Health Anxiety in Children: Development and Psychometric Properties of the Childhood Illness Attitude Scales

The course of severe anxiety surrounding health issues is unknown. The available literature suggests that adults who are overly anxious about health issues often interpret or misinterpret their bodily signs and symptoms to be indicative of a serious illness. The construct of health anxiety has not been examined in children and, to date, there has not been an instrument developed for this purpose. The Illness Attitude Scales is one of the most commonly used instruments for evaluating fears, beliefs, and attitudes that are associated with hypochondriasis and abnormal illness behaviour in adults. We sought to adapt the Illness Attitude Scales for use with children ages 8–15 years. The adapted Illness Attitude Scales was renamed the Childhood Illness Attitude Scales. Revisions to the adult version consisted of simplification of language, revision of Likert scale (i.e. 5-point to 3-point scale), and the addition of 7 questions to evaluate the role parents/guardians play in facilitating medical attention or treatment. Correlations between Childhood Illness Attitude Scales total scores and other self-report measures were supportive of the construct-related validity of the Childhood Illness Attitude Scales and suggested that it is a useful measure of health anxiety in school-age children. Practical and theoretical implications of the present results are discussed.     

The self-assessment of resilience and anxiety: psychometric properties

This report describes the psychometric properties of the Self-Assessment of Resilience and Anxiety (SARA) scale within the context of a study of kava for generalized anxiety. This eight-item, patient-rated scale includes questions designed to measure calmness, mental clarity, confidence, physical well being, sociability, and resilience. The SARA scale was administered during a clinical trial of kava versus placebo in 38 subjects diagnosed with generalized anxiety disorder (GAD). Validation of the SARA scale was assessed against the Hamilton Rating Scale for Anxiety, Hospital Anxiety and Depression Scale, Penn State Worry Questionnaire, Sheehan Disability Scale, Arizona Sexual Experience scale, and Clinical Global Impression of Illness Improvement scale. Good test-retest reliability, internal consistency, convergent validity, and sensitivity to treatment were identified, and factor analyses revealed a three-factor internal structure. The SARA scale was responsive to symptom change over time and correlated with comparable GAD symptom measures. The SARA scale demonstrates solid psychometric properties and may serve as a reliable and valid measure in the use of kava or related medicinal herbs.     

The social phobia and anxiety inventory: psychometric properties in a Spanish sample

This study is a validation of the Spanish version of the Social Phobia and Anxiety Inventory using a nonclinical sample (198 participants) and a clinical sample (72 participants with social phobia). The factor structure and concurrent validity with Fear of Negative Evaluation and Social Avoidance and Distress scales were analyzed. The Social Phobia and Anxiety Inventory demonstrated good concurrent validity, showing statistically significant relationships with Fear of Negative Evaluation and Social Avoidance and Distress. Results confirmed the rationale for the division of the SPAI into two subscales. Results also demonstrated the utility of the Social Phobia and Anxiety Inventory for differentiating between a nonclinical sample and participants with a social phobia, and its adequate reliability.     

Compensatory health beliefs: scale development and psychometric properties

Compensatory Health Beliefs (CHBs) are beliefs that the negative effects of an unhealthy behavior can be compensated for, or “neutralised,” by engaging in a healthy behavior. “I can eat this piece of cake now because I will exercise this evening” is an example of such beliefs. The present research describes a psychometric scale to measure CHBs (Study 1) and provides data on its reliability and validity (Studies 2 and 3). The results show that scores on the scale are uniquely associated with health-related risk behaviors and symptom reports and can be differentiated from a number of related constructs, including irrational health beliefs. Holding CHBs may hinder individuals from acquiring healthier lifestyles, for example lose weight or exercise.     

