Factor Structure Validity Research Articles

Validation of the athletic mental energy scale for Chinese school-age adolescents

Mental energy is an important factor in many domains, including athletic performance. The athletic mental energy scale (AMES) is one of the established tools available to measure athletes’ perceived mental energy state. To date, there is no validated questionnaire to assess athletic mental energy for Chinese adolescents. Therefore, purpose of this study was to validate a Chinese version of AMES (C-AMES) among the Chinese adolescents in Lanzhou, Gansu Province, China. We sampled 729 adolescents aged 14 to 18 in five middle schools in Lanzhou City, Gansu Province, China to complete the revised C-AMES. Data were analyzed for factor structure validity by performing CFA. The results showed that the fit index was acceptable (RMSEA = 0.050, CFI = 0.962, TLI = 0.951), and a six-factor model containing 18 C-AMES items had good measurement properties for athletic mental energy. We suggest future study may use C-AMES to examine the relationship between athletes’ mental energy and athletic performance and sporting behavior.

Psychometric properties of MG-ADL items and MG-ADL score: An assessment of distributional characteristics, validity and factor structure in two large datasets

BackgroundThe Myasthenia Gravis–Activities of Daily Living scale (MG-ADL) is an 8-item outcome measure to assess symptoms and functional limitations in myasthenia gravis (MG) patients. The MG-ADL score is an equally weighted level sum score that is used as primary outcome measures in clinical trials, in clinical practice, and as an end-point in health economic evaluation. This data analysis aims to obtain detailed knowledge of measurement properties of MG-ADL items and the MG-ADL score. MethodsCross-sectional data from a real-world prospective study (MRW) were combined with longitudinal data from the ADAPT trial. Outcome measures included were MG-ADL, Quantitative Myasthenia Gravis score (QMG), MG 15-item Quality of Life (MG-QOL15r) and EQ-5D-5L. Patients were categorized by their Myasthenia Gravis Foundation of America (MGFA) clinical classification. The following measurement properties were assessed: distributional characteristics, inter-item correlation, convergent, known groups and construct validity and internal factor structure. ResultsCorrelations of items within MG-ADL dimensions were moderate, while MG-ADL correlations between comparable MG-QOL15r and QMG items were mixed. Known groups validity for the MG-ADL score was demonstrated for MGFA class. Mean MG-ADL item level scores by MGFA class demonstrated construct validity. PCA, including all four outcome measures, resulted in a nine factor solution. DiscussionPsychometric properties of individual MG-ADL items were moderate to good. This study showed that the MG-ADL adequately captures the multidimensional heterogeneous nature of MG. This is, however, accompanied by mixed psychometric performance of the MG-ADL score, which may complicate health economic modelling.Registration: MyRealWorld-MG was registered on November 25, 2019, with registration numberNCT04176211. The ADAPT randomized clinical trial is registered atClinicalTrials.gov(NCT03669588).

Validation of the Standardized Needs Evaluation Questionnaire in Polish Cancer Patients.

Cancer influences various aspects of patients' functioning. Cancer patients face not only medical problems but also organizational, socio-psychological, and spiritual problems. Their needs often seem to be unrecognized because patients do not express their concerns and clinicians do not ask appropriate questions. Unmet needs impact patients' quality of life. The aim of this study was to select, adapt, validate, and introduce a simple instrument for estimating cancer patients' unmet needs in Poland. The Needs Evaluation Questionnaire (NEQ) was chosen for validation in a Polish population. The Polish version of the NEQ was developed with a back-translation procedure, as approved by a psycho-oncologist and a public health specialist. The psychometric properties of the NEQ (content analysis, reliability, construct validity, comprehensibility, and acceptability) were measured. This study was performed on a group of 121 cancer patients. The median time of completion for the NEQ was 10 min. The form, length, and font size of the NEQ were accepted by the respondents. Overall, the meaning of the questions was well understood, with only a few cases of discreetly heterogeneous interpretation of the content. The questionnaire showed good reliability and internal factor structure validity. The NEQ is a simple, easy-to-administer instrument with good psychometric properties and seems to be useful in assessing the unexpressed needs of cancer patients.

Validation of factor structure of the neurodevelopmental parent report for outcome monitoring in down syndrome: confirmatory factor analysis.

