Short version of the Multidimensional Scale of Dating Violence (MSDV 2.0) in Spanish-language: Instrument development and psychometric evaluation

1610 | J Adv Nurs. 2023;79:1610–1631.wileyonlinelibrary.com/journal/jan Received: 5 January 2022 | Revised: 30 March 2022 | Accepted: 26 April 2022 DOI: 10.1111/jan.15300 RESEARCH METHODOLOGY: INSTRUMENT DEVELOPMENT Short version of the Multidimensional Scale of Dating Violence (MSDV 2.0) in Spanishlanguage: Instrument development and psychometric evaluation María de los Ángeles García- Carpintero- Muñoz | Lorena Tarriño- Concejero | Eugenia Gil- García | Ana María Pórcel- Gálvez | Sergio Barrientos- Trigo This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2022 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd. Research Group PAIDICTS 1050 Complex Care, Chronicity and Health Outcomes, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain Correspondence Lorena Tarriño- Concejero, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, C/ Avenzoar, 6. 41009 Seville, Spain. Email: [email protected] Funding information The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article. This research was supported by contract with companies (Arts. 68/83 LOU): Promoting healthy relationships in Andalusian University Youth. Prevention of gender violence. (3921/1054). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. Abstract Aims: To develop and psychometrically test the short version of the Multidimensional Scale of Dating Violence (MSDV 2.0) in Spanishlanguage to detect violence perpetrated and suffered in dating relationships. Design: A psychometric instrument development and validation study. Methods: A twophase approach was used: Phase (1) the items of the original instrument were revised and new items related to online violence and sexual violence were incorporated. Content validation by a Delphi panel with 25 psychometric and dating violence experts were performed. Next, a face validity was performed in 32 students followed by a pilot study in another 74 participants. Phase (2) Psychometric validation, the instrument was tested in a sample of 1091 university students, analysing the psychometric properties based on construct validity and internal consistency. The study was conducted from September to November 2020 in the context of the Andalusian Public University System. Results: In phase (1) 42 items for each subscale (perpetration, victimization) were accepted by the Delphi panel, and acceptable values were obtained for the criteria of clarity, coherence, and relevance. In phase (2) the MSDV 2.0 showed acceptable psychometric properties. Confirmatory factor analysis showed a fivedimensional structure with 18 items for each subscale with excellent fit rates. Reliability analysis indicated adequate internal consistency (α = .879– .802) and correlations with the Depression, Anxiety, and Stress Scale (ρ = .418– .225) and the selfperceived health item (ρ = .380– .179), providing evidence of its convergent validity. Cutoff points were also calculated for each dimension, with their corresponding sensitivity and specificity, indicating to be a good instrument for detecting possible cases of dating violence. Conclusion: The MSDV 2.0 is the only short instrument published to date that measures the dating violence suffered and perpetrated taking into account all its | 1611 GARCÍA-CARPINTERO-MUÑOZ et al. 1 | INTRODUCTION Dating violence (DV) is classified as a type of intimate partner violence (IPV) and is defined as the perpetration of emotional, physical or sexual abuse in a dating relationship, regardless of duration, and is an increasingly prevalent public health problem among adolescents and young adults (Emelianchik et al., 2018). However, it has not received as much attention in research as adult IPV (Straus & Gozjolko, 2014; United Nations Entity for Gender Equality and the Empowerment of Women [UN Women], 2021). It is important to note that the victims of these behaviours are usually women. Globally, one in three women aged 15– 49 years report having suffered some type of physical and/or sexual violence by their partner [World Health Organization (WHO, 2021)]. These data coincide with the latest study conducted in Europe with all member countries (European Union Agency for Fundamental Rights, 2014) and with the recent study conducted in Spain, the Macrosurvey on Violence against Women, which finds that psychological violence is suffered mainly by young women (38.3%) in the 16– 24 years age bracket (Government Delegation against Gender Violence, Spain, 2019). 1.1 | Background 1.1.1 | The complexity of dating violence and its impact on health In adolescence and youth, in the cultural construct of ‘romantic love’, objectionable behaviours such as jealousy or control over the partner, are regarded as positive elements and even evidence of love, which are idealized in couple relationships at a young age (Bosch et al., 2019). In addition, in many of these couples there is a normalization of violence as a strategy to resolve conflicts, becoming a habitual element in the relationship, which go unnoticed and are not detected as violence, since only physical aggressions are identified as violence (Perles et al., 2019; Rodríguez- Santero et al., 2017). Violence in a dating relationship can include different acts, ranging from emotional abuse to physical aggression and/or sexual violence. Regarding psychoemotional abuse attitudes, we find actions of denigration and devaluation that set out to cause feelings of insecurity, such as threatening to break up with the other person or telling him/her that another person would be a better partner, ridiculing, insulting the other partner in front of others or telling him/her that he/she is a failure (García- Carpintero et al., 2018). In physical aggression behaviours, there is a wide range that escalates from threats or environmental violence to physical aggression (Rubio et al., 2015). The sexual violence dimension would include forced sexual relations by the partner through coercion with emotional control tactics, to forced sexual activity with or without penetration (Bagwell, 2021). In addition, having had multiple partners and/or consuming alcohol and other substances before