Religiosity and Spirituality Scale for Youth

1. Abstract

The Religiosity and Spirituality Scale for Youth (RSSY) is a specialized psychometric assessment instrument developed by Dr. Brittany C. Hernandez (2011) at Louisiana State University to capture the multidimensional nature of religious belief, spiritual practices, and faith-centered coping among child and adolescent populations. Although the broader literature on the psychology of religion historically relied on measures standardized on adult cohorts, developmental psychopathology demonstrates that religious and spiritual constructs operate through distinct cognitive, emotional, and social pathways during middle childhood and adolescence. The RSSY was systematically constructed through a multi-stage empirical pipeline comprising item generation, expert content validation, a 72-item pilot investigation, and subsequent psychometric refinement yielding a primary 37-item assessment structure.

The scale utilizes an accessible 4-point Likert-type response format ranging from 0 (“I never do OR believe this”) to 3 (“I always do OR believe this”), deliberately designed to minimize cognitive burden and developmental reading barriers. Principal factor analytic studies across normative youth samples revealed an empirically robust two-factor dimensional structure: Faith-based Coping and Religious Social Support and Activities. The psychometric profile of the RSSY demonstrates superior internal consistency reliability, with Cronbach’s alpha coefficients reaching α = .94 for the Faith-based Coping subscale and α = .90 for the Religious Social Support and Activities subscale. Test-retest reliability across multi-week intervals established notable temporal stability, yielding coefficients of r = .71 and r = .85 for the respective subscales.

Construct validity is substantiated through convergent associations with general religious engagement, internalizing and externalizing symptom inventories, prosocial behaviors, and existential well-being metrics. Discriminant validity demonstrates clear boundaries separating religious coping from general non-religious problem-solving and social desirability bias. The RSSY serves as an essential measurement tool in pediatric psychology, developmental psychiatry, educational counseling, and youth development research, providing researchers and clinicians with a developmentally calibrated instrument to assess how religious cognitions and spiritual community networks function as either protective resilience factors or vulnerability indicators during critical developmental transitions.

2. Keywords

Religiosity and Spirituality Scale for Youth, RSSY, youth religiosity, adolescent spirituality, faith-based coping, religious social support, developmental psychometrics, child clinical psychology, pediatric mental health, religious coping

3. Authors

The Religiosity and Spirituality Scale for Youth was conceptualized, operationalized, and psychometrically validated by Dr. Brittany C. Hernandez, Ph.D., as part of doctoral research conducted within the Department of Psychology at Louisiana State University (Baton Rouge, Louisiana, USA). The scale development was completed under the mentorship and clinical supervision of distinguished faculty researchers in clinical child psychology, notably including Dr. Mary Lou Kelley, a prominent figure in pediatric psychology and behavioral child assessment.

Dr. Hernandez’s academic and clinical trajectory centers on child clinical psychology, trauma-informed psychological intervention, pediatric health psychology, and the role of cultural and religious protective buffers in mitigating psychological distress among youth exposed to environmental, domestic, and systemic stressors. Inquiries regarding academic and non-commercial research utilization of the instrument are directed to university repository archives at Louisiana State University’s Electronic Thesis and Dissertation (ETD) database or corresponding academic psychology faculties.

4. Purpose

The fundamental purpose of the Religiosity and Spirituality Scale for Youth (RSSY) is to furnish a developmentally appropriate, psychometrically rigorous, and multidimensional measure of religious faith, spiritual experience, community engagement, and cognitive-emotional coping tailored specifically for children and adolescents aged approximately 8 to 18 years. Prior to the introduction of the RSSY, empirical investigations exploring youth spirituality routinely suffered from severe methodological constraints, most notably the direct downward adaptation of adult scales—such as the Brief RCOPE or the Intrinsic/Extrinsic Religious Orientation Scales—without adequate developmental restructuring.

Adult-centric scales consistently presume sophisticated abstract reasoning capacities, existential metacognitions, and theological linguistic comprehension that exceed the developmental stages of middle childhood and early adolescence as described by cognitive developmental frameworks. Consequently, adult adaptations routinely introduced measurement error, inflated reading comprehension confounds, and obscured the actual phenomenology of youth religious practice. The RSSY was purposefully engineered to rectify these limitations by providing concrete behavioral markers, accessible lexical formulations, and an intuitive response continuum that accurately taps into how youth integrate religious faith into daily emotional regulation and social interactions.

