Inconsistent Response Patterns Research Articles

Development and Psychometric Evaluation of a Caregiver Survey to Assess Family-Centered Care in the Emergency Department.

To develop and evaluate the psychometric properties of a family caregiver-reported survey that assesses family-centeredness of care in the context of pediatric emergency department (ED) encounters. We created a caregiver-reported scale, incorporated content expert feedback, and iteratively revised it based on cognitive interviews with caregivers. We then field tested the scale in a survey with caregivers. We dichotomized items using top-box scoring and obtained a summary score per respondent. Using a sample of 191 caregivers recruited from 9 EDs, we analyzed internal consistency reliability, dimensionality via item response theory modeling, and convergent validity with the ED Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. Feedback from the 9 experts led us to remove 4 items. We conducted 16 cognitive interviews and revised the survey in 4 rounds. An 11-item survey was field tested. Mean (standard deviation) respondent 11-item summary score was 77.2 (26.6). We removed 2 items given inconsistent response patterns, poor variability, and poor internal consistency, which increased coefficient alpha from 0.85 to 0.88 for the final scale. A multidimensional model fit the data best, but factor scores correlated strongly with summary scores, suggesting the latter are sufficient for quality improvement and future research. Regarding convergent validity, adjusted partial correlation between our scale's 9-item summary score and the ED CAHPS summary score was 0.75 (95% confidence interval 0.67-0.81). Psychometric analyses demonstrated strong item performance, reliability, and convergent validity for the 9-item scale. This survey can be used to assess family-centered care in the ED for research and quality improvement purposes.

Testosterone and cortisol responses to acute and prolonged stress during officer training school

Prolonged or severe stress has been found to inhibit the hypothalamic-pituitary-gonadal axis (HPG) and its testosterone release. In contrast, acute stress, including competition, social evaluation, or physical challenges, shows more inconsistent response patterns. This study examined changes in cortisol and testosterone across different types and durations of stress in the same individuals. We further explored the influence of baseline levels on hormonal stress responses. Sixty-seven male officer cadets in the Swiss Armed Forces (mean age 20.46 years ± 1.33) were assessed during two different acute stressors—the Trier Social Stress Test for Groups (TSST-G) and a brief military field exercise—and in the long-term during the 15-week officer training school. Several saliva samples were collected before and after the acute stressors for cortisol and testosterone. Morning testosterone was assessed four times during officer training school. There were significant increases in cortisol and testosterone during the TSST-G and the field exercise. Baseline levels of testosterone were negatively associated with acute cortisol response during the field exercise but not during the TSST-G. Morning saliva testosterone decreased during the first 12 weeks of officer training school and increased again in week 15, with no differences to baseline levels. The findings suggest that group stress tests such as the TSST-G or field exercises in groups may be particularly challenging for young men. The results also point to an adaptive role of testosterone during acute challenges during prolonged stress.

Studies in the Mentality of Literates: 3. Conceptual Structure and Nonsense of Personality Testing.

In this study, third in a series of studies of the relationships between the dominant type of the Word Meaning Structure (WMS) and various psychic processes, response patterns on personality questionnaires with Likert-type response format of individuals with different levels of education (including adult illiterates) in Brazil (N = 102) and in Estonia (N = 520) were assessed with person oriented methods of data analysis. We found that responses to two personality questionnaires (International Personality Item Pool Questionnaire, IPIP-Q60 and Estonian Collectivism Scale, ESTCOL) are inconsistent and do not correspond to theories that underlie construction and interpretation of such assessment tools. Two novel ways to assess inconsistent response patterns were developed. The Consistency Index (CI) characterizes between-item inconsistency and the Determinacy Index (DI) characterizes within-item inconsistency. The dominant type of the WMS and the level of education were related to both CI and DI. Higher level of between-item inconsistency characterizes everyday conceptual thinkers with lower levels of education and higher level of within-item inconsistency was observed among logical conceptual thinkers with higher levels of education. Systematic relationships between WMS and inconsistent patterns of responses indicate that responses on personality questionnaires cannot be interpreted in terms of personality characteristics. The results of our study also provide further support to the idea that dominant type of the WMS is a pervasive characteristic of the psyche and determines qualitatively possibilities and limits of the psychic processes. The results of this study are in agreement with the idea that WMS defines the "Great Divide."