Spanish and English Neuropsychological Assessment Scales (SENAS): further development and psychometric characteristics

The Spanish and English Neuropsychological Assessment Scales were devised to be a broad set of psychometrically matched measures with equivalent Spanish and English versions. Study 1 in this report used item response theory methods to refine scales. Results strongly supported psychometric matching across English and Spanish versions and, for most scales, within English and Spanish versions. Study 2 supported in both English and Spanish subsamples the 6-domain model of ability that guided scale construction. Study 3 examined differential item functioning (DIF) of one scale (Object Naming) in relation to education, ethnicity, gender, and age. Effects of DIF on scale-level ability scores were limited. Results demonstrate an empirically guided psychometric approach to test construction for multiethnic and multilingual test applications.     

The psychometric properties of the Interpersonal Sensitivity Measure in social anxiety disorder

The Interpersonal Sensitivity Measure (IPSM) was developed to assess hypersensitivity to interpersonal rejection, a suggested trait of depression-prone personality (Aust NZ J Psychiatry 23 (1989) 341). Although studies of the IPSM and interpersonal rejection sensitivity have primarily been conducted in depressed populations, it is important to investigate interpersonal rejection sensitivity as a relevant construct in the assessment of social anxiety. This study examined the psychometric properties of the IPSM in treatment-seeking individuals with social anxiety disorder. The results of this investigation support the convergent and divergent validity and internal consistency of the IPSM in socially anxious individuals. An exploratory factor analysis of the scale was also conducted after the original factor and subscale structure was shown to be a poor fit for the present data. Three factors emerged (Interpersonal Worry and Dependency, Low Self-Esteem, and Unassertive Interpersonal Behavior), and 29 items were retained. Because they demonstrated negative factor loadings on Factor 2, it is suggested that the scoring for four items of the original IPSM be reversed. In summary, the revised IPSM assesses three aspects of interpersonal rejection sensitivity and appears to be a valid and reliable instrument for its assessment in social anxiety disorder.     

The scale of ethnic experience: development and psychometric properties

The Scale of Ethnic Experience (SEE) is a new self-report instrument designed to measure multiple ethnicity-related cognitive constructs across ethnic groups. We present the development and psychometric properties here. We generated and refined an item pool using expert consultants and culturally diverse focus groups. We derived a final 32-item version of the SEE based on separate factor analyses of data from college students in 4 ethnic groups: African Americans, Caucasian Americans, Filipino Americans, and Mexican Americans. Four factors were consistent across the ethnic groups: Ethnic Identity, Perceived Discrimination, Mainstream Comfort, and Social Affiliation. We found evidence of test-retest reliability, internal consistency, and criterion and construct validity for all groups. Finally, we cross-validated the factor structure of the SEE in a culturally diverse sample. Results support the reliability and validity of the SEE as a multidimensional measure of ethnicity-related cognitive constructs that can be used across American ethnic groups.     

The MMPI-2 Clinical Scales and Restructured Clinical (RC) Scales: comparative psychometric properties and relative diagnostic efficiency in young adults

We examined the psychometric properties of the Restructured Clinical (RC) scales (Tellegen et al., 2003) of the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) in a large sample (N = 744) of 18-year-old college freshman. We found that the RC scales demonstrated good convergence with their Clinical scale counterparts and were more distinctive than the Clinical scales. The patterns of discriminant correlations for the RC scales were slightly clearer than those of the Clinical scales and a set of other existing MMPI-2 scales. Diagnostic efficiency statistics based on Clinical and RC scale elevation status did not differ appreciably. However, the diagnostic efficiency statistics of cutoff scores derived from mean RC and Clinical scale T scores improved on the traditional scale elevation measures. We consider the clinical implications of these findings.     

