J Occup Rehabil (2016) 26:32–44 DOI 10.1007/s10926-015-9619-9
Measuring the Virtues and Character Traits of Rehabilitation Clients: The Adapted Inventory of Virtues and Strengths Jeong Han Kim1 • Christine A. Reid1 • Brian McMahon1 • Rene Gonzalez2 Dong Hun Lee3 • Phillip Keck4
Published online: 5 January 2016 Springer Science+Business Media New York 2015
Abstract Purpose To develop the Adapted Inventory of Virtues and Strengths (AIVS), a measure of rehabilitation clients’ virtues and character traits. Methods Test items were devised through a multi-step procedure, and exploratory factor analysis was employed to derive the factor structure of the AIVS. Item-total correlation and internal consistency (Cronbach’s a) were examined to test reliability of the AIVS. Results AIVS subscales include Emotional Transcendence, Practical Wisdom, Integrity, Courage, and Commitment to Action. Construct validity of this measure was evaluated by correlating AIVS factors with measures of resilience, life satisfaction, and four types of well-being: physical, psychological, financial, and family and social well-being. AIVS subscales of Emotional Transcendence and Commitment to Action were moderately correlated with life satisfaction and three well-being areas, including family and social, physical, and psychological life. Most of the correlation coefficients between AIVS Practical Wisdom, Courage and Integrity factors and measures of life satisfaction and well-being fell below r = .3. However, greater correlations were found between
& Jeong Han Kim [email protected]
& Dong Hun Lee [email protected]
Department of Rehabilitation Counseling, Virginia Commonwealth University, Richmond, VA, USA
School of Rehabilitation Services and Counseling, The University of Texas Rio Grande Valley, Edinburg, TX, USA
Department of Education, Sungkyunkwan University, Seoul, South Korea
Pain Medicine Associates PC, Johnson City, TN, USA
all AIVS factors and resilience. Reliability information was examined through internal consistency (coefficient alpha) for each AIVS subscale, as well as examination of itemtotal correlation analysis within each subscale. Internal consistency estimates for AIVS subscales ranged from .77 to .84. Conclusion The AIVS is a reliable measure when used with the studied sample; implications for studying virtue and character strengths in rehabilitation, as well as potential for clinical use of the AIVS, are addressed. Keywords Virtues and character strengths Resilience Disability Positive psychology Psychosocial adaptation
Introduction The concept of virtue has received increasing attention in rehabilitation research, focused on how one’s virtuous pursuit of excellence improves well-being. The construct of virtue appeared often in early psychological literature. Unfortunately, the construct was viewed non-measurable and it quickly met its demise with the rise of empiricism in modern psychology. However, attention to virtue was rekindled with the emergence of positive psychology [1, 2]. Virtue in positive psychology is viewed as a behaviororiented term, when compared to values, in the respect that virtue emphasizes the practice of one’s value in everyday life, whereas values is an outlook or viewpoint that does not necessarily determine one’s behavior. Virtue begins with a value which is accompanied by a commitment to demonstrable action to implement and exercise that value in one’s everyday life . Briefly stated, a person diligently continues to put his/her values into action in order to live virtuously. Virtue theorists insist that there is no virtue without action . The persistence and diligence with
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which a person practices one’s virtue is manifested in one’s behavior, so called as character strengths, which are considered as measurable in modern psychology [3, 4], thus character strength is a behavioral indicator of one’s virtue. For example, an individual who pursues the virtue of wisdom develops character strengths such as openness, love of learning, and curiosity. In 2004, Peterson and Seligman published a book entitled, Virtues and Character Strengths: A Handbook and Classification. They highlighted the importance of virtue and character strengths in terms of life thriving and well-being, and provided a classification system. To stimulate more empirical investigation, they proposed definitions for virtues and character strengths based on the systemic review of literature in several disciplines. The classification system included six virtues and 24 corresponding character strengths including: (1) wisdom and knowledge (creativity, curiosity, judgment, love of learning, perspective); (2) courage (bravery, perseverance, honesty, zest); (3) humanity (love, kindness, social intelligence); (4) justice (teamwork, fairness, leadership); (5) temperance (forgiveness, humility, prudence, self-regulation); and (6) transcendence (appreciation of beauty and excellence, gratitude, hope, humor, spirituality). This system provides a framework for empirical investigation of these constructs on such topics as (examples only): • •
youth development (i.e. nurturing positive character strengths for children and adolescents ); and cross-cultural validation of the importance ranking of virtue and character strengths (i.e. humor is highly ranked in western culture; modesty in highly ranked in eastern culture [6–8].
