Next Article in Journal
Pregnancy, Childbirth, and Postpartum Experiences of Racialised Brazilian Women in Portugal: An Analysis of Obstetric Violence as Gender-Based Violence
Previous Article in Journal
Youth Voices Participating in the Improvement of Sexual Consent Awareness Campaigns
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Sexes
Volume 5
Issue 4
10.3390/sexes5040039
sexes-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Revising the Original Antonovsky Sense of Coherence Concepts: A Mixed Method Development of the Sense of Meaning Inventory (SOMI)

by
Denise M. Saint Arnault
1,* and
Zeynep Zonp
2
1
School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
2
College of Nursing, Wayne State University, Detroit, MI 48202, USA
*
Author to whom correspondence should be addressed.
Sexes 2024, 5(4), 596-610; https://doi.org/10.3390/sexes5040039
Submission received: 28 May 2024 / Revised: 7 October 2024 / Accepted: 14 October 2024 / Published: 30 October 2024
(This article belongs to the Section Gender Studies)
Browse Figure
Review Reports Versions Notes

Abstract

:
Trauma recovery research requires the development of instruments that capture gender-based violence (GBV) survivor recovery phases. The salutogenic concepts in Antonovsky’s Sense of Coherence (SOC) (manageability, comprehensibility, and meaning) could help capture trauma recovery stages, but the factorial structure of the SOC-13 has remained problematic. Moreover, most SOC revisions generally abandon the original intent of the SOC-13, developing scales that capture essential but different aspects of positive psychology. This study used mixed methods to develop the Sense of Meaning Inventory (SOMI), preserving the original concepts but updating the language, removing cultural idioms, and revising the response scales to stabilize the subscales. The qualitative phase evaluated and updated the items of the scale while retaining the original concepts. The quantitative phase conducted a two-sample psychometrics reliability and validity evaluation of the new scale with GBV survivors, finding a three-factor solution. This scale may be more amenable for international research and theory testing in GBV and other health conditions.

1. Introduction

Gender-based violence (GBV) disproportionately affects women worldwide, regardless of socioeconomic conditions or ethnicity, and is any act of violence that results in physical, sexual, or psychological harm or suffering to women and girls [1]. GBV survivors are at increased risk of depression and suicide attempts, physical injuries, unwanted pregnancies, HIV, and other sexually transmitted diseases, and are at increased risk of being killed by a partner [2], as well as Post-Traumatic Stress Disorder (PTSD), depression, and suicidal ideation [3,4,5], substance abuse and dependence disorders, eating disorders, somatoform disorders, and other medically unexplained symptoms [6,7]. While most research examines the risk factors, our work is focused on protective factors that can mitigate the impact of trauma on health [8]. Protective factors include social support, self-efficacy, resilience, goal-directed coping strategies, and having a ‘sense of coherence’ [9,10,11,12]. This study focuses on the measurement of a sense of coherence.

1.1. Sense of Coherence as a Protective Factor After GBV

Sense of Coherence (SOC) is defined as “a global orientation that expresses the extent to which one has a pervasive and enduring, though dynamic, feeling of confidence that one’s internal and external environments are predictable, and that there is a high probability that things can work out as well as can reasonably be expected” (Antonovsky, 1987, p. 19, [13]) [14,15]. The sense of coherence instrument (SOC-13) is a widely used seven-point semantic differential scale that examines the three hypothesized domains of the construct of the sense of coherence, including manageability, comprehension, and meaning. These concepts are further divided into cognitive, behavioral, and motivational facets. Cognitive facets are the evaluation of one’s life. Behavioral facets reference actions people take. Motivational facets refer to the aspects of our lives that motivate us to act. Comprehensibility is considered a cognitive facet of the SOC, characterized by individuals’ capacity to comprehend their surroundings. The behavioral facet, termed manageability, pertains to the ability to handle situations independently or with the support of the larger social context. The motivational facet, termed meaning, refers to the capacity to derive significance from challenging circumstances. The SOC questionnaire has been translated into more than 60 languages and used in over 50 countries, and most translations and cultural validation studies have endeavored to preserve the original items. The SOC-13 (13-item short version) demonstrated internal consistency and test-retest reliability [16]. In addition, studies have shown construct validity [16,17] and convergent validity with other analogous measures [16]. A meta-analysis of 47 studies that examined the relationship between SOC and post-traumatic stress conducted by Schäfer et al. (2019) [18] found that high SOC-13 levels were linked to less severe PTSD symptoms after a traumatic or stressful life event. They also reported that SOC is a crucial moderator for PTSD symptoms. Furthermore, research shows a negative relationship between SOC-13 and psychopathology [18,19,20]. The protective effect of SOC may be related to the ability to manage stressors, accurate perception of stressors, and general feelings that life has meaning and value.
The original SOC questionnaire did not intend to differentiate between the three salutogenic components (manageability, comprehensibility, and meaning) as separate constructs because they were viewed as overlapping. While we agree with that theoretically, in trauma recovery research and practice, we need to ascertain how managing, perceiving, and making meaning of stressors, especially after traumatic stress, may map onto phases of trauma healing. The three subscales in the original SOC are essential in measuring trauma recovery for GBV survivors because they conceptually represent aspects of the recovery process. Literature has shown that symptom management might be an essential first step in recovery. However, understanding trauma history’s role in one’s life and current health is vital to recovery. It could potentially be captured in the comprehensibility concept. In the later stages of recovery, understanding oneself in the larger world and one’s life’s meaning and purpose may be a step in the trauma integration process, and assessing the meaning component of SOC is also essential. Therefore, preserving the original theorizing of the aspects of SOC can help measure trauma recovery and trauma recovery phases. This study explains the development and psychometric testing of the SOMI (Sense of Meaning Inventory), which was developed to retain the original concepts of the SOC and stabilize the factors for use in the evaluation of GBV recovery.

1.2. Psychometric Issues of the SOC-13 Measure

Studies have shown that the three components of the SOC construct do not appear every time a factor analysis is used. While the factor analyses of the original SOC13 often yield ambiguity, the original conceptualization of SOC and the questionnaire items’ design precluded three separate subscales. This strategic design was because while any given item belongs to one of the three components, the items from each subscale share elements of the concepts from the other subscales [13,21]. Antonovsky (1993) [16] writes about the development of the original scale:
“I made the conscious, theoretically guided choice to have each scale item include four facets that describe a stimulus and a fifth, the SOC facet, which expresses one of the construct’s three components (comprehensibility, manageability, or meaning). Since the SOC is seen as a generalized orientation, I wanted to represent as wide a variety of stimuli as possible in the questionnaire”.
(Antonovsky, 1993, p. 726, [16])
There has been a longstanding and extensive evaluation of the construct or Sense of Coherence and its factor structure, and a thorough review is available in Eriksson and Contu [22]. In their roundup, they note that some researchers report it as a unitary construct, while others report 2–5 subscales. They summarize the evidence related to the lability or stability of the sense of coherence subscales in various populations and across the life course. For example, in one study by Lerdal et al. [23], they used Rasch analysis with adults with morbid obesity in Norway. They found that collapsing categories at the low end of the 7-category rating scale improved the overall functioning of the scale and that two items demonstrated poor fit. Once deleted from the scale, the remaining 11-item scale (SOC-11) demonstrated an acceptable item fit. However, neither the SOC-13 nor the SOC-11 met the criteria for unidimensionality, and none of the subscales could distinguish between population subgroups. They concluded that more psychometric examination and refinement of the SOC 13 scale is warranted.
Researchers have found these assumptions about facets and subscales elusive and have often concluded that the inconsistency of the factor structure presents research challenges, particularly for research questions that aim to assess the subscales themselves. Various attempts have been made to improve the psychometric properties of the original scale 29-item version, most notably the development of the 13-item short version (SOC13). Still, researchers find the factor structure unstable [24]. Other studies have indicated a variety of shortcomings, including external validity [25] and stability [26]. In addition, the revisions generally abandon some or all the original intent of the SOC, developing scales that capture essential but different aspects of positive psychology. For example, a recent approach to solving these problems has been the development of the revised Sense of Coherence Scale (SOC-R) by Bachem and Maercker [27]. This instrument defines the SOC as the general ability to perceive life phenomena as connected and to balance positive and negative appraisals of life experiences [28]. However, there were substantial changes to the instrument, notable the factors of “Manageability”, “Reflection”, and “Balance” [29]. While this is consistent with the Antonovsky (1987) [13] Manageability concept, the Bachem and Maercker SOC-R version focuses on emotional processes and self-awareness processes in the reflection and balance subscales [30]. This version, therefore, omits the original scale’s comprehensibility and meaning aspects, making it a measure of theoretical concepts different from the SOC.

