Interval-level Data Research Articles

Development and validation of the aristotelian virtue of conscientiousness scale using Rasch methodology

In the dominant Aristotelian view, virtues are traits that contribute to human flourishing, happiness and well-being. Although some scales in psychology are partially based on Aristotelian virtue theory, few of them operationalise all the aspects of virtues that Aristotle took to be essential. The aim of this project was to develop and validate the Aristotelian Virtue of Conscientiousness Scale (AVCS). The initial 60 scale items were developed based on Aristotelian virtue theory. This item pool was piloted and administered to a sample (n = 301) together with measures of distress, satisfaction with life and Big Five Conscientiousness. The twenty-eight most reliable items were selected based on psychometric criteria and subjected to Rasch analysis. The best model fit was achieved when items were combined into six testlets to address local dependency. The AVCS scale displayed excellent reliability (Person Separation Index = 0.88) and was invariant across gender and age. The ordinal-to-interval conversion tables were generated for the AVCS ordinal scores, which strongly correlated with life satisfaction. The AVCS is a reliable and valid measure with good psychometric properties that can be used in future happiness research. The ordinal AVCS scores can be transformed into interval level data using conversion tables published here, which improves accuracy of measurement.

Cross-national examination of the Distress Tolerance Scale using Rasch methodology

The 15-item Distress Tolerance Scale (DTS) is a widely used psychometric measure with evidence generally supporting its reliability and validity. However, limitations related to its ordinal response format and lack of cross-cultural comparisons have yet to be investigated using appropriate methods. The Partial Credit Rasch model was used to evaluate and enhance the psychometric properties of the DTS using responses from 2550 adult participants from the United States of America (USA), England, Canada, South Africa, Spain, and Argentina. The initial poor fit of the DTS to the Rasch model was improved by removing one item and combining locally dependent items into three testlets. These modifications resulted in the best fit of the 14-item DTS to the Rasch model for all the countries in our study, providing evidence of unidimensionality, high reliability and invariance across countries, meditation practice, and gender. Meeting the expectations of the Rasch model permitted the development of ordinal-to-interval conversion algorithms derived from person estimates of the Rasch model. Using the ordinal-to-interval conversion algorithms published in this article, ordinal DTS scores can be transformed into interval-level data, enhancing the precision of this scale for future research and clinical use across people from the six countries in this study and across the English and Spanish versions of the 14-item DTS.

Improving the measurement properties of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R): deriving a valid measurement total for the calculation of change

Background The Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) total score is a widely used measure of functional status in Amyotrophic Lateral Sclerosis/Motor Neuron Disease (ALS), but recent evidence has raised doubts about its validity. The objective was to examine the measurement properties of the ALSFRS-R, aiming to produce valid measurement from all 12 scale items. Method Longitudinal ALSFRS-R data were collected between 2013-2020 from 1120 people with ALS recruited from 35 centers, together with other scales in the Trajectories of Outcomes in Neurological Conditions-ALS (TONiC-ALS) study. The ALSFRS-R was analyzed by confirmatory factor analysis (CFA), Rasch Analysis (RA) and Mokken scaling. Results No definite factor structure of the ALSFRS-R was confirmed by CFA. RA revealed the raw score total to be invalid even at the ordinal level because of multidimensionality; valid interval level subscale measures could be found for the Bulbar, Fine-Motor and Gross-Motor domains but the Respiratory domain was only valid at an ordinal level. All four domains resolved into a single valid, interval level measure by using a bifactor RA. The smallest detectable difference was 10.4% of the range of the interval scale. Conclusion A total ALSFRS-R ordinal raw score can lead to inferential bias in clinical trial results due to its non-linear nature. On the interval level transformation, more than 5 points difference is required before a statistically significant detectable difference can be observed. Transformation to interval level data should be mandatory in clinical trials.

