Skip to main content
SpringerLink
Log in

Psychometric properties of two abbreviated Connor–Davidson Resilience scales in Chinese infertile couples

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to evaluate the psychometric properties of the 10-item and 2-item Connor–Davidson Resilience Scale (CD-RISC), the agreement between these two versions, and the measurement invariance of the CD-RISC-10 across genders in Chinese infertile couples.

Methods

A total of 170 infertile couples were enrolled from an infertility outpatient clinic between September 2019 and January 2020. The CD-RISC scores were tested for floor and ceiling effects. Reliability was evaluated by calculating Cronbach’s α. Convergent and divergent validity were assessed by bivariate correlations between resilience and infertility-related stress, depression, anxiety, and two divergent variables. Agreement between the two versions was evaluated using the intraclass correlation coefficient (ICC) and Bland–Altman analysis. A multiple-group confirmatory factor analysis (CFA) was conducted to assess the measurement equivalence of CD-RISC-10 across genders.

Results

No floor or ceiling effects were observed. Internal consistencies of CD-RISC-10 and CD-RISC-2 were 0.91 and 0.63, respectively. The CFA analysis indicated an excellent model fit for a one-factor structure of CD-RISC-10 (TLI > 0.950, CFI > 0.950, RMSEA < 0.060). Both scales displayed good convergent and divergent validity, and the agreement between them was significant with an ICC of 0.80 (95% CI ranging from 0.76 to 0.84). Measurement invariance across genders was supported by multigroup CFA, and a higher level of resilience was found in men than in women.

Conclusion

Our findings showed significant reliability, validity, and stability of CD-RISC-10 and acceptable internal consistency and validity of CD-RISC-2. CD-RISC-10 is recommended as a resilience measure in clinical evaluations of infertile patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data Availability

The data that support the findings of this study are available from the first and corresponding authors upon reasonable request.

Code availability

N/A

References

  1. Vander Borght, M., & Wyns, C. (2018). Fertility and infertility: Definition and epidemiology. Clinical Biochemistry, 62, 2–10. https://doi.org/10.1016/j.clinbiochem.2018.03.012

    Article  PubMed  Google Scholar 

  2. Meng, Q., Ren, A., Zhang, L., Liu, J., Li, Z., Yang, Y., et al. (2015). Incidence of infertility and risk factors of impaired fecundity among newly married couples in a Chinese population. Reproductive Biomedicine Online, 30(1), 92–100. https://doi.org/10.1016/j.rbmo.2014.10.002

    Article  PubMed  Google Scholar 

  3. Ergin, R. N., Polat, A., Kars, B., Oztekin, D., Sofuoglu, K., & Caliskan, E. (2018). Social stigma and familial attitudes related to infertility. Turkish Journal of Obstetrics and Gynecology, 15(1), 46–49. https://doi.org/10.4274/tjod.04307

    Article  PubMed  PubMed Central  Google Scholar 

  4. Nahar, P., & van der Geest, S. (2014). How women in Bangladesh confront the stigma of childlessness: agency, resilience, and resistance. Medical Anthropology Quarterly, 28(3), 381–398. https://doi.org/10.1111/maq.12094

    Article  PubMed  Google Scholar 

  5. Peters, K., Jackson, D., & Rudge, T. (2011). Surviving the adversity of childlessness: Fostering resilience in couples. Contemporary Nurse, 40(1), 130–140. https://doi.org/10.5172/conu.2011.40.1.130

    Article  PubMed  Google Scholar 

  6. Connor, K. M., & Davidson, J. R. T. (2003). Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18(2), 76–82. https://doi.org/10.1002/da.10113

    Article  PubMed  Google Scholar 

  7. Bonanno, G. A. (2008). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? Psychological Trauma: Theory, Research, Practice, and Policy. S(1),101-113. https://doi.org/10.1037/1942-9681.S.1.101

    Book  Google Scholar 

  8. Davydov, D. M., Stewart, R., Ritchie, K., & Chaudieu, I. (2010). Resilience and mental health. Clinical Psychology Review, 30(5), 479–495. https://doi.org/10.1016/j.cpr.2010.03.003

    Article  PubMed  Google Scholar 

  9. Shin, Y., Kim, S. M., Kim, H., Min, K. J., Yoo, S., Kim, E., et al. (2019). Resilience as a protective factor for depressive mood and anxiety among Korean employees. Journal of Korean Medical Science, 34(27), e188. https://doi.org/10.3346/jkms.2019.34.e188

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gameiro, S., van den Belt-Dusebout, A. W., Smeenk, J. M. J., Braat, D. D. M., van Leeuwen, F. E., & Verhaak, C. M. (2016). Women’s adjustment trajectories during IVF and impact on mental health 11–17 years later. Human Reproduction, 31(8), 1788–1798. https://doi.org/10.1093/humrep/dew131

