scholarly journals Development of self-report assessment tool for anxiety among adolescents: Indonesian version of the Zung self-rating anxiety scale

Author(s):  
Anggi Setyowati ◽  
Min-Huey Chung ◽  
Ah. Yusuf

Anxiety is common among adolescents. Self-report anxiety scales are needed to screen and prevent adolescents sinking into worse mental health. The purpose of this study was to assess the psychometric properties of Indonesia Zung Self-rating Anxiety Scale (SAS), including translation, validity, reliability and receiver operating characteristics (ROC). We used cross-sectional study and correlational design in this study. Total sample was 1,000 adolescents in junior and senior high school. The SAS was translated into Bahasa Indonesia based on World Health Organization guidelines. SAS and the Indonesia version of Beck Depression Inventori-(BDI) II questionnaires were used to develop construct validity. Correlation between item score and total score was used to establish convergent validity. Cronbach’s alpha was used to calculate reliability and ROC curves were used to examine cut-off point of SAS. Construct validity showed positive correlation between the SAS and Indonesia version of BDI II scores. Convergent validity showed positive correlation between each item and total score. Cronbach’s alpha 0.691 and the ROC 36.5. Thus, the Indonesia version of SAS provides a reliable and valid tool to screen anxiety among adolescents.

2020 ◽  
Author(s):  
Laura Elizabeth Bedford ◽  
Maegan Hon Yan Yeung ◽  
Chi Ho Au ◽  
Emily Tsui Yee Tse ◽  
Wing Yee Yim ◽  
...  

Abstract Background Patient enablement is a core tenet of patient-centred and holistic primary care. The Patient Enablement Instrument (PEI) is a transitional measure limited in its ability to measure changes over time. A modified version, PEI-2, has been developed to measure enablement at a given time-point without comparison to a recalled baseline. Objective To assess the validity, reliability, sensitivity and responsiveness of PEI-2. Methods PEI-2 was modified from the Chinese PEI to assess enablement over 4 weeks in a prospective cohort study nested within a community support programme [Trekkers Family Enhancement Scheme (TFES)] in Hong Kong. Construct validity was assessed by factor analysis and convergent validity by Spearman’s correlations with health-related quality of life and depressive symptoms. Internal reliability was assessed using Cronbach’s alpha. Test–retest reliability was assessed by intraclass correlation (ICC), responsiveness by 12–24-month change in PEI-2 score and sensitivity by differences in change of PEI-2 score between TFES participants and a control group. Results PEI-2 demonstrated construct validity with all items loading on one factor (factor loadings >0.7). Convergent validity was confirmed by significant correlations with 12-item Short Form Questionnaire, version 2 (r = 0.1089–0.1919) and Patient Health Questionnaire-9 (r = −0.2030). Internal reliability was high (Cronbach’s alpha = 0.9095) and test–retest reliability moderate (ICC = 0.520, P = 0.506). Significant improvements in PEI-2 scores among the TFES group suggested good responsiveness (P < 0.001). The difference in change of PEI-2 scores between TFES and control was significant (P = 0.008), indicating good sensitivity. Conclusions This study supports the validity, reliability, sensitivity and responsiveness of PEI-2 in measuring changes in enablement, making it a promising tool for evaluating enablement in cohort and intervention studies.


2017 ◽  
Vol 66 (1) ◽  
pp. 19-28
Author(s):  
Hugo Rafael de Souza e Silva ◽  
Kelsy Catherina Nema Areco ◽  
Paulo Bandiera-Paiva ◽  
Pauliana Valéria Machado Galvão ◽  
Analia Nusya de Medeiros Garcia ◽  
...  

