Development and validation of a Context-sensitive Positive Health Questionnaire (CPHQ): A factor analysis and multivariate regression study

BACKGROUND

The concept of Positive Health (PH) has gained increasing attention as a way of measuring individuals' ability to adapt in the face of contextual challenges. However, a suitable measurement instrument for PH that encompasses contextual factors has not yet been developed. This paper responds to this need by developing a Context-specific Positive Health (CPH) measurement instrument that aligns with the Capability Approach (CA).

METHODS

The measurement instrument was developed and tested among a representative sample of 1002 Dutch internet survey panel members with diverse sociodemographic backgrounds. The instrument was developed in two stages: a preparation phase consisting of focus groups and expert consultations, and a validation among a representative panel of Dutch citizens. The goal of the preparation phase, was to pilot test and refine previously proposed Positive Health questionnaires into an initial version of the CPHQ. The validation phase aimed to examine the initial CPHQ's factorial validity using Factor Analysis, and its concurrent validity using Multivariate Regression Analysis.

RESULTS

The developed questionnaire demonstrated adequate factorial and concurrent validity. Furthermore, it explicitly includes an assessment of resilience, this being a key component of PH.

CONCLUSIONS

The introduced measurement tool, the CPHQ, comprises 11 dimensions that we have labeled as follows: relaxation, autonomy, fitness, perceived environmental safety, exclusion, social support, financial resources, political representation, health literacy, resilience, and enjoyment. In this article, we present four major contributions. Firstly, we embedded the measurement in a theoretical framework. Secondly, we focused the questionnaire on a key concept of Positive Health - the "ability to adapt." Thirdly, we addressed issues of health inequality by considering contextual factors. Finally, we facilitated the development of more understandable measurement items.

Factorial validity and measurement invariance of the Athlete Burnout Questionnaire (ABQ)

The Athlete Burnout Questionnaire (ABQ) is the gold standard measure for burnout in athletes. However, previous assessments of factorial validity have: (a) tested overly restrictive measurement models; (b) provided mixed support for factorial validity; and (c) not been applied to assess measurement invariance across gender, sport type, or age. To address these issues, we used ABQ data provided by 914 athletes (Mage = 21.75 years, SD = 8.79) and examined factorial validity using confirmatory factor analysis (CFA) and exploratory structural equation modelling (ESEM) techniques. We also examined measurement invariance of the ABQ data across reported gender (female, male), sport type (individual, team), and age (≤18 years, >18 years) groups. The analyses revealed that an ESEM model provided superior fit over the corresponding CFA model. In terms of measurement invariance, support was provided for the equivalence of the ABQ across each group. This means that researchers using the ABQ can collect data across these groups and examine potential differences with confidence that the ABQ is approximately invariant. In all, we provide evidence that the majority of ABQ items are key target construct indicators and the burnout construct (as measured by the ABQ) has the same structure and meaning to different athlete groups.

Development and Validation of the Questionnaire for Adaptive Hyperactivity and Goal Achievement (AHGA)

Objective

This paper illustrates the preliminary psychometric properties of the Questionnaire for Adaptive Hyperactivity and Goal Achievement (AHGA), aimed at measuring adaptive characteristics of hyperactivity and goal pursuit in older adults.

Methods

The 12-item scale was administered to a sample of 120 subjects (older adults) between February 2022 and June 2022. The reliability of AHGA was measured using Cronbach's alpha, and factor structure was established using parallel analysis (PA) and principal component analysis (PCA). Convergent validity was tested against the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN).

Results

All included subjects have an average age of 74.1±5.1 years. AHGA reliability was good (Cronbach's alpha: 0.713 [95%CI: 0.630 to 0.783]). Factor analysis suggested two main components: goal achievement and hyperactivity, which explained 41% of the variance in the data. The results support the convergent validity of the scale: AHGA measures adaptive characteristics of hyperactivity and goal pursuit, in contrast to BRIAN, which measures pathological characteristics.

Conclusion

The reported findings represent an innovative approach to hyperthymic features by embracing a broader spectrum concept that conceptualizes the potential transition between pathological and adaptive aspects as a continuum.