Furthermore, character strengths most relevant to lifethriving and well-being were identified. According to Park, Peterson and Seligman , character strengths of hope, zest, love, gratitude, and curiosity were found to relate substantially to life satisfaction and well-being. Another line of study was initiated to understand the relationship between character strengths and recovery from illness. In 2006, Peterson, Park and Seligman  reported that appreciation of beauty, bravery, curiosity, fairness, forgiveness, gratitude, humor, kindness, love of learning, and spirituality were most prominent among individuals who had recovered from a serious illness, in comparison to those who had never experienced a serious illness. This finding appeals to the field of rehabilitation counseling and rehabilitation psychology because it speaks directly to an approach which may facilitate psychosocial adjustment—a primary goal of all rehabilitation endeavors. Although the contributions of positive psychologists were appreciated and acclaimed, there are some opponents who placed a cautionary note in the application of positive psychologists’
views about virtue and character strengths, summarized in the following section. Issues in Theory and Measurement A theory defines a construct and allows a researcher to conceptualize and operationalize the construct, further enabling empirical research. Broadly speaking with regards to the theories of virtue and character strengths, there exist two main approaches : the small v perspective and the capital V perspective. The small v virtue perspective views character strengths as independent . The major inquiry in this perspective is the identification of character strengths more salient in a certain life domain in order to suggest the development of those strengths. For example, hope, zest, love, gratitude, and curiosity are most relevant to life satisfaction and happiness , and it suggests the development and utilization of these strengths to help an individual experience better life satisfaction or happiness. In capital V virtue perspective, character strengths are viewed as interdependent, and research focused on explicating dynamic process in which character strengths interplay to produce best situational outcome—e.g., psychosocial adaptation to CID in rehabilitation context. In capital V perspective, a strengths in a certain context may not be a strengths in a different situation. For example, spirituality is important in one’s religious life, however too much reliance on a certain religion or folk remedies may not be ideal in the context of rehabilitation. Thus, the question in rehabilitation study becomes, which combinations of character strengths exercised in which manner will hasten the achievement of a positive psychosocial adaptation to CID? A major advantage of the small v virtue perspective is that it allows for the scientific investigation of each character strength individually. Nurturing specific socially valued character strengths was known to positively affect well-being in the aforementioned youth development studies . However, this perspective does not necessarily attempt to explain how and in what manner the use of character strengths would produce the best situational results. For example, it is not ideal for someone to always be social without considering the emotions of others. Conversely, the capital V virtue perspective emphasizes that character strengths are not independent of another. Therefore, socialization can be tempered by practical wisdom to achieve the best and safest possible outcome. For capital V researchers, determining and judiciously utilizing the best combination of strengths to adapt to CID becomes the primary purpose of inquiry. Again, the small v virtue perspective helps us understand how a specific character strength may be more prominent in a certain life domain, while the capital V virtue perspective helps us
understand the development and proper integration of character strengths to navigate and manage challenging life situations, such as CID. These two perspectives are not necessarily contradictory but rather may be complementary . For the small v virtue perspective, Peterson and Seligman  developed an instrument to measure character strengths known as the Values in Action Inventory of Strengths (VIA-IS). It consists of 24 subscales of character strengths, and allows for the identification of five signature character strengths. There are 10 items per character strength for a total of 240 items. The VIA-IS uses a Likert scale and typically requires 40–50 min to complete. Internal measures for the subscales are considered to be acceptable. The VIA-IS has also been translated into several different languages and is commonly used in studies of youth development, life-thriving, and well-being. While there are benefits to using the VIA-IS, there are some limitations to the VIA-IS as a tool for working with people who have CID. First, although VIA-IS attempts to assess one’s character strengths globally, extant VIA-IS norms do not include people with CID, thus limiting the instrument’s applicability for the population served by rehabilitation professionals . The definitions of character strengths introduced by Peterson & Seligman  that were used to develop the test items may also be distinctly unique from those used by individuals adjusting to CID . Virtue and character strengths are a learned disposition and develop in one’s frame of reference throughout their lives. Since CID includes a wide spectrum of conditions that are attributed to many causes and manifested in a wide range of symptoms and functional limitations, the definitions of virtues and character strengths may be inherently different from those of other populations. Second, the time required for administration may not be feasible for many individuals with a severe CID . For example, people with severe disabilities, such as a spinal cord injury, may find the 240-item survey too long and strenuous to provide accurate self-report. Third, the results of the VIA-IS allow the client to identify his/her top five signature character strengths, and clinicians may use the results to develop a strengthsbased intervention plan . However, VIA-IS does not offer recommendations for the application of the identified strengths to the understanding of psychosocial adaptation to CID, and thus implementation of strengths-based practice is often up to a clinician’s decision or expertise. As noted above in the case of spirituality, having a certain strengths does not necessarily mean that an individual is able to use it properly in a different situation. With this being said, relatively less has been achieved in the development of measures that assess virtues from the capital V virtue perspective, and the development of such a measure was the main purpose of this study.
