Page 75 - JCBP-3-1

Journal of Clinical and
Basic Psychosomatics Neuroticism scale: Reliability and validity

a term that had been widely used before his work. His and validity. However, it shares similarities with scales
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studies revealed that emotionality and anxiety share similar assessing mood disorders and is highly susceptible to
emotional experiences and noted that individuals with individual differences.
high levels of neuroticism exhibit rapid emotional arousal. In summary, existing scales present the following
Eysenck further identified a link between neuroticism and problems: (i) they contain too many items; (ii) they were
the function of the autonomous nervous system, especially not specifically developed for populations with psychiatric
the sympathetic nervous system. Neuroticism is often seen disorders; and (iii) they were not developed within the
as a reflection of maladaptive and negative emotionality, context of Chinese culture. Therefore, our goal is to develop
contrasting with emotional stability. Contemporary views a brief neuroticism scale with adequate reliability and
suggest that neuroticism reflects an individual’s capacity for validity, specifically tailored for the Chinese population
emotional stability and adjustment. 5
suffering from psychiatric disorders.
It is commonly understood that positive mental health
functioning is negatively correlated with neuroticism. 2. Methods
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At the same time, neuroticism can predict the severity of 2.1. Development of the neuroticism scale
depressive symptoms. Individuals with high neuroticism
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tend to exhibit neurological susceptibility, characterized by To develop the neuroticism scale, we initially conducted
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anxiety manifested through somatic symptoms, depression, interviews with a diverse group of participants, including
and difficulties in emotion regulation. These individuals 20 patients diagnosed with psychiatric disorders, 12 clinical
often struggle to respond to stress appropriately, leading psychologists, and 20 laypersons without any psychiatric
to a gradual decline in mental health. Some researchers diagnoses. The aim was to gather characteristics associated
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believe that higher levels of neuroticism may also increase with neuroticism. Each interview lasted approximately
the risk of suicidal ideation. 9 30 min and followed a semi-structured format to ensure
consistency while allowing for in-depth exploration of
High levels of neuroticism, often present in psychiatric
patients, can significantly impact their clinical outcomes individual experiences. The responses were categorized
into three main themes: difficulty in adjusting negative
and overall quality of life. Consequently, developing a
shorter, culturally relevant neuroticism scale is crucial emotions, excessive worry about potential future events,
for providing rapid and accurate assessments, enabling and insomnia due to worry. An expert working group was
timely interventions that can vastly improve patient recruited to draft the neuroticism scale. From the analysis
of the items, an initial version of the scale containing 30
care. Furthermore, it is essential to ensure the reliability items was developed.
and validity of such scales using a homogeneous sample
with specific psychiatric diagnoses. By developing a brief Subsequently, a homogeneity test was carried out to
neuroticism scale with robust reliability and validity assess the internal consistency of the original 30-item
tailored to the Chinese population suffering from scale, using Cronbach’s alpha to evaluate reliability. The test
psychiatric disorders, we aim to address existing limitations results indicated that Items 16, 20, 21, 23, and 29 were not
of current scales, such as their length, lack of specificity for highly correlated with the total score, suggesting that these
psychiatric populations, and cultural inadaptability. items should be removed to improve the scale’s coherence.
To date, the standard tools used to measure neuroticism To further refine the scale, an exploratory factor analysis
are mainly the Eysenck Personality Questionnaire (EFA) was performed to identify the underlying factor
(EPQ) and Neuroticism Extraversion Openness (NEO) structure. The Kaiser–Meyer–Olkin (KMO) measure of
Personality Inventory Scale. The EPQ, first proposed in sampling adequacy was 0.88, indicating that the data were
the 1940s, has undergone several revisions and includes suitable for factor analysis. Bartlett’s test of sphericity was
subscales for neuroticism, extraversion, psychoticism, significant (P < 0.001), suggesting that the correlations
and a lie scale. However, the EPQ has several limitations: between items were sufficiently strong for EFA. We used
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(i) inconsistencies exist between different versions of the the principal component method with varimax orthogonal
scale; (ii) there is an overlap between the neuroticism rotation to identify the factor loadings. Items with factor
scale and scales measuring related emotional disorders ; loadings below 0.45 were considered for deletion.
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and (iii) its binary response format restricts the accuracy After this process, four factors comprising 14 items were
of assessments. Costa and McCrae formulated the NEO- retained, cumulatively explaining 57.9% of the variance.
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Five-Factor Inventory (NEO-FFI), which consists of 60 The four factors were identified and labeled as low self-
items, including a neuroticism subscale with 12 items. esteem, excessive emotional sensitivity, unstable mood,
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The NEO-FFI has demonstrated excellent reliability and excessive worry. Finally, the cumulative interpretation
Volume 3 Issue 1 (2025) 69 doi: 10.36922/jcbp.3791