1.3. Research Aims

This project sought to preserve the three concepts of SOC and to create a measure called the Sense of Meaning Inventory (SOMI). This new scale assumes that the factors have some interaction but are distinct, allowing researchers to use them as subscales. To do this, we approached the revision of the SOC-13 scale from a different angle. Instead of changing the focus of the SOC, we aimed to separate and clarify the items so that they could reliably measure the three concepts. Therefore, we focused on the semantic differential scale and the reversals, the outdated nature of some items, including a few cultural idioms, and items in the scale that are not explicitly related to the central definitions. We used a mixed-method approach to reworking the SOC-13 scale, starting with a qualitative analysis of the constructs, their concepts, and the items that represented them. This scale revision aimed to retain the original SOC constructs by updating the language, ensuring all the items measured only the SOC concepts, and revising the measurement strategy. A more standard cognitive interviewing stage followed this analysis. Secondly, in two samples, this study examined the resulting SOMI scale’s psychometrics (which uses Likert-style items and no reversals) to discover whether our new scale retains the three-factor structure.
This project develops and tests a revision of the SOC-13 scale. We hypothesize that our revision will result in a valid scale with three subscales that are consistent with the original SOC-13 scale (meaning, comprehension, and manageability), that these subscales will demonstrate convergent and discriminate validity, and that the SOMI will explain the variance of depression and PTSD for GBV survivors.

2. Methods and Materials

This mixed-method study used an exploratory sequential approach consisting of a qualitative phase followed by a quantitative one [31]. The exploratory sequential design begins with qualitative methods and then uses the building to integrate those qualitative findings into a quantitative product and analysis [32]. The qualitative Phase 1 involved reviewing literature for contemporary manageability comprehension and meaning instruments and items, revising existing SOC items, and conducting cognitive interviewing with people identifying as women, most of whom were trauma survivors. The quantitative Phase 2 was performing a psychometric evaluation of the resulting scale.

2.1. Sampling

Qualitative Phase 1 sampling: The cognitive interviewing sample was a convenience snowball sample of 10 Americans aged eighteen years or older who self-identified as women.
Quantitative Phase 2 sampling: Quantitative data was gathered from samples recruited through a health system research portal that connects individuals who utilize the broader university healthcare system with research opportunities. Eligible participants were eighteen or older, self-identified as women, and had “experienced gender-based violence of any type”. The first sample (n = 291) was gathered between July 2019 and February 2020, and the second (n = 296) was recruited between April and December 2022. The University of Michigan Institutional Review Board exempted all procedures and materials for study 1 (HUM00191183) and approved study 2 (HUM00205708).

2.2. Measures

The measures in this study were employed to conduct psychometric testing. Demographic variables included gender identity, GBV history, current violence, age, education, and employment. Known group reliability was evaluated based on the GBV history variable, categorized as either current or past, as well as depression and a post-traumatic stress disorder (PTSD) symptom severity subgroup. Depressive symptoms were assessed through the Patient’s Health Questionnaire 8 (PHQ8) [33], which is an 8-item depression scale that does not include the suicidal thoughts item in the PHQ-9, making it suitable for community-based survey use. Statements are responded to on a 4-point Likert scale anchored at 0 = Not at all to 3 = Nearly every day, and scores are summed. A sum score of 10 or higher on the PHQ8 indicates probable major depression. Cronbach’s reliability in our study was 0.90. PTSD was assessed with the Post-Traumatic Stress Disorder Checklist (version 5) scale (PCL-5), which is a 20-item assessment scale [33]. This study used the short-form 8-item version [34]. Statements are responded to on a 5-point Likert scale anchored at 0 = Not at all to 4 = Extremely, and scores are summed. A sum score over 19 indicates probable PTSD. Cronbach’s reliability in our study was 0.91.
Convergent validity aims to investigate whether different measures are theoretically associated with each other and demonstrate this relationship practically. This study’s convergent validity variables included trauma-coping self-efficacy and recovery. The Trauma Coping Self-Efficacy (CSE-T) scale is a 20-item measure that assesses general trauma-related coping self-efficacy perceptions. We used the 9-item scale [35]. Statements are responded to on a 7-point Likert scale anchored at 1 = Completely incapable to 7 = Completely capable, and responses are summed. Cronbach alpha reliability for our study was 0.85. The 18-item Healing after GBV (GBV-Heal) scale [36] was used to assess trauma recovery. This instrument measures five dimensions of healing on a 5-point Likert scale anchored at 1 = Does not describe my feelings to 5 = Clearly describes my feelings and responses are summed. Cronbach’s alpha for our study was 0.95.
Divergent validity evaluates whether the measure effectively measures intended concepts and not closely related concepts and variables. This study examined divergent validity with trauma cognitions and barriers to help-seeking scales. The Post Trauma Cognitions Inventory (PTCI) is a 33-item scale that measures psychopathological trauma cognitions after trauma [37]. Statements are responded to on a 7-point Likert scale anchored at 1 = Totally disagree to 7 = Totally agree, and responses are summed. Cronbach’s alpha for our study was 0.83. The Barriers to Help Seeking-TR scale (BHS-TR) [38] is revised from the Barriers to Care instrument developed for the Ontario Mental Health Epidemiological study that examined service use in the past year. Our 34-item BHS-TR scale used the original 25 items plus an additional nine trauma-specific items [39]. Statements are responded to on a 4-point Likert scale anchored at 0 = Did not influence me to 3 = Strongly influenced me, and scores are summed. The full scale examines internal dimension barriers (I-BHS-TR), which is the sum of the shame, feeling frozen, and problem management beliefs sub scores, as well as external dimension barriers (E-BHS-TR), which is the sum of the discrimination, financial, and constraining forces in the environment sub scores. This study used only the I-BHS-TR dimension. Cronbach’s alpha for the I-BHS-TR dimension of the scale in our study was 0.85.

