The Children’s Somatic Symptoms Inventory-8: Psychometric Properties of a Brief Measure of Somatic Distress
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Procedure
2.1.1. Patient Sample
2.1.2. Community Sample
2.2. Measures
2.3. Item Reduction
2.4. Statistical Methods for Evaluating the CSSI-8
- 1.
- Descriptive statistics (mean, skew, and kurtosis) warn of floor or ceiling problems that reduce an item’s variance. If a test item is nearly constant (the same for everyone), its contribution to the total score may be weak. Floor/ceiling problems also may occur when an item’s mode reaches the item’s minimum or maximum or when items have skew or kurtosis >3.
- 2.
- Corrected item-total correlations (rit) show items that contribute to Cronbach’s alpha internal consistency reliability. Items with rit <0.4 may contribute less.
- 3.
- A single-factor confirmatory factor analysis (CFA) evaluates the test’s “factorial validity” for a one-factor measurement model. Warning flags highlight low-load items with standardized betas <0.4; such items may not measure the test’s main factor well. The measurement model’s fit to the data can be evaluated with a deviance-based fit index and a residual-based fit index. For example, using Bentler’s Confirmatory Fit Index (CFI; [43]), values “close to” 0.95 are considered adequate [44]. Using a residual-based fit measure such as the SRMR (Standardized Root Mean Squared Residual), values “close to” 0.08 are considered adequate [44]. Poor fit indices raise questions about the single-factor measurement model’s fit to the data.
- 4.
- Infit, outfit, and person separation reliability evaluate a test’s fit to a Rasch measurement model. Infit measures the model’s fit for closely targeted items, and outfit measures the fit for far-targeted items. Items with an infit or outfit outside the interval 0.5–1.5 may be problematic [45]. Even stricter limits for infit and outfit have been suggested [46]. Person separation reliability assesses a test’s ability to measure differences among people. For most tests, reliability should be > 0.80, although for a short tool such as the CSSI-8, a reliability of > 0.70 is acceptable [47].
3. Results
3.1. Item Targeting in the CSSI-8
3.2. Replication in a Community Sample
3.3. Relation of CSSI-8 Total Scores to Sample Type and Sex
3.4. Relation of the CSSI-8 to the CSI-24
3.5. Scoring the CSSI-8
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Measures | ||||
---|---|---|---|---|
Items | ||||
CSSI-8 | PHQ | CBCL | ||
Stomach Pain | X | X | X | |
Headache | X | X | X | |
Back Pain | X | X | X1 | |
Faintness or Dizziness | X | X | ||
Arm or Leg Pain | X | X | X1 | |
Heart Beating Fast | X | X | ||
Nausea | X | X | X | |
Weakness | X | |||
Constipation | X | |||
Shortness of Breath | X | |||
Menstrual Cramps | X | |||
Pain w/Intercourse | X | |||
Problems w/Eyes | X | |||
Rashes | X | |||
Vomiting | X |
Variable | Mean | Std Dev | Skew | Kurtosis | Item-Total r | Std CFA Beta | Measure | Infit | Outfit |
---|---|---|---|---|---|---|---|---|---|
Stomach Pain | 2.56 | 1.15 | −0.42 | −0.68 | 0.44 | 0.53 | 33.33 | 0.90 | 0.98 |
Headache | 1.35 | 1.18 | 0.48 | −0.69 | 0.43 | 0.50 | 46.89 | 1.01 | 1.00 |
Weakness | 0.87 | 0.98 | 1.02 | 0.46 | 0.53 | 0.64 | 53.07 | 0.78 | 0.73 |
Lower Back Pain | 0.77 | 1.10 | 1.28 | 0.58 | 0.38 * | 0.44 | 54.64 | 1.30 | 1.20 |
Faintness | 0.68 | 0.98 | 1.44 | 1.43 | 0.47 | 0.56 | 56.14 | 0.99 | 0.92 |
Arm or Leg Pain | 0.59 | 0.92 | 1.54 | 1.72 | 0.35 * | 0.41 | 57.80 | 1.21 | 1.08 |
Heart Too Fast | 0.42 * | 0.90 | 2.28 | 4.51 * | 0.38 * | 0.47 | 61.40 | 1.36 | 1.33 |
Nausea | 2.27 | 1.20 | −0.21 | −0.86 | 0.45 | 0.54 | 36.72 | 0.93 | 0.96 |
Sample | Mean (Sum) | Std Dev | Skew | Kurtosis | Cron. Alpha | SRMR | Bentler CFI | Person Sep Rel |
---|---|---|---|---|---|---|---|---|
Learning N = 417 | 9.51 | 5.00 | 0.59 | 0.04 | 0.74 | 0.07 | 0.82 * | 0.75 |
Cross-validation N = 459 | 9.84 | 5.22 | 0.64 | −0.02 | 0.74 | 0.06 | 0.85 * | 0.74 |
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Stone, A.L.; Garber, J.; Walker, L.S. The Children’s Somatic Symptoms Inventory-8: Psychometric Properties of a Brief Measure of Somatic Distress. Children 2024, 11, 1326. https://doi.org/10.3390/children11111326
Stone AL, Garber J, Walker LS. The Children’s Somatic Symptoms Inventory-8: Psychometric Properties of a Brief Measure of Somatic Distress. Children. 2024; 11(11):1326. https://doi.org/10.3390/children11111326
Chicago/Turabian StyleStone, Amanda L., Judy Garber, and Lynn S. Walker. 2024. "The Children’s Somatic Symptoms Inventory-8: Psychometric Properties of a Brief Measure of Somatic Distress" Children 11, no. 11: 1326. https://doi.org/10.3390/children11111326
APA StyleStone, A. L., Garber, J., & Walker, L. S. (2024). The Children’s Somatic Symptoms Inventory-8: Psychometric Properties of a Brief Measure of Somatic Distress. Children, 11(11), 1326. https://doi.org/10.3390/children11111326