The Jordanian version of the grief cognition questionnaire: factor analysis, validity and reliability
Assessment of cognitive thoughts after loss. Grief cognition questionnaire for the Jordanian context by testing its psychometric properties. Negative beliefs about oneself, the world and the future, cherishing and threatening interpretations after loss.
| Рубрика | Психология |
| Вид | статья |
| Язык | английский |
| Дата добавления | 02.09.2021 |
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Mutah University, Department of Counseling and Special Education, Al-Karak, Jordan
International Medical Corps, Al-Karak, Jordan
The Jordanian version of the grief cognition questionnaire: factor analysis, validity and reliability
Basim Aldahadha, Noor Aldmour
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
Университет Мутах, факультет консультирования и специального образования, Аль-Карак, Иордания
Международный 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.
2. 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.
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.
Table 1 Demographic and the loss-related characteristics (n= 645)
|
Variable |
Level |
N |
Percentage |
|
|
Gender |
Women |
176 |
60.27 |
|
|
Men |
116 |
39.73 |
||
|
Education |
Primary/ Secondary |
53 |
18.15 |
|
|
Diploma |
84 |
28.76 |
||
|
University or higher |
155 |
53.09 |
||
|
Deceased |
Mother |
47 |
16.09 |
|
|
Father |
56 |
19.17 |
||
|
Child |
11 |
3.76 |
||
|
Partner |
34 |
11.64 |
||
|
Sibling |
9 |
3.08 |
||
|
Grandparent |
57 |
19.52 |
||
|
Second degree relative |
45 |
15.41 |
||
|
Friend |
33 |
11.33 |
||
|
Cause of Death |
Illness (unexpected) |
97 |
33.20 |
|
|
Illness (expected) |
136 |
46.60 |
||
|
Traumatic accident |
59 |
20.20 |
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.
After that, a number of sources and places were selected to collect the research sample, taking into account the sampling of the three regions in Jordan in the north, center and south. The sample was obtained through two main sources. The first source was the hotline website, which was established at the Queen Rania Center for Psychological Counseling and was designed to address the trauma and loss of the victims of the Valley Wadi Maayan Dead Sea floods. The number was circulated to an extra number of individuals by the snowball sampling method from social networking sites, universities and ministries. The second source was sent through the questionnaire via e-mail to all universities, ministries and municipalities to be circulated to all employees and students in all governorates of the Kingdom. The objectives of the questionnaire and the demographic information were explained in addition to the questionnaire items, noting that reading the file and completing the questions required 25 to 30 minutes.
All addressees were asked to send the message again to all emails in their address book, thus increasing the size of the sample through a snowball technique. A total of 722 questionnaires were sent by E-mails, WhatsApp, Facebook, and Twitter, and 645 (89.34%) questionnaires were retrieved. It is worth mentioning that the contents of the questionnaire were sent using the mourner>s recruitment network. The data were automatically loaded to a system in one file prepared in cooperation with the computer department and a number of private sector experts from outside the university. It takes time to answer questionnaires between 20-30 minutes. Approval for participation in the research was obtained by informing participants that they should send the questionnaire only if the data were correct, that they were not obliged to complete it, and they had the freedom to decide to be part of the research. In addition, the participants were informed that the Queen Rania Center for Psychological Counseling receives cases from outside the university and provides psychological services for them free of charge. The hotline was provided by phone number.
Instruments
GCQ. The GCQ was developed by Boelen et al. (2003) to assess negative cognitions related to loss and grief. The GCQ contains 38 items answered on a six-point Likert Scale and nine subscales. Boelen and Lensvelt-Mulders (2005) found a nine-factor construct with good fit indices in their study conducted with 531 participants (x2 = 1839.76, df = 629, p < .001, CFI = .93, NFI = .90, TLI = .92, RMSEA = .06). To assess the convergent validity of the GCQ, they examined its correlations with the Life Orientation Test, the Depression and Anxiety subscales of the Symptom Checklist (SCL-90-R), and The Inventory of Traumatic Grief and Automatic Thoughts Questionnaire. The correlation coefficients were found to be between .58 and .80. The Cronbach's alpha measure of internal consistency was .96 for the entire scale and between .81 and .92 for the subscales. The test-retest reliability with a four-week interval was between .76 and .97.
