Measuring Self-Stigma Among Romanian Psychiatric Patients: Cultural Adaptation and Further Psychometric Insights for the Self-Stigma of Mental Illness Scale and the Paradox of Self-Stigma Scale.

Objective To translate the English version of Self-Stigma of Mental Illness Scale (SSMIS) into Chinese and evaluate the scale's reliability and validity. Methods According to Jones' Translation Model, the English version of Self-Stigma of Mental Illness Scale (SSMIS) was translated into Chinese. And then use the Self-esteem scale, self-efficacy scale to test the criterion validity of SSMIS.The study investigated in a sample of 192 patients with mental illness in Guangzhou city by convenience sampling. The exploratory factor analysis and Cronbach's α coefficient were used to test the scale's reliability and validity. Results The overall Coronach's α coefficient of SSMIS-C was 0.96, and the Coronach's α coefficient among the four subscales was from 0.90 to 0.94. The correlation coefficient between the total scale and each factor was from 0.81 to 0.90, the correlation coefficient among each factor was from 0.42 to 0.78. And the correlation coefficient between the self-esteem, self-efficacy and SSMIS-C showed statistical significance(r=-0.346~-0.144)(P<0.05 or P<0.01). Conclusion The reliability and construct validity of SSMIS-C are in line with the requirements of psychometrics, which can be applied to self-stigma in China. Key words: Mental illness; Stigma; Psychometric

The Victorian Institute of Sport Assessment - Achilles is fundamentally flawed and unfit for clinical practice or research: A Rasch Measurement Theory Analysis using COSMIN recommendations.

The current study assessed the measurement invariance of the Self-stigma of Mental Illness scale (SSOMI) across Chinese and US samples and assessed whether the SSOMI differentially relates to distress levels across Chinese and US participants. We included 487 participants in China and 550 in the US (mean age was 19.52 in China and 19.29 in the US). The results indicated that partial measurement invariance of the SSOMI scale across China and the United States participants was established. Furthermore, we observed validity evidence for the SSOMI scale through its correlations with a well-established self-stigma measure and measures of depression, anxiety, and stress. Finally, we found that the SSOMI scale is more strongly linked to symptoms of depression, anxiety, and stress in China than it is in the United States, supporting previous research. These findings enable researchers to utilize the scale cross-culturally (i.e., with participants of Chinese and US origin), and to develop and implement interventions targeting mental illness stigma in both China and the United States.

A new brief opioid stigma scale to assess perceived public attitudes and internalized stigma: Evidence for construct validity

: To translate and culturally adapt the Information Needs in Cardiac Rehabilitation (INCR) questionnaire into Korean and perform psychometric validation. : The original English version of the INCR, in which patients are asked to rate the importance of 55 topics, was translated into Korean (INCR-K) and culturally adapted. The INCR-K was tested on 101 cardiac rehabilitation (CR) participants at Kangwon National University Hospital and Seoul National University Bundang Hospital in Korea. Structural validity was assessed using principal component analysis, and Cronbach's alpha of the areas was computed. Criterion validity was assessed by comparing information needs according to CR duration and knowledge sufficiency according to receipt of education. Half of the participants were randomly selected for 1 month of re-testing to assess their responsiveness. : Following cognitive debriefing, the number of items was reduced to 41 and ratings were added to assess participants' sufficient knowledge of each item. The INCR-K structure comprised eight areas, each with sufficient internal consistency (Cronbach's alpha>0.7). Criterion validity was supported by significant differences in mean INCR-K scores based on CR duration and knowledge sufficiency ratings according to receipt of education (p<0.05). Information needs and knowledge sufficiency ratings increased after 1 month of CR, thus supporting responsiveness (p<0.05). : The INCR-K demonstrated adequate face, content, cross-cultural, structural, and criterion validities, internal consistency, and responsiveness. Information needs changed with CR, such that multiple assessments of information needs may be warranted as rehabilitation progresses to facilitate patient-centered education.

