The Jordanian Version of the Grief Cognition Questionnaire: Factor Analysis, Validity and Reliability

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^{1Mutah University, Department of Counseling and Special Education}

²International Medical Corps

The Jordanian Version of the Grief Cognition Questionnaire: Factor Analysis, Validity and Reliability

Basim Aldahadha¹, Noor Aldmour²

Al-Karak, Jordan

Abstract

This study aimed to codify the Grief Cognition Questionnaire (GCQ) for the Jordanian context by testing its psychometric properties. The sample consisted of 645 participants aged 18 years or older who had experienced a loss within the past 6 months of the time of the study. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were used. The results of the EFA showed five factors, with 62.245% of the variance explained.

These factors were negative cognitions about the self, world, and future and cherishing and threatening interpretations after loss. A CFA was performed to test the validity of the five factors. The results showed that the modified model was consistent with the data. The Cronbach's alpha coefficient for the total GCQ was .97 and was between .89 and .94 for the subscales. Based on these results, it was possible to determine that this tool had sufficient psychometric properties to be applied and adopted in the Jordanian context as a valid, reliable and consistent tool for evaluating postloss cognitive thoughts.

Keywords: Grief cognitions questionnaire, Validity, Reliability, and factor analysis.

Резюме

Иорданская версия анкеты опознания скорби: факторный анализ, достоверность и надежность

Басим Алдахадха¹, Нур Олдмур².¹Университет Мутах, факультет консультирования и специального образования, ²Международный медицинский корпус, Аль-Карак, Иордания

Это исследование было направлено на то, чтобы систематизировать вопросник по познанию горя (GCQ) для иорданского контекста путем проверки его психометрических свойств. Выборка состояла из 645 участников в возрасте от 18 лет и старше, которые испытали потери в течение последних 6 месяцев после исследования. Были использованы исследовательский факторный анализ (EFA) и подтверждающий факторный анализ (CFA). Результаты EFA показали пять факторов с объяснением 62,245% дисперсии. Этими факторами были негативные представления о себе, мире и будущем и лелеющие и угрожающие интерпретации после потери. Был проведен CFA для проверки правильности пяти факторов. Результаты показали, что модифицированная модель согласуется с данными. Альфа-коэффициент Кронбаха для общего GCQ составлял 0,97, а для подшкал - от 0,89 до 0,94.

На основании этих результатов можно было определить, что этот инструмент обладает достаточными психометрическими свойствами, чтобы его можно было использовать и применять в иорданском контексте в качестве надежного и последовательного инструмента для оценки когнитивных мыслей после потери.

Ключевые слова: опросник познания скорби, валидность, достоверность и факторный анализ.

Introduction

Most people who are bereaved by the death of loved ones, such as their relatives, recover from the tragedy without any problems. However, some of the symptoms that can be associated with this event, such as posttraumatic stress disorder, loss of confidence in others, avoidance behavior and some of the necessary functional disabilities, can persist (Prigerson et al., 2009; Prigerson & Jacobs, 2001). More importantly, so-called multiple or complicated loss can result in posttraumatic stress disorder. Specifically, people develop negative thoughts and interpretations that may contribute to painful feelings through the development of symptoms of depression, stress and anxiety (Boelen & Lensvelt-Mulders, 2005; Boelen, Van den Bout, de Keijser & Hoijtink, 2003). At a later stage, there is a high probability that these individuals' behaviors or actions will hinder the future process of adjustment. (Abrahms, 1981; Boelen, Van den Bout, & Van den Hout, 2003a, 2003b; Gluhoski, 1995; Spuij, Prinzie, & Boelen, 2017).

To date, most of the research on this topic has involved various samples of children, adolescents and adults to adapt the GCQ standard for them and to verify their psychometric properties in a scientific way (Spuij, Dekovic, & Boelen, 2015). Loss and feelings of sadness are inevitable and necessary and are normal stages that those who lose their loved ones must pass through, but there are exceptions when this process continues at unexpected stages (Bowlby, 1969; Cesur & Durak-Batigun; 2018; Janoff-Bulman, 1989; Janoff- Bulman, 1992), showing symptoms of various mental disorders (APA, 2013; Jacobs, Mazure & Prigerson, 2000; Prigerson et al., 1995; Shear, 2015).

