Abstract
The preliminary findings of this study suggest that the Computerized Implied Meaning Test may provide reliable, valid, and gender-unbiased results to inform interventions to manage theory-of-mind deficits for patients with schizophrenia.
Theory of mind (ToM) is a general ability to infer others’ mental states (e.g., intentions, feelings; Gil et al., 2012). Patients with schizophrenia tend to have severe deficits in ToM (Bora et al., 2009; Sprong et al., 2007), which may limit their interpretation of others’ behaviors and thereby hamper interpersonal relationships and social participation (Couture et al., 2006). For example, misinterpretation of others’ intentions as hostility may lead to a persecution delusion, which can cause negative experiences in interpersonal relationships. Moreover, negative experiences may reduce patients’ willingness to interact with others, limiting their engagement in occupations (e.g., education, work, leisure; American Occupational Therapy Association, 2020). Thus, ToM deficits are among the key factors affecting patients’ engagement in occupations.
Although the cause of ToM deficits in patients with schizophrenia remains unclear, a meta-analysis has indicated that ToM deficits may be correlated with abnormal brain activation (Kronbichler et al., 2017). For example, underactivation in social-related regions (e.g., medial prefrontal cortex) means that patients may not effectively differentiate ToM-related and non-ToM-related stimuli. Moreover, overactivation in attention- and cognition-related regions (e.g., bilateral inferior parietal lobe) may be a compensatory response that partly contributes to this problem (Kronbichler et al., 2017). Nevertheless, ToM deficits appear to be a promising target for interventions to promote social participation (Kurtz & Richardson, 2012). Occupational therapy practitioners need a reliable and valid measure to help manage patients’ ToM deficits.
Measures of ToM commonly used with patients with schizophrenia assess examinees’ understanding of a variety of social situations (e.g., implied meaning and hinting, faux pas, sarcasm; Gil et al., 2012). For example, the Strange Stories Test (SST; Happé, 1994), the Faux Pas Task (FPT; Baron-Cohen et al., 1999), and the Hinting Task (HT; Corcoran et al., 1995) describe social situations using stories and ask a series of open-ended questions to assess examinees’ understanding of the situations (e.g., metaphors). Other measures of ToM require examinees to infer others’ emotions from photographs of eye regions (i.e., Reading the Mind in the Eye Task; Baron-Cohen et al., 1997) or from a combination of clues (i.e., the Awareness of Social Inference Test [TASIT], which combines emotion recognition and understanding of sarcasm; McDonald et al., 2002). Despite differences in the content and difficulty of these measures, the scores are widely used to represent ToM ability in patients with schizophrenia.
The utility of these measures is limited, however. First, their validity may be unsatisfactory, potentially resulting in misinterpretation of scores. For example, the FPT is not unidimensional; it includes items assessing both cognitive ToM and affective ToM (Eddy, 2019), which are distinct abilities (Healey & Grossman, 2018). Second, the item difficulties of these measures may be inappropriate for patients with schizophrenia. For example, the HT has a severe ceiling effect (Davidson et al., 2018), meaning that its items are too easy for this population. Another problem is that the relative difficulties of these measures have not been demonstrated in patients with schizophrenia (Bora et al., 2009; Sprong et al., 2007), possibly because of the similar difficulties of these items and measures. Third, most measures have shown only modest to acceptable reliability for patients with schizophrenia (i.e., .50–.81; Chen et al., 2017; Pinkham et al., 2018), which is insufficient for clinical use (>.90; Lohr, 2002). Fourth, the gender bias of these items has not been examined or controlled for, which may explain gender inconsistencies in findings for patients with schizophrenia (Csukly et al., 2014; Navarra-Ventura et al., 2018). Thus, the commonly used ToM measures do not provide reliable, valid, and gender-unbiased assessments of ToM in patients with schizophrenia.
Rasch analysis can help resolve these limitations. Rasch analysis is based on a unidimensional model, which ensures that all Rasch-calibrated items assess the same construct (Wright & Masters, 1982). Rasch analysis can disentangle the dependence between the estimations of item difficulty and the examined ability (Wright & Masters, 1982), which facilitates examination of the item difficulty of a measure. Rasch analysis can also provide an individual reliability index (Hays et al., 2000), which helps determine whether the score is reliable. Finally, Rasch analysis provides an item-level analysis (i.e., differential item functioning [DIF]) for item bias (Zieky, 2003), which helps tool developers identify and control for the influence of gender-biased items.