    Article  PubMed  Google Scholar 

  11. Herrmann, D., Scherg, H., Verres, R., von Hagens, C., Strowitzki, T., & Wischmann, T. (2011). Resilience in infertile couples acts as a protective factor against infertility-specific distress and impaired quality of life. Journal of Assisted Reproduction and Genetics, 28(11), 1111–1117. https://doi.org/10.1007/s10815-011-9637-2

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chochovski, J., Moss, S. A., & Charman, D. P. (2013). Recovery after unsuccessfulin vitro fertilization: the complex role of resilience and marital relationships. Journal of Psychosomatic Obstetrics & Gynecology, 34(3), 122–128. https://doi.org/10.3109/0167482X.2013.829034

    Article  Google Scholar 

  13. Yu, Y., Peng, L., Chen, L., Long, L., He, W., Li, M., et al. (2014). Resilience and social support promote posttraumatic growth of women with infertility: The mediating role of positive coping. Psychiatry Research, 215(2), 401–405. https://doi.org/10.1016/j.psychres.2013.10.032

    Article  PubMed  Google Scholar 

  14. Li, Y., Zhang, X., Shi, M., Guo, S., & Wang, L. (2019). Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study. Health and Quality of Life Outcomes, 17(1), 38. https://doi.org/10.1186/s12955-019-1099-8

    Article  PubMed  PubMed Central  Google Scholar 

  15. Windle, G., Bennett, K. M., & Noyes, J. (2011). A methodological review of resilience measurement scales. Health and Quality of Life Outcomes, 9(1), 8. https://doi.org/10.1186/1477-7525-9-8

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sexton, M. B., Byrd, M. R., & von Kluge, S. (2010). Measuring resilience in women experiencing infertility using the CD-RISC: Examining infertility-related stress, general distress, and coping styles. Journal of Psychiatric Research, 44(4), 236–241. https://doi.org/10.1016/j.jpsychires.2009.06.007

    Article  PubMed  Google Scholar 

  17. Khoshouei, M. S. (2009). Psychometric evaluation of the Connor-Davidson Resilience Scale (CD-RISC) using Iranian students. International Journal of Testing, 9(1), 60–66. https://doi.org/10.1080/15305050902733471

    Article  Google Scholar 

  18. Yu, X., & Zhang, J. (2007). Factor analysis and psychometric evaluation of the Conner-Davidson resilience scale (CD-RISC) with Chinese people. Social Behavior and Personality: An International Journal, 35(1), 19–30. https://doi.org/10.2224/sbp.2007.35.1.19

    Article  Google Scholar 

  19. Campbell-Sills, L., & Stein, M. B. (2007). Psychometric analysis and refinement of the connor–davidson resilience scale (CD-RISC): Validation of a 10-item measure of resilience. Journal of Traumatic Stress, 20(6), 1019–1028. https://doi.org/10.1002/jts.20271

    Article  PubMed  Google Scholar 

  20. Goins, R. T., Gregg, J. J., & Fiske, A. (2012). Psychometric properties of the Connor-Davidson Resilience Scale with older American Indians. Research on Aging, 35(2), 123–143. https://doi.org/10.1177/0164027511431989

    Article  PubMed  PubMed Central  Google Scholar 

  21. Sharma, S., Pathak, A., Abbott, J. H., & Jensen, M. P. (2018). Measurement properties of the Nepali version of the Connor Davidson resilience scales in individuals with chronic pain. Health and Quality of Life Outcomes, 16(1), 56. https://doi.org/10.1186/s12955-018-0884-0

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wang, L., Shi, Z., Zhang, Y., & Zhang, Z. (2010). Psychometric properties of the 10-item Connor-Davidson Resilience Scale in Chinese earthquake victims. Psychiatry and Clinical Neurosciences, 64(5), 499–504. https://doi.org/10.1111/j.1440-1819.2010.02130.x

    Article  PubMed  Google Scholar 

  23. Cheng, C., Dong, D., He, J., Zhong, X., & Yao, S. (2020). Psychometric properties of the 10-item Connor-Davidson Resilience Scale (CD-RISC-10) in Chinese undergraduates and depressive patients. Journal of Affective Disorders, 261, 211–220. https://doi.org/10.1016/j.jad.2019.10.018

    Article  PubMed  Google Scholar 

  24. Vaishnavi, S., Connor, K., & Davidson, J. R. T. (2007). An abbreviated version of the Connor-Davidson Resilience Scale (CD-RISC), the CD-RISC2: Psychometric properties and applications in psychopharmacological trials. Psychiatry Research, 152(2–3), 293–297. https://doi.org/10.1016/j.psychres.2007.01.006

