Two-factor Structure Research Articles

Spirituality and mental health – investigating the association between spiritual attitudes and psychosomatic treatment outcomes

BackgroundThe relationship between spirituality and mental health has garnered attention, fostering overall well-being. Spirituality, posited as a protective factor, may enhance resilience and provide meaning, thus benefiting mental health. This study aims to identify spirituality-associated factors influencing clinical outcomes in psychosomatic inpatients and validate the Transpersonal Spirituality Inventory (TSI).MethodsThe study involved 4952 psychosomatic inpatients completing the Transpersonales Vertrauen (TPV) and 7739 patients completing the TSI, with assessments conducted at admission and discharge. Additional instruments included the ISR for symptom rating and the LK-18 for life skills. Factor analysis and Spearman’s rank correlation were used to evaluate the validity of TSI and the relationship between spirituality and clinical outcomes.ResultsFactor analysis confirmed the TSI’s two-factor structure: “centered connectedness” (F1) and “transcendent orientation” (F2), with satisfactory internal consistency (Cronbach’s α = 0.824 for F1 and 0.644 for F2). Higher spirituality levels, particularly in transpersonal trust and centered connectedness, correlated with lower depression and psychosomatic symptoms (ISR). Although these correlations were generally weak, significant associations were found between spirituality and life competences, particularly in meaning, belief, and values (r = .595 for TPV and .598 for TSI F1).ConclusionDespite correlations between psychosomatic health and spirituality as measured with TPV and TSI were rather small several spirituality items could be identified which seem to have a prominent connection to the diagnosis and development of psychosomatic health. Specific spiritual attitudes, such as access to inner stillness and connection to a greater whole, were linked to positive treatment responses and reduced symptom burden. These findings suggest potential benefits in incorporating spirituality into psychosomatic treatments, though its complex and multifaceted nature warrants further investigation.

Caregiver Contribution to Self-Care of Chronic Illness Inventory: Evaluation of Measurement Properties in a Middle-Income Country

Background/Objectives: Caregivers engage in essential tasks that support patients’ well-being and survival, including administering medications, promoting healthy lifestyle choices, and monitoring and managing symptoms. To date, no valid and reliable instrument is available to assess Caregiver Contribution (CC) to self-care in chronic conditions in middle-income countries such as Albania. Aim: To evaluate the measurement properties (structural and construct validity, internal consistency reliability, stability, and measurement error) of the instrument CC to Self-Care of the Chronic Illness Inventory (CC-SC-CII) in Albanian caregivers caring for elderly people affected by multiple chronic conditions. Methods: A cross-sectional study. We enrolled caregivers of patients with multiple chronic conditions, from August 2020 to April 2021, if they were (a) 18 years of age or older and (b) were identified by the patient as the main unpaid caregiver. Results: Confirmatory factor analysis confirmed the two-factor structure of the CC to Self-Care Maintenance and Management scales and the one-factor structure of the CC to Self-Care Monitoring scale. Reliability estimates were adequate for all (coefficients ranging between 0.827 and 0.961). The construct’s validity was supported. The measurement error was adequate. Conclusions: The Albanian version of the CC to Self-Care of the Chronic Illness Inventory features sound measurement properties and is a valid and reliable instrument for assessing caregiver contribution to patient self-care behaviors in the Albanian population.

The Validation of the Perinatal Post-Traumatic Questionnaire in the Italian Population: Risk and Protective Factors

Background: Postpartum Post-Traumatic Stress Disorder (P-PTSD) symptoms develop after experiencing childbirth as traumatic. Several individual and environmental factors influence the childbirth experience. However, in Italy, this phenomenon remains unexplored due to the lack of screening tools. This project aims to validate the Italian version of the Perinatal PTSD Questionnaire (PPQ-II) and to identify maternal, pregnancy, childbirth, and postpartum risk and protective factors associated with P-PTSD. Methods: A total of 702 women (6–24 months postpartum) participated in an online cross-sectional study. They completed the PPQ-II, Depression Anxiety Stress Scales-21 (DASS-21), Big Five Inventory-10 (BFI-10), and a questionnaire to assess sociodemographic and perinatal factors. Factor structure was estimated with an exploratory (EFA) and confirmatory factor analysis (CFA). Internal consistency of the scale, convergent and divergent analyses were computed. Associations between perinatal factors and P-PTSD were also investigated. Results: The EFA revealed a two-factor structure: “Arousal and Mood alteration” and “Avoidance and Intrusion”. CFA supported the factor structure, showing a good fit of the data. The validity was confirmed by a significant association between the PPQ-II and the DASS-21 and a lower correlation with the BFI-10. Significant associations were found between P-PTSD symptoms and factors across the maternal, pregnancy, childbirth, and postpartum periods. Conclusions: The Italian PPQ-II is a valid screening tool to include in maternity care protocols for the early identification of P-PTSD. This study also contributes to identifying perinatal factors for symptom detection and the promotion of maternal well-being.