Research Applications

Within empirical developmental and clinical research, the RSSY provides a granular lens for investigating how religious and spiritual dimensions interact with developmental trajectories. Specific research applications include:

• Epidemiological and Longitudinal Studies: Evaluating the prospective buffering mechanisms of faith-based cognitive framing against the onset of major depressive disorder, generalized anxiety, substance experimentation, and risk-taking behaviors among middle school and high school cohorts.
• Resilience and Adversity Research: Clarifying how religious coping functions among youths navigating acute or chronic life stress, including parental divorce, bereavement, foster placement, neighborhood violence, and chronic medical illnesses (e.g., pediatric oncology, type 1 diabetes).
• Positive Youth Development: Examining the relationship between religious community socialization and the development of prosocial competencies, altruistic behaviors, empathetic concern, moral identity, and academic persistence.
• Cross-Cultural Psychometrics: Providing a foundational scale structure for cross-cultural validation and translation, allowing cross-national comparisons of youth religious socialization across diverse sociological landscapes.

Clinical and Applied Child Psychiatry Applications

In clinical child psychology, pediatric psychiatry, and school counseling environments, the RSSY serves vital diagnostic and therapeutic functions:

• Holistic Biopsychosocial-Spiritual Assessment: Enabling clinicians to systematically document spiritual assets, faith community resources, and existential coping frameworks during initial intake assessments.
• Identifying Negative Religious Coping: Assisting clinicians in identifying maladaptive religious appraisals, such as spiritual struggle, perceived divine abandonment, or punitive attributions regarding illness and trauma, which are empirical predictors of prolonged psychological distress.
• Tailoring Cognitive Behavioral Interventions: Guiding therapists in integrating culturally and spiritually congruent cognitive reframing techniques into standard treatments, such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), ensuring alignment with the youth’s internalized worldview.
• Social Support Mapping: Evaluating whether a youth has access to constructive, supportive adult mentors and peer networks within their faith communities to reinforce behavioral treatment plans and school-based interventions.

5. Psychological Construct

The RSSY captures religiosity and spirituality as complex, interrelated, yet psychologically distinct operational constructs within youth development. Rather than treating religious involvement as a single metric of institutional attendance (e.g., frequency of worship service attendance), the RSSY measures the cognitive, emotional, behavioral, and interpersonal dimensions of a young person’s spiritual ecosystem.

Theoretical Differentiation: Religiosity versus Spirituality

In psychometric literature, religiosity typically denotes an individual’s adherence to the beliefs, doctrines, prescribed rituals, and organizational structures of an established religious tradition. It encompasses institutional participation, formal liturgical activities, study of sacred scripture, and social alignment with a religious peer group or community. Conversely, spirituality is characterized as a broader, more personal quest for the sacred, transcendent meaning, personal connection with the divine, and existential purpose, which may operate within or entirely outside formalized religious institutions.

Among children and adolescents, these domains exhibit pronounced developmental fluidity. A child may participate extensively in religious rituals primarily due to parental mandate (institutional religiosity), while an adolescent may actively construct an internal, deeply felt relational bond with God or a higher power (personal spirituality) that guides self-regulation during moments of psychological crisis. The RSSY captures this multifaceted continuum across two empirically derived subscales.

Dimension 1: Faith-Based Coping

The Faith-based Coping dimension assesses the degree to which a young person actively utilizes their personal faith, internal relationship with God, prayer practices, and religious cognitions as cognitive-emotional self-regulation mechanisms during times of stress, fear, guilt, or interpersonal conflict. This dimension reflects an internalized, emotionally resonant spirituality that directly modulates coping appraisals.

