Methodology Chapter on "Color of Stigma "Measuring the Grief Experiences"

Methodology Chapter 18 pages (7498 words) Sources: 15 Style: APA

[EXCERPT] . . . .

As well, there are five covariates: family history of suicide, relationship status, depression, age, and mother's socioeconomic status. Using the methodology of Judd & Kenny (2010) and that of Faul et al. (2007), sample determination for the study, using multiple regression, indicates significant power at 0.80 and a medium effect size of ?2 = 0.15 and significance set at p < 0.05. Thus, the sample size was set at N = 92.

Variables/Instruments

Surveys described below were used for measurements of the variables. Alignment with the constructs of the study was used for selection.

Independent Variable 1: Suicide as Perceived Stigma.

Fiegelberg and colleagues (2011) outline a Suicide Stigmatization Scale that is used in this work to determine the extent to which mothers of a son who committed suicide perceived that they have been 'stigmatized'. The SSS instrument is comprised of two assessments: (a) an 11-item sub-scale that addresses social harm and/or help as well as family harm and/or help; and (b) an 11-item subscale that addresses social and family strain (Fiegelman et al., 2011).

For this study, subscale questions for harm/help are coded as follows: 1 = harmful/very harmful; 0 = no effect/not harmful. Subscale questions for strain are coded as follows: 1 = became strained/weaker; 0 = not applicable/remained the same, or became closer/stronger. Subsequently, the SSS scale of 22 questions is computed by summing the two subscales. The resulting ratio ranges from 0 to 22, with lower scores indicating non-strained relationships.

According to Jordan (2012), Feigelman et al. (2011), and Feigelman & Feigelman (2011), the inter-item reliability for the SSS scale is good, with Cronbach's alpha in the mid 0.70s to mid 0.80s, and good 2-week test-retest reliability, with rs = 0.50s, ps <.01. As well, there is validity in terms of criterion for the SSS scale, with significant correlation for measures of complicated grief, rs = .70s, ps < .001 (Fiegelman et al., 2011; Fiegelman & Fiegelman, 2011; Jordan, 2012).

Independent Variable 2: Belief that Stigma is Due to Societal Causes.

The subscale 6-item societal causes of suicide from the interval-coded ATTS (Attitude Towards Suicide Scale) was used to determine the extent of individual attribution of societal causes for suicide according to the work of Knight and colleagues (2000) and Lester & Bean (1992). This subscale uses 6 = strongly agree to 1 = strongly disagree, called Likert-type scaling. For 6-items, that indicates the possibility that an individual's score will range between 6 and 36, with larger numbers being indicative of the individual considering society is the cause of suicide. Reliability is measured by test-retest methodology, determined at a 1-month interval and shown by Loibl and colleagues (2008) to have r = 0.56, p < 0.001 on the subscale for societal causes of suicide. As shown in many studies (Lester & Bean, 1992; Knight et al., 2000; Kodaka, et al., 2010; Loibl et al., 2008) for this subscale, the inter-item reliabilities range between low 0.90s to low 0.70s. Kodaka et al. (2007) and Vatan and colleagues (2010) report the subscale has a significant correlation with indicators for hopelessness and external control loci, demonstrating criterion-related validity with an rs from 0.14 to 0.20, and ps < 0.01.

Moderating Variable: John Henryism.

John Henryism is defined as a coping strategy used by black males involving over-work and resulting physical/physiological health issues [James et al. (1992)]. The scale rates agreement with statements such as "When things don't go the way I want them to, that just makes me work even harder;" and correlates with hypertension (James et al., 1992). James (1994) provided a 12-item scale for the John Henryism method of Active Coping which will be used here to assess the extent of John Henryism. This scale has an interval basis including: 5 = completely true; 4 = true, 3 = neither false nor true; 2 = false, and 1 = completely false. For 12 items, it is possible for scores to range from a high of 60 to a low of 12; lower scores are weaker John Henryism. As shown by many research groups (James, 1994; Neighbors et al., 2007; Rosenfield & Mouzon, 2013; Subramanyam et al., 2013; Wang, Trivedi, Treiber, & Snieder, 2005), there is strong reliability using this scale for inter-item evaluation of John Henryism in Active Coping: Cronbach's alpha ranges from mid 0.90s to mid 0.70s as used. According to James (1994), with a test-retest period of two weeks, the reliability was r = 0.50, p < 0.01. This approach also has excellent criterion-related validity, with a range from rs = 0.70s to rs = .50s to rs = .70s; ps < 0.001 with measures of perceived stress and self-reliance (Matthews et al., 2013; Merritt et al., 2011; Rosenfield & Mouzon, 2013).