Which fatigue scale should I use? A Rasch analysis of two fatigue scales in inflammatory conditions

Abstract Objectives This study aimed to assess the psychometric properties of two widely used fatigue scales in a sample of patients with inflammatory conditions. Methods Rasch analysis was used to examine scale reliability, item bias, unidimensionality and overall fit to the Rasch model. Subtest methodology was utilized to attempt to improve model fit for the Chalder Fatigue Scale (CFQ) and Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ). Results Initial analysis displayed strong reliability (person separation index 0.89–0.96) alongside a lack of item bias in both scales. However, evidence for unidimensionality was not found for either scale. Overall fit to the Rasch model was marginal for the CFQ and misfitting for the BRAF-MDQ. Local dependency was observed as well as significant item misfit for both scales. Subtest modifications resulted in the best model fit for the BRAF-MDQ [χ2(16) = 15.77, P = 0.469] and the CFQ [χ2(25) = 15.49, P = 0.929]. Modifications resulted in improved fit, reductions in measurement error and the production of ordinal-to-interval conversion tables for both scales. Conversion tables apply the benefits of enhanced measurement accuracy, valid comparison of BRAF-MDQ and CFQ scores to other interval-level data, appropriate use in parametric statistics and enhanced precision in clinical cut-off scores—without the need to change administration format. Conclusion The BRAF-MDQ and CFQ are valid, reliable tools for fatigue assessment. Psychometric indices and content factors suggest the CFQ is suited to measuring general fatigue, particularly when response burden is a concern, while the BRAF-MDQ should be used in clinical presentations where other symptoms are severe and the impact of fatigue on daily living and emotional and social well-being is of interest.

Enhancing precision of the Telephone Interview for Cognitive Status–Modified (TICS-M) using the Rasch model.

The Telephone Interview for Cognitive Status-modified (TICS-M) is a well-established and widely used screening instrument for dementia and assessment of global cognitive function in older people. This study aimed to evaluate the psychometric properties of the TICS-M and to enhance the accuracy of the instrument using Rasch methodology. Partial Credit Rasch model was applied to the TICS-M scores. The sample selected for Rasch analysis consisted of 432 participants aged 70-90 years (M = 78.85, SD = 4.73) including 195 males (237 females), and 132 (30.56%) of whom were diagnosed with dementia after the baseline assessment. Initial analysis indicated good reliability of the TICS-M assessment scores, but there were three misfitting items and local dependency issues. Combining locally dependent and misfitting items into super-items achieved the best Rasch model fit for the TICS-M. This modification improved reliability of the assessment scores and resulted in no misfitting items, no local dependency, strict unidimensionality, and invariance across individual factors such as participants age, sex, diagnosis, and in-person neuropsychological assessment scores. Satisfying Rasch model expectations allowed for creation of a transformation table to convert raw TICS-M scores into interval-level data, which improves precision of the instrument. In summary, the TICS-M assessment scores demonstrated excellent reliability as reflected by Person Separation Index (PSI = 0.86) and met expectations of the unidimensional Rasch model after minor adjustments. The ordinal-to-interval transformation table can be used to increase accuracy of the TICS-M without altering its current format. These findings contribute to more accurate assessments of cognitive decline in older people and screening for conditions such as dementia. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reliability and Validity Evidence for an Academic Gender Equity Questionnaire

Objective. The majority of practicing pharmacists and student pharmacists are women. However, instruments to assess perceptions of gender equity within pharmacy academia are not available. The objective of this research was to describe the psychometric analysis of a questionnaire developed to assess gender equity by a Gender Equity Task Force and to report reliability and validity evidence.Methods. A questionnaire with 21 items addressing the teaching, research, service, advancement, mentoring, recruitment, and gender of college leaders was created. The survey was distributed via email in December 2020 to all social and administrative science section members of two professional associations. Rasch analysis was performed to evaluate the reliability and validity evidence for the questionnaire.Results. After reverse coding, all items met parameters for unidimensionality necessary for Rasch analysis. Once adjacent categories were merged to create a 3-point scale, the scale and items met parameters for appropriate functionality. Items were ordered hierarchically in order of difficulty. The modified instrument and scale can be treated as interval level data for future use.Conclusion. This analysis provides reliability and validity evidence supporting use of the gender equity questionnaire in the social and administrative academic pharmacy population if recommended edits such as the 3-point scale are used. Future research on gender equity can benefit from use of a psychometrically sound questionnaire for data collection.