The Analysis Critical Thinking Skills of Guidance and Counseling Students : A Pilot Study Using RASCH Model Analysis

This study identified the critical thinking skills of Guidance and Counseling students. The analysis of this capability was illustrated in the scalogram resulted from the RASCH model analysis. The respondents were Guidance and Counseling students at a public University, in Bandung, Indonesia. The data obtained was used as a pilot study in measuring the critical thinking skill test constructed by the author. The results showed that the students' critical thinking skills were in the low category, with a percentage of 44%. The scalogram picture showed that there were three students who gave inconsistent patterns for several questions which showed that the result was still valid. The result of this study could be a reference for giving group counseling to some students who had inconsistent response patterns. In conclusion, counseling with a cognitive approach needed to be held in improving the critical thinking skills of Guidance and Counseling students who had low levels of critical thinking skill as a follow-up to this research. The implication of this study was that the research data could be used as a reference in the preparation of the guidance and counseling service program related to critical thinking skills.

I think, therefore I forget - using experimental simulation of dementia to understand functional cognitive disorders.

Symptoms of functional neurological disorder have traditionally been thought to depend, in part, on patients' ideas about symptoms rather than on the rules of pathophysiology. The possibility that functional cognitive symptoms might similarly reflect ideas of dementia has not been explored. We aimed to assess beliefs, through performance, about symptoms of dementia in healthy non-medical adults with the intention of identifying potential markers of functional cognitive disorders. Healthy volunteers were asked to simulate symptoms of mild dementia during testing with the Montreal Cognitive Assessment (MoCA), coin-in-hand forced-choice test, short digit span trials, Luria 3-step test and interlocking finger test. Family history of dementia was recorded. In 50 participants aged 18-27, simulating dementia, mean MoCA score was 16 (SD 5.5, range 5-26). Delayed recall was the most frequently failed item (100%) and cube drawing least frequently failed (42%). Twenty-six percent failed forward three-digit span and 36% failed reverse two-digit span. On the coin-in-hand test, 32% scored at or below chance level. Inconsistent response patterns were common. Cognitively healthy young adults simulating mild dementia perform similarly to older adults with mild dementia, demonstrating beliefs that dementia is associated with significant global impairment, including attention, motor function, and letter vigilance, but preservation of cube drawing. Inconsistent response patterns were common. Contrary to expectation, family history of dementia did not influence performance. Two and three digit span showed particular promise as a bedside test for simulation. Further investigation will establish whether similar patterns of results are produced in individuals with functional cognitive symptoms.

The effect of copper and chlorpyrifos co-exposure on biomarkers in the marine mussel Mytilus galloprovincialis

Metals and organophosphorous pesticides commonly co-occur in marine environment, but the effect of their mixtures on non-target organisms is still poorly understood. This study investigated the combined effect of the essential metal copper (Cu) and organophosphorous pesticide chlorpyrifos (Chp) in mussels (Mytilus galloprovincialis) after short-term exposure to their sublethal concentrations. Mussels were exposed for four days to 5 and 15 μg L−1 Cu and 0.05 and 5 μg L−1 Chp, and to their binary mixtures. The investigated biomarkers, namely acetylcholinesterase activity (AChE), glutathione S-transferase activity (GST), metallothioneins content (MTs) and lipid peroxide levels (LPO) displayed unspecific and inconsistent response patterns that varied depending on the concentration of chemicals and composition of mixtures. The exposure to Cu or Chp alone did not induce AChE activity changes, whereas only Cu provoked a significant GST activity increase. Exposure to lower and higher concentration of Chp resulted in MTs content and LPO level increase, respectively. Response of biomarkers to mixtures was generally inconsistent. Data integration by IBR index and PCA revealed different stress levels for given exposure conditions, but no explicit differentiation between single and joint exposures was found. The present results showed that low and environmentally relevant concentrations of Cu and Chp in mixtures may result in a detectable biological response, stressing the need for further investigation of joint effects of widespread marine contaminants in sentinel organisms.

