40An antenatal care indicator based on contact with services and content developed for 63 countries

Background Most antenatal care (ANC) indicators in use are criticized for considering only contact with services and not taking into account content of care. We aimed to create and validate a new indicator measured as a score, considering both contact and content, that can be used for monitoring. Methods We used data from national surveys conducted in low and middle-income countries (LMICs). Information on ANC was used to build an adequacy score (ANCq) that would be applicable to all women in need of ANC. We used a convergent validation approach, exploring the association of our proposed indicator with neonatal mortality. Results The ANCq score was derived from seven variables related to contact with services and content of care ranging from zero to ten. Surveys from 63 countries with all variables were used. The overall mean of ANCq was 6.7, ranging from 3.5 in Afghanistan to 9.3 in Cuba and the Dominican Republic. In most countries, the ANCq was inversely associated with neonatal mortality and the pooled for all surveys Odds Ratio was 0.90 (95% CI = 0.88-0.92). Conclusions The ANCq presented good validity properties, being a useful tool for assessing ANC coverage and adequacy of care in monitoring and accountability exercises. Key messages ANCq provides a standardized and comparable measure of ANC adequacy, allowing for comparisons between country population subgroups and between countries.

Multiverse Analysis: A Method to Determine Researcher Degrees of Freedom in Test Validation

ObjectiveIn psychometric validation there are a near limitless number of different approaches researchers can decide to take when choosing sample type and size, test metrics, and covariate measures. It is particularly important to factor in these different analytical pathways when validating tools intended for use in clinical populations. Here, we aimed to provide a tutorial paper showcasing the multiverse, or specification curve, technique to establish the robustness of analytical pathways on psychometric validation outcomes in an example test of executive function. MethodWe examined the impact of choices regarding sample groups, sample sizes, different types of metrics from a given test, covariate inclusions, and outlier removal on convergent validation correlations between new tests of executive function. Data were available for 88 neurologically healthy adults and 117 stroke survivors, a total of 6,660 different analyses were run. ResultsWe found that the type of sample group and sample size used for analyses impacted validation outcomes. Comparing test metrics within-category (e.g. accuracy vs accuracy) rather than between-category (e.g., accuracy vs time) significantly increased the observed correlation coefficients. Covariate inclusion and outlier removal choices did not impact the observed coefficients in our analyses. ConclusionThis tutorial paper showcases how authors can use the multiverse technique to evidence the robustness, or fragility, of their validation outcomes across many different analytical pathways. The example here highlights the importance of fully justifying and considering the analytical pathway to take in validation work on clinically relevant tools.

Meta-analytic Re-assessment of the Validity of Miller Forensic Assessment Test for Detection of Malingering

Background: The Miller Forensic Assessment of Symptoms Test (M-FAST) is used widely for the assessment of malingering of medical symptoms. Its validity has allegedly been supported by meta-analytic study of M-FAST in 2019 by Detullio et al. Credibility of Detullio’s results is damaged by an inclusion of data based on analog validation and also on dubious convergent validation procedures that falsify estimates of M-FAST’s validity. Method: In the present study, the meta-analysis was calculated on 3 types of M-FAST data: (1) 5 samples of scores of healthy persons instructed to respond honestly, (2) 5 samples of scores of medical patients, and (3) 10 samples of scores of healthy persons instructed to feign mental illness (so called “instructed malingerers”). Results: In an ANOVA (F(2,815)=398.50, p<.0001), significantly lowest M-FAST scores were those of healthy controls (mean=1.59, SD=2.80), the next significantly higher scores were those of legitimate patients (mean=4.85, SD=4.22), and the instructed malingerers had significantly highest scores (mean=12.34, SD=5.71). Discussion: The significant difference between healthy controls and patients shows that inferences from analog validations of the M-FAST are inherently false. Furthermore, data of legitimate patients with severe psychiatric illness suggested that they may face the risk of about 50% to be falsely classified as malingerers by the M-FAST. Moreover, almost all validations of the M-FAST were done only with “instructed malingerers” (healthy volunteers instructed to feign symptoms). This overestimates the test’s capacity to detect real-life malingerers. Montes and Guyton documented that “instructed malingerers” warned to avoid detection score much lower than the unwarned ones (effect size: Cohen’s d=3.05). M-FAST’s capacity for detection of real-life malingerers may be extremely low, in particular those more genuinely motivated to evade detection, well prepared, better educated, and systematically feigning only a few specific symptoms such as depression, pain, and insomnia. Conclusion: The M-FAST should no longer be used.

