The Psychometric Evaluation of the Connor-Davidson Resilience Scale Using a Chinese Military Sample

This study examined the psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) with a Chinese military population with the aim of finding a suitable instrument to quantify resilience in Chinese military service members. The confirmatory factor analysis results did not support the factorial structure of the original or the Chinese community version of the CD-RISC, but the exploratory factor analysis results revealed a three-factor model (composed of Competency, Toughness, and Adaptability) that seemed to fit. Moreover, the repeat confirmatory factory analysis replicated the three-factor model. Additionally, the CD-RISC with a Chinese military sample exhibited appropriate psychometric properties, including internal consistency, test-retest reliability, and structural and concurrent validity. The revised CD-RISC with a Chinese military sample provides insight into the resilience measurement framework and could be a reliable and valid measurement for evaluating resilience in a Chinese military population.     

Development of a Canine Care and Welfare Knowledge Scale: Implications for Welfare and Preventing Dogfighting

The objective of this study was to develop a Canine Care and Welfare Knowledge (CCWK) Scale for use in educational intervention development and evaluation and validate the instrument. The study population was 504 children, aged 11 to 19 years old, from Detroit, MI. In this cross-sectional study, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for scale development. The EFA and CFA of the CCWK Scale revealed a 2nd-order model with 6 factors to be a good fit of the data (chi-square [df = 269] = 433, p < .05, Comparative Fit Index = .94, Tucker-Lewis Index = .93, root mean square error of approximation = .05) with a Cronbach’s alpha of .78. The scale is valid and reliable to assess the study population’s CCWK.     

Diagnostic Validity of the Generalized Anxiety Disorder - 7 (GAD-7) among Pregnant Women

Objective

Generalized anxiety disorder (GAD) during pregnancy is associated with several adverse maternal and perinatal outcomes. A reliable and valid screening tool for GAD should lead to earlier detection and treatment. Among pregnant Peruvian women, a brief screening tool, the GAD-7, has not been validated. This study aims to evaluate the reliability and validity of the GAD-7.

Methods

Of 2,978 women who attended their first perinatal care visit and had the GAD-7 screening, 946 had a Composite International Diagnostic Interview (CIDI). The Cronbach’s alpha was calculated to examine the reliability. We assessed the criterion validity by calculating operating characteristics. The construct validity was evaluated using factor analysis and association with health status on the CIDI. The cross-cultural validity was explored using the Rasch Rating Scale Model (RSM).

Results

The reliability of the GAD-7 was good (Cronbach’s alpha = 0.89). A cutoff score of 7 or higher, maximizing the Youden Index, yielded a sensitivity of 73.3% and a specificity of 67.3%. One-factor structure of the GAD-7 was confirmed by exploratory and confirmatory factor analysis. Concurrent validity was supported by the evidence that higher GAD-7 scores were associated with poor self-rated physical and mental health. The Rasch RSM further confirmed the cross-cultural validity of the GAD-7.

Conclusion

The results suggest that the Spanish-language version of the GAD-7 may be used as a screening tool for pregnant Peruvian women. The GAD-7 has good reliability, factorial validity, and concurrent validity. The optimal cutoff score obtained by maximizing the Youden Index should be considered cautiously; women who screened positive may require further investigation to confirm GAD diagnosis.     

A Community-Based Validation Study of the Short-Form 36 Version 2 Philippines (Tagalog) in Two Cities in the Philippines

Objective

To evaluate the validity and reliability of the Philippines (Tagalog) Short Form 36 Health Survey version 2 (SF-36v2^®) standard questionnaire among Filipinos residing in two cities.

