Bowlby (1969/1982) described an infant's smile and pleasant vocalizations as attachment behaviors. However, most research on the formation of attachment relationships centers on the role of the caregiver's response to child distress, neglecting the role of behaviors that promote proximity in a positive context. This study aimed to 1) explore fathers' and mothers' laughter-eliciting behaviors and children's laughter using a newly developed coding instrument and 2) explore associations between these behaviors, children's laughter, and child attachment security. A sample of 144 English- and French-speaking families, with 3- to 5-year-old children, participated in a Laughing Task and a separation-reunion procedure. Distinct but similar factorial structures emerged for mothers and fathers, both including a Touch and a Movement/Sound factor. Parental strategies were significantly associated with preschoolers' laughter with both mothers and fathers. The path analysis results indicated that both laughter-eliciting strategies used by fathers were positively associated with children's laughter which was also positively associated with child attachment security. As for mother-child dyads, only the Touch factor was significantly associated with children's laughter. Furthermore, child attachment security was not associated with children's laughter, but was significantly associated with the Movement/Sound factor. Although fathers and mothers tend to use comparable strategies with similar success in making children laugh, the significance of this relational dynamic may differ in its contribution to the development of attachment security within parent-child dyads.

This study aimed to evaluate the psychometric properties and acceptability of the Vancouver Index of Acculturation (VIA) in a sample of UK-based East-Asian adults. Although widely used in cross-cultural research, relatively few studies have assessed the factor structure, validity, and user acceptability of the VIA in non-North American samples. A total of 236 East-Asian participants (mean age = 26.8, 47.06% female) completed the 20-item VIA and demographic questions. Confirmatory factor analysis (CFA) was conducted using AMOS with maximum likelihood estimation and robust standard errors. Exploratory factor analysis (EFA) using principal axis factoring and varimax rotation was also performed. Internal consistency, convergent and discriminant validity, and acceptability were evaluated. CFA showed poor model fit for the original two-factor VIA structure: χ2(169) = 367.12, p < 0.001; CFI = 0.84; RMSEA = 0.089. The Mainstream factor showed weak and mostly nonsignificant loadings, while the Heritage factor demonstrated strong loadings. Internal consistency was high for Heritage (α = 0.91) and acceptable for Mainstream (α = 0.81). EFA supported a refined 17-item two-factor model, excluding three low-loading Mainstream items. Discriminant validity was supported, but convergent validity was only partially established. Acceptability data indicated that while most items were well received, several were perceived as culturally ambiguous. Findings support the VIA's bidimensional structure but suggest that cross-cultural adaptation may be needed to improve measurement accuracy in UK-based East Asian populations. The study highlights the importance of further validation in culturally diverse samples.

Psychological factors influence return-to-sport (RTS) decisions after anterior cruciate ligament reconstruction (ACLR). While existing tools measure fear and confidence, none specifically capture athletes' risk-taking tolerance and intentions. This study proposes the development and validation of a scale assessing Risk-taking Intentions and Sport Engagement after ACLR (RISE-ACL scale). Scale development consisted of deductive (literature review) and inductive (expert panel) methods. Eleven experts generated and rated relevant items to be included in the consensus RISE-ACL scale. Content validity was established through expert agreement. For scale validation, 162 ACLR participants, 4-24 months postoperatively (median age 26.5 years; 65% male), completed the newly developed RISE-ACL scale. Criterion validity used a self-rated risk-tolerance scale (0-100%). Construct validity was examined through correlations with the Anterior Cruciate Ligament - Return to Sport after Injury (ACL-RSI) scale and clinical/demographic variables, followed by multivariate modeling. Exploratory factor analysis (principal axis factoring) identified factor structure, and principal component analysis (PCA) explored a short form. Reliability was assessed via Cronbach's alpha and test-retest intraclass correlation coefficient (ICC). Scale development aimed to a 16-item RISE-ACL scale with good content validity (mean agreement 86%), face validity feasibility (mean completion time = 2:05). Criterion validity against the self-rated risk-tolerance scale (0-100%) was moderate and statistically significant (ρ = 0.348, p < 0.001). Construct validity analyses showed that in multivariate modeling, only ACL-RSI remained a statistically significant independent predictor of RISE-ACL scores (Wald χ2 = 6.36, p = 0.012). Factor analysis yielded three interpretable factors (1) External Pressure, (2) Internal Pressure/Defiance, and (3) Urgency-explaining 47.72% of variance. Factor 3 correlated most with self-perceived risk-taking (ρ = 0.340), and Factor 2 most negatively with ACL-RSI (ρ = -0.166). Reliability showed good internal consistency (Cronbach's α = 0.84) and test-retest reliability (ICC = 0.84). A 6-item short form was proposed, showing a strong correlation with the total score (ρ = 0.891). The RISE-ACL is a 16-item self-administered scale designed to assess patients' risk-taking intentions during return to sport after ACLR. Validation demonstrated it is a reliable and valid tool, supporting shared decision-making to enhance RTS quality. NCT06748066 LEVEL OF EVIDENCE: II.