Psychometric properties and clinical utility of COVID-19-related distress scale among children and adolescents with Disabilities

Background

The aim was to estimate the psychometric properties of the COVID-19-related distress scale in our society, as well as verifying the global structure of the COVID-19-related distress scale through exploratory factor analysis and the confirmatory factor analysis model for the dimensions prepared in the light of previous studies and the general factor model.

Methods

The study follows the design of the exploratory cross-sectional studies by applying a scale electronically using the Google Forms tool. Construct validity was evaluated using confirmatory factor analysis, exploratory factor analysis, and content validity. Pearson product-moment correlation, Cronbach's alpha reliability coefficient, and test-retest methods were used to evaluate reliability.

Results

In the analysis made for internal consistency in the reliability study of the scale, the Cronbach's alpha reliability coefficients were determined as α = 0.93 for the physical dimension subscale, 0.90 for the psychological and emotional dimension, 0.92 for cognitive dimension, 0.91 for the social dimension, 0.92 for behavioral dimension, 0.87 for living Dimension and 0.94 for the whole scale. The total number of items on the scale is 62. It is clear that the items of the scale explained 55.49 % of the variance of the correlation matrix between the items, which indicates that the scale has an appropriate degree to extract the variance that explains COVID-19-related distress. The fit indices were found to be Chi square = 862.30 (p < .001), degree of freedom = 210 (χ2 = 862.30; df = 210, χ2/df = 4.10), root mean square error of approximation (RMSEA) = 0.07 (p < .05) standardized root mean- square residual (SRMR) = 0.05, comparative fit index (CFI) = 0.92, non-normed fit index (NNFI) = 0.95, goodness of fit index (GFI) = 0.95, and adjusted goodness of fit index (AGFI) = 0.94.

Conclusions

The COVID-19-related distress scale is an easy to administer, valid, and reliable instrument to assess COVID-19-related distress. This instrument can be a helpful tool informing us about distress related to COVID-19 and hence may prevent adverse long-term consequences arising due to pandemic.

The Body and Appearance Self-Conscious Emotions Scale (BASES): A comprehensive examination of its factorial validity, with recommendations for researchers

The 16-item Body and Appearance Self-Conscious Emotions Scale (BASES) is widely used to assess the discrete emotions of guilt, shame, authentic pride, and hubristic pride. However, recent work has questioned the factorial validity of the BASES (i.e., the extent to which it truly assesses a discrete set of self-conscious emotions). In the present study, we re-assessed the factorial validity of the BASES using confirmatory factor analysis (CFA) and exploratory structural equation modelling (ESEM). An online sample of adults from the United Kingdom (N = 637) were asked to complete the BASES. Our analyses indicated that the original 4-factor CFA model had adequate fit but resulted in very high latent correlations between similarly valenced facets (Guilt/Shame and Authentic/Hubristic Pride, respectively). An alternative 2-factor CFA model (combining Guilt-Shame and Authentic-Hubristic Pride) had a less-than-ideal fit. Conversely, 4-factor and 2-factor ESEM solutions both resulted in a superior fit to the data than their CFA counterparts, and in reduced estimates of factor correlations. Both of these ESEM solutions were also fully invariant across gender. These results have important theoretical and practical implications for our understanding of body and appearance-related self-conscious emotions and how this construct is currently measured.

The Strengths and Difficulties Questionnaire self-report-, parent-, and teacher version in children with intellectual and developmental disabilities

BACKGROUND

The Strengths and Difficulties Questionnaire (SDQ) is a frequently used behavioral screening instrument. However, its psychometric properties have been rarely examined among children with intellectual and developmental disabilities (IDD).

AIMS

The main aims of this study were to examine the internal consistency (i.e., McDonald's Omega), the convergent validity (by correlating the Total difficulties score with the Aberrant Behavior Checklist [ABC]), the divergent validity (by correlating the Total difficulties score with the Vineland Adaptive Behavior Composite; VABS-II Total) and the factorial validity (by the means of confirmatory factor analyses [CFA]) of the SDQ self-report-, parent-, and teacher version in a sample of children with IDD.

METHOD

Participants were 365 children and adolescents (males n = 238; 65 %) aged 4-18 years (M = 10.11, SD = 3.82) referred for a developmental/neurological assessment to the neuropediatric outpatient clinics in the specialist health services. The SDQ was filled inn by 115 children, 337 parents, and 248 teachers.