Moroccan Adaptation of the 'Self-Care Behaviour Assessment Scale' for Arteriovenous Fistula in Haemodialysis.

Arteriovenous fistula self-care behaviours in patients receiving haemodialysis are essential to maintain patency of vascular access and prevent its life-threatening complications. Assessing arteriovenous fistula self-care behaviours in patients receiving haemodialysis requires a reliable and valid tool. The aim of this study was to adapt and translate the Portuguese scale for the assessment of self-care behaviours of arteriovenous fistula in patients receiving haemodialysis into the Moroccan dialect and evaluate its psychometric properties in the Moroccan context. A quantitative cross-sectional validation study. This study included 283 patients undergoing haemodialysis with arteriovenous fistula in the Marrakech-Safi region of Morocco. The translation was performed in accordance with international guidelines. Instrument validity was assessed using content validity and factor analysis with Varimax rotation for construct validity. Instrument reliability was assessed by measuring internal consistency using Cronbach's α. Content validity was assessed by a panel of experts. The Kaiser-Meyer-Olkin score of 0.885 justified data adaptation for factorial analysis. Bartlett's sphericity test confirmed the existence of significant relationships (chi-square = 1347.328; p < 0.001). A two-factor structure was extracted, explaining 50.85% of the total variance. Cronbach's α was 0.892, 0.853 and 0.752 for the overall scale, the self-care subscale for managing signs and symptoms and the self-care subscale for preventing complications, respectively. The Moroccan version of the Self-Care Behaviour Assessment Scale for Arteriovenous Fistula is a reliable and valid instrument for future studies evaluating the self-care behaviours of patients receiving haemodialysis with an arteriovenous fistula in Morocco.

Latent Structure and Profiles of Emotion Regulation: Reappraisal and Suppression Patterns with the Polish Version of the Emotion Regulation Questionnaire.

Background/Objectives: The Emotion Regulation Questionnaire (ERQ) is a 10-item self-report measure of two emotion regulation strategies, cognitive reappraisal (CR) and expressive suppression (ES). This study aimed to (1) examine the latent structure of the Polish version of the ERQ, and (2) use it to explore different profiles of emotion regulation strategy use and their links with mental health outcomes. Methods: Our sample was 1197 Polish-speaking adults from the general community in Poland. Results: A factor analysis showed that the ERQ had strong factorial validity, with an intended two-factor structure (CR and ES factors) that was invariant across gender, age, and education categories, as well as across different levels of psychopathology symptoms and alexithymia. Our latent profile analysis extracted four emotion regulation profiles (subtypes): a Mainly Reappraisal profile (high CR, low ES), a Mainly Suppression profile (low CR with high ES), a Generally Low Regulation profile (low CR, low ES), and a Generally High Regulation profile (high CR, high ES). People with the Mainly Reappraisal profile had the best mental health outcomes, whereas people with the Mainly Suppression profile had the poorest mental health outcomes. Conclusions: Conceptually, these findings support the process model of emotion regulation, illustrating the differential affective outcomes of various emotion regulation strategies. Our results highlight the importance of considering individual differences in strategy use patterns, including combinations of strategies within an emotion regulation profile. The Polish version of the ERQ appears to be a robust measure of these key emotion regulation processes across a variety of demographic groups. To facilitate its use, including score interpretations in clinical practice, we present Polish percentile rank norms for the ERQ.

