Nonparametric Item Response Theory Research Articles

Occupational self-efficacy scale: Validity in teachers

Occupational self-efficacy has gained attention because of its importance in understanding the effects of psychosocial factors at work, but because of its relevance, it is necessary to study it in the context of the COVID-19 pandemic. The Occupational Self-Efficacy Short Scale Form (OSS-SF) is a measure of individual variability in self-efficacy within the work context and has been used in some studies in Latin America. The aim of this study was to obtain evidence of the validity of the OSS-SF for 214 Peruvian teachers and to evaluate its internal structure and associations with other constructs. The sample, composed of 214 teachers (Mage = 44, SDage = 10), was selected using nonprobabilistic convenience sampling and evaluated via online forms. Nonparametric item response theory was used. Among the results, a unidimensional structure and high scalability at the item and scale levels were obtained (>0.70). The reliability was approximately 0.90. There was moderate convergence with job satisfaction (0.39) and slight convergence with the perception of the management of virtual tools (0.18). The OSS-SF is a scale with adequate evidence of validity and reliability for Peruvian teachers who work remotely. Therefore, it can be used as a diagnostic measure of intervention and training needs to benefit teachers and students.

Harmonizing perspectives to understand attitudes: A mixed methods approach to crafting an assessment literacy attitude scale

Assessment literacy's vital role in faculty effectiveness within higher education lacks sufficient tools for measuring faculty attitudes on this matter. Employing a sequential mixed-methods approach, this study utilized the theory of planned behavior to develop the Assessment Literacy Attitude Scale (ALAS) and evaluate its psychometric properties within the U.S. higher education context. The qualitative phase involved a literature review of relevant studies and existing self-report measures, interviews with stakeholders, and panel reviews to shape initial item development. Following the establishment of a conceptual foundation and a comprehensive overview of the scale's construction, our study advanced to the quantitative stage that involves factor analytical and item response theory approaches using data from 260 faculty across three public universities in the U.S. Exploratory factor analysis (EFA) was employed initially to obtain preliminary insights into the scale's factorial structure and dimensionality. Confirmatory factor analysis (CFA) was subsequently applied with separate data and the findings largely supported the conclusions from the EFA. Exploratory and confirmatory factor analyses resulted in 15 items loading across two factors in a good model fit range. Finally, we used nonparametric item response theory (IRT) techniques based on Mokken Scale Analysis (MSA) to evaluate individual items for evidence of effective psychometric properties to support the interpretation of ALAS scores, including monotonicity, scalability, and invariant item ordering. The newly-developed scale shows promise in assessing faculty attitudes toward enhancing their assessment literacy.

The MACE-SCREEN – Screening for Abuse and Neglect Across Developmental Stages

ABSTRACT Few high-quality instruments are available to comprehensively screen for multiple interpersonal traumatic childhood experiences differentiated by developmental stage. One instrument assessing various forms of childhood trauma is the Maltreatment and Abuse Chronology of Exposure (MACE-X, Teicher & Parigger, 2015), which allows for the assessment of age at exposure for every item. The aim of this study is the development of a shorter version, which is suitable for screening. In- and out-patients (n = 719) of a somatic clinic were assessed with the German version of the 75-item MACE. Descriptive statistics, a nonparametric item response theory model (Mokken Scale Analysis), and factor analysis were combined to select items for a screening version. A screener (MACE-SCREEN) with 39 items allocated to five scales was developed. Scales differentiate between abuse types and neglect, direct experience vs. witnessing violence, and the age of the perpetrator (adults vs. peers). The scales showed good internal consistency (Alpha .78 to .91) and the total score a strong correlation with the total score of the long version (r = .96). This screening version is still comprehensive as it assesses exposure to various forms of interpersonal traumatic events, including peer violence and witnessing domestic abuse. As it also allows for the concurrent assessment of age at exposure, it lends itself to assessing exposure across developmental stages.

