Psychometric properties of the Insomnia Catastrophizing Scale (ICS) in a large community sample

ABSTRACT

The purpose was to investigate the psychometric properties of the Insomnia Catastrophizing Scale (ICS) including factorial validity and internal consistency as well as discriminative and convergent validity. Associations with sleep parameters and daytime impairment are also examined. Drawn from a randomly selected sample of the general population, 1615 participants completed a survey on insomnia-related nighttime and daytime symptoms, health outcomes and psychological processes, including the ICS. A one-factor solution was supported for both the nighttime catastrophizing (11 items) and daytime catastrophizing (6 items) subscales. Both subscales displayed high internal consistencies (α > 0.90) and accounted for 59.1–70.1% of the variance. The insomnia disorder group had significantly higher scores than participants without insomnia on the two subscales and on the individual items. Cutoffs were established for both subscales with acceptable sensitivity and specificity. Both subscales displayed adequate convergent validity with measures indexing worry, cognitive pre-sleep arousal and anxiety. The two subscales were also significantly associated with nighttime and daytime insomnia symptoms. The ICS is a reliable and valid scale for the assessment of insomnia-related catastrophizing. Future research is needed to examine the test-retest reliability and treatment sensitivity of the ICS.     

Mediation of Mothers’ Anxiety and Parenting in Children’s Behavior Problems during COVID-19

The outbreak of COVID-19 is affecting the lives of millions of families around the world. The current study was carried out in Israel, following the pandemic’s initial outbreak and during the resulting enforced quarantine, confining parents and children to their homes. A sample of 141 Israeli mothers with at least one child between the ages of 3 and 12 (M?=?6.92, SD?=?2.55) participated as volunteers. About half the sample (50.7%) consisted of girls. Most mothers were cohabiting with a spouse (93%). Mothers completed online questionnaires about their perceptions about the health and economic threats of COVID-19, availability of social support, their anxiety symptoms, hostile/coercive and supportive/engaged parenting behavior, and their children’s behavior problems. Results showed expected significant associations between the mothers’ reports about having little social support, their anxiety symptoms, hostile/coercive and supportive/engaged parenting behavior, and children’s externalizing problems. Likewise, expected significant associations were found between mothers’ perceptions about the health and economic threats of COVID-19, their anxiety symptoms, hostile/coercive parenting behavior, and children’s internalizing and externalizing problems. Importantly, maternal anxiety and hostile/coercive parenting behavior mediated the associations between lack of support, negative perceptions about the health and economic threats of COVID-19, and children’s behavior problems. These findings stress the importance of mothers’ mental health and parenting behaviors for children’s socioemotional adaptation in the context of COVID-19. Implications of the findings for family interventions intended to help parents and children at this time are suggested.

     

Initial Validation of the Children’s Worry Management Scale

We investigated the psychometric properties of a new instrument, the Children’s Worry Management Scale (CWMS). The CWMS has three subscales that specify methods of regulating worry: inhibition (the suppression of worry), dysregulation (exaggerated displays of worry), and coping (constructive ways of managing worry). Using a Caucasian, middle-class sample of 214 children (M = 9 years, 1 month), Study 1 provides reliability and validity data through patterns of correlations to parent- and child-completed measures of emotion management and behavioral problems. Internal consistencies range from .69 to .74. Study 2 establishes discriminant validity by demonstrating that the CWMS Dysregulation and Coping subscales differentiated, in the expected directions, between a group of children (n = 27) with DSM-IV anxiety diagnoses and a control group of children with no psychological disorders.     

Validation of the Dutch Eating Behavior Questionnaire (DEBQ) in a sample of Chinese adolescents

We sought to validate the Dutch Eating Behavior Questionnaire (DEBQ) in a sample of Chinese adolescents and investigate differences in eating behaviors among Chinese normal weight, overweight, and obese adolescents. Chinese middle and high school students completed the DEBQ, Eating Disorder Inventory-1, and the Self-Control Scale. Result showed that the DEBQ had good internal consistency, test–retest reliability and criterion validity. Furthermore, the obese and overweight adolescents scored significantly higher than normal weight adolescents on three subscales. The DEBQ is effective for assessing eating behaviors in Chinese adolescents.     

