The Revised Mood Rhythm Instrument: A Large Multicultural Psychometric Study

Melissa Alves Braga de Oliveira, Euclides José de Mendonça Filho, Alicia Carissimi, Luciene Lima Dos Santos Garay, Marina Scop, Denise Ruschel Bandeira, Felipe Gutiérrez Carvalho, Salina Mathur, Kristina Epifano, Ana Adan, Benicio N Frey, Maria Paz Hidalgo, Melissa Alves Braga de Oliveira, Euclides José de Mendonça Filho, Alicia Carissimi, Luciene Lima Dos Santos Garay, Marina Scop, Denise Ruschel Bandeira, Felipe Gutiérrez Carvalho, Salina Mathur, Kristina Epifano, Ana Adan, Benicio N Frey, Maria Paz Hidalgo

Abstract

Background: Recent studies with the mood rhythm instrument (MRhI) have shown that the presence of recurrent daily peaks in specific mood symptoms are significantly associated with increased risk of psychiatric disorders. Using a large sample collected in Brazil, Spain, and Canada, we aimed to analyze which MRhI items maintained good psychometric properties across cultures. As a secondary aim, we used network analysis to visualize the strength of the association between the MRhI items.

Methods: Adults (n = 1275) between 18-60 years old from Spain (n = 458), Brazil (n = 415), and Canada (n = 401) completed the MRhI and the self-reporting questionnaire (SRQ-20). Psychometric analyses followed three steps: Factor analysis, item response theory, and network analysis.

Results: The factor analysis indicated the retention of three factors that grouped the MRhI items into cognitive, somatic, and affective domains. The item response theory analysis suggested the exclusion of items that displayed a significant divergence in difficulty measures between countries. Finally, the network analysis revealed a structure where sleepiness plays a central role in connecting the three domains. These psychometric analyses enabled a psychometric-based refinement of the MRhI, where the 11 items with good properties across cultures were kept in a shorter, revised MRhI version (MRhI-r).

Limitations: Participants were mainly university students and, as we did not conduct a formal clinical assessment, any potential correlations (beyond the validated SRQ) cannot be ascertained.

Conclusions: The MRhI-r is a novel tool to investigate self-perceived rhythmicity of mood-related symptoms and behaviors, with good psychometric properties across multiple cultures.

Keywords: circadian rhythms; depressive symptoms; mood disorders; mood symptoms; network analysis.

Conflict of interest statement

B.N.F. received a research grant from Pfizer, outside of this work. The remaining authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart showing the various steps in the development of the revised mood rhythm instrument (MRhI-r).
Figure 2
Figure 2
MRhI-r network. (A) Lasso (least absolute shrinkage and selection operator) correlations network containing the 11 items that compose the MRhI-r. Thicker lines represent stronger correlations. Gray lines stand for positive correlations and red lines for negatives correlations. (B) Node strength estimates (n = 1275), including bootstrapped 95% confidence intervals.
Figure 3
Figure 3
Correlations between the total sum of MRhI-r dichotomous variables (MRhI-r sum) and self-reporting questionnaire (SRQ-20) total scores (SRQ-20 score) separately for domain and country. SRQ cut-offs, which are distinct according to country, are displayed as dashed lines. Only data from participants that completed the entire SRQ were included (Spain-cognitive, n = 417; Spain-affective, n = 418; Spain-somatic, n = 419; Brazil-cognitive, n = 411; Brazil-affective, n = 412; Brazil-somatic, n = 412; Canada-cognitive, n = 367; Canada-affective, n = 367; Canada-somatic, n = 367). The significant correlations were in affective domains for all countries, in the cognitive domain for Spain, and in the somatic domain for Spain and Canada.

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