales of emotional regulation, reminiscence/reflectiveness, and humor, which accounted for a significant gender difference in total wisdom. Although the age differences are consistent with prior research, the gender differences are relatively novel. Overall, results indicate that the SAWS has excellent psychometric properties and can be used in cross-cultural work.

Greek Validation of the Factor Structure and Longitudinal Measurement Invariance of the Strengths and Difficulties Questionnaire-Self Report (SDQ-SR): Exploratory Structural Equation Modelling

The study examined the factor structure and longitudinal measurement invariance over three time points (1-year apart) of the Strengths and Difficulties Questionnaire-Self Report (SDQ-SR) for ratings provided by adolescents in Greece. It used exploratory structural equation modelling (ESEM) to achieve these two goals. At time point one, a total of 968 adolescents (males = 508, and females = 460) between 12 and 17.9 years completed the SDQ-SR. In relation to factor structure, ESEM tested the fit of one- to five-factor models. The findings were interpreted as indicating most support for the ESEM model with three factors (the factors being dysregulation, peer problems, and prosocial behaviour). This model showed support for configural invariance and full metric invariance across the three time points. Except for two thresholds, all other thresholds were also invariant across the three time points. Thus, there was good support for longitudinal measurement invariance. The implications of the findings for use of the SDQ-SR are discussed.

Factor structure and measurement invariance of the Chinese version of the Center for Epidemiological Studies Depression (CES-D) scale among undergraduates and clinical patients

BACKGROUND

The Center for Epidemiologic Studies Depression scale (CESD) was widely used for screening of depressive symptoms. The purpose of the current study was to investigate the factor structure and measurement invariance of the CESD across genders and groups in a sample of Chinese undergraduates and clinical patients.

METHODS

Participants included 3093 undergraduates from the Hunan province and 336 patients from psychological clinics. The structure of the CESD scale was analyzed by confirmatory factor analysis (CFA). Multiple sets of CFAs were used to test measurement invariance across genders among undergraduates and clinical patients. Internal consistency reliability was also evaluated.

RESULTS

The five-factor model achieved satisfactory fit (in the undergraduate sample: WLSMVχ² = 1662.385, df = 160, CFI = 0.973, TLI = 0.968, RMSEA = 0.055; in the clinical patients: WLSMVχ² = 502.089, df = 160, CFI = 0.962, TLI = 0.955, RMSEA = 0.072). The measurement invariance of the five-factor model across genders was supported fully assuming different degrees of invariance. The CESD also showed acceptable internal consistency.

CONCLUSION

Due to its sound structure and measurement invariance, the five-factor model of the CESD is best suited for testing in Chinese mainland college students and clinical patients.

Psychometric properties of an Italian translation of the Functionality Appreciation Scale (FAS)

The Functionality Appreciation Scale (FAS; Alleva et al., 2017) is a widely used instrument for the measurement of individual's appreciation of their body for what it can do and is capable of doing (i.e., functionality appreciation). Here, we examined the psychometric properties of a novel Italian translation of the FAS. A sample of 950 Italian adults completed the FAS, as well as previously validated measures of body image (body appreciation, body esteem, body surveillance), disordered eating symptoms, and psychological well-being (self-esteem, general distress). Exploratory and confirmatory factor analyses supported a 1-dimensional model of FAS scores, with all 7 items retained. Scores achieved scalar invariance across gender, and the gender difference in latent FAS scores was not significant. FAS scores were found to have adequate internal consistency, test-retest reliability up to three weeks, and convergent and criterion-related validity through significant correlations with all additional constructs. However, evidence of incremental validity was weak, and likely reflected high nomological and conceptual similarity between functionality and body appreciation in this national context. Overall, these results provide strong evidence that scores on the Italian FAS are psychometrically valid, which may aid future development of interventions to promote more positive body image in Italian-speaking samples.