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Specific Aims of the Study The field of rehabilitation is in need of an instrument to measure a rehabilitation client’s virtue and character strengths based on the capital V virtue perspective to guide the practitioner on how an individual may use their strengths in terms of psychosocial adaptation to CID. The capital V virtue perspective emphasizes the importance of understanding interactions between character strengths relative to CID. When used in conjunction with VIA-IS, a measure based on the small v virtue perspective, it can provide further insight into character strengths developed over one’s life span and further point to how character strengths can be utilized to facilitate adjustment to CID . The specific aims of the current study are listed below. 1.
2. 3. 4.
To construct a psychometrically sound instrument to measure rehabilitation clients’ virtuous effort to better navigate CID (the Adapted Inventory of Virtue and Strengths, a measure constructed from the capital V virtue perspective). To identify underlying virtue factors of the AIVS. To establish psychometric information and soundness of the AIVS. To provide suggestions and implications in order to guide rehabilitation professionals’ clinical use of the AIVS.
Methodology Item Development Authors of this study used a semantic differential scale format for AIVS items, in part to address the physical stamina issues some people with severe CID may experience. A semantic differential scale format arranges two opposing adjectives or phrases, and asks people to intuitively locate their feelings and thoughts between the two extremes. There are three major advantages of using a semantic differential scale. First, as compared to a Likert scale, it requires relatively fewer items to acquire a certain level of reliability, thus reducing the total number of items . Second, because the semantic differential scale asks for one’s intuitive response to the testing items, it can reduce administration time. Third, it allows room to thoughtfully address potentially different meanings of character strengths held by people with CID. Forth, according to Friborg, Martinussen, and Rosenvinge’s study conducted in 2006 , semantic differential is better in terms of reducing acquiescence bias in measuring positive construct such as resilience and psychosocial adaptation.
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Several research teams were organized to develop an initial item pool. Educational sessions were provided to introduce the guiding theory (the classification of character strengths that provides the definitions of virtues and character strengths ). This classification theory was selected for two reasons. First, it built upon the very few definitional studies of virtue and character strengths that have been completed. Second, the purpose of the study is to develop a measure from the capital V virtue perspective that can be used in conjunction with the VIA-IS to complement the limitations of VIA-IS, especially in terms of clinical utility to guide contextual and integrative use of clients strengths to cope with CID. The description of how two measures can be used together in the context of rehabilitation is further explained within the discussion section of this paper. After the educational sessions, research teams devised 385 adjectives and 270 corresponding antonyms utilizing previous research, dictionaries and thesauri. When it became difficult to uncover a single adjective that best described a particular meaning of a character strength, the team constructed a short phrase. After initial item development, six research teams carefully reviewed the initially devised adjectives and phrases. Based on their review of how well the adjectives/phrases described a particular meaning of character strength, items were rated on a scale ranging from (1) not at all to (5) excellent. Items averaging less than 3 were eliminated from further consideration. In the next phase, other review teams were asked to compare opposing antonyms/phrases for each adjective and rate the antonyms/opposing phrases based on how well the pair of adjectives/phrases described the definition of the character strength by using the same 5-point rating scale, resulting in 64 pairs. Subsequently, the 64-item pairs were randomly presented to a five-person expert panel whose qualifications included (1) having at least one or more publications in the area of positive psychology or (2) having served as dissertation chair or committee member in a relevant area. This panel classified the 64 testing items according to the original classification of character strengths presented in the Peterson and Seligman’s 2004 Classification Theory . For example, the item of ‘‘scholarly–unscholarly’’ was constructed to measure the character strengths for ‘‘love of learning’’ in the classification theory, and the researchers tested whether the experts were able to sort this item into the ‘‘love of learning’’ category. A total of 49 items were successfully classified and the remaining items were revised following the experts’ suggestions.
Research Participants To recruit college students with disabilities to participate in this study, a listing of universities posted to the website www.disabilityfriendlycolleges.com was consulted. Among the 75 post-secondary institutions listed on this site, 31 were identified as universities which ‘‘go beyond’’ requirements mandated by Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA). Those 31 institutions were contacted with a request to disseminate to their students with disabilities an invitation to participate in the study. Of these 31 post-secondary institutions contacted, 10 elected to participate in this study via their Offices of Disability Support Services. After the research protocol was reviewed and approved by Ball State University’s Institutional Review Board (IRB), student participants were recruited from these institutions and informed consent was obtained from all individual participants included in the study. A total of 327 students with CID participated. After data cleaning, responses from 256 students with CID were retained for further analysis. The inclusion criteria were: (a) having a chronic illness or disability (excluding students whose primary disability was psychiatric), and (b) being greater than 18 years of age. Staff members from the participating universities took the responsibility of constructing a listserv to disseminate information about the survey. Instrumentation For the purpose of construction and validation of the AIVS, measures of life satisfaction, resilience and well-being were also administered to the participants, as well as a demographic questionnaire. The description of each measure is provided below. Demographic Questionnaire The demographic information surveyed in this study included: age, gender, race, student status (freshmen, sophomore, etc.), type of disability, mental or emotional reactions to CID, onset of disability, and governmental benefits status. Adapted Inventory of Virtue and Strengths (AIVS) The AIVS is a newly constructed instrument to measures an individual’s virtues in the context of psychosocial adaptation to CID, as reflected in one’s character strengths. The item pool includes a total of 64 adjective pairs that describe the meaning of a certain character strength.