Study Design and Setting

The official Philippines (Tagalog) SF-36v2 standard (4-week recall) version was pretested on 30 participants followed by formal and informal cognitive debriefing. To obtain the feedback on translation by bilingual respondents, each SF-36v2 question was stated first in English followed by Tagalog. No revisions to the original questionnaire were needed except that participants thought it was appropriate to incorporate "po" in the instructions to make it more polite. Face-to-face interviews of 562 participants aged 20-50 years living in two barangays (villages) in the highly urbanized city of Makati City (Metro Manila) and in urban and rural barangays in Tanauan City (province of Batangas) were subsequently conducted. Content validity, item level validity, reliability and factor structure of the SF-36v2 (Tagalog) were examined.

Results

Content validity of the SF-36v2 was assessed to be adequate for assessing health status among Filipinos. Item means of Philippines (Tagalog) SF-36v2 were similar with comparable scales in the US English, Singapore (English and Chinese) and Thai SF-36 version 1. Item-scale correlation exceeded 0.4 for all items except the bathing item in PF (correlation: 0.31). In exploratory factor analysis, the US two-component model was supported. However, in confirmatory factor analysis, the Japanese three-component model fit the Tagalog data better than the US two-component model.

Conclusions

The Philippines (Tagalog) SF-36v2 is a valid and reliable instrument for measuring health status among residents of Makati City (Metro Manila) and Tanauan City (Province of Batangas).     

Gene expression profiling – Clusters of possibilities

Advances in qPCR technology allow studies of increasingly large systems comprising many genes and samples. The increasing data sizes allow expression profiling both in the gene and the samples dimension while also putting higher demands on sound statistical analysis and expertise to handle and interpret its results. We distinguish between exploratory and confirmatory statistical studies. In this paper we demonstrate several techniques available for exploratory studies on a system of Xenopus laevis development from egg to tadpole. Techniques include hierarchical clustering, heatmap, principal component analysis and self-organizing maps. We stress that even though exploratory studies are excellent for generating hypotheses, results have not been proven statistically significant until an independent confirmatory study has been performed. An exploratory study may certainly be valuable in its own right, and there are often not enough resources to report both an exploratory and a confirmatory study at the same time. However, exploratory and confirmatory studies are intimately connected and we would like to raise that awareness among qPCR practitioners. We suggest that scientific reports should always have a hypothesis focus. Reports are either hypothesis generating, from an exploratory study, or hypothesis validating, from a confirmatory study, or both. In either case, we suggest the generated or validated hypotheses be specifically stated.     

Application of west java water sustainability index to three water catchments in west java,Indonesia

This study presents a comparative application of the West Java Water Sustainability Index to Citarum, Ciliwung and Citanduy catchments in West Java, Indonesia. A two-fold comparison is presented, firstly, that of the overall condition of water resources using the final index value and secondly, that of specific water sustainability issues using the comparison of the sub-index values of the indicators. The overall comparison ranks the condition of water resources of Citanduy catchment is slightly better, whereas sub-index values of Education, Health Impact, Water Demand, and Poverty show important differences among catchments. Based on the performance of the catchments identified in this study, priority of actions has been recommended to the authorities.     

Benchmarking sustainability using indicators: An Indian case study

This paper develops an index to measure sustainability based on the broad themes of social, economy and environment. Nineteen appropriate indicators were selected based on relevance, data availability, and periodicity for each leg of sustainable development. A correlation analysis was carried out to assess relationships between the 19 indicators representing different parameters under the three themes. These parameters were then normalized using Z-score technique. The Z-scores computed for each of these parameters were then used to develop a Sustainable Development Index (SDI). The index is pilot tested on different States and Union Territories (UTs) of India. The values are compared and interpreted to adjudge the forerunners and laggards on the various dimensions of human well-being and environment. Significant relationships have been observed between income levels and area of administrative regions with sustainability indices of the regions. Smaller administrative regions with higher income levels have been observed with higher sustainability scores. The proposed index provides a useful measure of identifying problematic areas that can be plugged through policy measures and ensures that the region moves on sustainable development pathways.     