To provide a reliable, valid, and gender-unbiased measure of ToM, the ability to understand implied meaning or hinting is a promising starting point because it seems to be a unidimensional ability having high correlations with social competence (Eddy, 2019; Pinkham et al., 2018). We aimed to develop a Rasch-calibrated measure, the Computerized Implied Meaning Test (COTIME), for assessing theory of mind in patients with schizophrenia.
Method
Participants
This study was approved by the ethics committees of the hospitals where the participants were recruited. All participants provided written informed consent.
We recruited both patients with schizophrenia and healthy adults to ensure diversity in participants’ ability to understand implied meaning and hinting, from low (assumed to be patients) to high (assumed to be healthy adults). We recruited patients from four psychiatric hospitals across northern and southern Taiwan and healthy adults via online ads.
The inclusion criteria for patients were as follows: diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013), ability to follow three-step instructions, and age ≥20 yr. Potential participants were excluded if they had a diagnosis of mental illness other than schizophrenia (e.g., major depression), a history of substance abuse or brain injury, or an inability to complete all the study assessments.
Procedures
We generated items for the COTIME on the basis of the definition of implied meaning and an article review (Corcoran et al., 1995; Gil et al., 2012). We defined implied meaning as true meaning or intention that can be understood only through inference based on the given situation. The items were reviewed for content validity by an expert panel consisting of three occupational therapists and one researcher with expertise in measure development and validation. We tested the items on about 10 patients with schizophrenia to ensure readability and face validity. We used only the items agreed on by all experts in data collection.
Participants completed the items on a laptop computer in a quiet room at the locations where they were recruited. The testing system was programmed in JavaScript. After participants completed the COTIME, a trained interviewer gathered demographic data for all participants and, for the patients, administered either the Mini-Mental State Examination (MMSE; Folstein et al., 1975) or the Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005) as a measure of cognitive function and the Clinical Global Impression–Severity scale (CGI–S; Busner & Targum, 2007) as a measure of symptom severity, in that order. To lessen fatigue, a break time of a few minutes (depending on the participant’s need) was provided.
Measures
The COTIME initially comprised 27 items. Each item provided a vignette of a daily-life social interaction between two people (e.g., friends) and asked two multiple-choice questions: a test question and a control question (see Figure 1 for an example). The test questions required examinees to infer the speakers’ true or real intention in each vignette. The control questions were designed to ensure that examinees fully understood the vignettes. Four response choices were provided for each question, and only one was correct. To ensure that examinees fully understood the vignettes in each item, the test questions were scored only if the control items were answered correctly. Item difficulty was manipulated on the basis of how explicitly key information was presented; most response options were designed to be reasonable without the key information. For easy items, key information was presented more explicitly and could be easily detected, whereas for difficult items, the key information was more implicit and complex, requiring more inferences to identify the correct answer.
Screen shot of an example COTIME item.
The 11-item MMSE and the 30-item MoCA were used, depending on the interviewers’ clinical routine, to assess patients’ cognitive function. These measures assess numerous cognitive domains, including orientation and memory. Both measures have good test–retest reliability (intraclass correlation coefficients [ICCs] >.74) and good concurrent validity (rs >.62 with cognitive measures) in patients with schizophrenia (Folstein et al., 1975; Harvey et al., 1995; Rodríguez-Bores Ramírez et al., 2014; Wu et al., 2017).
The CGI–S was used to assess patients’ overall symptom severity in the past 7 days using a Likert-type scale from 1 (normal) to 7 (most severe; Busner & Targum, 2007). The CGI–S has good interrater reliability (ICCs >.70) and good concurrent validity (rs >.75 with the Positive and Negative Syndrome Scale) in patients with schizophrenia (Haro et al., 2003).