Satisfaction with Life Scale (SWLS) SWLS  is a Likert scale measuring life satisfaction. Rating scores range from 5 to 35 with higher scores indicating higher life satisfaction. Reported alphas from previous studies fall between .79 and .89, showing good internal consistency. Test–retest reliability coefficients fall between .54 and .84 . Van Beuningen  tested SWLS’ convergent validity and the results show that SWLS is significantly related to alternative global life satisfaction. Connor-Davidson Resilience Scale (CD-RISC) The CD-RISC measures resilience; the preliminary validation study demonstrated high internal consistency and validity . It contains 25 items based on a 5-point frequency rating scale: not true at all (0); rarely true (1); sometimes true (2); often true (3); and true nearly all of the time (4). The responses are based on how the respondent has felt over the past month. The total score ranges from 0 to 100 with higher scores reflecting greater resilience. Internal consistency using Cronbach’s alpha is .89 for the general population. Sense of Well-Being-Revised (SWBI-R) The original SWBI was developed by Rubin, Chan, Bishop and Miller  in order to define the construct of wellbeing for clients in vocational rehabilitation; the scale was revised by Catalano et al. in . The revised version consists of 20 items, using a 4-point frequency rating scale (1: strongly disagree; 2: disagree; 3: agree; 4: strongly agree). The SWBI-R is composed of four subscales including: (1) Physical Well-Being, (2) Psychological Well-Being, (3) Financial Well-Being, and (4) Family and Social Well-Being. The reported alphas from Catalano’s 2010 study, measured based on internal consistency, were .81, .82, .81, and .85, respectively.
Analyses A series of statistical analyses including descriptive analysis, exploratory factor analysis (EFA), item-total correlation, correlation analyses between measures, and regression analysis were used to test the validity and reliability of AIVS. The purpose and results of these analyses are discussed below.
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Although students with primarily psychiatric disabilities were excluded from the sample, when participants were asked about their emotional responses to CID, 53.1 % of participants reported that they have experienced depression, low self-esteem, mood swings, and/or anxiety. The prevalence of CIDs and functional limitations reported by the participants is presented in Table 1. Exploratory Factor Analysis (EFA) After developing the initial item-pool for the AIVS, EFA was employed to explore its underlying factor structure. Two types of factor analyses are commonly used in the development of a new measure. One type is the EFA and the other is the confirmatory factor analysis (CFA); both are powerful statistical procedure. EFA is more often used to explore the possible underlying factor structure whereas while CFA is used to verify the factor structure of a set of observed variables. Accordingly, the CFA requires a researcher to use theoretical knowledge, empirical research, or both to postulate the relationship . Psychosocial adaptation to CID from a virtue perspective is an emerging area of study and there is limited knowledge to establish a strong theory-driven relationship between variables. Thus, the current study used the EFA approach. Assessing the degree to which the obtained data satisfied assumptions necessary for EFA, the Kaiser–Meyer–Olkin (KMO) statistics result in a sampling adequacy measurement of .864 (greater than .50), and the Bartlett test of sphericity indicated that it was appropriate to proceed with the EFA, v2 (df = 1891, n = 256) = 7254.468, p \ .001. Results of the factor analysis suggested that a five factor solution was most appropriate. Cattell’s scree test showed an ‘‘elbow’’ in the percentage of variance accounted for by successive factors at the five factor point; eigenvalues for those five factors were 13.095, 4.468, 3.126, 2.918, and 2.041. Promax rotation was used because the factors are moderately or highly correlated with each other (both statistically and theoretically). The resulting five-factor solution accounted for 41.37 % of the total variance. To interpret the factors and assess whether the five factor solution was sufficiently parsimonious and interpretable, factor loadings were examined. Only items with a factor loading of .3 or greater, but which did not load on any other factor at .3 or greater, were retained, thereby reducing the initial 64 items to 46 items retained. The pattern matrix is presented in Table 2. Factors were named based on interpretation of the sets of items associated with each factor.
Descriptive Statistics Factor 1: Emotional Transcendence The majority of student participants were female (66.4 %) and white non-Hispanic (85.2 %). Most participants (54.3 %) reported that their disabilities were congenital.
This factor, labeled Emotional Transcendence, consists of twelve items designed to measure character strengths of
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Table 1 Descriptive Statistics for Participants (n = 256) Characteristics
Table 1 continued
Race White (non-Hispanic)
Black or African American
American Indian/Alaska Native
Onset of Disability Congenital
Work skills Communication
Physical (not specified)
‘‘religious, spiritual, thankful, grateful, optimistic, enthusiastic, energetic, forgiving, caring, affectionate, loving, believing life has meaning, and admiring beauty’’. The underlying theme of this set of character strengths seem to reflect one’s ability to transcend emotional experiences related to a life situation. The reported alpha of Emotional Transcendence is .84 indicating good internal consistency. Factor 2: Practical Wisdom Factor 2, labeled Practical Wisdom, includes eleven test items designed to measure character strengths of ‘‘openminded, receptive to new ideas, curious, inventive, creative, valuing equality, unbiased, light-hearted, playful, humorous, and funny.’’ The underlying theme for this set of character strengths reflects one’s ability to make situational decisions (i.e. demonstrate practical wisdom). Basically, the test items emphasize one’s disposition to be open and curious towards acquiring new knowledge and using knowledge inventively and creatively with fairness and humor in mind. Thus, what is reflected is well aligned with the definition of practical wisdom: one’s cognitive strengths that entail the acquisition and use of knowledge in the context of a given situation, such as CID . The reported alpha of Practical Wisdom factor is .78, indicating acceptable reliability.
Factor 3: Integrity
Emotional responses to CID Yes
Types of CID Not reported
Factor 3 includes eleven test items designed to measure character strengths of ‘‘careful, cautious, prudent, sensible, self-controlled, loyal, honest, trustworthy, modest, humble, and fair.’’ All items seem to be very relevant to integrity and one’s ability to develop strong and healthy interpersonal relationships . Thus, this factor was labeled Integrity, and the reported alpha coefficient is .78, indicating acceptable reliability. Factor 4: Courage Factor 4 includes only five items designed to measure character strengths of ‘‘commanding, leading, bold,
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Table 2 Rotated matrix (principal axis factoring; Promax with Kaiser normalization) Item
Factor 1 (emotional transcendence, a = .844, n = 12) Believing life has meaning–Believing life is meaningless
Admiring beauty–disregarding beauty
Factor 2 (practical wisdom, a = .784, n = 11) Openmindedness–closeminded
Receptive to new ideas–unreceptive to new ideas
Factor 3 (integrity, a = .784, n = 11) Careful–careless Honest–dishonest
Factor 4 (courage, a = .77, n = 5) Commanding–submissive
Factor 5 (commitment to action, a = .78, n = 7) Scholarly–unscholarly
Persistent–giving up easily
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Table 2 continued Item
Appreciating excellence–disregarding excellence
courageous, and brave.’’ The underlying theme for this factor appears to be very relevant to one’s courage when facing uncertainty after the onset of CID. The reported alpha of Courage factor is .77, indicating acceptable reliability. Factor 5: Commitment to Action Factor 5 includes 7 test items designed to measure character strengths of: scholarly, persevering, persistent, hardworking, appreciating excellence, and self-disciplined.’’ Virtue means that people must pursue their values and excellence in everyday life; the underlying theme for this factor seems to exactly emphasize consistent forward movement and goal directed action. This factor was labeled Commitment to Action and the reported alpha is .78, indicating acceptable reliability. Reliability Analyses In order to improve reliability of the AIVS, item-total correlations were inspected in conjunction with analysis of the AIVS’ internal consistency. The former analysis was conducted to identify which items could be considered significantly different from other items in terms of their measurement of the construct. A decision rule was established for deleting any items with negative item-total correlations, and carefully examining for possible deletion any items with item-total correlations under r = .3. None of AIVS items had an item-total correlation below r = .3, so all of the 46 items were retained. The reported reliabilities of AIVS subscales measured in terms of internal consistency were .84 (Emotional Transcendence), .78 (Practical Wisdom), .78 (Integrity), .77 (Courage), and .78 (Commitment to Action). Item-total correlations and internal consistency reliability estimates are presented in Table 3. Validity Several methodological steps were established to examine validity of the AIVS to assess virtues with a population of people with CID. First, three devices were used to address both content validity and face validity: (1) providing orientation sessions for item writers (introducing them to Seligman & Peterson’s theory of virtue and character