The Neurodevelopmental Parent Report for Outcome Monitoring (ND-PROM), initially developed to monitor developmental and behavioral functions in children with autism spectrum disorder (ASD), assesses symptoms across a wide range of domains relevant in Down syndrome (DS). Psychometric properties of ND-PROM were assessed in 385 individuals with DS and 52 with a combined diagnosis of DS and ASD (DS+ASD), whose caregivers completed the ND-PROM questionnaire for a clinical visit in a specialized Down syndrome program at a tertiary pediatric hospital. Confirmatory factor analysis was conducted to evaluate the internal structure validity of the ND-PROM. Measurement invariance was assessed, with a comparison group of 246 individuals with ASD, and latent mean differences between the DS and ASD-only groups, as well as the combined DS+ASD groups, were assessed. Findings support the existence of the 12 clinically-derived factors in the DS population: Expressive Language, Receptive Language, Adaptive skills/Toileting, Social Emotional Understanding, Social Interaction, Independent Play, Sensory Processes, Challenging Behaviors, Impulse/ADHD, and Mental Health. Differences in response patterns of development and behaviors were observed between those with DS and those with ASD, including those with DS having higher abilities in nonverbal communication, social emotional understanding, and social interaction, and fewer restricted and repetitive behaviors and interests, impulsivity or ADHD symptoms, and mental health concerns compared to those with ASD. Individuals in the DS+ASD group had more difficulties with expressive and receptive language, nonverbal and social communication, social interaction, independent play, and adaptive skills than either the DS-only group or the ASD-only groups. The ND-PROM has a desirable factor structure and is a valid and clinically useful tool that captures a range of distinct and independent areas of developmental and behavioral functioning in DS, for individuals with and without an ASD diagnosis.

Development and Testing of the School Healthcare Partnership Scale for Parents.

Cooperation between parents and school nurses is essential for the successful completion of school courses and a healthy school life for children with long-term conditions. Therefore, this study aimed to develop and test a scale to measure parental perceptions of partnerships between school nurses and parents in the school health care (SHC) system for children with type 1 diabetes (T1D). The content validity, factorial structure validity, convergent validity, discriminant validity, known-group validity, internal consistency reliability, and test-retest reliability of the School Healthcare Partnership Scale for Parents (SHCPS-P) were evaluated. Data were analyzed by performing exploratory factor analysis (EFA), Pearson's correlation, Cronbach's α, and independent t-tests. The total sample included 155 parents for the EFA and 49 parents for the stability test. Seventeen items, grouped into 3 dimensions, were extracted through principal axis factoring. The total variance explained by these factors was 53.57%. The scale demonstrated a high correlation with parental satisfaction regarding school nursing and a moderate correlation with diabetes-related safety, thereby showing convergent validity. A low correlation with empathy demonstrated discriminant validity. A significant difference existed in the partnership scores in known-group comparisons. Cronbach's α was 0.95, and the test-retest correlation coefficient was 0.95, which showed reliability. This study suggests that the SHCPS-P is a reliable and valid tool for measuring the perception of SHC partnership among parents of children with T1D and can be used as an indicator to measure parents' perspectives about SHC.

Assessment of perinatal anxiety: diagnostic accuracy of five measures.

Anxiety in pregnancy and after giving birth (the perinatal period) is highly prevalent but under-recognised. Robust methods of assessing perinatal anxiety are essential for services to identify and treat women appropriately. To determine which assessment measures are most psychometrically robust and effective at identifying women with perinatal anxiety (primary objective) and depression (secondary objective). We conducted a prospective longitudinal cohort study of 2243 women who completed five measures of anxiety and depression (Generalized Anxiety Disorder scale (GAD) two- and seven-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS)) during pregnancy (15 weeks, 22 weeks and 31 weeks) and after birth (6 weeks). To assess diagnostic accuracy a sample of 403 participants completed modules of the Mini-International Neuropsychiatric Interview (MINI). The best diagnostic accuracy for anxiety was shown by the CORE-10 and SAAS. The best diagnostic accuracy for depression was shown by the CORE-10, SAAS and Whooley questions, although the SAAS had lower specificity. The same cut-off scores for each measure were optimal for identifying anxiety or depression (SAAS ≥9; CORE-10 ≥9; Whooley ≥1). All measures were psychometrically robust, with good internal consistency, convergent validity and unidimensional factor structure. This study identified robust and effective methods of assessing perinatal anxiety and depression. We recommend using the CORE-10 or SAAS to assess perinatal anxiety and the CORE-10 or Whooley questions to assess depression. The GAD-2 and GAD-7 did not perform as well as other measures and optimal cut-offs were lower than currently recommended.