Cross-Cultural Validation of the High Blood Pressure Health Literacy Scale in a Chinese Community

BackgroundConsidering the importance of health literacy (HL) for the maximum yield from the hypertension control programs, development of a reliable and valid instrument of hypertension-related HL is critical. This study aimed to translate and validate the High Blood Pressure-Health Literacy Scale (HBP-HLS) into Chinese (C-HBP-HLS) and evaluate its psychometric properties in Chinese context.MethodBetween June 2013 and January 2014, a cross-sectional study was conducted among recruited hypertensive patients belonging to the Han and Kazakh-Chinese communities in Urumqi, Xinjiang, China.ResultsA pilot sample (n = 242) was selected for the exploratory factor analysis of the translated and modified instrument. Another sample (n = 308) was recruited for the confirmatory factor analysis. C-HBP-HLS consisted of five dimensions (Print Health Literacy, Medication Label, Understanding Ability, Newest Vital Sign Test, and Avoiding Food Allergy) containing 15 items, accounting for 77.7% of the total variance. The 5-factor model demonstrated a good overall fit. The scale-level content validity index was 0.85. Cronbach’s alpha of the overall scale was 0.78 and test-retest reliability was 0.96. Education level had a strong positive correlation with the scores for items Q1, Q2, and Q3(r = 0.481, 0.492, 0.475, respectively). Health Literacy scores among Kazakh patients were significantly lower than Han (7.13±7.90 vs. 30.10±13.42, Z = -14.573, P<0.001).ConclusionC-HBP-HLS demonstrated suitable factor structure and robust psychometric properties for measuring health literacy level among hypertensive patients in China.     

Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context

Background

HIV-related stigma has negative consequences for infected people''s lives and is a barrier to HIV prevention. Therefore valid and reliable instruments to measure stigma are needed to enable mapping of HIV stigma. This study aimed to evaluate the psychometric properties of the HIV stigma scale in a Swedish context with regard to construct validity, data quality, and reliability.

Methods

The HIV stigma scale, developed by Berger, Ferrans, and Lashley (2001), was distributed to a cross-sectional sample of people living with HIV in Sweden (n = 194). The psychometric evaluation included exploratory factor analysis together with an analysis of the distribution of scores, convergent validity by correlations between the HIV stigma scale and measures of emotional well-being, and an analysis of missing items and floor and ceiling effects. Reliability was assessed using Cronbach''s α.

Results

The exploratory factor analysis suggested a four-factor solution, similar to the original scale, with the dimensions personalised stigma, disclosure concerns, negative self-image, and concerns with public attitudes. One item had unacceptably low loadings and was excluded. Correlations between stigma dimensions and emotional well-being were all in the expected direction and ranged between −0.494 and −0.210. The instrument generated data of acceptable quality except for participants who had not disclosed their HIV status to anybody. In line with the original scale, all subscales demonstrated acceptable internal consistency with Cronbach''s α 0.87–0.96.

Conclusion

A 39-item version of the HIV stigma scale used in a Swedish context showed satisfactory construct validity and reliability. Response alternatives are suggested to be slightly revised for items assuming the disclosure of diagnosis to another person. We recommend that people that have not disclosed should skip all questions belonging to the dimension personalised stigma. Our analysis confirmed construct validity of the instrument even without this dimension.     

Exploring the Factor Structure of Neurocognitive Measures in Older Individuals

Here we focus on factor analysis from a best practices point of view, by investigating the factor structure of neuropsychological tests and using the results obtained to illustrate on choosing a reasonable solution. The sample (n=1051 individuals) was randomly divided into two groups: one for exploratory factor analysis (EFA) and principal component analysis (PCA), to investigate the number of factors underlying the neurocognitive variables; the second to test the “best fit” model via confirmatory factor analysis (CFA). For the exploratory step, three extraction (maximum likelihood, principal axis factoring and principal components) and two rotation (orthogonal and oblique) methods were used. The analysis methodology allowed exploring how different cognitive/psychological tests correlated/discriminated between dimensions, indicating that to capture latent structures in similar sample sizes and measures, with approximately normal data distribution, reflective models with oblimin rotation might prove the most adequate.     

