Multiple-group Confirmatory Factor Analysis Research Articles

Fit Indices for Measurement Invariance Tests in the Thurstonian IRT Model.

This study examined whether cutoffs in fit indices suggested for traditional formats with maximum likelihood estimators can be utilized to assess model fit and to test measurement invariance when a multiple group confirmatory factor analysis was employed for the Thurstonian item response theory (IRT) model. Regarding the performance of the evaluation criteria, detection of measurement non-invariance and Type I error rates were examined. The impact of measurement non-invariance on estimated scores in the Thurstonian IRT model was also examined through accuracy and efficiency in score estimation. The fit indices used for the evaluation of model fit performed well. Among six cutoffs for changes in model fit indices, only ΔCFI > .01 and ΔNCI > .02 detected metric non-invariance when the medium magnitude of non-invariance occurred and none of the cutoffs performed well to detect scalar non-invariance. Based on the generated sampling distributions of fit index differences, this study suggested ΔCFI > .001 and ΔNCI > .004 for scalar non-invariance and ΔCFI > .007 for metric non-invariance. Considering Type I error rate control and detection rates of measurement non-invariance, ΔCFI was recommended for measurement non-invariance tests for forced-choice format data. Challenges in measurement non-invariance tests in the Thurstonian IRT model were discussed along with the direction for future research to enhance the utility of forced-choice formats in test development for cross-cultural and international settings.

Validity and correlates of the Brief Satisfaction With Appearance Scale for patients with limited and diffuse systemic sclerosis: Analysis from the University of California, Los Angeles Scleroderma Quality of Life Study.

The Brief Satisfaction With Appearance Scale measures two dimensions (Dissatisfaction with Appearance and Social Discomfort) of body image dissatisfaction in systemic sclerosis. This study examined the structural validity of the Brief Satisfaction With Appearance Scale across limited and diffuse systemic sclerosis subtypes, compared body image dissatisfaction by systemic sclerosis subtype, and identified the significant sociodemographic and medical correlates of body image dissatisfaction and whether they differed by subtype. Participants were 183 adults participating in the University of California, Los Angeles Scleroderma Quality of Life Study with limited cutaneous (n = 101) or diffuse cutaneous (n = 82) systemic sclerosis who received clinical examinations and completed questionnaires. Multiple-group confirmatory factor analysis, multivariate analysis of variance, and structural equation modeling were used. The Brief Satisfaction With Appearance Scale's two-factor structure fit well for both subtypes. Patients with diffuse systemic sclerosis reported greater body image dissatisfaction on both factors than patients with limited disease. Greater Dissatisfaction with Appearance was associated with younger age and being unmarried for limited patients, and with younger age and increased finger/hand skin involvement for diffuse patients. Greater Social Discomfort was associated with younger age and being unmarried for both subtypes. The Brief Satisfaction With Appearance Scale scores can be meaningfully compared across limited and diffuse systemic sclerosis. Patients with diffuse disease reported more body image dissatisfaction than those with limited disease. Findings demonstrate that both medical and sociodemographic variables are associated with body image dissatisfaction in systemic sclerosis and can be used to identify which patients may be at increased risk for body image dissatisfaction.

Measurement Invariance and Informant Discrepancies of the KIDSCREEN-27 in Children with Mental Disorder

Study objectives were to examine measurement invariance of the KIDSCREEN-27 between children with mental disorder and their parents; compare health-related quality of life (HRQL) scores to identify potential domain discrepancies; and, identify mental disorders associated with informant discrepancies. Participants consisted of parents with children who were currently receiving mental health services and screened positive for mental disorder according to the Mini International Neuropsychiatric Interview (n = 92). Measurement invariance was investigated using multiple-group confirmatory factor analysis using maximum likelihood estimation with robust standard errors. Multiple regression was used to identify child mental disorders associated with informant discrepancies, adjusting for relevant child and parent characteristics. Partial invariance was obtained for all domains on the KIDSCREEN-27 with the exception of Physical Well-being for which full invariance was obtained. Parents reported lower KIDSCREEN-27 scores compared to children with significant differences for Psychological Well-being [d = 1.98 (1.62, 2.33)] and Social Support and Peers [d = 0.41 (0.11, 0.70)]. For children with oppositional defiant or conduct disorder who report low HRQL, parents underestimate Psychological Well-being scores (B = 1.29, p < 0.001; B = 1.00, p < 0.01) and for children with major depressive episode, parents underestimate Social Support and Peers scores (B = 0.57, p < 0.05). Findings suggest that the KIDSCREEN-27 is a valid measure of HRQL in children with mental disorder. Externalizing behaviors exhibited by children with oppositional defiant and conduct disorder may prevent parents from recognizing compromises in their psychological well-being. Health professionals should be cognizant that these clinical profiles may predispose informant discrepancies when assessing HRQL in children.