the sexual act is associated with a greater propensity to be victims of sexual violence (Demissie et al., 2018; Khanhkham et al., 2020). Moreover, information and communication technologies in social relationships plays a very important role in young people, as they spend most of their time using them (Gabelas & Marta, 2020). In some dating relationships, attitudes of control and surveillance can occur, including actions such as spying on photos and comments uploaded to networks, monitoring friendships or demanding that the partner delete content or profiles, monitoring the connection time or geolocation, thus creating a situation of effective control (Estébanez, 2018; Rodríguez et al., 2018).Cyberbullying is also found, which includes acts such as sending threats, disseminating private information and insulting a person on social media (Cava et al., 2020). All these types of violent relationships generate negative consequences on health and lifestyle in adolescents and young people. Among others, high rates of low selfesteem, anxiety (Pérez- Marco et al., 2020), increase in eating disorders (Cha et al., 2016) and school failure (Banyard & Cross, 2008) are standing out consequences. It increases antisocial behaviours and risky behaviours, such as use of illicit substance, having multiple sex partners and engaging in unsafe sex, which can lead to sexually transmitted diseases and unwanted pregnancies (Kisa & Zeyneloğlu, 2019). All of them, in the long term, in their adulthood, could increase various mental disorders (Pérez- Marco et al., 2020), psychopathological disorders (Davila et al., 2016) and physical injury (Kisa & Zeyneloğlu, 2019). These consequences are more severe for girls dimensions. Its use would serve as support in prevention programs and design of public policies. Impact: The short version of the MSDV 2.0 could be a comprehensive enough instrument to enable a detection and evaluation of dating violence in the educational setting. KEYWORDS assessments, nursing, adolescence and youth, dating violence, instrument development, intimate partner violence, nursing, psychometric properties, public health surveillance, validation studies 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 1612 | GARCÍA-CARPINTERO-MUÑOZ et al. than for boys, implying greater physical and emotional sequelae (WHO, 2021). That is why health professionals, and especially nursing, have an outstanding role in the prevention and detection of DV (Jack et al., 2021). 1.1.2 | Validating measures of dating violence Due to the high prevalence and incidence of DV, it is crucial that there be instruments that detect and measure these behaviours. Thus, over the last decade different instruments have been published that measure this phenomenon, encompassing several dimensions, such as the Dating Violence Questionnaire (DVQ; López et al., 2016), Violence in Adolescents' Dating Relationships Inventory (VADRI; Aizpitarte et al., 2017), Measure of Adolescent Relationship Harassment and Abuse (MARSHA; Rothman et al., 2021), Teen Dating Violence: Victimization and Perpetration scale. TDVVP Scale (Soriano et al., 2021), Dating Violence Questionnaire- R (DVQ- R; Rodríguez- Díaz et al., 2017), Conflict in adolescent dating relationships inventory short form (CADRI- S; Fernández et al., 2012) and the Conflict Tactics Scales (CTS) in its different versions, modified (CTS- M; Ronzón et al., 2019) or revised (CTS- 2; Anderson & Leigh, 2011). Most of these instruments have been validated in young university students, since at those ages, young people's first relationships usually begin or are consolidated (Llano- Suárez et al., 2021). Prevention and detection is also crucial in this context, since universities are institutions that promote health, ensure the right to the freedom, physical and emotional integrity of all its collective, and are guarantors of progress in our society (Spanish Network of Healthy Universities, 2021). Designing valid and reliable instruments in the target population are a vital stage to be able to carry out the first step, which is to accurately detect the different types of violence and develop protocols or action plans to improve health in the adolescents and young people who are affected. In addition, the analysis of the data produced by these instruments can be used to develop prevention programs and public policies that promote the development of egalitarian relationships in young couples. Our research team has validated the Multidimensional Scale of Dating Violence (MSDV; García- Carpintero et al., 2018). This instrument is composed of two subscales that explore the violence perpetrated and violence suffered. Each subscale contains 32 items with six answer options (0: never; 1: hardly ever; 2: more than three times; 3: more than four times; 4: more than 10 times; 5: always, usually). They measure six dimensions (physical and sexual abuse, harassment, surveillance, cyber bullying, domination and denigration) in the violence suffered and five dimensions (physical and sexual abuse, harassment, surveillance, domination and denigration) in the violence perpetrated. Internal consistency was adequate, with Cronbach's alpha between .93 and .91 for violence perpetrated and violence suffered, respectively, and with acceptable adjustment indices in the confirmatory factor analysis (CFA). Although it has proven to be valid and reliable, but we consider it pertinent to review and update its items since, in recent years, online violence and sexual violence are marked by new behaviours. On the other hand, the extensive literature on instruments that measure DV shows that there is still no brief instrument that assesses violence in young people in a comprehensive manner with an estimate of severity hence the relevance of our research. It is important to have a brief multidimensional instrument, which allows for easier use, with a cutoff score that can be used to establish a minimum threshold, which will follow a diagnostic approach and could serve as a community screening tool. 2 | THE STUDY 2.1 | Aims The aim of the present study has been to develop the short version of the Multidimensional Scale of Dating Violence (MSDV 2.0) in Spanishlanguage and evaluate its psychometric properties. 