Factor Structure of the Japanese Version of the Edinburgh Postnatal Depression Scale in the Postpartum Period

Background

The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool for postpartum depression (PPD). Although the reliability and validity of EPDS in Japanese has been confirmed and the prevalence of PPD is found to be about the same as Western countries, the factor structure of the Japanese version of EPDS has not been elucidated yet.

Methods

690 Japanese mothers completed all items of the EPDS at 1 month postpartum. We divided them randomly into two sample sets. The first sample set (n = 345) was used for exploratory factor analysis, and the second sample set was used (n = 345) for confirmatory factor analysis.

Results

The result of exploratory factor analysis indicated a three-factor model consisting of anxiety, depression and anhedonia. The results of confirmatory factor analysis suggested that the anxiety and anhedonia factors existed for EPDS in a sample of Japanese women at 1 month postpartum. The depression factor varies by the models of acceptable fit.

Conclusions

We examined EPDS scores. As a result, “anxiety” and “anhedonia” exist for EPDS among postpartum women in Japan as already reported in Western countries. Cross-cultural research is needed for future research.     

A matched-pair cluster design study protocol to evaluate implementation of the Canadian C-spine rule in hospital emergency departments: Phase III

Background

The Competing Values Framework (CVF) has been widely used in health services research to assess organizational culture as a predictor of quality improvement implementation, employee and patient satisfaction, and team functioning, among other outcomes. CVF instruments generally are presented as well-validated with reliable aggregated subscales. However, only one study in the health sector has been conducted for the express purpose of validation, and that study population was limited to hospital managers from a single geographic locale.

Methods

We used exploratory and confirmatory factor analyses to examine the underlying structure of data from a CVF instrument. We analyzed cross-sectional data from a work environment survey conducted in the Veterans Health Administration (VHA). The study population comprised all staff in non-supervisory positions. The survey included 14 items adapted from a popular CVF instrument, which measures organizational culture according to four subscales: hierarchical, entrepreneurial, team, and rational.

Results

Data from 71,776 non-supervisory employees (approximate response rate 51%) from 168 VHA facilities were used in this analysis. Internal consistency of the subscales was moderate to strong (α = 0.68 to 0.85). However, the entrepreneurial, team, and rational subscales had higher correlations across subscales than within, indicating poor divergent properties. Exploratory factor analysis revealed two factors, comprising the ten items from the entrepreneurial, team, and rational subscales loading on the first factor, and two items from the hierarchical subscale loading on the second factor, along with one item from the rational subscale that cross-loaded on both factors. Results from confirmatory factor analysis suggested that the two-subscale solution provides a more parsimonious fit to the data as compared to the original four-subscale model.

Conclusion

This study suggests that there may be problems applying conventional CVF subscales to non-supervisors, and underscores the importance of assessing psychometric properties of instruments in each new context and population to which they are applied. It also further highlights the challenges management scholars face in assessing organizational culture in a reliable and comparable way. More research is needed to determine if the emergent two-subscale solution is a valid or meaningful alternative and whether these findings generalize beyond VHA.     

Uncertainty and sensitivity analysis of West Java Water Sustainability Index – A case study on Citarum catchment in Indonesia