How you ask matters: evidence-based assessment connecting decentering, reappraisal, and self-reported wellbeing in a post-secondary sample

Effective and efficient Wellbeing measurement is essential within the social sciences and public health. Wellbeing is described as a three-factor construct composed of Life Satisfaction, Positive Affect, and Negative Affect, yet there are few measurement models validated for the increasingly popular use of longitudinal, app-based assessment. We explored Wellbeing measurement in a postsecondary student sample, including two mechanistic indicators described in Mindfulness-to-Meaning Theory: Decentering and Positive Reappraisal. Across two studies, we compared and validated popular measurement models for each construct. The most parsimonious Wellbeing model indicated only a two-factor structure comprised of positive (e.g., happiness, life satisfaction, and flourishing) and negative dimensions (e.g., anger, sadness, and anxiety). A third study revealed that a three-factor structure for Wellbeing was only supported when sampling a greater diversity of positive emotions than the earlier studies. Furthermore, while the Mindfulness-to-Meaning pathway to Wellbeing was replicated, only some operationalizations of Decentering and Reappraisal accounted for variance in Wellbeing. Concrete recommendations for the longitudinal assessment are provided. This research contributes not only to our understanding of Wellbeing, but also informs its optimal assessment in longitudinal research such as clinical trials and experience sampling studies.

The student feedback literacy instrument (SFLI): multilingual validation and introduction of a short-form version

Feedback literacy is gaining recognition as a key concept for understanding how engage with and learn from feedback in higher education. This study presents validity evidence for a refined version of the Student Feedback Literacy Instrument (SFLI), designed to measure the construct across two dimensions—feedback attitudes and feedback practices—in German, English, and Turkish. We developed both a full-length and a short-form version (SFLI-S). Using confirmatory factor analyses on different student samples (N total= 1424), we confirmed the two-factor structure across languages, supporting the model of feedback literacy comprising of attitudinal and behavioral components. Associations with related constructs further support the instrument’s convergent validity. As a psychometrically sound, multilingual instrument, the SFLI can facilitate cross-cultural feedback literacy research and provide a valuable tool for research and educational practice. The SFLI-S offers an economical alternative, enabling wider integration into studies on how students engage with feedback.

Translation and cultural adaption of MacLeod Clark professional identity scale among Chinese therapy students.

Fostering a strong professional identity (PI) enhances career fulfillment. In China, therapy education is undergoing development, integrating both Western and traditional health concepts, causing inconsistent PI among therapy students. To date, no validated tools exist to measure and monitor PI of Chinese therapy students. This study aimed to translate and validate the 9-item MacLeod Clark Professional Identity Scale (MCPIS-9) for this purpose. This study involved translation and cultural adaptation of the MCPIS-9, followed by a rigorous assessment of its model fit and psychometric properties using data collected via an online questionnaire. A forward- and backward- translation process was conducted. Content validity was evaluated using item-level content validity index (I-CVI) and scale level content validity index average method (S-CVI/Ave). Therapy students across all grades at undergraduate and postgraduate levels in China were eligible. Exploratory factor analysis (EFA) examined the underlying factor structure. Model fit was evaluated through confirmatory factor analysis (CFA) using the Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Standardized Root Mean Square Residual (SRMR) and Root Mean Square of Error of Approximation (RMSEA). Convergent validity was assessed through Pearson's correlations coefficient (r) with the Professional Identity Scale for Health Students and Professionals (PISHSP). Internal consistency was examined using Cronbach's Alpha (Cα) and McDonald's Omega (ω). A total of 1054 students participated. Content validity was excellent (I-CVI = 0.86-1.0, S-CVI/Ave = 0.98). EFA indicated a two-factor structure with acceptable model fit (CFI = 0.978; TLI = 0.968; SRMR = 0.033; RMSEA = 0.063). Reliability was strong (Cα = 0.835; ω = 0.817). Convergent validity demonstrated a strong correlation (r = 0.75) with the PISHSP. The Chinese MCPIS-9 is a reliable and valid tool for assessing PI among therapy students. Future research could focus on refining item 4 of this tool, potentially through further exploration of therapy students' perceptions of PI within the unique context of the Chinese healthcare system.

Psychometric assessment of scales used to evaluate sexual assault prevention programming in the United States Air Force.