2.2 | Design A psychometric instrument development and validation methodological study were carried out in two phases: (1) design and content validation, and (2) psychometric validation. In the first phase, design and content validation of MSDV 2.0, the items of the original scale were revised and new items related to online violence and sexual violence were incorporated. Content validation, face validity and piloting were performed. In the second phase, psychometric validation, the scale was tested in a sample of university students, analysing the psychometric properties (construct validity and internal consistency) of the scale (Figure 1). The Consensusbased Standards for the Selection of Health Measurement Instruments (COSMIN) Study Design checklist was followed for this study (Mokkink et al., 2019). The study was conducted from September to November 2020. 2.3 | Instrument The preliminary design of the instrument was developed in the first phase. The research team reviewed, formulated and incorporated new items based on the original scale (MSDV), and a review of the literature and instruments for measuring DV, focusing on the new behaviour related to sexual violence and online violence which has emerged in recent years. The whole process was carried out following the guidelines established by Morales et al. (2003). Of the 32 items per subscale (victimization and perpetration) of the MSDV, 13 items were reformulated, 10 new items were added and 19 items of the original scale were retained. A set of 42 items for each subscale was designed to cover five proposed dimensions (cyber bullying, control and surveillance, psychoemotional, physical and sexual) basing our design on the MSDV and improving its structure by 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License | 1613 GARCÍA-CARPINTERO-MUÑOZ et al. referring to the existing literature. Each item was accompanied by the phrase ‘He/She has done it to me’ for the victimization subscale and ‘I have done it’ for the perpetration subscale. They were scored on a Likert scale, with five response options (1: never; 2: sometimes (1 or 2 times); 3: occasionally (3– 4 times); 4: repeatedly (5– 10 times); 5: habitually (more than 10 times). The authors of the original scale and three researchers with experience in psychometrics and DV participated in this process. Next, all the contents designed in the previous phase were subjected to a Delphi panel with the participation of 25 experts in DV and psychometrics. In the first round, 38 items were accepted for reaching mean scores between 3.12 and 3.96 in the criteria of clarity, coherence and relevance proposed by Abad et al. (2011) (accepting items with mean scores ≥3, in a range of 1– 4, where the higher the score, the greater clarity, coherence and relevance) and an interrater agreement of content relevance, and a V Aiken between .81 and .97 proposed by Penfield and Giacobbi (2004) (accepting items with values >0.7). Four items did not reach the minimum scores in one of the criteria: clarity. The responses to the openended questions and the suggestions provided were analysed. Modifications were made and proposed for a second round. In the second round, these four items were accepted because they achieved average values for the proposed criteria. The adequacy of the items for the proposed dimensions was also analysed, obtaining means between 3.44– 3.72 and a V Aiken of 0.81– 0.91. Finally, 42 items were obtained for five dimensions, by subscales. The whole process with the proposed items analysed in the first round and those reformulated in the second, as well as the scores, can be seen in Table A1. In the face validity, 32 university students with an average age of 21.3 years (21 females and 11 males) participated. The objective was to determine the clarity, accuracy and comprehension of each of FIGURE 1 Phases of the investigation 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 1614 | GARCÍA-CARPINTERO-MUÑOZ et al. the items (Cruz & Muñoz, 2015). No errors were identified, all items were understood, clear and accurate with mean scores of between 3.25 and 3.63, in a range of 1– 4. The higher the score, the greater the clarity, accuracy and comprehension, and only scores ≥3 were accepted. Finally, the Pilot test was carried out, which helps to reduce possible biases and errors in obtaining subsequent data and improves the methodology previously proposed (Van Van Teijlingen & Hundley, 2002). Seventyfour young university students participated in the study (67 women and seven men) of Spanish nationality, with a mean age of 19.59 years (SD 1.59). They were students on a Nursing Undergraduate Degree course at the University of Seville (51.4%) and the University of Jaen (48.6%). The mean time of the participants in a couple relationship was 28.23 months (SD 22.78) and 62% had a partner at the time of the study, while only one of the participants was cohabiting with their partner. No errors were detected related to the comprehension, acceptability and completion time of the questionnaire. The 42 items by subscales belonging to five dimensions (Cyber bullying; Control and surveillance; Psychoemotional; Physical and Sexual) produced by this phase were subjected to psychometric validation in the next phase. 2.4 | Sample and fieldwork The second phase was conducted in the context of the Andalusian Public University System, composed of 10 statefunded universities with a total of 46,346 students enrolled in the 2019/2020 academic year (Integrated University Information System, 2021). A total of 1382 young university students were recruited by convenience from an awareness program funded by the Andalusian Youth Institute entitled ‘Promoting healthy relationships in Andalusian university youth; prevention of gender violence’, in which eight statefunded universities participated. Of the participants, 1091 young people met the inclusion criteria (having enrolled in the 2020/2021 academic year in an Andalusian university, being between 18 and 24 years old and having had or currently having a couple relationship). 