ABSTRACT Objective To evaluate construct validity and reliability of the Portuguese (Brazil) version of Online Cognition Scale (OCS-BR). Methods Portuguese (Brazil) versions of Online Cognition Scale (OCS), of Internet Addiction Test (IAT) and socio demographic questionnaire was applied to a sample (n = 359) of health university students. Construct validity evidence was verified through the factorial and convergent validity by Confirmatory Factor Analysis (CFA) and internal consistency and stability analysis through Cronbach’s alpha and intraclass correlation coefficient (ICC) respectively. Discriminative power of items were analyzed using item-total correlation and point biserial correlation. Results OCS-BR presented satisfactory evidence of construct validity. The instrument showed Cronbach’s alpha of 0.91 and ICC of 0.91. Conclusion Portuguese (Brazil) version of OCS shows items consistently gatherd to measure the Problematic Internet Use (PIU) construct, it is considered s stable instrument in time and with sufficient evidence of construct validity.


Salud Mental ◽  
2017 ◽  
Vol 40 (5) ◽  
pp. 209-218 ◽  
Author(s):  
Omar Hernández-Orduña ◽  
◽  
Rebeca Robles-García ◽  
Nicolás Martínez-López ◽  
Carolina Muñoz-Toledo ◽  
...  

Introduction. Valid and feasible measures to properly assess the most impaired areas of functioning in various groups of patients with mental disorders would allow the development and evaluation of interventions designed to modify the specific environmental barriers that contribute to patients´ disability. Objective. This article seeks to evaluate the internal consistency and construct and convergent validity of the Spanish version of the World Health Organization’s Disability Assessment Schedule WHODAS 2.0, as well as its relationship with sociodemographic variables and symptomatic severity in Mexican patients with and without psychotic symptoms. Method. The WHODAS 2.0 and the Social and Occupational Functioning Assessment Scale SOFAS were administered to 153 patients with any of the following diagnoses: affective disorders, anxiety disorders, stress-related disorders, and psychotic disorders. Results. The WHODAS 2.0 showed high internal consistency in patients with psychotic symptoms (Cronbach’s alpha = .92) and without psychotic symptoms (Cronbach’s alpha = .89). Nevertheless, only in patients without psychotic symptoms, was a significant negative correlation between WHODAS (disability) and SOFAS (functioning) total scores observed, together with significant differences in WHODAS scores between those with mild and severe symptomatology. Discussion and conclusion. The WHODAS 2.0 is an adequate measure of disability in patients without psychotic symptoms. It could be used as a complementary measure of disability in those with psychotic symptoms. Further studies are required to determine other psychometric properties of the WHODAS 2.0, particularly those related to temporal stability and sensitivity to change.


Author(s):  
Vahid Farnia ◽  
Mehdi Moradinazar ◽  
Nasrin Abdoli ◽  
Mostafa Alikhani ◽  
Mansour Rezaei ◽  
...  

Background: No standard self-report instrument for withdrawal symptoms is available in Iran. Objectives: This study aimed to evaluate the psychometric properties of the Persian version of the 10-item Amphetamine Withdrawal questionnaire version 2 (AWQV2). Methods: A sample of 388 methamphetamine addicts (215 females and 173 males) referred to addiction recovery centers and psychiatric ward of Farabi Hospital in Kermanshah. A two-stage random sampling method was used. The reliability and internal consistency of the AWQV2 items were examined using Cronbach’s alpha and test-retest reliability, respectively, and the instrument validity of the AWQV2 was measured using construct validity and convergent validity. Results: The AWQV2 had a Cronbach’s alpha of 0.72. Factor analysis using the main component analysis with a varimax rotation introduced three factors of hyperarousal, anxiety, and reversed vegetative symptoms. These factors explained 0.58 of the total variance. The coefficient of test-retest reliability at a 2-week interval was equal to 0.77. The convergent validity of the AWQV2 was examined by simultaneously administering the Advanced Warning of Relapse (AWARE) questionnaire to 40 subjects, with a correlation coefficient of 0.81. Conclusions: Based on the results, the AWQV2 has very good psychometric properties and may be used in research and therapeutic interventions.