Inventory of Complicated Grief (Nickerson et al., 2014). This instrument measures symptoms of prolonged grief disorder (PGD). This 12-item scale encompasses nine items indexing symptoms proposed for the diagnosis of PGD and three items related to the duration of symptoms and impairment. Only the nine symptom items were used in this study to quantify the presence and severity of PGD symptoms. A dichotomous indicator variable (absent/present) for each symptom was derived from each symptoms. A symptom was considered present if the individual rated it as occurring "sometimes" 3, "often" 4, or "always" 5 or experiencing it as "some" 3, "marked" 4 or "overwhelming" 5 on the Arabic version was created by Prigerson et al. (1995).
Depression Anxiety Stress Scale-21 (DASS-21) developed by Lovibond & Lovibond, 1995; revised by Antony, Bieling, Cox, Enns, & Swinson, 1998. The DASS-21 is composed of 21 items divided across three subscales, depression, anxiety, and stress, which are rated on a 4-point Likert-type scale, where 0 = does not apply at all to 3 = applies all of the time. The total score for every factor ranges from 0-21, with higher scores indicating that the respondents are more likely to be anxious or depressed. In previous studies, the scale has been shown to have good internal consistency; Cronbach's a were .77, .79, and .89 for depression, anxiety, and the total scale, respectively (Moussa, Lovibond, & Laube, 2001).
Automatic Thoughts Questionnaire (ATQ) (Hollon & Kendall, 1980). This measure is a 30-item inventory in which respondents are asked to indicate, on a scale of 1 = not at all to 5 = all the time, how frequently automatic negative thoughts such as "I'm worthless" have occurred in the past week. The response range for the questionnaire was from 30 to 150. The Arabic version of the ATQ (Aldahadha, Sulaiman, 2012) was then tested with a group of 10 faculty members to collect feedback about the content and usage of the instrument. The feedback from the faculty members emphasized that the instrument has both face and content validity. Cronbach's alpha reliability coefficient for the ATQ was 0.89.
The Arab List of Optimism and Pessimism (Abdelkhaleq, 1996). The list is composed of 30 items divided into two subfactors: the optimism measure is 15 items, and the pessimism scale is 15 items. There are acceptable indicators of stability in the list. The coefficient of stability was 0.94. As for validity, the list was calculated in different ways, including the correlation between the two measures and different scales. The validity and reliability of the list were also calculated in a number of studies conducted in Arabic and foreign countries (Alansari & Kazem, 2008).
Posttraumatic Stress Disorder (PTSD) (Norris & Hamblen, 2003). This measure is a self-reported measure to assess the symptoms of PTSD according to the criteria of the DSM-IV-TR. The trauma symptoms inventory, the Oman version (Al-Marhon, 2011) and the Jordan version (Al-Momani, 2008) consist of 17 items (scores range from 17-85). A diagnostic measure based on the DSM-IV-TR, which was in use when the study commenced, includes five alternative answers (5-point Likert scale) for each question depending on the severity of the symptom: 1 = none, 2 = a little, 3 = some, 4 = much, 5 = most. Participants responded to the scale indicating how frequently they experienced specific symptoms of PTSD. Reliability and validity and other psychometric proprieties were applied and accounted step-by-step for the Omani study by Al-Marhon (2011) and taking in consideration the psychometric properties done by Al-Momani (2008). The PTSD has demonstrated good test-retest reliability (r = .95) and internal consistency (r = .92). Concurrent validity was assessed by comparing the PTSD with the Al-Qadomi PTSD scale. The two scales were significantly correlated at .05.
Statistical Analysis
The data were analyzed using SPSS v 20 and AMOS v 23. The results of the EFA were first extracted as the questionnaire factors were new to the Arabic language and the Jordanian context. Some studies carried out the CFA first and found that the results were not identical (Cesur and Durak-Batigun, 2018). Therefore, an EFA must first be carried out and then a CFA through calculating the following tests: TLI, GFI, CFI, NFI, RMSEA, and AGFI. Spearman correlation coefficients were used because of the normal distribution of the variables.
3. Results
Exploratory Factor Analysis
The appropriateness of the items for factor analysis was first tested. The Kaiser-Meyer-Olkin test (KMO) was .924, which is a very high value, justifying using a factor analysis. Additionally, the results of Bartlett>s test of sphericity showed a statistically significant effect (x2 = 3006.270, df = 351, p < .000). The results of the EFA indicated five main factors by eigenvalues greater than one. The factors excluded 12 items as the item loadings were less than .55, and they were likely to adversely affect the results of the CFA. A Principal component factor analysis with varimax rotation was conducted on the 26 items again, a five-factor structure was obtained, and the total variance explained by these factors was 62.245%.