Psychometric properties of an insomnia-specific measure of worry: the Anxiety and Preoccupation about Sleep Questionnaire

The aim of this study was to examine the psychometric properties of the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), with a focus on factorial validity and internal consistency as well as discriminative, convergent, and association with sleep parameters and daytime impairment. Among a randomly selected sample from the general population (N = 5,000), 2,333 participants completed a survey on nighttime symptoms, daytime symptoms, health outcomes, and psychological processes. The study sample consisted of 1800 participants who did not fulfill criteria for another sleep disorder than insomnia. A two-factor solution, accounting for 70.7% of the variance, was extracted from the 10 APSQ items. One six-item factor determined worries about the consequences of poor sleep (α = .91); the second factor, with four items, assessed worries about the uncontrollability of sleep (α = .86). The two factors were significantly intercorrelated (ρ = .65) and significantly associated with the total APSQ (ρs = .97 and .76, respectively). The APSQ and the two subscales showed discriminant validity between three sleep status groups (normal sleep, poor sleep, and insomnia disorder; R(2) = .33-.41). The APSQ and the subscales demonstrated convergent validity with measures on cognitive arousal, sleep-related beliefs, anxiety, and depression. They also were significantly correlated with sleep parameters and daytime impairment. The findings suggest that the APSQ is a psychometrically sound instrument for assessing worry in insomnia.     

The perceived ethnic discrimination questionnaire--community version: validation in a multiethnic Asian sample

This study evaluated the validity and reliability of the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV) Lifetime Exposure scale in a multiethnic Asian sample (N = 509). The 34-item scale measures perceived interpersonal racial/ethnic discrimination and includes four subscales assessing different types of discrimination: Social Exclusion, Stigmatization, Discrimination at Work/School, and Threat/Aggression. The Lifetime Exposure scale demonstrated excellent reliability across the full group and in all major subgroups. Subscales displayed good reliability across the full group and moderate-to-good reliability in each subgroup. The Lifetime Exposure scale was significantly correlated with the depression and anxiety subscales of the SCL-90-R, providing preliminary evidence of construct validity. The data suggest the Lifetime Exposure scale, previously validated in Black and Latino adults, is also appropriate for use with Asian samples, and can be used to examine both within-group and between-groups differences in discrimination.     

The associations of cultural worldviews,political orientation,and trust with COVID-19 risk beliefs in the U.S.

Given that risk beliefs predict engagement in behaviors to prevent disease, it is important to understand the factors associated with risk beliefs. In the present paper, we conducted path analyses to investigate the associations of belief systems (political orientation and cultural worldviews of individualism and hierarchy) with COVID-19 risk beliefs (i.e., perceived likelihood, perceived severity, and worry about disease; Studies 1 and 2), and the indirect effect through trust in information sources in these relationships (Study 1). Two online panels of U.S. adults were surveyed at three timepoints during the COVID-19 pandemic (Study 1: baseline n = 1,667, 1-year follow-up n = 551; Study 2: n = 404). Results of path analyses indicated that, across studies and timepoints, when controlling for political orientation, trust, and demographic factors, greater individualism had consistent significant direct effects on lower perceived severity and worry about COVID-19, whereas greater hierarchy had consistent significant direct effects on lower perceived severity. However, after accounting for cultural worldviews of individualism and hierarchy (and trust and demographic factors), none of the associations among political orientation and any of the three COVID-19 risk beliefs were significant. The test of indirect effects indicated that individualism and hierarchy were indirectly associated with lower perceived severity of and worry about COVID-19 through less trust. The findings suggest that cultural worldviews of individualism and hierarchy play a role in shaping people's risk beliefs.     

