Rasch analysis of the coping inventory for stressful situations in individuals with moderate to severe traumatic brain injury

Abstract

Objective: To evaluate psychometric properties of the Coping Inventory for Stressful Situations (CISS) in individuals with traumatic brain injury (TBI).

Design: Archival study using Rasch analysis.

Setting: Postacute rehabilitation hospital.

Participants: Adults (N=331) 1 to 15 years after moderate to severe TBI, recruited consecutively.

Interventions: Not applicable.

Main outcome measure: CISS.

Results: Indices of unidimensionality and model fit supported the scale's proposed multidimensional structure consisting of Task, Emotion, and Avoidant coping style; 3 unidimensional scales showed better fit than a single combined scale. The 3 scales met Rasch expectations of reliability and separation for persons and items, as well as adequate response category functioning. The scales were generally well targeted but showed some evidence of ceiling effect for Task, and floor effects for Emotion and Avoidant coping; item difficulties did not fully capture extreme ranges demonstrated by some participants, suggesting that measurement of coping after TBI on the CISS would be improved with additional items at low and high ranges of difficulty. Results were generally equivalent for cross-sectional groups representing short-term (1y), intermediate (2y), and long-term (5-15y).

Conclusions: The CISS showed good psychometric properties as a measure of coping style among persons with moderate to severe TBI in acute and chronic phases of recovery, and showed evidence of multidimensionality as predicted by theory, consistent with 3 unidimensional scales. Added items tapping broader (or more accessible, less cognitively complex) ranges of coping responses would likely benefit the scale overall and improve correspondence with the response needs of people with TBI.

Keywords: Brain injuries, traumatic; Coping behavior; Psychometrics; Rehabilitation.