The factors were named in order as negative cognitions about the self, the world, and the future, and cherishing and threatening interpretations after loss. The factor loadings of the items ranged from .563 to .887, see Table 2.
Table 2 Factor Loadings of Items of the GCQ (n=645)
|
Self |
World |
Future |
Cherish |
Threaten |
||
|
Item 1 |
.881 |
|||||
|
Item 2 |
.815 |
|||||
|
Item 3 |
.752 |
|||||
|
Item 4 |
.751 |
|||||
|
Item 5 |
.725 |
|||||
|
Item 6 |
.713 |
|||||
|
Item 21 |
.687 |
|||||
|
Item 23 |
.681 |
|||||
|
Item 26 |
.664 |
|||||
|
Item 7 |
.887 |
|||||
|
Item 8 |
.876 |
|||||
|
Item 9 |
.824 |
|||||
|
Item 10 |
.820 |
|||||
|
Item 12 |
.814 |
|||||
|
Item 15 |
.804 |
|||||
|
Item 16 |
.763 |
|||||
|
Item 17 |
.729 |
|||||
|
Item 18 |
.685 |
|||||
|
Item 19 |
.675 |
|||||
|
Item 32 |
.820 |
|||||
|
Item 33 |
.709 |
|||||
|
Item 34 |
.628 |
|||||
|
Item 13 |
.613 |
|||||
|
Item 35 |
.703 |
|||||
|
Item 37 |
.644 |
|||||
|
Item 38 |
.563 |
Table 2
|
Correlations between GCQ subscales |
||||||
|
Self |
- |
|||||
|
World |
.646 |
-- |
||||
|
Future |
.546 |
.686 |
-- |
|||
|
Cherish |
.842 |
.712 |
.541 |
-- |
||
|
Threating |
.519 |
.796 |
.521 |
.696 |
-- |
Finally, the Jordanian version is composed of 26 items divided into five factors. The first factor consisted of all items on the first factor in the original study plus two items from factor 5 and one item from factor 6 in the original study. The second factor included 3 items from the second factor in the original study plus one item from the third factor in the original study. The third factor consisted of all the items from the fourth factor in the original study and one item from the third factor in the original study. Finally, factor 5 was made up of 3 items from the last factor from the original study, see Figure. The factors in this study were named in parallel with the original study.
CFA results of the Jordanian version of the Grief Cognition Questionnaire (n = 645)
Table 3 Confirmatory Factor Analyses of the Grief Cognition Questionnaire: Overall Model Fit
|
Model |
X2 |
df |
X2/df |
TLI |
GFI |
CFI |
NFI |
RMSEA |
AGFI |
|
|
Five factor model 1 |
r 1322.98 r |
374 |
3.706 |
.77 |
.84 |
r .69 r |
.55 |
.082 |
.79 |
|
|
Second order five factor model 2 |
Г 1503.41 Г |
397 |
3.303 |
.82 |
.71 |
Г .73 r |
.68 |
.089 |
.69 |
|
|
Orthogonal five factor model 3 |
Г 2177.43 Г |
401 |
5.246 |
.85 |
.61 |
r .88 r |
.77 |
.121 |
.66 |
|
|
Modified five factor model 4 |
Г 1039.97 Г |
378 |
2.189 |
.94 |
.87 |
r .93 |
.88 |
.073 |
.89 |
Note: CFI - Comparative Fit Index; TLI - Tucker Lewis Index; NFI - Normed Fit Index; RMSEA - Root Mean Square Error of Approximation.
Confirmatory Factor Analysis
The CFA was conducted using the AMOS v. 23 to test the validity of the five factors. There were 645 participants in this analysis who had participated in the EFA. Initially, the data were verified, and the assumptions regarding the results were obtained from the same source and by e-mail. The value of z = (-3.31 > z < 3.31) and the histogram and box-plot were calculated. Based on the results, all participants were included the GCQ scores were normally distributed.
Five-factor model with correlated factors (model 1), second order five- factor model (model 2) and finally orthogonal five factor model (model 3) were tested. After testing 3 models, a five-factor model with correlated factors was found to better fit the data (x2 = 1322.98, df = 374, p = .000). However, goodness of fit indices showed that the model did not fit at an expected level (GFI = .84, CFI = .69, NFI = .55, RMSEA = .082, AGFI = .79). When modification indices were analyzed, there was a notable relation between the error covariance of the following items: item 26 with 21; item 4 and 6; item 8 and 12; that existed under the same factor in this model. These item pairs were also close to each other with respect to meaning. It was therefore decided to correlate the errors for these items and the CFA was repeated after each correlation. Consequently, it was revealed that the modified model fit the data better (x2 = 1039.97, df= 378, p = .000; GFI = .87, CFI = .93, NFI = .88, RMSEA= .073, AGFI = .89). See Table 3 and Figure with correlation among the five factors.
Validity
The results of correlation analyses conducted to determine convergent validity revealed that there is strong positive correlation between the GCQ factors and each of the pessimism subscale (ranging from .45 to .66), the depression subscale (ranging from .48 to .79), the anxiety subscale (ranging from .43 to .73), the ATQ (ranging from .38 to .64), the PTSD (ranging from .29 to .50), and the PGD (ranging from .32 to .64). There are negative correlation between GCQ and the optimism subscale ranging from .26 to .43. Therefore, the correlations were high. (see Table 4).
Additionally, when shared variance of depression and anxiety subscales and the PGD were controlled, the significance relationship remained among GCQ total and subscales and PGD (p < .01) (Respectively: r= .64, .51, .46, .49, .47, .39).
To achieve greater discrimination validity, an independent-samples t-test was performed between the total score of the GCQ and GCQ factor scores and the mean scores on the PGD scale (70.04). Participants were divided into two groups with a high mean and a low mean according to the PGD cut point. High scores on the PGD scale also had high and significant scores on the GCQ total (t (109) = -12.03, p<.01) and its subscales (respectively: t (92) = -10.42, p < .01; t (92) = -10.81, p < .01; t (92) = -8.67, p < .01; t (92) = -11.54, p < .01; t (92) = -7.95, p < .01).
Table 4 Spearman Correlations of the Grief Cognition Questionnaire (GCQ) With Measures of Cognitions (n = 645)
|
GCQ F1 |
GCQ F2 |
GCQ F3 |
GCQ F4 |
GCQ F5 |
GCQ Total |
Optimism |
Pessimism |
Depression |
Anxiety |
ATQ |
PTSD |
||
|
GCQ F1 |
- |
||||||||||||
|
GCQ F2 |
.53 |
- |
|||||||||||
|
GCQ F3 |
.49** |
.32* |
- |
||||||||||
|
GCQ F4 |
.61** |
.77** |
.62** |
- |
|||||||||
|
GCQ F5 |
.39** |
.47** |
.55** |
.63** |
- |
||||||||
|
GCQ Total |
.73** |
.59** |
.43** |
.75** |
.51** |
- |
|||||||
|
Optimism |
-.43** |
-.31* |
- .29* |
-.33** |
- .26* |
- .37** |
- |
||||||
|
Pessimism |
.45** |
.77** |
.56** |
.53** |
.66** |
.72** |
-.53** |
- |
|||||
|
Depression |
.79** |
.49** |
.53** |
.77** |
.48** |
.66** |
-.31* |
.65** |
- |
||||
|
Anxiety |
.65** |
.73** |
.43** |
.65** |
.76** |
.71** |
-.28* |
.71** |
.40** |
- |
|||
|
ATQ |
.46** |
.64** |
.62** |
.38** |
.59** |
.52** |
-.32* |
.43** |
.53** |
.63** |
- |
||
|
PTSD |
.42** |
.50** |
.48** |
.48** |
.29* |
.62** |
-.25* |
.50** |
.62** |
.48** |
.54** |
- |
|
|
PGD |
.64** |
.32* |
.39** |
.54** |
.36** |
.40** |
-.30** |
.38** |
.43** |
.76** |
.64** |
.41** |
Note: *p < .05. **p < .01; GCQ = Grief Cognition Questionnaire; ATQ = Automatic Thought Questionnaire; PTSD = Post-Traumatic Stress Disorder; PGD = Prolonged Grief Disorder.
Reliability
To test the reliability of the questionnaire, two different samples were chosen from the first sample. The first sample consisted of 65 participants with a mean age of 35.76 years (SD = 5.37) and a mean time since the accident of 4.87. The Cronbach's alpha for all GCQ items was .97 and ranged between .89 and .94 for the factors. The Spearman-Brown split half reliability was .91, p <.001.