Data Analysis
Rasch analysis was performed in ConQuest Version 2 (Wu et al., 2007). Model fits to the Rasch model were examined using both infit and outfit mean square (MnSq). Misfit items were defined as those with infit or outfit MnSq exceeding the sample-size-adjusted criterion (i.e.,
Differential item functioning items were defined as items that achieved significantly large DIF values. A DIF value is the difference in estimated item difficulty between male and female participants given the same level of ability to understand implied meaning. A DIF value ≥.38 indicates severe DIF (Zieky, 2003). The significance was set as an absolute value of a z score exceeding 1.96 (Zieky, 2003), representing a difference that is less likely to result from estimation error. The DIF items were removed.
Confirmatory factor analysis was used to further confirm the unidimensionality of the COTIME items and was performed in EQS Version 6.1 (Bentler & Wu, 2005). Three fit indices were considered simultaneously for the model fits. The first was the comparative fit index (CFI), which compares the model fits between the null model and the hypothesized model. CFI ≥.95 was considered good and CFI ≥.90 acceptable. The second was the standard root mean square residual (SRMR), which conceptually represents the differences between the observed and model-implied item correlations. An SRMR <.08 was considered good. The third was the root-mean-square error of approximation (RMSEA), which refers to the difference in model fit between the hypothesized model and the real model. An RMSEA ≤.06 was considered good and RMSEA <.08 acceptable (Schreiber et al., 2006).
Rasch reliability was examined using both group-level (average Rasch reliability) and individual indices (the percentage of patients having Rasch reliability >.90). We report the reliabilities only of patients’ scores because they were the target population in this study; we conducted both Rasch analysis and confirmatory factor analysis for all participants.
Known-groups validity was examined using an independent t test and Cohen’s d effect size; ds of ≥0.2 were considered small, ≥0.5 moderate, and ≥0.8 substantial (Cohen, 1992). Moreover, the person strata, which represent the number of statistically distinguishable groups in terms of examinees’ level of ToM ability, were calculated using the following formula:
Results
We collected data from 344 participants, 240 patients with schizophrenia and 104 healthy adults, with no missing data in the major assessments (Table 1). The average ages of the patients and healthy adults were 47.2 yr and 23.3 yr, respectively. Women outnumbered men (51.3% of patients and 65.4% of healthy adults). The patients had good cognitive function (average MMSE score = 27.2; average MoCA score = 23.8) and mild symptom severity (CGI–S median score = 3). The patient group had significantly lower COTIME scores than the healthy adults, Cohen’s d = –2.5, t(342) = 19.6, p < .001, calculated based on Rasch score. The patients and healthy adults could be divided into five and three strata, respectively.
Participant Characteristics (N = 344)
Note. CGI–S = Clinical Global Impression–Severity scale; COTIME = Computerized Implied Meaning Test; IQR = interquartile range (the differences between the Quartile 1 [25th percentile of the score] and Quartile 3 [75th percentile of the score]); MMSE = Mini-Mental State Examination; MoCA = Montreal Cognitive Assessment; NA = not applicable.
Twenty-seven items were initially generated, revised for readability, agreed on by the experts, and administered to the participants for Rasch analysis. On the basis of the sample size of 344, we used infit and outfit MnSq values >1.4 to retain or remove the COTIME items. After 12 misfit items and one DIF item were removed, the remaining 14 items (see Appendix A) showed acceptable model fits to the Rasch model (infit MnSq ≤ 1.16, outfit MnSq ≤ 1.24) and one-factor structure (χ2 = 242.7, CFI = .91, SRMR = .05, RMSEA = .08), with small DIF values (<.32; Table 2).
Item Parameters of the Item Bank
Note. DIF = differential item functioning; MnSq = mean square; SE = standard error. Item parameters were estimated based on 240 patients and 104 healthy adults.
The distribution of item difficulties covered most of the patients’ levels of ToM ability (Figure 2). Only a few patients achieved the highest (n = 7, 2.9%) and lowest (n = 5, 2.1%) scores. The relative difficulties of these items generally fitted our expectation, namely, that the more implicit and complex key information would be associated with greater item difficulty. Completing all 27 items took about 19 min. The average Rasch reliability for the patients was high (.91). Most of the patients (81.7%) achieved individual Rasch reliability of ≥.90.
Distributions of item difficulties of the COTIME item bank and participants’ abilities.