Association of depression and anxiety with different aspects of dental anxiety in pregnant mothers and their partners.

The aim was to confirm the factor structure of Modified Dental Anxiety Scale (MDAS) and to investigate whether the association of these factors with general anxiety and depression varied across gender. The FinnBrain Birth Cohort Study (www.finnbrain.fi) data from the first collection point at gestational week 14 were used. Of the invited participants (n=5790), 3808 (66%) expectant mothers and 2623 fathers or other partners of the mother agreed to participate, and 3095 (81.3%) mothers and 2011 (76.7%) fathers returned the self-report questionnaire. Dental anxiety was measured with the MDAS, general anxiety symptoms with Symptom Checklist-90 (anxiety subscale) and depressive symptoms with the Edinburgh Postnatal Depression Scale. Multiple group confirmatory factor analysis (MGCFA) was conducted to test the equivalence of the factor structure and multiple group SEM (MGSEM) to test the configural invariance (unconstrained model) and metric invariance (structural weights model), across genders. Of those consenting, 3022 (98%) women and 1935 (96%) men answered the MDAS. The MGCFA indicated good convergent validity for the two-factor model for MDAS, but somewhat low discriminant validity (factors demonstrated 72% shared variance). The MDAS items loaded clearly higher for the assigned factor than to the other factor (differences in loadings >0.2), indicating that the 2-factor model has merit. According to the final MGSEM model, anxiety symptoms were directly related to anticipatory dental anxiety, but not to treatment-related dental anxiety. When assessing dental anxiety with MDAS, considering also its two factors may help clinicians in understanding the nature of patient's dental anxiety.

The Structure of Conflict Styles in Adolescents

Abstract. This study examines the latent structure of the Rahim Organizational Conflict Inventory – II (ROCI-II) in several samples of secondary school students. Findings from earlier studies conducted in adult populations suggested that the instrument has a four- or five-factor structure; however, the exploratory factor analysis (EFA) in this study yielded a three-factor (integrating, dominating, avoiding) solution, with most of the items associated with a fourth factor (Obliging) failing to load as predicted. A confirmatory factor analysis (CFA) replicated the three-factor solution satisfactorily. A multiple-group CFA indicated that the ROCI-II showed invariant measurement properties in male and female students and corroborated the concurrent validity of the three-factor solution. The integrating factor was related positively to a measure of perspective taking but negatively to a measure of reluctance to participate. The avoiding factor was associated with a measure of reluctance to participate. We discuss the implications of the results for understanding the latent structure of the ROCI-II in adolescents.

Factor structure and measurement invariance of the Jefferson Teamwork Observation Guide® (JTOG®) individual version

Abstract Background The Jefferson Teamwork Observation Guide® (JTOG®) is a self-report measure that has been developed into several additional versions (patient, support person, and individual) in order to provide a 360-degree assessment of teamwork skills of health professions students and providers. Purpose The primary aim of this study was to examine the psychometric properties of the Individual JTOG when used both as a self-assessment and as a peer assessment of collaborative practice (CP) and teamwork skills. Method Two samples of nursing undergraduate and health sciences graduate students (N = 1347, total) used the Individual JTOG to assess their own and their teammates’ collaborative practice skills following an IPE module. Exploratory and confirmatory factor analyses were used to determine the structure and reliability of the self- and peer assessments. Discussion Results illustrated that a two-factor structure was sufficient to explain most of the variance in both self- and peer assessments of teamwork. Multiple-groups confirmatory factor analysis illustrated that both the self-assessments and peer assessments have strong measurement invariance across genders.. Conclusions The Individual JTOG can be used as a valid and reliable indicator of CP skills, and is best used as a formative assessment..

