Working with values and values-based behavioral change in psychological interventions for athletes has become more common in sport psychology, but measures adapted for the sport context are needed. A new instrument based on the Bull’s-Eye Values Survey, called Bull’s-Eye for Athletes (BEA), was developed and adapted to assess values and values-based behavior in athletes. BEA consists of four values items, (1) Competition, (2) Training, (3) Preparation and recovery, and (4) Life outside of sport. Athletes identify their values and rate their behavioral commitment for each value item and to what extent they experience obstacles behaving according to their values, both related to their sport and life outside of sport. BEA was completed online by 155 athletes in Sweden competing at junior elite to senior international level. Scale dimensionality, invariance, monotonicity of response categories, and reliability were investigated using Rasch analysis. Convergent and discriminant validity was also investigated through correlation with other scales. Results indicated that BEA worked as a unidimensional scale with satisfactory psychometric properties. Item probability functions were investigated, and response categories were merged to achieve ordered item thresholds. No indication of invariance was found through differential item functioning (DIF) analyses for demographic (age, sex) or sport-related variables (competitive level, sport type, or current injury), nor for temporal stability of item properties through test-retest. Convergent and discriminant validity was supported by medium correlations with psychological inflexibility in athletes, general valued living, life satisfaction, subjective performance, and a few subtypes of performance anxiety and sport motivation. BEA is a promising instrument for measuring and working with values and values-based behavior in sport. Response categories were merged for two items (competition and training) to achieve ordered item thresholds. Labeling of the instrument’s response categories could be a potential improvement for BEA to be investigated. Further investigations are needed across various sports contexts with larger sample sizes, as well as evaluations of its usefulness in longitudinal designs in sport psychological intervention research as a measure of self-reported behavioral change.

Objective: Reliable and accurate measurement is fundamental to scientific progress; however, the dominant measurement practices in psychology, clinical psychology, and prediction research often lack rigor. Improving measures using Rasch Measurement Theory (RMT) offers advantages by fulfilling the key psychometric properties of unidimensionality, local independence of items, ordering of response categories, and invariance. Ordinal-level sum scores can be transformed into interval-level latent trait scores, thereby improving the measurement precision. However, the impact of using psychometrically advanced questionnaires with latent trait scores, as opposed to traditional sum scores, in predictive models is still unclear. This study evaluates whether using latent trait scores as predictors and outcomes, in accordance with RMT, improves predictive performance compared to using traditional sum scores when predicting treatment outcomes during psychological treatment. Methods: Self-rated symptom data from three different questionnaires, collected over the first 4 weeks of psychological treatment from 6,464 patients undergoing a 12-week treatment program, were used to predict post-treatment outcomes on the same questionnaires. This was done in two ways: (1) using sum scores as the questionnaires were originally developed and (2) using a reformulated, more psychometrically robust version of the questionnaires based on Rasch analysis, which was also shorter. The prediction models used were linear regression, Bayesian ridge regression, and random forest. Multiple imputations were used to address missing data, and nested cross-validation was employed for hyperparameter tuning and scoring. Results: Latent scores calculated using the psychometrically optimized shorter version, which comprises 23% of the full scale, showed similar predictive performance compared to the sum score of the full scale. Overall, there was a statistically significant but practically negligible difference of 0.007–0.008 in the root mean squared error (RMSE) when comparing the original sum score to the latent trait scores. Conclusion: Initial findings comparing psychometrically improved questionnaires with the original ordinal sum scores within a predictive framework indicate that using latent trait scores derived from these improvements showed the predictive performance similar to the sum score of the full scale. The small differences suggest that the improved versions remain valuable owing to their enhanced psychometric qualities and the reduction in response burden by using considerably fewer items. Further research is needed to explore the use of latent trait scores compared to ordinal sum scores in predictive research. Copyright

Objectives Psychological inflexibility (PI) is a potentially important yet understudied factor in therapist training, as it may hinder engagement in learning activities central to psychotherapy education and is negatively associated with learner wellbeing. However, few instruments have been developed to assess PI in educational and training contexts, and evidence from psychotherapy training populations are limited. This study aimed to develop a new measure of PI intended for use in educational settings, and to evaluate its psychometric properties within the specific context of psychotherapy training. Method In Study One, an initial version of the scale was developed and tested with 195 mental health professionals who were currently or previously enrolled in psychotherapy continuing education. Preliminary psychometric evaluation included expert review, cognitive interviews, exploratory factor analysis, and Mokken scale analysis. Rasch methodology was then applied to assess dimensionality, item independence, response category ordering, targeting, invariance, and reliability. In Study Two, a new sample (n = 337) was used to validate the revised instrument through Rasch analysis. Results Results supported a unidimensional, 7-item scale demonstrating good model fit, local independence, ordered thresholds, invariance, and acceptable reliability. Additional analyses suggested a small but statistically significant negative association between age and psychological inflexibility (rho = −0.18), while no consistent differences were found across gender or profession. Conclusion The resulting instrument – the Karolinska Inner-Barriers Scale for Education (KIBS-Ed) – offers a brief and psychometrically sound measure of psychological inflexibility, suitable for use in educational and training settings. Our evaluation within two samples from the psychotherapy training population supports its application within therapist education. Despite providing only preliminary validation and requiring further evaluation with additional outcomes and instruments, the present study represent a rigorous and important first step