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ni, M. Y., Li, T. K., Yu, N. X., Pang, H., Chan, B. H. Y., Leung, G. M., et al. (2016). Normative data and psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) and the abbreviated version (CD-RISC2) among the general population in Hong Kong. Quality of Life Research, 25(1), 111–116. https://doi.org/10.1007/s11136-015-1072-x

    Article  PubMed  Google Scholar 

  26. Kuiper, H., van Leeuwen, C. C. M., Stolwijk-Swüste, J. M., & Post, M. W. M. (2019). Measuring resilience with the Connor-Davidson Resilience Scale (CD-RISC): which version to choose? Spinal Cord, 57(5), 360–366. https://doi.org/10.1038/s41393-019-0240-1

    Article  PubMed  Google Scholar 

  27. Vatanparast, M., Ardekani, S. M. Y., Anvari, M., Kalantari, A., Yaghmaie, F., & Royani, Z. (2020). Resilience as the predictor of quality of life in the infertile couples as the most neglected and silent minorities. Journal of Reproductive and Infant Psychology,1–12, Advance online publication. https://doi.org/10.1080/02646838.2020.1843613

    Article  PubMed  Google Scholar 

  28. Abolghasemi, A., Rajabi, S., Sheikhi, M., Kiamarsi, A., & Sadrolmamaleki, V. (2013). Comparison of resilience, positive/negative affect, and psychological vulnerability between Iranian infertile and fertile men. Iranian Journal of Psychiatry and Behavioral Sciences, 7(1), 9–15.

    PubMed  PubMed Central  Google Scholar 

  29. Cheung, G. W., & Rensvold, R. B. (2002). Evaluating Goodness-of-Fit Indexes for Testing Measurement Invariance. Structural Equation Modeling: A Multidisciplinary Journal, 9(2), 233–255. https://doi.org/10.1207/S15328007SEM0902_5

    Article  Google Scholar 

  30. Pulido-Martos, M., Fernández-Sánchez, M. D., & Lopez-Zafra, E. (2020). Measurement invariance across gender and age in the Connor-Davidson Resilience Scale (CD-RISC) in a Spanish general population. Quality of Life Research, 29(5), 1373–1384. https://doi.org/10.1007/s11136-019-02389-1

    Article  PubMed  Google Scholar 

  31. Zegers-Hochschild, F., Adamson, G. D., Dyer, S., Racowsky, C., de Mouzon, J., Sokol, R., et al. (2017). The international glossary on infertility and fertility care, 2017. Fertility and Sterility, 108(3), 393–406. https://doi.org/10.1016/j.fertnstert.2017.06.005

    Article  PubMed  Google Scholar 

  32. Newton, C. R., Sherrard, W., & Glavac, I. (1999). The Fertility Problem Inventory: measuring perceived infertility-related stress. Fertility and Sterility, 72(1), 54–62. https://doi.org/10.1016/S0015-0282(99)00164-8

    Article  CAS  PubMed  Google Scholar 

  33. Peng, T., Coates, R., Merriman, G., Zhao, Y., & Maycock, B. (2011). Testing the psychometric properties of Mandarin version of the fertility problem inventory (M-FPI) in an infertile Chinese sample. Journal of Psychosomatic Obstetrics & Gynecology, 32(4), 173–181. https://doi.org/10.3109/0167482X.2011.609950

    Article  Google Scholar 

  34. Tong, X., An, D., McGonigal, A., Park, S., & Zhou, D. (2016). Validation of the Generalized Anxiety Disorder-7 (GAD-7) among Chinese people with epilepsy. Epilepsy Research, 120, 31–36. https://doi.org/10.1016/j.eplepsyres.2015.11.019

    Article  PubMed  Google Scholar 

  35. Yuan, J., Ding, R., Wang, L., Sheng, L., Li, J., & Hu, D. (2019). Screening for depression in acute coronary syndrome patients: A comparison of Patient Health Questionnaire-9 versus Hospital Anxiety and Depression Scale-Depression. Journal of Psychosomatic Research, 121, 24–28. https://doi.org/10.1016/j.jpsychores.2019.03.018

    Article  PubMed  Google Scholar 

  36. Terwee, C. B., Bot, S. D., de Boer, M. R., van der Windt, D. A., Knol, D. L., Dekker, J., et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60(1), 34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012

    Article  PubMed  Google Scholar 

  37. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55. https://doi.org/10.1080/10705519909540118

    Article  Google Scholar 

  38. Meredith, W., & Teresi, J. A. (2006). An essay on measurement and factorial invariance. Medical Care, 44(11 Suppl 3), S69–S77. https://doi.org/10.1097/01.mlr.0000245438.73837.89