strengths and associated definitions); (2) organizing itempool development teams to discuss and provide feedback about item development; and (3) using item review panels. Content validity is concerned with whether the measure covers all dimensions of the construct . Both the item development and the item review phases focused on ensuring accurate sampling of the relevant content domain with relevant items. The item review and categorization phase using expert panelists was conducted by panel members who met pre-established qualification criteria (previous publication related to positive psychology, and service as a dissertation committee member for a dissertation related to positive psychology). In the item development and review phases, item writers and panelists also paid attention to face validity (whether or not the items look like they are measuring what they are supposed to measure), because that can influence the degree to which people using the AIVS take it seriously. In addition, construct validity was examined by correlating AIVS subscales (as derived through EFA) with measures of life satisfaction; resilience; and well-being in the areas of physical, family, social, psychological, and financial well-being. Results indicated that AIVS subscales of Emotional Transcendence and Commitment to Action are moderately and statistically significantly correlated to the life satisfaction and SWBI’s physical, psychological, and family and social well-being subscales. In addition, moderate and statistically significant correlations were also found between AIVS’ Integrity factor and SWBI’s family and social wellbeing. None of correlations between subscales of the AIVS and SWBI’s financial well-being subscale were over .3. Table 4 below presents a summary of correlations. The results of correlation analysis between AIVS subscales and the CD-RISC produced correlations ranging from .37 to .69, indicating moderate to high correlation. Although AIVS factors were rotated in a manner that allowed correlation between factors, the relatively low correlation between some of those factors (e.g., r = .03 between Integrity and Courage) supports the conclusion that virtue is not a unidimensional construct among college students with CID. Tables 4 and 5 below presents a summary of correlation analyses between factors of the AIVS and other comparison measures. Finally, criterion-related validity of the AIVS was tested by employing simultaneous multiple regression analysis to
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Table 3 Item-total correlation of AIVS factors
Table 3 continued
Factor and item-total correlation
Factor and item-total correlation
(a = .84)
Believing life has meaning
(a = .78)
Commitment to action
(a = .78)
(a = .78)
Unbiased Receptive to new ideas
(a = .77)
examine its relationship to a measure of resilience. The means, standard deviations, and intercorrelations can be found in Table 4. The combination of AIVS virtue factors to predict one’s resilience was statistically significant, F (5, 250) = 80.156, p \ .00. The beta coefficients are presented in Table 5, showing that the Emotional Transcendence, Courage, and Commitment to Action factors significantly predict one’s resilience. The adjusted R2 value was .608. This indicates that almost 61 % of the variance in one’s resilience is explained by this model. According to Cohen , this is a large effect (Table 6).
Discussion The Adapted Inventory of Virtues and Strengths (AIVS) was constructed to better understand how people with CID use their character strengths in terms of psychosocial adaptation to CID. It is important to discuss (1) the systematic procedure used in developing the AIVS in order to maximize validity and reliability for its intended purpose, (2) labeling and meaningfulness of each factor in terms of psychosocial adaptation to CID, (3) the potential of AIVS factors to enhance understanding of psychosocial adaptation to CID, (4) one unique aspect of AIVS in terms of the capital V virtue perspective, and (5) future implications regarding clinical use of the AIVS. The first goal of this current study was to construct a psychometrically sound instrument to measure rehabilitation clients’ virtues reflected in their character strengths. The two most important considerations were: (1) the systematic approach to construct a relevant test, and (2) further refinement of the measure. AIVS item development was guided by a well-respected existing theory (i.e. the classification of virtue and character strengths) and a preestablished multi-step procedure. Several review teams and expert panels were prepared to construct the best adjective pairs. These multiple and cross-peer review systems improved the quality of testing items. Expert panels reviewed the testing items in order to further address content validity of the AIVS. Exploratory factor analysis was employed to identify subscales of the AIVS; eigenvalues, a scree test, parsimony and interpretability were taken into consideration to determine the best AIVS factor solution. Several psychological measures in the area of life
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Table 4 Bivariate correlations between factors and other Scales
Commitment to action
SWLS Satisfaction with Life Scale, CDRISC Connor-Davidson Resilience Scale, SWBI Sense of WellBeing Inventory, PHY Physical well-being, PSY Psychological well-being, FIN Financial well-being; and FAM&SO Family & social well-being * p \ .05; ** p \ .01 correlation is significant at the .01 level
Table 5 Means, standard deviations, and intercorrelations for resilience and predictors variables Variables
Commitment to action
Commitment to action
Table 6 Simultaneous multiple regression analysis summary Variable
Commitment to action
R2 = .61; F(5, 250) = 80.156, p = .00 ** p \ .01
satisfaction, well-being and resilience were also included to assess construct validity of the AIVS. The results indicate that AIVS subscales are convergent with the measures of resilience, life satisfaction and well-being in physical, psychological and family and social life dimensions. All AIVS factors were highly correlated with a measure of resilience, but different patterns of correlations emerged for the relationship between AIVS factors and life satisfaction, and well- being in physical, psychological, and family and social life areas. Comparatively low correlations between AIVS factors and a measure of financial well-being in this sample may be related to the restricted range of economic status of college students with CID.