RESULTS

McDonald's Omega was overall lowest for the self-report version. Correlations of the SDQ Total difficulties score and the ABC subscales were strongest for the parent version. The results of the CFA indicated best model fit for the six-factor model that included a method factor for all three versions of the SDQ, however, model fit was overall not good.

CONCLUSIONS

Further research that examines the psychometric properties of the SDQ among multiple informants in large samples of children with IDD is needed.

Development and cross-cultural validation of the Goal Content for Weight Maintenance Scale (GCWMS)

PURPOSE

Long-term weight management requires sustained engagement with energy-balance-related behaviours. According to self-determination theory, behaviour goals can support or undermine motivation depending on the quality of their content (i.e., extrinsic and intrinsic motivation). This study aimed to develop and validate the goal content for weight loss maintenance scale (GCWMS).

METHODS

The GCWMS was administered to 1511 participants who had achieved clinically significant weight losses and were taking part in a large weight loss maintenance study: the NoHoW Trial (ISRCTN88405328). The scale derived from two well-established questionnaires regarding exercise goals. Construct validity was examined for 4 theory-driven domains: Health Management, Challenge, Image, and Social Recognition. Split-sample confirmatory factor analysis was conducted to test the factorial validity and multi-group measurement invariance (configural, metric, scalar, and residual invariance). The reliability estimates were also assessed, and discriminant validity was evaluated using 2 conceptually related questionnaires.

RESULTS

The first analysis showed a poor fit of the original factorial structure. Subsequent investigation with a new specified model indicated close fit to the data after removal of 3 items χ²(58) = 599.982; p < .001; χ²/df = 10.345; CFI = 0.940; GFI = 0.941; SRMR = 0.063; RMSEA = 0.079 (LL = 0.073; UL = .084). Good internal consistency was achieved in all subscales (α > .775), convergent and divergent validity were verified through associations with other theoretical related constructs. Findings from multi-group invariance test demonstrated that the specified model of GCWMS achieved full measurement invariance for gender but did not support residual invariance across countries.

CONCLUSION

Findings support the hypothesised four-dimension structure of the GCWMS, confirming reliability and multi-group invariance in factor structure. Analysis also supports valid group means comparisons on latent factors at gender and at cross-cultural level. Ways to improve the quality of the scale are discussed.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive.

Assessing the psychometric properties of the Guarding Minds @ Work questionnaire recommended in the Canadian Standard for Psychological Health and Safety in the Workplace

This study examines the item and dimension distribution and factorial reliability and validity of the GM@W questionnaire for assessing the 13 dimensions of the work environment outlined in The Canadian National Standard for Psychological Health and Safety in the Workplace (The Standard). Methods An internet survey of 1,006 Ontario workers was conducted between February 10th and March 5th, 2020. Respondents had to be employed in a workplace with five or more employees. The survey included the 65 items from the GM@W questionnaire, and questions to assess sociodemographic characteristics and employment arrangements. Analyses examined the distribution of scores for items and for overall dimensions. A confirmatory factor analysis (CFA) examined the relationship between the 13 proposed dimensions and each of the 65 questions, using only respondents with complete information (N = 900). Results Low levels of missing responses were observed, although 14 of the 65 items had potential ceiling effects. CFA analyses demonstrated poor fit for the conceptual model linking the 13 dimensions of The Standard to the 65-items. High correlations between dimensions were also noted. The GM@W questionnaire displayed poor discriminant in measuring the specific dimensions proposed in The Standard. Conclusions Our results suggest the GM@W survey is unable to isolate the proposed dimensions of the psychosocial work environment as outlined in The Standard. These limitations are important, as workplaces using the GM@W survey will not be able to identify dimensions of the work environment which require attention or assess changes in particular dimensions over time.