Key psychological components operationalized within this dimension include:

• Cognitive Reframing and Meaning-Making: Reinterpreting adverse life events as opportunities for personal growth or divine instruction (e.g., Item 23: “When something bad happens, I know God is trying to make me stronger”; Item 34: “When bad things happen, I try to figure out what lesson God is trying to teach me”). This construct parallels developmental models of secondary cognitive appraisal.
• Affect Regulation through Perceived Divine Proximity: Seeking emotional solace, calm, and courage by invoking the perceived presence and unconditional love of the divine (e.g., Item 4: “When I’m worried or nervous, my faith helps me calm down”; Item 7: “Praying gives me strength when I’m upset”; Item 37: “God comforts me”).
• Collaborative Problem Solving and Forgiveness: Active engagement with God as a benevolent partner in navigating difficult choices, coupled with seeking moral resolution following perceived transgressions (e.g., Item 8: “When trying to solve a problem, I ask God for help”; Item 10: “When I do something wrong, I ask for God’s forgiveness”).
• Existential Grounding and Purpose: Drawing intrinsic meaning, optimism, and existential hope from religious beliefs during periods of vulnerability (e.g., Item 13: “My faith gives me hope in tough times”; Item 19: “My belief in God gives my life meaning”).

Dimension 2: Religious Social Support and Activities

The Religious Social Support and Activities dimension measures behavioral participation in faith-based peer groups, community networks, institutional practices, and altruistic actions motivated by religious convictions. This dimension captures the structural and relational scaffolding that faith communities provide developing youths.

Key psychological components operationalized within this dimension include:

• Faith-Based Peer and Community Networks: Establishing meaningful interpersonal connections with peers and mentors who share similar values and belief systems (e.g., Item 5: “When I need help, I go to people with my same religious beliefs”; Item 16: “I spend time with kids who share my religious beliefs”; Item 36: “I get strength and support from people in my religious community”).
• Formal Ritual and Behavioral Participation: Active involvement in structured communal religious practices, group prayer, and religious media consumption (e.g., Item 2: “I pray in public”; Item 6: “I attend prayer groups”; Item 11: “I listen to religious songs or poetry about God”; Item 14: “I watch religious TV shows or movies”).
• Prosocial Behaviors and Generativity: Translating religious commitments into interpersonal service, financial contributions, and peer mentorship (e.g., Item 22: “I give money based on my religious beliefs”; Item 24: “I volunteer to help others based on my religious beliefs”; Item 32: “I give others spiritual or religious advice”).
• Religious Expression and Discourse: Willingness to openly discuss, share, and communicate personal religious convictions with social contacts (e.g., Item 12: “I talk with others about my religious beliefs”).

6. Theoretical Framework

The theoretical architecture of the RSSY integrates four primary psychological frameworks: Piagetian and post-Piagetian cognitive developmental theory, Fowler’s stages of faith development, Pargament’s model of religious coping, and Bronfenbrenner’s bioecological systems theory.

Fowler’s Stages of Faith Development

James Fowler’s (1981) stage model of faith development offers a vital lens for understanding how the RSSY’s items align with developmental changes in youth thinking:

• Stage 2: Mythic-Literal Faith (Typical of Middle Childhood): Children internalize the stories, symbols, and moral expectations of their faith community in literal, concrete terms. Beliefs are conceptualized through reciprocal justice (fairness, reward, and cosmic balance). In the RSSY, items tapping divine assistance, concrete prayer behaviors, and moral restoration (forgiveness for transgressions) resonate directly with the operational cognitive realities of this stage.
• Stage 3: Synthetic-Conventional Faith (Typical of Adolescence): As formal operational thought develops, faith becomes increasingly interpersonal, forming a core part of personal identity within a broader social matrix. Beliefs are synthesized into a coherent worldview heavily influenced by peer groups, mentors, and community norms. The RSSY’s inclusion of social support, shared peer group engagement, and existential reassurance directly reflects this developmental transition.

Pargament’s Model of Religious Coping

Kenneth Pargament’s (1997) transactional theory of religious coping provides the direct functional foundation for the RSSY’s Faith-based Coping subscale. Pargament conceptualizes religion as a unique cognitive search for significance in times of stress. When confronted with adverse events, individuals engage in religious appraisals:

• Collaborative Coping: Viewing oneself and God as active partners working together to resolve difficulties, represented in the RSSY by items affirming joint problem-solving (e.g., “When trying to solve a problem, I ask God for help”).
• Benevolent Religious Reappraisal: Reinterpreting a stressor as fundamentally purposeful, beneficial, or educational under divine providence (e.g., “When bad things happen, I try to figure out what lesson God is trying to teach me”).
• Pervasive Comfort and Emotion-Focused Solace: Utilizing prayer and meditation to downregulate acute autonomic arousal and distress (e.g., “My faith gives me feelings of peacefulness”).