Introduction and validation of the open symptom framework: a public domain modular framework for patient-reported measurement of symptoms related to cancer and its treatment

PurposeWe provide an initial description and validation of some public domain patient-reported outcome (PRO) items to assess cancer symptom burden to address immediate barriers to symptom assessment use in clinical practice and facilitate future research.MethodsWe created the Open Symptom Framework (OSF), a flexible tool for clinical cancer-related symptom assessment. The items comprise six components: recall period, concept, symptom, qualifier(s), a definition, and a 5-point Likert-type response. We recruited patients receiving cancer therapy in the United States and United Kingdom. We assessed external construct validity by comparing OSF scores to the PRO-CTCAE measure and assessed reliability, scalability, dimensionality, and item ordering within a non-parametric item response theory framework. We tested differential item functioning for country, age, gender, and level of education.ResultsWe developed a framework alongside clinical and psychometric experts and debrieifed with 10 patients. For validation, we recruited 331patients. All items correlated with the PRO-CTCAE equivalents (r = 0.55–0.96, all p < 0.01). Mokken analysis confirmed the scalability and unidimensionality of all symptom scales with multiple items at the scale (Ho = 0.61–0.75) and item level (Hi = 0.60–0.76). Items are interpreted consistently between demographic groups (Crit = 0 for all groups).ConclusionThe public domain OSF has excellent psychometric properties including face, content, and criterion validity and can facilitate the development of flexible, robust measurements to fulfil stakeholder need. The OSF was designed specifically to support clinical assessment but will function well for research. Further work is planned to increase the number of symptoms and number of questions per symptom within the framework.

Using a nonparametric item response theory model to identify patterns of cognitive decline: The Mokken scale analysis.

Cognitive decline, particularly in dementia, presents complex challenges in early detection and diagnosis. While Item Response Theory (IRT) has been instrumental in identifying patterns of cognitive impairment through psychometric tests, its parametric models often require large sample sizes and strict assumptions. This creates a need for more adaptable, less demanding analytical methods. This study aimed to evaluate the effectiveness of Mokken scale analysis (MSA), a nonparametric IRT model, in identifying hierarchical patterns of cognitive impairment from psychometric tests. Using data from 1164 adults over 60 years old, we applied MSA to the orientation subscale of ACE-III. Our analysis involved calculating scalability, monotone homogeneity, invariant item ordering (IIO) and response functions. The MSA effectively retrieved the hierarchical order of cognitive impairment patterns. Most items showed strong scalability and consistent patterns of cognitive performance. However, challenges with IIO were observed, particularly with items having adjacent difficulty parameters. The findings highlight MSA's potential as a practical alternative to parametric IRT models in cognitive impairment research. Its ability to provide valuable insights into patterns of cognitive deterioration, coupled with less stringent requirements, makes it a useful tool for clinicians and researchers.

Interpretation of course conceptual structure and student self-efficacy: an integrated strategy of knowledge graphs with item response modeling

BackgroundThere is a scarcity of studies that quantitatively assess the difficulty and importance of knowledge points (KPs) depending on students’ self-efficacy for learning (SEL). This study aims to validate the practical application of psychological measurement tools in physical therapy education by analyzing student SEL and course conceptual structure.MethodsFrom the “Therapeutic Exercise” course curriculum, we extracted 100 KPs and administered a difficulty rating questionnaire to 218 students post-final exam. The pipeline of the non-parametric Item Response Theory (IRT) and parametric IRT modeling was employed to estimate student SEL and describe the hierarchy of KPs in terms of item difficulty. Additionally, Gaussian Graphical Models with Non-Convex Penalties were deployed to create a Knowledge Graph (KG) and identify the main components. A visual analytics approach was then proposed to understand the correlation and difficulty level of KPs.ResultsWe identified 50 KPs to create the Mokken scale, which exhibited high reliability (Cronbach’s alpha = 0.9675) with no gender bias at the overall or at each item level (p > 0.05). The three-parameter logistic model (3PLM) demonstrated good fitness with questionnaire data, whose Root Mean Square Error Approximation was < 0.05. Also, item-model fitness unveiled good fitness, as indicated by each item with non-significant p-values for chi-square tests. The Wright map revealed item difficulty relative to SEL levels. SEL estimated by the 3PLM correlated significantly with the high-ability range of average Grade-Point Average (p < 0.05). The KG backbone structure consisted of 58 KPs, with 29 KPs overlapping with the Mokken scale. Visual analysis of the KG backbone structure revealed that the difficulty level of KPs in the IRT could not replace their position parameters in the KG.ConclusionThe IRT and KG methods utilized in this study offer distinct perspectives for visualizing hierarchical relationships and correlations among the KPs. Based on real-world teaching empirical data, this study helps to provide a research foundation for updating course contents and customizing learning objectives.Trial registrationNot applicable.