2.3. Analyses

Qualitative Phase 1: For the scale revision aim of this study, we reviewed the literature and conducted a qualitative analysis of each item in the SOC13 to discern the concept it captured and simplify it. The exploratory analysis for phase 1 included (1) Clarifying and defining the constructs and concepts, (2) Rewording reversals into positive wording or rewording cultural idioms, (3) Simplifying questions that were double-barreled, and (4) Converting all items into a 5-point Likert scale. Next, we used cognitive interviewing to evaluate the clarity of the scale and the items [40]. With cognitive interviewing, we tried to understand how participants comprehend, process, and respond to the scale and the items. We asked participants to verbalize their thoughts while answering questions and any challenges they faced in understanding or responding to the items.
Quantitative Phase 2: The SOMI scale’s psychometric properties were analyzed using exploratory factor analysis (EFA) with Direct Oblimin rotation (with sample 1) and confirmatory factor analysis (CFA) (with sample 2) for the construct validity. In the CFA, items with a factor loading lower than 0.30 were evaluated as potentially problematic items (such as being double-barreled, problematic wording, etc.). They were removed, and items that double-loaded at 0.30 or higher were excluded from further analyses [40]. Significance was assessed at p < 0.05 level. Also, the Kaiser–Meyer–Olkin (KMO) proficiency measurement and Bartlett’s sphericity test were used to measure suitability for factor analysis [41].
Next, we used sample 2 two to evaluate the resulting scale using Confirmatory Factor Analysis (CFA), reliability analysis, confirmatory and discriminant analysis, and known group validity. The chi-square/degrees of freedom (CMIN/DF) for acceptable fit were used, and the p-value should be >0.05 [42]. The goodness of fit index (GFI) measures the fit between the hypothesized model and the observed covariance matrix. The adjusted goodness of fit index (AGFI) corrects the GFI, which is affected by the number of indicators of each latent variable. The GFI and AGFI range between 0 and 1, with a value of over 0.90, generally indicating an acceptable model fit. The GFI and the AGFI should be >0.95 and >0.90, respectively [43,44]. The comparative fit index (CFI) analyzes the model fit by examining the discrepancy between the data and the hypothesized model. CFI values range from 0 to 1, with larger values indicating better fit [45]. The root mean square error of approximation (RMSEA) [43,46]. The Normed Fit Index (NFI) of 0.95 indicates that the model improves the fit by 95 [43]. The Tucker-Lewis index (TLI) over 0.90 indicates that the model fits well [43]. The Incremental Fit Index (IFI) adjusts the Normed Fit Index (NFI) for sample size and degrees of freedom [47].
Discriminant validity was evaluated with the Average Variance Extracted (AVE) and Maximum Shared Variance (MSV) computations. AVE should exceed MSV, indicating that the latent variable has more in common with the related items than it has with related concepts [48,49]. Known group validity is a method used to assess the validity of a questionnaire by comparing the scores for two groups that are known to differ on a specific variable. We examined known groups’ validity using t-tests for groups with reported current violence in the last year and those with probable depression and PTSD. We also examined correlations and regression analysis to explore interrelationships between the SOMI and other key variables. Analysis was conducted with SPSS and Amos, version 29 [50].

3. Findings and Results

3.1. Participant Characteristics

The cognitive interviewing sample consisted of 10 women aged 35–65, and 2/3rd of them said “Yes” when asked if they had ever experienced GBV, but we did not ask about the type of violence. Two women had high school education, four had college degrees, and two had advanced college degrees.
Psychometric samples. The demographic data for both samples are shown in Table 1. Sample 1 comprised 291 GBV survivors with a mean age of 37.9 years (SD = 14.8), and about 46% had children. Over half of the sample had college degrees, and about half worked. Income, insurance status, and racial/ethnic identity were not assessed. Depression and PTSD screening tools assessed distress scores. Mean PHQ8 scores were 11.3 (SD = 6.5), and about 27.1% of the sample had probable depression. Mean PTSD screen scores were 2.1 (SD = 1.5), and almost half had probable PTSD (43.6%). About 25% experienced GBV in the last year or were currently experiencing GBV. The type of GBV was elicited as “all that apply”, so the types were not mutually exclusive. Over half of the sample reported physical abuse, and 2/3rds reported a history of sexual abuse.
Sample 2 was comprised of 296 GBV survivors who had a mean age that was identical to sample 1: 37.9 years (SD = 14.8). About 5% of the sample identified as transgender or gender-non-conforming. The sample predominately identified as Caucasian (81%), with 7% identifying as Black/African American, 8% as Asian, 5% as Hispanic, and 2.4% as Native/Alaskan Native or Pacific Islander. Two percent indicated they had immigrated. About two-thirds of the sample had some college education, and half worked. Distress scores were assessed by depression and PTSD tools. Mean PHQ8 scores were 10.9 (SD = 6.0), and about 54% of the sample had probable depression. Mean PCL-5 scores were 14.7 (SD = 8.2), and about one-third had probable PTSD (32%). About one-third experienced GBV in the last year or were currently experiencing GBV. Most of the sample reported either or both physical and sexual abuse histories.

3.2. Qualitative Phase 1: Scale Revision and Cognitive Interviewing

Phase 1 required working definitions of the three SOC-13 constructs and their sub-concepts. Manageability is understood as the instrumental or behavioral dimension of SOC. Manageability is defined in this study as the perceived ability to manage different types of stressors, the belief that one has adequate inner resources to meet life’s demands, and a positive assessment of personal competencies. It is comprised of the sub-concepts of self-efficacy and emotional self-efficacy. Self-efficacy is a person’s confidence in their ability to complete a task or achieve a goal. Emotional self-efficacy is confidence in one’s ability to control emotions and emotional responses to situations.
Comprehensibility is understood as the cognitive dimension of SOC. Comprehensibility is defined in this study as the extent to which one perceives internal and external stimuli as predictable, understandable, explainable, orderly, coherent, clear, and structured. Comprehensibility is the basis for future expectations related to how one understands the world. It is comprised of the sub-concepts of sense-making and self-insight. Sense-making is the action or process of making sense of something, especially an ambiguous situation, and requires situational awareness and understanding of complexity or uncertainty to make decisions. Self-insight is the ability to perceive and understand what makes one who they are and why they do what they do, including their emotions and thoughts.
Meaning is understood as the motivational dimension of SOC. Meaning is defined in this study as the value and importance of one’s life, the extent to which demands in life are viewed as worth investing in and engaging with, knowing what one’s life is about, and how one fits into the world around them; feeling the significance of living; and enjoying the act of living. It comprises the sub-concepts of purpose in life and life satisfaction. Purpose in life is defined as goals or action-oriented motivational aims of one’s life. Purpose in life can guide life decisions, influence behavior, shape goals, offer a sense of direction, and create meaning. Life satisfaction is a stable and long-lived general feeling about one’s life and how pleased they are with how it’s going.
The lead author evaluated each item of the SOC-13 based on the working definitions and was either retained, reworked, or dropped (see Table 2). For example, after creating the working definitions of the three concepts, items that examined different aspects were removed, or items that represented more than one concept were split. We dropped SOC-13 items #3, 5, and 9 because they did not map onto the concepts. We reversed the wording for items 1, 8, 10, 12, and 13 into positive wording. For clarity, we revised the wording for 1, 2, 4, 6–8, and 10–13. Finally, we created 12 new items to ensure we had enough items to capture some of the SOC-13’s less explicated concepts accurately. The resulting 22-item scale was used in the next Cognitive Interviewing (CI) phase.
Cognitive interviewing. Results from the cognitive interviewing included creating a stem for the overall scale that invites the participant to reflect on their life overall, using the phrase “in general” before each question, and framing the entire scale as looking at life overall. Interviewed participants reflected that the terms “understandable and predictable” and “goals and purpose” differed, so those items were broken apart. The concept of the social world (that we had developed) was changed to the social circle. In summary, one item was dropped (I understand my motivations and behavior), 2 items were split, and one was revised, leaving a 22-item revised scale that was then tested psychometrically with two samples of GBV survivors.

