The Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F): Factorial Validity and Reliability in a US Sample

Context. Death anxiety has been hypothesized to be a transdiagnostic construct, meaning that the fear of death may increase one's vulnerability to the development or maintenance of a number of psychological disorders. As such, effective and efficient measurement of this construct becomes a priority for hospice and palliative medicine specialists. The Multidimensional Orientation Toward Dying and Death Inventory (MODDI-F) is the only factor-analytically constructed multidimensional scale with a conceptual rationale that measures both the fear and acceptance of dying and death. Objectives. To determine the factor structure of the MODDI-F with an English-speaking sample, so as to expand the scale's potential for use in hospice and palliative medicine, clinical psychology, and thanatology research. Methods. Participants comprise a random sample of 404 adults ranging in age from 20 to 85, stratified by sex, age, and ethnicity. They completed the 47-item MODDI-F/eng and were contacted five months later for a test-retest follow-up survey. Results. Although confirmatory factor analyses did not fit the models previously found for the German-and Chines-language versions of the MODDI-F, exploratory factor analyses resulted in a five-factor fear dimension and a two-factor acceptance dimension that were empirically and conceptually similar to the German-and Chinese-language versions. Additional psychometric analyses yielded evidence for the internal consistency reliability, five-month test-retest reliability, and construct validity of the seven-factor scores of the English-language MODDI-F. Conclusion. The results from this psychometric investigation of the English-language version of the MODDI-F are promising and warrant further investigation with clinical populations in hospice and palliative care settings. (c) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.