Development and Initial Validation of the in-Session Patient Affective Reactions Questionnaire (SPARQ) and the Rift In-Session Questionnaire (RISQ)
Abstract
:1. Introduction
Aim
2. Materials and Methods
2.1. Procedures and Sample Characteristics
2.2. Item Generation
2.3. Additional Measures
2.4. Statistical Analyses
3. Results
3.1. Sample Characteristics
3.2. Preliminary Analyses
3.3. Item Pool Reduction—Iterative Exploratory Factor Analysis
3.4. Item Response Theory
3.5. Confirmatory Factor Analysis
3.6. Invariance Testing with Multigroup CFA
3.7. Internal Consistency and Score Precision
3.8. Criterion Validity
3.9. Sensitivity Analyses
4. Discussion
Strengths, Limitations, and Future Directions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Appendix A.1. in-Session Patient Affective Reactions Questionnaire (SPARQ)
Item nr. | Not at All | A Little | Somewhat | A Lot | Very Much | |
---|---|---|---|---|---|---|
1 | I felt happy to see my therapist. | 0 | 1 | 2 | 3 | 4 |
2 | I felt ashamed with my therapist about my fantasy, desires, mindset, behavior, or symptoms. | 0 | 1 | 2 | 3 | 4 |
3 | I felt worried my therapist couldn’t help me. | 0 | 1 | 2 | 3 | 4 |
4 | I felt shy, like I wanted to hide from my therapist or end the session early. | 0 | 1 | 2 | 3 | 4 |
5 | I felt afraid to spoke my mind, for fear of being judged, criticized, disliked by my therapist. | 0 | 1 | 2 | 3 | 4 |
6 | I felt my therapist cared about me. | 0 | 1 | 2 | 3 | 4 |
7 | I felt respected by my therapist. | 0 | 1 | 2 | 3 | 4 |
8 | I felt appreciated by my therapist. | 0 | 1 | 2 | 3 | 4 |
Appendix A.2. Rift In-Session Questionnaire (RISQ)
Item nr. | |||
1 | I felt provoked or attacked by my therapist. | No | Yes |
2 | I felt scared, uneasy, like my therapist might harm me. | No | Yes |
3 | I felt rejected by my therapist. | No | Yes |
4 | I felt disparaged or belittled by my therapist. | No | Yes |
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Demographics | % (n) |
---|---|
Biological sex | |
Male | 18% (126) |
Female | 80% (564) |
I prefer not to say | 2% (11) |
Age (years) | |
18–29 | 40% (282) |
30–39 | 19% (131) |
40–49 | 15% (104) |
50–59 | 15% (105) |
≥60 | 11% (79) |
Clinical Characteristics | |
Average number of diagnoses, M (SD) | 2.55 (1.53) |
Any anxiety disorder | 75% (529) |
Any (unipolar) depressive disorder | 54% (378) |
Any bipolar or related disorder | 17% (117) |
Any personality disorder | 13% (93) |
Any trauma- and stressor-related disorders | 30% (209) |
Treatment Characteristics | |
In psychotherapy from | |
0 to 3 months | 18% (124) |
4 to 6 months | 10% (72) |
7 to 12 months | 12% (86) |
13 to 24 months | 12% (84) |
>24 months | 48% (335) |
Session frequency | |
≤1 per month | 24% (171) |
2 to 3 per month | 35% (244) |
1 per week | 37% (256) |
≥2 per week | 4% (30) |
Therapist’s biological sex Female | 77% (539) |
Patient–Therapist biological sex match Same-sex | 74% (521) |
Item Content | α | β1 | β2 | β3 | β4 | |
---|---|---|---|---|---|---|
Factor 1 | I felt disparaged or belittled by my therapist | 3.05 | 1.46 | |||
RISQ | I felt rejected by my therapist | 4.73 | 1.28 | |||
I felt provoked or attacked by my therapist | 2.31 | 1.84 | ||||
I felt scared, uneasy, like my therapist might harm me | 2.23 | 2.06 | ||||
Factor 2 | I felt respected by my therapist | 2.60 | −2.07 | −1.32 | −0.73 | 0.19 |
SPARQ Positive | I felt my therapist cared about me | 2.98 | −1.95 | −1.04 | −0.40 | 0.51 |
I felt happy to see my therapist | 2.47 | −1.83 | −0.91 | −0.25 | 0.61 | |