Cross-validation of the body appreciation scale-2: invariance across sex, body mass index, and age in Mexican adolescents

Cross-validation is a useful strategy to address problems associated with the post hoc model fitting. The aim of this study was to cross-validate the BAS-2, in two samples (Calibration and Validation Samples), using an invariance testing strategy. 1127 Mexican adolescents (508 males and 619 females), aged 11-19 years (M = 15.41, SD = 2.30), allocated in two samples (n₁ = 672; n₂ = 455) completed the Mexican version of the BAS-2, along with other body image-related instruments. The cross-validation supported the generalizability of the one-factor respecified model of the BAS-2. The measure was invariant across body mass index and age, but not across sex. Internal consistency and test-retest reliability (a three-week period between each test) was excellent. In support of the validity of the BAS-2, it was positively associated with scores on body esteem, but negatively with body mass index, drive for thinness, and body dissatisfaction. Normal-weight and young adolescents groups showed higher body appreciation than excess-weight and late adolescents groups, respectively. Considering these findings, it is reasonable to conclude that the BAS-2 is a reliable and valid instrument to assess body appreciation in Mexican adolescents. LEVEL OF EVIDENCE: Level V, cross-sectional, descriptive study.

Psychometric properties of the Chinese version of adjustment disorder new module-20 in breast cancer patients

Background

After the new definition of adjustment disorder (AjD) by the International Classification of Diseases-11(ICD-11), AjD has attracted more and more attention. Adjustment disorder new module-20 (ADNM-20), which is used to diagnose AjD, has been verified in some countries, but it has not been verified in China. As a result, the purpose of this study was to investigate the validity and reliability of the Chinese version of the Adjustment disorder new module-20 (ADNM-20) in female breast cancer patients.

Methods

The ADNM-20 translated into Chinese employed the translation and back translation technique. Three hundred fifty four newly diagnosed (< 1 year) female breast cancer patients were recruited from Tongji Hospital and Hubei Cancer Hospital in Hubei, China. The patients completed the self-report questionnaire including demographic characteristics and the scale ADNM-20. Data on psychometric properties were evaluated in terms of internal consistency, item-total correlations, test-retest reliability, and factorial validity.

Results

ADNM-20 core symptoms included 8 items and two factors, which were extracted by using exploratory factor analysis (EFA). It could explain 61.74% of the total variance. ADNM-20 accessory symptoms including 12 items and four factors, which were extracted by using EFA. It could explain 68.34% of the total variance. Cronbach’s α coefficient for ADNM-20 was 0.93, split-half reliability was 0.87, and the test-retest correlation coefficient was 0.74. The correlation coefficient between each subscale was ranged from 0.53 to 0.71 (P < 0.01), while the correlation coefficient between the subscales and total scale was ranged from 0.79 to 0.89 (P < 0.01).

Conclusions

The study verified the validity and reliability of the Chinese version of ADNM-20. It is applicable to measure the prevalence of adjustment disorder in the breast cancer population.

Stress among university students: factorial structure and measurement invariance of the Italian version of the Effort-Reward Imbalance student questionnaire

Background

In the last decade academic stress and its mental health implications amongst university students has become a global topic. The use of valid and theoretically-grounded measures of academic stress in university settings is crucial. The aim of this study was to examine the factorial structure, reliability and measurement invariance of the short student version of the effort-reward imbalance questionnaire (ERI-SQ).

Methods

A total of 6448 Italian university students participated in an online cross-sectional survey. The factorial structure was investigated using exploratory factor analysis and confirmatory factor analysis. Finally, the measurement invariance of the ERI-SQ was investigated.

Results

Results from explorative and confirmatory factor analyses showed acceptable fits for the Italian version of the ERI-SQ. A modified version of 12 items showed the best fit to the data confirming the 3-factor model. Moreover, multigroup analyses showed metric invariance across gender and university course (health vs other courses).

Conclusions

In sum, our results suggest that the ERI-SQ is a valid, reliable and robust instrument for the measurement of stress among Italian university students.

Psychometric Assessments of Three Self-Report Autism Scales (AQ, RBQ-2A, and SQ) for General Adult Populations

This study assesses the psychometric properties of three self-report measures of autistic-like tendencies in the general adult population: autistic spectrum quotient (AQ), adult repetitive behaviours questionnaire-2 (RBQ-2A), and systemizing quotient (SQ). Three rounds of development and testing using different U.S. and global samples led to three instruments that are psychometrically sound, parsimonious, and generalizable across populations. The resulting AQ-9, consisting of two factors: social communication and attention to detail, now mirrors the current dual diagnostic criteria in the DSM-5. The RBQ-2A-R has now been refined through CFA for the first time. The new SQ-7 scale also has updated content. All three refined scales demonstrate satisfactory psychometric validity and parsimony and now provide evidence of their appropriateness for empirical research.