2.5 | Data collection Data were collected by means of a selfadministered online questionnaire, via Google Forms. Sociodemographic variables were included: sex, age, nationality, university campus, university degree, average time in a relationship, whether they had a partner at the time of the study and whether they were living with a partner. The study was conducted from September to November 2020 in the context of the Andalusian Public University System. For the DV analysis, the 42 items per subscale (victimization and perpetration) of the MSDV 2.0 resulting from the previous phase were incorporated. For convergent validity, the Abbreviated Scale of Depression, Anxiety and Stress (DASS- 21) scale and the selfperception of health item were used. The DASS- 21 scale is a selfadministered instrument with 21 items. It measures levels of anxiety, depression and stress, where higher scores correspond to worse levels in the respective dimensions. It has demonstrated good psychometric properties with an internal consistency of 0.9 for the total scale, 0.8 for the depression subscale, 0.73 for the anxiety subscale and 0.81 for the stress subscale. It has been validated in Spain in the university context by Fonseca et al. (2010). On the other hand, the item of selfperception of health describes health in general, where higher scores indicate a worse selfperception of health. It has been used in major international health surveys (Idler & Benyamini, 1997; Moreno et al., 2012) demonstrating its validity. Dichotomous variables (yes/no) were also recorded for the validity of the criteria of the different dimensions for each subscale: Has your partner harassed you social media?/Have you harassed your partner on social media?; Has your partner controlled and/or monitored you?/Have you controlled and/or monitored your partner?; Have you felt denigrated and/or dominated by your partner?/Have you denigrated and/or dominated your partner?; Have you suffered any physical aggression from your partner?/Have you ever physically assaulted your partner?; Has your partner compelled or forced you to perform some sexual act that you did not want to do?/Have you compelled or forced your partner to perform some sexual act that he/she did not want to do? 2.6 | Ethical considerations This research was approved by the Research Ethics Committee of the Virgen Macarena and Virgen del Rocío University Hospitals, study code VNRS_18. The young people participated voluntarily, received information about the study and signed an informed consent form. All data were processed safeguarding the confidentiality of the participants. The entire study complied with Spanish data protection legislation (Organic Law 3/, 2018). 2.7 | Data analysis SPSS 26.0 (IBM Corp, 2019) and AMOS 23.0 (Arbuckle, 2014) programs were used for data analysis. Univariate analysis was performed by calculating absolute and relative frequencies, means and standard deviations. Ceiling and floor effects were calculated for all items for each subscale. Prior to the bivariate analysis, the Kolmogorov– Smirnov test was performed to test the normality of quantitative variables, which turned out not to follow normality. After that, the Mann– Whitney U test was used to check the association between dichotomous qualitative variables and continuous variables. The effect size for Mann– Whitney U test was calculated using the probability coefficient of superiority [PSest] estimating the following categories: No effect (PSest ≤0.0); small 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License | 1615 GARCÍA-CARPINTERO-MUÑOZ et al. (PSest ≤0.56); medium (PSest: 0.57– 0.70) and large (PSest ≥0.71; Grissom, 1994). 2.7.1 | Validity analysis Confirmatory factor analysis was performed to determine whether the data fit the proposed model after content validation on the two subscales. The method chosen was that of Robust maximumlikelihood estimation, to mitigate the possible biases that could occur in the estimates due to the observed floor effects (Brown, 2015). The following fit indices (FI) were used: (a) chisquare significance (χ2), considered adequate if it was not significant for the model (Wang et al., 2017); (b) comparative fit index (CFI) and Tucker– Lewis Index (TLI), for which values >0.90 indicate an adequate fit, while >0.95 indicate an excellent fit (Bentler, 1990; Tucker & Lewis, 1973) and (c) root mean square error of approximation (RMSEA), for which values below 0.08 indicate an acceptable model fit and 0.06 an excellent fit, for the value and its 90% confidence interval (Hu & Bentler, 2009). We considered fitting the instrument by studying the discrepancies between the model and the data through the modification indexes (MI; Sörbom, 1989). MI indicates the amount of decrease in the chisquare statistic of the model with one degree of freedom. A high value of MI indicates that the corresponding fixed parameter should be released, by removing it, to improve the model fit (Wang et al., 2017). Therefore, specific items with higher MI were removed, which resulted in an improvement of the model fit, with a decrease of chisquare and a substantial improvement of the other FIs (Jreskog & Srbom, 1989). Elimination was performed one at a time starting with the one with the highest MI and so on, since changing a single parameter in a model could affect other parts of the solution (MacCallum et al., 1992). After each elimination, the CFA was repeated on the elements that remained, evaluating the FI. These steps were repeated progressively until these indices indicated a good fit of the model according to the criteria specified in the previous paragraph for both the experienced and perpetrated violence scale. A balance between the empirical bases/theoretical rationale of the original scale (MSDV) and the revised bibliography was taken into account throughout the process. Once the items that were retained in the short version of the scale were determined, reliability and other validity properties were evaluated to determine whether, in addition to their dimensionality, they also had good psychometric properties. The convergent validity of the two subscales (victimization and perpetration) of the MSDV 2.0 and their dimensions were tested with the DASS- 21, for its three subscales (Depression, anxiety and stress) and the selfperception of health item. We anticipated that they would correlate based on previous literature (Comecanha & Maia, 2018; Rothman et al., 2021; Wong et al., 2018). The starting hypothesis was that both subscales would present a strong and positive relationship. Bivariate correlations were performed with Spearman's rho coefficient because the Kolmogorov– Smirnov test showed no normality in quantitative variables. The interpretation of the values was made according to Hernández et al. (2010), with the following correlation ranges: from .91 to 1.00 perfect, .76 to .90 very strong, .51 to .75 considerable, .11 to .50 medium, .01 to .10 weak and .00 no correlation. 