Dependent Variable: Grief in Response to Suicide.

The intensity of grief as a result of suicide was measured using the Inventory of Complicated Grief (ICG: Prigerson et al., 1995, 1996). This instrument is a 19-item scale that is interval-coded, having responses ranging from 5 = always to 1 = never; thus the potential scores can range between 95 and 5, with lower scores being indicative of grief that may be less complicated (Prigerson et al., 1995, 1996). Cronbach's alphas range from the high 0.80s to mid 0.90s for the ICG, which has excellent inter-item reliability (Boelen & Prigerson, 2013; Boelen, van den Bout, & de Keijser, 2003; Lobb, Kristjanson, Aoun, Monterosso, Halkett, & Davies, 2010; Mitchell, Kim, Prigerson, & Mortimer-Stephens, 2004; Prigerson et al., 1995, 1996). Pearson correlations are in the 0.80s for one month test-retest reliability (Lobb et al., 2010; Prigerson et al., 1995, 1996). Indeed, a particular advantage to the ICG is that it can discriminate between clinical depression and individuals who may or may not have prolonged grief disorder (Boelen & Prigerson, 2013; Sung et al., 2011); as well, the ICG has usefully been shown to have criterion-related validity for measures of spiritual grief, with rs = 0.40s, ps < 0.05 (Burke et al., 2014).

Covariate: Maternal Socioeconomic Status.

In order to ascertain the socioeconomic status of mothers being interviewed, the question "How would you rate the financial well-being of your family?" was asked. This question, coded in intervals from 5 = very well-off to 1 = not at all well off, has been used nationally in research of demographics (Caro & Cortes, 2012).

Covariate: Maternal Age.

The interval variable age will be determined using the birth date provided by the respondents in this study, who were asked "What is your birth date?." This question was used because previous studies have shown that participants will more readily provide a birth year than their actual age (Settersten & Mayer, 1997; Skoog & Ciecka, 2010).

Covariate: Maternal Relationship Status.

Gates (2011) recommended a single-item question to determine partner relationships:

"What is your current relationship status?." The status of the maternal relationship is a categorical variable. Defined responses to the question include: 5 = widowed; 4 = divorced; 3 - in a committed relationship but not married; 2 = married; and 1 = single.

Covariate: Depression.

Eaton and colleagues (2004) provide a revised measure for depression: the CESD-R, Revised Center for Epidemiologic Studies Depression Scale, which is a 20-item ratio-coded instrument that measures depression severity as rated by the individual. The scoring on the CESD-R includes 4 - 'nearly every day for two weeks' for symptoms that are severe to 0 - 'not at all or less than one day; with 20 items and scores of 0 to 4, the possible scale is 0 to 80. According to Wood and colleagues (2010), any score over 16 suggests higher levels of depression.

Many researchers report that the CESD-R is widely used as an instrument for analysis of depression (Murphy, 2002; Pigeon et al., 2011; Van Dam & Earleywine, 2011; Wood, Taylor & Joseph, 2010). It has been used widely with a variety of different populations including minorities, women, and elderly (Wood, Taylor & Joseph, 2010; Pigeon et al., 2011). This instrument has been shown to have 'strong criterion-related validity', with rs from 0.20 to 0.70 using depression measures including: the Patient Health Questionnaire?9 (PHQ?9); the Geriatric Depression Scale (GDS); and the Hospital Anxiety and Depression Scale (HADS) (Aalto et al., 2012; Dozois et al., 1997; Gloria, Castellanos, Kanagui-Munoz, & Rico, (2012; Smarr & Keefer, 2011).

A validation of the CESD-R by Van Dam and Earleywine (2011) indicated that the measure usefully provided reproducibly convergent and divergent validity, strong factor loadings, strong internal consistency, and excellent psychometric properties. Their study indicated that the CESD-R is a useful tool for measurement of depression in populations being assessed as well as being readily understood (Murphy, 2002; Pigeon et al., 2011; Van Dam & Earleywine, 2011; Wood, Taylor & Joseph, 2010). CESD-R has been widely used internationally as well as being used in alternative formats such as electronic, paper,… READ MORE

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