Measuring rail passenger crowding: Scale development and psychometric properties

Research on rail passenger crowding often tacitly subscribes to a measurement of crowding based on density (i.e. physical conditions involving space limitations) and rarely considers the possible role psychological factors may play in measuring this construct. This paper describes the development of an instrument that captures the dimensionality of rail passenger crowding and its relationship to the experience of stress and feelings of exhaustion. The proposed instrument is a 20-item self-rating questionnaire consisting of three sub-scales designed to assess subjective crowding experiences among rail users (n = 525). Findings from the factor analyses generally support the hypothesised three-factor structure of the measurement model (evaluation of the psychosocial aspects of the crowded situation, evaluation of the ambient environment of the crowded situation, and affective reactions to the crowded situation). All sub-scales demonstrate excellent internal consistency and construct validity as well as good convergent and discriminant validity values. The instrument was further tested using structural equation modelling to examine the impact of crowding on commuters’ stress and feelings of exhaustion. With the addition of the “passenger density” variable as an indicator of objective measurement of crowding operating in tandem with the crowding sub-scales, the results reveal that: (1) commuters’ evaluations of the psychosocial aspects of the crowded situation and of its ambient environment, alongside their rating of passenger density, significantly predict affective reactions to the crowded situation; (2) these affective reactions, in turn, significantly predict stress and feelings of exhaustion; and (3) evaluations of the psychosocial aspects of the crowded situation and of its ambient environment as well as passenger density do not directly predict stress and feelings of exhaustion. The link between rail passenger crowding and the negative outcomes therefore does not appear as a simple, direct relationship, but is mediated by affective feelings of crowdedness. Overall, these results provide satisfactory psychometric properties for the proposed instrument and support its use as an assessment tool for measuring crowding experience in the rail setting.     

Observations on the Methodology in Attitude Scales

Abstract

Male and female undergraduates (N = 130) rated themselves or an actor-confederate on factors influencing them not to cheat on a test when situational variables served to either inhibit or facilitate tendencies to cheat. Results indicated a partial reversal of the actor-observer phenomenon and some evidence that actors' attributions fit the covariance model and observers', the schematic model.     

Bryant's Empathy Index for children and adolescents: psychometric properties in the Spanish language

The present study investigated the following issues: (1) the structure of Bryant's Empathy Index for children and adolescents in a Spanish sample of 408 boys and 424 girls (M age=14.4 yr.), and (2) sex differences, including effect sizes and internal consistency of the scale. A principal components factor analysis with oblimin rotation showed that 20 of the index's 22 items load on three robust factors, related to Feelings of Sadness, Understanding Feelings, and Tearful Reaction with regard to the emotions of others. The 3-factor structure obtained an adequate fit to the data in the confirmatory factor analysis. Coefficients alpha ranged between .72 and .78. The 3 factors accounted for 42% of variance. As expected, girls scored higher than boys. It was concluded that the Spanish version of Bryant's Empathy Index has an acceptable reliability and construct validity, making it useful for research.     

Measuring explicit attitude toward doping: Review of the psychometric properties of the Performance Enhancement Attitude Scale

ObjectivesDoping use is seldom an accident – it is a deliberate action often requiring considerable commitment. Attitudes are known to influence this type of action and hence they are likely to be predictive of doping-related behaviours. To measure ‘doping attitude’, a valid and reliable tool is required.DesignThis paper briefly reviews methodological issues in doping attitude research, introduces the Performance Enhancement Attitude Scale (PEAS) and provides a comparative analysis of its reliability and validity as a self-reported measure of a generalized doping attitude.MethodsThe scale's reliability was examined with Cronbach's internal consistency coefficient and test–retest correlations using data from 9 independent studies encompassing 7 years. Confirmatory factor analysis was performed to assess the scale's structure. Known-groups' validation strategy was employed to examine construct validity in 4 studies.ResultsEstimates of the PEAS' internal consistency (ranged between .71 and .91 across various samples) provided good evidence of the scale's simultaneous reliability. The chi-square/df ratio in all cases was below the threshold with an average of 1.85 (ranging from 1.370 to 2.291), indicating an acceptable measurement model fit. Theoretically expected difference in doping attitudes was found between doping users and non-users with elevated PEAS scores from users, as well as predictable dynamics of PEAS scores across the repeated measures, provided support for construct validity of the scale.ConclusionThe psychometric properties of the 17-item unidimensional PEAS suggest that the scale is a useful tool for measuring self-declared attitudes toward doping, with adequate reliability and promising validity estimates. Suggestions are discussed for the continuous scale development and validation process.     