Psychometric properties of the Persian version of the cognitive emotion regulation questionnaire-short (CERQ-P-short): Reliability, validity, factor structure, treatment sensitivity, and measurement invariance

This study aimed to validate a culturally adapted Health Belief Model (HBM) questionnaire for assessing breast cancer screening beliefs among Chinese women and to evaluate its structural validity and measurement invariance. A cross-sectional survey was conducted with 314 women aged 18–70 in Guizhou Province, China, using multistage sampling. The original HBM questionnaire underwent cultural adaptation and expert content review. Exploratory and confirmatory factor analyses were conducted to examine the factor structure, and measurement invariance was tested across residential settings and age groups. A seven-factor solution was identified, encompassing all six core HBM constructs, with self-efficacy splitting into two empirically distinct dimensions. The final 41-item model demonstrated strong model fit (CFI = 0.914, TLI = 0.906, RMSEA = 0.059, SRMR = 0.060), high internal consistency (ω ≥ 0.88), and full invariance across subgroups. Convergent validity and inter-construct correlations aligned with theoretical expectations. In particular, strong positive associations were observed among self-efficacy, perceived benefits, and cues to action, while perceived barriers showed inverse relationships with perceived severity and risk perception. These findings offer empirical justification for both single-construct and multi-construct intervention strategies. The validated scale provides a psychometrically sound and culturally grounded tool for identifying psychological barriers to screening among Chinese women. It may guide the design of theory-informed public health interventions that address individual belief profiles and promote screening uptake.

BackgroundSelf-care is increasingly recognized as the foundation of person-centered healthcare and a key driver for simultaneously improving population health outcomes and reducing healthcare expenditures. While the Self-Care Inventory (SCI) has been validated in several languages, Japan lacks a standardized instrument for assessing self-care in the general adult population. Moreover, it remains unclear whether the SCI reflects culturally specific self-care behaviors and retains its psychological measurement properties in non-Western contexts. Addressing both aspects, this study aimed to evaluate the Japanese version of the SCI (JSCI) in terms of its psychometric properties and its association with concrete health behaviors.MethodsWe adapted the JSCI following COSMIN guidelines using forward/backward translation, expert review, and cognitive debriefing. Psychometric evaluation was based on two samples: a nationwide web-based survey (n = 504) and a community-based paper survey (n = 75). Structural validity was examined via CFA; internal consistency via Cronbach’s alpha and McDonald’s omega; and test–retest reliability via ICCs. Convergent and criterion validity were assessed through correlations with relevant psychological constructs. Measurement invariance and DIF across modes were tested, and associations with five external self-care behaviors were evaluated using AUC.ResultsThe hypothesized three-factor structure of the JSCI was supported across both administration modes (CFI = 0.926–0.942; SRMR < 0.06), although some subscales had elevated RMSEA. Internal consistency was acceptable to high (α = 0.75–0.85; ω = 0.81–0.92). ICCs indicated moderate to good temporal stability. JSCI scores correlated with self-care efficacy and other related constructs, supporting convergent and criterion validity. Configural invariance was confirmed, and no significant DIF was detected across modes. JSCI scores modestly discriminated individuals engaging in concrete self-care behaviors such as physical activity, strength training, Helicobacter pylori testing, and having a regular primary or dental care provider (AUCs = 0.62–0.80).ConclusionsThe JSCI demonstrated satisfactory psychometric properties and structural validity across diverse research settings. Its observed associations with a range of meaningful self-care behaviors support the scale’s ecological and practical relevance in the Japanese context. The JSCI may serve as a reliable tool for evaluating and promoting self-care in both research and population health initiatives.Supplementary informationThe online version contains supplementary material available at https://doi.org/10.1265/ehpm.25-00209.