Water sustainability indices have been recently used to measure the sustainability of water resources within a catchment. Developing a sustainability index involves various steps, some of which have uncertainties associated with them. For the recently developed West Java Water Sustainability Index (WJWSI), three sources of uncertainties were identified, namely uncertainties in the thresholds of non-categorical indicators and sub-indicators, in the weighting schemes, and in the aggregation methods. This paper presents the uncertainty and sensitivity analysis of WJWSI, based on the application of WJWSI to Citarum catchment in West Java, Indonesia. The results of the uncertainty analysis, measured by the coefficient of variation of the thresholds and the sub-indices, indicates that minimum thresholds of Land Use Changes, Coverage, Education, Poverty, Health Impact and Sanitation, and the maximum threshold of Water Quality have higher variation when compared to variation of the other thresholds. The results of the sensitivity analysis, measured by the correlation coefficients between the final index and the thresholds, indicate that changes in the thresholds of WJWSI indicators have not significantly affected the sub-index values of most indicators and sub-indicators. The sensitivity analysis also concluded that either the equal or non-equal weighting scheme can be used for future use of the aggregation of WJWSI indicators and sub-indicators, as changes from equal to non-equal weighting scheme did not significantly affect the final index. However, it was found that the final index values were most sensitive to the aggregation method used (i.e. arithmetic and geometric methods), shown by the significant changes in the final index value when the aggregation method was changed from arithmetic to geometric. The uncertainty and sensitivity analysis presented in this study will not just assist in the efficient use of the WJWSI, but will also help undertake similar analysis for other indices.     

Prognostic Impact of Diabetes Mellitus on Overall Survival in a Nationwide Population-Based Cohort of Patients With Pancreatic Cancer

Objective: Diabetes mellitus (DM) is a risk factor for pancreatic cancer but its prognostic impact remains controversial. We aimed to investigate the association between long-standing DM and the risk of mortality.Methods: This population-based cohort study analyzed data from the national healthcare database in Taiwan. We identified all patients diagnosed with pancreatic cancer and excluded those who were diagnosed with DM with-in 2 years of the cancer diagnosis. Eligible patients were grouped into long-standing DM (>2 years) and nondiabetic controls, and were compared for overall survival using a Cox proportional hazard model. Sensitivity tests stratified by cancer stages (as indicated by specific treatment) were performed.Results: Patients with long-standing DM were significantly older (mean age, 71.38 years versus 66.0 years; P<.0001) and had a higher Charlson comorbidity index (9.53 versus 6.78; P<.0001) and diabetes comorbidity severity index (2.38 versus 0.82; P<.0001) compared with the non-DM controls. Although the unadjusted analysis showed a higher risk of mortality in the patients with long-term DM (crude hazard ratio &lsqb;HR], 1.26; 95% confidence interval &lsqb;CI], 1.20 to 1.33; P<.0001), the association became insignificant after adjustment for age, sex, and comorbidity index (adjusted HR, 1.01; 95% CI, 0.95 to 1.06, P = .84). Subgroup analyses also showed no association between long-term DM and mortality in various subgroups stratified by cancer treatment.Conclusion: After adjusting for associated comorbidities and complications, long-standing DM per se was not an independent prognostic factor for overall survival in this nationwide population-based cohort with pancreatic cancer.Abbreviations: CCI = Charlson Comorbidity Index; CI = confidence interval; DCSI = Diabetes Complication Severity Index; DM = diabetes mellitus; HR = hazard ratio; ICD = International Classification of Diseases; NHIRD = National Health Insurance Research Database; RCIPD = Registry for Catastrophic Illness Patient Database     

Validatieonderzoek Welzijnsmeter-dementie

The Well-Being Measure – dementia is a digital observation instrument that assesses the well-being of persons with dementia on four domains of quality of life: Mental well-being, Physical well-being, Participation, and Living arrangements. Its goal is to assess the well-being of persons with dementia in an easy and positive way. Besides illness-related symptoms and problems, the instrument also assesses positive aspects of functioning. It visualizes the results and provides specific behavioural advice to the caregivers. The goal of the present article is to conduct a first psychometric analysis: factor structure, reliability (Cronbach’s alpha), concurrent, and convergent validity.Observations were carried out among 168 persons with dementia in eleven different small-scale psychogeriatric wards. Five existing instruments were used among 63 persons to validate the Well-Being Measure-dementia: quality of life, neuropsychiatric symptoms, care dependency, depression, and agitation.The expected factor structure was found in each of the four domains. Coefficients were high on the expected factor and low on the other factor(s). The scale means were on the positive side, but showed an adequate range and variability. Reliability was satisfactory to good. The relation with existing scales was moderate to strong. The pattern of relations was consistent with the measurement intentions of the different existing instruments.The Well-Being Measure – dementia appears to be a valid and reliable scale. Further studies should assess its test-retest reliability, sensitivity to change and relation with the course of dementia. Current experience shows that the instrument is also useful in everyday practice.     