Item-total correlation analysis in conjunction with internal consistency were examined to evaluate the reliability of AIVS, and the results indicate that there are no items with item-total correlation below r = .3. Reported coefficient alphas for AIVS subscales were between .77 and .84, indicating acceptable ranges of reliability. Labeling of each factor from the EFA was challenging, and required consideration of theoretical aspects of virtue and associated character strengths. The first virtue factor was labeled as Emotional Transcendence, and includes 12 testing items. Psychosocial adjustment is the status in which an individual is in the process of adaptation, dealing with awareness and acceptance of the CID. Transcendence implies that an individual has forged past traditional limitations associated with disability and developed a new positive identity that incorporates CID as part of self—the selfconcept that has become transcendent . According to Egnew , experiencing the threat of CID can be relieved through the development of a sense of wholeness. This sense of wholeness involves one’s physical, mental, emotional, social, and spiritual aspects. It is perhaps one’s holistic nature that ultimately allows one to transcend the limits imposed by CID, including societally-imposed barriers. All character strengths testing items associated with this virtue factor (believing life has meaning, religious, spiritual, thankful, grateful, optimistic, enthusiastic,
energetic, forgiving, caring, affectionate, loving, and admiring beauty) seem to be very relevant to the pursuit of virtue and the ability to transcend CID in a positive and constructive manner. The second virtue factor was labeled Practical Wisdom. Practical wisdom in virtue theory is associated with cognitive ability that is used to derive the best situational decision . The onset of CID may bring unexpected challenges to an individual as the ramifications of CID are felt in many aspects of one’s life. How an individual copes with these challenges always remains situational. Ideally, one should be able to see the context of CID in one’s life objectively, and realize the need to analyze and utilize existing strengths. People with CID may also see the importance of obtaining new knowledge in order to navigate the prognosis of CID. Most of the character strengths testing items related to this factor (open-minded, inventive, creative, valuing equality, lighthearted, curious, playful, unbiased, receptive to new ideas, humorous, and funny) seem to be very relevant to one’s adjustment to CID, especially when fully engaging in the rehabilitation experience. The third virtue factor was labeled Integrity. Virtue theory states that the nature of virtue is communal , and emphasizes the pursuit of a socially and communally valued virtue. As such, community reinforcement promotes one’s constant intrinsic motivation. Integrity is also very highly associated with community participation, an important component of the biopsychosocial model of disability. All eleven character strengths testing items (careful, cautious, prudent, sensible, self-controlled, loyal, honest, trustworthy, modest, humble, fair) seem to be very relevant to the communal and interpersonal aspects as well as consistent with the independent living principles which underlie all rehabilitation endeavors. The fourth virtue factor was labeled Courage. Courage in the study of psychosocial adaptation to CID is often viewed as an initiating agent to face the uncertainty after the onset of CID. Fear-avoidance is highly associated with fear of pain, resulting in depression, anxiety and social isolation . Disability can bring about a moratorium on expectations, accompanied by financial disincentives to work. These become very seductive and lead to ‘‘illness behavior’’ and ‘‘disability as a career.’’ It requires considerable courage to detach oneself from these trappings and to confront the effort, time and expense of resuming a rigorous regimen of rehabilitation and responsibility. Virtue theory also states that courage is an important agent to consistently initiate actions to cope with the unpredictably of changing life circumstances . All character strengths testing items of character strengths in this factor (commanding, leading, bold, courageous and brave) appear to be very relevant to
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one’s courage and the initiation of the committed action required for rehabilitation. The fifth virtue factor included seven character strengths testing items (scholarly, persevering, persistent, hardworking, appreciating excellence, and self-disciplined) and was labeled Commitment to Action. Three important words to describe virtue are consistency, action, and excellence, because virtue is defined as one’s constant pursuit of excellence [2, 4]. This definition simply implies that this pursuit is manifest in one’s behavior (e.g., honest action). It is action that converts values to virtues. Through our activities of daily living, virtue can grow or strengthen as a habitual component of one’s character that represents who he/she is. Virtue ethics state there is no virtue without action. The seven test items in the fifth factor seem to be very relevant to one’s constant pursuit of Commitment to Action which is, in turn, imperative for psychosocial adjustment to CID. The role of each factor for understanding psychosocial adaptation to CID warrants future study. The highest correlation observed involved the AIVS and CD-RISC: 61 % of the variance in resilience is predicted from the combined effects of AIVS factors. Among those, three factors (Emotional Transcendence, Commitment to Action, Courage) are most significant contributors to the model. Based on Richardson’s resilience theory , current trends in resilience study seek to discover the force that drives a person toward self-actualization and reintegration after disruption, thus emphasizing the importance of motivational forces that promote one’s constant effort. These three big contributors—(Emotional Transcendence, Commitment to Action, and Courage) appear to merit consideration as