Stages of change in anxiety: psychometric properties of the University of Rhode Island Change Assessment (URICA) scale

Readiness for change is increasingly cited as an important variable in the health behaviours literature, yet there remains a dearth of research related to this construct in mental health. This study examined the psychometric properties of the University of Rhode Island Change Assessment (URICA) scale in two samples. In Study 1 (n = 252), undergraduates completed the URICA and were administered measures of hopelessness, the consequences of worry, self-esteem, anxious symptomatology, and social desirability. The reliability and validity of the URICA were generally supported, although the goodness-of-fit with the intended subscales was only moderate. The Precontemplation, Contemplation and Maintenance subscales correlated as expected with ancillary measures, but the Action subscale did not. In Study 2 (n = 81), individuals with panic disorder were administered the URICA at initial assessment and following cognitive behavioural therapy. The URICA demonstrated excellent reliability, significantly predicted treatment retention and dropout, and showed modest utility for predicting treatment outcome. Confirmatory factor analysis, however, revealed an inadequate fit to the intended subscales. The implications of these findings are discussed and directions for future research highlighted.     

The brief Reasons for Living Inventory for adolescents (BRFL-A)

This study modified and evaluated the psychometric properties of the Reasons for Living Inventory (RFL) in samples of adolescents. Internal consistency reliability, corrected item-total scale correlation, and exploratory factor analysis procedures were used with a mixed sample of 260 adolescents to identify 14 items for the brief version of the RFL (BRFL-A). Confirmatory factor analyses provided support for the five-factor oblique structure of the BRFL-A in a psychiatric inpatient sample with a range of suicidal behaviors. Reliabilities of the BRFL-A subscales were satisfactory. Four of the five subscales differentiated between suicidal and nonsuicidal adolescents. Significant correlations were found between three BRFL-A subscales and several suicide indices. Convergent-discriminant validity was examined by correlating the BRFL-A subscales with the Minnesota Multiphasic Personality Inventory—Adolescents (MMPI-A) Content Scales. Limitations of the study are discussed.This study was supported in part by a Project Grant from the Graduate College, The University of Northern Iowa.     

The Contribution of Worry Behaviors to the Diagnosis of Generalized Anxiety Disorder

Worry behaviors (i.e., overt acts to avoid or cope with worry-induced distress) have been recognized as being important in the psychopathology and treatment of generalized anxiety disorder (GAD). This study evaluated the worry behaviors criterion proposed for DSM-5 GAD, but was ultimately not adopted due to insufficient evidence. In 800 outpatients with emotional disorders (366 with GAD), most patients with GAD (92.6%) met the proposed worry behaviors criterion, which was at a rate significantly higher than other patient groups (e.g., patients with mood disorders). Patients who met the worry behaviors criterion had more severe GAD than patients who did not. The worry behaviors criterion, and 3 of its 4 constituent behaviors, were associated with no better than “fair” interrater reliability. Diagnostic reliability of GAD was not improved in cases where both interviewers agreed the worry behaviors criterion was met. The worry behaviors criterion significantly predicted DSM-5 GAD holding core GAD features constant (e.g., excessive worry), but this contribution was weak and did not appreciably improve the classification accuracy of GAD diagnostic status. Mixed support was obtained for the discriminant validity of the worry behaviors criterion in relation to mood disorders. Raising the proposed threshold of the criterion (requiring 2 instead of 1 behaviors) did not result in a substantial improvement in reliability, prediction, and classification accuracy. Although additional research is warranted (e.g., importance of worry behaviors in the treatment and natural course of GAD), the results raise questions about the role of worry behaviors in the diagnostic classification of GAD.     

Development and validation of the counterfactual thinking for negative events scale

We examined the psychometric properties of the newly created Counterfactual Thinking for Negative Events Scale (CTNES) in two studies involving university undergraduates. In Study 1 (N = 634), factor analysis revealed four subscales that correspond with various types of counterfactual thinking: Nonreferent Downward, Other-Referent Upward, Self-Referent Upward, and Nonreferent Upward. The subscales were largely orthogonal and had adequate internal consistency and test-retest reliability. The CTNES subscales were positively correlated with a traditional method of assessing counterfactual thinking and were related as expected to contextual aspects of the negative event, negative affect, and cognitive style. In Study 2 (N = 208), we further examined the validity of the scale and demonstrated that the subscales were sensitive to an experimental manipulation concerning the type of negative event participants recalled. Moreover, the CTNES subscales correlated in the expected direction with measures of coping and cognitive style.     