Multiple-Group Confirmatory Factor Analysis in R--A Tutorial in Measurement Invariance with Continuous and Ordinal Indicators

Multiple-group confirmatory factor analysis (MG-CFA) is among the most productive extensions of.structural equation modeling. Many researchers conducting cross-cultural or longitudinal studies are interested in testing for measurement and structural invariance. The aim of the present paper is to provide a tutorial in MG-CFA using the freely available R-packages lavaan, semTools, and semPlot. The combination of these packages enable a highly efficient analysis of the measurement models both for normally distributed as well as ordinal data. Data from two freely available datasets – the first with continuous the second with ordered indicators - will be used to provide a walk-through the individual steps.

The Brief 10-Item Community Assessment of Psychic Experiences-Positive Scale (Brief CAPE-P10): Initial psychometric properties, gender measurement invariance and mean differences among Nigerian adolescents.

The aim of this study was to evaluate the Community Assessment of Psychic Experiences-Positive Scale (CAPE-P) for its psychometric properties in terms of its reliability and validity, in addition to its factor structure and gender measurement invariance among Nigerian adolescents (n = 1336, Mage = 15.15). The sample consisted of 606 (45.4%) males, who completed the 20-items CAPE-P in addition to the Positive and Negative Suicide Ideation Inventory (PANSI), the Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale (RSES). We compared 11 a priori models of the CAPE-P with the aim of identifying the one with the best fit indices applying Confirmatory Factor Analysis (CFA). Gender measurement invariance was examined with nested multiple-group confirmatory factor analysis (MGCFA). All the 11 a priori models had poor fit indices. An examination of the scale's 20 items revealed that 10 items had poor correlation with the overall scale. The remaining 10 items which we labelled as the Brief CAPE-P10 were subjected to CFA which yielded a 3-factor model (Bizarre Experiences-5 items, Delusional Ideation-3 items and Perceptual Anomalies-2 items) with satisfactory fit indices (CFI = 0.961, SRMR = 0.0376, RMSEA = 0.062/90% CI = 0.052-0.069). The validity and reliability of the Brief CAPE-P10 and its subscales were modestly satisfactory. MGCFA affirmed the configural, metric and scalar gender invariance of the 3-factor Brief CAPE-P10. The Brief CAPE-P10 is a promising instrument for the evaluation of PLEs among Nigerian adolescents.

Cross-Cultural Invariance of the Mental Toughness Index among American and Greek Athletes

To date, there has been no effort to uncover the extent of the universality of mental toughness (MT) in sport between any European country and the US via the Mental Toughness Index (MTI). The authors attempted to examine the invariance of MT between American and Greek athletes and further validate MTI. The MTI was completed by 99 Greek and 173 US athletes. Invariance testing was conducted using multiple group confirmatory factor analysis with increasingly restrictive models. The model-data fit in both samples was very good (CFI Greek = .995, RMSEA Greek = .046; CFI US = .998, RMSEA US = .032). The scalar invariance model was selected as the best fitting (CFA scalar = .930, RMSEA scalar = .078), but with a slightly different item intercept for one item (Item 4; <.5). The results imply that the meaning of the construct is equal in both cultures. Therefore, their MT scores can be directly compared.

Alternative Models Examination and Gender Measurement Invariance of the 12-item General Health Questionnaire among Nigerian Adolescents.

Objective The objective of this study was to examine the factor structures of the a priori alternative models of the 12-items General Health Questionnaire (GHQ-12), its psychometric characteristics and gender measurement invariance in a sample of non-clinical Nigerian adolescents (n=1326; Mage=15.16). Methods The sample consisted of 606 (45.7%) males, who completed the GHQ-12 in addition to the Hospital Anxiety and Depression Scale (HADS), the Rosenberg Self-Esteem Scale (RSES) and the Suicidal Behaviors Questionnaire-Revised (SBQ-R). We compared 21 models to identify which has the best fit indices applying confirmatory factor analysis. Gender measurement invariance was examined with nested multiple-group confirmatory factor analysis (MGCFA). Results The model that best captures psychological distress was a three-factor model that was initially described among the Australian general population (CFI=0.952, SRMR=0.0310, RMSEA=0.042) (90%CI=0.035–0.049). The internal consistencies (ω) of this model and its dimensions were modestly satisfactory. The criterion validity of this model was supported via significant correlations with the other study measures. MGCFA supported the configural, metric and scalar gender invariances of this model. Conclusion A three-factor GHQ-12 model (anhedonia/sleep disturbances; social performance and Loss of confidence) is useful as a psychological distress assessment tool among Nigerian adolescents.