Preventing sexual assault in the United States (U.S.) military is essential to safeguard the overall well-being of military personnel and support the military to function in alignment with its intended mission and objectives. Valid instruments are needed to accurately and reliably evaluate programming effectiveness. The goal of this research was to psychometrically assess measures used to evaluate the Sexual Communication and Consent (SCC) program within the Air Force Basic Military Training (BMT) context. We evaluated four measures used to assess the SCC program implemented at Air Force BMT in 2019-2020: Date Rape Attitudes, Self-Efficacy to Resist Unwanted Advances, Risky and Protective Dating Behaviors, and Bystander Intentions. The analytic sample included 7,126 BMT trainees (74% male). We assessed structural validity with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We used full information maximum likelihood estimation with robust standard errors in Mplus. We refined each scale based on factor analysis results and assessed internal consistency reliability by computing Cronbach's coefficient alpha for each scale in the overall sample, by sex, and by tailored SCC intervention group. We identified a two-factor structure for the Date Rape Attitudes scale; subscale reliability was moderate within the overall sample and among males, though low among females. We found single-factor structures and excellent reliability for both the Self-Efficacy to Resist Unwanted Advances scale and the Bystander Intentions scale. The Dating Behaviors scale CFA did not confirm the two-factor solution suggested by the EFA, but subscale reliability was acceptable. This research fills a critical gap in the psychometric literature in military settings. Based on our findings, we recommend approaches for using the finalized scales in future evaluations of sexual assault prevention programming in the U.S. Air Force BMT setting.

The structure and correlates of the Narcissistic Admiration and Rivalry Questionnaire among U.S. racial/ethnic groups.

Research on externalizing psychopathology has relied heavily on White samples to generate core knowledge, with few studies examining variability in its components, including grandiose narcissism, across racial/ethnic groups. This preregistered (https://osf.io/n4s3f/) study addressed the following research questions: (1) Is there evidence for measurement invariance of the Narcissistic Admiration and Rivalry Questionnaire (NARQ) across racial/ethnic groups?; (2) Are there racial/ethnic group differences in (a) mean levels of the two NARQ subscales: admiration and rivalry, and (b) correlations between NARQ subscales and self-esteem?; (3) Do variations in ethnic identity commitment account for any observed group differences in the mean levels and correlations? The sample consisted of 1,248 U.S. adults between ages 18 and 30, evenly divided among those self-identifying as Black, Latine, and White. Both Confirmatory Factor Analysis and Exploratory Structural Equation Modeling indicated the intended two-factor structure across groups demonstrated configural, metric, scalar, and residual invariance. Group mean differences were most pronounced for the admiration subscale, with Black adults scoring higher than White (d = 0.63) and Latine adults (d = 0.46-0.47). Black-White mean differences in admiration were reduced by half when accounting for group differences in ethnic identity commitment. As admiration captures assertive self-promotion, participants identifying strongly as Black may endorse greater agency as an adaptive response to marginalization. Black-Latine mean differences were unaffected by group differences in ethnic identity commitment. This article highlights the importance of, and provides a framework for, psychometric examinations before interpreting group mean differences. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Translating and Validating the Japanese Version of the Tolerance for Ambiguity Scale

Abstract Background Ambiguity is inherent in medicine, and tolerance for ambiguity (TFA) has recently been of substantial interest. Effective medical education for TFA requires a validated inventory; one validated measure in wide use is the seven-item TFA scale. In Japan, however, a tool for measuring TFA in undergraduate medical education has not been available. Here, we aimed to develop and validate the Japanese version of the TFA scale (J-TFA scale). Methods We translated the original English scale into Japanese following an international guideline. We then conducted a validation survey by distributing an online anonymous self-administered questionnaire to medical students at three medical schools in Japan. We assessed the structural validity and internal reliability of consistency of the scale. Results A total of 399 participants were included in our analysis. We used a split-half validation approach, with exploratory factor analysis (EFA) on the first half and confirmatory factor analysis (CFA) on the second. EFA indicated a two-factor structure. CFA showed that the two-factor structure suggested by EFA had acceptable model fitness indices. Cronbach’s alpha was 0.72, exceeding the satisfactory internal reliability consistency criteria. Conclusions The J-TFA scale was developed and its psychometric properties were confirmed. This instrument may be useful for future educational interventions and research on TFA.