2021 ◽  
Author(s):  
Άνθιμος Τζίκος

Οι εκδηλώσεις διασχιστικού/αποσυνδετικού τύπου και οι συναφείς Διασχιστικές/Αποσυνδετικού Τύπου Διαταραχές είναι ένα αρκετά σκοτεινό ζήτημα της σύγχρονης ψυχοπαθολογίας. Κάποιοι τις θεωρούν «απόνερα» που άφησε πίσω του, φεύγοντας από το προσκήνιο, ο όρος και η κλινική εικόνα της Υστερίας. Δημιουργούν γύρω τους έντονη διχογνωμία, οι ερευνητές διστάζουν να τις αναγνωρίσουν και οι θεραπευτές αποφεύγουν να ασχοληθούν μαζί τους. Σε ελάχιστες περιπτώσεις, στα αρχεία Ψυχιατρικών Εξωτερικών Ιατρείων και Κλινικών, αναγράφεται η διάγνωση κάποιας Διασχιστικής Διαταραχής. Γενικά, οι περισσότεροι από τους κλινικούς δεν αισθάνονται άνετα όταν πρέπει να εκτιμήσουν και να αντιμετωπίσουν ένα άτομο που παρουσιάζει διασχιστική συμπτωματολογία, είτε γιατί θεωρούν τον εαυτό τους ανεπαρκή, είτε γιατί δεν αναγνωρίζουν τη διαταραχή ως τέτοια. Η ενημέρωση για θέματα που αφορούν τη διάσχιση/αποσύνδεση είναι συνήθως ελλιπής και βασίζεται σε πληροφορίες που προέρχονται από μη επιστημονικές πηγές. Η πιο συχνά χρησιμοποιούμενη, διεθνώς, κλίμακα για τη διάσχιση/αποσύνδεση είναι το ερωτηματολόγιο Dissociative Experience Scale (DES). Στην Ελλάδα, δεν έχει σταθμιστεί ούτε εφαρμοστεί στον πληθυσμό της, κάποιο εργαλείο μέτρησης διασχιστικών/αποσυνδετικών φαινομένων. Σκοπός της παρούσας εργασίας είναι, αφενός η στάθμιση του ερωτηματολογίου Dissociative Experience Scale (DES) που μετρά τη διάσχιση/αποσύνδεση και αφετέρου η εφαρμογή του για την αξιολόγηση της διάσχισης/αποσύνδεσης σε πληθυσμούς της Θράκης.Για την έρευνα αυτή αρχικά συλλέχθηκε η βιβλιογραφία που αφορούσε στη μελέτη και τη διάγνωση της διάσχισης και των Διασχιστικών Διαταραχών. Επιλέχθηκαν διαγνωστικά εργαλεία που σχετίζονταν με το θέμα. Αυτά ήταν τα παρακάτω: Dissociative Experience Scale (DES), Multiscale Dissociation Inventory (MDI) και Structured Clinical Interview for DSM-IV-Dissociative Disorders Revised (SCID-D-R). Λήφθηκαν άδειες και οδηγίες για τη χρήση τους από τους δημιουργούς τους, για κάθε κλίμακα ξεχωριστά. Μεταφράστηκαν στα ελληνικά και προσαρμόστηκαν στο ελληνικό κοινωνικοπολιτισμικό πλαίσιο. Το δείγμα της έρευνας αποτελείται από 340 άτομα (122 ασθενείς των Εξωτερικών Ιατρείων - κλινικό δείγμα και 218 τυχαίους μάρτυρες). Οι συμμετέχοντες συμπλήρωσαν, αρχικά, ένα ερωτηματολόγιο με τα κοινωνικο–δημογραφικά τους χαρακτηριστικά. Ακολούθως, αξιολογήθηκαν με τη χρήση των εργαλείων DES, MDI, της κλίμακας άγχους Zung Self-Rating Anxiety Scale, μιας ψυχιατρικής Κλινικής Εξέτασης εστιασμένης στην διασχιστική συμπτωματολογία καθώς και της SCID-D-R. Για τη στάθμιση της DES:α) εφαρμόστηκε διερευνητική ανάλυση παραγόντων,β) η αξιοπιστία της κλίμακας αξιολογήθηκε με τον υπολογισμό αφενός του συντελεστή Cronbach’s alpha για την εσωτερική συνάφεια, στο σύνολο του δείγματος και αφετέρου του συντελεστή ενδοταξικής συσχέτισης (ICC), για την αξιοπιστία εξέτασης επανεξέτασης, σε μέρος του δείγματος (25 ασθενείς και 29 μάρτυρες) που εξετάσθηκε δυο φορές σε διάστημα δύο εβδομάδων.γ) για την αξιολόγηση της εγκυρότητας της DES υπολογίσθηκαν η συντρέχουσα εγκυρότητά της έναντι της Κλινικής Εξέτασης καθώς και της SCID-D-R, η συγκλίνουσα εγκυρότητά της έναντι των εργαλείων MDI και Zung και τέλος η διακρίνουσα εγκυρότητά της με τη σύγκριση των βαθμολογιών της DES μεταξύ ασθενών και μαρτύρων.