Exploring the psychometric properties and construct validity of the MCMI-III anxiety and avoidant personality scales

The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983) is a commonly used self-report instrument designed to aid in the assessment of Axis I and Axis II disorders. Concerns have been expressed regarding the procedures used in the normative research for the current version of the MCMI (MCMI-III; Millon, 1994) leading to a call for additional validity research on the MCMI-III (Retzlaff, 1996). In this study, we investigated the psychometric properties of the MCMI-III's Anxiety and Avoidant personality scales in a sample of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) anxiety disorders. Our results suggest that the MCMI-III Avoidant scale is reliable (r =.89) and it was found to demonstrate appropriate convergent and divergent validity with other self-report measures. The MCMI-III Anxiety scale also showed adequate reliability (r =.78); however, our findings raise some concerns about the discriminant validity of this scale. A scale composed of the MCMI-III core anxiety items was found to have better discriminant validity. These findings are consistent with those reported by other researchers regarding the relationship between self-report measures of anxiety, avoidance, and depression. We conclude that the MCMI-III measures of anxiety and avoidance are consistent with other measures of these constructs and may provide valuable clinical information in this regard.     

A sensation seeking scale for children: Further refinement and psychometric development

A revision of the Sensation Seeking Scale for Children (SSSC) was standardized and validated on a community sample of 660 elementary- and middle-school children and 168 clinic-referred male children. Factor analysis of the combined samples yielded three unique factors, entitled Thrill and Adventure Seeking, Drug and Alcohol Attitudes, and Social Disinhibition. Psychometric indices of reliability and validity were acceptable, but test-retest reliability was only moderate. Differences in SSSC scores according to sex, ethnic group, age, and intellectual status were similar to those found previously with the adult Sensation Seeking Scales. Consistent with documented relations between adult antisocial personality and sensation seeking, the SSSC distinguished boys with conduct disorder (CD) from clinic controls, but the SSSC scores of boys with CD did not differ from those of the community sample boys. Discussion includes suggestions as to the continued study of the assessment of sensation seeking in children.This research was supported by National Institutes of Health Grant 1-R01-MH42529-04 and is based on the doctoral research of the first author.     

The physical activity and sport anxiety scale (PASAS): Scale development and psychometric analysis

Research suggests that social anxiety may be elicited in athletic or sporting situations, resulting in decreased physical activity due to avoidance behavior. Given the myriad physical and psychological health consequences of a non-active lifestyle, valid assessment of social anxiety and avoidance in this domain is warranted. However, none of the common measures of social anxiety appear to assess social anxiety in physical activity or sporting domains. Therefore, the purpose of this study was to develop and evaluate a brief measure of social anxiety in physical activities and sports. A 16-item self-report questionnaire, the Physical Activity and Sport Anxiety Scale (PASAS), was extracted from a larger pool on empirical and theoretical grounds. The PASAS demonstrated excellent internal consistency across a number of samples, and excellent temporal stability. The PASAS also demonstrated good convergent and divergent validity, and is related to self-perceived performance biases as postulated by cognitive-behavioral models of social anxiety.     

