Construct validity and factor structure of sense of coherence (SoC-13) scale as a measure of resilience in Eritrean refugees living in Ethiopia

Abstract

BackgroundThere is a scarcity of adapted measures to study resilience and mental health of people in humanitarian settings in Africa. The aim of this study was to identify the factor structure and other psychometric properties of the Sense of Coherence (SoC-13) scale in Eritrean refugees living in Ethiopia.MethodsIn a cross-sectional survey, 562 adults were selected randomly from Eritrean refugees living in Mai Aini camp, Ethiopia. The SoC-13, the Center for Epidemiologic Studies Depression scale (CES-D), the Pre and Post-Migration Living Difficulties checklist, the Primary Care Post-Traumatic Stress Disorder screener (PC-PTSD), the Oslo Social Support Scale (OSS-3), the Coping Style scale and the Fast Alcohol Screening Test (FAST) were administered concurrently. Confirmatory Factor Analysis (CFA) was used to investigate the factor structure of the SoC-13 using IBM SPSS Amos, version 21.ResultA one factor model of the SoC with twelve items had the best fit to the current data (CFA = 0.982, RMSEA = 0.035 [90%CI = 0.018, 0.050]), with good internal consistency (Cronbach’s Alpha = 0.75). When all 13 items of the Tigrigna version were considered, there was an inverse association of SoC-13 with PC-PTSD(r = − 0.433, p < 0.001), CES-D (r = − 0.597, p < 0.001), Pre and post-migration living difficulties checklist (r = − 0.265, p < .001and r = − 0.249, p < 0.001 respectively), and FAST (r = − 0.105, p < 0.001), providing support for the divergent validity of the scale. The SoC-13 was associated positively with the Oslo Social Support scale (OSS-3)(r = 0.363 p < 0.001) and task-oriented coping (r = 0.089, p < 0.001), demonstrating convergent validity. The four items, specifically item-1, item-2, item-3 and item-12 have shown relatively weaker item loadings (β<0.40); but item-2 demonstrated non-significant loading (β = 0.06, p>0.05) in a one factor model of SoC-13.ConclusionsAlthough the 13-items of the Tigrigna version of the SoC scale loaded significantly onto their respective factors in the three factor model, only 12 items loaded significantly onto the one factor model, which demonstrated superior fit to the current data. Keeping in mind that future research should examine the conceptualizations of the four items demonstrating poor convergent validity in this Eritrean sample, the reduced Tigrigna version of SoC-12 is a reasonable measure of sense of coherence in this community.Electronic supplementary materialThe online version of this article (10.1186/s13031-019-0185-1) contains supplementary material, which is available to authorized users.

Validity of the Center for Epidemiologic Studies Depression Scale (CES-D) in Eritrean refugees living in Ethiopia

“…Of all measures used in the current study, CES-D is highly correlated with PC-PTSD, although the direction of relationship cannot be inferred from the current cross-sectional study design 57. On the other hand, an acceptable and expected significant inverse association was demonstrated between SoC-13 and CES-D on the same sample of Eritrean refugees, as reported in a recent publication 58. This means CES-D as measure of depression in the Eritrean community did not positively relate to measures of resilience and well-being (sense of coherence), implying its acceptable divergent validity.…”

Introduction to the special collection: developing valid psychological measures for populations impacted by humanitarian disasters

“…The six papers contained within this special collection span a wide range of populations impacted by humanitarian disasters, a wide range of tools measuring a variety of psychological constructs, and a wide range of psychometric approaches used to evaluate the use of these tools within these populations. Samples include young adult secondary school students in Haiti [12], internally displaced adults and veterans from Ukraine [13], Eritrean refugees living in Ethiopia [14], refugees from the Darfur region of Sudan living in Chad [15], refugees from Iraq, Iran, Sri Lanka and other countries currently residing in Australia [16] and a national, representative sample of Sri Lankan adults affected by civil war [17]. Psychological constructs measured include the psychopathological constructs most common to the psychosocial aid literature, posttraumatic stress disorder (PTSD), major depression, and anxiety [12,16,17], but also substance abuse [13], cultural concepts of distress [15] and broader phenomena related to wellbeing [14].…”

“…Samples include young adult secondary school students in Haiti [12], internally displaced adults and veterans from Ukraine [13], Eritrean refugees living in Ethiopia [14], refugees from the Darfur region of Sudan living in Chad [15], refugees from Iraq, Iran, Sri Lanka and other countries currently residing in Australia [16] and a national, representative sample of Sri Lankan adults affected by civil war [17]. Psychological constructs measured include the psychopathological constructs most common to the psychosocial aid literature, posttraumatic stress disorder (PTSD), major depression, and anxiety [12,16,17], but also substance abuse [13], cultural concepts of distress [15] and broader phenomena related to wellbeing [14]. Psychometric approaches include confirmatory factor analysis (CFA) [14,16,17], receiver operating characteristics (ROC) [12], item response theory (IRT) [13], and dynamic network analysis [15]; one study even shows how qualitative methods can be integrated to develop and validate tools [13].…”

“…Psychological constructs measured include the psychopathological constructs most common to the psychosocial aid literature, posttraumatic stress disorder (PTSD), major depression, and anxiety [12,16,17], but also substance abuse [13], cultural concepts of distress [15] and broader phenomena related to wellbeing [14]. Psychometric approaches include confirmatory factor analysis (CFA) [14,16,17], receiver operating characteristics (ROC) [12], item response theory (IRT) [13], and dynamic network analysis [15]; one study even shows how qualitative methods can be integrated to develop and validate tools [13].…”

“…More and more psychologists are examining the role that psychological constructs related to resilience play in determining the mental health of disaster-impacted populations (e.g., [21,22]). Getnet and Alem [14] assessed the validity and reliability of a scale measuring such a psychological construct, namely sense of coherence, in adult Eritrean refugees living in Ethiopia. Using CFA, they identified four items that did not work well in this population; however, a shortened version of the scale fit well, and demonstrated convergent validity with measures of social support and coping.…”