Ακολούθως, χρησιμοποιήθηκαν μονομεταβλητή και πολυμεταβλητή γραμμική παλινδρόμηση με την DES ως εξαρτημένη μεταβλητή και ως ανεξάρτητες μεταβλητές. τα δημογραφικά χαρακτηριστικά του δείγματος (ηλικία, φύλο, οικογενειακή κατάσταση, μορφωτικό επίπεδο, πληθυσμιακή ομάδα, τόπος διαμονής, εργασιακή κατάσταση) και την κλινική κατάσταση (κλινικό δείγμα/μάρτυρες). Από την ανάλυση παραγόντων προέκυψε ένα εργαλείο 28 ερωτήσεων, η Κλίμακα Εμπειριών Αποσύνδεσης/Διάσχισης (DES). Αναδείχθηκαν τέσσερεις παράγοντες: «Αποπροσωποποίηση», «Αμνησία», «Απορρόφηση» και «Διάφορα Διασχιστικά Βιώματα», οι οποίοι εξηγούν το 61% της συνολικής διασποράς.Η τιμή του συντελεστή Cronbach’s alpha για την DES είναι 0.95, δηλώνοντας υψηλή εσωτερική συνάφεια. O συντελεστής ενδοταξικής συσχέτισης (ICC) του συνολικού σκορ της DES μεταξύ της πρώτης συνέντευξης και της επανεξέτασης είναι 0.84, δείχνοντας ικανοποιητική αξιοπιστία εξέτασης – επανεξέτασης.Η συντρέχουσα εγκυρότητα της DES σε σχέση με την Κλινική Εξέταση ως «χρυσό κανόνα» είναι ικανοποιητική (0,77). Οι συσχετίσεις της DES με τις MDI και ZUNG κυμαίνονται από 0.58 έως 0.96, δείχνοντας ικανοποιητική συγκλίνουσα εγκυρότητα, παρομοίως. Το συνολικό αποτέλεσμα της DES ήταν στατιστικά σημαντικά υψηλότερο στο κλινικό δείγμα σε σχέση με τους μάρτυρες (17.8 ± 16.2 vs. 5.8 ± 7.2, p < .001), αποδεικνύοντας υψηλή διακρίνουσα εγκυρότητα του οργάνου.Με ανάλυση καμπύλης Λειτουργικού Χαρακτηριστικού Δέκτη (ROC) χρησιμοποιώντας ως χρυσό κανόνα την Κλινική Εξέταση η περιοχή κάτω από την καμπύλη (Area Under the Curve) ήταν 0.78, δηλώνοντας ικανοποιητική ικανότητα της DES να ξεχωρίζει τη διασχιστικότητα μεταξύ κλινικού δείγματος και μαρτύρων. Με σημείο τομής 11 η DES εμφανίζει ευαισθησία 57% και ειδικότητα 85%. Αντιστοίχως στην ανάλυση ROC με χρυσό κανόνα SCID-D-R η περιοχή κάτω από την καμπύλη ROC (AUC) ήταν 0.99, δηλώνοντας άριστη ικανότητα της DES ξεχωρίζει μεταξύ κλινικού δείγματος και μαρτύρων. Ως σημείο/κατώφλι διαχωρισμού (cut-off point) για την εμφάνιση υψηλών επιπέδων διάσχισης και την αυξημένη πιθανότητα ύπαρξης Διασχιστικής Διαταραχής επιλέχθηκε τιμή της DES ίση με 20. Στο σημείο αυτό η DES εμφανίζει ευαισθησία 100% και ειδικότητα 91,7%.Κατά την εφαρμογή της DES στον πληθυσμό της Θράκης, δεν παρατηρήθηκαν στατιστικά σημαντικές διαφορές στην βαθμολογία της, όσον αφορά στην πληθυσμιακή ομάδα, το φύλο, την οικογενειακή κατάσταση, τον τόπο κατοικίας και την ηλικία. Αντίθετα παρατηρήθηκε στατιστικά σημαντική διαφορά βαθμολογίας της DES, σε σχέση με την εκπαίδευση. Οι συμμετέχοντες που είχαν ολοκληρώσει μόνο την πρωτοβάθμια εκπαίδευση είχαν σημαντικά υψηλότερες τιμές της DES από τους πιο μορφωμένους. Τα ευρήματα αυτά αναδείχθηκαν με την εφαρμογή της πολυμεταβλητής ανάλυσης γραμμικής παλινδρόμησης. Επίσης η DES έλαβε στατιστικά σημαντικές διαφορετικές τιμές μεταξύ των διαφόρων ομάδων των ασθενών του κλινικού δείγματος, με αυτούς με Διαταραχή Προσωπικότητας να έχουν μεγαλύτερες τιμές.Η ελληνική εκδοχή της DES, η Κλίμακα Εμπειριών Αποσύνδεσης/Διάσχισης (DES) είναι ένα σημαντικό, αξιόπιστο και έγκυρο εργαλείο για την κλινική πρακτική αλλά και για την έρευνα των ειδικών ψυχικής υγείας. Η στάθμισή της αποτελεί ένα πρώτο βήμα στην κατανόηση και διαχείριση της διάσχισης/αποσύνδεσης. Παρά το ότι η φαινομενολογία της διάσχισης μπορεί να έχει ποικίλες εκφάνσεις στα διάφορα περιβάλλοντα, με την εξαίρεση του επιπέδου εκπαίδευσης, η ίδια η διάσχιση ως φαινόμενο είναι κοινή παντού, ανεξάρτητα από την ομάδα στην οποία ανήκει κάποιος.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maha Zakhour ◽  
Chadia Haddad ◽  
Hala Sacre ◽  
Kassandra Fares ◽  
Marwan Akel ◽  
...  