The aim of this study is to explain the phenomenon of brand polarization in the context of the sports industry and to develop a valid and reliable scale to measure this phenomenon. Although polarization has been examined across various disciplines in the literature, the lack of a systematic measurement tool in the context of sports marketing and football fandom is noteworthy. In this study, the concepts of polarization, brand, and brand polarization were first examined theoretically, followed by an analysis of the transformation of the sports industry, the globalization of football, and fan behavior. Based on this theoretical foundation, scale items were developed and refined through expert opinions, a pilot study, and data collected from the sample. The validity and reliability of the scale were tested using Cronbach’s Alpha, KMO, Bartlett’s Test, Exploratory Factor Analysis, and Confirmatory Factor Analysis. The findings indicate that the scale demonstrates high internal consistency and a robust factor structure. Data were collected through snowball and convenience sampling methods and tested across different demographic groups. The analyses revealed two dimensions: the positive pole, reflecting fans’ strong positive attitudes toward their supported teams, and the negative pole, representing their strong negative attitudes toward rival teams. In conclusion, the developed scale provides an original theoretical contribution to the fields of international business, international marketing, and sports literature, while also serving as a practical tool applicable across all sports disciplines.

Purpose This study aims to investigate how virtual reality (VR) video types (walking, driving and aerial) and background music genres (classical, Latin and country) shape tourist immersion and visit intentions. It also examines the mediating role of psychological and emotional factors, including immersion, curiosity and arousal, on visit intentions. Design/methodology/approach This study used a within-subjects experimental design with a 3 × 3 factorial structure, resulting in nine scenarios that paired three VR video types with three music genres. Findings Results indicated that VR video type significantly affects both immersion and visit intentions, with aerial VR videos producing higher levels of immersion and visit intentions than walking and driving VR videos. The relationship between aerial VR video and visit intention was mediated by psychological and emotional factors (immersion, curiosity and arousal). However, this indirect effect did not emerge in the walking or driving VR videos. Regarding music genres, a significant difference was found between Latin and classical music, but it occurred only in the walking VR video. Originality/value This study uniquely compares different VR video types and incorporates background music genres, a largely neglected area. Using a within-subjects design further controls for individual variability, enhancing the reliability of the results.