Measuring distress in older population: Rasch analysis of the Kessler Psychological Distress Scale

ObjectivesThe 10-item Kessler Psychological Distress Scale (K−10) is a widely applied distress measure; however, its psychometric properties were not established with older populations using advanced methodology. The aim of this study was to examine psychometric properties of the K-10 through application of Rasch methodology and if possible, develop an ordinal-to-interval conversion to improve its reliability in older populations. MethodThe Partial Credit Rasch Model was applied to analyse K-10 scores of the sample including 490 participants (56.3 % females) aged 70 to 90 years and without dementia from the Sydney Memory and Ageing Study (MAS). ResultsThe initial analysis of the K-10 showed poor reliability and significant deviation from the expectations of the Rasch model. The best model fit was evident after correcting disordered thresholds and creating two testlet models to address local dependency between items (χ2(35) = 29.87, p = 0.71). The modified K-10 demonstrated strict unidimensionality, enhanced reliability and scale invariance across personal factors, such as sex, age, and education and permitted development of ordinal-to-interval transformation algorithms. LimitationsOrdinal-to-interval conversion can only be applied for older adults with complete data. ConclusionsThe K-10 satisfied principles of fundamental measurement defined by Rasch model after minor modifications. Clinicians and researchers can transform K-10 raw scores into interval-level data using converging algorithms published here without altering the original scale response format, which increases reliability of the K-10.

The Dyskinesia Impairment Scale, Second Edition: Development, construct validity, and reliability.

To create a shortened, more user-friendly Second Edition of the Dyskinesia Impairment Scale (DIS-II) to assess dystonia and choreoathetosis, and evaluate its construct validity and reliability. Scale development included an online expert meeting (n=21) and iterative discussions within the research group (n=6). A Rasch measurement model analysis on DIS scores from individuals with dyskinetic cerebral palsy or inherited/idiopathic dystonia (n=123, 74 males, mean age14 years, SD5 years) was performed to evaluate the construct validity and reliability of the DIS-II. The DIS-II evaluates dystonia and choreoathetosis in action and rest in 11 body regions, with action items scored from 0 to 3 and rest items 0 to 2. The number of videos to record are reduced from 26 to 14 and the items to score are reduced from 144 to 88. Rating scale functioning, goodness-of-fit evaluation, principal component analysis, and targeting met the predefined quality criteria of the study and construct validity was therefore considered good. Furthermore, person reliability indicated that the DIS-II can separate individuals into eight distinct ability levels. The DIS-II provides valid and reliable measures for dystonia and choreoathetosis, and reduces the administration and scoring time compared with the DIS. The DIS-II logit scores (interval level data) enhance comparison over time and between individuals in clinical practice and research. Compared with the Dyskinesia Impairment Scale (DIS), the shortened edition (DIS-II) requires half of the number of videos to be scored. The DIS-II has a simplified rating scale, requiring scoring of 88 instead of 144 items. The DIS-II has shown excellent reliability and good construct validity. The interval properties of the DIS-II are superior to the ordinal level outcome measures of the DIS.

