Content validity of measures of theoretical constructs in health psychology: Discriminant content validity is needed

Dixon, Diane; Johnston, Marie

doi:10.1111/bjhp.12373

Cited by 24 publications

(17 citation statements)

References 26 publications

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“…To our knowledge, this study is the first to empirically investigate the content of pain catastrophizing instruments, addressing the extent to which items are relevant for the construct 'pain catastrophizing' and to what extent these items are distinct from other related constructs and pain outcome constructs. Despite being an essential property of an instrument (Terwee et al, 2007), content validity is often neglected and overlooked at the expense of other forms of validity such as construct and criterion validity (Dixon & Johnston, 2019;Wiering, Boer & Delnoij, 2017). Furthermore, content validity is often confused with face validity (i.e., the extent to which an instrument appears to be valid), which is technically not a form of validity (Lilienfeld et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…We recommend that in future studies on the role of psychosocial variables, content overlap with outcomes is systematically addressed. The DCV method used here can be easily adopted (Dixon & Johnston, 2019).…”

Section: Discussionmentioning

confidence: 99%

“…Third, pain catastrophizing questionnaires should be distinct from questionnaires assessing other theoretical constructs (e.g., pain vigilance, pain-related worry, or fear), and from primary outcomes (e.g., pain severity, pain-related distress, or pain-related disability; (Hirsh et al, 2007). Otherwise, theory building becomes hazardous (Dixon & Johnston, 2019;Goubert, Crombez & Van Damme, 2004;Wideman, Adams & Sullivan, 2009) and the explanatory power of pain catastrophizing may be inflated.…”

Section: Introductionmentioning

confidence: 99%

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Let’s talk about pain catastrophizing measures: an item content analysis

Crombez

Paepe

Veirman

et al. 2020

PeerJ

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Background Concerns have been raised about whether self-report measures of pain catastrophizing reflect the construct as defined in the cognitive-behavioral literature. We investigated the content of these self-report measures; that is, whether items assess the construct ‘pain catastrophizing’ and not other theoretical constructs (i.e., related constructs or pain outcomes) using the discriminant content validity method. Method Items (n = 58) of six pain catastrophizing measures were complemented with items (n = 34) from questionnaires measuring pain-related worrying, vigilance, pain severity, distress, and disability. Via an online survey, 94 participants rated to what extent each item was relevant for assessing pain catastrophizing, defined as “to view or present pain or pain-related problems as considerably worse than they actually are” and other relevant constructs (pain-related worrying, vigilance, pain severity, distress, and disability). Results Data were analyzed using Bayesian hierarchical models. The results revealed that the items from pain-related worrying, vigilance, pain severity, distress, and disability questionnaires were distinctively related to their respective constructs. This was not observed for the items from the pain catastrophizing questionnaires. The content of the pain catastrophizing measures was equally well, or even better, captured by pain-related worrying or pain-related distress. Conclusion Based upon current findings, a recommendation may be to develop a novel pain catastrophizing questionnaire. However, we argue that pain catastrophizing cannot be assessed by self-report questionnaires. Pain catastrophizing requires contextual information, and expert judgment, which cannot be provided by self-report questionnaires. We argue for a person-centered approach, and propose to rename ‘pain catastrophizing’ measures in line with what is better measured: ‘pain-related worrying’.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Let’s talk about pain catastrophizing measures: an item content analysis

Crombez

Paepe

Veirman

et al. 2020

PeerJ

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“…Until now content validity has been largely overlooked at the expense of other forms of validity, such as construct (i.e., convergent and discriminant validity) and criterion validity (i.e., predictive, concurrent, and retrospective validity) (e.g., Lumley, Neely & Burger, 2007 ; Parker, Taylor & Bagby, 2003 ; Bagby, Parker & Taylor, 2020 ). This is surprising as content validity is a fundamental property of any measure of any theoretical construct ( Haynes et al, 1995 ) and key in theory testing, intervention design, and practical applications ( Dixon & Johnston, 2019 ; Van Ryckeghem, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…It is key that correlations between the TAS-20 and health anxiety are not (partially) explained by content overlap. If the TAS-20 is contaminated by content relevant to related constructs such as anxiety, depression, and health anxiety, relationships between the measures of these constructs may then simply be due to content overlap resulting in inflated explanatory power of alexithymia and hazardous theory building ( Dixon & Johnston, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

What do alexithymia items measure? A discriminant content validity study of the Toronto-alexithymia-scale–20

Veirman

Ryckeghem

Verleysen

et al. 2021

PeerJ

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Background Questions have been raised about whether items of alexithymia scales assess the construct alexithymia and its key features, and no other related constructs. This study assessed the (discriminant) content validity of the most widely used alexithymia scale, i.e., the Toronto Alexithymia Scale (TAS-20). Methods Participants (n = 81) rated to what extent TAS-20 items and items of related constructs were relevant for assessing the constructs ‘alexithymia’, ‘difficulty identifying feelings’, ‘difficulty describing feelings’, ‘externally-oriented thinking’, ‘limited imaginal capacity’, ‘anxiety’, ‘depression’, and ‘health anxiety’. Results Results revealed that, overall, the TAS-20 did only partly measure ‘alexithymia’. Only the subscales ‘difficulty identifying feelings’ and ‘difficulty describing feelings’ represented ‘alexithymia’ and their intended construct, although some content overlap between these subscales was found. In addition, some items assessed (health) anxiety equally well or even better. Conclusions Revision of the TAS-20 is recommended to adequately assess all key features of alexithymia. Findings with the TAS-20 need to be interpreted with caution in people suffering from medical conditions.

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