Health literacy is an asset for and indicator of adolescents’ health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-national context, using data from the health behaviour in school-aged children 2017/18 survey. The data were obtained from 25 425 adolescents (aged 13 and 15 years) from seven European countries. Determination was made of the best item combination to form a shorter version of the health literacy instrument. Thereafter, the structural validity, reliability, measurement invariance, and criterion validity of the new 5-item instrument were examined. Confirmatory factor analysis showed a good model fit to the data across countries and in the total sample, confirming the structural validity (CFI = 0.995, TLI = 0.989, SRMR = 0.011, RMSEA = 0.031). The internal consistency of the instrument was at a good level across countries (α = 0.87–0.98), indicating that the instrument provided reliable scores. Configural and metric invariance was established across genders, ages, and countries. Scalar invariance was achieved for age and gender groups, but not between countries. This indicated that the factor structure of the scale was similar, but that there were differences between the countries in health literacy levels. Regarding criterion validity, structural equation modelling showed a positive association between health literacy and self-rated health in all the participating countries. The new instrument was found to be valid and reliable for the purposes of measuring health literacy among adolescents in a cross-national context.

Personal Growth Initiative (PGI), a cognitive and behavioural skill set for intentional growth, is often measured using the multidimensional Personal Growth Initiative Scale-II (PGIS-II). This systematic review examined its structural validity, reliability, measurement invariance, and construct validity. A literature search across multiple databases identified 15 studies evaluating the psychometric properties of the PGIS-II. Study quality was assessed with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist (version 3.0). The specified psychometric properties were evaluated based on COSMIN criteria for good measurement properties, and a modified Grading, Recommendations, Assessment, Development, and Evaluation (GRADE) approach assessed the certainty of evidence. Findings showed structural validity and internal consistency variability, with some modifications to the first-order four-factor model lacking theoretical justification. A second-order four-factor structure and a bifactor model demonstrated moderate to high-quality evidence. Test–retest reliability was confirmed only for the Chinese (moderate quality) and Turkish (low quality) versions. Measurement invariance was supported for the English and Portuguese first-order four-factor models, as well as the English bifactor model. Construct validity was examined for seven versions, yielding mixed results. While some versions may be suitable for specific contexts, inconsistencies in psychometric evidence emphasise the need to further clarify the instrument's structure and psychometric performance in diverse populations through high-quality studies. Nevertheless, based on our findings, the bifactor model appears to be the most suitable structure for the PGIS-II, as it captures both the general PGI construct and its subdimensions, at least for now.

Substance Abuse-Related Mortality Among Middle-Aged Male VA Psychiatric Patients

This study assesses the psychometric properties of the Chinese version of the Zimbardo Time Perspective Inventory (C-ZTPI-20) in an adolescent population. The investigation encompasses a sample of 2634 middle school students from China and aims to evaluate the instrument's reliability, structural validity, measurement invariance, criterion validity, and network structure attributes. First, descriptive analysis revealed satisfactory reliabilities for four out of five C-ZTPI-20 dimensions, with Present Fatalistic (PF) exhibiting relatively low reliability. Moreover, Confirmatory Factor Analysis (CFA) supported the 5-dimensional structure across all samples and sexes, albeit with a modest Tucker-Lewis Index (TLI) for girls. Furthermore, measurement invariance analysis underscores unbiased assessment across sexes. Sex differences emerge in the Present Hedonistic (PH) dimension, where boys showed higher scores. Furthermore, criteria validity analysis revealed that Past Positive (PP) and Future (F) were positively associated with extraversion, agreeableness, conscientiousness, openness, grit, and mental health, while they were negatively associated with neuroticism. Past Negative (PN) and PF showed inverse trends, while PH perspective demonstrated complex, varied correlations with these psychological traits, underscoring the multifaceted nature of time perspectives. Finally, network analysis revealed positive inter-correlations within dimensions and significant edge differences between sexes, particularly in inter-dimension connections. Despite differing rankings, the most central and marginal items remained consistent between boys and girls in network models. These findings contribute to understanding the C-ZTPI-20's effectiveness in assessing adolescent time perspectives and inform interventions promoting psychological well-being and coping strategies.