Social and psychological determinants of value co-creation behavior for South Korean firms

PurposeIn view of the increasing importance of creating values that require shared societal responsibilities to be borne by not just firms but customers as well, the purpose of this paper is to empirically investigate whether customers’ social capital plays a role in creating shared values for South Korean firms directly or indirectly through social identity and corporate authenticity.Design/methodology/approachTo understand the effects of social capital on value co-creation, the authors conducted a face-to-face questionnaire survey with a selected group of 400 adult respondents aged more than 20 years. To verify precision in wording and sentence structure and the validity of questions in reflecting the study objective, the authors conducted a pretest on 40 respondents before administering the main survey. Ultimately, 50 questionnaires considered inappropriate and with inconsistent response patterns were discarded, leaving 350 questionnaires for the statistical analysis.FindingsThis research adopts the consumer-centric as well as societal perspectives to conceptualize value co-creation behavior, and tests the moderating roles of psychometric measures of self-monitoring and corporate trust. Next, the research confirms whether social identity and perceived corporate authenticity mediate the relationship between social capital and value co-creation.Originality/valueThe study results shed new insights into the societal, psychological and normative aspects of value co-creation.

Chinese Female Undergraduate’s Explicit and Implicit Attitude toward Chinese Skincare Brands and Japanese and South Korean Skincare Brands

The study aimed to explore the Chinese female college students’ attitudes toward skincare brands (including Chinese brands and Japanese and Korean brands) by comparing the results of self-report survey and the Implicit Association Test (IAT). The results showed that participants have inconsistent response patterns in explicit/implicit measures toward Chinese brands and Japanese and Korean brands, and both explicit and implicit attitude measures are significantly differences. That is, participants holds a more positive attitude on Japanese and Korean brands than Chinese brands in explicit attitude, but a more negative in implicit attitude.

Rethinking Internal Consistency in Cronbach's Alpha

ABSTRACTCronbach's alpha estimates the internal consistency of responses in multi-item bipolar scales. This article examined three research questions (RQ): (1) To what extent do inconsistencies exist in data (e.g., responses of −2 −2 2 2)? (2) Does the number of scale items influence the amount of inconsistency? (3) Does Cronbach's alpha mask inconsistencies? Data were obtained from 29 research projects (n = 10,616). Each survey had place attachment questions comprising two concepts: place identity and place dependence. Respondents were classified as consistent or inconsistent based on their responses to the place attachment questions. Results demonstrated that: (a) inconsistent response patterns existed in the data (RQ1), (b) number of scale items influenced amount of inconsistency (RQ2), and (c) alpha masked these inconsistencies (RQ3). Discussion focused on implications of these findings.

An Examination of the Frequency of Invalid Forgetting on the Test of Memory Malingering

The Test of Memory Malingering (TOMM) is the most used performance validity test in neuropsychology, but does not measure response consistency, which is central in the measurement of credible presentation. Gunner, Miele, Lynch, and McCaffrey (2012) developed the Albany Consistency Index (ACI) to address this need. The ACI consistency measurement, however, may penalize examinees, resulting in suboptimal accuracy. The Invalid Forgetting Frequency Index (IFFI), created for the present study, utilizes an algorithm to identify and differentiate learning and inconsistent response patterns across TOMM trials. The purpose of this study was to assess the diagnostic accuracy of the ACI and IFFI against a reference test (Malingered Neurocognitive Dysfunction criteria), and to compare both to the standard TOMM indexes. This retrospective case-control study used 59 forensic cases from an outpatient clinic in Southern Kansas. Results indicated that sensitivity, negative predictive value, and overall accuracy of the IFFI were superior to both the TOMM indexes and ACI. Logistic regression odds ratios were similar for TOMM Trial 2, Retention, and IFFI (1.25, 1.24, 1.25, respectively), with the ACI somewhat lower (1.18). The IFFI had the highest rate of group membership predictions (79.7%). Implications and limitations of the present study are discussed.