Discussion
The 14 COTIME items demonstrated satisfactory model fits to the Rasch model and one-factor structure, supporting the unidimensionality of these items. Moreover, the content validity of the items was supported by the consensus of the expert panel. Accordingly, the COTIME appears to be a valid measure for assessing ToM in patients with schizophrenia based on their ability to understand implied meaning.
The major causes of misfit items may have been the multidimensional content and items assessing abilities other than the major ability (i.e., to understand implied meaning) targeted for assessment (i.e., the “other ability” problem). In both situations, higher levels of the major ability may not have guaranteed a higher probability of correctly answering that item because of insufficient levels of other abilities (e.g., to understand sarcasm), which did not match the assumption of monotonic increase (i.e., a high-level examinee should be able to correctly answer easy items, and a low-level examinee should be unable to do so) and yielded unsatisfactory model fits. Among the removed misfit items, the multidimensionality may have resulted from items assessing both cognitive and affective ToM, whereas the other ability problem may be relevant to items assessing the ability to understand sarcasm or lies. In future studies, these ToM abilities should be assessed separately to improve the measurement of ToM in patients with schizophrenia.
The patients with schizophrenia demonstrated high Rasch reliability in both group- and individual-level indices, suggesting that scores may be more reliable than those of the SST, the FPT, and the TASIT, which have only modest to acceptable reliability (Chen et al., 2017; Pinkham et al., 2018). The higher reliability of the COTIME may be partially explained by the matching distributions of participants’ levels of ability and item difficulties because these items are more informative for ability estimation (Wright & Masters, 1982). Moreover, only a few patients (<3%) obtained the highest and lowest scores, indicating acceptable floor and ceiling effects. Thus, the COTIME appears to be a reliable measure that is appropriate for patients with schizophrenia.
All COTIME items had small DIF values, indicating that the item difficulties and scoring were not biased by participants’ gender and suggesting that the COTIME scores are gender unbiased. The removed DIF item may be related to different gender-related life experiences (e.g., men may have less opportunity to experience shopping situations) or communication habits (e.g., women may respond emotionally to show their engagement in conversation). Nevertheless, the COTIME may be the first ToM measure in which the DIF of gender has been examined. Thus, our study may shed some light on examining gender-biased items and thereby improving ToM measurements.
The patients’ COTIME scores were significantly lower than those of the healthy adults. These findings are consistent with results of previous studies (Bora et al., 2009; Sprong et al., 2007) and indicate that the patients had more severe deficits in ToM. However, the differences were larger than those in previous studies (effect sizes of 2.5 in Bora et al., 2009, and 1.1 in Sprong et al., 2007), which may be attributable to the higher reliability of the COTIME. The higher reliability may have enabled the COTIME to identify statistically distinguishable strata of ToM ability, five for the patients (very high, high, medium, low, and very low) and three for the healthy adults (high, medium, and low). Nevertheless, the large and significant differences found between the patients and healthy adults support the known-groups validity of the COTIME.
An advantage of the COTIME is the greater interpretability of scores. First, differences in COTIME scores can directly represent differences in examinees’ ToM ability because Rasch scores are interval scores (Wright & Masters, 1982). Second, the individual reliability index allows users to consider the precision of assessments. Third, the COTIME provides transformed standard T scores (see Appendix B), which allow users to compare examinees’ ToM ability with those of the 344 participants in this study. Accordingly, the COTIME can provide informative and useful assessment for clinicians and researchers.
A weakness of the COTIME may be the presentation of items using literal descriptions, which require examinees to imagine the social situations in each item and thus may limit the tool’s utility for some patients because of the additional cognitive functions required (e.g., reading ability). Future studies should consider alternative delivery methods for the COTIME for patients with cognitive impairment; for example, video clips could be used to present social situations.
This study has several limitations. First, convenience sampling was used. Second, the patients had mild clinical severities and relatively good cognitive function, and cognitive function was not assessed in the healthy adults, potentially limiting generalizability of the results. Third, the healthy adults were much younger than the patients, which may have yielded an overestimation of the severity of ToM deficits because younger people tend to have better ToM (Henry et al., 2013). Fourth, we did not examine the DIF of other important characteristics (e.g., age, education level) because of insufficient participants for subgroups. Last, we did not examine other important psychometric properties (e.g., test–retest reliability, responsiveness).