3.3. Phase 2: Psychometric Testing

3.3.1. Construct Validity and Principal Component Analysis

Exploratory factor analysis (EFA) was used to evaluate the construct validity of the SOMI with the first sample. Principal Component Analysis (PCA) with Direct Oblimin rotation was conducted, and three components with eigenvalues exceeding 1 were identified, which captured 75.8% of the total observed variance. Eight items were either weakly loaded or double-loaded in the analyses (items #1–3, 5–8, and 17), so these items were removed. One item, #4 (“I know how to manage the situations in my life”), loaded on both factor 1 (meaning) and factor 3 (manageability), but we chose to keep it in the manageability factor since the item references management. The KMO value of sampling adequacy for the sample’s responses is 0.949 for this final 3-factor model, indicating EFA’s appropriateness [51]. Bartlett’s sphericity test provided a p-value of 0.00 (χ2(120) = 3840.205), so the null hypothesis could be rejected, and the factorability of the correlation matrix was supported [52]. The final model included three components on the 15-item final scale that used a 5-point Likert scale, anchored from 1 (Seldom or never) to 5 (Always). Cronbach’s alpha reliability values for meaning, comprehension, and manageability subscales of the SOMI were 0.94, 0.85, and 0.86, respectively. The pattern matrix is presented below in Table 3.

3.3.2. Confirmatory Factor Analysis

We used a second sample CFA to confirm the 3-factor model that we identified with EFA. The root mean square error of approximation (RMSEA) was within the range of reasonable fit at 0.088 for the scale [46], and the chi-square/degrees of freedom (CMIN/DF) value was 2.891, which showed an acceptable fit [42]. The scale’s model’s fit indices were improved by creating a covariance between e1 and e2, e3 and e6, e6 and e8, and e10 and e11. All fit indices were acceptable (see Table 4). The analysis further revealed a consensus between the scree plot and the 3-factor model fit. The 3-factor model for CFA is presented in Figure 1, and the CFA model fit indices are presented in Table 4.

3.3.3. Convergent and Discriminant Validity

Convergent validity was assessed with the GBV-Heal scale and the Trauma Self-Efficacy scale (CSE-T). The SOMI showed a significant strong positive correlation with the GBV-Heal (r = 0.83) and a significant moderate positive correlation with the CSE-T (r = 0.56). Discriminant validity was assessed with the Post-Trauma Cognitions Inventory (PTCI) and the Barriers to Help Seeking Internal dimension scale (sums of the Problem Management, Shame, and Frozen subscales) (I-BHS-TR). There were strong significant positive correlations between GBV-Heal and SOMI-ME (r = 0.796), SOMI-CO (r = 0.641), and SOMI-MA (r = 0.685), as well as between CSE-T and SOMI-ME (r = 0.517). There were moderate significant positive correlations between CSE-T, SOMI-CO (r = 0.445), and SOMI-MA (r = 0.496). There was a strong significant negative correlation between SOMI ME and PTCI (r = −0.513) and moderate significant negative correlations between PTCI and SOMI-CO (r = −0.391) and SOMI-MA (r = −0.461). There were weak significant negative correlations between Internal Barriers to Help Seeking (I-BHS-TR) and SOMI-ME (r = −0.239), SOMI-CO (r = −0.227), and SOMI-MA (r = −0.221). All correlations were significant at the 0.01 level. The intercorrelations among the variables are in Table 5.
Discriminant validity was determined using AVE and MSV values. The Average Variance Extracted (AVE) values for factors SOMI-ME, SOMI-CO, and SOMI-MA were 0.68, 0.69, and 0.57, respectively. The Maximum Shared Variance (MSV) for factors SOMI-ME, SOMI-CO, and SOMI-MA were 0.70, 0.63, and 0.70, respectively.

3.3.4. Known Group Validity

We used independent samples t-tests to compare means for survivors who had experienced GBV in the last year, were depressed, or who had PTSD compared with their no recent abuse, non-distressed counterparts using the sum of the three SOMI subscales. SOMI sum scores were significantly lower for participants who reported violence in the last year (M = 39.8, SD = 12.5) compared with those who had had no violence in the last year (M = 46.7, SD = 14.2) t(294) = 3.89, p < 0.01. SOMI sum scores were significantly lower for the survivors in the depression group (PHQ8 < 10) (M = 38.0, SD = 11.3) compared with those who were not depressed (M = 52.7, SD = 12.9) t(294) = 10.45, p < 0.0. SOMI sum scores were also significantly lower for the survivors in the PTSD group (PCL5 8 item scale < 19) (M = 36.9, SD = 11.6) compared with those who did not exceed the threshold for PTSD (M = 48.3, SD = 13.9) t(294) = 7.1, p < 0.01).
Regression analysis for the relationship of SOMI sum scores on PHQ8 scores was significant, explaining 37% of the variability of the PHQ8 scores F(1, 294) = 173.0, p < 0.001. The relationship of SOMI sum scores on PCL5 scores was also significant, explaining 26% of the variability of the PHQ8 scores F(1, 294) = 104.7, p < 0.001.

4. Discussion

As far as we know, this is the first attempt to use mixed methods to evaluate and update a “classic” and well-used instrument. Preserving the original theoretically sound concepts was our primary goal rather than revising the SOC-13 with similar concepts that were often different from these original concepts. The qualitative approach in this endeavor was similar to the lead authors’ semantic translation techniques [53], which evaluate concepts and their use within the culture and language. Using this approach allowed us to modernize phrases and remove idioms, which may have made translation difficult and may have been a component of the subscale instability.
For good discriminant validity, the MSV should be less than the AVE of the factors. In our case, the AVE values for the SOMI-CO factor were somewhat lower than the MSV. Following Chin et al. [54], while we use caution, we also note that all other psychometrics are good. Therefore, we believe that additional research should be conducted with more extensive and more diverse samples in the future.
Some readers might note that validation analysis for this instrument should consider the subsamples in our population, such as history of GBV, age, gender identity, and education. Measurement invariance testing of the equivalence of variables across these groups could be conducted in the future for various groups using CFA [55].
The moderate to weak correlations of the instruments we selected for convergent and divergent validity of the SOMI suggest that the concepts in the SOMI were distinct. These instruments were selected because qualitative and theory testing suggested these were essential aspects of the trauma survivors’ recovery experiences. For example, qualitative research has shown that internal barriers to help-seeking are essential for diverse survivors and may be related to self-understanding and understanding of the recovery experience [38,56,57]. Despite these moderate relationships, known group validity shows that the SOMI can explain significant variability in PTSD and depression scores. Future research must determine if this is true in other cultures and minority groups. While encouraging, future research with diverse cultural groups and other clinical populations is needed to confirm that the three-factor structure is stable.
The original SOC-13 used the semantic differential (SD) scale approach [22]. However, this scaling technique has been reported to have drawbacks. Semantic differential scales can be challenging to translate [58], partly because they assume a cultural logic of bipolar ends of a continuum. In addition, early research reports suggest that assumptions in SD scales may not be accurate, social desirability effects can be enhanced, and individual differences in size and character of understanding the semantic space held by the concept [59]. Others have reported that analysis of variance models of SD responses reveals that individuals’ scores on a scale for a particular concept can be attributed to various sources [60]. We elected to stabilize this using Likert-type scaling. Future research must confirm whether this increases the ease of translation and the stability of the factor structure for various groups.
One impetus for this research was the need for stable factors that could be used in the clinical evaluation of trauma recovery. There has been limited research on SOC-13 in GBV survivors [61]. While the original SOC questionnaire didn’t intend to differentiate between the three components as separate theoretical constructs, we still believe this development of a tool that conceptualizes distinct concepts can have value in trauma recovery research. For example, GBV recovery research has shown that at least the management of symptoms (which could be measured by the SOMI manageability subscale) and meaning-making (which could be measured by the SOMI meaning subscale) might be different phases of the recovery process [62,63,64]. Our theory testing in GBV populations also showed that meaning-making might result from trauma recovery [65]. Clinical research could evaluate whether manageability might be an initial step, followed by sense-making (comprehensibility) and meaning-making as a recovery outcome.
The generalizability of these findings is limited by the cross-sectional data from primarily American, Caucasian, employed people who identify as women. In addition, we developed this in a highly distressed population (GBV survivors), which can limit the generalizability with other, less distressed populations. Moreover, future research is needed to understand how this scale will operate with people from different cultures, socioeconomic statuses, ethnicities, and gender expressions. Of course, confining our research to GBV survivors limits our ability to discern the applicability of the scales to other clinical populations. However, this effort to retain the original concepts and many of the original SOC-13 items (albeit revised) makes this scale promising for broad applicability.

