Ineffectiveness of reverse wording of questionnaire items: let's learn from cows in the rain.
OBJECTIVE
We examined the effectiveness of reverse worded items as a means of reducing or preventing response bias. We first distinguished between several types of response bias that are often confused in literature. We next developed arguments why reversing items is probably never a good way to address response bias. We proposed testing whether reverse wording affects response bias with item-level data from the Multidimensional Fatigue Inventory (MFI-20), an instrument that contains reversed worded items.


METHODS
With data from 700 respondents, we compared scores on items that were similar with respect either to content or to direction of wording. Psychometric properties of sets of these items worded in the same direction were compared with sets consisting of both straightforward and reversed worded items.


RESULTS
We did not find evidence that ten reverse-worded items prevented response bias. Instead, the data suggest scores were contaminated by respondent inattention and confusion.


CONCLUSIONS
Using twenty items, balanced for scoring direction, to assess fatigue did not prevent respondents from inattentive or acquiescent answering. Rather, fewer mistakes are made with a 10-item instrument with items posed in the same direction. Such a format is preferable for both epidemiological and clinical studies.
Department of Health Sciences, Section Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. f.l.p.van.sonderen@umcg.nl
Eric
E
van Sonderen
Robbert
R
Sanderman
James C
JC
Coyne
D000818:Animals; D015982:Bias; D002417:Cattle; D005221:Fatigue / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000523:psychology; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires