Extreme response style bias in burn survivors

This paper explores extreme response style to the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a measure of social participation in burn survivors. We fit a Multidimensional Generalized Partial Credit Model (MGPCM) with a positive extreme response style (PERS) factor and compared this model with the original MGPCM, estimated the impact that PERS has on scores, and examined the personal characteristics that may result in an individual more likely to respond in a fashion that would inflate their true low scores. The average impact of the PERS, based upon the root mean squared bias, ranged from 0.27 to 0.50 of a standard deviation of the scale. Individuals who were older, had participated in a burn survivor support group, and had selected to self-administer the measure were less likely to have a high PERS bias that masks low scores. Future work can consider PERS when measuring the psychosocial impacts of burn injuries and other health conditions.