Implementation science offers an innovative approach to advance universal health coverage, a key element of the Sustainable Development Goals. Yet, there is limited empirical evidence on the conceptual clarity, validity, and reliability of implementation outcomes, particularly in the context of digital health booking systems in sub-Saharan Africa. This study aimed to assess the psychometric properties of measures evaluating the acceptability, appropriateness, and feasibility of students' online health appointment system (SOHAS) in a public university in Ghana. A cross-sectional study was conducted among students at the Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, using a 15-item adapted implementation outcome measure. The items were adapted for SOHAS and were also ensured to be culturally, linguistically, and contextually relevant to Ghanaian university students. Participants were recruited online via a text message containing a link to the electronic questionnaire. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were utilized to assess the underlying factor structure and model fit, respectively. Cronbach's alpha and item-total correlations were applied to measure internal consistency. Convergent and discriminant validity were examined using composite reliability (CR), average variance extracted (AVE), Fornell-Larcker criteria, and heterotrait-monotrait (HTMT) ratios. Cronbach's alpha for the three constructs ranged from 0.946 to 0.977, and CR ranged from 0.949 to 0.976. EFA revealed a three-factor structure with substantial communalities and high loadings (0.716-0.969). The CFA also demonstrated a good model fit (CFI = 0.969, TLI = 0.962, RMSEA = 0.092, SRMR = 0.022). Convergent validity was strong, with AVEs ranging from 0.790 to 0.892. However, there was insufficient evidence to establish discriminant validity, as HTMT ratios between appropriateness and acceptability exceeded acceptable levels, and inter-construct correlations exceeded √AVE values. We found promising psychometric properties of the adapted Acceptability, Appropriateness, and Feasibility measures, including high internal consistency, good model fit, and strong convergent validity. However, significant overlap between acceptability and appropriateness necessitates that future studies refine these constructs conceptually and empirically, thereby improving their discriminant validity. Importantly, these validated measures provide a valuable framework for guiding evaluations of digital health implementation in similar settings.

Purpose The purpose of this study is to investigate the role of policy incentives (PIs) on the adoption intention (AI) of electric vehicles (EVs). It also examines the mediating and moderating roles of technology knowledge (TK) and environmental awareness (EA) to promote EVs in the context of sustainable transportation. Design/methodology/approach A cross-sectional quantitative study using structured questionnaires is administered, and data from 312 responses are analysed with the help of SPSS and AMOS. Exploratory factor analysis is used to confirm the factor structure, while SEM is used to test the direct, mediating and moderating hypotheses. Findings The results of the study reveal that PIs significantly influence the AI of EVs. These incentives also impact the TK of consumers positively. TK is found to mediate the relationship between PIs and AI of EVs, signifying that PIs’ impact on EV adoption is enhanced if the consumer knows about EV technology. Furthermore, EA is found to moderate both PIs and TK relations with AI of EVs, implying that higher environmental consciousness converts PIs and TK into better adoption prospects. Research limitations/implications Based on technology acceptance model and theory of planned behaviour, this study integrates PIs with environmental and technological variables to analyse a comprehensive adoption framework for EVs. It examines the interplay between PIs, TK and EA and extends the multilayer understanding into consumer behaviour in the EV domain. Practical implications The focus of EV firms and policymakers, in addition to financial and non-financial incentives, should be on enhancing consumer knowledge about the EV technology. Making the masses aware of the environmental issues through sustainability messaging can significantly strengthen EV adoption rates. EV makers can use TK and EA as segmenting variables to develop tailormade strategies for EV adoption. Social implications This study shows how the impact of PIs can be complemented through TK and EA to encourage pro-environmental behaviour, such as the adoption of EVs in society. The combination of economic, technological and psychological factors is therefore required to bridge the socio-environmental gap that still exists globally. Originality/value This study integrates TK and EA with PIs to analyse their impact on EV adoption rates. The insights into direct, mediating and moderating roles of these variables thus offer new insights for advancing sustainable mobility.

Psychometric evaluation of the flourishing-at-work scale in the Indonesian context.