2.7.2 | Reliability analysis Internal consistency was determined by Cronbach's alpha test, with an acceptable value of >.7 (Nunnally & Bernstein, 1994). 2.7.3 | Cutoff points and receiver operating characteristic curves Cutoff points were established for each dimension. Receiver operating characteristic (ROC) curves were used with the proposed criterion variables. Youden's J statistic was calculated for all the points on the ROC curve, and the maximum value of the index was used as a criterion for selecting the optimal cutoff point to obtain better sensitivity and specificity (Schisterman et al., 2005), with an area under the curve >0.7 (Swets, 1988). 3 | RESULTS 3.1 | Sample characteristics Participants were 85% women and 15% men, with a mean age of 20.1 years (SD 1.67). Ninetysix percent (n = 1051) were of Spanish nationality and 4% (n = 40) of other nationalities (Italian, Brazilian, Moroccan and Portuguese); 91% lived in urban areas. The mean length of time in a dating relationship was 23.6 months (SD 19.31), where 81.7% were in a dating relationship at the time of questionnaire administration and only 5% were living together. 3.2 | Validity analysis 3.2.1 | Confirmatory factor analysis The CFA of the proposed model, with 42 items per subscale, did not obtain good adjustment indices. Items were progressively eliminated until an adequate fit of the data to the model was achieved, obtaining 18 items that fit well to a fivefactor model for each of the subscales (Table 1). The fit indices were excellent for both the victimization subscale chisquared (χ2 = 503.168 (p < .0001); CFI = 0.946; TLI = 0.934; RMSEA = 0.053 (90% CI: 0.048– 0.058) and the perpetration subscale (χ2 = 509.859 (p < .0001); CFI = 0.926; TLI = 0.909; RMSEA = 0.053 (90% CI: 0.048– 0.058). Figure 2a,b shows the final models selected with their factorial loads. As can be seen, in the victimization subscale all items have loads >0.53, except item 7 which 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 1616 | GARCÍA-CARPINTERO-MUÑOZ et al. TABLE 1 Dimensions and items of the MSDV 2.0 Dimensions Items Victimization subscale Perpetration subscale MSD % Floor effect % Celling effect Factorial loads MSD % Floor effect % Celling effect Factorial loads Cyber bullying 1. Send WhatsApp messages insistently, or other types of messages through social networks 2.48 1.18 21.7 7.3 0.75 1.98 0.94 33.5 2.4 0.57 2. Spy on each other's activity on social media: comments on photos uploaded by friends to know what they say, what they do and with whom 2.13 1.14 36.9 4.3 0.78 1.91 0.95 38.6 2.2 0.71 3. Monitor the time of the last connection in WhatsApp messages and/or the other person's social networks 2.16 1.19 36.7 6.4 0.80 1.88 0.97 40.6 2.7 0.64 Control and surveillance 1. Make unsolicited gifts or favours 2.55 1.22 23.2 8.8 0.17 2.64 1.24 21.5 9.6 0.26 2. Deliberately frequent the places where the other person is usually to be found (home, work, bars, party, etc.) 1.74 0.99 54.1 2.0 0.53 1.59 0.86 59.4 1.1 0.40 3. Ask where the other person is ‘every minute of the day’ and/or what the other person is doing 1.56 0.98 67.8 3.3 0.74 1.41 0.68 68.0 0.5 0.51 4. Try to make the other person feel guilty for not spending enough time together 1.78 1.08 55.7 3.8 0.74 1.52 0.72 59.6 0.1 0.60 5. Check up with friends, family or other means, whether it is true that the other person was where s/he said s/he was 1.38 0.78 75.9 0.5 0.66 1.49 0.74 63.2 0.1 0.61 Psychoemotional 1. Bring up something from the past to do harm 1.87 1.06 46.7 3.8 0.80 1.62 0.81 54.1 0.9 0.74 2. Blame him/her for things that do not go well 1.66 0.96 58.0 2.4 0.77 1.44 0.69 65.0 0.4 0.66 3. Avoid or refuse to talk to the other person (for a long time) when the perpetrator is angry 1.90 1.07 46.1 3.8 0.83 1.71 0.92 52.2 2.0 0.53 Physical 1. Physically harm someone known to either the victim 1.07 0.34 95.4 0.1 0.61 1.02 0.17 98.3 0.0 0.74 2. Physically assault the other person in a serious way (slap, punch, etc.) 1.09 0.41 93.5 0.3 0.76 1.02 0.18 97.9 0.0 0.89 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License | 1617 GARCÍA-CARPINTERO-MUÑOZ et al. has a load lower than the value determined as adequate (0.17). In the perpetration subscale all the items had loads >0.40, except item 7 again, which, as in the other subscale, presents a lower load (0.26). 3.2.2 | Convergent validity The victimization subscale score showed significant positive correlations in medium magnitude range with the selfperceived health item (rho = 0.380, p < .01), where higher levels of violence experienced correlated with worse levels of selfperceived health. It also correlated with the DASS- 21 score (rho = 0.418, p < .01), showing higher levels of depression (rho = 0.444, p < .01), anxiety (rho = 0.470, p < .01) and stress (rho = 0.182, p < .01) those young people who presented greater violence suffered. In turn, the subscale perpetration score also correlated positively and significantly, but in a smaller range, with selfperception of health (rho = 0.179, p < .01), the DASS- 21 (rho = 0.225, p < .01) and its three dimensions: depression (rho = 0.210, p < .01), anxiety (rho = 0.267, p < .01) and stress (rho = 0.132, p < .01). All correlations can be seen in Table 2. 3.3 | Reliability analysis. Internal consistency Since the CFA showed that the MSDV 2.0 is a multidimensional scale, Cronbach's alpha was evaluated for each dimension. For victimization violence, the reliability coefficients ranged from 0.703 to 0.828. For perpetration items, the alpha values ranged from 0.703 to 0.869. The lowest values were found in the control and surveillance dimension of both subscales. In general, the subscales of the MSDV presented good internal consistency (Table 3). 