Modification and psychometric evaluation of the child perceptions questionnaire (CPQ11-14) in assessing oral health related quality of life among Lithuanian children

Background

Oral health related quality of life (OHRQoL) research among children and adolescents in Lithuania is just starting and no measures have been validated to date. Therefore, this study aimed to validate a Lithuanian version of the full (37 items) Child Perceptions Questionnaire (CPQ_11–14) within a random sample of children aged 11 to 14.

Methods

A cross-sectional survey among a randomly selected sample of schoolchildren (N = 307) aged 11 to14 was conducted. An anonymous questionnaire included the full CPQ_11–14 and items on global life satisfaction, oral health and oral life quality self-rating. The questionnaire was translated into Lithuanian using translation guidelines. In addition, an item on the oral pain was modified identifying the pain location. Standard tests (Cronbach’s α, construct validity and discriminant validity), supplemented with both exploratory and confirmatory factor analyses, were employed for psychometric evaluation of the instrument. The questionnaire was also tested by comparison students’ and their parents’ (N = 255) responses about oral symptoms and functional limitations.

Results

The modified Lithuanian version of CPQ_11–14 revealed good internal consistency reliability (Cronbach’s alpha for the total scale was 0.88). The measure showed significant associations with perceived oral health status and oral well-being, as well as with global life satisfaction (p < 0.01). Discriminant validity of the instrument was approved by comparison of children’s groups defined by self-reported caries experience and malocclusion. Factor analysis revealed a complex structure with two or three factors in each of four domains of the CPQ_11–14. Excellent or acceptable levels of indices of model fitting with the given data were obtained for oral symptoms, functional limitations and emotional well-being domains, but not for the social well-being domain. A significant association between child and parental responses was found (intraclass correlation coefficient was 0.56 and 0.43, correspondingly in domains of oral symptoms and functional limitations).

Conclusion

The Lithuanian version of the CPQ_11–14 (with a modified item that identifies location of oral pain) appears to be a valid instrument to be used in further studies for measuring OHRQoL among 11 to 14 year old children in Lithuania.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0701-5) contains supplementary material, which is available to authorized users.

Construct and correlates of basic motor competencies in primary school-aged children

BACKGROUND

A central aim of physical education is the promotion of basic motor competencies (in German: Motorische Basiskompetenzen; MOBAK), which are prerequisites for children's active participation in sports culture. This article introduces the MOBAK-1 test instrument for 6- to 8-year-old children and determines the construct validity of this test instrument. In addition, the relationship between MOBAK and motor ability (i.e., strength) as well as body mass index (BMI), sex, and age is investigated.

METHODS

We analyzed data of 923 first and second graders (422 girls, 501 boys, age = 6.80 ± 0.44 years). The children's basic motor competencies were assessed by the MOBAK-1 test instrument. Besides analyses of frequency, correlation, and variance, 3 confirmatory factor analyses with covariates were performed.

RESULTS

We found 2 MOBAK factors consisting of 4 items each. The first factor, locomotion, included the items balancing, rolling, jumping, and side stepping; the second factor, object control, included the items throwing, catching, bouncing, and dribbling. The motor ability strength had a significant influence on the factors locomotion (β = 0.60) and object control (β = 0.50). Older pupils achieved better results than younger pupils on object control (β = 0.29). Boys performed better on object control (β = -0.44), whereas girls achieved better results in locomotion (β = 0.07). Pupils with a high BMI achieved lower performance only on the factor locomotion (β = -0.28).

CONCLUSION

The MOBAK-1 test instrument developed for this study meets psychometric validity demands and is suitable to evaluate effects of sports and physical education.

An analysis of the size and direction of the association between mental toughness and Olympic distance personal best triathlon times

BACKGROUND

Athletes, coaches, sport psychology practitioners, and researchers suggest that mental toughness represents an important construct that is associated with athletic performance. Unfortunately, the absence of real-world performance as a dependent variable has limited our ability to substantiate this claim. The concern of a lack of ecologically valid measures of sports performance might be addressed by examining the relationship between mental toughness and sports performance using a standardized measure of personal best (PB) triathlon time and a validated unidimensional measure of mental toughness.

METHODS

Three hundred and sixteen triathletes completed the 8-item mental toughness index (MTI), reported their age, and provided a PB Olympic distance triathlon time and the total number of triathlons they had completed to date. Given that males are typically quicker than females, a standardized time was calculated by dividing the PB by the current Olympic record for gender; we also hypothesized that more experienced triathletes would report quicker PB times because of greater frequency and duration of training. Once we had controlled for gender and experience, we predicted that mental toughness would be negatively associated with triathlon time and the size of the relationship would be of a moderate magnitude.

RESULTS

Results revealed small- to moderate-sized negative relationships between both completed number of triathlons and mental toughness with standardized PB time.

CONCLUSION

The hierarchical regression analysis showed that mental toughness provided a unique contribution to the variability in standardized Olympic triathlon PB after controlling for the total number of triathlons completed.

Self-assessment of negative symptoms - Critical appraisal of the motivation and pleasure - Self-report's (MAP-SR) validity and reliability

OBJECTIVE

The negative symptom domain remains a major challenge concerning treatment. A valid self-report measure could assist clinicians and researchers in identifying patients with a relevant subjective burden. The Motivation and Pleasure - Self Report (MAP-SR) derives from the CAINS and is supposed to reflect the "amotivation" factor of negative symptoms. We evaluated different aspects of the scale's reliability and validity. This is the first factorial analysis as well as the first analysis of test-retest reliability.

METHODS

We assessed three samples of subjects with schizophrenia or schizoaffective disorder (n = 93) and a broad spectrum of related domains.

RESULTS

We explored a 3-, 2- and 1-factor solution (explaining 50.93, 44.85 and 36.18% of variance, respectively). The factor "pleasure and hedonic activity" consists of eight items and was most robust; the factors "social motivation" and "motivation for work" were problematic. Test-retest reliability of the scale was adequate (r_S = 0.63, p = .005). Neither the MAP-SR nor the "pleasure and hedonic activities" factor are associated with the PANSS negative symptom scale. There are significant associations with the observer-rated CAINS-MAP scale, experiences of pleasure, and social cognition but none with functional outcome. Discriminant validity could not be established with regards to depression and extrapyramidal symptoms.

CONCLUSIONS

We found that the MAP-SR is adequate to assess anhedonia but is less suitable when assessing motivation. Therefore, we propose using the "pleasure and hedonic activity scale" to cover the "anhedonia" subdomain. We think the "motivation" part of the instrument requires reconstruction.

Psychometric evaluation and sex invariance of the Spanish version of the Body and Appearance Self-Conscious Emotions Scale

This study examined the psychometric properties of a Spanish translation of the Body and Appearance Self-Conscious Emotions Scale (BASES; Castonguay et al., 2014) in a sample of university Spanish students. A total of 815 participants enrolled in two public universities located in Almería and Elche, Spain, completed the BASES along with measures of social physique anxiety and positive/negative affect. Exploratory and confirmatory factor analyses showed that one item failed to load clearly on the hypothesized factor (guilt). Once it was removed, results supported the hypothesized four-factor structure. Evidence of invariance of the four-factor structure across sex was obtained. Scores on the BASES showed adequate internal consistency and acceptable convergent validity. Compared to men, women reported significantly higher body and appearance-related guilt and shame, and significant lower authentic and hubristic pride. Preliminary evidence supporting the validity and reliability of the Spanish translation of the BASES is provided.

Assessment of depression before and after inpatient rehabilitation in COPD patients: Psychometric properties of the German version of the Patient Health Questionnaire (PHQ-9/PHQ-2)

BACKGROUND

Depression is a frequent comorbidity of COPD and leads to worse clinical COPD-outcomes. PHQ-9 and PHQ-2 are two widely used brief instruments to assess depression. However, psychometric properties in COPD patients are unknown. This study examines factorial validity, measurement invariance and composite reliability (CR) of PHQ-9/PHQ-2, respectively, and concordance between both tools.

METHODS

This is a secondary analysis of N = 561 COPD patients who filled out the PHQ-9 at the begin (T0), the end (T1) and 3/6/9/12 (T2/T3/T4/T5) months after pulmonary inpatient rehabilitation. Structural equation modeling was used to examine factorial validity and measurement invariance between gender, GOLD disease severity groups and over time. Concordance was assessed using Cohen's Kappa, Yules Y, positive and negative agreement.

