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Psychometric properties of the Brief Symptom Inventory in nomophobic subjects: insights from preliminary confirmatory factor, exploratory factor, and clustering analyses in a sample of healthy Italian volunteers

Authors Adawi M, Zerbetto R, Re TS, Bisharat B, Mahamid M, Amital H, Del Puente G, Bragazzi NL

Received 7 May 2018

Accepted for publication 19 November 2018

Published 12 March 2019 Volume 2019:12 Pages 145—154


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Professor Igor Elman

Mohammad Adawi,1 Riccardo Zerbetto,2 Tania Simona Re,2,3 Bishara Bisharat,4,5 Mahmud Mahamid,4 Howard Amital,6,7 Giovanni Del Puente,8 Nicola Luigi Bragazzi2,3,8,9

1Bar-Ilan Faculty of Medicine, Padeh and Ziv Hospitals, Zafat, Israel; 2GESTALT Study Center (CSTG), Milan, Italy; 3UNESCO Chair “Health Anthropology, Biosphere and Healing Systems”, University of Genoa, Genoa, Italy; 4EMMS Nazareth Hospital, Nazareth, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; 5The Society for Health Promotion of the Arab Community, The Max Stern Yezreel Valley College, Nazareth, Israel; 6Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 7Zabludowicz Center for Autoimmune Diseases, Department of Medicine B, Sheba Medical Center, Tel HaShomer, Israel; 8DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; 9Department of Health Sciences, Postgraduate School of Public Health, University of Genoa, Genoa, Italy

Background: The Brief Symptom Inventory (BSI), developed by Derogatis in 1975, represents an important standardized screening instrument that enables one to quantitatively assess psychological distress and psychiatric disorders. The BSI is a 53-item self-report scale, measuring nine dimensions that can be summed up to reflect three global indices, including the General Severity Index (GSI). In the era of new information and communication technologies, nomophobia (“no mobile phobia”) is an emerging disorder, characterized by the fear of being out of mobile phone contact. Nothing is known, however, about the factor structure and reliability of the BSI in a population of nomophobic subjects. This study aimed at addressing this gap in knowledge.
Methods: A sample of 403 subjects aged 27.91±8.63 years (160 males, 39.7% of the entire sample, and 243 females, 60.3%), recruited via snowball sampling, volunteered to take part in the study. The Italian versions of the Nomophobia questionnaire and the BSI were administered. Exploratory factor analyses, confirmatory factor analyses, and clustering analysis were carried out together with correlation analysis, analysis of variance, and multivariate regression analysis.
Results: For each BSI subscale, scores were significantly higher than the norms. The nine subscales exhibited acceptable-to-good Cronbach’s alpha coefficients, varying from 0.733 for psychoticism to 0.875 for depression. Overall, the reliability of the entire instrument proved to be excellent (alpha coefficient=0.972). Furthermore, all BSI subscales as well as BSI synthetic indexes correlated with nomophobia in a significant way. Stratifying the population according to the severity of nomophobia (mild, 206 individuals, 51.1% of the sample; moderate, 167 subjects, 41.4%; and severe, 30 individuals, 7.4%), the GSI score could distinguish (P<0.001) between mild and moderate (0.99±0.71 vs 1.32±0.81) and between mild and severe (0.99±0.71 vs 1.54±0.79) nomophobia, although not between moderate and severe nomophobia (P>0.05). Similar patterns could be found for the other subscales of the BSI. Finally, looking at the fit indexes, the second-order 9-factor model best fit the data compared with the Derogatis 1-factor model.
Conclusion: The findings of our study show that the BSI is a reliable and valid instrument with acceptable psychometric properties, and can be administered to populations of nomophobic subjects.

Keywords: nomophobia, Brief Symptom Inventory, psychometric properties, questionnaire, confirmatory factor analysis

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