The Tardive Dyskinesia Impact Scale (TDIS), a novel patient-reported outcome measure in tardive dyskinesia: development and psychometric validation

BackgroundTardive dyskinesia (TD), a movement disorder in which patients experience abnormal involuntary movements, can have profound negative impacts on physical, cognitive, and psychosocial functioning. The Abnormal Involuntary Movement Scale (AIMS), a clinician-rated outcome, is considered the gold standard for evaluating treatment efficacy in TD clinical trials. However, it provides little information about the impacts of uncontrolled movements from a patient perspective and can be cumbersome to administer in clinical settings. The Tardive Dyskinesia Impact Scale (TDIS) was developed as a patient-reported outcome measure to fulfill the need for a disease-specific impact assessment in TD. The objective of the present study was to develop and evaluate the psychometric properties of the TDIS to determine whether it is fit-for-purpose to measure TD impact.MethodsData from qualitative studies and phase 3 trials of a VMAT2 inhibitor for the treatment of TD (KINECT3 and KINECT4) were used to determine the psychometric properties of the TDIS. Qualitative research included concept elicitation and cognitive debriefing interviews with TD patients and their caregivers in order to assess how well the TDIS captured key domains of TD impact. Quantitative analyses to examine the psychometric properties of the TDIS included assessing construct validity (factor structure, known groups, and predictive validity) and responsiveness to change.ResultsQualitative results showed that the TDIS captures the key TD impacts reported by patients and caregivers and that the TDIS was interpreted as intended and relevant to patients’ experiences. Quantitative results found evidence of 2 underlying domains of the TDIS: physical and socioemotional (Comparative Fit Index > 0.9). Known groups and predictive validity indicated that, compared with the AIMS, the TDIS captures unique content (correlation between AIMS and TDIS = 0.2–0.28). The TDIS showed responsiveness to change in treatment, with TDIS scores improving over 48 weeks in the 2 phase 3 trials.ConclusionsThe TDIS captures relevant information about the impact of TD and is easily administered in a clinician’s office or patient’s home. It may be used longitudinally to show changes in TD burden over time. The TDIS complements the AIMS; using these assessments together provides a more holistic assessment of TD.

Factor Structure Validation and Measurement Invariance Testing of the Five C’s Model of Positive Youth Development among Emerging Adults in Malaysia

While validation of positive youth development (PYD) measures has increased considerably of late, validation of the Five C’s of PYD among emerging adults in non-WEIRD countries remains limited. The main objective of this study was to examine the factor structure, measurement invariance, and criterion-related validity of the Five C’s model of PYD through the use of the Positive Youth Development Inventory (PYDI). Data were collected from 436 university students in Malaysia, with a mean age of 21.19 ( SD = 1.19). The findings supported a modified bifactor model of the PYDI, which demonstrated strong measurement invariance across gender and race, but not across age categories. Connection showed the strongest latent factor correlations with the other four C’s. Criterion-related validity was supported through its association with psychological hardiness. The findings demonstrate adequate psychometric properties and cultural applicability of a modified bifactor model of the Five C’s model of PYD among emerging adults in Malaysia.

Amsterdam complex pelvic pain symptom scale with subscales: Based on a Norwegian translation, psychometric assessment and modification of the Amsterdam hyperactive pelvic floor scale.