When Eating Right,Is Measured Wrong! A Validation and Critical Examination of the ORTO-15 Questionnaire in German

The characteristic trait of individuals developing a pathological obsession and preoccupation with healthy foods and a restrictive and avoidant eating behavior is described as orthorexia nervosa (ON). For ON, neither universal diagnosis criteria nor valid tools for large-scale epidemiologic assessment are available in the literature. The aim of the current study is to analyze the psychometric properties of a translated German version of the ORTO-15 questionnaire. The German version of the ORTO-15, a eating behavior and dieting habits questionnaire were completed by 1029 German-speaking participants (74.6% female) aged between 19 and 70 years (M = 31.21 ± 10.43 years). Our results showed that after confirmatory factor analysis, the best fitting model of the original version is a single-factor structure (9-item shortened version: ORTO-9-GE). The final model showed only moderate internal consistency (Cronbach’s alpha = .67), even after omitting 40% of the original question. A total of 69.1% participants showed orthorectic tendencies. Orthorectic tendencies are associated with special eating behavior features (dieting frequency, vegetarian and vegan diet). Education level did not influence ON tendency and nutritional students did not show higher ON tendency compared to students from other disciplines. This study is the first attempt to translate and to evaluate the psychometric properties of a German version of the ORTO-15 questionnaire. The ORTO-9-GE questionnaire, however, is only a mediocre tool for assessing orthorectic tendencies in individuals and shows moderate reliability and internal consistency. Our research suggests, that future studies are needed to provide more reliable and valid assessment tools to investigate orthorexia nervosa.     

Gastrointestinal specific anxiety in irritable bowel syndrome: validation of the Japanese version of the visceral sensitivity index for university students

Objective

The visceral sensitivity index (VSI) is a useful self-report measure of the gastrointestinal symptom-specific anxiety (GSA) of patients with irritable bowel syndrome (IBS). Previous research has shown that worsening GSA in IBS patients is related to the severity of GI symptoms, suggesting that GSA is an important endpoint for intervention. However, there is currently no Japanese version of the VSI. We therefore translated the VSI into Japanese (VSI-J) and verified its reliability and validity.

Material and methods

Participants were 349 university students aged 18 and 19 years and recruited from an academic class. We analyzed data from the VSI-J, Anxiety Sensitivity Index (ASI), Hospital Anxiety and Depression scale (HAD), and Irritable Bowel Syndrome Severity Index (IBS-SI). The internal consistency, stability, and factor structure of the VSI-J and its associations with anxiety, depression and severity measures were investigated.

Results

The factor structure of the VSI-J is unidimensional and similar to that of the original VSI (Cronbach’s α?=?0.93). Construct validity was demonstrated by significant correlations with ASI (r?=?0.43, p?<?0.0001), HAD-ANX (r?=?0.19, p?=?0.0003), and IBS-SI scores (r?=?0.45, p?<?0.0001). Furthermore, the VSI-J was a significant predictor of severity scores on the IBS-SI and demonstrated good discriminant (p?<?0.0001) and incremental (p?<?0.0001) validity.

Conclusion

These findings suggest that the VSI-J is a reliable and valid measure of visceral sensitivity.