Abstract Background According to the World Health Organization (WHO) figures in 2015, the number of people attempting suicide worldwide per year exceeds 800,000 individuals. The majority of completed suicides (78%) occur in low- and middle-income countries. Therefore, this study aimed to validate the suicidal ideation subscale of the Columbia-Suicide Severity Rating Scale and evaluate risk factors (emotional intelligence, alexithymia, anxiety, depression, and stress) related to suicidal ideation among the Lebanese adult population. Methods A structured cross-sectional survey was carried out between November 2017 and March 2018, enrolling a proportionate random sample of 789 community-dwelling participants from all the Lebanese regions. A correlation analysis between the C-SSRS and anxiety and depression assessed the convergent validity of the scale. An exploratory and a confirmatory factor analysis validated its construct. Cronbach’s alpha was used to assess internal consistency reliability. Multiple linear regression was performed using the suicidal ideation score as the dependent variable. All variables were included in the multivariable model. Results The C-SSRS scale converged over a solution of one factor; the proportion of explained variance was 0.797. The Cronbach’s alpha value was good (0.797). The convergent validity was tested with depression and anxiety scales. The results showed a moderate positive correlation between the suicide ideation score and depression (rho = 0.507, p < 0.001) and anxiety (rho = 0.402, p < 0.001). The multivariable analysis showed that higher depression (Unstandardized Beta, B = 0.035, p < 0.001), higher anxiety (B = 0.015, p = 0.008), and higher alcohol dependence (B = 0.024, p < 0.001) were significantly linked to higher suicidal ideation score. However, higher self-esteem (B = -0.041, p = 0.006) was significantly associated with lower suicidal ideation scores. Conclusion Our findings suggest that the Arabic version of the C-SSRS subscale could serve as an appropriate assessment tool for suicidal ideation. This paper also gave insights into factors correlated with higher suicidal ideation scores, such as depression, anxiety, and alcohol dependence. Further studies are necessary to confirm our findings and implement suicide prevention programs.


Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 897
Author(s):  
Christos Bakirtzis ◽  
Artemios Artemiadis ◽  
Elli Nteli ◽  
Marina Kleopatra Boziki ◽  
Maria-Valeria Karakasi ◽  
...  

The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a self-report instrument developed to assess barriers faced by People with Multiple Sclerosis (PwMS) in the workplace. The aim of this study was to explore the psychometric properties of the Greek version of the MSWDQ-23. The study sample consisted of 196 PwMS, all currently working in part- or full-time jobs. Participants underwent clinical examination and cognitive screening with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and completed self-report measures of fatigue, psychological functioning, and quality of life, along with the MSWDQ-23 questionnaire. Confirmatory Factor Analysis (CFA) was performed, and goodness-of-fit measures were used to evaluate construct validity. Convergent validity was checked by correlating MSWDQ-23 scores with study measures. Cronbach’s alpha value was produced to assess internal consistency. CFA yielded a model with a fair fit confirming the three-factor structure of the instrument. Higher work difficulties were associated with higher Expanded Disability Status Scale (EDSS) scores, poorer cognitive function, more fatigue, stress, anxiety, and depression, and poorer health status, supporting the convergent validity of MSWDQ-23. Internal consistency (Cronbach’s alpha = 0.94) and test–retest reliability (ICC = 0.996, 95%, CI = 0.990–0.998) were excellent. The Greek MSWDQ-23 can be considered a valid patient-reported outcome measure and can be used in interventions aiming to improve the vocational status of PwMS.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026712 ◽  
Author(s):  
Jürgen Barth ◽  
Alexandra Kern ◽  
Sebastian Lüthi ◽  
Claudia M Witt

ObjectiveTo develop a short self-report instrument for the assessment of expectations (Expectation for Treatment Scale(ETS)) using acupuncture as a case example.DesignA cross-sectional assessment with retest after 1 week.SettingA web-based survey with patients suffering from pain.MethodsIn a three-step approach, we reduced the initially collected number of items from 17 to 9 and to 5, including expectations about coping ability, vitality, physical health and reduction of patient complaints. Items were selected according to internal consistency (Cronbach’s alpha); convergent and divergent validities with related constructs (optimism, pessimism, resilience, perceived sensitivity to medicines, depression and others); 1-week retest reliability (intraclass correlation coefficient (ICC)); and exploratory and confirmatory factor analysis (CFA).ResultsA total of 102 patients suffering from pain were included, and 54 of these patients completed the retest assessment. The final version of the ETS consisted of five items and had an excellent Cronbach’s alpha (0.90), with 72.33% variance on one single factor. Depression, pessimism and perceived sensitivity to medicines showed positive correlations with our expectation measure (r=0.23, r=0.20 and r=0.34, respectively); the correlation between the ETS and optimism was low (r=−0.07) and no correlation between the ETS and resilience was found (r=−0.07). Convergent validity was confirmed with a high correlation (r>0.90) between ETS and a treatment-specific measure of expectations. The retest ICC was 0.86, which showed high stability over 1 week. A CFA (n=439) with data from patients with low back pain confirmed the single-factor structure of the instrument.ConclusionThe ETS showed strong psychometric properties and covered a distinct construct. As the next step, the ETS might be implemented in different clinical conditions and settings to investigate psychometrics and its predictive power for treatment outcomes.


