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. 2013 Nov 15;334(1-2):112-8.
doi: 10.1016/j.jns.2013.08.002. Epub 2013 Aug 9.

Assessing social isolation in motor neurone disease: a Rasch analysis of the MND Social Withdrawal Scale

Chris J Gibbons  1 , Everard W Thornton, John Ealing, Pamela J Shaw, Kevin Talbot, Alan Tennant, Carolyn A Young; UKMND-QoL Group
Collaborators, Affiliations

Assessing social isolation in motor neurone disease: a Rasch analysis of the MND Social Withdrawal Scale

Chris J Gibbons et al. J Neurol Sci. .

Abstract

Objective: Social withdrawal is described as the condition in which an individual experiences a desire to make social contact, but is unable to satisfy that desire. It is an important issue for patients with motor neurone disease who are likely to experience severe physical impairment. This study aims to reassess the psychometric and scaling properties of the MND Social Withdrawal Scale (MND-SWS) domains and examine the feasibility of a summary scale, by applying scale data to the Rasch model.

Methods: The MND Social Withdrawal Scale was administered to 298 patients with a diagnosis of MND, alongside the Hospital Anxiety and Depression Scale. The factor structure of the MND Social Withdrawal Scale was assessed using confirmatory factor analysis. Model fit, category threshold analysis, differential item functioning (DIF), dimensionality and local dependency were evaluated.

Results: Factor analysis confirmed the suitability of the four-factor solution suggested by the original authors. Mokken scale analysis suggested the removal of item five. Rasch analysis removed a further three items; from the Community (one item) and Emotional (two items) withdrawal subscales. Following item reduction, each scale exhibited excellent fit to the Rasch model. A 14-item Summary scale was shown to fit the Rasch model after subtesting the items into three subtests corresponding to the Community, Family and Emotional subscales, indicating that items from these three subscales could be summed together to create a total measure for social withdrawal.

Conclusion: Removal of four items from the Social Withdrawal Scale led to a four factor solution with a 14-item hierarchical Summary scale that were all unidimensional, free for DIF and well fitted to the Rasch model. The scale is reliable and allows clinicians and researchers to measure social withdrawal in MND along a unidimensional construct.

Keywords: ALS; Amyotrophic lateral sclerosis; MND; Motor neurone disease; Psychological distress; Rasch analysis; Social withdrawal.

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Figures

Fig. 1
Fig. 1
Person–item threshold distribution for Physical subscale. This figure shows the distribution of person and item thresholds (above the x-axis) and item (below the x-axis). A ceiling effect is evident between 2.2 and 3.8 logits.
Fig. 2
Fig. 2
Person–item threshold distribution for Summary scale. This figure displays the person–item threshold distribution for the Summary scale. The normal distribution of bars above the x-axis that fall within the range of the items (below the x-axis).
See this image and copyright information in PMC

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