RESULTS

A one-factor model (with one freed residual covariance) showed best model fit. At least partial scalar invariance could be established. Concordance between both instruments was substantial. 31.7% (26.2%) COPD patients showed clinically relevant depression according to PHQ-9 (PHQ-2) at T0. At T0-T2, PHQ-9 classified more patients as depressed than did PHQ-2. According to both measures, depression rates declined after rehabilitation. Reliability was high for both PHQ-9 (CR = 0.94) and PHQ-2 (CR = 0.89).

LIMITATIONS

No gold-standard (clinical interview) to assess depression was used. Therefore, diagnostic accuracy for PHQ-9/PHQ-2 remains unclear.

CONCLUSIONS

PHQ-9 and PHQ-2 fulfill important psychometric criteria (factorial validity, invariance, reliability) for measuring depression in COPD. The results support their use in clinical practice to assess severity of depression. Diagnostic accuracy to identify major/minor depression of both instruments should be examined in future studies.

The structure of schizotypal personality traits: a cross-national study

BACKGROUND

Schizotypal traits are considered a phenotypic-indicator of schizotypy, a latent personality organization reflecting a putative liability for psychosis. To date, no previous study has examined the comparability of factorial structures across samples originating from different countries and cultures. The main goal was to evaluate the factorial structure and reliability of the Schizotypal Personality Questionnaire (SPQ) scores by amalgamating data from studies conducted in 12 countries and across 21 sites.

METHOD

The overall sample consisted of 27 001 participants (37.5% males, n = 4251 drawn from the general population). The mean age was 22.12 years (s.d. = 6.28, range 16-55 years). The SPQ was used. Confirmatory factor analysis (CFA) and Multilevel CFA (ML-CFA) were used to evaluate the factor structure underlying the SPQ scores.

RESULTS

At the SPQ item level, the nine factor and second-order factor models showed adequate goodness-of-fit. At the SPQ subscale level, three- and four-factor models displayed better goodness-of-fit indices than other CFA models. ML-CFA showed that the intraclass correlation coefficients values were lower than 0.106. The three-factor model showed adequate goodness of fit indices in multilevel analysis. The ordinal α coefficients were high, ranging from 0.73 to 0.94 across individual samples, and from 0.84 to 0.91 for the combined sample.

CONCLUSIONS

The results are consistent with the conceptual notion that schizotypal personality is a multifaceted construct and support the validity and utility of SPQ in cross-cultural research. We discuss theoretical and clinical implications of our results for diagnostic systems, psychosis models and cross-national mental health strategies.

Validation of the Farsi version of the revised Adolescent Sleep Hygiene Scale (ASHSr): a cross-sectional study

BACKGROUND

Restoring sleep is associated with a broad variety of favorable cognitive, emotional, social and behavioral benefits during the day. This holds particularly true for adolescents, as maturational, social, cognitive, emotional and behavioral changes might unfavorably impact on adolescents' sleep. Among adolescents, poor sleep hygiene practices are a potentially modifiable risk factor that can be addressed via appropriate interventions. Accordingly, having reliable and valid self-report measures to assess sleep hygiene practices is essential to gauge individual responses to behavioral interventions and evaluate sleep hygiene recommendations. The aim of the present study therefore was to translate and to test the psychometric properties (internal consistency, test-retest reliability, factorial and concurrent validity) of the Farsi/Persian version of the revised version of the Adolescent Sleep Hygiene Scale (ASHSr).

METHOD

A total of 1013 adolescents (mean age: M = 15.4 years; SD = 1.2; range: 12-19 years; 42.9% females) completed the ASHSr and the Pittsburgh Sleep Quality Index (PSQI) in their classroom during an official school lesson. Further, 20% completed the ASHSr 6 weeks later to evaluate the test-retest reliability. Cronbach's alpha coefficients were calculated to examine internal consistency, confirmatory factor analysis (CFA) was used to test factorial validity, whereas concurrent validity and test-retest reliability were examined via correlation analyses.

RESULTS

A first-order confirmatory factor analysis (CFA) corroborated the six-factor structure of the ASHSr, including a physiological, behavioral arousal, cognitive/emotional, daytime sleep, sleep environment, and sleep stability factor. A second-order CFA showed that a higher-order sleep hygiene construct explained sufficient variance in each factor. Cronbach's alpha values ranged between .71 and .75, correlations for test-retest reliability between .82 and .87. Significant correlations were found between most ASHSr scales and the PSQI indices. However, the magnitude of these correlations was weak.