ABSTRACT No information is available on the validation of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration in Spanish (JeffSATIC-S). Few studies have examined attitudes toward collaborative work among medical residents, and research focusing specifically on medical residents in Mexico is currently absent. We evaluated the validity and reliability of the JeffSATIC-S. We then examined attitudes toward interprofessional collaboration among medical residents and their associations with empathy, personality traits – including covert narcissism – and affective – cognitive dysregulation. All medical residents at a public tertiary care teaching hospital were invited to participate in the survey; 213 completed the anonymous online questionnaire (77% response rate). Exploratory factor and reliability analyses were performed. Partial Spearman’s correlation coefficients (rs) were calculated, adjusting for sex, age, specialty, and year of residence. The factor structure resembled the original instrument. Cronbach’s alpha was 0.90 for working relationships and 0.73 for accountability. Empathy was significantly and positively correlated with the two domains (working relationships: rs = 0.557; accountability: rs = 0.495; p < .001). In contrast, aggression – hostility (rs = −0.212 and −0.241, respectively; p < .001) and affective – cognitive dysregulation (rs=−0.328 and −0.347, respectively; p <0.001) were significantly negatively correlated. Covert narcissism, impulsive sensation seeking, and neuroticism-anxiety were significantly and negatively linked to accountability, but not to working relationships. The JeffSATIC-S is valid and reliable. Individual factors influence teamwork attitudes in different ways: some affect both working relationships and accountability, whereas others affect only the latter. Medical educators should anticipate interpersonal variability when designing training to enhance attitudes toward interprofessional collaboration. At the organizational level, teamwork-supportive cultures and learning environments should benefit all learners while accommodating additional support when needed.

ABSTRACTThe study investigated the effect of different compost types on the growth performance of cashew (Anacardium occidentale L.) varieties cultivated in a Lixisol from Northern Ghana. Six compost formulations were prepared using various combinations of poultry manure, cow dung, biochar, and cashew apple residue at different mixing ratios. The experimental design was a completely randomized block design arranged in a 2 × 6 factorial structure with three replicates. Three cashew varieties were planted at a spacing of 10 m × 10 m and amended with compost types at a rate of 50 kg ha−1. Growth parameters were recorded over two seasons, while nut yield was recorded in year 2. Results showed that cashew apple residue combined with biochar and poultry manure produced composts with higher organic carbon (OC) and total nitrogen (N) than the controls. In the first year, variety B3T101 treated with either cow dung or a mixture of poultry manure, biochar, and cashew apple residue in a 2:1:1 ratio recorded significantly (p < 0.05) higher heights (205.70 and 193.00 cm, respectively). However, in year 2, all compost types had statistically similar effects on plant height (p < 0.05). Variety B3T57 treated with poultry manure alone and biochar‐poultry manure‐cashew apple residue had statistically similar (p < 0.05) nut yield of 803.70 and 872.30 g, respectively. The findings demonstrate that cashew apple residue is as valuable as the traditional decomposed cow dung and poultry manure used in cashew farming for use as an organic fertilizer in cashew farming.

Purpose This study aimed to develop and validate a measurement scale for assessing resilience among immigrant youth. Methods We adopted a mixed-method approach, conducting interviews with 26 immigrant youth and testing these items in a quantitative study of 215 immigrant youth from Windsor-Essex, Canada. Results The EFA using Principal Axis Factoring yielded five factors, accounting for 50% of the total variance. The internal reliability for the total scale was 0.92. As expected, the newly developed Resilience Scale for Immigrant Youth (RSIY) and all five subscales were significantly and positively related to another measure of resilience, CYRM, ranging from r = .37 to r = .55, p &lt; .00. The RSIY scale differentiated youth based on their emotional and behavioral difficulties level, providing evidence for its convergent validity. Discussion The initial psychometric evidence indicates that the scale demonstrates good internal consistency, well-supported factor structure, and evidence of construct and predictive validity.