Implications for Occupational Therapy Practice
This study has the following implications for occupational therapy practice with patients with schizophrenia: Occupational therapy practitioners can determine the severity of ToM deficits in patients with schizophrenia by comparing their COTIME score with those of the participants (patients or healthy adults) in this study. Occupational therapy practitioners can use the COTIME items as examples or templates for generating practice scenarios for ToM interventions. However, to ensure reliability and validity, practitioners should neither explain the COTIME items to patients nor use them to explain how to detect the key information in the implied meaning communication. Occupational therapists can evaluate whether a patient’s ToM deficits are severe enough to warrant intervention. If a patient’s COTIME score is significantly lower than that of healthy adults (i.e., <1.5 logit), ToM interventions may be needed.
Conclusion
Our preliminary results suggest that the COTIME is a reliable, valid, and gender-unbiased measure for assessing ToM ability in patients with schizophrenia. The COTIME may be used in both clinical and research settings to assess the severity of patients’ ToM deficits and to investigate factors relevant to their ToM ability.
Supplemental Material
Supplementary material for Development of a Rasch-Calibrated Test for Assessing Implied Meaning in Patients With Schizophrenia
Supplementary material, sj-pdf-1-aot-10.5014_ajot.2022.047316.pdf for Development of a Rasch-Calibrated Test for Assessing Implied Meaning in Patients With Schizophrenia by Shih-Chieh Lee, Kuan-Wei Chen, Chien-Yu Huang, Pei-Chi Li, Ton-Lin Hsieh, Ya-Chen Lee and I-Ping Hsueh in The American Journal of Occupational Therapy
Footnotes
Acknowledgments
Ya-Chen Lee and I-Ping Hsueh equally contributed to this work and serve as corresponding authors. This work was supported by the Taiwan Ministry of Science and Technology (107-2314-B-002-041-MY3 and 107-2314-B-468-004-MY2).
Appendix A. Final 14 Items of the Computerized Implied Meaning Test
Note that the English version of the items that appear in this appendix were not translated using a standardized procedure. Given that the original items were designed for Taiwan, a standardized translation and cultural adaption process will be needed before an English version of the test can be used. Each item has two questions; the first is the test question, and the second is the control question. The item is scored only if the control question is answered correctly.
1. Licensing examination
Mary is preparing for her licensing exam. This exam makes her nervous because she will lose her job if she fails it. When the results are posted, her colleague asks about her examination. She says, “Well, a different job might be nice!”
Why does Mary say that? She passed the examination. However, she thinks that changing jobs will be better for her. She failed the examination, so she cheers herself up by changing jobs. She failed the examination, so she comforts herself by believing that changing jobs would be good for her. She wants to change her job because the current one is too stressful.
How well did Mary do on her examination? Pretty well—she passed the examination. Not well—she failed the examination. Unknown—the information is insufficient. She does not want other people to know.
2. Criticism
James likes to comment on everything. He often makes judgments based on first impressions and doesn’t listen to what others have to say. Therefore, he is not popular with his classmates. Robert and Mary have the following conversation:
Robert says, “I have so many good ideas. Aren’t I clever?”
Mary looks at Robert and says, “Sure; you might just be a bit better than James.”
Why does Mary say Robert is a bit better than James? She thinks Robert is more impressive than James. She is inadvertently praising James. She is praising Robert for being easier to talk to than James because Robert listens to people. She is comparing Robert to James, who is not popular, implying that Robert is no better than James.
Why is James not popular with his classmates? Because he likes to comment on everything. Because he isn’t as cool as Robert, whom his classmates like more. Because he isn’t as well spoken as Robert. Because he makes judgments based on first impressions and doesn’t listen to what others have to say.
3. Chess game
Mary is playing chess with Patricia, who is very competitive. In one instance, Mary makes a move, but before her hand leaves the chess piece, Patricia says, “Are you sure about that?”