Validation of the I- and D-type epistemic curiosity scale among young Chinese children and implications on early curiosity nurture

Curiosity, an innate and intrinsic motivation to explore, makes vital contributions to learning in individuals of various ages. Epistemic curiosity centers on the drive to close information gaps and can be classified into joyous exploration and interest (I) and deprivation sensitivity (D) types. Each subtype is associated with different academic achievements, personality traits, emotions, and aspects of creativity. Building on the concept of epistemic curiosity in adults, the I- and D-type Epistemic Curiosity in Young Children (I/D-YC) scale was developed. The purpose of the present study was to validate the Chinese I/D-YC scale for preschoolers. Both exploratory factor analyses of data from 111 parents (Sample 1) and confirmatory factor analyses of data from 389 parents (Sample 2) indicated that the Chinese I/D-YC replicated the two-factor structure of the original scale. The scales’ convergent validity was examined with data from 189 parents (Sample 3) and 129 teachers (Sample 4), as its reliability and test–retest reliability was respectively examined with data from 389 to 82 parents (from sample 2). The results established the Chinese I/D-YC scale as a valid and reliable measure of epistemic curious behaviors in young Chinese children. Moreover, the cultivation of epistemic curiosity should weaken inhibition and this might enhance well-being and creativity and learning.

Factorial validation and invariance of the Academic Procrastination Scale in Colombian students

BackgroundAcademic procrastination is an increasingly pertinent issue among university students, impacting their academic performance, interpersonal relationships, and emotional well-being. However, brief assessment tools for timely intervention are scarce, especially in the Colombian context. Therefore, this study aims to evaluate the psychometric properties of the academic procrastination scale and analyze its relationship with mental health and life satisfaction. MethodsA total of 805 Colombian university students were selected through convenience sampling. Their ages ranged from 17 to 35 years, with an average age of 20.4 years (SD = 3.0). ResultsThe findings reveal a modified two-factor structure of the scale, with adequate fit indices (χ2 = 65.65, df = 13, p < .001; CFI = .96, TLI = .93, RMSEA = .07 (90% CI .06 − .09), SRMR = .03) and loadings above .50. Furthermore, both factors of the scale exhibited high reliability, with Cronbach’s alpha and McDonald’s omega coefficients greater than .80. The scale was also found to be gender invariant. Lastly, academic procrastination correlates positively with mental health and negatively with life satisfaction, while mental health relates negatively to life satisfaction.ConclusionThe Modified Academic Procrastination Scale (EPA-C) demonstrates adequate psychometric properties and is gender-invariant for assessing academic procrastination among Colombian university students. Moreover, it has an impact on the mental health and life satisfaction of these students.

Psychometric Properties of The Parental Stress Scale for Parents of Children with Intellectual and Developmental Disabilities.

Parental stress can be debilitating for parents and their families. This is particularly true for parents who have a child with autism spectrum disorder (ASD) or other intellectual and developmental disability (I/DD). Effective screening and measurement of parental stress leads to accurate and effective intervention. The purpose of this study was to understand the psychometric properties of the Parental Stress Scale (PSS) for families who have a child with I/DD (ages ranging from 1 to 18 years old, with a mean of 5.28). Caregivers of 3220 families who have a child with I/DD (91% diagnosed with ASD) completed the scale. The psychometric properties including internal reliability and factor structure were completed as well as discriminant validity. Results of confirmatory factor analysis with the 18-item scale revealed a poor model fit with three items not meeting minimum factor loading threshold. Given this, the three items were removed, and confirmatory factor analysis was reconducted with 15 items of the PSS. Results revealed good internal consistency and discriminant validity, as well as a good model fit with all 15 items loading above the minimum threshold. The identified two-factor structure is consistent with the dichotomous (rewarding/burdensome) construct of parental stress that Berry and Jones (J Soc Pers Relationsh 12(3):463-472, 1995) originally designed the scale to index. Thus, the 15-item PSS has initial psychometric evidence in a large sample of families with a child with I/DD.

Italian version of the Headache Disability Inventory: Cross-cultural adaptation, validity, and reliability.

