Development and Content Validity of IFERA-II for Adults

Natália Martins Dias,Alessandra Gotuzo Seabra,Bruna Tonietti Trevisan,Grace Zauza,Luiz Renato Rodrigues Carreiro

doi:10.1590/0102.3772e3759

Abstract

Abstract Considering the importance of the functional assessment, a scale was developed to evaluate Executive Functions (EFs), State Regulation (SR) and Delay Aversion (DA) in adults, based on a children’s scale, and evidence of content validity was investigated. In Phase 1, items from the children’s version were adapted to generate the Inventory of Difficulties in Executive Functions, Regulation and Delay Aversion for Adults (IFERA-II), with 28 items of EFs (inhibition, working memory and flexibility), RS and DA. Analysis by judges verified the representativeness of the contents of the items. After adaptations, 18 adult participants responded to the IFERA-II and were interviewed regarding comprehension, need for examples and clarity of vocabulary. A new revision led to the preliminary version of the IFERA-II, the psychometric properties of which should be investigated.

Highlights

Executive Functions (EFs) refer to high-level skills that, through control over other processes, allow the regulation of thoughts, emotions and actions and the direction of behavior towards goals
This process led to version A of IFERA-II (Trevisan et al, 2016), composed of 28 items, representing the five dimensions of Working Memory (WM), Inhibitory Control (IC), Cognitive Flexibility (CF), Delay Aversion (DA) and State Regulation (SR), with a Likert-type score with five options (Never, Rarely, Sometimes, Often, Always)
Some examples are: WM - “When you are in the middle of an activity, you often get lost or forget what you were doing”; IC - “You begin to answer a question, even before it is finished”; CF - “You take a long time or have difficulty finding a new way or different alternatives to solve a problem when you are stuck”; DA - “When you want something, you expect to get it immediately”; and SR - “You have difficulty starting an uninteresting task, needing help or more time for it”

Summary

Introduction

Executive Functions (EFs) refer to high-level skills that, through control over other processes, allow the regulation of thoughts, emotions and actions and the direction of behavior towards goals. A widely accepted model and one of the most referenced in the area (Baggetta & Alexander, 2016) considers three core skills: a) inhibition, the ability to inhibit inappropriate behavior or impulse, including the ability to inhibit attention to distractors; b) working memory, the ability to sustain, update and manipulate information mentally; and c) cognitive flexibility, the ability to change the attentional focus or perspective and adapt to different demands These skills participate in the performance in more complex situations (e.g. planning or decision making) (Diamond, 2013). In the context of ADHD studies, it is suggested that these individuals have a motivational pattern that leads them to perceive delays as extremely aversive (Sonuga-Barke, 2005) Both SR and DA can be related to EFs and overlap with the concept of hot EFs, i.e., aspects of EFs needed in situations with significant emotional or motivational loads, such as in decision making and regulation of emotions. Deficits in EFs, including SR and DA, have been identified and associated with the characteristic signs of neurodevelopmental disorders, such as ADHD (Coghill et al, 2018; Silverstein et al, 2018; Wagner et al, 2016), as well as Autistic Spectrum Disorder and Learning Disorders, among others (American Psychological Association [APA], 2014; Berenguer et al, 2018; Taghizadeh et al, 2017)

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