C-Test construct validity: Evidence from nonparametric item response theory

C-Test is a gap-filling test designed to measure first and second language proficiency. Over the past four decades, researchers have shown the fit of C-Test data to parametric item response theory (IRT) models, but no study so far has shown the fit of C-Tests to nonparametric IRT models. The purpose of this study is to contribute to the ongoing C-Test validation project by providing evidence of fit to the Mokken scale analysis as a widely used nonparametric IRT model. A six-passage C-Test battery was analyzed using the monotone homogeneity model and the double monotonicity model of Mokken. Unidimensionality was evaluated using the automatic item selection procedure. Findings showed that the C-Test passages form a strong unidimensional scale, fit well to the monotone homogeneity model, and, after deleting one item, have a sufficient fit to the double monotonicity model. The findings also indicated that the items form a hierarchy, and persons can be located on an ordinal scale using their C-Test sum scores. Implications of the study for C-Test validity and application are discussed.

Validity evidence for the coping strategy indicator-short version (CSI-S) among psychology students

The abbreviated measurement of coping strategies is useful for monitoring and identifying the effects of stress. The Coping strategy indicator-Short version (CSI-S, including the dimensions of seeking support, problem solving and avoidance strategies) is a new adaptation of the full version of this indicator, and additional evidence of its validity is needed. Psychology students (n = 125) from a public university in Lima, Peru, were recruited to help provide such evidence of validity in terms of internal structure, reliability and associations with other variables (perceived stress and general efficacy in cope with difficulties), which were evaluated using nonparametric item response theory procedures. Support-seeking and problem-solving items from the Mokken scale and the avoidance scale exhibited limitations. The correlations between the scales were moderate or low and exhibited theoretical consistency, and the relationship with perceived stress highlighted the predictive capacity of avoidance and problem-solving strategies. In general, the CSI-S exhibits suitable psychometric properties; however, the avoidance score requires further examination or reconstruction of its items.

Scoring the EQ-HWB-S: can we do it without value sets? A non-parametric item response theory analysis

BackgroundOnly one pilot value set (UK) is currently available for the EQ Health and Wellbeing Instrument short version (EQ-HWB-S). As an alternative to preference-weighted scoring, we examined whether a level summary score (LSS) is appropriate for the EQ-HWB-S using Mokken scaling analyses.MethodsData from patients, carers and the general population collected during the developmental phase of the EQ-HWB-S in Australia, US and UK were used, noting 3 of 9 items have since undergone revision. EQ-HWB-S data fit was examined using R package Mokken scaling’s monotone homogeneity model, utilizing the automated item selection procedure (AISP) as well as Loevinger’s scaling coefficients for items and the scale (HS). Manifest monotonicity was assessed by examining whether the cumulative probability for responses at or above each response level did not decrease across the summary score.ResultsEQ-HWB-S data were available for 3340 respondents: US = 903, Australia = 514 and UK = 1923. Mean age was 50 ± 18 and 1841 (55%) were female. AISP placed all 9 items of the EQ-HWB-S on a single scale when the lower bound was set to < 0.448. Strong scalability (HS = 0.561) was found for the EQ-HWB-S as a single scale. Stronger scales were formed by separating the psychosocial items (n = 6, HS = 0.683) and physical sensation items (n = 3, HS = 0.713). No violations of monotonicity were found except for the items mobility and daily activities for the subgroups with long-term conditions and UK subjects, respectively.DiscussionAs EQ-HWB-S items formed a strong scale and subscales based on Mokken analysis, LSS is a promising weighting-free approach to scoring.

Nonparametric Kernel Smoothing Item Response Theory Analysis of Likert Items

Likert scales are the most common psychometric response scales in the social and behavioral sciences. Likert items are typically used to measure individuals’ attitudes, perceptions, knowledge, and behavioral changes. To analyze the psychometric properties of individual Likert-type items and overall Likert scales, mostly methods based on classical test theory (CTT) are used, including corrected item–total correlations and reliability indices. CTT methods heavily rely on the total scale scores, making it challenging to directly examine the performance of items and response options across varying levels of the trait. In this study, Kernel Smoothing Item Response Theory (KS-IRT) is introduced as a graphical nonparametric IRT approach for the evaluation of Likert items. Unlike parametric IRT models, nonparametric IRT models do not involve strong assumptions regarding the form of item response functions (IRFs). KS-IRT provides graphics for detecting peculiar patterns in items across different levels of a latent trait. Differential item functioning (DIF) can also be examined by applying KS-IRT. Using empirical data, we illustrate the application of KS-IRT to the examination of Likert items on a psychological scale.