Psychological responses, mental health, and sense of agency for the dual challenges of climate change and the COVID-19 pandemic in young people in the UK: an online survey study

BackgroundThe COVID-19 pandemic and climate change are both significant and pressing global challenges, posing threats to public health and wellbeing. Young people are particularly vulnerable to the distress both crises can cause, but understanding of the varied psychological responses to both issues is poor. We aimed to investigate these responses and their links with mental health conditions and feelings of agency.MethodsWe conducted an online survey between Aug 5 and Oct 26, 2020, targeting a diverse sample of young people (aged 16–24 years, n=530) in the UK. The survey was distributed using a combination of a survey panel (panel sample) and direct approaches to youth groups and schools who shared the survey with young people in their networks (community sample). We collected data on respondents’ psychological responses to both climate change and the COVID-19 pandemic, their sense of agency to respond to each crisis, and the range of impacts on their lives. We also collected demographics data and screened for mental health and wellbeing indicators. We used non-parametric tests for most statistical comparisons. For paired samples, we used Wilcoxon's signed-rank test, and used Mann-Whitney U-tests or Kruskal-Wallis tests for two or more independent samples. Summed scale scores were considered as interval-level data and analysed with Student's t tests and ANOVAs. Effect sizes are reported as Cohen's d and partial eta-squared (η·2p), respectively.FindingsAfter excluding 18 suspected bots and 94 incomplete responses, 530 responses were retained for analysis. Of the 518 respondents who provided demographic data, 63% were female, 71·4% were White, and the mean family affluence score was 8·22 (SD 2·29). Most participants (n=343; 70%) did not report a history of diagnosis or treatment for a mental health disorder, but mental health scores indicated a common experience of (relatively mild) symptoms of anxiety, depression, and stress. Although UK youth reported more life disruption and concern for their future due to the COVID-19 pandemic, climate change was associated with significantly greater distress overall, particularly for individuals with low levels of generalised anxiety. The COVID-19 pandemic was more associated with feelings of anxiety, isolation, disconnection, and frustration; distress around loss and grief; and effects on quality of life. Climate change was more likely to evoke emotions such as interest and engagement, guilt, shame, anger, and disgust. The greater distress attributed to climate change overall was due, in particular, to higher levels of guilt, sense of personal responsibility, and greater distress triggered by upsetting media coverage. Agency to address climate change was associated with greater climate distress, but pandemic-related distress and agency were unrelated.InterpretationThe COVID-19 pandemic and climate change are affecting the wellbeing of UK young people in distinct ways, with implications for health service, policy, and research responses. There is a need for mental health practitioners, policy makers, and other societal actors to account for the complex relationship between climate agency, distress, and mental wellbeing in young people.FundingImperial College London.

Using the Rasch model to examine pre-service teachers approach to learning profiles

Examining the manner in which learning is organized for educators is an important aspect of educational research. However, one main overarching methodological concern with previous studies was the consistent treatment of Likert scales as an interval type data, that may have resulted in slight inaccuracies in the results. This study thus aims to introduce an alternative method using a Rasch model that may be more suitable to understand the learning profiles of educators. Participants were 352 students (106 male, 246 female) enrolled in a postgraduate program in education. The theoretical framework was based on deep and surface learning approaches and was measured using the instrument RASI. The measurement tool was first validated using the Rasch Rating Scale model and the ability measures of deep learning and surface learning for each student were computed. Analysis indicated that the data was an excellent fit for the Rasch model and that the categories for all items were clearly ordered. Both of the subscales captured most of the spread of person measures. Subsequently, a person-orientated approach was used on the ability measures to categorize the pre-service teachers. The cluster analysis on these ability measures indicated that four groups of students differing in their levels of deep and surface approach to learning were obtained, namely D+/S−, D+/S+, D/S−, and D−/S. Comparisons across clusters for age and gender showed that students with a high deep and low surface approach were significantly older than others. In summary, the present study has demonstrated an alternative method of cluster analysis to identify different learning profiles, by transforming ordinal survey data to an interval level data.

Effect of Dichotomization on the Latent Structure of Data

We investigated whether dichotomous data showed the same latent structure as the interval-level data from which they originated. Given constancy of dimensionality and factor loadings reflecting the latent structure of data, the focus was on the variance of the latent variable of a confirmatory factor model. This variance was shown to summarize the information provided by the factor loadings. The results of a simulation study did not reveal exact correspondence of the variances of the latent variables derived from interval-level and dichotomous data but shrinkage. Since shrinkage occurred systematically, methods for recovering the original variance were fleshed out and evaluated.