To translate and cross-culturally adapt the Headache Disability Inventory (HDI) into Italian and study its reliability and validity. A total of 132 participants with primary and secondary headaches were included. The translation was performed following international guidelines with forward and back translation procedures. Structural validity, internal consistency, test-retest reliability, measurement error, and construct validity were studied. Test-retest reliability and measurement error were tested on a subsample of 32 participants. The cross-cultural adaptation into Italian was performed without issues. Confirmatory factor analysis supports the structural validity partially (comparative fit index = 0.963; Tucker-Lewis index = 0.959; root mean square error of approximation = 0.051; standardized root mean square residual = 0.084), showing a two-factor structure (i.e., emotional and functional). Each subscale presented high internal consistency (α = 0.87 and 0.87 for the emotional and functional subscales, respectively), excellent and good test-retest reliability (intraclass correlation coefficient = 0.93 and 0.88 for the emotional and functional subscales, respectively), and acceptable measurement error (standard error of the measurement [SEM] = 3.6 points, minimal detectable change [MDC] = 10.0 points for the emotional subscale; SEM = 3.8 points, MDC = 10.7 points for the functional subscale). Construct validity was satisfactory for the emotional subscale and moderate for the functional subscale, as 85.7% (6/7) and 57.1% (4/7) of a priori hypotheses were met, respectively. The HDI was successfully translated into Italian and has acceptable psychometric properties. The Italian version of the HDI can be used in daily clinical practice and research to assess the functional and emotional impact of primary and secondary headaches. Further research should study other psychometric properties (i.e., content validity, responsiveness, and reliability in a larger sample).

Internal structure of the Patient Health Questionnaire-9: A systematic review and meta-analysis.

This review aimed to evaluate the internal structure (structural validity, internal consistency, and measurement invariance) of the Patient Health Questionnire-9 (PHQ-9), which is one of the most widely used self-administered instruments for assessing and screening depression. The updated COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology for a systematic review of self-reported instruments was used. PubMed, Embase, CINAHL, PsycINFO, and Cochrane Library databases were searched from their inception up to February 28, 2023. This study reviewed 98 psychometric studies reported on in 90 reports conducted in 40 countries. Various versions of the PHQ-9 were identified: one-factor structures (8 types), two-factor structures (10 types), bifactor structures (4 types), three-factor structure (1 type), and second-order three-factor structure (1 type). There was sufficient high-quality evidence for structural validity of the one-factor structure with nine items scored using a four-point Likert scale based on confirmatory factor analysis, for internal consistency with a quantitatively pooled Cronbach's alpha of .85, and for measurement invariance across sex, age, education level, marital status, and income groups. There was sufficient high-quality evidence for structural validity, internal consistency (Cronbach's alpha = .76 - .92, = .83 - .92), and measurement invariance across sex for the PHQ-8 (which excluded item 9: "suicidality or self-harm thoughts"). The one-factor PHQ-9 and PHQ-8 (excluding item 9) scored using a four-point Likert scale have the best internal structure based on the current evidence. The one-factor PHQ-9 and PHQ-8 justify the use of aggregated total scores in both practice and research. The total score of the PHQ-9 using a four-point Likert scale can be used to compare depression levels across sex, age, education level, marital status, and income groups due to the availability of sufficient evidence for measurement invariance across these demographic groups.

Second Generation DNA Methylation Age Predicts Cognitive Change in Midlife: The Moderating Role of Childhood Socioeconomic Status.

DNA methylation age (DNAmAge) surpasses chronological age in its ability to predict age-related morbidities and mortality. This study analyzed data from 287 middle-aged twins in the Louisville Twin Study (mean age 51.9 years ± 7.03) to investigate the effect of DNAmAge acceleration on change in IQ (ΔIQ) between childhood and midlife, while testing childhood socioeconomic status (SES) as a moderator of the relationship. DNAmAge was estimated with five commonly used algorithms (Horvath, Horvath Skin and Blood, GrimAge, and PhenoAge). A factor analysis of these measures produced a two-factor structure which we identified as first generation and second generation measures. Results of genetically informed, quasi-causal regression models indicated that accelerated second generation DNAmAge predicted more negative ΔIQ from childhood to midlife, after accounting for genetic and environmental confounds shared by twins. The relationship between DNAmAge and ΔIQ was moderated by childhood SES, with a stronger effect observed among twins from low SES backgrounds. Second generation DNAmAge measures trained to estimate phenotypic biological age show promise in their predictive value for cognitive decline in midlife. Our genetically informed twin design suggested that DNAmAge may represent a biological pathway through which early-life socioeconomic disadvantage impacts midlife cognitive health.

