Psychometrics of the SCL-90-R and Development and Testing of Brief Versions SCL-45 and SCL-9 in Infertile Couples.

Abstract

Although infertile couples are mentally healthy, dealing with infertility and assisted reproductive technology (ART) treatment is usually associated with psychological distress. It would therefore be useful to have short, multidimensional instruments to be able to identify people who present more intense emotional reactions and follow up their emotional distress throughout the ART. The goals of the study were to analyze the psychometric adequacy of the original 90-item version of the Symptom Checklist (SCL-90) in a sample of Spanish women and their partners undergoing ART, as well as to develop and analyze two brief versions of the SCL-90, given the absence of adequate short versions for this population. A cross-sectional design for patients and their partners in the process of ART through in vitro fertilization was used. The two brief scales were obtained, which took into account the levels of variance explained by the items and confirmatory factor analysis. Two brief instruments were developed. The first, with 45 items (SCL-45-I Infertility), includes nine subdimensions: Somatization, Interpersonal Sensitivity, Obsessive-Compulsive Disorder, Depression, Anxiety, Hostility, Paranoid Ideation, Phobic Anxiety, and Psychoticism. The second instrument contains nine items (SCL-9-I or Global Severity Index [GSI]), one item for each dimension. Both instruments were psychometrically adequate (SCL-45-I: χ/df = 7.24, RMSEA = .057, 95% CI [.056, .059], CFI = .97, NNFI = .97, SRMR = .049; SCL-9-I: χ/df = 9.66, RMSEA = .068, 95% CI [.061, .076], CFI = .97, NNFI = .96, SRMR = .035). Measurement invariance analysis by gender was conducted, and the instruments were shown to be suitable for both men and women. The suitability of the SCL-90-R for use in ART was verified, and two valid instruments-useful and easy to use for nurses, psychologists, and other care providers-were developed.