German translation, cultural adaptation and validation of the unidimensional self-efficacy scale for multiple sclerosis

BackgroundSelf-efficacy concerns individuals’ beliefs in their capability to exercise control in specific situations and complete tasks successfully. In people with multiple sclerosis (PwMS), self-efficacy has been associated with physical activity levels and quality of life. As a validated German language self-efficacy scale for PwMS is missing the aims of this study were to translate the Unidimensional Self-Efficacy Scale for Multiple Sclerosis (USE-MS) into German, establish face and content validity and cultural adaptation of the German version for PwMS in Austria. A further aim was to validate the German USE-MS (USE-MS-G) in PwMS.MethodsPermission to translate and validate the USE-MS was received from the scale developers. Following guidelines for translation and validation of questionnaires and applying Bandura’s concept of self-efficacy, the USE-MS was forward-backward translated with content and face validity established. Cultural adaptation for Austria was performed using cognitive patient interviews. Reliability was assessed using Cronbach’s alpha, Person separation index and Lin’s concordance correlation coefficient. Rasch analysis was employed to assess construct validity. Comparison was made to scales for resilience, general self-efficacy, anxiety and depression, multiple sclerosis fatigue and health-related quality of life. Data were also pooled with an historic English dataset to compare the English and German language versions.ResultsThe translation and cultural adaptation were successfully performed in the adaptation process of the USE-MS-G. Pretesting was conducted in 30 PwMS, the validation of the final USE-MS-G involved 309 PwMS with minimal to severe disability. The USE-MS-G was found to be valid against the Rasch model when fitting scale data using a bifactor solution of two super-items. It was shown to be unidimensional, free from differential item functioning and well targeted to the study population. Excellent convergent and known-groups validity, internal consistency, person separation reliability and test-retest reliability were shown for the USE-MS-G. Pooling of the English and German datasets confirmed invariance of item difficulties between languages.ConclusionThe USE-MS-G is a robust, valid and reliable scale to assess self-efficacy in PwMS and can generate interval level data on an equivalent metric to the UK version.Trial registrationISRCTN Registry; ISRCTN14843579; prospectively registered on 02. 01. 2019.

Applying Rasch analysis to evaluate and enhance the Academic Motivation Scale

ABSTRACT Objective The 28-item Academic Motivation Scale (AMS) is a widely used measure of students’ motivation to learn but it has the common limitations of an ordinal scale such as low precision and unsuitability for parametric statistics. The current study aimed to evaluate the psychometric properties of the AMS using Rasch methodology and enhance the precision of the scale using ordinal-to-interval transformation. Method The Partial Credit Rash model was used to analyze responses of 429 New Zealand medical students who completed the scale in English. Results The initial poor fit of the AMS to the Rasch model was improved by creating four super-items combining dependent subscales/items that displayed higher residual correlations with each other. These modifications resulted in the best fit to the Rasch model with no significant deviations of scale parameters from the model expectations (χ2 (24) = 19.79, p = 0.71), invariance across sex, age and ethnic groups, unidimensionality and high reliability (PSI = 0.81). Conclusions This study supported the robust psychometric properties of the AMS and produced conversion tables to transform the ordinal AMS scores into interval-level data to enhance the precision of the scale and enable use of parametric statistics without altering the original scale structure. KEY POINTS What is already known about this topic: (1) The Academic Motivation Scale (AMS) was developed to measure academic motivation which is important in higher education settings to evaluate students’ motivation to learn. (2) The AMS is an ordinal scale which is not suitable for parametric statistical tests and has other limitations of an ordinal measure, such as low precision. (3) The full-scale AMS is the most reliable according to the recent evidence, while the individual subscales of the AMS have low generalisability across student population and response occasions. What this topic adds: (1) Using Rasch methodology provides a powerful tool to evaluate and enhance the psychometric properties of an ordinal scale such as the AMS. (2) Rasch model fit indicates that the AMS complies with fundamental principles of measurement, such as unidimensionality, invariance, and interval scale metrics. (3) This study produced ordinal-to-interval conversion tables to transform ordinal responses to the AMS into interval level data that increases precision of the instrument and its suitability for parametric statistics

