Identifying vulnerability in grief: psychometric properties of the Adult Attitude to Grief Scale
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Purpose Grief is a reaction to a significant loss that can profoundly affect all aspects of life and capacity to function well. The consequences can vary from severe psychological distress through to physical disturbances and significant social problems. This study sought to identify a measure of vulnerability in grief, by examining the psychometric properties of the Adult Attitude to Grief (AAG) scale in a sample of 168 people seeking help in their bereavement.
Methods The factor structure of the scale, its internal consistency, its construct validity and optimum classification cutoffs were tested.
Results Confirmatory factor analysis broadly supported the factor structure of the AAG, but identified one item that could profitably be reworded. Internal consistency of the three subscales was acceptable. Construct validity and discriminative validity were supported by correlations with allied constructs (depression and anxiety) and a significant difference between scores for clients with Prolonged Grief Disorder and those without. A correlation with counsellors’ own clinical ratings of vulnerability demonstrated criterion-related validity of the AAG. Using receiver operating characteristic methods, optimum cutoff scores on the scale were identified for the classification of different levels of vulnerability.
Conclusion The AAG was found to be a psychometrically promising tool for identifying vulnerability in grief.
KeywordsAdult Attitude to Grief scale Vulnerability Psychometrics Validity Reliability Factor analysis
List of symbols
Adult Attitude to Grief scale
Comparative fit index
Generalized Anxiety Disorder Assessment 7
Prolonged Grief Disorder Scale
Prolonged grief disorder
Patient Health Questionnaire 9
Root means square error of approximation
Receiver operating characteristic
Weighed least squares mean and variance adjusted
This study was funded by the North Staffordshire Medical Institute. The authors wish to thank the Dove Service (North Staffordshire, UK), St Giles Hospice (Lichfield, UK) and the Marie Curie Hospices (Belfast and Hampstead, UK) for their help with data collection, Aisling Bartlam for help with data entry, and Kelvin Jordan for advice on the manuscript.
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