The development, validation, and feasibility of the Experienced Coercion Scale

Area of Science:

• Psychiatry
• Psychometrics
• Health Services Research

Background:

• Existing scales for measuring experienced coercion have limitations in scope and applicability.
• There is a need for a validated, brief self-report measure of coercion applicable across diverse care settings and phases.

Purpose of the Study:

• To develop and validate a short self-report scale, the Experienced Coercion Scale (ECS), for measuring patient experiences of coercion.
• To ensure the scale's utility across different care settings, phases, and measures.

Main Methods:

• Item pool development using literature, patient accounts, interviews, and expert feedback.
• Two cross-sectional studies (N=212, N=219) involving patients from inpatient, outpatient, and supported housing settings.
• Psychometric validation including item selection based on performance, correlation with the Coercion Ladder, principal component analysis, and factor analysis.

Main Results:

• The final 15-item Experienced Coercion Scale (ECS) demonstrated high internal consistency and a score distribution approaching normality.
• ECS scores correlated strongly with the Coercion Ladder.
• Legal status and involuntary medication significantly predicted ECS scores, while demographic variables, diagnosis, treatment duration, and care setting did not.

Conclusions:

• The Experienced Coercion Scale (ECS) shows promising psychometric properties for measuring experienced coercion.
• The ECS is suitable for use across various care settings and is valuable for research and service evaluation in mental health.