The Jena Voice Learning and Memory Test (JVLMT): A standardized tool for assessing the ability to learn and recognize voices

The ability to recognize someone’s voice exists on a broad spectrum with phonagnosia on the low end and super recognition at the high end. Yet there is no standardized test to measure an individual’s ability of learning and recognizing newly-learnt voices with samples of speech-like phonetic variability. We have developed the Jena Voice Learning and Memory Test (JVLMT), a 22min-test based on item response theory and applicable across languages. The JVLMT consists of three phases in which participants first become familiarized with eight speakers and then perform a three-alternative forced choice recognition task, using pseudo sentences devoid of semantics. Acoustic (dis)similarity analyses were used to create items with different levels of difficulty. Test scores are based on 22 Rasch-conform items. Items were selected based on 232 and validated based on 454 participants in an online study. Mean accuracy is 0.51 with an SD of .18. The JVLMT showed high and moderate correlations with the convergent validation tests (Bangor Voice Matching Test; Glasgow Voice Memory Test, respectively) and a weak correlation with the discriminant validation test (Digit Span). Empirical (marginal) reliability is 0.66. Four participants with super recognition abilities and 7 participants with phonagnosia were identified (at least 2 SDs above or below the mean, respectively).The JVLMT is a promising diagnostic tool to screen for voice recognition abilities in a scientific and neuropsychological context.

Development and Validation of the Test of Orthorexia Nervosa (TON-17)

This study aims to develop and validate a new self-report questionnaire to measure orthorexia nervosa (ON). Based on a current review of the scientific literature and interviews with people at risk of orthorexia, 40 items were selected to test orthorexia nervosa (TON-40). A total sample of 767 individuals (M = 26.49, SD = 9.66, 56.98% women) participated in the study. The exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and composite construct analysis (CCA) were performed to find an appropriate model of sufficient reliability and validity and stable construction. Convergent validation was performed regarding the correlation of the TON-17 with another measure of ON (ORTO-15), eating disorders (the EAT-26 and DEAS), healthy behavior (the HBI), quality of life (the Brief WHOQOL), physical health (the GRSH), anxiety (the GAD-7), depression (the PHQ-9), and obsessive-compulsive disorder (the OCI-R). Gender, Body Mass Index (BMI), and the medical reasons for a restrictive diet were also examined. As a result of the structural analyses, the number of items was reduced from 40 to 17. The best fit indices of the TON-17 were found for the hierarchical bi-factor model, with three lower-order factors (Control of food quality, Fixation of health and healthy diet, and Disorder symptoms) and one general higher-order factor (Orthorexia). According to the 95th percentile method of estimation, the prevalence of ON was 5.5% for the TON-17 total score. The TON-17 scale and subscales showed good psychometric properties, stability, reliability, and construct validity. The TON-17 indicated a positive relationship with the ORTO-15, EAT-26, DEAS, HBI, OCI-R, GAD-7, and PHQ-9. TON-17 can be considered as a useful tool for assessing the risk of ON.

Looking Out For (White) Australia

We conceptualized and developed a measure of right-wing protective popular nationalism (RWPPN) – a specific form of popular nationalism where people seek to protect the national culture from outgroup influences. RWPPN is derived from a sociological analysis of right-wing popular nationalism in Australia and is theoretically related to several key psychological constructs, including right-wing authoritarianism (RWA), social dominance orientation (SDO), and symbolic threat. We conducted two surveys using nationally representative samples of Australian citizens. In study 1 ( n = 657), participants completed measures of RWPPN and related constructs. Exploratory and confirmatory factor analysis resulted in a 10-item scale. Construct validity was tested and confirmed across divergent, convergent, predictive, and concurrent validation domains. Additional convergent validation with RWA and SDO was tested in study 2 ( n = 316). Together, RWPPN was found to relate to expressions of national identity, prejudice, perceived outgroup threat, opposition to multiculturalism, and aggressive tendencies toward ethnic minorities. These effects remained significant when controlling for nationalism (measured as a concern for national superiority) and blind patriotism. In study 2, the effect on aggressive tendencies held when controlling for RWA and SDO and RWPPN mediated the relationship between RWA and aggressive tendencies. Reflecting the conservative nature of Australian popular nationalism, RWPPN correlated with right-wing political alignment. The research was conducted in Australia, but given the rise in right-wing populism internationally, RWPPN may be a phenomenon in other countries. Therefore, this paper offers a new construct and scale to investigate it in Australia and internationally.