Introduction. The issue of homework is one of the most acute and relevant for modern schoolchildren, as well as for their parents and teachers. While educators do not doubt the benefits of homework to improve learning skills and foster independence, students often respond with reluctance to complete it. In Russian psychology, there is a lack of diagnostic tools for assessing different types of homework motivation. The aim of this study was to develop a new diagnostic instrument for assessing homework motivation among students in grades 3-11 of secondary schools. Methods. The proposed Homework Motivation Questionnaire (HMQ) assesses three characteristic types of motivation – autonomous motivation, introjected motivation, and external motivation; the theoretical foundation of the questionnaire is Self-Determination Theory. To test the validity of the questionnaire on a large sample of students from elementary, middle, and high school (N=1854), measures of satisfaction of basic psychological needs at school, academic performance, perseverance, as well as satisfaction with school, teachers, family, and self were used. Results. Analysis of the factor structure and psychometric properties of the questionnaire showed that it is characterized by acceptable indices of internal consistency and a factor structure consistent with theoretical expectations. The validity of the scales is confirmed by correlations with indicators of basic needs satisfaction at school and life satisfaction. The importance of autonomous motivation for perseverance and academic achievement is demonstrated, as well as the dynamics of the three types of homework motivation from elementary to middle and high school among students in mainstream schools. Discussion. A new compact homework motivation scale has been developed, which can be useful both for further research on the role of psychological predictors of homework perseverance and in the practical work of school psychologists to identify adolescents at risk of low academic performance.

The Evidence-Based Practice Attitude Scale (EBPAS) is a widely used measurement tool to assess mental health providers' attitudes toward adopting research-based interventions. To date, this scale has not been used or validated in an interdisciplinary sample of mental health professionals in Latin America. This study investigated the factor structure, psychometric properties, cross-cultural validity, and model fit of the EBPAS in a sample of Spanish-speaking and Latino social workers, counselors, and psychologists. A culturally and linguistically tailored version of the 15-item EBPAS scale was administered to a sample of Puerto Rican mental health professionals (N = 222) working across various settings, including schools, healthcare clinics, and community organizations. The EBPAS's scores were derived from four distinct constructs involving willingness to adopt EBPs (i.e., requirements, openness to innovation, appeal, and divergence from research). A Confirmatory Factor Analysis (CFA) examined the psychometric properties of the EBPAS scale. Several first and second-order factor models were specified. A global and approximate fit examination of the measurement model and composite reliability estimation for each subscale was conducted. RStudio version 4.3.1 software was used for the CFA. The CFA supported a first-order factor model. Most subscales showed strong reliability coefficients ranging from 0.83 to 0.91, except for the divergence subscale, which showed a coefficient of 0.77. After allowing for covariance between two items in the appeal dimension, the correlated factor model demonstrated a satisfactory fit to the data, although some misspecification was observed. The tailored EBPAS-15 demonstrated adequate psychometric properties in this Latinx sample of mental health professionals, suggesting that its factor structure and reliability may be useful in a Spanish-speaking and Caribbean sample of mental health professionals working across a variety of settings and contexts. Findings contribute to the scant literature on culturally and linguistically validated measures examining attitudes toward EBPs in Latin America.

Healthy Adult (HA), a key schema therapy construct, represents the individual’s ‘healthy’ state, characterized by balancing personal and others’ needs within a realistic perspective. We developed the Multidimensional Healthy Adult Scale to explore how various dimensions of the HA contribute to different aspects of well-being and tested its factor structure and psychometric properties. Data were collected from 472 participants (24.1% male, 75.5% female) between the ages of 18 and 60. The items of the scale were generated based on a qualitative study conducted in Türkiye. Data were analyzed using Confirmatory Factor Analysis and Structural Equation Modeling in Lavaan, which demonstrated a strong fit for the measurement and predictive models. The Bond, Balance, and Battle factors, along with the overarching HA, showed good fit. Low Balance scores were associated with higher psychopathology and negative affect, while high Battle scores were associated with greater life satisfaction and positive affect. Although Bond correlated positively with Balance and Battle, high Bond scores, when controlling for the others, were linked to increased psychopathology and negative affect. These results provide evidence for a multidimensional structure of the HA. Further validation of the scale and clarification of Bond’s role is needed for clinical insights.