A General Approach for Assessing Person Fit and Person Reliability in Typical-Response Measurement

In constant-θ IRT models, person unreliability is regarded as a source of person misfit. In Variable-θ IRT models, on the other hand, it is regarded as a relevant individual characteristic, which is modeled as an additional person parameter. As in any IRT application, person fit must be assessed when a variable-θ model is fitted to real data. This assessment aims to detect inconsistent response patterns once person unreliability has been taken into account. The present paper makes a general proposal for assessing person fit based on variable-θ models that are intended to be used with personality and attitude measures. For the three types of variable-θ IRT models developed to date—binary, graded, and (approximately) continuous response models—(a) graphical procedures, (b) global person-fit indices, and (c) residual indices at the item level are proposed and discussed. A multistage approach for using the indices and procedures is also proposed and illustrated using an empirical example.

A Comparison of Implicit and Explicit Attitude Measures: An Application of the Implicit Association Test (IAT) to Fast Food Restaurant Brands

The study attempted to assess people's attitudes toward fast food restaurant brands by comparing the results of explicit and implicit attitude measures. A total of 60 college students (33 Americans and 27 Koreans) were recruited to complete both a self-report survey and the Implicit Association Test (IAT). Two known fast food restaurant brands were selected and the results of this study show that Korean respondents have inconsistent response patterns in explicit/implicit measures toward the two brands, while consistent patterns are found among Americans in the same context. In terms of the correlation results, it was observed that both explicit and implicit attitude measures are significantly correlated with the frequency of fast food restaurant visits (FFRV) among Koreans, whereas explicit liking was not correlated with FFRV in the significant correlations between other variables (GEA and IA) among Americans. The researchers' elaborations on the literature and the experimental study reveal several conclusions, recommendations, and implications.

Item Bias Analysis of the Young Schema-Questionnaire for Psychopathology, Gender, and Educational Level

This study examines the construct validity of the Young Schema-Questionnaire at the item level in a Dutch population. Possible bias of items in relation to the presence or absence of psychopathology, gender, and educational level was analyzed, using a cross-validation design. None of the items of the YSQ exhibited differential item functioning (DIF) for gender, and only one item showed DIF for educational level. Furthermore, item bias analysis did not identify DIF for the presence or absence of psychopathology in as much as 195 of the 205 items comprising the YSQ. Ten items, however, spread over the questionnaire, were found to yield relatively inconsistent response patterns for patients and nonclinical participants.

Non-trading, lexicographic and inconsistent behaviour in stated choice data

This paper discusses a number of issues relating to the pre-analysis and cleaning of stated choice data, where we look specifically at the problems caused by non-trading, lexicographic and inconsistent response patterns. We argue that this process is considerably more complex and challenging than many in the field have hitherto acknowledged, with the standard practice being the use of rather ad hoc procedures for the identification of these phenomena. A detailed analysis on four different stated choice datasets highlights the potential impacts of these methods on model estimation results.

Do Patients Consistently Report Comorbid Conditions Over Time?

Comorbidity is an important dimension of patient health status. However, limited attention has been given to assessing the reliability of patient-reported data on comorbid conditions. We sought to evaluate the consistency of self-report of 12 comorbid conditions at 3 distinct time points and examine the sociodemographic, clinical, health status, and survey factors associated with reliability. We undertook a longitudinal cohort analysis of survey and medical record abstract data obtained from a population-based sample of 3095 prostate cancer survivors. Consistent and inconsistent response patterns were assessed using descriptive statistics and regression modeling. More than half of the cohort demonstrated consistent responses to all comorbid condition questionnaire items. Arthritis had the highest (13%) and liver disease the lowest (1%) proportion of inconsistent responses. Older age, lower income, and poorer general and mental health status were significant predictors of inconsistent responses. Subset analyses of the 4 most prevalent comorbid conditions (ie, arthritis, diabetes, hypertension, and depression) showed that respondents who reported that they were limited by, or taking prescription medicine for, the condition were more likely to provide consistent responses than those neither limited nor taking medicine. Response consistencies of 92% or better were obtained for 11 of the 12 conditions. Men with a relatively recent prostate cancer diagnosis are generally able to provide reliable reports of their concomitant health conditions. To increase the likelihood of obtaining reliable data, investigators should consider ascertaining condition severity and current medical management when querying subjects about comorbid conditions in surveys.