Measurement Invariance and Sleep Quality Differences Between Men and Women in the Pittsburgh Sleep Quality Index.

Previous research has reported mixed results in terms of sex differences in sleep quality. We conducted an analysis of measurement invariance of the Pittsburgh Sleep Quality Index (PSQI) between men and women to provide a necessary foundation for examining sleep differences. The sample included 861 adults (mean age = 52.73 years, 47.85% male) from the 2012-2016 wave of the Midlife in the United States (MIDUS) Refresher Biomarker survey. We randomly divided the sample into two half samples for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. We conducted EFA with a weighted least squares mean and variance adjusted (WLSMV) estimator and Geomin rotation to explore the underlying structure of the PSQI. We then employed multiple-group CFA with the WLSMV estimator and theta parameterization to examine measurement invariance between males and females. EFA suggested a two-factor structure of the PSQI, and the two-factor CFA model fit the data well. The finding that the two-factor PSQI model was invariant between males and females on configuration, factor loadings, thresholds for all but one measure, and residual variances for all but one measure provided evidence that the two-factor PSQI model was partially invariant between men and women. Females had higher means on latent factors, suggesting worse self-reports of sleep among women. Overall, the measure of the PSQI assesses the same factors in a comparable way among men and women. Women reported worse sleep than men.

Age and sex invariance of the International Cognitive Ability Resource (ICAR)

To encourage broader assessment of cognitive abilities in research across scientific fields, Condon and Revelle (2014) developed the first cognitive assessment in the public domain, the International Cognitive Ability Resource (ICAR). Despite initial support for its psychometric properties, little is known about the construct validity of the ICAR across distinct groups of individuals. In order to meaningfully interpret ICAR scores across diverse populations, measurement invariance must be established. To this end, a multiple group confirmatory factor analysis (MGCFA) was conducted on the full 60-item ICAR (ICAR60) and the 16-item Sample Test (ICAR16) to test for invariance across self-reported biological sex and age groups. A moderated nonlinear factor analysis (MNLFA) was conducted on the ICAR16 to test for differential item functioning (DIF) across linear age, age squared, sex, and their respective interaction terms. The baseline MGCFA models proposed by the test developers fit the data well for males and females and across age groups based on the fit indices Mc, CFI, TLI, and RMSEA. In the MCGFA, both forms demonstrated acceptable changes in the Mc (∆< .02) and CFI (∆< .01) in both loading- and threshold-constrained models for the sex and age group models. The MNLFA supported the weak and strong measurement invariance of the ICAR16 found in the MGCFA; no meaningful differences in item thresholds or factor-loadings were found across age, sex, or their interaction terms. Overall findings provide evidence that both forms measure the same constructs across sex and age, and the same strength of the relations exists among the first-order factors and the items. Despite these findings, the internal consistency of the subscales suggests only the total score of the ICAR16 be used for research; those interested in the subscales of the ICAR are advised to use the ICAR60.

Measurement Invariance of Three Versions of the Pathological Narcissism Inventory across Gender-Matched Italian Adolescent High School and Young Adult University Students

To assess the measurement invariance of the three versions of the Pathological Narcissism Inventory (PNI) across adolescent and young adult participants, 678 Italian adolescent high school students (M = 16.83 years old, SD = 1.85 years) and 678 adult university students (M = 23.99 years old, SD = 2.60 years) matched on gender, civil status, and geographic area, were administered the Italian translation of the original 52-item PNI. The PNI, the Brief-Pathological Narcissism Inventory (B-PNI), and Super Brief-Pathological Narcissism Inventory (SB-PNI) scales all showed adequate reliabilities in both adolescent and young adult samples. In both samples, robust maximum likelihood confirmatory factor analysis indicated that covariation among the PNI/B-PNI first-order scales, as well as among the SB-PNI items, could be adequately explained by two-correlated factors operationalizing narcissistic grandiosity (NG) and narcissistic vulnerability (NV), respectively. Multiple-group confirmatory factor analyses supported scalar invariance for both B-PNI and SB-PNI NG and NV factors, and metric invariance for the PNI NG and NV factors.