Author Contributions

Conceptualization, D.M.S.A.; methodology, D.M.S.A. and Z.Z.; validation, Z.Z.; formal analysis, D.M.S.A.; investigation, D.M.S.A.; resources, D.M.S.A.; data curation, D.M.S.A.; writing—original draft preparation, D.M.S.A.; writing—review and editing, D.M.S.A. and Z.Z. funding acquisition, D.M.S.A. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the University of Michigan School of Nursing and the University of Michigan Institute for Research on Women and Gender.

Institutional Review Board Statement

The University of Michigan Institutional Review Board exempted all procedures and materials for study 1 (HUM00191183; 11/13/2015 to present) and approved study 2 (HUM00205708; 6/27/2022 to present).

Informed Consent Statement

Informed consent for participation was obtained from all subjects involved in the study.

Data Availability Statement

De-identified data is available to share upon request.

Acknowledgments

We thank Avishai Antonovsky, Head of Research Division, Center for Mental Health Services, Medical Corps, Israel, for his insightful comments on earlier drafts of this manuscript.

Conflicts of Interest

The authors have no competing interests to declare.

References

  1. United Nations General Assembly. Declaration on the Elimination of Violence Against Women; United Nations: Paris, France, 1993. [Google Scholar]
  2. World Health Organization. Women and Health: Today’s Evidence Tomorrow’s Agenda; World Health Organization: Geneva, Switzerland, 2009. [Google Scholar]
  3. Carlson, B.E.; McNutt, L.-A.; Choi, D.Y.; Rose, I.M. Intimate partner abuse and mental health: The role of social support and other protective factors. Violence Against Women 2002, 8, 720–745. [Google Scholar] [CrossRef]
  4. Coker, A.L.; Smith, P.H.; Thompson, M.P.; McKeown, R.E.; Bethea, L.; Davis, K.E. Social Support Protects against the Negative Effects of Partner Violence on Mental Health. J. Women’s Health Gend. Based Med. 2002, 11, 465–476. [Google Scholar] [CrossRef] [PubMed]
  5. Zlotnick, C.; Johnson, D.M.; Kohn, R. Intimate Partner Violence and Long-Term Psychosocial Functioning in a National Sample of American Women. J. Interpers. Violence 2006, 21, 262–275. [Google Scholar] [CrossRef] [PubMed]
  6. Crowne, S.S.; Juon, H.-S.; Ensminger, M.; Burrell, L.; McFarlane, E.; Duggan, A. Concurrent and Long-Term Impact of Intimate Partner Violence on Employment Stability. J. Interpers. Violence 2011, 26, 1282–1304. [Google Scholar] [CrossRef] [PubMed]
  7. Pico-Alfonso, M.A.; Garcia-Linares, M.I.; Celda-Navarro, N.; Blasco-Ros, C.; Echeburúa, E.; Martinez, M. The impact of physical, psychological, and sexual intimate male partner violence on women’s mental health: Depressive symptoms, post-traumatic stress disorder, state anxiety, and suicide. J. Women’s Health 2006, 15, 599–611. [Google Scholar] [CrossRef]
  8. Hoge, E.A.; Austin, E.D.; Pollack, M.H. Resilience: Research evidence and conceptual considerations for post-traumatic stress disorder. J. Depress. Anxiety 2007, 24, 139–152. [Google Scholar] [CrossRef]
  9. Horn, S.R.; Feder, A. Understanding Resilience and Preventing and Treating PTSD. Harv. Rev. Psychiatry 2018, 26, 158–174. [Google Scholar] [CrossRef]
  10. Institute of Medicine. How Far Have We Come in Reducing Health Disparities? The National Academies Press: Washington, DC, USA, 2012. [Google Scholar]
  11. King, L.A.; Pless, A.P.; Schuster, J.L.; Potter, C.M.; Park, C.L.; Spiro, A., III; King, D.W. Risk and Protective Factors for Traumatic Stress Disorders. In The Oxford Handbook of Stress Disorders; Oxford University Press: Oxford, UK, 2012; pp. 333–346. [Google Scholar]
  12. Thabet, A.A.M. Risk and Protective Factors in Relation to Trauma and Post Traumatic Stress Disorders: A Meta-Analytic Review. EC Psychol. Psychiatry 2017, 2, 122–138. [Google Scholar]
  13. Antonovsky, A. Unraveling the Mystery of Health: How People Manage Stress and Stay Well; Jossey-Bass: San Francisco, CA, USA, 1987. [Google Scholar]
  14. Mittelmark, M.B.; Sagy, S.; Eriksson, M.; Bauer, G.F.; Pelikan, J.M.; Lindström, B.; Arild Espnes, G. Handbook of Salutogenesis; Springer Nature: Singapore, 2022; Available online: https://library.oapen.org/handle/20.500.12657/52407 (accessed on 13 July 2023).
  15. Super, S.; Wagemakers, M.A.E.; Picavet, H.S.J.; Verkooijen, K.T.; Koelen, M.A. Strengthening sense of coherence: Opportunities for theory building in health promotion. Health Promot. Int. 2016, 31, 869–878. [Google Scholar] [CrossRef]
  16. Antonovsky, A. The structure and properties of the sense of coherence scale. Soc. Sci. Med. 1993, 36, 725–733. [Google Scholar] [CrossRef]
  17. Frenz, A.W.; Carey, M.P.; Jorgensen, R.S. Psychometric evaluation of Antonovsky’s Sense of Coherence Scale. Psychol. Assess. 1993, 5, 145–153. [Google Scholar] [CrossRef]
  18. Schäfer, S.K.; Becker, N.; King, L.; Horsch, A.; Michael, T. The relationship between sense of coherence and post-traumatic stress: A meta-analysis. Eur. J. Psychotraumatol. 2019, 10, 1562839. [Google Scholar] [CrossRef] [PubMed]
  19. Kazlauskas, E.; Gailiene, D.; Vaskeliene, I.; Skeryte-Kazlauskiene, M. Intergenerational Transmission of Resilience? Sense of Coherence Is Associated between Lithuanian Survivors of Political Violence and Their Adult Offspring. Front. Psychol. 2017, 8, 1677. [Google Scholar] [CrossRef]
  20. Veronese, G.; Pepe, A. Sense of coherence mediates the effect of trauma on the social and emotional functioning of Palestinian health providers. Am. J. Orthopsychiatry 2014, 84, 597–606. [Google Scholar] [CrossRef] [PubMed]
  21. Antonovsky, A.; Department of Health and Well-Being, Medical Corps, Ramat Gan, Israel. Personal communication, 2024.
  22. Eriksson, M.; Contu, P. The sense of coherence: Measurement issues. In The Handbook of Salutogenesis; Springer: Berlin/Heidelberg, Germany, 2022; pp. 79–91. [Google Scholar]