Barriers to integrating routine depression screening into community low vision rehabilitation services: a mixed methods study

BackgroundUndetected depression is common in people with low vision and depression screening has been recommended. However, depression screening is a complex procedure for which low vision practitioners need training. This study examined the integration of routine depression screening, using two questions, and referral pathways into a national low vision service in Wales at 6 months following practitioner training, and identified key barriers to implementation.MethodsThis pre-post single group study employed a convergent mixed methods design to collect quantitative questionnaire and qualitative interview data on low vision practitioners’ clinical practice and perceived barriers to implementing depression screening. Forty practitioners completed questionnaires pre-, immediately post- and 6 months post-training and nine engaged in interviews 6 months post-training. Ordinal questionnaire scores were Rasch-transformed into interval-level data before linear regression analyses were performed to determine the change in scores over time and the association between perceived barriers and clinical practice. Thematic Analysis was applied to the interviews and the narrative results merged with the questionnaire findings.ResultsBefore training, only one third of practitioners (n = 15) identified depression in low vision patients, increasing to over 90% (n = 37) at 6 months post-training, with a corresponding increase in those using validated depression screening questions from 10% (n = 4) to 80% (n = 32). Six months post-training, practitioners reported taking significantly more action in response to suspected depression (difference in means = 2.77, 95% CI 1.93 to 3.61, p < 0.001) and perceived less barriers to addressing depression (difference in means = − 0.95, 95% CI − 1.32 to − 0.59, p < 0.001). However, the screening questions were not used consistently. Some barriers to implementation remained, including perceived patient reluctance to discuss depression, time constraints and lack of confidence in addressing depression.ConclusionsThe introduction of depression screening service guidelines and training successfully increased the number of low vision practitioners identifying and addressing depression. However, standardized screening of all low vision attendees has not yet been achieved and several barriers remain. Healthcare services need to address these barriers when considering mental health screening, and further research could focus on the process from the patients’ perspective, to determine the desire for and acceptability of screening.

Psychometric Evaluation of the Interpersonal Mindfulness Scale Using Rasch Analysis

The 27-item Interpersonal Mindfulness Scale (IMS) was recently developed to assess mindfulness as it occurs during interpersonal interactions but its psychometric properties have not been evaluated for compliance with fundamental principle measurement using Rasch analysis. A Partial Credit Rasch model was applied to investigate the psychometric properties of the IMS in a sample of 584 participants who completed the scale in English. With 3 super-items combining related items of the three domains including nonjudgmental presence, awareness of self and others, and nonreactivity, the IMS meets expectations of the unidimensional Rasch model (χ2 (27) = 33.61, p = 0.18) and demonstrated good reliability (PSI = 0.76). This permitted transformation from ordinal to interval measure based on person estimates of the Rasch model with the converging algorithm presented in a table. These findings support robust psychometric properties, reliability, and internal validity of the IMS. Transformation of the ordinal IMS responses into interval-level data using Rasch conversion tables published here enhances the accuracy of measurement and suitability of data for parametric statistical tests without violating their fundamental assumptions.

Brain magnetic resonance imaging is a predictor of bimanual performance and executive function in children with unilateral cerebral palsy.

