Development of a brief scale to assess frequency of symptoms and problems associated with tanning.

Some university students are at risk to display tanning behaviors analogous to drug use behaviors (e.g., continuing to tan despite negative consequences, tanning beyond what is necessary to achieve their desired appearance).1,2 Screeners1,2 and structured interviews3 help identify those who may be dependent on tanning. Additionally, researchers and clinicians may find useful a measure that assesses frequency of symptoms and psychosocial consequences of tanning. We assessed the psychometric properties of a tanning adaptation of the Short-Rutgers Alcohol Problem Index (S-RAPI).4 We chose the S-RAPI given the similarities between problematic tanning and other addictions,1,2 and the strong psychometric properties of the S-RAPI among university students.4 The Tanning Problems Index (TPI) included 11 items characterizing potential problems associated with past-year tanning (Table 1 includes items, scale anchors, and response distributions). We removed five of the S-RAPI’s 16 items because they were irrelevant to tanning (see Table 1 footnote). Following Institutional Review Board approval, 414 students from a large Midwestern university who reported indoor/outdoor tanning were administered online questionnaires to assess various characteristics (Table 2). Table 1 N (%) by response option on items of the Tanning Problem Index Table 2 Summary of demographic and tanning-related characteristics The TPI showed good internal consistency (α = .86). Overall, we found that 9–29% of students across items (Table 1) reported a problem at least once in the past year. In support of construct validity, those screening positive for tanning dependence on the Tanning-DSM (M = 5.6, SD = 5.6) had significantly higher TPI scores than those screening negative (M = 1.4, SD = 2.9), t(412) = −9.92, p < .001. In support of criterion validity, higher TPI scores were associated with more frequent past-month tanning, r(412) = .36, p < .001, more money spent on tanning r(409) = .41, p < .001, greater perceived difficulty to stop tanning, r(410) = .55, p < .001, and less frequent use of sunscreen, r(410) = −.15, p = .003. In a regression analysis with past-month tanning frequency as a dependent variable and TPI scores and Tanning-DSM scores as independent variables, TPI scores remained significant (β = .14, p < .005) when controlling for the variance explained by Tanning-DSM scores (β = .44, p < .001), overall F(2,418) = 81.65, p < .001, adjusted R2 = .28. This finding suggests that the TPI provides unique information from the Tanning-DSM when evaluating past-month tanning frequency. This evaluation of the TPI suggests that there exists a subset of students that experience problems associated with tanning. These findings provide initial support for the internal consistency, construct validity, and criterion validity of the TPI. This appears to be a brief, psychometrically sound instrument that clinicians could administer to assess frequency of tanning-related problems and to enhance motivation to change tanning behaviors. Future studies should replicate these findings in other samples and consider revised response options given that few participants reported the highest frequencies of these tanning-related problems. Researchers could use the TPI as an outcome measure to track the frequency of tanning-related problems. Furthermore, researchers should continue to assess the relationship between TPI and other tanning-related characteristics and psychiatric problems (e.g., substance use, anxiety disorders).5