Analyzing Polytomous Test Data: A Comparison Between an Information-Based IRT Model and the Generalized Partial Credit Model

Item response theory (IRT) models the relationship between the possible scores on a test item against a test taker’s attainment of the latent trait that the item is intended to measure. In this study, we compare two models for tests with polytomously scored items: the optimal scoring (OS) model, a nonparametric IRT model based on the principles of information theory, and the generalized partial credit (GPC) model, a widely used parametric alternative. We evaluate these models using both simulated and real test data. In the real data examples, the OS model demonstrates superior model fit compared to the GPC model across all analyzed datasets. In our simulation study, the OS model outperforms the GPC model in terms of bias, but at the cost of larger standard errors for the probabilities along the estimated item response functions. Furthermore, we illustrate how surprisal arc length, an IRT scale invariant measure of ability with metric properties, can be used to put scores from vastly different types of IRT models on a common scale. We also demonstrate how arc length can be a viable alternative to sum scores for scoring test takers.

Is Less More? Reevaluating the Psychometric Properties of the Sense of Coherence-13 and a Revised Seven-Item Version in South Africa Using Classical Theory and Item Response Theory

Studies on the dimensionality and factor structure of the Sense of Coherence-13 (SOC-13) scale have produced inconsistent results, and there is a need for comprehensive psychometric testing of the scale in different populations and using diverse methodologies. SOC refers to the individual’s ability to perceive life as comprehensible, manageable, and meaningful. The current study investigated the dimensionality of the SOC-13 through the use of confirmatory factor analysis (CFA), ancillary bifactor indices and item response theory in a sample of young adults in South Africa. Participants were students (n = 322) who completed the SOC-13, the Connor–Davidson Resilience Scale, the PTSD Checklist for DSM-5 and short forms of the Center for Epidemiological Studies Depression Scale, and the trait scale of the Spielberger State-Trait Anxiety Inventory. CFA indicated the best fit for a one-factor model, but the problematic parameter estimates raise concerns about the construct validity of the scale. Non-parametric item response theory (Mokken scale analysis [MSA]) identified limitations in the original 13-item version, suggesting a more dependable seven-item version (SOC-7). This revised scale exhibited strong psychometric characteristics and was consistent with the theoretical foundations that underpin the construct. We verified the unidimensional structure of the SOC with the more stringent parametric item-response theory (Rasch analysis) which confirmed that the seven-item SOC is unidimensional. Rasch analysis confirmed the measurement invariance of the SOC-13 in terms of gender and area of residence. The study suggests that a shorter seven-item version consisting of items from the three components of sense of coherence has comparative properties to the 13-item version but the evidence does not provide support for the use of the SOC-13 as a multidimensional measure. Research in the area of sense of coherence would benefit from further validation studies of both the original SOC-13 and the revised SOC-7, especially across populations and settings.

Nutrition-associated health levels in persons with cancer: item response modelling based on the International Classification of Functioning, Disability and Health.

The nutritional status of individuals with cancer is a crucial determinant of their health and well-being, and addressing nutrition-related functioning conditions is essential for maintaining physical activity levels and participating in daily activities. This study aims to identify an evidence-based International Classification of Functioning, Disability and Health (ICF) scale using item response theory for nutrition conditions in patients with cancer, which can differentiate and assess nutrition-related functioning conditions of cancer survivors. Cross-sectional study. Sir Run Run Hospital, Nanjing Medical University. One hundred cancer patients were enrolled. Via convenience sampling, the study administered a questionnaire consisting of 89 ICF items to participants. The original five-point rating system was binarized (1 = no problem, 0 = problem). Through data shaping, non-parametric IRT analysis and parametric IRT analysis, psychometric properties of nutritional ICF scale were calculated using R software. The study extracted a unidimensional scale with 32 items and constructed 2-parameter logistic model with good fitness, whose root mean square error approximation (RMSEA) = 0.0759, Tucker-Lewis Index (TLI) = 0.9655, and Comparative Fit Index (CFI) = 0.9677. The model demonstrated high reliability, as indicated by a Cronbach's α of 0.95, Guttman λ<inf>2</inf> of 0.95, Molenaar Sijtsma statistic of 0.96 and a latent class reliability coefficient (LCRC) of 0.98. Besides, there was a strong correlation between the total score of 32 ICF items and the score of Patient-Generated Subjective Global Assessment (PG-SGA, P<0.001, r=-0.77) and Mini Nutritional Assessment (MNA, P<0.001, r=0.76), suggesting the 32-item scale had high validity. The study constructed an evidence-based ICF scale for nutrition conditions in patients with cancer with 32-item and 2PLM for evaluating nutrition-associated health level in persons with cancer, including high validity and reliability. The IRT model based on ICF provided a promising assessment tool to discriminate nutrition-associated health level of persons with cancer, and offered an auxiliary method for selecting rehabilitation intervention targets. This has the potential to lead to improved outcomes in cancer treatment and increased quality of life for cancer survivors.