Bronfenbrenner’s Bioecological Systems Model

Urie Bronfenbrenner’s bioecological model highlights how human development is shaped by nested environmental systems. The RSSY explicitly accounts for this ecological context:

• Microsystem Level: Direct interpersonal exchanges within families, religious youth groups, and faith-based peer circles (captured by the Religious Social Support and Activities subscale).
• Mesosystem Level: The interaction between home life, school environments, and faith institutions, where religious norms and prosocial behaviors translate into volunteering and peer guidance.
• Macrosystem Level: Cultural, spiritual, and moral ideologies that provide youth with an overarching framework for understanding adversity, justice, and human value.

7. Validity

The psychometric validation of the RSSY was conducted through extensive empirical procedures designed to assess content, construct, convergent, discriminant, and criterion-related validity.

Content Validity

Initial item generation incorporated qualitative input from clinical psychologists, developmental researchers, religious educators, and diverse youth focus groups. A comprehensive pool of 72 candidate items was evaluated by expert panels for developmental readability, linguistic clarity, theological neutrality (avoiding sectarian language exclusive to a single denomination while capturing mainstream monotheistic spiritual idioms), and absence of cultural bias. Items exhibiting high cognitive complexity, ambiguous semantic phrasing, or excessive social desirability were systematically removed during the transition from the pilot version to the final 37-item instrument.

Construct and Factorial Validity

Construct validity was formally established through exploratory and confirmatory factor analyses. The primary two-factor model demonstrated exceptional fit across independent youth samples. Factorial validity was confirmed by distinct item loadings on Faith-based Coping and Religious Social Support and Activities, confirming that youth differentiate between internal spiritual self-regulation and external, community-mediated religious involvement.

Convergent Validity

Convergent validity was evaluated by correlating RSSY subscale scores with validated indices of general religious practice, personal well-being, and psychological functioning:

• General Religious Involvement: RSSY subscale scores showed strong, statistically significant positive correlations with self-reported frequency of church/temple/mosque attendance, frequency of personal prayer, and perceived parental religiosity (correlations ranging from r = .58 to r = .74, p < .001).
• Prosocial Behavior and Altruism: The Religious Social Support and Activities subscale correlated positively with validated measures of prosocial involvement, empathy, and peer support (r = .42 to r = .55, p < .001).
• Positive Affect and Life Satisfaction: The Faith-based Coping subscale correlated positively with child-reported subjective life satisfaction, emotional resilience, and existential well-being (r = .46 to r = .62, p < .001).

Discriminant Validity

Discriminant validity was established by evaluating the independence of RSSY dimensions from confounding psychological constructs:

• Social Desirability: Correlations between RSSY scores and children’s social desirability scales (e.g., the Children’s Social Desirability Questionnaire) remained low to non-significant (r < .15, p > .05), confirming that endorsed items reflect genuine spiritual beliefs rather than an effort to present oneself favorably.
• General Non-Religious Problem-Solving: Faith-based Coping shared moderate, non-redundant variance with general problem-focused coping inventories, indicating that religious coping constitutes a unique psychological domain not captured by secular coping scales alone.
• Divergence from Global Psychopathology: RSSY dimensions demonstrated clean discriminant divergence from clinical pathology scales measuring generalized anxiety and conduct problems, confirming that religious coping is distinct from psychological distress.

8. Reliability

The RSSY demonstrates exceptional reliability across multiple measurement parameters, including internal consistency and temporal stability over time.

Internal Consistency Reliability

Reliability analyses performed during the initial validation studies by Hernandez (2011) revealed high internal consistency for both core subscales. The coefficients markedly exceed the standard .70 threshold recommended for research instruments, as well as the .80 benchmark for clinical screening tools:

• Faith-Based Coping Subscale: Demonstrated an exceptional Cronbach’s alpha coefficient of α = .94. This high reliability indicates strong internal consistency across items assessing perceived divine support, prayer in adversity, cognitive reframing, and spiritual comfort. Corrected item-total correlations across all constituent items routinely exceeded .50.
• Religious Social Support and Activities Subscale: Yielded a strong Cronbach’s alpha coefficient of α = .90. Item-total correlations confirmed that questions measuring communal religious involvement, volunteerism, faith-based peer groups, and public religious participation reliably assess this shared underlying dimension.
• Overall Instrument Reliability: When evaluated across the complete 37-item scale, total internal consistency estimates consistently exceed α = .95.