Pneumatic tool torque reaction: reaction forces, displacement, muscle activity and discomfort in the hand-arm system

Reaction forces, hand-arm displacement, muscle activity and discomfort ratings were studied during the securing of threaded fasteners with three angle nutrunners with different shut-off mechanisms, but with the same spindle torque (72–74 Nm). The three tools were tested according to the method specified in ISO 6544. One of the tools had an almost instantaneous shut-off. Another had a more slowly declining torque curve. For the third tool the maximum torque was maintained for a while before shut-off. Twelve male subjects participated in the study. A force platform measured the reaction force between the subject and the floor. The option of the hand-arm system and the shoulder was measured with an optoelectronic measuring system. The muscle activity (EMG) in six muscles in the arm and shoulder was measured with surface electrodes. Significant differences in the arm movements and ground reaction forces were found between the three tools. The smallest values were found with the fast shut-off tool while the delayed shut-off tool caused the largest values. The EMG measures gave inconsistent response patterns. Discomfort ratings were highly correlated with the time for which the tool torque exceeded 90% of peak preset torque, but the time for which the tool torque exceeded 90% of peak calculated by the method specified in ISO 6544. Nutrunners with a shut-off mechanism that causes a slowly decreasing torque or a torque that is maintained for a while before shut-off should be avoided. If no substitutes are available, then a torque reaction bar should be mounted on the tool.

Incidence of measurement disturbances in the Dental Admission Quantitative Reasoning Test

This paper describes the incidence of inconsistent person-response patterns in the Quantitative Reasoning Test (QRT), which is part of the Dental Admission Test (DAT) battery. using the Rasch person analysis approach to estimate the likelihood of a response pattern resulting from only two factors (the difficulty of the items and the ability of the person), a statistical profile of inconsistent response patterns was developed for a sample of students taking the DAT. The results of two test dates, April 1987 and October 1988, were included in this study. A random sample of 1,000 persons was drawn from each of these two test administrations. For the Fall 1988 sample, the person analysis was supplemented by a questionnaire designed to check the correspondence between a student's self-reported response behavior and the statistical profile provided by the person analysis. The analysis of the two samples of response patterns indicates a high incidence (50 percent+) of atypical response patterns on the test. This has serious implications for the admissions procedure since many of the atypical response patterns invalidate the standard scores reported for those students.

Inconsistent response patterns and the prediction of child maltreatment

Inconsistent response patterns have been used with other measures to screen for child maltreatment. To date the inconsistency (IC) scale, a validity scale on the Child Abuse Potential (CAP) Inventory, has not been used as a screening criterion for physical child abuse. The present study examined the responses of 89 physical child abusers and 108 comparison subjects to determine if the CAP Inventory IC scale has any utility in the screening for physical child abuse. While results indicated the CAP Inventory IC scale scores were significantly higher for the physical child abuse group, a series of discriminant analyses indicated that the IC scale did not account for any meaningful variance after variance related to child abuse factors was removed. Further, the results indicated that dependence on the IC scale alone for physical child abuse screening purposes could be expected to produce excessive false positive and false negative classifications.

EFFECTS OF STANDARD EXTREMITY ON MIXED STANDARD SCALE PERFORMANCE RATINGS1

It was suggested that the extremity of the scale values associated with standards used to represent effective and ineffective performance in Mixed Standard Scales may affect the nature of performance ratings derived from MSS responses and decisions based on MSS ratings. When the extremity of standards was experimentally manipulated, it was found that standard extremity affects both the level of performance ratings and the proportion of logically inconsistent response patterns observed. In addition, standard extremity appears to affect the rankings on performance of ratees. The implications of these observations for the development of Mixed Standard Scales were discussed.

Mixed Standard Scale Response Inconsistencies as Reliability Indices

The mixed standard scale is a rating format which allows researchers to count illogical (i.e., internally inconsistent) response patterns. These counts have been interpreted as an index of rater reliability, based on the notion that illogical response patterns reflect carelessness in responding. This study investigated the meaning of these counts, using 943 accountants as raters. It was found that the counts of illogical response patterns were not related to reliability as measured by Cronbach's alpha, and alternative interpretations for such indices are suggested.