To examine the association between brain magnetic resonance imaging (MRI) characteristics and executive function and bimanual performance in children with unilateral cerebral palsy (CP). Clinical MRI brain scans were classified as: (1) predominant pathological pattern (normal, white matter injury [WMI]; grey matter injury; focal vascular insults [FVI]; malformations; or miscellaneous); and (2) focal lesions (frontal, basal ganglia, and/or thalamus). Assessments included: (1) bimanual performance; (2) unimanual dexterity; and (3) executive function tasks (information processing, attention control, cognitive flexibility, and goal setting) and behavioural ratings (parent). From 131 recruited children, 60 were ineligible for analysis, leaving 71 children (47 males, 24 females) in the final sample (mean age 9y [SD 2y], 6y-12y 8mo). Brain MRIs were WMI (69%) and FVI (31%); and frontal (59%), thalamic (45%), basal ganglia (37%), and basal ganglia plus thalamic (21%). Bimanual performance was lower in FVI versus WMI (p<0.003), and with frontal (p=0.36), basal ganglia (p=0.032), and thalamic/basal ganglia lesions (p=0.013). Other than information processing, executive function tasks were not associated with predominant pattern. Frontal lesions predicted attention control (p=0.049) and cognitive flexibility (p=0.009) but not goal setting, information processing, or behavioural ratings. Clinical brain MRI predicts cognitive and motor outcomes when focal lesions and predominate lesion patterns are considered. What this paper adds Early brain magnetic resonance imaging (MRI) predicts bimanual performance and cognitive outcomes. Brain MRI may identify children requiring targeted interventions. Basal ganglia with/without thalamic lesions predicted bimanual performance. Frontal lesions were associated with attention control and cognitive flexibility. Brain MRI predominant patterns predicted motor, not cognitive outcomes, other than information processing.

How Do Acculturation, Maternal Connectedness, and Mother-Daughter Sexual Communication Affect Asian American Daughters' Sexual Initiation?

Purpose: There was a growth of approximately ten million Asian American individuals in the United States between 2000 and 2015. Asian Americans have conservative values surrounding sexual health and sexual communication is a cultural taboo. Researchers have shown discrepancies on whether the level of acculturation influences Asian mother-daughter sexual communication. In other minority populations there is evidence that a connected mother–daughter relationship increases sexual communication and delays sexual initiation. The purpose of this study was to examine whether mother-daughter connectedness and level of acculturation predict sexual communication in turn affecting the age of female Asian emerging adult’s sexual initiation. Methods: This was a longitudinal, secondary analysis of AddHealth examining whether mother-daughter connectedness and level of acculturation predict sexual communication. There were 243 Asian American mother-daughter dyads in Wave I with linked data in Wave III who were included in the study. Acculturation, connectedness, and sexual communication were all measured using interval level data. Results: Connectedness did not significantly contribute to the relationship between any of the concepts. Although it was predicted that sexual communication would delay initiation, the opposite was found. Also, communication mediated the relationship between acculturation and initiation. Conclusions: Further studies are needed to explore how connectedness is defined by Asian American mother-daughter dyads. In addition, more detailed operational definitions of acculturation and communication are needed, specifically the timing of sexual communication.

New avenue for the geriatric depression scale: Rasch transformation enhances reliability of assessment

BackgroundDepression is a common problem in older adults. The 15-item Geriatric Depression Scale (GDS-15) is a widely used psychometric tool for measuring depression in the elderly, but its psychometric properties have not been yet rigorously investigated. The aim was to evaluate psychometric properties of the GDS-15 and improve precision of the instrument by applying Rasch analysis and deriving conversion tables for transformation of raw scores into interval level data. MethodsThe data was extracted from the prospective cohort Sydney Memory and Ageing Study of initially not demented individuals aged 70 years and older. The GDS-15 items scores of 212 participants (47.2% males) were analysed using the dichotomous Rasch model. ResultsInitially poor reliability of the GDS-15, Person Separation Index (PSI) = 0.68, was improved by combining locally dependent items into seven super-items. These modifications improved reliability of the GDS-15 (PSI = 0.78) and resulted in the best Rasch model fit (χ2(28)=37.72, p = =0.104), strict unidimensionality and scale invariance across personal factors such as gender, diagnostic and language background. LimitationsPresence of participants with cognitive impairment may be a potential limitation. ConclusionsReliability and psychometric characteristics of the GDS-15 were improved by minor modifications and now satisfy expectations of the unidimensional Rasch model. By using Rasch transformation tables published here psychiatrists, psychologists and researchers can transform GDS raw scores into interval-level data, which improves reliability of the GDS-15 without the need to modify its original response format. These findings increase accuracy of clinical psychometric assessments, leading to more precise diagnosis of depression in the elderly.