A multiple-group confirmatory factor analysis of psychosocial stressors among Medicaid-covered pregnant women

A multiple-group confirmatory factor analysis of psychosocial stressors among Medicaid-covered pregnant women

Peer-to-Peer Mental Health Support on Community College Campuses: Examining the Factorial Invariance of the Mental Distress Response Scale

ABSTRACT The number of community college students reporting mental health disorders increased from approximately 40% to 49% between 2014 and 2016. Peer-to-peer mental health support, for example, recognize and refer, initiatives have utility for promoting college student mental health on four-year universities. The potential efficacy of peer-to-peer mental health support, however, has not been extended to the community college student population. The primary aim of the present study was to test the psychometric properties of the Mental Distress Response Scale (MDRS) with a national random sample, stratified by age, gender, generational status, and ethnicity, of community college students. The MDRS is a screening tool for appraising responses to encountering a peer in mental distress. A multiple-group confirmatory factor analysis supported the factorial invariance of the MDRS across a number of demographic characteristics associated with college student mental health. The researcher also identified demographic differences in community college students’ MDRS scores. Findings contribute to the community college knowledge base by providing support for the utility of the MDRS for enhancing interventions geared towards promoting peer-to-peer mental health support. Implications for how the MDRS can be used to promote the cultural sensitivity of peer-to-peer mental health support on community college campuses are discussed.

Measurement invariance of the patient health questionnaire-9 (PHQ-9) depression screener in U.S. adults across sex, race/ethnicity, and education level: NHANES 2005-2016.

Despite its popularity, little is known about the measurement invariance of the Patient Health Questionnaire-9 (PHQ-9) across U.S. sociodemographic groups. Use of a screener shown not to possess measurement invariance could result in under/over-detectionof depression, potentially exacerbating sociodemographic disparities in depression. Therefore, we assessed the factor structure and measurement invariance of the PHQ-9 across major U.S. sociodemographic groups. U.S. population representative data came from the 2005-2016 National Health and Nutrition Examination Survey (NHANES) cohorts. We conducted a measurement invariance analysis of 31,366 respondents across sociodemographic factors of sex, race/ethnicity, and education level. Considering results of single-group confirmatory factor analyses (CFAs), depression theory, and research utility, we justify a two-factor structure for the PHQ-9 consisting of a cognitive/affective factor and a somatic factor (RMSEA = 0.034, TLI = 0.985, CFI = 0.989). On the basis of multiple-group CFAs testing configural, scalar, and strict factorial invariance, we determined that invariance held for sex, race/ethnicity, and education level groups, as all models demonstrated close model fit (RMSEA = 0.025-0.025, TLI = 0.985-0.992, CFI = 0.986-0.991). Finally, for all steps ΔCFI was <-0.004, and ΔRMSEA was <0.01. We demonstrate that the PHQ-9 is acceptable to use in major U.S. sociodemographic groups and allows for meaningful comparisons in total, cognitive/affective, and somatic depressive symptoms across these groups, extending its use to the community. This knowledge is timely as medicine moves towards alternative payment models emphasizing high-quality and cost-efficient care, which will likely incentivize behavioral and population health efforts. We also provide a consistent, evidence-based approach for calculating PHQ-9 subscale scores.

Ölçme Değişmezliğinin Değerlendirilmesi: Türk ve Amerikalı Öğrenciler için Madde İşlev Farklılığının Belirlenmesinde Çoklu Grup Doğrulayıcı Faktör Analizi Kullanımı

International assessments are often developed in one country and applied in other countries. Assessing the measurement invariance across countries is an important step in determining valid conclusions, comparisons across countries. This paper investigated measurement invariance, across two countries, of selected questions from the Programme for International Student Assessment 2009 student questionnaire. Turkey and United States were compared with the multiple group confirmatory factor analysis for scores on polytomous items to detect differential item functioning (DIF). The results were based on the chi-square goodness of fit test and root mean squared error of approximation, the comparative fit index and the Tucker-Lewis index. The items exhibit DIF, learning strategies, were investigated with Item Response Theory based on the chi-square goodness of fit and t-test.

Longitudinal measurement invariance of the Satisfaction With Life Scale in adolescence.