BackgroundThe Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population.MethodsHealthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU_SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test–retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI.ResultsWe identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953–0.989, Tucker–Lewis index = 0.931–0.984, root means square error of approximation = 0.040–0.092, standardized root mean square residual = 0.039–0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU_SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach’s alpha = 0.811–0.835, McDonald’s omega = 0.805–0.832), and test–retest reliability (intraclass correlation coefficient = 0.829).ConclusionThe SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students.

To examine the structural validity, measurement invariance, reliability, and some other psychometrical properties of the Italian version of the Yale Food Addiction Scale 2 (I-YFAS 2.0) in patients with severe obesity and the general population. 704 participants-400 inpatients with severe obesity and 304 participants enrolled from the general population-completed the I-YFAS 2.0 and questionnaires measuring eating disorder symptoms. A first confirmatory factor analysis (CFA) tested a hierarchical structure in which each item of the I-YFAS 2.0 loaded onto one of the twelve latent symptoms/criteria which loaded onto a general dimension of Food Addiction (FA). The second CFA tested a first-order structure in which symptoms/criteria of FA simply loaded onto a latent dimension. Measurement invariance (MI) between the group of inpatients with severe obesity and the sample from the general population was also tested. Finally, convergent validity, test-retest reliability, internal consistency, and prevalence analyses were performed. CFAs confirmed the structure for the I-YFAS 2.0 for both the hierarchical structure and the first-order structure. Configural MI and strong MI were reached for hierarchical and the first-order structure, respectively. Internal consistencies were shown to be acceptable. Prevalence of FA was 24% in the group of inpatients with severe obesity and 3.6% in the sample from the general population. The I-YFAS 2.0 represents a valid and reliable questionnaire for the assessment of FA in both Italian adult inpatients with severe obesity and the general population, and is a psychometrically sound tool for clinical as well as research purposes. Level V, descriptive study.

BackgroundGiven the rapid proliferation and use of online health resources, many of which may be of dubious quality, there is an increasing need to develop electronic health literacy (e-health literacy) skills among the population of internet users. E-health literacy encompasses the skills and abilities needed to access, understand, validate, evaluate, interpret, and apply online health-related information. Measuring e-health literacy has become crucial for developing targeted interventions, assessing their impact, and producing high-quality research findings that can inform health policy and clinical practice, which can lead to improved health outcomes and potentially reducing health inequalities. The scales need to be valid and reliable so that decisions are based on high-quality data. In this regard, the issue of the measurement invariance of scales across different demographic groups has been neglected. This is critical, as assessments should be valid across different sociodemographic groups to avoid bias when comparing them. The aim of this study was to validate the Extended e-health literacy scale (eHEALS-E) on general population and investigate its structural validity and internal consistency, construct validity in terms of convergent and discriminant validity, and examine its measurement invariance across gender, age, education and social status.MethodsThe data were collected as a part of a national health literacy survey conducted by the Slovenian National Institute of Public Health. For this survey the initial eHEALS-E scale was revised in order to address its limitations and applicability to general population. Based on a nationally representative sample, the final sample for the analysis comprised 1,944 individuals who at least occasionally used one of the various internet services to obtain health-related information. Multiple group confirmatory factor analysis was used to examine the measurement invariance of the scale.ResultsWith some adjustments, the measurement model of the revised 6-dimensional eHEALS-E scale demonstrated a good fit to the data (χ2 = 2508, df = 282, RMSEA = 0.064, SRMR = 0.070, CFI = 0.90). The scale had good internal consistency (alpha = 0.89). Although evidence of the scale’s convergent and discriminant validity was partially provided, the analysis revealed robust measurement invariance across sociodemographic groups.ConclusionsWith a minor limitation, the scale ensures an unbiased e-health literacy assessment across different social groups, which is crucial for interventions that aim to reduce health-related social inequalities. This ensures that the interventions derived from the assessment of reality are equally valid and effective for everyone, regardless of their sociodemographic background.