Evaluating the validity and reliability of the Chinese entrapment scale and the relationship to depression among men who have sex with men in Shanghai, China

Abstract

Background Perception of entrapment can emerge when someone feels trapped in an aversive situation and incapable of escape. Depression is closely related to the construct of entrapment. In China, men who have sex with men (MSM) have a high prevalence of depression; therefore, a tool to evaluate entrapment in this population is needed. We evaluated the validity and reliability of the Chinese version of the entrapment scale (ES) and the relationship to depression among MSM in Shanghai, China. Methods We recruited 304 MSM from four districts in Shanghai, China. Participants completed health behavior questionnaires that included baseline information and psychological measurements such as the ES and Patient Health Questionnaire (PHQ-9). The sample was randomly divided into two groups for exploratory factor analysis (n = 143) and confirmatory factor analysis (n = 161). Criterion validity was tested to explore the correlation between the ES and PHQ-9 scores. The reliability of the ES was evaluated with internal consistency reliability (Cronbach’s α coefficient) and split-half reliability (Spearman-Brown coefficient). We performed hierarchical regression analysis to determine the variance explained of entrapment to predicting depressive symptoms after adjusting for sociodemographic factors. Finally, receiver operator characteristic curve analysis was performed to measure the optimal ES cut-off value for predicting depression. Results Factor analysis showed the ES had one principal component, and one-dimensional scale had more acceptable model fit indices than two-dimensional model. The correlation coefficient between the ES and PHQ-9 scores was 0.756 (P < 0.01). The Cronbach’s α coefficient was 0.970 and the Spearman-Brown coefficient was 0.976. ES scores significantly predicted an additional 45.1% of depressive symptoms after controlling for sociodemographic characteristics in the MSM population (β = 0.689, P < 0.001). The optimum cut-off value was 23, which had a sensitivity of 70% and a specificity of 85.4%. Conclusions The Chinese version of the ES has good validity and reliability in the MSM population in Shanghai, and can be used to evaluate perception of entrapment among MSM. The findings confirmed an association between entrapment and depression.

The Mental Health and Syndemic Effect on Suicidal Ideation among Migrant Workers in China: A Cross-Sectional Study

“…The concepts of entrapment and defeat were first proposed according to the social rank theory and proven to be promising variables for the study of depression [ 38 ]. Entrapment and defeat can be felt following long-term and stressful life events [ 40 ]. Evolutionary models suggested the two feels can co-occur to result in the development of mental disorders.…”

“…The higher the total score, the greater the degree of entrapment (Cronbach’s α = 0.956; range 0–30). The Chinese version of ES proved to be a valid and reliable screening tool in a prior study [ 40 ].…”

A nomogram of suicidal ideation among men who have sex with men in China: Based on the integrated motivational-volitional model of suicidal behavior

“…The total scale score ranges from 0 to 64, with higher score indicating a higher level of entrapment ( 17 ). The Chinese version of the ES has been validated with good reliability among MSM ( 35 ).…”

Mpox risk perception and associated factors among Chinese young men who have sex with men: Results from a large cross‐sectional survey

“…Depressive symptoms were measured using the widely‐used Patient Health Questionnaire‐9 (PHQ‐9) 25 . PHQ‐9 had been validated in Chinese MSM and showed good psychometric properties 26 . The 9‐item scale asked the frequency of the listed symptoms in the previous 2 weeks (e.g., having little interest or pleasure in doing things).…”

“…25 PHQ-9 had been validated in Chinese MSM and showed good psychometric properties. 26 The 9-item scale asked the frequency of the listed symptoms in the previous 2 weeks (e.g., having little interest or pleasure in doing things). For each item, respondents rated on a 4-point Likert scale (from "0 = none of the time"…”