Affect | I felt appreciated by my therapist | 2.44 | −1.29 | −0.57 | 0.22 | 1.14 |
Factor 3 | I felt worried my therapist couldn’t help me | 1.42 | −0.51 | 0.68 | 1.54 | 2.32 |
SPARQ Negative Affect | I felt afraid to spoke my mind, for fear of being judged, criticized, disliked by my therapist | 2.67 | 0.34 | 1.26 | 1.77 | 2.32 |
I felt ashamed with my therapist about my fantasy, desires, mindset, behavior, or symptoms | 1.73 | 0.37 | 1.32 | 2.12 | 2.95 | |
I felt shy, like I wanted to hide from my therapist or end the session early | 1.96 | 0.54 | 1.48 | 2.09 | 2.79 |
RISQ | SPARQ | ||
---|---|---|---|
Positive Affect | Negative Affect | ||
Descriptive statistics | |||
Potential Range | 0 to 4 | 0 to 16 | 0 to 16 |
Observed Range | 0 to 4 | 0 to 16 | 0 to 16 |
Mean, SD | 0.36 (0.87) | 10.45 (4.16) | 3.03 (3.11) |
POMP, SD | 9.00 (21.75) | 65.31 (26.00) | 18.94 (19.44) |
Skew | 2.67 | −0.58 | 1.33 |
Kurtosis | 6.75 | −0.53 | 1.57 |
Standard Error of Measurement (SEm) | 0.44 | 1.56 | 1.55 |
Standard Error of Difference (SEd) | 0.63 | 2.20 | 2.50 |
Internal consistency reliability | |||
X2/df | 7.16 | 3.24 | |
CFI | 0.98 | 0.98 | |
TLI | 0.94 | 0.97 | |
RMSEA | 0.09 | 0.06 | |
SRMR | 0.03 | 0.05 | |
Average inter-item r | 0.43 | 0.61 | 0.41 |
Alpha | 0.75 | 0.86 | 0.74 |
Omega total | 0.74 | 0.86 | 0.75 |
Clinical change benchmarks | |||
90% Critical Change | 1.02 | 3.63 | 3.63 |
95% Critical Change | 1.21 | 4.31 | 4.61 |
Minimally important difference | 0.44 | 2.08 | 1.55 |
Jacobson benchmark threshold (5% tail) | -- | LB: 2.30 | UB: 9.13 |
Scale correlations | |||
SPARQ—Positive Affect | −0.45 * | 1 | |
SPARQ—Negative Affect | 0.49 * | −0.40 * | 1 |
Criterion Variable | RISQ | SPARQ | |
---|---|---|---|
Positive Affect | Negative Affect | ||
Age | −0.04 | 0.05 | −0.15 *** |
Sex | −0.06 | 0.04 | −0.06 |
Average # of diagnoses | 0.04 | −0.07 | 0.17 *** |
Any anxiety disorder | −0.10 * | −0.00 | 0.03 |
Any bipolar disorder | 0.05 | −0.05 | 0.03 |
Any depressive disorder | −0.14 *** | 0.06 | 0.02 |
Any personality disorder | 0.20 *** | −0.11 * | 0.17 *** |
Cluster A PD | 0.08 * | −0.08 | 0.08 * |
Cluster B PD | 0.19 *** | −0.12 ** | 0.13 ** |
Cluster C PD | 0.07 | −0.08 | 0.09 * |
Any trauma- and stressor-related disorder | −0.02 | 0.04 | 0.05 |
Therapy length | −0.11 * | 0.13 ** | −0.05 |
Session frequency | 0.03 | 0.10 * | 0.06 |
Therapist’s sex | −0.13 ** | 0.10 * | −0.07 |
Patient–Therapist sex match | −0.10 * | 0.09 * | −0.12 ** |
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Stefana, A.; Langfus, J.A.; Vieta, E.; Fusar-Poli, P.; Youngstrom, E.A. Development and Initial Validation of the in-Session Patient Affective Reactions Questionnaire (SPARQ) and the Rift In-Session Questionnaire (RISQ). J. Clin. Med. 2023, 12, 5156. https://doi.org/10.3390/jcm12155156
Stefana A, Langfus JA, Vieta E, Fusar-Poli P, Youngstrom EA. Development and Initial Validation of the in-Session Patient Affective Reactions Questionnaire (SPARQ) and the Rift In-Session Questionnaire (RISQ). Journal of Clinical Medicine. 2023; 12(15):5156. https://doi.org/10.3390/jcm12155156
Chicago/Turabian StyleStefana, Alberto, Joshua A. Langfus, Eduard Vieta, Paolo Fusar-Poli, and Eric A. Youngstrom. 2023. "Development and Initial Validation of the in-Session Patient Affective Reactions Questionnaire (SPARQ) and the Rift In-Session Questionnaire (RISQ)" Journal of Clinical Medicine 12, no. 15: 5156. https://doi.org/10.3390/jcm12155156