Therefore, fear of the development and emergence of symptoms and psychological problems and cognitions associated with loss and death calls for studying and understanding their processes (Cesur & Durak-Batigun; 2018; Nickerson et al., 2014(. In any case, few studies have examined the subject of cognition after death or tragedy. The most important of these studies was the first study by Schwartzberg and Janoff-Bulman (1991), in which they found that the participants in the study recalled that life became meaningless after the loss of their loved one.

In a similar study by Mancini, Prati and Bonanno (2011), the results indicated that participants with loss experiences had a low life value and that life had become meaningless and hopeless. They had high degrees of benevolence toward the world. This finding can be explained by the fact that the loss experience led to more complex effects than expected. In the same context, Boelen, Kip, Voorsluijs and van den Bout (2004) reported that people who experienced loss have shown more negative thoughts about the self and the world than any other control group. On the other hand, Boelen, Van Den Hout, and Van Den Bout (2006), discussed the emotional effects on a person who is bereaved and that the loss event can affect the feelings of individual adaptation as a result of the formation of negative thoughts associated with the tragic event, such as negative cognitive cognitions, selfblame and negative threats.

Another study was conducted on a sample of children and adolescents between the ages of eight and 18 years. The results showed that there is one factor of the GCQ that may be appropriate for children. The results showed the validity and stability of the one-factor scale. This study added important insight regarding cognitive thinking in children and adolescents (Spuij, Prinzie & Boelen, 2017). Recently, Cesur and Durak-Batigun (2018) conducted a study on the adaptation of the Turkish version of the GCQ in a sample of adult participants. The results found that there were six factors that explained 67.8% of the variance. The Cronbach Alpha coefficient for the total GCQ was .97 and between .78 and .94 for subscales. The results showed that this measure achieved appropriate properties for measuring and evaluating cognitions after loss among Turks.

Many of the tools and measures that are concerned with post loss shock and trauma adjustment, such as the Utrecht Grief Ruminations Scale (Eisma et al. 2014) and the Typical Beliefs Questionnaire (Skritskaya et al. 2017), have several differences compared to the GCQ. It is worth noting that the Arab world lacks studies that are concerned with the verification of the GCQ, and the need for this measure is urgent for dealing with the losses that occurred from the flash floods in the Dead Sea in Jordan in October 2018.

Accordingly, the objective of this study is to codify and adapt the GCQ and to explore its properties in the Arabic language and the Jordanian context. The current study also examined the internal stability and temporal stability of the GCQ and tested predictions concerning its convergent and discriminative validity. With respect to the convergent validity, the GCQ was expected to be positively associated with measures of pessimistic depression anxiety automatic thoughts questionnaire, post-traumatic stress disorder, and prolonged grief disorder. In addition, based on cognitive behavioral conceptualizations of complicated grief, the GCQ was expected to be negatively associated with optimism. With respect to the discriminative validity, it was hypothesized that the GCQ would be able to distinguish individuals suffering from the disorder of Complicated Grief as defined by Nickerson et al. (2014) from those who did not.

Method

Participants. The sample for this study consisted of 645 participants who were over the age of 18 years and who had experienced loss within the last 6 months of completing the questionnaire. All those suffering from mental disorders, whether diagnosed by visiting a psychiatrist or counselors or with a previous satisfactory history, were excluded from the study sample. In all, 645 participants were included in the EFA, which was the final sample size that met study criteria.

The participants ranged in age from 18 to 62 years with a mean age of 31.3 (SD = 12.9). There was a time interval of mean 5.65 years (SD = 4.92) after the tragedy.

Table 1

Demographic and the loss-related characteristics (n= 645)

For the CFA, the study sample consisted of all participants. The same procedures were adopted for verifying the validity of the results and enhancing the output. Table 1 presents the demographic characteristics of the participants in the current study.

Procedures. The procedures of the study went through a number of initial steps, including approval by the GCQ author and then translating the scale from English to Arabic. The process of translating the scale was started through preparing and translating the English version into the Arabic version, and then the scale was presented to two psychologists who had mastered Arabic and English to improve the translation in addition to two other translation specialists. In a subsequent step, the four versions were compared to each other. The decision was made to paraphrase some items, modify some, and change some words to more precise and specialized options. The Arabic version was then translated back to English and then compared to the original version to verify the conformity of the meaning and translation. Finally, to make the scale suitable for the Arabic language in general and for the Jordanian context in particular, the scale was presented to (10) reviewers in psychology, and all of them confirmed that the measure was appropriate in its current form for the Jordanian environment.