ABSTRACT Background People with aphasia (PWA) have varying degrees of language impairment with anomia being among the most prominently affected components. Anomia is generally assessed using picture naming tests. However, to date, no comprehensive naming test has been developed that accounts for the psycholinguistic variables, linguistic structures, and cultural characteristics specific to Turkish. Aims This study aimed to evaluate the reliability and validity of the RAT (Resim Adlandırma Testi), an original confrontation naming test developed for Turkish-speaking PWA, incorporating systematic psycholinguistic control and refined through pilot testing. Methods & Procedures RAT was administered to 247 healthy controls (HC) and 35 PWA. Participants were divided into four age groups (<50, 50–59, 60–69, ≥70 years) and two education groups (1–8 and ≥9 years). Construct validity was evaluated using Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), item analysis and independent samples t-tests. Criterion validity was assessed by comparing RAT scores with the Naming subtest of the Afazi Dil Değerlendirme Testi (ADD). Additionally, an exploratory cut-off score of 44 for the RAT was established using Receiver Operating Characteristic (ROC) analysis. Reliability was examined via internal consistency metrics (Cronbach’s alpha and split-half reliability), inter-rater reliability, and test administration consistency. The effects of demographic variables (age, education, and gender) on test performance in both groups, as well as the frequency of naming errors by aphasia type, were also examined. Outcomes & Results Based on the EFA, five items with low factor loadings were excluded from the final version of the test. The remaining items showed a clear unidimensional factor structure. CFA results further confirmed this structure, with multiple indices demonstrating an acceptable model fit. Item analysis revealed that all items were internally consistent and effectively discriminated between levels of naming ability. RAT scores successfully distinguished between the HC and PWA groups. The results of the RAT and ADD Naming Subtest were highly correlated. The RAT scores decreased significantly in those over 70 years of age in both groups. While higher educational levels were associated with significantly higher test scores in HC, education level did not significantly influence performance in PWA. Gender did not have a significant effect on test scores in either group. Overall, there was no clear relationship between the frequency of naming errors within fluent and non-fluent aphasia groups. Conclusions The RAT is a valid, reliable, and valuable tool for the detailed assessment of naming abilities in Turkish-speaking PWA.

Background: Fatigue is a multidimensional and subjective experience, and it is one of the most common symptoms of multiple sclerosis (MS), affecting up to 80% of patients and acting as a major driver of work disability. Despite its clinical significance, existing assessment tools often lack conceptual clarity or remain too lengthy for routine clinical use. Objective: To develop and evaluate a new patient-reported outcome instrument designed to assess multidimensional fatigue domains in patients with multiple sclerosis (MS) for use in clinical practice. Methods: This study was carried out in three research stages. Stage 1 (Concept Elicitation) involved qualitative interviews (n = 19) to identify core fatigue domains based on patient experience. Stage 2 (Cognitive Interviews) consisted of interviews with 50 patients to ensure the relevance and clarity of the items. Stage 3 (Exploratory Factor Analysis) and internal consistency testing (Cronbach’s alpha) were performed on the same sample of 50 patients to examine the preliminary factor structure and reliability. Results: Concept elicitation identified lack of energy and persistent exhaustion as core symptoms. The resulting 14-item instrument covers three subdomains: Psychosocial, Physical, and Cognitive. Exploratory factor analysis supported a three-factor solution explaining 75% of the total variance (Factor 1: 28%; Factor 2: 27%; Factor 3: 20%). Internal consistency was high across all factors: Psychosocial (α = 0.923), Physical (α = 0.895), and Cognitive (α = 0.844). Conclusions: This new instrument is a conceptually robust tool that captures the interconnected nature of fatigue in multiple sclerosis (MS). These initial findings support its internal structure and conceptual foundation, providing a practical tool for symptom monitoring in neurological consultations.

Psychometric properties of the Chinese version of the observable social cognition rating scale in chronic schizophrenia.

