Personality and treatment response to electroacupuncture. A new measure of mood change and further analysis of questionnaire response styles
Creators: name: Mayor, David
name: Steffert, Tony
Publisher: name: F1000 Research Limited
Year: 2018

description: <i>Background </i><br>In our research into the effects of electroacupuncture (EA) delivered in a classroom situation we previously used the Brunel Mood Scale (BRUMS24) and multiple numerical rating scales (NRS-M) to assess moods and their changes. We also investigated the effects of some personality measures and the helpfulness of prior acupuncture on these changes. In this further study, we pilot a multiple mood change Likert scale (MMCL) instead of using before and after measures, and consider a different and extended set of personality measures.<br><br><i>Objectives</i><br>1. To apply several primary measures of personality type/attitude and continue prior explorations of the helpfulness of prior acupuncture in a teaching situation; 2. To further investigate some of the secondary measures previously used to describe how the various scales are completed (midpoint and extreme response styles – MRS and ERS – and Shannon entropy of questionnaire scores); 3. To pilot the MMCL, examine its validity and internal consistency, and compare its performance with the mood scales we used previously. Further objectives are described.<br><br><i>Methods</i><br>Ninety respondents were recruited during six EA teaching sessions in the UK and Denmark, attended as part of the requirement for a qualification in acupuncture practice or as part of a continuing professional development programme. The teaching sessions all followed a similar standard pattern, although duration varied between half a day and two days; respondents were encouraged to complete the scales but not obliged to do so. Ethics approval was granted under applications for related studies by the Health and Human Sciences Ethics Committee of the University of Hertfordshire. Permission was also received from the course organisers and respondents themselves.<br><br><i>Results</i><br>The MMCL shows acceptable convergent validity (|rho| &gt; 0.4) and internal consistency (Cronbach’s alpha &gt; 0.5) for the mood changes considered as ‘desirable’ or ‘undesirable’, when analysed separately. Sensitivity of the scale to mood changes is better than that of the NRS-M and BRUMS24 (median effect size 0.585 vs 0.245 and 0.42, respectively), although there is little difference between the three mood scales for test discrimination, <i>delta<sub>G</sub></i>. Mood changes in response to treatment did not appear to be greatly affected by personality type, attitude or whether acupuncture had been found helpful in the past. However, those with a more positive view of life tended to report benefits from past acupuncture treatment. There was a degree of agreement between response style (RS) for different questionnaires, and also a tendency for extreme RS and Shannon entropy (SE) to be positively correlated, but there does not seem to be a ‘Shannon entropy response style’ across different questionnaires. Furthermore, the standard deviation of responses (SD) – a standardised measure of variance – also correlated strongly with MRS, ERS and SE, although clearly these all represent different constructs. Further results, together with the questionnaires and secondary measures used and a full analysis, are reported at http://electroacupuncture.qeeg.co.uk/mood3.<br><br><i>Conclusions</i><br>Despite problems with missing data, the multiple mood change Likert scale (MMCL) introduced here shows acceptable validity, internal consistency and sensitivity when compared to existing scales used to assess mood changes. Disappointingly, interactions between several measures of personality, attitude and the helpfulness of prior acupuncture with the MMCL were not particularly revealing; further research using different personality and outcome measures is indicated. In contrast, secondary measures used – response style (RS), responsiveness and Shannon entropy (SE) – were all of potential interest to anyone using questionnaires in research.