CONCLUSIONS

The Farsi/Persian version of the Adolescent Sleep Hygiene Scale can be used as a reliable and valid tool for evaluation of sleep hygiene practices among Farsi/Persian-speaking adolescents.

Development of an instrument for community-level health related social capital among Japanese older people: The JAGES Project

BACKGROUND

We developed and validated an instrument to measure community-level social capital based on data derived from older community dwellers in Japan.

METHODS

We used cross-sectional data from the Japan Gerontological Evaluation Study, a nationwide survey involving 123,760 functionally independent older people nested within 702 communities (i.e., school districts). We conducted exploratory and confirmatory factor analyses on survey items to determine the items in a multi-dimensional scale to measure community social capital. Internal consistency was checked with Cronbach's alpha. Convergent construct validity was assessed via correlating the scale with health outcomes.

RESULTS

From 53 candidate variables, 11 community-level variables were extracted: participation in volunteer groups, sports groups, hobby activities, study or cultural groups, and activities for teaching specific skills; trust, norms of reciprocity, and attachment to one's community; received emotional support; provided emotional support; and received instrumental support. Using factor analysis, these variables were determined to belong to three sub-scales: civic participation (eigenvalue = 3.317, α = 0.797), social cohesion (eigenvalue = 2.633, α = 0.853), and reciprocity (eigenvalue = 1.424, α = 0.732). Confirmatory factor analysis indicated the goodness of fit of this model. Multilevel Poisson regression analysis revealed that civic participation score was robustly associated with individual subjective health (Self-Rated Health: prevalence ratio [PR] 0.96; 95% confidence interval [CI], 0.94-0.98; Geriatric Depression Scale [GDS]: PR 0.95; 95% CI, 0.93-0.97). Reciprocity score was also associated with individual GDS (PR 0.98; 95% CI, 0.96-1.00). Social cohesion score was not consistently associated with individual health indicators.

CONCLUSIONS

Our scale for measuring social capital at the community level might be useful for future studies of older community dwellers.

Translation and psychometric evaluation of a Standard Chinese version of the Body Appreciation Scale-2

The present study examined the factorial and construct validity of a Standard Chinese translation of the Body Appreciation Scale (BAS-2; Tylka & Wood-Barcalow, 2015b). Participants were 191 women and 154 men from mainland China who were resident in Hong Kong at the time of recruitment. Results of confirmatory factor analysis indicated that the one-dimensional model of the BAS-2, in which all 10 items loaded onto the same factor, had adequate fit, and was invariant across sex. Body appreciation scores had good internal consistency and were significantly correlated with self-esteem and life satisfaction, and, in women, with weight discrepancy and body mass index. There were no significant differences in body appreciation scores between women and men. The present findings suggest that the Standard Chinese translation of the BAS-2 has the same one-dimensional factor structure as its parent scale and may facilitate cross-cultural studies of positive body image.

Factorial validity of a subjective outcome evaluation tool for implementers of a positive youth development program

STUDY OBJECTIVES

This study examined the dimensionality of the subjective outcome evaluation tool assessing the views of program implementers in the context of the Project P.A.T.H.S. in Hong Kong. For illustration purpose, both exploratory and confirmatory factor analyses were performed to examine the factor structure of the instrument.

DESIGN

Subjective outcome evaluation findings were collected from 1,170 program implementers who implemented the Grade 7 level program. A validated subjective outcome evaluation scale was used to assess the views of the program implementers. Conceptually, the scale was designed to assess program implementers' perceptions about program content, implementer qualities, and program effectiveness after completion of the program.

RESULTS

Exploratory factor analyses showed that 3 factors were abstracted from the scale and they were stable across 2 random subsamples. Confirmatory factor analyses showed that there was support for a higher-order factor model containing 3 primary factors and 1 second-order factor, and that evidence supporting factorial invariance was found. The 3 subscales were also shown to be reliable with acceptable internal consistency.

CONCLUSION

Both exploratory and confirmatory factor analyses provided support for the factorial validity of the subjective outcome evaluation tool designed for program implementers in the Project P.A.T.H.S. in Hong Kong.