This study created and validated the culturally based Queer- Affirmative Approach Inventory Scale (QAAIS) to assess Filipino mental health professionals' queer-affirmative competence. Exploratory sequential mixed-methods was used. In-depth interviews with licensed Filipino psychologists and guidance counselors revealed five main themes: Respectful Engagement, Affirming Communication, Safe and Empowering Spaces, Counselor Reflexivity and Growth, and Advocacy and Systemic Support. The initial 35-item QAAIS pool was based on these concepts. The quantitative step included pilot testing and large-scale validation with licensed practitioners. EFA determined factor structure, and CFA assessed model fit and structural validity. With adequate goodness-of-fit indices, the studies supported a coherent and parsimonious factor structure. Internal consistency was good in maintained domains after reliability testing. Results show the final QAAIS is culturally relevant and psychometrically sound. Through qualitative insights and quantitative validation, the scale mirrored Filipino practitioners' lived experiences and culturally anchored methods. QAAIS simplifies Philippine LGBTQ+- affirmative mental health care, research, policy development, and training.

Background/Objectives: Pulmonary arterial hypertension (PAH) impacts various aspects of patients' lives. Some questionnaires assessing health-related quality of life are specific to PAH patients. The aims of the study were to translate and investigate the factor structure and psychometric properties of the Polish version of the EmPHasis-10 health-related quality of life questionnaire in a group of adults with PAH. Construct validity was explored by the relationship with results of the 36-Item Short Form Survey (SF-36) and non-invasive prognostic factors: WHO functional class, 6 min walk distance (6MWD) and NTproBNP level were measured. Methods: In a single-center study, PAH patients were included. The diagnosis of PAH was confirmed by right heart catheterization. The demographic and clinical data were obtained. The EmPHasis-10 and the SF-36 questionnaires were administered to all patients. Results: Data from 120 PAH patients, median age 57 (IQR 45-68.7) years, 88 (73%) women, were obtained. Most of the patients suffered from IPAH (73, 61%). Results revealed a unidimensional structure of the EmPHasis-10 questionnaire and demonstrated satisfactory reliability (Cronbach α = 0.94). The EmPHasis-10 showed an adequate relationship with both SF-36 dimensions and three non-invasive prognostic parameters, i.e., WHO functional class, 6MWD and NTproBNP level. Regression analysis indicated that the 6MWD was the only predictor of the EmPHasis-10. Conclusions: The obtained results showed very good psychometric properties and adequate internal consistency of the Polish version of EmPHasis-10 in PAH patients. The results showed a unidimensional structure and very good psychometric properties, including satisfactory internal consistency and external validity of the Polish version of the EmPHasis-10 scale in patients with PAH.

Background/Objective: This study extends prior clinimetric evaluations by examining the factor structure, internal consistency, and distributional properties of the Problem Behaviors Assessment – Short Form (PBA-s) in a large sample of people with Huntington's disease (pwHD) at various stages of progression using the Huntington's Disease Integrated Staging System (HD-ISS) framework. Methods: Baseline PBA-s item total scores were analyzed from 14,371 Enroll-HD participants. Using HD-ISS criteria, participants were categorized as Stage 0/1 (n = 3262; 23%), Stage 2 (n = 1722; 12%), or Stage 3 (n = 9387; 65%). Results: Missing responses were low across items and stages. Item total score distributions demonstrated significant skew in Stages 0/1 and 2. Within Stage 3, skewness was less prevalent but still present in most distributions. In all groups, the PBA-s demonstrated moderate internal consistency, though five items exhibited weak item-total correlations. Resultant factor structures differed from those previously reported and varied by HD-ISS stage. In Stages 0/1 and 2, a three-factor model representing internalizing, externalizing, and cognitive control problems accounted for 39–42% of the total variance. In Stage 3, a five-factor solution explained 56% of the overall variance and consisted of internalizing, externalizing, cognitive control problems, suicidality, and cognitive dysfunction. Conclusions: While the PBA-s demonstrates adequate internal consistency, our results revealed high rates of non-endorsement (i.e., item total scores = 0) and a variable factor structure with disease progression. Thus, the PBA-s may not distinguish mild changes in behavioral symptoms that might occur in early HD-ISS stages of disease.