    Article  PubMed  Google Scholar 

  39. Meade, A. W., Johnson, E. C., & Braddy, P. W. (2008). Power and sensitivity of alternative fitindices in tests of measurement invariance. Journal of Applied Psychology, 93(3), 568–592. https://doi.org/10.1037/0021-9010.93.3.568

    Article  Google Scholar 

  40. Koo, T. K., & Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine, 15(2), 155–163. https://doi.org/10.1016/j.jcm.2016.02.012

    Article  PubMed  PubMed Central  Google Scholar 

  41. Bland, J. M., & Altman, D. G. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1(8476), 307–310.

    Article  Google Scholar 

  42. Schafer, J. L., & Graham, J. W. (2002). Missing data: Our view of the state of the art. Psychological Methods, 7(2), 147–177. https://doi.org/10.1037//1082-989X.7.2.147

    Article  PubMed  Google Scholar 

  43. Shin, G., Choi, K., Jeong, K. S., Min, Y., Ahn, Y., & Kim, M. (2018). Psychometric properties of the 10-item Conner-Davidson resilience scale on toxic chemical-exposed workers in South Korea. Annals of Occupational and Environmental Medicine, 30, 52. https://doi.org/10.1186/s40557-018-0265-5

    Article  PubMed  PubMed Central  Google Scholar 

  44. Kline, R. (2011). Principles and practice of structural equation modeling.3rd ed. New York: Guilford publications.

  45. Hwang, Y. I. J., Arnold, S., Trollor, J., & Uljarević, M. (2020). Factor structure and psychometric properties of the brief Connor-Davidson Resilience Scale for adults on the autism spectrum. Autism, 24(6):1572-1577. https://doi.org/10.1177/1362361320908095

    Article  PubMed  Google Scholar 

  46. Jeong, H. S., Kang, I., Namgung, E., Im, J. J., Jeon, Y., Son, J., et al. (2015). Validation of the Korean version of the Connor-Davidson Resilience Scale-2 in firefighters and rescue workers. Comprehensive Psychiatry, 59, 123–128. https://doi.org/10.1016/j.comppsych.2015.01.006

    Article  PubMed  Google Scholar 

  47. Meng, M., He, J., Guan, Y., Zhao, H., Yi, J., Yao, S., et al. (2019). Factorial invariance of the 10-Item Connor-Davidson Resilience Scale across gender among Chinese elders. Frontiers in Psychology, 10, 1237. https://doi.org/10.3389/fpsyg.2019.01237

    Article  PubMed  PubMed Central  Google Scholar 

  48. Okuyama, J., Funakoshi, S., Tomita, H., Yamaguchi, T., & Matsuoka, H. (2018). Longitudinal characteristics of resilience among adolescents: A high school student cohort study to assess the psychological impact of the Great East Japan Earthquake. Psychiatry and Clinical Neurosciences, 72(11), 821–835. https://doi.org/10.1111/pcn.12772

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We gratefully thank all the clinical staffs at hospital for their support and all the participants for their patience. This research was supported by College Natural Science Research Project of Jiangsu Province (Grant No.19KJD320004). We would like to thank Editage (www.editage.cn) for English language editing.

Funding

This research was supported by the College Natural Science Research Project of Jiangsu Province (Grant No.19KJD320004).

Author information

Author notes

  1. Xuekun Zhang, Yuanyuan Mo have contributed equally to this paper.

Authors and Affiliations

  1. School of Nursing, Medical College, Soochow University, Suzhou, China

    Xuekun Zhang, Yuanyuan Mo & Huiling Li

  2. The Reproductive Medicine Center, The First Affiliated Hospital of Soochow University, Suzhou, China

    Chunxia Yan

  3. School of Nursing, The University of Texas at Austin, Austin, USA

    Yang Li

  4. The First Affiliated Hospital of Soochow University, Suzhou, China

    Huiling Li

Authors
  1. Xuekun Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuanyuan Mo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chunxia Yan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yang Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Huiling Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

ZXK and LHL designed the study. ZXK, MYY, and YCX collected the data. MYY analysis of the data and ZXK and MYY drafted the manuscript. LY revised the manuscript. All authors contributed to the critical and substantial revisions of the paper and the final approval of the manuscript.

Corresponding author

Correspondence to Huiling Li.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

Ethical approval was granted by the Ethics Committee of Soochow University (ECSU-2019000144).

Informed Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Informed consent for the publication of their data was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, X., Mo, Y., Yan, C. et al. Psychometric properties of two abbreviated Connor–Davidson Resilience scales in Chinese infertile couples. Qual Life Res 30, 2405–2414 (2021). https://doi.org/10.1007/s11136-021-02820-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-021-02820-6

Keywords

Search

Navigation