key components to any serious discussion of psychosocial adaptation to CID, particularly for practitioners of positive psychology. The AIVS is a measure that allows for the assessment of rehabilitation clients’ virtues as they are reflected in one’s character strengths in the context of rehabilitation. AIVS items to measure character strengths were constructed based on the classification theory that was used to develop the VIA-IS. However, contrary to the assumption underlying the VIA-IS and the ‘‘small v’’ virtue perspective, correlational results indicated that these strengths are correlated, supporting the capital V virtue perspective. This aspect of the AVIS, which allows one’s strengths to be related to each other, is a unique aspect that facilitates its complementary use to complement the VIA-IS. A strong feature of the VIA-IS is that it identifies five signature strengths; and these character strengths can be incorporated into the development of strengths-based practices that have long been discussed in rehabilitation literature. According to Rapp, Saleebey and Sullivan , six standards that constitute strengths-based practice are:
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(1) goal orientation, (2) strengths assessment, (3) resources from the environment, (4) explicit methods to identify client and environmental strengths for goal attainment, (5) hope-inducing relationship, and (6) meaningful choice. The VIA-IS is a great tool that allows for the assessment of one’s individual character strengths; however, it does not explain how rehabilitation clients should use their character strengths in terms of goal orientation and hope-inducing relationship, especially in terms of psychosocial adaptaion to CID. Instead, it relies heavily on the therapist’s clinical expertise. For example, VIA-IS can tell us what strengths an individual posses; however, it does not offer any suggestion in terms of how to integrate and utilize the strengths to deal with CID. It often relies on the practioner’s clinical experience. AVIS, instead, restructures the classification of virtues and character strengths, and provides an insight in terms of how one’s character strengths can be utilized in terms of five virtue aspects (Emotional Transcendence, Practical Wisdom, Commitment to Action, Integrity, and Courage). It is the unique clinical utility of AIVS, and it is better aligned with the standards of strengths-based practice. For example, the strengths that comprise the Practical Wisdom factor highlight one’s capacity to make the best situationally meaningful decisions toward psychosocial adaptation to CID, which is one of the ultimate goals of rehabilitation. The strengths under Courage and Commitment to Action factor highlight one’s courageousness and constant goalattaining commitment to achieve psychosocial adaptation to CID from a virtuous living manner. The Integrity factor requires strengths in all matters related to one’s social and interpersonal relationship. The strengths under the Emotional Transcendence factor emphasize the importance of emotional and spiritual cultivation to continue to pursue virtuously living with CID. For example, based on VIA-IS, character strengths of spirituality and hope are only related to transcendence, love relates to humanity, zest relates to courage, and forgiveness relates to temperance. While these character strengths stand alone in the VIA-IS, in the AIVS, the interplaying relationship of these character strengths can be emphasized and encouraged as a part of Emotional Transcendence to facilitate one’s adjustment to CID. Thus, the AIVS promotes contextual understanding and utilization of one’s virtues and character strengths in terms of psychosocial adaptation to CID. This is how AIVS facilitates the utilization of character strengths in terms of capital V perspective and is well suited to the rehabilitation context, particularly regarding one’s psychosocial adaptation to CID from a virtue perspective. Going forward, the clinical utility of the AIVS will need to be further explored based on the type of CID, rehabilitation contexts (resilience, coping, disability acceptance, peer relations, vocational outcomes), and sample populations (cross-
validation in another similar sample, as well as different samples such as children, adolescents, elderly, males vs. females, etc.). Diversity issues can also be addressed by investigating application of AIVS virtue subscales in multicultural settings. The AIVS is a measure constructed from a capital V virtue perspective, and assists both clients and clinicians to better understand how one’s character strengths can be integrated to promote one’s virtuous efforts to adjust to CID. When it is used in conjunction with VIA-IS, AIVS adds unique clinical utility indicating that the utilization of one’s strengths goes beyond the possession of certain strengths. The AIVS is a promising measure of one’s virtues and character strengths in rehabilitation study, and currently available in three different languages (English, Korean, and Spanish). However, it is a relatively new psychological instrument that requires further validation with various norming populations. Further translation and study of the equivalence of various translations is another area needing attention. Also, future research warrants in terms of examining interrelationship between AIVS’ five virtue factors. For example, developing profiles that look into how possessing different patterns of the five virtues results in different challenges and different clinical approaches. In the meantime, this article is an effort to familiarize clinicians with the current status of the AIVS in terms of its development and clinical utility. Acknowledgments We gratefully acknowledge the input and advice from all Testing Item Review Panel participants (Drs. Fong Chan, University of Wisconsin-Madison; Denise Catalano, University of North Texas; Blain Fowers, University of Miami). Their knowledge, insight, perspective and suggestions allowed us to develop the Adapted Inventory of Virtues and Strengths (AIVS).
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