Validation of the 4-Item and 10-Item Uncertainty Stress Scale in a Community-Based Sample of Chinese Adults

Figures & data

Figure 1 ROC curve analysis for predicting severe perceived stress (>3) (A) ROC curve for USS-10; (B) ROC curve for USS-4.

Table 1 Overview of the Demographic Characteristics of the Sample

Variables	N	%	Item Mean (95% C.I.)
			USS-10	USS-4
Age			F=6.03, p<0.001**	F=4.04, p=0.003**
<20	25	2.8	3.16(2.78–3.54)	3.18(2.77–3.59)
20–24	230	25.4	2.85(2.72–2.97)	2.86(2.73–2.99)
25–29	199	22.0	2.79(2.66–2.93)	2.78(2.65–2.92)
30–39	208	23.0	2.67(2.55–2.80)	2.67(2.54–2.80)
40+	242	26.8	2.51(2.40–2.62)	2.59(2.47–2.71)
Gender			t=2.51, p=0.012*	t=1.83, p=0.068
Male	377	41.7	2.81(2.71–2.91)	2.80(2.70–2.90)
Female	527	58.3	2.65(2.57–2.73)	2.68(2.60–2.76)
Place of residence			t=−4.73, p<0.001**	t=−4.59, p<0.001**
Urban	652	72.2	2.62(2.55–2.69)	2.64(2.57–2.72)
Rural	251	27.8	2.95(2.83–3.06)	2.97(2.85–3.09)
Ethnicity			t=−0.58, p=0.565	t=0.13, p=0.900
Han	871	96.3	2.71(2.65–2.77)	2.73(2.67–2.80)
Minority	33	3.7	2.81(2.50–3.12)	2.71(2.39–3.03)
Marital status			F=5.48, p=0.004**	F=4.97, p=0.007**
Unmarried	369	40.8	2.80(2.70–2.89)	2.82(2.72–2.92)
Married	507	56.1	2.63(2.55–2.71)	2.65(2.57–2.74)
Divorced/widowed	28	3.1	3.07(2.70–3.44)	3.08(2.71–3.46)
Education			F=1.84, p=0.138	F=2.74, p=0.042*
Junior high school or less	160	17.7	2.75(2.61–2.89)	2.80(2.66–2.96)
High school	159	17.6	2.84(2.69–3.00)	2.89(2.72–3.05)
Junior college	157	17.4	2.73(2.58–2.88)	2.73(2.58–2.89)
College or higher	428	47.3	2.65(2.56–2.73)	2.65(2.56–2.74)
Occupation			F=3.11, p=0.026*	F=4.00, p=0.008**
Public official/professionals	257	28.4	2.58(2.46–2.70)	2.57(2.45–2.69)
Enterprise personnel	238	26.3	2.77(2.65–2.88)	2.80(2.68–2.92)
Commerce/service/operations	215	23.8	2.83(2.71–2.95)	2.85(2.73–2.98)
Others	194	21.5	2.69(2.55–2.83)	2.73(2.59–2.88)
Household annual income (RMB)			F=9.82, p<0.001**	F=8.61, p<0.001**
Less than 20,000	128	14.2	2.82(2.65–2.99)	2.82(2.64–3.00)
20,000–60,000	357	39.5	2.83(2.73–2.92)	2.85(2.75–2.95)
60,000–100,000	226	25.0	2.75(2.64–2.85)	2.76(2.65–2.87)
More than 100,000	193	21.3	2.40(2.26–2.54)	2.43(2.28–2.57)

Notes: **p<0.01; *p<0.05.

Table 2 Overview of the Results for Validity and Reliability Analysis for USS-4 and USS-10

Variables	Item	Reliability		Validity		Mean (SD)
		Cronbach’s Alpha	CR	KMO	AVE	Total Score	Item Score
USS-10	10	0.941	0.950	0.954	0.655	27.14(9.38)	2.71(0.94)
USS-4	4	0.851	0.900	0.815	0.692	10.93(3.89)	2.73(0.97)

Abbreviations: USS, Uncertainty Stress Scale; CR, composite reliability; AVE, average variance extracted; KMO, Kaiser-Meyer-Olkin.

