OBJECTIVETo perform the first comprehensive psychometric evaluation of the Hypoglycemia Fear Survey-II (HFS-II), a measure of the behavioral and affective dimensions of fear of hypoglycemia, using modern test-theory methods, including item-response theory (IRT).RESEARCH DESIGN AND METHODSSurveys completed in four previous studies by 777 adults with type 1 diabetes were aggregated for analysis, with 289 subjects completing both subscales of the HFS-II and 488 subjects completing only the Worry subscale. The aggregated sample (53.3% female, 44.4% using insulin pumps) had a mean age of 41.9 years, diabetes duration of 23.8 years, HbA1c value of 7.7%, and 1.4 severe hypoglycemic episodes in the past year. Data analysis included exploratory factor analysis using polychoric correlations and IRT. Factors were analyzed for fit, trait-level locations, point-measure correlations, and separation values.RESULTSInternal and test-retest reliability was good, as well as convergent validity, as demonstrated by significant correlations with other measures of psychological distress. Scores were significantly higher in subjects who had experienced severe hypoglycemia in the past year. Factor analyses validated the two subscales of the HFS-II. Item analyses showed that 12 of 15 items on the Behavior subscale, and all of the items on the Worry subscale had good-fit statistics.CONCLUSIONSThe HFS-II is a reliable and valid measure of the fear of hypoglycemia in adults with type 1 diabetes, and factor analyses and IRT support the two separate subscales of the survey.

The HFS Worry subscale measures one construct of anxiety about various aspects of hypoglycaemia. In contrast, the HFS Behaviour subscale appears to measure two distinct aspects of behavioural avoidance to prevent hypoglycaemia, actions which maintain high blood glucose and other behaviours to avoid hypoglycaemic risk. These results demonstrate the clinical importance of the HFS Behaviour subscales and their differential relationships with measures of diabetes outcome such as HbA1c .

The authors report differential item functioning (DIF) between Black and White participants completing the 60-item Padua Inventory (PI) for obsessive-compulsive disorder (OCD). The authors use an Internet-generated sample that included 105 Blacks, 67 Hispanics, 582 Whites, and 136 additional participants reporting an OCD diagnosis. Factor analysis replicated prior work indicating the PI consists of four factors: contamination fears, checking behaviors, impaired control over thoughts, and fear of losing control over impulses. On the contamination subscale, nonclinical Black and Hispanic mean scores were as high as the OCD group. Comparing Blacks to Whites, the authors applied an item response theory, DIF-graded response model to each factor and found significant DIF on eight items, with biased items in each factor. Results suggest that extraneous factors contribute to racial differences on scores. Cultural practices and fear of being negatively stereotyped may contribute to item bias.

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Social climate-specifically, the level of support for sexual minorities in a given locale-helps to explain well-being among lesbian, gay, and bisexual (LGB) individuals. No published reports have examined whether wellbeing also varies as a function of social climate for family members of LGB individuals. We present results from two studies (Study 1, n069; Study 2, n070) demonstrating that social climate predicts well-being among adults reared by LGB parents, regardless of their own sexual orientation. Across both studies, population characteristics (e.g., density of same-sex couples in an area) emerged as the strongest and most consistent predictors of well-being. Some variables assessing local politics (e.g., LGB hate crime policy) also predicted well-being, though these associations were less robust. Overall, findings suggest that the social environment for sexual minorities is an important correlate of psychological adjustment for many Americans, regardless of their sexual orientation.