  23. Lerdal, A.; Opheim, R.; Gay, C.L.; Moum, B.; Fagermoen, M.S.; Kottorp, A. Psychometric limitations of the 13-item Sense of Coherence Scale assessed by Rasch analysis. BMC Psychol. 2017, 5, 18. [Google Scholar] [CrossRef] [PubMed]
  24. Gana, K.; Garnier, S. Latent structure of the sense of coherence scale in a French sample. Pers. Individ. Differ. 2001, 31, 1079–1090. [Google Scholar] [CrossRef]
  25. Strümpfer, D.J.W.; Gouws, J.F.; Viviers, M.R. Antonovsky’s Sense of Coherence Scale related to negative and positive affectivity. Eur. J. Pers. 1998, 12, 457–480. [Google Scholar] [CrossRef]
  26. Volanen, S.-M.; Suominen, S.; Lahelma, E.; Koskenvuo, M.; Silventoinen, K. Negative life events and stability of sense of coherence: A five-year follow-up study of Finnish women and men. Scand. J. Psychol. 2007, 48, 433–441. [Google Scholar] [CrossRef]
  27. Bachem, R.; Maercker, A. Development and psychometric evaluation of a revised sense of coherence scale. Eur. J. Psychol. Assess. 2016, 34, 206–215. [Google Scholar] [CrossRef]
  28. Arciero, G.; Guidano, V.F. Experience, explanation, and the quest for coherence. In Construction of Disorder: Meaning-Making Frameworks for Psychotherapy; Neimeyer, R.A., Raskin, J.D., Eds.; American Psychological Association: Washington, DC, USA, 2000; pp. 91–118. [Google Scholar] [CrossRef]
  29. Yaccarini, C.; Simkin, H.; Bachem, R.; Azzollini, S. Validation and Adaptation into Spanish of the Revised Sense of Coherence Scale (SOC-R): A Scale Associated with Life Satisfaction. J. Consum. Satisf. Dissatisf. Complain. Behav. 2022, 35, 146–156. [Google Scholar]
  30. Mc Gee, S.L.; Höltge, J.; Maercker, A.; Thoma, M.V. Evaluation of the revised Sense of Coherence scale in a sample of older adults: A means to assess resilience aspects. Aging Ment. Health 2018, 22, 1438–1447. [Google Scholar] [CrossRef]
  31. Creswell, J.W. A Concise Introduction to Mixed Methods Research; SAGE Publications: Los Angeles, CA, USA, 2021. [Google Scholar]
  32. Fetters, M.D.; Curry, L.A.; Creswell, J.W. Achieving Integration in Mixed Methods Designs—Principles and Practices. Health Serv. Res. 2013, 48, 2134–2156. [Google Scholar] [CrossRef] [PubMed]
  33. Kroenke, K.; Strine, T.W.; Spitzer, R.L.; Williams, J.B.; Berry, J.T.; Mokdad, A.H. The PHQ-8 as a measure of current depression in the general population. J. Affect. Disord. 2009, 114, 163–173. [Google Scholar] [CrossRef] [PubMed]
  34. Blevins, C.A.; Weathers, F.W.; Davis, M.T.; Witte, T.K.; Domino, J.L. The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. J. Trauma. Stress 2015, 28, 489–498. [Google Scholar] [CrossRef] [PubMed]
  35. Price, M.; Szafranski, D.D.; van Stolk-Cooke, K.; Gros, D.F. Investigation of abbreviated 4 and 8 item versions of the PTSD Checklist 5. Psychiatry Res. 2016, 239, 124–130. [Google Scholar] [CrossRef]
  36. Benight, C.C.; Shoji, K.; James, L.E.; Waldrep, E.E.; Delahanty, D.L.; Cieslak, R. Trauma Coping Self-Efficacy: A context-specific self-efficacy measure for traumatic stress. Psychol. Trauma Theory Res. Pract. Policy 2015, 7, 591–599. [Google Scholar] [CrossRef]
  37. Sinko, L.; Özaslan, Z.Z.; Schaitkin, C.; Saint Arnault, D. Psychometric Evaluation of the Healing After Gender-Based Violence Scale: An Instrument for Cross-Sectional and Longitudinal Assessment of Recovery Progress for Women-Identifying Survivors. J. Fam. Violence 2021, 37, 1161–1179. [Google Scholar] [CrossRef]
  38. Foa, E.B.; Ehlers, A.; Clark, D.M.; Tolin, D.F.; Orsillo, S.M. The post-traumatic cognitions inventory (PTCI): Development and validation. Psychol. Assess. 1999, 11, 303. [Google Scholar] [CrossRef]
  39. Saint Arnault, D.; Zonp, Z. Understanding help-seeking barriers after gender-based violence: Validation of the Barriers to Help Seeking-Trauma version (BHS-TR). Arch. Psychiatr. Nurs. 2022, 37, 1–9. [Google Scholar] [CrossRef]
  40. Lin, E.; Goering, P.; Offord, D.R.; Campbell, D.; Boyle, M.H. Use of mental health services in Ontario: Epidemiological Findings. Can. J. Psychiatry 1996, 41, 572–577. [Google Scholar] [CrossRef]
  41. Miller, K.; Chepp, V.; Willson, S.; Padilla, J.-L. Cognitive Interviewing Methodology; John Wiley & Sons: Hoboken, NJ, USA, 2014. [Google Scholar]
  42. Tabachnick, B.G.; Fidell, L.S. Principal components and factor analysis. Using Multivar. Stat. 2001, 4, 582–633. [Google Scholar]
  43. Hooper, D.; Coughlan, J.; Mullen, M. Evaluating model fit: A synthesis of the structural equation modeling literature. In Proceedings of the 7th European Conference on Research Methodology for Business and Management Studies, London, UK, 19–20 June 2008. [Google Scholar]
  44. Byrne, B.M. Structural Equation Modeling with EQS and EQS/Windows; Sage Publications: Los Angeles, CA, USA, 1994. [Google Scholar]
  45. Hu, L.T.; Bentler, P.M. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct. Equ. Model. Multidiscip. J. 1999, 6, 1–55. [Google Scholar] [CrossRef]
  46. Bentler, P.M. Comparative Fit Indexes in Structural Models. Psychol. Bull. 1990, 107, 238–246. [Google Scholar] [CrossRef]
  47. Browne, M.W.; Cudeck, R. Alternative ways of assessing model fit. Sociol. Methods Res. 1992, 21, 230–258. [Google Scholar] [CrossRef]
  48. Bollen, K.A. A New Incremental Fit Index for General Structural Equation Models. Sociol. Methods Res. 1989, 17, 303–316. [Google Scholar] [CrossRef]
  49. Fornell, C.; Larcker, D.F. Evaluating structural equation models with unobservable variables and measurement error. J. Mark. Res. 1981, 18, 39–50. [Google Scholar]
  50. Hair, J.F.; Black, W.C.; Babin, B.J.; Anderson, R.E. Multivariate Data Analysis, 7th ed.; Prentice-Hall: Hoboken, NJ, USA, 2009. [Google Scholar]
  51. IBM Corp. IBM SPSS Statistics for Windows; Version 28.0; IBM Corp.: Armonk, NY, USA, 2021. [Google Scholar]
  52. Cerny, B.A.; Kaiser, H.F. A Study of a Measure of Sampling Adequacy for Factor-Analytic Correlation Matrices. Multivar. Behav. Res. 1977, 12, 43–47. [Google Scholar] [CrossRef]