     

The Quest for Comparability: Studying the Invariance of the Teachers’ Sense of Self-Efficacy (TSES) Measure across Countries

Teachers’ self-efficacy is an important motivational construct that is positively related to a variety of outcomes for both the teachers and their students. This study addresses challenges associated with the commonly used ‘Teachers’ Sense of Self-Efficacy (TSES)’ measure across countries and provides a synergism between substantive research on teachers’ self-efficacy and the novel methodological approach of exploratory structural equation modeling (ESEM). These challenges include adequately representing the conceptual overlap between the facets of self-efficacy in a measurement model (cross-loadings) and comparing means and factor structures across countries (measurement invariance). On the basis of the OECD Teaching and Learning International Survey (TALIS) 2013 data set comprising 32 countries (N = 164,687), we investigate the effects of cross-loadings in the TSES measurement model on the results of measurement invariance testing and the estimation of relations to external constructs (i.e., working experience, job satisfaction). To further test the robustness of our results, we replicate the 32-countries analyses for three selected sub-groups of countries (i.e., Nordic, East and South-East Asian, and Anglo-Saxon country clusters). For each of the TALIS 2013 participating countries, we found that the factor structure of the self-efficacy measure is better represented by ESEM than by confirmatory factor analysis (CFA) models that do not allow for cross-loadings. For both ESEM and CFA, only metric invariance could be achieved. Nevertheless, invariance levels beyond metric invariance are better achieved with ESEM within selected country clusters. Moreover, the existence of cross-loadings did not affect the relations between the dimensions of teachers’ self-efficacy and external constructs. Overall, this study shows that a conceptual overlap between the facets of self-efficacy exists and can be well-represented by ESEM. We further argue for the cross-cultural generalizability of the corresponding measurement model.     

Psychometric Properties of the Multidimensional Health Locus of Control Scale Form C in a Non-Western Culture

Form C of the Multidimensional Health Locus of Control Scales (MHLC-C) was designed to investigate health-related control beliefs of persons with an existing medical condition. The aim of the present study was to examine the psychometric properties of this instrument in a culture characterized by external control beliefs and learned helplessness—contrary to the societal context of original test development. Altogether, 374 Hungarian patients with cancer, irritable bowel syndrome, diabetes, and cardiovascular and musculoskeletal disorders were enrolled in the study. Besides the MHLC-C, instruments measuring general control beliefs, anxiety, depression, self-efficacy, and health behaviors were also administered to evaluate the validity of the scale. Both exploratory and confirmatory factor analytic techniques were used to investigate the factor structure of the scale. Our results showed that the Hungarian adaptation of the instrument had a slightly different structure than the one originally hypothesized: in the present sample, a three-factor structure emerged where the items of the Doctors and the Others subscales loaded onto a single common component. Internal reliability of all three subscales was adequate (alphas between .71 and .79). Data concerning the instrument''s validity were comparable with previous results from Western countries. These findings may suggest that health locus of control can be construed very similarly to Western countries even in a post-communist society—regardless of the potential differences in general control beliefs.     

The Pathological Buying Screener: Development and Psychometric Properties of a New Screening Instrument for the Assessment of Pathological Buying Symptoms

The study was designed to develop a new screening instrument for pathological buying (PB), and to examine its psychometric properties in a large-scale sample. By using a facet theoretical approach and based on literature as well as on clinical experience, a 20-item Pathological Buying Screener (PBS) was developed and administered to a representative German sample (n = 2,539). Valid data were available from 2,403 participants who were subjects for three subsequent empirical studies. The first study explored the factor structure using exploratory factor analyses in a subsample of 498 participants. Based on factor loadings, a 13-item version with the two factors loss of control / consequences and excessive buying behavior was revealed. This two-factor model was confirmed in study 2 by confirmatory factor analysis performed on another subsample (n = 1,905). Study 3 investigated age and gender effects and convergent validity of the PBS using the Compulsive Buying Scale (CBS) in the full sample (N = 2,403). The total PBS score was adequately correlated with the CBS score. Hierarchical regression analyses with the CBS score as the dependent variable and the two PBS factors as the predictors indicated an own incremental validity of the two factors in participants ≤ 65 years. The reliability of the total score as well as of the two subscales was good to excellent. Overall, the PBS represents a useful measure for PB. Future studies are needed to replicate the two-factor structure in clinical samples and to define a valid cutoff for PB.