The main purpose of this research was to examine the longitudinal measurement invariance of the Satisfaction With Life Scale (SWLS) in adolescence. The sample was composed by 484 adolescents from Spain, 46.7% were males. All participants belonged to six academic levels from Grade 7 to Grade 12, and answered the questionnaires at two different times: at the beginning (Mage1 = 14.95, SD1 = 1.81) and at the end of the school year (Mage2 = 15.61, SD2 = 1.81). The reliability of the scale was obtained through Cronbach's alpha, Guttman lambda, and MacDonald's Omega total. The multiple group confirmatory factor analysis (MGCFA) was used to examine the fit of the unifactorial model to data and to test the measurement of longitudinal invariance of the scale across two time points (at the beginning T1, and the end T2, of the academic year), and the time points and groups (gender and age). The values of the single-factor SWLS structure were T1 (CFI1 = 1.000, TLI1 = .997, RMSEA1 = .080, and SRMR1 = .028), and T2 (CFI2 = .997, TLI2 = .995, RMSEA2 = .032, and SRMR2 = .034). On the other hand, values of the reliability and composite reliability when analyzing both time points together as well as separately were as follows: Cronbach's alpha = .86, Guttman's lambda = .84, McDonald's Omega total = .89. Results confirmed the longitudinal invariance of SWLS. The differences in gender and age were not significant and the small differences across time points showed that the means of the latent factor remained the same over time in both variables. The present study confirmed the single-factor structure of the SWLS in Spanish adolescents, as well as a good reliability and composite reliability. The full longitudinal measurement invariance was also found and there were negligible differences across time points considering gender and age. If these findings are further replicated, the scale could be used to compare the life satisfaction across two time points considering different age and gender groups.

Test-Retest Measurement Invariance of the Nine-Item Internet Gaming Disorder Scale in Two Countries: A Preliminary Longitudinal Study

The reliable longitudinal assessment of Internet Gaming Disorder (IGD) behaviors is viewed by many as a pivotal clinical and research priority. The present study is the first to examine the test-retest measurement invariance of IGD ratings, as assessed using the short-form nine-item Internet Gaming Disorder Scale (IGDS9-SF) over an approximate period of 3 months, across two normative national samples. Differences referring to the mode of the data collection (face-to-face [FtF] vs. online) were also considered. Two sequences of successive multiple group confirmatory factor analyses (CFAs) were calculated to longitudinally assess the psychometric properties of the IGDS9-SF using emergent adults, gamers from (i) the United States of America (USA; N = 120, 18–29 years, Meanage = 22.35, 51.6% male) assessed online and; and (ii) Australia (N = 61, 18–31 years, Meanage = 23.02, 75.4% male) assessed FtF. Configural invariance was established across both samples, and metric and scalar invariances were supported for the USA sample. Interestingly, only partial metric (factor loadings for Items 2 and 3 non-invariant) and partial scalar invariance (i.e., all thresholds of Items 1 and 2, and thresholds 1, 3, for Items 4, 6, 8, and 9 non-invariant) were established for the Australian sample. Findings are discussed in the light of using IGDS9-SF to assess and monitor IGD behaviors over time in both in clinical and non-clinical settings.

Factor Structure and Measurement Invariance for the Cognitive Emotion Regulation Questionnaire (CERQ) Among Women Newly Diagnosed With Breast Cancer.

BackgroundGiven that emotion regulation counts for much in breast cancer, it is important to fully understand its construct. The cognitive emotion regulation questionnaire (CERQ) is a widely applied instrument for measuring conscious cognitive coping strategies in both general and clinical samples; however, there are no data on its factor structure in women with breast cancer, not to mention evidence of measurement invariance (MI) across sociodemographic variables. Thus, the purpose of the present study was to examine the latent factor structure and MI between different sociodemographic groups for CERQ in specific patients.MethodsThe sample consisted of 1032 women newly diagnosed with breast cancer, with a mean age of 47.54 years (SD = 8.51). The latent factor structure for CERQ was tested using confirmatory factor analysis (CFA). Further, MI various sociodemographic variables was evaluated by a series of multiple-group CFA process.ResultsThe nine-factor CFA model was an adequate fit for the data collected in women with breast cancer. Also, this nine-factor structure had strong factorial invariance across age, place of residence, educational levels, and employment status.ConclusionThis study firstly examined the latent factor structure for CERQ among Chinese women with malignancy and MI across various sociodemographic variables, which deepens the understanding of the construct for CERQ as a useful tool for assessing patients’ conscious cognitive component of emotion regulation based on self-report.