Why do U.S. conservatives take fewer COVID-19 precautions? The role of worry,perceived risk,and governmental trust

Research suggests a U.S. political ideology gap for taking COVID-19 precautions, but we do not know the role of cognitive risk (assessed here as perceived risk) and affective risk (assessed here as worry) in explaining why conservative Americans participated in fewer recommended precautions (e.g., mask wearing) and whether governmental trust attenuates the effect. We predicted that conservatives (compared with liberals) would take fewer precautions because they thought they were less at risk and were less worried about COVID-19, but that this would be more pronounced for those with low governmental trust. In this study, U.S. adults (representative sample: N = 738; M_age = 46.8; 52% women; 78% white) who had not had COVID-19 took two online surveys 2 weeks apart during the first wave of the pandemic (April 2020). Participants reported ideology, perceived risk of getting or dying of COVID-19, worry about COVID-19, and trust in the CDC and state officials at baseline. At follow-up, participants reported on COVID-19 precautions: (1) prevention behavior participation (e.g., mask wearing) and (2) behavioral willingness for future behaviors (e.g., vaccination). Results showed that, politically conservative Americans took fewer precautions due to lower worry (but unexpectedly not due to lower perceived risk). As predicted, when trust was high, the ideology gap was muted for predicting precautions as well as for predicting perceived risk and worry. In sum, conservatives worried less about COVID-19 which predicted fewer precautions, but trust in governmental institutions reduced this ideological gap. Improving governmental trust could be one fruitful path to increasing COVID-19 precautions.     

An abbreviated tool for assessing feminine norm conformity: psychometric properties of the Conformity to Feminine Norms Inventory-45

The Conformity to Feminine Norms Inventory-45 (CFNI-45; Parent & Moradi, 2010) is an important tool for assessing level of conformity to feminine gender norms and for investigating the implications of such norms for women's functioning. The authors of the present study assessed the factor structure, measurement invariance, reliability, and validity of the CFNI-45 with data from 520 college women (55% White). Confirmatory factor analyses with data from this sample suggested acceptable fit for the posited 9-factor structure. Furthermore, analyses of measurement invariance indicated similar structural properties with members of socioculturally dominant (i.e., White) and nondominant (i.e., women of color) racial/ethnic status groups. Also, subscales of the CFNI-45 demonstrated acceptable internal consistency reliability coefficients, and correlations with convergent and discriminant validity indicators supported the validity of subscales scores. Overall, results offered support for the CFNI-45 as a multidimensional measure of women's conformity to feminine norms. The CFNI-45 can be used in research to facilitate evaluation of the theorized roles of conformity to feminine norms in women's mental health, vocational behavior, interpersonal relationships, and other domains. The CFNI-45 can be used in clinical practice to assess and attend to clients' conformity to feminine norms as is called for in the American Psychological Association's (2007) Guidelines for Psychological Practice with Girls and Women.     

The development and validation of the Relational, Individual, and Collective self-aspects (RIC) Scale

A new scale measuring Relational, Individual, and Collective self-aspects (RIC) was developed. The RIC Scale consists of ten questions each followed by three options reflecting the three self-aspects. Respondents rate each option in terms of its applicability to the self, yielding three subscale scores and revealing the relative prominence of each self-aspect. Two samples of university students (N1 = 170, N2 = 214) were used to develop and refine the scale. Analyses supported the reliability and validity of the three RIC subscales. Each self-aspect correlated in predicted ways with several existing scales. The RIC Scale also proved useful in assessing gender differences in self-aspect prominence. Validity of the three-part model of the self and implications for future research are discussed.     

A multi-dimensional measure of worry: Development and preliminary validation of the anxious thoughts inventory

This paper reports the development of a dispositional self-report measure of multiple dimensions of generalised worry. Factor analyses demonstrated a replicable three factor structure indicating that this measure of worry comprises three basic dimensions: social worry, health worry, and meta-worry. The first two factors reflect different content dimensions whereas the meta-worry factor consists of both content and process dimensions of worry. Individual differences in subscale scores show moderate stability over time, and the subscales possess good psychometric properties. Significant correlations were found between worry subscales and personality dimensions of self-consciousness and EPI scores. The role of multi-dimensional measurement in the exploration of worry is discussed.     