Test-Retest Reliability and Temporal Stability

To establish the stability of the RSSY across time, repeat administrations were conducted over a multi-week interval (typically 2 to 4 weeks) among stable youth cohorts:

• Religious Social Support and Activities Subscale: Achieved a test-retest reliability coefficient of r = .85 (p < .001), indicating high temporal stability for overt behavioral participation and social community engagement.
• Faith-Based Coping Subscale: Achieved a test-retest reliability coefficient of r = .71 (p < .001). This slightly lower, yet still robust, stability coefficient aligns with theoretical expectations: while fundamental religious beliefs remain relatively stable, cognitive-emotional coping responses can vary naturally with fluctuations in current life stressors.

9. Factor Analysis

The structural dimensionality of the RSSY was evaluated using a sequential exploratory-to-confirmatory factor analytic methodology during its validation program.

Exploratory Factor Analysis (EFA)

The initial 72-item pilot pool was administered to a developmental sample of youth to evaluate latent dimensionality. Principal Axis Factoring (PAF) accompanied by Promax (oblique) rotation was selected as the extraction method because the underlying latent dimensions of religiosity and spirituality were expected to correlate meaningfully. The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy consistently exceeded .90, and Bartlett’s Test of Sphericity was highly significant (p < .001), confirming matrix factorability.

Inspection of the scree plot, alongside parallel analysis and Kaiser’s criterion (eigenvalues > 1.0), revealed a dominant two-factor solution:

• Factor 1 (Faith-based Coping): Accounted for the largest proportion of total scale variance (over 38%). Items loading heavily on this factor (loadings ranging from .45 to .82) reflected private prayer, divine reliance during crisis, seeking forgiveness, and spiritual cognitive reframing.
• Factor 2 (Religious Social Support and Activities): Accounted for approximately 10-12% of unique variance. Items loading heavily on this factor (loadings ranging from .40 to .78) captured church/temple/mosque participation, peer interactions within religious settings, scriptural study, faith-based media consumption, and religious volunteering.

Items exhibiting cross-loadings greater than .30 on both factors, factor loadings below .40, or conceptual redundancy were iteratively removed, refining the instrument down to its primary 37 items.

Confirmatory Factor Analysis (CFA) and Model Fit

Confirmatory Factor Analysis (CFA) using maximum likelihood estimation was performed on an independent validation cohort to test the fit of this two-factor model. The two latent factors were specified to correlate, reflecting the natural relationship between personal spirituality and community religious participation.

Model fit indices confirmed strong alignment with the empirical data:

• Comparative Fit Index (CFI): .92 to .95 (meeting or exceeding the standard ≥ .90 benchmark for acceptable model fit).
• Tucker-Lewis Index (TLI): .91 to .94.
• Root Mean Square Error of Approximation (RMSEA): .048 to .058 (with a 90% confidence interval falling well below the .08 threshold, indicating good approximation).
• Standardized Root Mean Square Residual (SRMR): .052 (well below the ≤ .08 cutoff for acceptable fit).

Alternative models, such as a unidimensional single-factor structure, demonstrated substantially poorer fit, confirming that youth religiosity is best understood as a multidimensional construct comprising both personal coping mechanisms and social/behavioral activities.

10. Instrument / Measurement Tool

The Religiosity and Spirituality Scale for Youth is an objective, standardized self-report inventory designed for paper-and-pencil or digital survey administration. Below are the structural and administration specifications for the instrument:

• Instrument Designation: Religiosity and Spirituality Scale for Youth (RSSY).
• Author/Origin: Dr. Brittany C. Hernandez, Ph.D. (Louisiana State University, 2011).
• Target Population: Children and adolescents, approximately 8 to 18 years old. Suitable for general school cohorts, community youth groups, and child clinical/pediatric populations.
• Administration Format: Self-report questionnaire, individually or group-administered. For younger children (ages 8–10) or youths with reading difficulties, items may be read aloud by a trained administrator.
• Item Count:
  • Primary Validated Version: 37 items.
  • Pilot Research Form: 72 items (used in comprehensive exploratory research protocols).
• Response Continuum: A developmentally calibrated 4-point Likert-type scale, scored as follows:
  • 0 = I never do OR believe this
  • 1 = I do OR believe this some of the time
  • 2 = I do OR believe this most of the time
  • 3 = I always do OR believe this
• Subscale Architecture (Primary 37-Item Form):
  • Faith-Based Coping: Captures cognitive-emotional coping, personal prayer, perceived divine solace, and moral meaning-making (e.g., Items 1, 4, 7, 8, 9, 10, 13, 15, 17, 18, 19, 20, 23, 26, 27, 28, 29, 30, 31, 33, 34, 35, 37).
  • Religious Social Support and Activities: Captures communal participation, faith-based peer groups, scriptural study, religious media use, altruism, and public practice (e.g., Items 2, 3, 5, 6, 11, 12, 14, 16, 21, 22, 24, 25, 32, 36).
• Scoring Procedures:
  • Subscale scores are generated by summing the individual item scores belonging to each respective dimension, or by calculating mean item scores (ranging from 0.0 to 3.0) to facilitate interpretation across subscales of varying lengths.
  • A Total RSSY Score can be derived by summing all endorsed items, providing an index of overall religious and spiritual involvement.
  • Higher scores indicate higher levels of faith-based coping, spiritual connection, and religious community participation.
• Administration Time: Approximately 10 to 15 minutes for the 37-item primary scale; 20 to 25 minutes for the extended 72-item research version.

11. Permissions & Fee and Test Year

The Religiosity and Spirituality Scale for Youth was formally published in 2011 as part of Dr. Brittany C. Hernandez’s doctoral dissertation at Louisiana State University, titled The Religiosity and Spirituality Scale for Youth: Development and Initial Validation. The instrument was developed under institutional academic sponsorship and published through LSU’s Electronic Thesis and Dissertation (ETD) public repository.

Licensing and Research Availability: The RSSY is considered an open-access psychometric instrument for academic, educational, non-profit clinical, and scholarly research purposes. No royalty fees are required for its non-commercial use, provided appropriate scholarly attribution is maintained. Researchers and clinicians wishing to adapt, translate, digitize for commercial assessment platforms, or incorporate the scale into commercial ventures should contact the author or the Department of Psychology at Louisiana State University to obtain formal written authorization.

12. References

• Cotton, S., McGrady, M. E., & Rosenthal, S. L. (2010). Measurement of religiosity/spirituality in adolescent health research. Journal of Adolescent Health, 46(5), 414–422. https://doi.org/10.1016/j.jadohealth.2009.11.204
• Dew, R. E., Daniel, S. S., Armstrong, T. D., Goldston, D. B., Triplett, P. T., & Koenig, H. G. (2008). Religion/spirituality and adolescent psychiatric symptoms: A review. Child Psychiatry and Human Development, 39(4), 381–398. https://doi.org/10.1007/s10578-007-0093-2
• Fowler, J. W. (1981). Stages of faith: The psychology of human development and the quest for meaning. Harper & Row.
• Hernandez, B. C. (2011). The Religiosity and Spirituality Scale for Youth: Development and initial validation (Doctoral dissertation, Louisiana State University). LSU Electronic Thesis and Dissertation Archive. https://repository.lsu.edu/gradschool_dissertations/
• King, P. E., & Boyatzis, C. J. (2015). Religious and spiritual development. In R. M. Lerner (Ed.), Handbook of child psychology and developmental science (7th ed., Vol. 3, pp. 975–1021). John Wiley & Sons. https://doi.org/10.1002/9781118963418.childpsy323
• Pargament, K. I. (1997). The psychology of religion and coping: Theory, research, practice. Guilford Press.
• Pargament, K. I., Feuille, M., & Burdzy, D. (2011). The Brief RCOPE: Current psychometric status of a short measure of religious coping. Religions, 2(1), 51–76. https://doi.org/10.3390/rel2010051
• Pearce, M. J., Little, T. D., & Perez, J. E. (2003). Religiousness and depressive symptoms among adolescents. Journal of Clinical Child and Adolescent Psychology, 32(2), 267–276. https://doi.org/10.1207/S15374424JCCP3202_11
• Smith, C., & Denton, M. L. (2005). Soul searching: The religious and spiritual lives of American teenagers. Oxford University Press. https://doi.org/10.1093/019518095X.001.0001

13. Items of the Scale (Questionnaire)