In terms of temporal reliability, a group of individuals from outside the sample 73 participants with a mean age of 35.76 years and a standard deviation of 5.37 and a mean time of 4.87 since the accident. They completed the GCQ twice with four weeks between two applications. The results showed that the r was .90 p < .001, and the value with eight weeks of separation was .94, p < .01. This result indicates the stability of the scale and its reliability. The standards for instrument reliability using Cronbach's alpha by Robinson, Shaver, and Wrightsman 1991 were used to judge the quality of the instrument scales. These standards were 0.84 to 1.00 = exemplary reliability, 0.73 to 0.84 = extensive reliability, 0.63 to 0.65 = moderate reliability, and < 0.63 = minimal reliability.
Discussion
This study has contributed to the development and provision of an important and necessary tool for the Arabic language in general and for Jordan in particular to be valid and consistent for measuring cognition of loss or death. The original tool consists of 38 items distributed across 9 factors, while the Jordanian version is composed of 26 items divided into five factors. The fives factors explained 62.245% of the total variance. This result is high and acceptable for continuing study procedures (Scherer, Wiebe, Luther & Adams, 1988). In addition, 12 items from the scale were excluded because these items did not meet the standards for an EFA, the loadings were weak and the items may not be suitable for Jordanian society or may have been translated in an inappropriate manner that led to distorting the meaning (Aldahadha, 2019,a; Aldahadha, 2019, b).
In any case, the differences in culture and values influenced the differences seen in the redistribution of the items of this questionnaire to its current form. The loadings for the items from this scale reached .563 - .887, which means that the results are reliable and can be generalized to Jordanian society (Floyd and Widaman, 1995). Following the EFA, a CFA was carried out on the same sample to verify the validity of the results. The GCQ was validated, and four CFA models were tested with CFA. The modified five-factor model 4 was the most appropriate and had better fit. After modifications, the goodness of fit indices of the model (GFI = .87, CFI = .93, TLI = .94, NFI = .88, RMSEA = .066) were fairly close to those in the original study (CFI = .93, TLI = .92, NFI = .90, RMSEA = .073). All fit indices were at acceptable values (Browne and Cudeck, 1993). Therefore, it can be concluded that the model shows good fit to the data and we can say that the results of this study confirm that the questionnaire had good and reliable psychometric properties.
On the other hand, the validity of the questionnaire was verified as a follow-up step. The results also showed statistically significant correlations in its discriminatory validity. The questionnaire distinguished between high means and low means of the PGD. Different findings supported the convergent validity of the GCQ. The five subscales and total score were found to be positively related with measures of pessimism, depression, anxiety, PTSD, ATQ, and PGD, and negatively with a measure of optimism cognitions. Furthermore, all GCQ subscales predicted the severity of symptoms of PGD, depression, anxiety, PTSD, ATQ, and PGD. Correlations of the GCQ with all measures were significant. The results of this study agreed with both the original version (Aldahadha, 2010; Boelen & Lensvelt-Mulders, 2005) and the Turkish version (Cesur & Durak-Batigun, 2018).
As for the reliability of the tool, the results also showed that the Cronbach's alpha coefficient ranged on the subfactors between .79 and .88, and the scale as a whole had an alpha of .92. The Spearman splithalf reliability coefficients showed that the stability was equal to .91. The reliability coefficients at retest were .89 and .78. Based on these results, we can say that the Jordanian version of the GCQ is suitable and adequate. It can be relied upon as a valid and consistent tool to assess loss and death situations and to identify the content and nature of cognition of affected individuals, which will contribute to the psychological literature and provide counselors and clinical psychologists the appropriate tools for detecting symptoms of postloss disorder.
The study had a number of limitations. Most notably, the study did not include an inventory of traumatic grief among the tools in this study due to the lack of availability of an Arabic version, which can be relied upon to measure the psychometric properties in this questionnaire. This questionnaire is considered nonclinical, and the generalization of this tool is for nonclinical individuals. Therefore, we recommend conducting studies on a clinical sample. We also recommend conducting descriptive and experimental studies to determine the effectiveness of cognitive behavioral therapy methods and rational-emotional therapy in dealing with the symptoms of post loss trauma and to explore the extent the factors of this questionnaire are related to other variables.
loss jordanian psychometric negative
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