2021 ◽  
Vol 12 ◽  
Author(s):  
Long She ◽  
Lan Ma ◽  
Fatemeh Khoshnavay Fomani

Background: The consideration of future consequences (CFC) determines the extent to which individuals consider the potential future outcomes of their current behavior. The significance of assessing the CFC scale’s validation in different contexts has been acknowledged by the previous studies. While the majority of the studies have been conducted in western countries, no study has been conducted in Malaysia. The aim of the current study was to validate a Malaysian version of the CFC scale among Malaysian young adults.Methods: The methodological cross-sectional approach was adopted in this study. The study recruited 529 young adults (age range from 25 to 40) who fulfilled the inclusion criteria of the paper survey. Construct validity was assessed using content validity, convergent validity, and discriminant validity. Cronbach’s alpha, McDonald’s omega, and average inter-item correlation (AIC) were used to assess the scale’s internal consistency. Also, composite reliability (CR) and maximal reliability (MaxR) were used to assess the construct reliability. Measurement invariance was tested across gender.Results: The findings of the exploratory factor analysis indicated that the Malaysian version of the CFC scale has a two-factor structure (i.e., CFC-Future and CFC-Immediate) with 10-item explaining 61.682% of the total variance. The confirmatory factor analysis (CFA) supported the two-factor structure of the CFC scale with good construct validity. The internal consistency and CR were acceptable. [The Cronbach’s alpha, McDonald’s omega, and CR for CFC-I were 0.901 (CI 95%: 0.881–918), 0.901, and 0.887, respectively. Also, these parameters for CFC-F were 0.867 (CI 95%: 0.838–891), 0.868, and 0.867, respectively].Conclusion: We found acceptable psychometric evidence for the 10-item two-factors CFC scale used in the context of young adults in Malaysia. The validated instrument can be used in future studies to assess young adults’ CFC tendency and CFC-related behavior in Malaysia.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247037
Author(s):  
Emma Černis ◽  
Esther Beierl ◽  
Andrew Molodynski ◽  
Anke Ehlers ◽  
Daniel Freeman

Background Dissociative experiences occur across a range of mental health disorders. However, the term ‘dissociation’ has long been argued to lack conceptual clarity and may describe several distinct phenomena. We therefore aimed to conceptualise and empirically establish a discrete subset of dissociative experiences and develop a corresponding assessment measure. Methods First, a systematic review of existing measures was carried out to identify themes across dissociative experiences. A theme of ‘Felt Sense of Anomaly’ (FSA) emerged. Second, assessment items were generated based on this construct and a measure developed using exploratory (EFA) and confirmatory (CFA) factor analyses of 8861 responses to an online self-report survey. Finally, the resulting measure was validated via CFA with data from 1031 patients with psychosis. Results ‘Felt sense of anomaly’ (FSA) was identified as common to many dissociative experiences, affecting several domains (e.g. body) and taking different forms (‘types’; e.g. unfamiliarity). Items for a novel measure were therefore systematically generated using a conceptual framework whereby each item represented a type-by-domain interaction (e.g. ‘my body feels unfamiliar’). Factor analysis of online responses found that FSA-dissociation manifested in seven ways: anomalous experiences of the self, body, and emotion, and altered senses of familiarity, connection, agency, and reality (Χ2 (553) = 4989.435, p<0.001, CFI = 0.929, TLI = 0.924, RMSEA = 0.052, SRMR = 0.047). Additionally, a single-factor ‘global FSA’ scale was produced (Χ2 (9) = 312.350, p<0.001, CFI = 0.970, TLI = 0.950, RMSEA = 0.107, SRMR = 0.021). Model fit was adequate in the clinical (psychosis) group (Χ2 (553) = 1623.641, p<0.001, CFI = 0.927, TLI = 0.921, RMSEA = 0.043, SRMR = 0.043). The scale had good convergent validity with a widely used dissociation scale (DES-II) (non-clinical: r = 0.802), excellent internal reliability (non-clinical: Cronbach’s alpha = 0.98; clinical: Cronbach’s alpha = 0.97), and excellent test-retest reliability (non-clinical: ICC = 0.92). Further, in non-clinical respondents scoring highly on a PTSD measure, CFA confirmed adequate model fit (Χ2 (553) = 4758.673, CFI = 0.913, TLI = 0.906, RMSEA = 0.052, SRMR = 0.054). Conclusions The Černis Felt Sense of Anomaly (ČEFSA) scale is a novel measure of a subset of dissociative experiences that share a core feature of FSA. It is psychometrically robust in both non-clinical and psychosis groups.


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