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Psychometrics of the SCL-90-R and Development and Testing of Brief Versions SCL-45 and SCL-9 in Infertile Couples

Martínez-Pampliega, Ana; Herrero-Fernández, David; Martín, Sagrario; Cormenzana, Susana

doi: 10.1097/NNR.0000000000000363

Background Although infertile couples are mentally healthy, dealing with infertility and assisted reproductive technology (ART) treatment is usually associated with psychological distress. It would therefore be useful to have short, multidimensional instruments to be able to identify people who present more intense emotional reactions and follow up their emotional distress throughout the ART.

Objectives The goals of the study were to analyze the psychometric adequacy of the original 90-item version of the Symptom Checklist (SCL-90) in a sample of Spanish women and their partners undergoing ART, as well as to develop and analyze two brief versions of the SCL-90, given the absence of adequate short versions for this population.

Methods A cross-sectional design for patients and their partners in the process of ART through in vitro fertilization was used. The two brief scales were obtained, which took into account the levels of variance explained by the items and confirmatory factor analysis.

Results Two brief instruments were developed. The first, with 45 items (SCL-45-I Infertility), includes nine subdimensions: Somatization, Interpersonal Sensitivity, Obsessive-Compulsive Disorder, Depression, Anxiety, Hostility, Paranoid Ideation, Phobic Anxiety, and Psychoticism. The second instrument contains nine items (SCL-9-I or Global Severity Index [GSI]), one item for each dimension. Both instruments were psychometrically adequate (SCL-45-I: χ2/df = 7.24, RMSEA = .057, 95% CI [.056, .059], CFI = .97, NNFI = .97, SRMR = .049; SCL-9-I: χ2/df = 9.66, RMSEA = .068, 95% CI [.061, .076], CFI = .97, NNFI = .96, SRMR = .035). Measurement invariance analysis by gender was conducted, and the instruments were shown to be suitable for both men and women.

Discussion The suitability of the SCL-90-R for use in ART was verified, and two valid instruments—useful and easy to use for nurses, psychologists, and other care providers—were developed.

Ana Martínez-Pampliega, PhD, is Professor, School of Psychology and Education, University of Deusto, Bilbao, Spain.

David Herrero-Fernández, PhD, is Associate Professor, School of Health Sciences, Universidad Europea del Atlántico, Santander, Spain. At the time this research was completed, David was Post-Doctoral Researcher at Deusto Family Psych Research Team, School of Psychology and Education, University of Deusto.

Sagrario Martin, PhD, is Psychotherapist, Arratia Psychological Center, Igorre, Spain. At time this research was completed, she was psychotherapist at QuirónSalud Bilbao Assisted Reproduction Center, Bilbao, Spain.

Susana Cormenzana, PhD, is Associate Professor, School of Psychology and Education, University of Deusto, Bilbao, Spain.

Accepted for publication October 19, 2018.

The study was the result of the collaboration between Quirónsalud Bilbao Assisted Reproduction Center and the School of Psychology and Education of the University of Deusto. The research received no specific grant from any funding agency of the public, commercial, or not-for-profit sectors.

Ethical Conduct of Research: All procedures contributing to this work complied with the original declaration of Helsinki (Ethical Approval ETK-8/13-14).

The authors have no conflicts of interest to report.

Corresponding author: Ana Martínez-Pampliega, PhD, Faculty of Psychologist and Education, University of Deusto, Avd. Universidades, 24, 48007 Bilbao, Spain (e-mail:

Online date: April 2, 2019

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