How urban green areas influence different dimensions of sustainable behaviour

Purpose: The alternative of sustainable consumption is proposed to change the excessive demand and production that aggravate environmental problems. However, translating ecosystems concerns into sustainable attitudes is a well-known challenge. This study analyzes the hypothesis of a positive correlation between how often people visit urban green areas and their perception of sustainable consumption Design/methodology/approach: Based on the nonparametric item response theory (NIRT) and logistic regression models. Findings: The hypothesis was partially confirmed. Implications: The importance of urban green areas and their potential to encourage sustainable consumption reinforces the need for governments to develop environmental education programs that include incentives to visit public parks and emphasize the reduction of environmental degradation. Originality/value: This research contributes (i) to present the importance of urban green areas to change the individuals’ behavior toward sustainable consumption and (ii) to test how urban green areas influence different dimensions of sustainable behavior.

Internal Structure of the Work-Family Conflict Questionnaire (WFCQ) in Teacher Teleworking.

The interference between family and work roles has led to the development of scales for their measurement. However, instrumental studies of work-family conflict have not been conducted in the context of teacher teleworking during the COVID-19 pandemic. For this reason, the objectives of this study were set to obtain evidence of the internal structure and fairness of the Blanch and Aluja Work-Family Conflict Questionnaire, as well as its association with job satisfaction and other sociodemographic variables. A total of 235 Peruvian school teachers between the ages of 24 and 72 years (M = 43.79 and SD = 9.67) responded to the scale using the online form. The analysis employed the non-parametric item response theory modeling (Mokken scaling analysis). The structure of two correlated factors was confirmed: work conflict in the family (WCF) and family conflict in the work (FCW). Both dimensions were invariant with respect to sex group and educational level. The association of both dimensions with job satisfaction was theoretically convergent, and the gender of the teachers slightly moderated this relationship. The reliability was adequate for group research. Finally, the instrument can be useful in the organizational context of teachers who telework.

Developmental Language Differences in Children with Autism Spectrum Disorders and Possible Sex Difference.

Developmental difference is a common characteristic of autism spectrum disorder (ASD) with unclear sex differences. The current study included 610 children with ASD, aged between 2 and 7years, with completed language profiles. We used a nonparametric item response theory model called Mokken scale analysis to examine the order of acquisition of developmental language milestones in children with ASD. Our results demonstrated the developmental language differences in the expressive and receptive language dimensions in children with ASD compared with typical developmental sequences. Furthermore, The acquisition of gestures and pragmatics was more impaired in the female subgroup than in the male subgroup. The identified developmental language sequence could help provide a more comprehensive ASD developmental profile.

Transcultural adaptation and psychometric validation of the Thai-Brief Resilient Coping Scale: a cross-sectional study during the coronavirus disease 2019 pandemic in Thailand

This study aimed to examine the transcultural adaptation, construct validity, and psychometric properties of the Thai-Brief Resilient Coping Scale (BRCS) among the general population and college students through the coronavirus disease 2019 (COVID-19) pandemic in Thailand. We invited the 4004 participants to complete sets of anchor-based measurement tools, including depressive symptoms, anxiety symptoms, perceived stress, well-being, and perceived social support. The scale factor structure of the Thai-BRCS was assessed using factor analysis, and nonparametric item response theory (IRT) analysis. The psychometric properties of the Thai-BRCS for validity (convergent and discriminant) and reliability (internal consistency and reproducibility) were assessed. Based on the construct validity testing, factor analysis, and nonparametric IRT analysis reaffirmed the unidimensionality with a one-factor structure of the Thai-BRCS version. For convergent validity, the scale was significantly correlated with all sets of anchor-based measurement tools (all P < 0.001). The discriminant validity was satisfactory with a group of medium and low resilience and the risk of adverse mental outcomes. For scale reliability, it revealed excellent internal consistency (alpha = 0.84, omega = 0.85) and reproducibility (intraclass correlation = 0.91). The Thai-BRCS version fulfills transcultural adaptation with satisfactory psychometric properties to measure psychological resilience in the Thai population during the COVID-19 pandemic.