The Autism-Spectrum Quotient (AQ) Adolescent's Version in Turkey: Factor Structure, Reliability and Validity

We assessed the reliability and validity of the Turkish version of the autism spectrum quotient (AQ)-adolescent. Three assessment groups of adolescents, aged 11-18, were: 80 with Asperger syndrome/high-functioning autism (AS/HFA), 71 with other psychiatric disorders (PDs; 35 major depression, 18 obsessive-compulsive disorder, 18 social phobia), and 249 healthy controls. The scores of the AS/HFA group were significantly higher than the healthy control and PD groups. Cronbach α value was 0.829. Ordinal alpha value was 0.90. We showed the AQ-adolescent four-factor structure in the factor analysis. In the test-retest of AQ-adolescent and subscale scores, "very strong" significant correlation values were detected. A cut-off score of 24 best distinguished the autism group from healthy controls with 0.975 sensitivity and 0.991 specificity.

Longitudinal measurement invariance of the patient health questionnaire in a German sample

BACKGROUND

The Patient Health Questionnaire-8 (PHQ-8) is a screening questionnaire of depressive symptoms. However, it is unknown whether it is equivalent across time and between groups of individuals. The aim of our paper was to test whether the PHQ-8 has the same meaning in two groups of individuals over time.

METHODS

Primary care patients were proactively recruited from three German cities. PHQ-8 data from a baseline assessment (n = 588), two assessments during the intervention (n = 246/225), and a six (n = 437) and 12 months (n = 447) follow-up assessment were first used to examine the factor structure of the PHQ-8 by confirmatory factor analysis (CFA). The best fitting factor solution was then used to test longitudinal invariance across time and between intervention and control group by Multiple Group CFA.

RESULTS

A two-factor structure consistently showed the best model fit. Only configural longitudinal invariance was evidenced when the baseline assessment was included in the analysis. Without the baseline assessment, strict longitudinal invariance was shown across the intervention and the follow-up assessments. Scalar invariance was established between the intervention and control group for the baseline assessment and strict invariance between groups and across the 6- and 12-month follow-up assessments.

CONCLUSIONS

The lack of longitudinal invariance might be attributed to various differences between the baseline assessments and all following assessments, e.g., assessment mode (iPad vs telephone), potential changes in symptom perception, and setting.

TRIAL REGISTRATION

DRKS0001163 5, date of trial registration: 20.01.2017; DRKS00011637 , date of trial registration: 25.01.2017.

Large-scale evaluation of the Positive and Negative Syndrome Scale (PANSS) symptom architecture in schizophrenia

Although the Positive and Negative Syndrome Scale (PANSS) is widely utilized in schizophrenia research, variability in specific item loading exist, hindering reproducibility and generalizability of findings across schizophrenia samples. We aim to establish a common PANSS factor structure from a large multi-ethnic sample and validate it against a meta-analysis of existing PANSS models. Schizophrenia participants (N = 3511) included in the current study were part of the Singapore Translational and Clinical Research Program (STCRP) and the Clinical Antipsychotic Trials for Intervention Effectiveness (CATIE). Exploratory Factor Analysis (EFA) was conducted to identify the factor structure of PANSS and validated with a meta-analysis (N = 16,171) of existing PANSS models. Temporal stability of the PANSS model and generalizability to individuals at ultra-high risk (UHR) of psychosis were evaluated. A five-factor solution best fit the PANSS data. These were the i) Positive, ii) Negative, iii) Cognitive/disorganization, iv) Depression/anxiety and v) Hostility factors. Convergence of PANSS symptom architecture between EFA model and meta-analysis was observed. Modest longitudinal reliability was observed. The schizophrenia derived PANSS factor model fit the UHR population, but not vice versa. We found that two other domains, Social Amotivation (SA) and Diminished Expression (DE), were nested within the negative symptoms factor. Here, we report one of the largest transethnic factorial structures of PANSS symptom domains (N = 19,682). Evidence reported here serves as crucial consolidation of a common PANSS structure that could aid in furthering our understanding of schizophrenia.