The Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F): Factorial Validity and Reliability in a U.S. Sample

Abstract

ContextDeath anxiety has been hypothesized to be a transdiagnostic construct, meaning that the fear of death may increase one's vulnerability to the development or maintenance of a number of psychological disorders. As such, effective and efficient measurement of this construct becomes a priority for hospice and palliative medicine specialists. The Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F) is the only factor-analytically constructed multidimensional scale with a conceptual rationale that measures both the fear and acceptance of dying and death. ObjectivesTo determine the factor structure of the MODDI-F with an English-speaking sample, so as to expand the scale's potential for use in hospice and palliative medicine, clinical psychology, and thanatology research. MethodsParticipants comprise a random sample of 404 adults ranging in age from 20 to 85, stratified by sex, age, and ethnicity. They completed the 47-item MODDI-F/eng and were contacted five months later for a test-retest follow-up survey. ResultsAlthough confirmatory factor analyses did not fit the models previously found for the German- and Chinese-language versions of the MODDI-F, exploratory factor analyses resulted in a five-factor fear dimension and a two-factor acceptance dimension that were empirically and conceptually similar to the German- and Chinese-language versions. Additional psychometric analyses yielded evidence for the internal consistency reliability, five-month test-retest reliability, and construct validity of the seven-factor scores of the English-language MODDI-F. ConclusionThe results from this psychometric investigation of the English-language version of the MODDI-F are promising and warrant further investigation with clinical populations in hospice and palliative care settings.