Standardization and Convergent Validation of the State-Trait Anxiety Inventory with measures of Personality, Affective Control and, Risk Propensity

We standardized the State-Trait Anxiety Inventory (STAI) on 407 young adults. Norms (high, medium, and low anxiety scores) were derived based on T scores and percentile ranks. Convergent validation was performed using correlation and multiple regression analysis followed by moderation analysis to study the relationship between STAI and NEO-FFI 3, Affective Control Scale, and Risk Propensity Scale. Results suggest that higher openness to experience acts as a protective factor against both state and trait anxiety. State anxiety emerged as a significant predictor for both affective control and risk propensity. While trait anxiety moderated the relationship between personality and affective control as well as personality and risk propensity. Higher levels of trait anxiety seem to increase the disabling effect of neuroticism on affective control; risk propensity is least for low trait anxiety and high conscientiousness. These results highlight the differential effects of types of anxiety and also to investigate the structure of STAI with Trait and State Anxiety not simply as two sides of the same coin but themselves as different constructs. The current study adds to the evidence that STAI is a valuable measure for investigating the effect of anxiety in healthy adults across populations/cultures and that anxiety is correlated with cognitive-affective-predisposition factors.

Validity of the Modified Dyspnea Index for the French—Canadian Population

Background and PurposeMultidimensional tools could evaluate the dyspnea of patients with chronic lung disease. The aim was to validate the use of the French–Canadian version of the modified dyspnea index (MDI) among patients with pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD).MethodsThe Spearman test analyzed the convergent validation of the MDI with pulmonary function tests (PFTs), New York Heart Association (NYHA) functional classification, the Modified Borg Scale, the Veterans Specific Activity Questionnaire (VSAQ), physical capacity, physical activity (Godin- Shephard Leisure-Time Physical Activity Questionnaire [GSLTPAQ]), and quality of life (SF-12).ResultsThe MDI had a low correlation with PFT and physical activity; a moderate with physical capacity; a high with the physical dimension (SF-12).ConclusionThe results support the convergent validation of the MDI French–Canadian version with PAH or ILD.

Essential Characteristics and Diagnostic Technique of Psychological Types of Love

The paper is aimed at theoretical insight into phenomenology of psychological manifestations of love styles, identified by J. A. Lee, the Canadian sociologist, who used types of love described by ancient Greek philosophers as a basis for his classification. The author employs a number of aspects as the criteria for the analysis of essential characteristics of love styles: differentially expressed features of feelings, self-awareness, social perception, types of human relationships (suggested by J. L. Moreno and M. Buber), ways of realization of inward human nature (described by E. S. Fromm), level of sense of community and compensation mechanism for inferiority feeling (conceptualized by A. Adler). As a result of the theoretical study, the author outlined six psychological types of love: passionate love-admiration (eros), hedonistic love (ludus), love-friendship (storge), practical love (pragma), obsessive love (mania), altruistic love (agape). Theoretical representations of psychological types of love, formulated upon carrying out the phenomenological analysis, and application of substantive deductive construction strategy for psychological inventories enabled the author to design a diagnostic technique for psychological types of love. To test the technique, the author conducted the empirical study that involved 143 participants (89 women and 54 men) aged 18–32 (mean age = 22). The paper gives the reliability indicators for six scales of the diagnostic technique for the psychological types of love and the results of its convergent validation that prove good psychometric applicability of the designed psychodiagnostic tools and their differential diagnostic potential. The study revealed correlations of degree of psychological types of love with some sustainable personality traits (R. B. Cattell’s technique) and indicators of social and psychological adaptability.

Prophetic Leadership Scale’s Validation and the Tendency of Normative Response

This study aims to validate the prophetic leadership scale by using a quantitative approach. 202 leaders were involved in this study. Data analysis technique that has been used for construct validation is factorial validation with confirmatory factor analysis (CFA), a convergent validation, discriminant validation, and social desirability bias with Pearson correlation. There are 4 instruments used in this study, namely the measuring instrument of prophetic leadership, the measuring instrument of authentic leadership as a convergent validator, the measuring instrument of religiosity as a discriminant validator, and the measuring tool of social desirability as a validator of social appropriateness bias. The prophetic leadership measurement tool measures the same construct as the authentic leadership measurement tool, and measures different constructs from the religiosity measurement tool, and the prophetic leadership measurement tool has a social appropriateness bias or the respondent's tendency to give answers in accordance with norms. The findings raise a prospect that social desirability bias’s influences fitness indices in a scale’s validation.