Women with an abnormally high pelvic floor muscle tone may have a clinical presentation that is complex, involving urinary, anorectal and/or sexual dysfunction, genital/pelvic pain and psychological distress. The Amsterdam Hyperactive Pelvic Floor Scale (AHPFS) is a Dutch 30-item condition-specific self-report questionnaire developed to measure these complex pelvic pain symptoms. The aim of this study was to translate the Dutch version into Norwegian, to assess the psychometric properties, and to present a valid factor structure. Translation, back-translation and a review of the back-translated version were performed. Thereafter, a pilot test including feedback from six clinical experts and cognitive interviews with 11 patients from the target group was conducted. Next, a field test was performed among women who were (1) patients at the gynecological outpatient clinic/pelvic floor physiotherapist at St. Olav's Hospital, (2) members of the Vulvodynia or the Endometriosis Patient Associations or (3) female students and employees from the Faculty of Medicine and Health Science, the Norwegian University of Science and Technology, in a web-based survey. To ensure a sample with symptomatic women, only women who scored ≥11 according to the Dutch prespecified factor structure were included in the statistical analyses (n = 232). Content/face validity demonstrated that the questionnaire was perceived as relevant, comprehensive and understandable. Some adjustments in the instructions of the questionnaire and the response categories were made, which lead to the Norwegian translation ACPPS-30. Assessment of the questionnaire's dimensionality revealed a five-factor structure similar to the original Dutch Amsterdam Hyperactive Pelvic Floor Scale (AHPFS) but without the Urinary tract infection factor and seven other items. The translated and modified ACPPS-16 total score and subscales correlated as expected with scales measuring similar conditions. Test-retest reliability demonstrated good stability for scales (intraclass correlation coefficient 0.85-0.93) and single items (weighted kappa values from 0.34 to 0.90). A modified Norwegian version ACPPS-30 was presented, in addition to a shorter version with only 16 of the translated items distributed among five factors similar to the original Dutch version (ACPPS-16). Both versions proved to be valid, stable and reliable tools to investigate complex pelvic pain symptoms possibly due to an abnormally high-toned pelvic floor muscle.

Validation of the inventory of Callous-Unemotional Traits among school-going adolescents in Malaysia.

A key component in the study of antisocial behaviour among adolescents is the presence of callous-unemotional (CU) traits. Among the established tools available to measure CU traits is the Inventory of Callous-Unemotional traits (ICU). To date, there is no validated questionnaire to assess CU traits for the local population. Therefore, there is a need to validate the Malay version of the ICU (M-ICU) so that research can be conducted to explore CU traits among adolescents in Malaysia. The aim of the study is to validate the M-ICU. Two phases of cross-sectional study involving 409 (phase 1 -exploratory factor analysis (EFA), n = 180; phase 2-confirmatory factor analysis (CFA), n = 229) adolescents aged between 13 to 18 years old were conducted from July until October 2020 at six secondary schools in Kuantan district. Participants were selected via multistage random sampling. The ICU was initially translated into Malay language using forward-backward translation procedure by a group of bilingual researchers. Study participants completed the final version of the M-ICU questionnaire and socio-demographic questionnaire. Data was analysed using SPSS version 26 and MPlus software for factor structure validity by performing EFA and CFA. Initial EFA revealed three factors with two items deleted. A further EFA with two factors resulted in the deletion of unemotional factor items. Cronbach's alpha for overall scale improved from 0.70 to 0.74. CFA supported a two-factor solution with 17 items compared to the original English version that has three factors with 24 items. The findings revealed acceptable fit indices (RMSEA = 0.057, CFI = 0.941, TLI = 0.932, WRMR = 0.968). The study revealed that a two-factor model with 17 items of the M-ICU has good psychometric properties. The scale is valid and reliable to measure CU traits among adolescents in Malaysia.

Disability Stigma Perspectives and Practice Survey: Predicting Teacher Efforts to Improve Acceptance

Disability stigma is widespread in society, particularly in schools, and generates long-term risks for those stigmatized. Research shows teachers are well situated to address stigma in classrooms through empirically-based practices. However, disconnect arises between empirical recommendations and practical applications in schools. Therefore, further research was required to identify causes and potential implications. Survey measures for related constructs of teachers’ backgrounds, personal attitudes towards students with disabilities, awareness of public stigma, use of empirically-based practices to increase acceptance, and perceived barriers to implementing practices were not yet developed. In this study, the Disability Stigma Perspectives and Practice (DSPP) survey was created for these purposes. The composite scales were adapted from existing measures or developed originally, and analyzed to ensure reliability, validity, and accurate factor structure. In initial analyses, 142 participants recruited through a school district completed the survey electronically. Correlational, item, and rasch analyses were conducted to revise the scales. Subsequently, 330 additional participants from the school district responded to finalized measures. Further correlational analyses, and exploratory and confirmatory factor analyses were completed. Implementation of the DSPP allows for examination of teachers’ impacts on use of empirically-based practices to address disability stigma, and informs methods of supporting teachers for this purpose.

