Exploratory Factor Analysis of the Vestibular Activities Avoidance Instrument.

Area of Science:

• Vestibular Disorders
• Behavioral Psychology
• Clinical Measurement

Background:

• Fear avoidance is a common response to dizziness, potentially leading to chronic symptoms and vestibular system maladaptation.
• Currently, no valid and reliable clinical measure exists for assessing fear avoidance in individuals experiencing dizziness.
• The original Vestibular Activities Avoidance Instrument (VAAI) was too lengthy for practical clinical application.

Purpose of the Study:

• To shorten the VAAI for clinical utility.
• To assess the internal consistency and construct validity of the revised VAAI.
• To examine the VAAI's associations with measures of disability, quality of life, and psychological well-being.

Main Methods:

• A prospective cohort study involving 404 adults with dizziness.
• Exploratory factor analysis was used to reduce the 81-item VAAI to a 9-item version (VAAI-9).
• Internal consistency (Cronbach α) and convergent validity (Spearman correlations) were assessed against established measures of activity, participation, health status, and psychological well-being.

Main Results:

• The VAAI was successfully reduced to a 9-item measure (VAAI-9).
• The VAAI-9 demonstrated excellent internal consistency (Cronbach α = 0.92).
• The VAAI-9 showed significant positive associations with disability and psychological distress, and negative associations with quality of life.

Conclusions:

• The VAAI-9 is a brief, reliable, and valid instrument for measuring fear avoidance in dizziness.
• The VAAI-9 is associated with key patient-reported outcomes, including quality of life and psychological status.
• Further validation, including test-retest reliability and external sample validation, is warranted for the VAAI-9.