Why does Patricia ask whether Mary is sure about her move? She is warning Mary about a violation of rules. Mary’s move is disadvantageous to Patricia, so Patricia attempts to intimidate Mary by causing her to doubt her move. Patricia is urging Mary to make a move because she is taking too long. Patricia feels disinterested in the game and wants to chat with Mary.
What is Patricia’s personality like? Competitive Friendly Calm Impulsive
4. Low-fat cake
Jennifer buys a cake for her colleagues.
Linda says, “I’m on a diet, but thanks anyway.”
Jennifer replies, “Oh, but this cake is low fat.”
Why does Jennifer say the cake is low fat? She thinks Linda should eat more cake because cake is healthy. She wants to tell Linda the cake she bought is low fat. Low-fat food is healthier, so she is advising Linda to eat low-fat food instead. She is telling Linda not to worry about her dieting plans because low-fat cake contains fewer calories.
Why does Linda refuse the offer initially? She is already full from lunch. She doesn’t like cake. She thinks she is overweight. She likes full-cream cake more.
5. Valentine’s Day dinner
Elizabeth is single, and she knows Michael likes her.
On Valentine’s Day eve, Michael invites Elizabeth to dinner. Michael asks, “Are you available tonight? Let’s have dinner together.”
Elizabeth replies, “Sorry; I already made plans with my boyfriend.”
Why does Elizabeth say she already made plans with her boyfriend? She already made plans with her boyfriend. She is politely declining Michael’s invitation. She is bragging about her tight schedule to attract attention. She likes to eat alone.
Why does Michael invite Elizabeth to dinner on Valentine’s Day eve? He likes to celebrate. He likes Elizabeth. He wants to invite her as a friend. He wants to talk about work.
6. My heart is with you
William is a businessman with a tight work schedule next week. William receives a phone call from a classmate, David, inviting him to a high school class reunion next weekend. Williams says, “I have an important meeting next weekend. I will be with you all in spirit!”
Why does William say that? He is blaming David for not notifying him earlier so he could apply for leave on the day of the reunion. The theme of the meeting next week is “I will be with you all in spirit!” He wants to go to the reunion but is unable to because of the important meeting. He is a businessman, and his boss values work performance.
When is the high school class reunion? Next summer Next weekend Tonight This Friday
7. Could you pick me up?
After a class reunion, Susan phones her boyfriend, Richard.
Susan says, “I just came out of the reunion. But the subway station is so far, and a taxi is too expensive . . .”
Richard replies, “How are you going to get home, then?”
Susan says, “Well, are you free?”
Why does Susan ask whether Richard is free? She wants to know whether Richard is busy or not. She is hinting that Richard should pick her up. She wants to know whether Richard is free to go out with her. She doesn’t want to go home. She is staying at a friend’s house tonight.
Why doesn’t Susan take the taxi home? She thinks the taxi stand is too far. She thinks taxi trips are too expensive. She thinks taxis are not safe. She thinks taking the taxi will take too much time.
8. The pants are tight
It’s been a while since Jessica has seen Sarah.
Jessica notices Sarah’s tight pants and says, “You’ve been doing well!”
Why does Jessica make that comment? That is how they greet each other. She envies Sarah’s financial situation, which allows her to buy pretty pants. She is teasing Sarah that she has gained weight and her pants have become tight. She is worried that Sarah’s pants might burst, so she is telling Sarah to get new pants.
How is Sarah different from before? She is no different. She has become richer. She has grown taller. She has gained weight.
9. I wasn’t born yesterday
Thomas is called to his boss’s office. His boss puts Thomas’s report on the desk and asks Thomas, “What do you think of the report?”
Thomas replies, “Pretty good, I think. Everything is in there.”
His boss frowns and says, “Even a 3-year-old could write this.”
Why does Thomas’s boss say that even a 3-year-old could write the report? The boss is telling Thomas that 3-year-olds can write reports. The boss is telling Thomas that his report is written badly. The boss is comforting Thomas, telling him that at least his report is up to a 3-year-old’s standards. The boss is sharing his own experiences with Thomas.
Why was Thomas called into his boss’s office? To discuss his report To receive a promotion To receive a demotion To discuss his retirement
10. Sleepover with friends
Karen asks her mother, “Can I stay at my friend’s house tonight?”
Her mother replies, “Go and never come back!”