Table 3 Overview of the Intercorrelations Between Uncertainty Stress Scale Items

Item	1	2	3	4	5	6	7	8	9	10
1	1
2	0.650**	1
3	0.560**	0.606**	1
4	0.586**	0.648**	0.619**	1
5	0.579**	0.580**	0.643**	0.639**	1
6	0.587**	0.619**	0.548**	0.591**	0.614**	1
7	0.585**	0.637**	0.613**	0.608**	0.633**	0.741**	1
8	0.550**	0.603**	0.588**	0.600**	0.582**	0.585**	0.640**	1
9	0.579**	0.612**	0.626**	0.618**	0.608**	0.585**	0.628**	0.667**	1
10	0.552**	0.627**	0.661**	0.615**	0.642**	0.619**	0.643**	0.681**	0.738**	1

Note: **<0.01.

Table 4 Overview of the Factor Loadings and Reliability Analysis for the 10-Item Uncertainty Stress Scale (USS-10)

Item	Factor Loadings	Item-Total Correlation	Cronbach’s α if Item Deleted	Item Content (English; Items Were Tested in Chinese)
1	0.767	0.768	0.937	Life is impalpable, and fate is unpredictable
2	0.813	0.812	0.935	Feeling things are not going well
3	0.798	0.800	0.936	Social values are chaotic, and I am experiencing confusion
4	0.806	0.806	0.935	Unexpected things often happen in life
5	0.806	0.806	0.935	The world is changing too fast and I cannot keep up
6	0.802	0.804	0.936	I do not know how to reach my own goals
7	0.833	0.834	0.934	Confused about the future
8	0.803	0.802	0.936	Many people ignore the rules and I do not know what to do
9	0.825	0.822	0.934	Inability to handle important changes in life
10	0.840	0.837	0.934	Feeling there are no rules and paths to follow

Notes: Adapted with permission from Yang T. Health Research: Social and Behavioral Theory and Methods. Beijing: People’s Medical Publishing House; 2018.¹⁹

Table 5 Overview of the Factor Loadings and Reliability Analysis for 4-Item Uncertainty Stress Scale (USS-4)

Item	Factor Loadings	Item-Total Correlation	Cronbach’s α if Item Deleted	Item Content (English; Items Were Tested in Chinese)
1	0.817	0.816	0.819	Life is impalpable, and fate is unpredictable
3	0.827	0.831	0.814	Social values are chaotic, and I am experiencing confusion
5	0.856	0.852	0.795	The world is changing too fast and I cannot keep up
6	0.826	0.828	0.815	I do not know how to reach my own goals

Notes: Adapted with permission from Yang T. Health Research: Social and Behavioral Theory and Methods. Beijing: People’s Medical Publishing House; 2018.¹⁹

Table 6 Overview of the Goodness-of-Fit Indices of USS-10 and USS-4

	CFI	TLI	GFI	RMSEA	SRMR
USS-10	0.96	0.95	0.94	0.09	0.03
USS-4	0.99	0.98	0.99	0.08	0.02

Abbreviations: CFI, comparative fit index; TLI, Tucker–Lewis index; GFI, goodness of fit index; RMSEA, root mean square error of approximation; SRMR, standardized root mean-square residual.

Table 7 Overview of the Results of the Correlation Analysis Between Different Scale Scores

Variables	USS-10	USS-4	CPSS-8
USS-10	1
USS-4	0.956**	1
CPSS-8	0.497**	0.475**	1

Note: **<0.01.

Abbreviations: USS, Uncertainty Stress Scale; CPSS, Chinese Perceived Stress Scale.

Table 8 Overview of the Results of ROC Curve Analysis

Scale	AUC	Standard Error	p	95% C.I.	Cut Off Value	Sensitivity	Specificity	Youden’s Index
USS-10→PS	0.738	0.017	0.000	0.704–0.772	2.750	0.763	0.622	0.385
USS-4→PS	0.725	0.018	0.000	0.690–0.759	2.625	0.784	0.552	0.337

Abbreviations: USS, Uncertainty Stress Scale; PS, perceived stress; AUC, area under the curve.

Yang T. Health Research: Social and Behavioral Theory and Methods. Beijing: People’s Medical Publishing House; 2018.

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