  53. Saint Arnault, D.; Hatashita, H.; Suzuki, H. Semantic Examination of a Japanese Center for Epidemiologic Studies Depression: A Cautionary Analysis Using Mixed Methods. Can. J. Nurs. Res. 2016, 48, 80–92. [Google Scholar] [CrossRef]
  54. Chin, W.W.; Gopal, A.; Salisbury, W.D. Advancing the Theory of Adaptive Structuration: The Development of a Scale to Measure Faithfulness of Appropriation. Inf. Syst. Res. 1997, 8, 342–367. [Google Scholar] [CrossRef]
  55. Putnick, D.L.; Bornstein, M.H. Measurement invariance conventions and reporting: The state of the art and future directions for psychological research. Dev. Rev. 2016, 41, 71–90. [Google Scholar] [CrossRef]
  56. Saint Arnault, D.; O’Halloran, S. Using mixed methods to understand the healing trajectory for rural Irish women years after leaving abuse. J. Res. Nurs. 2016, 21, 369–383. [Google Scholar] [CrossRef]
  57. Sinko, L.; Burns, C.J.; O’Halloran, S.; Saint Arnault, D. Trauma Recovery Is Cultural: Understanding Shared and Different Healing Themes in Irish and American Survivors of Gender-based Violence. J. Interpers. Violence 2019, 36, NP7765–NP7790. [Google Scholar] [CrossRef] [PubMed]
  58. Heise, D.R. Some methodological issues in semantic differential research. Psychol. Bull. 1969, 72, 406–422. [Google Scholar] [CrossRef]
  59. Finstuen, K. Use of Osgood’s semantic differential. Psychol. Rep. 1977, 41 (Suppl. S3), 1219–1222. [Google Scholar] [CrossRef]
  60. Sagara, M.; Yamamoto, K.; Nishimura, H.; Akuto, H. A Study on the Semantic Structure of Japanese Language by the Semantic Differential Method. Jpn. Psychol. Res. 1961, 3, 146–156. [Google Scholar] [CrossRef]
  61. Zonp, Z.; Saint Arnault, D. The Reliability and Predictive Validity of Sense of Coherence Scale for American Survivors of Gender-Based Violence. Violence Against Women 2023, 29, 1670–1686. [Google Scholar] [CrossRef]
  62. Sinko, L.; Hughesdon, K.; Grotts, J.H.; Giordano, N.; Choi, K.R. A Systematic Review of Research on Trauma and Women’s Health in the Nurses’ Health Study II. Nurs. Women’s Health 2022, 26, 116–127. [Google Scholar] [CrossRef]
  63. Kita, S.; Kamibeppu, K.; Saint Arnault, D. “Knitting Together the Lines Broken Apart”: Recovery Process to Integration among Japanese Survivors of Intimate Partner Violence. Int. J. Environ. Res. Public Health 2022, 19, 12504. [Google Scholar] [CrossRef]
  64. Koutra, K.; Burns, C.; Sinko, L.; Kita, S.; Bilgin, H.; Saint Arnault, D. Trauma Recovery Rubric: A Mixed-Method Analysis of Trauma Recovery Pathways in Four Countries. Int. J. Environ. Res. Public Health 2022, 19, 10310. [Google Scholar] [CrossRef]
  65. Kita, S.; Zonp, Z.; Saint Arnault, D. Initial testing of components of the cultural determinants of trauma recovery (CDTR) theory amongst American Gender-Based violence survivors: Structural equation modelling. J. Adv. Nurs. 2022, 79, 1476–1492. [Google Scholar] [CrossRef]
Sexes 05 00039 g001
Figure 1. Unstandardized model of Confirmatory Factor Analysis for SOMI (Sample 2).
Figure 1. Unstandardized model of Confirmatory Factor Analysis for SOMI (Sample 2).
Sexes 05 00039 g001
Table 1. Demographics.
Table 1. Demographics.
Demographic Variablesn = 291n = 296
Sample 1Sample 2
M (SD.)M (SD.)
Age37.9 (14.8)37.9 (14.8)
Migration history5.5%2%
Employment (not mutually exclusive)
Working46%54%
Unemployed, looking for work, Working in the home17%25.%
Student16%23%
Retired or disabled20%15%
Education
High school and/or technical school22%22%
College or college graduate39.2%60%
Postgraduate29.2%24%
Children46.4%Unknown
PHQ8
Probable depression27%54%
PTSD
Probable PTSD44%32%
GBV in the last year (missing = 8)
Yes7285
No211211
Violence type (not mutually exclusive)
Physical violence55%82%
Sexual violence67%71%
Table 2. Qualitative Evaluation of the SOC-13 Items.
Table 2. Qualitative Evaluation of the SOC-13 Items.
SOC-13
Construct		SOC ConceptOriginal SOC ItemQualitative Analysis of the ConceptChanges in the Item for Cognitive InterviewingFinal Item for Final CFA Psychometric Testing
Manageability SOC3: Has it happened that people whom you counted on disappointed you?Disappointment in social relationships
(Similar to SOC2)		Dropped
SOC5: Do you have the feeling that you’re being treated unfairly?Fairness, justiceDropped
Self-efficacySOC10: Many people—even those with a strong character—sometimes feel like sad sacks (losers) in certain situations. How often have you felt this way in the past?Feeling ineffectiveNew: I feel like I know what to do and how to do itItem 1 Double loaded, dropped
Reversed and revised: I believe I have the strength and capacity to deal with what life offers.Item 2 Double loaded, dropped.
New: I believe I am capable of being as emotionally strong as I need to beItem 3 Double loaded, dropped
New: I know how to manage the situations in my lifeItem 4
Emotional self-controlSOC13: How often do you have feelings that you’re not sure you can keep under control?Control of feelingsReversed and revised: I believe that I can manage my negative feelingsItem 5 Double loaded, dropped
New: I can express happiness and joy when things go wellItem 6 Low loading, dropped.
ComprehensibilitySense-making, predictability, certaintySOC2: Has it happened in the past that you were surprised by the behavior of people whom you thought you knew well?Understanding the motives of othersRevised: I generally feel I understand the people in my social worldItem 7: I understand the people in my social circle; weak loading, dropped.
New: I understand the way things work and my role within themItem 8 double-loaded dropped.
SOC6: Do you have the feeling that you are in an unfamiliar situation and don’t know what to do?Don’t know what to doRevised: I recognize what is happening and what I need to doItem 9
SOC11: When something happened, have you generally found that:
1 You overestimated or underestimated its importance: 7 You saw things in the right proportion		Things seem out of proportionRevised: The world is understandable and predictableSplit after CI
