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Psychometric validation and refinement of the Interoception Sensory Questionnaire (ISQ) in adolescents and adults on the autism spectrum

Authors
  • Suzman, Evan1
  • Williams, Zachary J.2, 3, 3, 4
  • Feldman, Jacob I.2, 3
  • Failla, Michelle5
  • Cascio, Carissa J.3, 3, 6, 7
  • Wallace, Mark T.2, 3, 3, 6, 7, 3
  • Niarchou, Maria7
  • Sutcliffe, James S.7, 3
  • Wodka, Ericka8, 9
  • Woynaroski, Tiffany G.2, 3, 3, 6
  • 1 Vanderbilt University, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN, 37232, USA , Nashville (United States)
  • 2 Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN, 37232, USA , Nashville (United States)
  • 3 Vanderbilt University, Nashville, TN, USA , Nashville (United States)
  • 4 Vanderbilt University School of Medicine, Nashville, TN, USA , Nashville (United States)
  • 5 The Ohio State University, Columbus, OH, USA , Columbus (United States)
  • 6 Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA , Nashville (United States)
  • 7 Vanderbilt University Medical Center, Nashville, TN, USA , Nashville (United States)
  • 8 Johns Hopkins University School of Medicine, Baltimore, MD, USA , Baltimore (United States)
  • 9 Kennedy Krieger Institute, Baltimore, MD, USA , Baltimore (United States)
Type
Published Article
Journal
Molecular Autism
Publisher
BioMed Central
Publication Date
Jun 07, 2021
Volume
12
Issue
1
Identifiers
DOI: 10.1186/s13229-021-00440-y
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundIndividuals on the autism spectrum are reported to display alterations in interoception, the sense of the internal state of the body. The Interoception Sensory Questionnaire (ISQ) is a 20-item self-report measure of interoception specifically intended to measure this construct in autistic people. The psychometrics of the ISQ, however, have not previously been evaluated in a large sample of autistic individuals.MethodsUsing confirmatory factor analysis, we evaluated the latent structure of the ISQ in a large online sample of adults on the autism spectrum and found that the unidimensional model fit the data poorly. Using misspecification analysis to identify areas of local misfit and item response theory to investigate the appropriateness of the seven-point response scale, we removed redundant items and collapsed the response options to put forth a novel eight-item, five-response choice ISQ.ResultsThe revised, five-response choice ISQ (ISQ-8) showed much improved fit while maintaining high internal reliability. Differential item functioning (DIF) analyses indicated that the items of the ISQ-8 were answered in comparable ways by autistic adolescents and adults and across multiple other sociodemographic groups.LimitationsOur results were limited by the fact that we did not collect data for typically developing controls, preventing the analysis of DIF by diagnostic status. Additionally, while this study proposes a new 5-response scale for the ISQ-8, our data were not collected using this method; thus, the psychometric properties for the revised version of this instrument require further investigation.ConclusionThe ISQ-8 shows promise as a reliable and valid measure of interoception in adolescents and adults on the autism spectrum, but additional work is needed to examine its psychometrics in this population. A free online score calculator has been created to facilitate the use of ISQ-8 latent trait scores for further studies of autistic adolescents and adults (available at https://asdmeasures.shinyapps.io/ISQ_score/).

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