Using Mokken scaling techniques to explore carelessness in survey research.

Careless responding is a pervasive issue that impacts the interpretation and use of responses from survey instruments. Researchers have proposed numerous useful methods for detecting carelessness in survey research, including relatively simple summary statistics such as the frequency of adjacent responses in the same category (e.g., "long-string" analysis) and outlier statistics (e.g., Mahalanobis distance). Researchers have also used methods based on item response theory (IRT) models to identify examinees whose response patterns are unexpected given item parameters. However, researchers have not fully considered the use of nonparametric IRT methods based on Mokken scale analysis (MSA) to detect carelessness in survey research. MSA is a promising framework in which to consider participant carelessness because it is well suited to contexts in which parametric IRT models may not be appropriate, while still maintaining a focus on fundamental measurement requirements. We used a real data analysis and a simulation study to examine the sensitivity of MSA indicators of response quality to examinee carelessness and compared the results to those from standalone indicators. We also examined the impact of carelessness on the sensitivity of MSA item quality indicators. Numeric and graphical indicators of response quality from MSA indicators were sensitive to examinee carelessness. Graphical displays of nonparametric person response functions (PRFs) provided supplementary insight that can alert researchers to potentially problematic responses. Our results also indicated that MSA indicators of item quality are robust to the presence of participant carelessness. We consider the implications of our findings for research and practice.

Application of nonparametric item response theory in determining the one-dimensionality and adaptability of TOEFL iBT listening test

Listening comprehension in English, as one of the most fundamental skills, has an essential role in the process of learning English. Non-parametric item Response Theory (NIRT) is a probabilistic-nonparametric approach to item response theory (IRT) which determines the one-dimensionality and adaptability of test. NIRT techniques are a useful tool for researchers who wish to construct one-dimensional tests. The current study utilized the NIRT to examine adaptability of TEOFL iBT listening test, administered on 400 EFL university students in the Iranian context. The results illustrated no main concerns in terms of item adaptability. It was concluded that the ordering of items according to their mean is invariant across examinees. Dimensionality analysis results depicted that the test is one dimensional -confirming evidence of the validity of the test in measuring a single ability dimension. The empirical application depicted a potential and feasible approach, whereby NIRT could be used as a valuable method for exploring the behavior of scaled items in response to varying levels of a latent trait in education research.

Short-form adaptive measure of financial toxicity from the Economic Strain and Resilience in Cancer (ENRICh) study: Derivation using modern psychometric techniques.

ObjectivesThis study sought to evaluate advanced psychometric properties of the 15-item Economic Strain and Resilience in Cancer (ENRICh) measure of financial toxicity for cancer patients.MethodsWe surveyed 515 cancer patients in the greater Houston metropolitan area using ENRICh from March 2019 to March 2020. We conducted a series of factor analyses alongside parametric and non-parametric item response theory (IRT) assessments using Mokken analysis and the graded response model (GRM). We utilized parameters derived from the GRM to run a simulated computerized adaptive test (CAT) assessment.ResultsAmong participants, mean age was 58.49 years and 278 (54%) were female. The initial round factor analysis results suggested a one-factor scale structure. Negligible levels of differential item functioning (DIF) were evident between eight items. Three items were removed due to local interdependence (Q3>+0.4). The original 11-point numerical rating scale did not function well, and a new 3-point scoring system was implemented. The final 12-item ENRICh had acceptable fit to the GRM (p<0.001; TLI = 0.94; CFI = 0.95; RMSEA = 0.09; RMSR = 0.06) as well as good scalability and dimensionality. We observed high correlation between CAT version scores and the 12-item measure (r = 0.98). During CAT, items 2 (money you owe) and 4 (stress level about finances) were most frequently administered, followed by items 1 (money in savings) and 5 (ability to pay bills). Scores from these four items alone were strongly correlated with that of the 12-item ENRICh (r = 0.96).ConclusionThese CAT and 4-item versions provide options for quick screening in clinical practice and low-burden assessment in research.