Reliability and validity of an auditing tool for person-centred psychotherapy and counselling for young people: The PCEPS-YP

The present study aimed to test the reliability and validity of the Person Centred and Experiential Psychotherapy Scale–Young Person version (PCEPS-YP). This is a newly developed and adapted 9-item scale which aims to measure counsellor competences in, and adherence to, person-centred practice, when working with adolescents. Counselling practice was assessed for 19 counsellors by randomly selecting 20-min audio segments from 142 recorded counselling sessions. Audio material was independently rated by eight raters using the PCEPS-YP to produce an average adherence rating per counsellor. Scale reliability was assessed via interrater reliability and internal consistency testing. Convergent validity was tested using ratings from the observer-rated Barrett-Leonard Relationship Inventory (BLRI Obs 40), and the scale was subjected to exploratory factor analysis. Results showed a high degree of internal consistency within raters (α = 0.95), marginally acceptable reliability across grouped raters (α = 0.58) and weaker reliability between pairs of raters (α = 0.50). Exploratory factor analysis revealed one strong factor for the scale with no subscales. Small-to-moderate correlations existed between the PCEPS-YP and the BLRI subscales and mean total score (rs = .12 to .40). Our findings suggest that the PCEPS-YP has potential as an effective, reliable and valid tool for assessing competence and adherence in person-centred practice with young people, both for research and for clinical purposes. However, training procedures need to be established that can enhance interrater reliability, and more evidence of convergent validity is needed.     

The feasibility,reliability and validity of the EORTC QLQ-C30 in assessing the quality of life of patients with a symptomatic HIV infection or AIDS (CDC IV)

Abstract

The objective of this study was to evaluate the feasibility, reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (the QLQ-C30) in a longitudinal study of the quality of life (QoL) of patients with a symptomatic HIV infection or AIDS. The OLQ-C30 is a 30-item questionnaire composed of five functional subscales. 3 symptom subscales, an overall QoL subscale, and a number of additional single item symptom measures. The questionnaire was administered serially to a sample of 156 Dutch patients. The average time to complete the questionnaire was less than 11 minutes, with most patients requiring no assistance. With one exception (role functioning subscale), the data supported the hypothesized scale structure of the questionnaire. Eight of the 9 subscales met or approached the minimal criterion for reliability (Cronbach's alpha ≤ .70) at baseline and/or follow-up. The validity of the QLQ-C30 was supported by 3 findings: (1) the correlations observed among the subscales. while statistically significant, were of only a moderate magnitude, indicating that distinct components of QoL are being assessed; (2) a number of the subscales could discriminate clearly between patients differing in stage of disease and in Karnofsky Performance Status; and (3) significant changes in QLQ-C30 scores in the expected direction, were observed over time. These results lend support to the QLQ-C30 as a reasonably reliable and valid instrument for assessing the QoL of patients with HIV infection. Additional research is needed to improve the role functioning subscale. to evaluate the QLQ-C30's concurrent validity by comparing it with other available QoL instruments, and to examine more thoroughly its responsiveness to clinically important changes in patients' health status over the entire disease and treatment trajectory.     

Specific worry about breast cancer predicts mammography use in women at risk for breast and ovarian cancer.

This longitudinal study examined predictors of mammography use among women with a family history of breast cancer participating in a risk assessment and surveillance program (N = 213). Assessed were background variables (age, prior mammography utilization), cognitive variables (perceived vulnerability), and affective variables (cancer worry and general distress). Results of logistic regression analyses predicting adherence 1 year after baseline contact, in which variables of prior utilization, feelings of vulnerability, and general distress were controlled for, indicated that cancer worry and age were significant predictors of mammography adherence. Results suggest that moderate levels of cancer worry facilitate, rather than undermine, adherence. The results have implications for the construction of educational messages that should be designed to acknowledge feelings of cancer-specific worry and to provide guidance in health protective behaviors.