Interpersonal Mindfulness in Parenting Scale: Testing the Psychometric Properties of a Korean Version

Mindful parenting is the extension of intra-personal mindfulness to inter-personal processes by developing and fostering mindfulness during interactions with a child when acting in the role of a parent. While some empirical evidence points to various benefits of mindful parenting both for the parent and the child, suitable measurement tools for mindful parenting are still being developed, especially for use in non-Western countries such as Korea. The present study involved development of a Korean version of the Interpersonal Mindfulness in Parenting (IM-P) scale using a large sample of Korean parents (n = 554) recruited online and a second, replication sample of Korean parents with children attending kindergarten (n = 283). Using an iterative approach of exploratory and confirmatory factor analysis guided by conceptual criteria, an 18-item Korean version of the instrument (IM-P-K) met psychometric criteria of classical test theory. Rasch analysis confirmed internal validity of this solution and also produced algorithms to convert the total ordinal-level summary scores to interval-level data. While the reliability of the six individual three-item subscales was only marginally acceptable, the reliability of the total interval-transformed score was excellent. The IM-P-K total scores correlated in expected directions with various other psychological constructs known to be associated with mindfulness, such as self-compassion, depression, psychological well-being, and perceived stress. This 18-item IM-P-K thus offers a suitable self-report instrument to investigate mindful parenting in Korean samples.

Reliability and validity of the de Morton Mobility Index in individuals with sub-acute stroke

Purpose: To establish the validity and reliability of the de Morton Mobility Index (DEMMI) in patients with sub-acute stroke. Methods: This cross-sectional study was performed in a neurological rehabilitation hospital. We assessed unidimensionality, construct validity, internal consistency reliability, inter-rater reliability, minimal detectable change and possible floor and ceiling effects of the DEMMI in adult patients with sub-acute stroke. Results: The study included a total sample of 121 patients with sub-acute stroke. We analysed validity (n = 109) and reliability (n = 51) in two sub-samples. Rasch analysis indicated unidimensionality with an overall fit to the model (chi-square = 12.37, p = 0.577). All hypotheses on construct validity were confirmed. Internal consistency reliability (Cronbach’s alpha = 0.94) and inter-rater reliability (intraclass correlation coefficient = 0.95; 95% confidence interval: 0.92–0.97) were excellent. The minimal detectable change with 90% confidence was 13 points. No floor or ceiling effects were evident. Conclusions: These results indicate unidimensionality, sufficient internal consistency reliability, inter-rater reliability, and construct validity of the DEMMI in patients with a sub-acute stroke. Advantages of the DEMMI in clinical application are the short administration time, no need for special equipment and interval level data. The de Morton Mobility Index, therefore, may be a useful performance-based bedside test to measure mobility in individuals with a sub-acute stroke across the whole mobility spectrum.Implications for RehabilitationThe de Morton Mobility Index (DEMMI) is an unidimensional measurement instrument of mobility in individuals with sub-acute stroke.The DEMMI has excellent internal consistency and inter-rater reliability, and sufficient construct validity.The minimal detectable change of the DEMMI with 90% confidence in stroke rehabilitation is 13 points.The lack of any floor or ceiling effects on hospital admission indicates applicability across the whole mobility spectrum of patients with sub-acute stroke. Trial registration: German Clinical Trials Register identifier: DRKS00004681.