Social Media Bashing Assessment Scale (SM-BASH): Development and Psychometric Testing

The pervasive use of social media exposes individuals to negative experiences, including social media bashing, which profoundly impacts mental health, yet there is a conspicuous lack of a standardized scale to assess these experiences. This study assessed the psychometric properties of the Social Media Bashing Assessment Scale (SM-BASH). A total of 978 college students from the Philippines participated in the study. An exploratory factor analysis (EFA) was conducted to determine the underlying structure of the SM-BASH, followed by a confirmatory factor analysis (CFA) to validate the model. The scale’s reliability was examined using Cronbach’s alpha and inter-item/inter-total correlation, while its validity was examined through content and criterion validity tests. The EFA and CFA revealed a two-factor structure model, which explained 70.57% of the total variance, comprising ‘Explicit Social Media Bashing’ and ‘Implicit Social Media Bashing’. The scale demonstrated excellent criterion validity and high internal consistency, with a Cronbach’s alpha of .92. The 10-item SM-BASH is a valid and reliable tool for quantifying negative encounters on social media platforms, particularly among student populations. Its strong psychometric properties make it appropriate for use in research and potentially in clinical settings to assess and address the impacts of social media bashing on individuals’ well-being.

Cross-cultural translation, validation, and responsiveness of the Pittsburgh Fatigability Scale - Italian version (PFS-I) in a mixed-sample of older adults

IntroductionOlder adults experience fatigue which impacts health-related quality of life. The Pittsburgh Fatigability Scale (PFS) was specifically designed to assess perceived physical and mental fatigability in older adults. The aim of this study was to translate the PFS into Italian (PFS-I) and to investigate its psychometric properties.MethodsThe PFS-I was translated in accordance with international standards. The following properties were evaluated: structural validity, internal consistency, hypotheses testing for construct validity, test-retest reliability using intraclass correlation coefficients (ICC), and minimal clinically important difference (MCID) for responsiveness.ResultsThe study included 87 older adults with cardiovascular/respiratory diseases (CVRD), 46 with Parkinson disease (PD), and 67 healthy controls (HC). The PFS-I Physical and Mental subscales scores were significantly different in these populations, with HC reporting the lowest fatigability. Exploratory and confirmatory factor analysis showed a two-factor structure for both subscales, with good internal consistency (Cronbach’s alpha: 0.86 and 0.89, respectively). The PFS-I Physical subscale showed weak goodness-of-fit of the confirmatory factor analysis models, whereas the PFS-I Mental subscale was deemed acceptable. Construct validity of the PFS-I was excellent with 75% (18 out of 24) of hypotheses accepted. Test-retest reliability was analyzed in a subset of 23 patients with CVRD and showed excellent results for both the PFS-I Physical and Mental subscales (ICC = 0.93 and 0.92, respectively). MCID ranged between 6 and 7 points for the Physical and 7–9 points for the Mental subscale.ConclusionsThe PFS-I is a valid, reliable, and responsive instrument to assess perceived fatigability for healthy older adults as well as those with CRVD and PD.

Confirmatory validation of the transgender health care humanization scale

BackgroundDespite the critical importance of humanized healthcare for transgender individuals, no existing measures specifically assess care humanization for this population. The Transgender Health Care Humanization Scale (THcH Scale) was developed to address this gap, yet it initially lacked confirmatory validation. This study validates the Transgender THcH scale for evaluating healthcare providers’ sensitivity towards transgender patients.MethodsThis study involved 443 healthcare professionals and students from a public university and associated hospital. Participants were divided randomly into two groups for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Using the Kaiser-Meyer-Olkin Measure of Sampling Adequacy and Bartlett’s Test of Sphericity, EFA confirmed data suitability for factor analysis. Factors were identified using parallel analysis with an oblique Promax rotation to allow for inter-factor correlations. The internal consistency of the factors was assessed using Cronbach’s alpha. CFA was performed using Maximum Likelihood estimation, with goodness-of-fit evaluated by multiple indices. The THcH Scale’s divergent validity was assessed through Spearman’s correlation analysis with the Duke University Religion Index (DUREL).ResultsExploratory and Confirmatory Factor Analyses confirmed the scale’s two-factor structure with excellent psychometric properties, including high internal consistency (Cronbach’s alpha > 0.8) and good fit indices (χ²/df = 1.74, CFI = 0.972, TLI = 0.964, GFI = 0.989, RMSEA = 0.069, SRMR = 0.043). Divergent validity was established through moderate correlations with the DUREL index.ConclusionsThe THcH scale is a reliable and valid tool for promoting sensitivity and awareness among healthcare professionals, thereby enhancing healthcare access and quality for the transgender population. Further research should expand its application to primary care and diverse populations and settings.