Development and validation of a comprehensive health literacy tool for adults in Hong Kong.

Health literacy (HL) refers to an individual's ability to process and use health information to make health-related decisions. However, previous HL scales did not fully cover all aspects of this concept. This study aimed to develop a comprehensive Hong Kong HL scale (HLS-HK) and evaluate its psychometric properties among Chinese adults. A scale of 31-item covering Nutbeam's framework, namely functional and interactive HL (FHL and IHL), and critical HL (CHL) within three subdomains: critical appraisal of information, understanding of social determinants of health, and actions to address social determinants of health, was developed based on previous literature review and Delphi survey. Cognitive interviews were performed to examine all items' face validity in terms of three aspects: comprehensiveness, clarity, and acceptability. A cross-sectional survey was conducted to investigate the scale's psychometric properties, including its internal consistency reliability, factorial structure validity, convergent validity, and predictive validity. Nine interviewees participated in the cognitive interviews in October 2021. Based on the input from respondents, two items were deleted, two items were combined, and several items' wording was revised. The other items were clear and readable. Finally, 28 items remained. A total of 433 adults completed the questionnaire survey between December 2021 and February 2022. After excluding one item with low inter-item correlations, the scale's internal consistency reliability was acceptable, with a Cronbach's alpha of 0.89. Exploratory factor analysis produced a five-factor model, as shown in the original theoretical framework. These factors accounted for 53% of the total variance. Confirmatory factor analysis confirmed that the fit indices for this model were acceptable (comparative fit index = 0.91, root mean square error of approximation = 0.06, and root mean square residual = 0.06). The scale is also significantly correlated with theoretically selected variables, including education and self-rated health. The HLS-HK is a valid and reliable tool for evaluating HL. Compared with existing tools, this scale extended the operationalization of FHL, IHL, and CHL and fully operationalized the CHL via three subdomains. It can be used to understand the difficulties and barriers that people may encounter when they use health-related information and services.

Urdu Translation and Validation of the Consolidated Helicopter Parenting Scale on Pakistani Youth

Research has demonstrated that helicopter parenting has adverse effects on the psychological well-being of youth. Consolidated Helicopter Parenting Scale (Schiffrin et al., 2019) is a reliable and valid scale for assessing helicopter parenting, however, this scale is not available in Urdu language. Hence, the objective of this research was to translate and validate this measure. This objective was achieved in two phases where in Phase I, the scale was translated into Urdu language using Brislin’s (1980) guideline. In Phase 2, validity was examined using a sample of 480 young people with an age range between 16-22 years (M = 18.6, SD = 1.60) with equal number of male and female participants using purposive and convenient sampling technique. The translated version showed greater internal consistency and confirmatory analysis provided a good fit of the model to the data reflecting upon the valid factor structure of the scale on a Pakistani sample. Overall, findings demonstrated that this is a valid and reliable tool and therefore, would improve further assessment of this parenting style in Pakistani sample.

Preventive Health Management Self-Efficacy related to Premature Labor (PHMSE-PL) scale for Korean women of childbearing age: instrument development and validation.

PurposeThis study aimed to develop and examine the validity and reliability of a self-efficacy scale for preventive health management related to premature labor (PHMSE-PL) for women of childbearing age.MethodsInstrument development and validation were undertaken in three steps: conceptualization through a literature review and in-depth interviews, item generation and evaluation of content validity, and evaluation of construct validity and reliability. The content validity, factorial structure validity, and internal consistency reliability of the PHMSE-PL were evaluated, and cognitive interviewing was undertaken. Data were analyzed using confirmatory factor analyses, Cronbach's α, and 95% confidence intervals (CIs).ResultsThe content validity was assessed by experts and was strengthened through cognitive interviews with women of childbearing age. The PHMSE-PL comprised 34 items across five factors. The construct validity of the PHMSE-PL was supported. Cronbach's α for the total scale was .97 (95% CI=.96-.97).ConclusionAn evaluation of the psychometric properties of the PHMSE-PL scale found it to be a valid and reliable tool for women of childbearing age. The scale appears to be useful for women of childbearing age to self-assess their preventive health management self-efficacy related to premature labor and for health professionals to evaluate and promote women's preventive health management.