3.4 | Cutoff points and receiver operating characteristic curves A cutoff score for each of the five dimensions was identified to assess their accuracy and predictive value in young people who had been victims of or had perpetrated DV. All the dimensions had an area under the curve greater than 0.7. The sensitivity and specificity values were greater than 72% in the subscale victimization, except for the sensitivity of the physical dimension, which was 64.7%. In the perpetration subscale, the values of sensitivity and specificity and sensitivity showed a more limited balance and the cutoff points for the dimensions of cyberbullying and sexual violence were lower, compared with those obtained for the subscale of victimization (Table 4). Also, odds ratios were performed out to find the relationship between being a victim and a perpetrator (Table A2). Finally, we compared those participants who reported yes/no to each of the variables criteria with their mean score by dimensions in the corresponding subscale, which can give us a direct validation of the scale (Table A3). Dimensions Items Victimization subscale Perpetration subscale MSD % Floor effect % Celling effect Factorial loads MSD % Floor effect % Celling effect Factorial loads Sexual 1. Not request consent to sexual intercourse 1.24 0.66 83.7 1.0 0.76 1.07 0.37 95.7 0.2 0.41 2. Take advantage of the other being drunk or drugged to have sex 1.13 0.42 89.6 0.1 0.53 1.03 0.21 97.7 0.0 0.83 3. Ask for some sex act that the other person does not wish to perform, such as using dangerous objects, or having unwanted sex with other people 1.22 0.58 84.3 0.5 0.61 1.04 0.22 96.7 0.0 0.75 4. Push for sexual practices without a condom 1.38 0.82 76.9 1.9 0.59 1.05 0.29 95.8 0.0 0.57 5. Touching of a sexual nature without the other person's consent 1.25 0.63 82.0 0.7 0.78 1.05 0.31 96.4 0.1 0.54 Abbreviations: factorial loads, factor loadings of the item in its dimension; M, mean; SD, standard deviation. TABLE 1 (Continued) 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 1618 | GARCÍA-CARPINTERO-MUÑOZ et al. 3.5 | Differences according to sex In the violence victimization subscale, statistically significant differences were found according to sex (p < .05), with females scoring significantly higher as victims in the cyber bullying, control and surveillance and sexual dimensions, and males as aggressors in the psychoemotional, physical and sexual dimensions with statistically significant differences. However, the statistically significant differences found should be taken with caution, as they show a small effect size (PSest ≤0.56; Table 5). 3.6 | Evaluation of the quality of MSVN 2.0 The quality of the instrument was independently assessed by two psychometric experts using the COSMIN Risk of Bias checklist (Mokkink et al., 2019). Scores were obtained between Very Good to Adequate in the properties that were developed: PROM development; Content validity; Structural validity; Internal consistency; Criterion validity; Hypotheses testing for construct validity (Table A4). 4 | DISCUSSION The results of this study show the development of a tool with solid psychometric properties, showing that it is a reliable and valid alternative to other widely used instruments such as the CTS- 2 (Anderson & Leigh, 2011) or the CADRI- S (Fernández et al., 2012), which analyse DV in young people. An update and reduction of its items has been achieved, resulting in a brief instrument of 18 items for each of its subscales (victimization and perpetration). It measures five dimensions of DV: cyber bullying, control and surveillance, psychoemotional, physical and sexual. It shows high and adequate values regarding the quality of its psychometric properties (reliability and validity). In addition, as a differentiating feature to instruments available in the literature, cutoff points were calculated for each dimension and could be used as diagnostic criteria. Compared with the 32- item MSDV, the MSDV 2.0 showed somewhat lower internal consistency values decreasing from 0.93 (MSDV) to 0.897 (MSDV 2.0) in the violence victimization subscale and from 0.91 (MSDV) to 0.802 (MSDV 2.0) in the violence perpetration subscale but achieved a more homogeneous structure for the FIGURE 2 (a) CFA diagram victimisation MSDV 2.0. (b) CFA diagram perpetration MSDV 2.0 (a) (b) 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License | 1625 GARCÍA-CARPINTERO-MUÑOZ et al. APPENDIX A TABLE A1 Delphi panel analysis for the criteria of clarity, coherence and relevance of the proposed items Items proposed in the Delphi panel for experts Clarity Coherence Relevance XSD V Aiken XSD V Aiken XSD V Aiken 1ª Round 1. Send WhatsApp messages insistently, or other types of messages through social networks (R) 3.6 0.75 0.87 3.44 0.70 0.81 3.48 0.75 0.83 2. Spy on each other's activity on social media: comments on photos uploaded by friends to know what they say, what they do and with whom (R) 3.76 0.59 0.92 3.56 0.57 0.85 3.64 0.56 0.88 3. Monitor the time of the last connection in WhatsApp messages and/or the other person's social networks(R) 3.72 0.53 0.91 3.56 0.57 0.85 3.72 0.53 0.91 4. Monitor the other person's location by electronic devices (N) 3.72 0.66 0.91 3.52 0.75 0.84 3.56 0.75 0.85 5. Demand that the other person delete videos or photos from social media profiles because they find them intolerable (N) 3.68 0.61 0.89 3.64 0.62 0.88 3.68 0.61 0.89 6. Upload photos of the other person to social networks to harm and/or insult him/her on social networks (R) 3.68 0.54 0.89 3.56 0.70 0.85 3.56 0.70 0.85 7. Make unsolicited gifts or favours (O) 3.72 0.66 0.91 3.64 0.69 0.88 3.72 0.66 0.91 8. Change classes, practical sessions or the like to be closer (to him or her) (OR) 3.64 0.56 0.88 3.56 0.57 0.85 3.6 0.57 0.87 9. Wait for the other person outside class, home or work (O) 3.72 0.66 0.91 3.6 0.63 0.87 3.64 0.69 0.88 10. Deliberately frequent the places where the other person is usually to be found (home, work, bars, party, etc.) (O) 3.6 0.69 0.87 3.44 0.75 0.81 3.6 0.69 0.87 11. Stalk him/her (O) 3.72 0.53 0.91 3.44 0.75 0.81 3.44 0.75 0.81 12. Ask where the other person is ‘every minute of the day’ and/or what the other person is doing (R) 3.76 0.58 0.92 3.44 0.70 0.81 3.6 0.69 0.87 13. Try to get the other person to leave their hobbies so they can spend more time together (R) 3.68 0.61 0.89 3.52 0.70 0.84 3.56 0.70 0.85 14. Try to make the other person feel guilty for not spending enough time together (O) 3.56 0.57 0.85 3.48 0.64 0.83 3.52 0.64 0.84 15. Check up with friends, family or other means, whether it is true that the other person was where s/he said s/he was (O) 3.72 0.45 0.91 3.8 0.40 0.93 3.72 0.45 0.91 16. Tell the other person how they should dress, comb their hair, put on makeup, tattoo or other items of their body image (N) 3.68 0.61 0.89 3.52 0.70 0.84 3.56 0.70 0.85 17. Tell the other person that s/he is worthless, that s/he is ugly, a failure, or similar (R) 3.84 0.46 0.95 3.64 0.69 0.88 3.64 0.69 0.88 18. Ridicule the other person's physical appearance or something similar (O) 3.68 0.55 0.89 3.64 0.56 0.88 3.6 0.63 0.87 19. Insult or belittle the other person in front of others (O) 3.44 0.75 0.81 3.4 0.75 0.80 3.4 0.75 0.80 20. Threatening to leave him/her and start dating someone else who would be a better partner (R) 3.76 0.43 0.92 3.64 0.48 0.88 3.76 0.43 0.92 21. Tell him/her that someone else would be a better partner (O) 3.72 0.53 0.91 3.6 0.57 0.87 3.68 0.55 0.89 22. Bring up something from the past to do harm (O) 3.76 0.51 0.92 3.56 0.64 0.85 3.64 0.62 0.88 23. Blame him/her for things that do not go well (O) 3.84 0.46 0.95 3.68 0.61 0.89 3.72 0.60 0.91 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 1626 | GARCÍA-CARPINTERO-MUÑOZ et al. Items proposed in the Delphi panel for experts Clarity Coherence Relevance XSD V Aiken XSD V Aiken XSD V Aiken 24. Refuse to deal with a problem or talk to the other person for a long time, when the perpetrator is angry (R) 2.76 0.81 0.58 3.24 0.59 0.75 3.12 0.71 0.71 25. Become so aggressive as to scare the other person (punching or kicking the wall, a car, or hitting something) (R) 3.84 0.46 0.95 3.84 0.37 0.95 3.72 0.53 0.91 26. Threaten to physically assault a known person (O) 3.52 0.70 0.84 3.44 0.64 0.81 3.48 0.70 0.83 27. Physically harm someone known to either the victim (O) 3.52 0.70 0.84 3.44 0.64 0.81 3.48 0.70 0.83 28. Drive recklessly to scare the other person (O) 3.48 0.70 0.83 3.2 0.85 0.73 3.48 0.70 0.83 29. Threaten to break, steal or throw away the other person's personal items (O) 3.6 0.69 0.87 3.52 0.70 0.84 3.6 0.69 0.87 30. Break or throw away the other person's personal items (R) 3.92 0.27 0.97 3.8 0.40 0.93 3.88 0.32 0.96 31. Physically assault the other person in a mild way (grab, push, etc.) (O) 3.4 0.69 0.80 3.44 0.64 0.81 3.36 0.69 0.79 32. Physically assault the other person in a serious way (slap, punch, etc.) (O) 3.88 0.32 0.96 3.64 0.48 0.88 3.8 0.40 0.93 33. Threaten selfharm (O) 3.48 0.64 0.83 3.4 0.57 0.80 3.4 0.57 0.80 34. Hurt oneself or try to pressure the other person (R) 3.88 0.32 0.96 3.72 0.45 0.91 3.84 0.37 0.95 35. Sexual assault using force or threats (R) 3.96 0.20 0.99 3.8 0.40 0.93 3.88 0.32 0.96 36. Seek consent before having sex. Make sure the other person also wants to have sex and has said so (N) 2.72 1.34 0.57 3.56 0.70 0.85 3.16 1.05 0.72 37. Take advantage of the other person while inebriated or under the influence of other drugs to have sex (N) 2.8 0.85 0.6 3.2 0.63 0.73 3.12 0.71 0.71 38. Ask for some sex act that the other person does not wish to perform, such as using dangerous objects, or having unwanted sex with other people (N) 3.68 0.61 0.89 3.6 0.57 0.87 3.64 0.62 0.88 39. Push for sexual practices without a condom (N) 3.88 0.32 0.96 3.72 0.45 0.91 3.84 0.37 0.95 40. Send sexual images or photos with obscene content (N) 3.76 0.43 0.92 3.52 0.57 0.84 3.64 0.56 0.88 41. Touching of a sexual nature without the other person's consent (N) 3.96 0.20 0.99 3.72 0.45 0.91 3.84 0.37 0.95 42. Pressure or blackmail to have sex that the other person does not consent to (N) 2.92 0.84 0.64 3.12 0.65 0.71 3.12 0.71 0.71 2ª Round 24. Avoid or refuse to talk to the other person (for a long time) when the perpetrator is angry (R*) 3.71 0.54 0.90 3.71 0.54 0.90 3.75 0.52 0.92 36. Not request consent to sexual intercourse (R*) 3.46 0.71 0.82 3.58 0.57 0.86 3.63 0.56 0.88 37. Take advantage of the other being drunk or drugged to have sex (R*) 3.50 0.71 0.83 3.71 0.61 0.90 3.58 0.57 0.86 42. Have unwanted sex, so that the other person does not get angry or out of fear of the other person (R*) 3.46 0.71 0.82 3.54 0.58 0.85 3.50 0.50 0.83 Abbreviations: N, proposed new item; O, original item of the EMVN; R, reformulated item of the MSDV; R*, item reformulated after the second round according to the contributions of the experts; SD, standard deviation; VAkein, VAkein statistic (Clarification: Item 24, in the second round was reformulated because it was in the original scale); X, mean. TABLE A1 (Continued) 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License | 1627 GARCÍA-CARPINTERO-MUÑOZ et al. TABLE A2 Odd ratios between the criteria variables of each dimension of the victimization and perpetration subscale Criteria variables victimization subscale Criteria variables perpetration subscale Cyber bullying Yes (N = 116; 10.6%) Control and surveillance Yes (N = 67; 6.1%) Psychoemotional Yes (N = 65; 6.0%) Physical Yes (N = 14; 1.3%) Sexual Yes (N = 2; 0.2%) Cyber bullying No (N = 822; 75.3%) 23 24 28 6 1 Yes (N = 269; 24.7%) 93 43 37 81 p<.001 <.001 <.001 .005 .405 OR (95% CI) 18.4 (11.3– 29.8) 6.3 (3.8– 1.6) 4.5 (2.7– 7.5) 4.2 (1.4– 12.1) Control and surveillance NO (N = 935; 85.7%) 79 19 40 9 1 Yes (N = 156; 14.3%) 37 48 25 5 1 p<.001 <.001 <.001 .021 .149 OR (95% CI) 3.4 (2.2– 5.2) 21.43 (12.1– 37.8) 4.3 (2.5- (7.3) 3.4 (1.1– 10.3) Psychoemotional No (N = 864; 79.2%) 69 28 13 6 1 Yes (N = 227; 20.8%) 47 39 52 81 p<.001 <.001 <.001 .001 .309 OR (95% CI) 3.0 (2.0– 4.5) 6.2 (3.7– 10.3) 19.5 (10.4– 36.5) 5.2 (1.8– 15.2) Physical No (N = 1023; 93.8%) 104 53 49 7 1 Yes (N = 68; 6.2%) 12 14 16 7 1 p.53 <.001 <.001 <.001 .010 OR (95% CI) 4.7 (2.5– 9.0) 6.1 (3.3– 11.5) 16.7 (5.7– 48.9) 15.3 (0.9– 246.6) Sexual No (N = 1048; 96.1%) 106 54 55 12 1 Yes (N = 33; 3.9%) 10 13 10 2 1 p.006 <.001 <.001 .045 .001 OR (95% CI) 2.7 (1.3– 5.6) 7.9 (3.9– 16.1) 5.5 (2.6– 11.7) 4.2 (0.9– 19.4) 24.9 (1.5– 405.4) Note: No, sample that answered ‘no’ to the criterion variable related to the dimension; Yes, sample that ‘Yes’ answered to the criterion variable related to dimension; p, p value (p < .05); OR, odds ratio (95% confidence interval). 