Beliefs About Psychological Services (BAPS): development and psychometric properties

A scale to measure attitudes towards seeking psychological help was developed (Beliefs About Psychological Services [BAPS]) and evaluated. This scale was based on items gathered from students, colleagues, and the authors when asked about common positive and negative attitudes toward psychologists and their services. Items were also based on the Fischer and Turner (1970 Fischer, EH and Turner, JLeB. 1970. Orientations to seeking professional help: Development and research utility of an attitude scale. Journal of Consulting and Clinical Psychology, 35: 79–90. [Crossref], [PubMed], [Web of Science ®] [Google Scholar]) Attitudes Toward Seeking Professional Psychological Services (ATSPPH) measure. Three studies are reported describing the construction and evaluation of the psychometric properties of the BAPS. The BAPS is an 18-item measure consisting of three subscales: Intent, Stigma Tolerance, and Expertness. Support was found for the reliability and validity of the measure.     

Exploratory factor analysis and psychometric properties of the General Health Questionnaire in Spanish adolescents

The aim of this study was to assess the homogeneity of items, reliability as a metric indicator of global quality (internal consistency and temporal stability), and the exploratory factor structure of the General Health Questionnaire-28 (GHQ-28) in a sample of 2,010 Spanish adolescents. Mean age was 15.9 yr. (range 14-19, SD = 2.1). The test was administered twice with 20 days between responses, Answers were scored on a Likert-type scale. The internal consistency and test-retest reliabilities obtained were .93 and .94. In exploratory factor analysis, four factors explained 52.7% of the variance. These results indicated that the GHQ-28 is a psychometrically sound mental health measure in Spanish adolescents.     

A psychometric study of the Family Adaptability and Cohesion Evaluation Scales

The Family Adaptability and Cohesion Evaluation Scales (FACES), a measure of family functioning, contains three scales: cohesion, adaptability, and social desirability. These were slightly modified (FACES- R) on the basis of pilot data and were administered to 42 clinic families (families seeking or receiving psychological services) and 206 nonclinic families. Support for the scales was found in high coefficient alpha reliabilities and similarity of the sample means and standard deviations to those of the standardization sample. However, there was little agreement among family members' scale scores. Therapists' ratings of cohesion and adaptability did not correlate with scale scores among clinic families. There was no difference between clinic and nonclinic samples on the cohesion or adaptability scales, although the social desirability scale did discriminate between groups. Factor analysis suggested that cohesion, adaptability, and social desirability cannot be clearly differentiated using this measure.This work was supported by the American Association of University Women and by Grant R01HD13820 from the National Institute of Child Health and Human Development.     

Measuring gratitude in youth: assessing the psychometric properties of adult gratitude scales in children and adolescents

Before the developmental trajectory, outcomes, and related interventions of gratitude can be accurately and confidently studied among the youth, researchers must ensure that they have psychometrically sound measures of gratitude that are suitable for this population. Thus, considering that no known scales were specifically designed to measure gratitude in youth, this study aimed to answer an important question: Are the existing gratitude scales used with adults valid for use with youth? The present study is an empirical investigation, based on a large youth sample (N = 1,405) with ages ranging from 10 to 19 years old, of the psychometric properties of scores of the Gratitude Questionnaire-6 (GQ-6; M. E. McCullough, R. A. Emmons, & J.-A. Tsang, 2002), the Gratitude Adjective Checklist (GAC; M. E. McCullough, R. A. Emmons, & J.-A. Tsang, 2002), and the Gratitude Resentment and Appreciation Test (GRAT)-short form (M. Thomas & P. Watkins, 2003). Single-group and multiple-group confirmatory factor analyses indicated that the factor structures of these gratitude scales resemble those found with adults and were invariant across age groups. Scores of all three gratitude scales revealed acceptable internal consistency estimates (i.e., >.70) across age groups. Results showed that whereas scores of all three gratitude scales were positively correlated with each other for 14- to 19-year-olds, GRAT-short form scores tended to display relatively low correlations with scores of the other two measures for younger children (10-13 years old). Furthermore, the nomological network analysis showed that scores of all three gratitude scales were positively correlated with positive affect and life satisfaction scores across the age groups. The relationships with negative affect and depression scores, however, seemed dependent on the child's age. Pending results from subsequent research recommendations for researchers interested in studying gratitude in youth are offered.