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Measuring the bright side of being blue: a new tool for assessing analytical rumination in depression.

Barbic SP, Durisko Z, Andrews PW - PLoS ONE (2014)

Bottom Line: Evidence of misfit for 2 items suggested that a 20-item scale with 4-point response categories best captured the concept of AR, fitting the Rasch model (χ2 = 95.26; df = 76, p = 0.07), with high reliability (rp = 0.86), ordered response scale structure, and no item bias (gender, age, time).Our study provides evidence for a 20-item Analytical Rumination Questionnaire (ARQ) that can be used to quantify AR in adults who experience symptoms of depression.Future work is needed to establish the validity of this measure in people with major depression.

View Article: PubMed Central - PubMed

Affiliation: Social Aetiology of Mental Illness (SAMI) Canadian Institute of Health Research (CIHR) Training Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

ABSTRACT

Background: Diagnosis and management of depression occurs frequently in the primary care setting. Current diagnostic and management of treatment practices across clinical populations focus on eliminating signs and symptoms of depression. However, there is debate that some interventions may pathologize normal, adaptive responses to stressors. Analytical rumination (AR) is an example of an adaptive response of depression that is characterized by enhanced cognitive function to help an individual focus on, analyze, and solve problems. To date, research on AR has been hampered by the lack of theoretically-derived and psychometrically sound instruments. This study developed and tested a clinically meaningful measure of AR.

Methods: Using expert panels and an extensive literature review, we developed a conceptual framework for AR and 22 candidate items. Items were field tested to 579 young adults; 140 of whom completed the items at a second time point. We used Rasch measurement methods to construct and test the item set; and traditional psychometric analyses to compare items to existing rating scales.

Results: Data were high quality (<1% missing; high reliability: Cronbach's alpha = 0.92, test-retest intraclass correlations >0.81; evidence for divergent validity). Evidence of misfit for 2 items suggested that a 20-item scale with 4-point response categories best captured the concept of AR, fitting the Rasch model (χ2 = 95.26; df = 76, p = 0.07), with high reliability (rp = 0.86), ordered response scale structure, and no item bias (gender, age, time).

Conclusion: Our study provides evidence for a 20-item Analytical Rumination Questionnaire (ARQ) that can be used to quantify AR in adults who experience symptoms of depression. The ARQ is psychometrically robust and a clinically useful tool for the assessment and improvement of depression in the primary care setting. Future work is needed to establish the validity of this measure in people with major depression.

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Related in: MedlinePlus

Summary of targeting to the sample of 20 items included in the Analytical Rumination Questionnaire.A. Distribution of items across the measurement continuum in the prototype analytical rumination questionnaire (ARQ). B. Item map showing expected score to each item, with items shown in order of difficulty. C. The location of the 20 items, relative to each other, on an interval scale.
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pone-0112077-g002: Summary of targeting to the sample of 20 items included in the Analytical Rumination Questionnaire.A. Distribution of items across the measurement continuum in the prototype analytical rumination questionnaire (ARQ). B. Item map showing expected score to each item, with items shown in order of difficulty. C. The location of the 20 items, relative to each other, on an interval scale.

Mentions: The item response options for 13/22 (59%) items were disordered. As shown in Figure 2b, we rescored disordered items by collapsing the middle category “half of the time” with the second category “some of the time”. After rescoring, statistical and graphical evidence of misfit remained for only two items: “I thought about all the bad things that could happen to me because of the situation I am in” (item 13: fit residual  = 5.95; χ2 = 48.09, df  = 9, p<0.01); and “I thought about how others were likely to respond to some of the actions I could take” (item 9: fit residual  = 4.33; χ2 = 29.42, df  = 9, p<0.01). Both items had ICCs well below the theoretical curve, providing evidence of poor discrimination ability. After consultation with two content experts and two clinicians, and revision of conceptual model, the two items were removed.


Measuring the bright side of being blue: a new tool for assessing analytical rumination in depression.

Barbic SP, Durisko Z, Andrews PW - PLoS ONE (2014)

Summary of targeting to the sample of 20 items included in the Analytical Rumination Questionnaire.A. Distribution of items across the measurement continuum in the prototype analytical rumination questionnaire (ARQ). B. Item map showing expected score to each item, with items shown in order of difficulty. C. The location of the 20 items, relative to each other, on an interval scale.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4232398&req=5

pone-0112077-g002: Summary of targeting to the sample of 20 items included in the Analytical Rumination Questionnaire.A. Distribution of items across the measurement continuum in the prototype analytical rumination questionnaire (ARQ). B. Item map showing expected score to each item, with items shown in order of difficulty. C. The location of the 20 items, relative to each other, on an interval scale.
Mentions: The item response options for 13/22 (59%) items were disordered. As shown in Figure 2b, we rescored disordered items by collapsing the middle category “half of the time” with the second category “some of the time”. After rescoring, statistical and graphical evidence of misfit remained for only two items: “I thought about all the bad things that could happen to me because of the situation I am in” (item 13: fit residual  = 5.95; χ2 = 48.09, df  = 9, p<0.01); and “I thought about how others were likely to respond to some of the actions I could take” (item 9: fit residual  = 4.33; χ2 = 29.42, df  = 9, p<0.01). Both items had ICCs well below the theoretical curve, providing evidence of poor discrimination ability. After consultation with two content experts and two clinicians, and revision of conceptual model, the two items were removed.

Bottom Line: Evidence of misfit for 2 items suggested that a 20-item scale with 4-point response categories best captured the concept of AR, fitting the Rasch model (χ2 = 95.26; df = 76, p = 0.07), with high reliability (rp = 0.86), ordered response scale structure, and no item bias (gender, age, time).Our study provides evidence for a 20-item Analytical Rumination Questionnaire (ARQ) that can be used to quantify AR in adults who experience symptoms of depression.Future work is needed to establish the validity of this measure in people with major depression.

View Article: PubMed Central - PubMed

Affiliation: Social Aetiology of Mental Illness (SAMI) Canadian Institute of Health Research (CIHR) Training Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

ABSTRACT

Background: Diagnosis and management of depression occurs frequently in the primary care setting. Current diagnostic and management of treatment practices across clinical populations focus on eliminating signs and symptoms of depression. However, there is debate that some interventions may pathologize normal, adaptive responses to stressors. Analytical rumination (AR) is an example of an adaptive response of depression that is characterized by enhanced cognitive function to help an individual focus on, analyze, and solve problems. To date, research on AR has been hampered by the lack of theoretically-derived and psychometrically sound instruments. This study developed and tested a clinically meaningful measure of AR.

Methods: Using expert panels and an extensive literature review, we developed a conceptual framework for AR and 22 candidate items. Items were field tested to 579 young adults; 140 of whom completed the items at a second time point. We used Rasch measurement methods to construct and test the item set; and traditional psychometric analyses to compare items to existing rating scales.

Results: Data were high quality (<1% missing; high reliability: Cronbach's alpha = 0.92, test-retest intraclass correlations >0.81; evidence for divergent validity). Evidence of misfit for 2 items suggested that a 20-item scale with 4-point response categories best captured the concept of AR, fitting the Rasch model (χ2 = 95.26; df = 76, p = 0.07), with high reliability (rp = 0.86), ordered response scale structure, and no item bias (gender, age, time).

Conclusion: Our study provides evidence for a 20-item Analytical Rumination Questionnaire (ARQ) that can be used to quantify AR in adults who experience symptoms of depression. The ARQ is psychometrically robust and a clinically useful tool for the assessment and improvement of depression in the primary care setting. Future work is needed to establish the validity of this measure in people with major depression.

Show MeSH
Related in: MedlinePlus