Item 10: I can understand why things in my life happen as they do.
Item 11: I can usually predict how things will go in my life
Self-insight; clarity of self-understandingSOC8: Do you have very mixed-up feelings and ideas?Understanding your own feelingsReversed and revised: I understand why I feel the way I doItem 12
New: I usually have a clear sense of why I do what I doItem 13: I have a clear sense of why I do what I do
New: I can see the link between my situations and my feelings and behaviorItem 14: I can see the connection between my situations and my feelings
New: I understand my motivations and my behaviorsDropped after CI.
SOC9: Does it happen that you have feelings inside you would rather not feel?Painful feelingsDropped
MeaningPurpose in lifeSOC4: Until now your life has had:
1 No clear goals or purpose at all: 7 Very clear goals and purpose		Clear purposeRevised: My life has clear goals and purposeItem 15: My life has clear goals.
Item 16: I think my life has a clear purpose.
New: I understand what I want and how to accomplish itItem 17: I understand what I want and need-Double loaded, Dropped.
New: I am active in making my life the way I think it should beItem 18
Life satisfactionSOC7: Doing the things you do every day is: 1 A source of deep pleasure and satisfaction: 7 A source of pain and boredomLife satisfactionRevised: My daily life is a source of satisfactionItem 19
New: I think my life is excellentItem 20
Sense of meaningSOC12: How often do you have the feeling that there’s little meaning in the things you do in your daily life? 1 Very often: 7 very seldom or neverMeaningReversed and revised: My life is meaningful and worth livingItem 21
SOC1: Do have the feeling that you don’t really care about what goes on around you? 1 Never happened: 7 Always happenedApathyReversed and revised: I feel involved and interested in my lifeItem 22
New: I am a significant part of the world around meItem 23: I believe I am a significant part of the world around me
Table 3. Oblimin Principal Component Analysis Sample 2 (n = 296).
Table 3. Oblimin Principal Component Analysis Sample 2 (n = 296).
Component
123
Meaning (α = 0.94; AVE = 0.68; MSV = 0.70)
SOMI19 I feel my daily life is a source of satisfaction0.857
SOMI20 I think my life is excellent0.826
SOMI22 I feel involved and interested in my life0.930
SOMI23 I believe I am a significant part of the world around me0.885
SOMI15 I think my life has clear goals0.669
SOMI21 I find my life is meaningful and worth living0.920
SOMI18 I am active in making my life the way I think it should be0.742
SOMI16 I think my life has a clear purpose0.813
Comprehension (α = 0.85; AVE = 0.69; MSV = 0.63)
SOMI14 I can see the connection between my situations and my feelings 0.778
SOMI12 I understand why I feel the way I do 0.792
SOMI13 I have a clear sense of why I do what I do 0.852
Manageability (α = 0.86; AVE = 0.57; MSV = 0.70)
SOMI11 I can usually predict how things will go in my life 0.849
SOMI10 I can understand why things in my life happen as they do 0.767
SOMI9 I Recognize what is happening in my life and what I need to do 0.616
SOMI4 I know how to manage the situations in my life0.380 0.614
Cronbach’s reliability for the 15-item scale was 0.95
Table 4. Fit Indices for the Confirmatory Factor Analysis (Sample 2).
Table 4. Fit Indices for the Confirmatory Factor Analysis (Sample 2).
Fit IndexAcceptable ValuesPerfect ValuesActual Values for Sense of Meaning Inventory
CMIN/Df0 ≤ χ2/df ≤ 33 ≤ χ2/df ≤ 52.010
GFI0.80 ≤ GFI0.90 ≤ GFI0.932
AGFI0.80 ≤ AGFI0.90 ≤ AGFI0.900
CFI0.85 ≤ CFI0.95 ≤ CFI0.977
RMSEA0.0 ≤ RMSEA ≤ 0.050.06 ≤ RMSEA ≤ 1.00.059
NFI0.80 ≤ NFI0.95 ≤ NFI0.956
TLI0.80 ≤ TLI0.90 ≤ TLI0.971
IFI0.85 ≤ IFI0.95 ≤ IFI0.978
CMIN/Df: the chi-square/degrees of freedom, GFI: the goodness of fit index, AGFI: the adjusted goodness of fit index, CFI: the comparative fit index, RMSEA: the root means square error of approximation, NFI: the normed fit index, TLI: the Tucker-Lewis Index, IFI: the incremental fit index.
Table 5. Correlation Matrix for Sample 2.
Table 5. Correlation Matrix for Sample 2.
PHQ8PCL5HealIBHSPTCICSE-TSOMI-MESOMI-COSOMI-MA
PHQ8-----
PCL50.782-----
Heal−0.516−0.421-----
IBHS0.4200.502−0.298-----
PTCI0.5260.559−0.4930.524-----
CSE-T−0.598−0.6410.571−0.484−0.564-----
SOMI-ME−0.599−0.5290.796−0.239−0.5130.517-----
SOMI-CO−0.443−0.3310.641−0.227−0.3910.4450.609------
SOMI-MA−0.476−0.4310.685−0.221−0.4610.4960.7340.699-----
PHQ8 = Patient’s Health Questionnaire 8 item Sum; PCL5 = Post-Traumatic Stress Disorder Checklist Sum; PTCI = Post-Trauma Cognitions Inventory Sum; CSE-T = Trauma Self-Efficacy scale SUM; IBHS = Internal Barriers to Help-Seeking Scale Internal dimension Sum; Heal = GBV-Heal Sum; SOMI-ME = SOMI Meaning Subscale; SOMI-CO = SOMI-Comprehension subscale; SOMI-MA = SOMI Manageability subscale. All correlations are significant at ≤0.01 level (2-tailed).
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Saint Arnault, D.M.; Zonp, Z. Revising the Original Antonovsky Sense of Coherence Concepts: A Mixed Method Development of the Sense of Meaning Inventory (SOMI). Sexes 2024, 5, 596-610. https://doi.org/10.3390/sexes5040039

AMA Style

Saint Arnault DM, Zonp Z. Revising the Original Antonovsky Sense of Coherence Concepts: A Mixed Method Development of the Sense of Meaning Inventory (SOMI). Sexes. 2024; 5(4):596-610. https://doi.org/10.3390/sexes5040039

Chicago/Turabian Style

Saint Arnault, Denise M., and Zeynep Zonp. 2024. "Revising the Original Antonovsky Sense of Coherence Concepts: A Mixed Method Development of the Sense of Meaning Inventory (SOMI)" Sexes 5, no. 4: 596-610. https://doi.org/10.3390/sexes5040039

APA Style

Saint Arnault, D. M., & Zonp, Z. (2024). Revising the Original Antonovsky Sense of Coherence Concepts: A Mixed Method Development of the Sense of Meaning Inventory (SOMI). Sexes, 5(4), 596-610. https://doi.org/10.3390/sexes5040039

Article Metrics

Back to TopTop