Psychometrics have long relied on rule-of-thumb critical values for goodness of fit metrics. With powerful personal computers it is both feasible and desirable to use simulation methods to determine appropriate cutoff values. This paper evaluates the use of an R package for Rasch psychometrics that has implemented functions to simplify the process of determining simulation-based cutoff values. Through six simulation studies, comparisons are made between information-weighted conditional item fit (“infit”) and item-restscore correlations using Goodman and Kruskal’s γ. Results indicate the limitations of small samples (n < 500) in correctly detecting item misfit, especially when a larger proportion of items are misfit and/or when misfit items are off-target. Infit with simulation-based cutoffs outperforms item-restscore with sample sizes below 500. Both methods result in problematic rates of false positives with large samples (n >= 1000). Large datasets should be analyzed using nonparametric bootstrap of subsamples with item-restscore to reduce the risk of type-1 errors. Finally, the importance of an iterative analysis process is emphasized, since a situation where several items show underfit will cause other items to show overfit. Underfit items should be removed one at a time, and a re-analysis conducted for each step to avoid erroneously eliminating items.

Cardiac anxiety (CA) is a commonly occurring condition in populations with both cardiac and mental health conditions. It is assessed using the CA questionnaire (CAQ), which has been translated to several languages and its validity and reliability has been investigated using classical test theory. The factor structure of the CAQ remains uncertain, and no study has investigated the psychometric properties of the CAQ using modern test theory approaches. The aim of this study was to use Rasch analysis to test the validity and reliability of the original 18-item CAQ in a Swedish sample of patients with myocardial infarction, as well as other scales, based on previous findings. Participants were 754 patients after myocardial infarction with preserved cardiac function. Data were fitted to the Rasch model, investigating dimensionality, ordering of response categories, invariance, targeting and measurement uncertainty. Additionally, a confirmatory factor analysis (CFA) was conducted using a weighted least mean squares estimator and dynamic fit indices. All three subscales indicated problems with dimensionality and several items had disordered response categories, and with some of them minimal distance between steps. Many items displayed local dependency. There were also small problems with differential item functioning. Person locations were lower than the item threshold locations, but there were no significant floor or ceiling effects. The CFA also demonstrated a poor model fit of the three subscales in the 18-item version of the CAQ. An iterative removal of items resulted in a modified 10-item version still with questionable reliability. The original 18-item version of the CAQ did not fit the Rasch model. The major problems with the 18-item version were dimensionality, local dependency, and disordered response categories. No other version of the CAQ achieved acceptable fit to the Rasch model. These results indicate that the CAQ is lacking in terms of reliability and a revision of the scale is called for. Trial registration: ClinicalTrials.gov. (2017, August 09). Evaluation of Decreased Usage of Betablockers After Myocardial Infarction in the SWEDEHEART Registry (REDUCESWEDEHEART). U.S. National Library of Medicine. https//clinicaltrials.gov/study/NCT03278509

Depression is one of the most common psychiatric conditions. Given its high prevalence and disease burden, accurate diagnostic procedures and valid instruments are warranted to identify those in need of treatment. The Patient Health Questionnaire-9 (PHQ-9) is one of the most widely used self-report measures of depression, and its validity and reliability has been evaluated in several languages. However, the Swedish translation has yet not been subject to psychometric evaluation, and no previous psychometric evaluation of the instrument have used both Rasch analysis and classic test theory. The aim of this study was to investigate validity and reliability of the PHQ-9 in a Swedish sample of individuals with self-reported current or past mental health problems using Rasch analysis and confirmatory factor analysis. A sample of 4958 participants was recruited from an online survey covering different aspects of covid-19 and mental health targeted towards individuals with mental health problems. Results showed that a one-factor solution fit the data after removing one item and that some items had a different response pattern for older respondents. Furthermore, after removing item 2 and merging the two middle response categories for item 9, the Swedish translation of PHQ-9 showed adequate psychometric properties. The findings suggests that the Swedish translation of PHQ-9 may need to be adapted in order to make adequate interpretations of an individual score and to differentiate between populations. Further tests of its validity and reliability in other Swedish samples are needed to fully understand the properties of the Swedish version of PHQ-9. 

Background and Aim: To address knowledge gaps in safe patient handling and mobility methods (SPHMM) among rehabilitation professionals in Sweden, a national knowledge center, HMC, provides training on SPHMM. The study’s aim was to report on outcomes at 3 months after training in terms of self-perceived competence in SPHMM and self-perceived utility of acquired competence in SPHMM. Methods: Training participants (occupational therapists and physiotherapists) completed a study-specific questionnaire, with 1065 doing so at 3 weeks before the training and 389 at 3 months after training. Linear mixed models were used for analyses. Results: Self-perceived competence improved significantly at 3 months after training (p < 0.001). Occupational therapists, specifically, and rehabilitation professionals generally with less clinical experience reported greater improvement compared to physiotherapists and those with longer experience (p < 0.001). Rehabilitation professionals overall with shorter clinical experience also reported higher self-perceived utility of the acquired SPHMM competence (p < 0.001), but occupational therapists and physiotherapists did not differ significantly (p = 0.369). Conclusion: Among rehabilitation professionals, greater self-perceived competence and self-perceived utility of the acquired competence in SPHMM is possible after HMC training. Improvements were greater for those with shorter clinical experience. By enhancing competence among rehabilitation professionals, HMC training has the potential to advance working person-centered and efficient transfer practices in interdisciplinary care settings.