Why does Karen’s mother say that? She wants to encourage Karen to move to her friend’s place. She doesn’t think it is appropriate for Karen to stay overnight with a boy, so she is refusing Karen’s request. She thinks Karen will disturb others too much, so she is refusing Karen’s request. She dislikes Karen and wants her to move out.
To what extent does Karen’s mother agree to let Karen stay overnight at her friend’s place? Completely agree Somewhat agree Somewhat disagree Completely disagree
11. Earthquake
Daniel, Mathew, and Anthony are talking about an earthquake the previous night.
Daniels says, “There was a big earthquake last night!”
Mathew replies, “I didn’t feel it because I was asleep.”
Anthony replies, “Mother Nature must have forgotten about your house!”
Why does Anthony say that? He is joking. He wants to talk about Mother Nature. He is envious of Mathew’s treatment by Mother Nature. Mother Nature forgot to shake Mathew’s house in the earthquake.
When was the earthquake? Dawn Noon Dusk Night
12. Axiomatic answer
Christopher is a hardworking student who spends a lot of time preparing for an upcoming exam. However, his grades have been below the class average. When he approaches his sister about a question on the exam, his sister says, “This is a no-brainer.”
Why does Christopher’s sister say that? She is telling Christopher to solve the question without using his brain. She thinks the question is too difficult for Christopher and doesn’t know how to explain it to him. She cannot be bothered to use her brain to explain this question, so she is refusing to use her brain. She thinks this question is too easy and cannot be bothered to explain it to Christopher.
Why does Christopher approach his sister? To get help with his grades To chat with his sister To help hide his grades from their parents, for fear of being scolded To embarrass his sister with a difficult question
13. Pocket money
Mark told Paul that he gets paid $10 for doing chores, which makes Paul envious. One day, Paul’s mother tells Paul to mop the floor.
Paul says, “Apparently Mark gets paid $10 for doing chores.”
Why does Paul say that? He is sharing things about his friend with his mother. He dislikes mopping. He is expressing disapproval of Mark’s behavior. He also wants to get paid for doing chores.
How did Mark get $10? By doing chores By getting a perfect score on an exam By completing his homework on time By being well behaved at school
14. Souvenir
Emily brings her neighbor Michelle a souvenir from an overseas trip.
Michelle says, “Thank you! But I can’t possibly accept this gracious gift.”
Emily replies, “We’ve been neighbors for so long. Don’t be so polite!”
Why does Emily say that? She wants Michelle to accept the gift. She is scolding Michelle for refusing her gift. She is expressing surprise because she doesn’t understand why Michelle is refusing her gift. She feels upset that Michelle is being too polite.
What is the relationship between Emily and Michelle? Work colleagues Mother and daughter Neighbors Sisters
Appendix B. Transformations Among the Raw Scores,Rasch Scores,and T Scores
| Raw Score | Rasch Score | T Score | Rasch Score (SE) | Rasch Reliability |
|---|---|---|---|---|
| 0 | −4.52 | 25 | 1.86 | .50 |
| 1 | −3.22 | 30 | 1.07 | .81 |
| 2 | −2.38 | 34 | 0.81 | .87 |
| 3 | −1.81 | 36 | 0.71 | .90 |
| 4 | −1.35 | 38 | 0.66 | .91 |
| 5 | −0.93 | 40 | 0.63 | .92 |
| 6 | −0.53 | 41 | 0.63 | .92 |
| 7 | −0.14 | 43 | 0.63 | .92 |
| 8 | 0.27 | 45 | 0.65 | .91 |
| 9 | 0.71 | 47 | 0.68 | .90 |
| 10 | 1.21 | 49 | 0.73 | .89 |
| 11 | 1.78 | 51 | 0.80 | .87 |
| 12 | 2.51 | 54 | 0.92 | .83 |
| 13 | 3.58 | 59 | 1.18 | .75 |
| 14 | 5.07 | 65 | 1.94 | .35 |
Note. T scores were calculated based on the Rasch scores using the formula T = 50 + 10 × (score − 1.5)/2.4; 1.5 was the average, and 2.4 was the standard deviation of all participants’ Rasch scores in this study. SE = standard error.
References
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