Development and Validation of the Young Adult Nutrition Literacy Tool

ObjectiveTo create a tool to measure college students’ functional, interactive, and critical nutrition literacy. Design(1) Focus group: item generation, (2) expert review, (3) exploratory factor structure analysis, (4) item refinement and modification, (5) factor structure validation, and (6) criterion validation. SettingTwo land-grant college campuses. ParticipantsCollege students aged between 18 and 24 years. Main Outcome MeasuresSurvey data was used to assess nutrition literacy. AnalysisExploratory factor analysis, confirmatory factor analysis (CFA), item response theory (IRT) analyses, and correlations. ResultsOne-hundred and twenty-three items were generated and tested in an online survey format. Items were eliminated on the basis of face validity, expert feedback, exploratory factor analysis, and CFA/IRT. The 3 measures (functional, interactive, and critical) were analyzed separately. All 3 measures showed reasonable model fit in the CFA/IRT models. Criterion validity showed small to medium effect sizes between measures and fruit/vegetable intake. Reliability estimates met reasonable standards for each measure. Conclusions and ImplicationsThe Young Adult Nutrition Literacy Tool is a novel instrument that measures all 3 domains of nutrition literacy. Strengths include a rigorous 6-step development process, reasonable psychometric properties, and a large breadth of items.

Validity, Reliability, and Confirmatory factor structure of the Persian version of Emotion and Motivation Self-Regulation Questionnaire (EMSR-Q)

Validity, Reliability, and Confirmatory factor structure of the Persian version of Emotion and Motivation Self-Regulation Questionnaire (EMSR-Q)

Validity, Reliability, and Confirmatory factor structure of the Persian version of Emotion and Motivation Self-Regulation Questionnaire (EMSR-Q)

Background and Aim: Emotion and Motivation Self-regulation plays an important role on student learning at classroom, so presence of appropriate tools for evaluating and assessing this structure is necessary. The aim of this study was to investigate the validity, reliability and confirmatory factor structure of the Persian version of Emotion and Motivation Self-Regulation Questionnaire (EMSR -Q). Methods: The present study had a descriptive and Psychometric design, and the statistical population included all middle and high school students of Semnan city. After providing double translation technique, Persian version of EMSR -Q carried out within 306 students from ages 12 to 16 years old. The study sample selected through random sampling method. Internal consistency and Item rest correlations methods were used to investigate the scale validity and the reliability were investigated by confirmatory factor analysis, subscales correlations, and criterion validity. Data were analyzed using SPSSV19 and LISRELV8.80 softwares. Results: Chronbach’s alpha coefficients range (0/71 to 0.86) implied appropriate Internal consistency of this scale and its subscales. Results of confirmatory factor analysis supported five factor structures (Avoidance oriented Self Regulation, Performance oriented Self Regulation, Negative Self Regulation of Stress, Positive Self Regulation of motivation, and Process Oriented Self Regulation) of scale. There were Average and meaningful correlation coefficients between the scales of Persian version of EMSR -Q with Cognitive Emotion Regulation and Educational Motivation Questionnaires. In addition, the correlation coefficients between subscales were high. Conclusion: It can be concluded that Persian version of EMSR -Q has a good validity and reliability in Iranian population and can be practical in different fields.