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 1628 | GARCÍA-CARPINTERO-MUÑOZ et al. TABLE A3 Comparison between the young people who reported yes/no in each of the criterion variables and their mean ranks in the corresponding dimension Criteria variable Cyber bullying Control and surveillance Psychoemotional Physical Sexual Total Victimization subscale Mean ranks pMean ranks pMean ranks pMean ranks pMean ranks pMean ranks p Victimization subscale Cyber bullying No (N = 822) 454.53 <.001* 468.90 <.001* 467.11 <.001* 525.60 <.001* 501.69 <.001* 451.51 <.001* Yes (N = 269) 825.50 781.59 787.06 608.33 681.41 834.73 Control and surveillance No (N = 935) 492.95 <.001* 496.90 <.001* 498.66 <.001* 529.17 <.001* 514.92 <.001* 488.87 <.001* Yes (N = 156) 863.93 840.29 829.72 646.88 732.27 888.43 Psychoemotional No (N = 864) 486.25 <.001* 495.42 <.001* 474.84 <.001* 526.59 <.001* 498.13 <.001* 471.74 <.001* Yes (N = 227) 773.43 738.53 816.83 619.90 728.19 828.65 Physical No (N = 1023) 527.50 <.001* 528.69 <.001* 524.97 <.001* 525.05 <.001* 531.04 <.001* 522.92 <.001* Yes (N = 68) 824.26 806.42 862.35 861.15 771.11 893.20 Sexual No (N = 1048) 535.05 <.001* 534.54 <0.001* 533.04 <0.001* 539.62 <0.001* 527.87 <0.001* 529.14 <0.001* Yes (N = 43) 812.99 825.28 861.91 701.53 987.81 956.99 Criteria variable Cyber bullying Control and surveillance Psychoemotional Physical Sexual Total perpetration subscale Mean ranks pMean ranks pMean ranks pMean ranks pMean ranks pMean ranks p Perpetration subscale Cyber bullying No (N = 975) 508.34 <.001* 522.23 <.001* 516.59 <.001* 541.52 <.001* 540.69 .001* 508.76 <.001* Yes (N = 116) 862.50 745.82 793.22 583.66 590.66 859.01 Control and surveillance No (N = 1024) 529.26 <.001* 531.96 <.001* 530.68 <.001* 543.71 .001* 542.95 .009* 526.91 <.001* Yes (N = 67) 801.80 760.58 780.10 581.06 592.69 837.81 Psychoemotional No (N = 1026) 531.90 <.001* 534.09 <.001* 528.78 <.001* 542.08 <.001* 542.86 .006* 527.44 <.001* Yes (N = 65) 768.55 734.01 817.83 607.92 595.63 838.98 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License | 1629 GARCÍA-CARPINTERO-MUÑOZ et al. Criteria variable Cyber bullying Control and surveillance Psychoemotional Physical Sexual Total perpetration subscale Mean ranks pMean ranks pMean ranks pMean ranks pMean ranks pMean ranks p Physical No (N = 1077) 542.48 .001* 543.51 .021* 542.06 <.001* 543.13 <.001* 544.01 <.001* 541.85 <.001* Yes (N = 14) 816.93 737.71 849.07 766.79 699.11 865.25 Sexual No (N = 1089) 545.67 .418 545.24 .061 545.41 .138 545.51 <.001* 545.54 .019* 545.33 .100 Yes (N = 2) 724.00 959.50 867.25 810.50 795.25 912.00 Note: The effect size for Mann– Whitney U test was small (PSest ≤ .56) in all statistically significant differences. Abbreviations: N, sample size; p, p value (*p < .05). TABLE A3 (Continued) 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 1630 | GARCÍA-CARPINTERO-MUÑOZ et al. TABLE A4 COSMIN risk of bias checklist. Evaluating the MSDV 2.0 Psychometric property Score 1. PROM development Rater 1 Rater 2 Consensus 1.a PROM design V V V 1.b Cognitive interview study or other pilot test A V A Total lowest score of items 1.a−1.b A V A 2. Content validity Rater 1 Rater 2 Consensus 2.a Asking patients about relevance V V V 2.b Asking patients about comprehensiveness V V V 2.c Asking patients about comprehensibility V V V 2.d Asking professionals about relevance V V V 2.e Asking professionals about comprehensiveness V V V Total Lowest score of items 2.a−2.e V V V 3. Structural validity Rater 1 Rater 2 Consensus 3.1 For CTT: Was exploratory or confirmatory factor analysis performed? V V V 3.2 For IRT/Rasch: does the chosen model fit to the research question? V V V 3.3 Was the sample size included in the analysis adequate? V V V 3.4 Were there any other important flaws? V V V Total Lowest score of items 1– 4 V V V 4. Internal consistency Rater 1 Rater 2 Consensus 4.1 Was an internal consistency statistic calculated for each unidimensional (sub) scale separately? V V V 4.2 For continuous scores: Was Cronbach's alpha or omega calculated? V V V 4.3 For dichotomous scores: Was Cronbach's alpha or KR- 20 calculated? V V V 4.4 For IRT- based scores: Was standard error of the theta (SE [θ]) or reliability coefficient of estimated latent trait value (index of [subject or item] separation) calculated? V V V 4.5 Were there any other important flaws? V V V Total Lowest score of items 1– 5 V V V 5. Crosscultural validity\measurement invariance NT 6. Reliability NT 7. Measurement error NT 8. Criterion validity NT 8.1 For continuous scores: Were correlations, or the area under the receiver operating curve calculated? V V V 8.2 For dichotomous scores: Were sensitivity and specificity determined? V V V 8.3 Were there any other important flaws? V V V Total lowest score of items 1– 3 V V V 9. Hypotheses testing for construct validity 9a. Comparison with other outcome measurement instruments (convergent validity) Rater 1 Rater 2 Consensus 9.a.1 Is it clear what the comparator instrument(s) measure(s)? V V V 9.a.2 Were the measurement properties of the comparator instrument(s) adequate? A V A 9.a.3 Was the statistical method appropriate for the hypotheses to be tested? V V V 9.a.4 Were there any other important flaws? V V V Total lowest score of items 1– 4 A V A 9b. Comparison between subgroups (discriminative or knowngroups validity) NT 10. Responsiveness NT Score: V = very good; A = adequate; D = doubtful; I = inadequate; N = not applicable. Not rated (NT) = only those parts of the boxes need to be completed for which its psychometric property has been realized. 13652648, 2023, 4, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jan.15300 by Universidad De Sevilla, Wiley Online Library on [30/01/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License | 1631 GARCÍA-CARPINTERO-MUÑOZ et al. The Journal of Advanced Nursing (JAN) is an international, peer-reviewed, scientific journal. 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