Validation of Perceived Mental Fatigability Using the Chinese Version of the Pittsburgh Fatigability Scale

Background: Recently we validated the simplified-Chinese version of the Pittsburgh Fatigability Scale (PFS) Physical subscale. Next step is to validate the PFS Mental subscale in order to introduce a reliable measure of perceived mental fatigability among Chinese community-dwelling older adults. Methods: This cross-sectional study was conducted in an urban community in Beijing. Internal consistency of the PFS Mental subscale was evaluated by Cronbach’s alpha. The participants were divided in half to evaluate the factor structure validity by exploratory factor analyses and confirmatory factor analysis. Convergent validity and discriminant validity were evaluated against cognitive function (assessed by MOCA) and global fatigue from FRAIL Scale. Results: Our study included 370 participants (mean=83.8 years). The simplified-Chinese version of PFS Mental subscale showed strong internal consistency (total Cronbach’s alpha=0.82, each items Cronbach’s alpha ranged from 0.78 – 0.83). The results of exploratory factor analysis showed all 10 items loaded on two factors: moderate to high and low intensity activities, which explained 60.8% of the total variance. Confirmatory factor analysis showed fit indices: SRMSR = 0.090, RMSEA = 0.120, CFI = 0.89. PFS Mental scores demonstrated moderate concurrent and construct validity against cognitive function (r = －0.24, P<.001). Additionally, the PFS Mental subscale had strong convergent validity, discriminating according to established cognitive impairment or FRAIL Scale fatigue testing cut points, with differences in PFS Mental scores ranging from 3.2 to 8.4 points. Conclusions: The PFS Mental subscale simplified-Chinese version is a valid tool to assess perceived mental fatigability in Chinese-speaking older adults.

Assessing Warning Signs of Relapse in Drug Addicts: Translation and Validation of AWARE Questionnaire

Aim: To translate and validate Advance Warning of Relapse (AWARE) Questionnaire in to Urdu language for assessing relapse among drug addicts of Pakistan. Methods: The research comprises of translation of AWARE, temporal validation of translated scale, and its construct validation. Two items (22, 28) were modified keeping structural and functional equivalence. Sample for validation was obtained from rehabilitation centers of Islamabad and Rawalpindi, with age ranging from 18-60 years (M=29.3; SD=8.2). Temporal validity was determined by test-retest reliability. Exploratory factor analysis (EFA) was used to determine the valid factor structure, whose model fitness was assessed using Confirmatory factor analysis (CFA). Reliability was used to assess the internal consistency. Results: It was found that translated scale possess significant temporal validity (α= .81). EFA demonstrate a unifactorial structure (λ &gt; .30) explaining variance of about 34.3%; such that four items (8, 14, 20, 26) were removed based on poor factor loadings. Indices of model fit through CFA confirm factor structure. Reliability of scale was also significant (α= .90). Conclusion: Findings suggested the reliable and valid nature of AWARE-Urdu to assess warning signs of relapse in drug addicts. Keywords: Warning signs, relapse, drug addicts, Urdu translation, validation, AWARE

Craving for Ketamine and Its Relationship With Clinical Outcome Indicators in Males With Ketamine Use Disorder.

Background: Craving is considered a hallmark of substance use disorder and is one of the criteria of substance use disorder. The Desires for Drug Questionnaire (DDQ) is a widely used questionnaire to assess craving for heroin. This study aimed to examine the psychometric properties of the ketamine version of the DDQ (DDQ-K) and the associations between craving for ketamine as measured using the DDQ-K and clinical outcome indicators in individuals with ketamine use disorder.Methods: In total, 651 individuals with ketamine use disorder completed the DDQ-K and the Visual Analog Craving Scale (VACS). Demographic data, severity of ketamine use, money spent on ketamine, positive/negative aspects of ketamine use, and readiness to change ketamine use were also recorded. We examined the reliability (internal consistency), construct validity (factor structure), and concurrent validity of the DDQ-K. Multiple regression analysis was used to examine the relationships of craving measured using the DDQ-K with clinical outcome indicators, including money spent on ketamine, severity of ketamine use, positive/negative aspects of ketamine use, and readiness to change ketamine use.Results: The original three-factor model of the DDQ-K was acceptable for use in individuals with ketamine use disorder according to confirmatory factor analysis. The subscales of Desire and Intention and Negative Reinforcement of the DDQ-K, but not the subscale of Control, were of acceptable concurrent validity. The score on the Desire and Intention subscale was positively associated with the level of ketamine dependence, money spent on ketamine use, and positive/negative aspects of ketamine use and negatively associated with readiness to change ketamine use.Conclusion: This study supported the use of the Desire and Intention and Negative Reinforcement subscales of the DDQ-K to assess craving in patients with ketamine use.