Structural validity of the Rosenberg self-esteem scale in patients with schizophrenia in Indonesia

Muhammad Muslih; Min-Huey Chung

doi:10.1371/journal.pone.0300184

. 2024 May 10;19(5):e0300184. doi: 10.1371/journal.pone.0300184

Structural validity of the Rosenberg self-esteem scale in patients with schizophrenia in Indonesia

Muhammad Muslih ^1,², Min-Huey Chung ^1,^3,^*

Editor: Silvia Escribano Cubas⁴

PMCID: PMC11086833 PMID: 38728256

Abstract

Background

The Rosenberg self-esteem scale (RSES) is a commonly employed instrument for measuring self-esteem in the general population and those with mental illness. However, confirmatory factor analyses (CFA) to determine the structural validity of the RSES for schizophrenia patients in Indonesia are limited.

Objectives

We examined the structural validity of the RSES as a measurement for patients with schizophrenia in Indonesia through confirmatory factor analyses (CFA), as well as assessing internal consistency and reliability.

Methods

The sample comprised 260 participants. Over two weeks, 30 subjects were added to investigate test-retest reliability. The structural validity analyzed was based on a CFA to determine the model fit. We used internal consistency (Ordinal alpha) to evaluate the reliability evidence.

Results

Four different models were analyzed in this study. Considering the single-factor model (Model 1a), the overall fit criteria were inadequate. However, after some modification indices, all fit criteria were significantly adequate (Model 1b). The adequacy of all fit standards remained satisfactory when the two-factor model (Model 2) and hierarchical model (Model 3) were applied. The RSES had an ordinal alpha coefficient of 0.75. While 0.89 and 0.88 for the positive and negative self-esteem subscale, respectively. Test-retest reliability yielded adequate results with an interclass correlation score ranging from 0.87 to 0.93.

Conclusions

1. Introduction

Self-esteem is an overall individual evaluation or appraisal of the self [1] and how a person thinks of themselves. Self-esteem is "the degree to which a person values, approves of, or likes himself or herself" [2]. Self-esteem is a crucial component of mental health and general psychological well-being. It influences an individual’s achievements and successes, social interactions, and ability to cope with environmental stressors [3, 4]. Individuals with high self-esteem believe they possess many positive qualities and attitudes toward themselves [5]. In summary, self-esteem is a pivotal psychological construct [6] that controls several facets of an individual’s existence, encompassing mental well-being, accomplishments, interpersonal engagements, and coping abilities [3, 4].

There is a reciprocal relationship between self-esteem and mental illnesses [7]. A previous study found that self-esteem plays a vital role in developing diverse mental illnesses and social problems encompassing a range of internalizing issues, such as depression, suicidal tendencies, eating disorders, and anxiety, as well as externalizing problems, including violence and substance abuse [8]. Conversely, it has been hypothesized that mental illnesses can lead to low self-esteem as a significant consequence [9]. Consistent with prior research, low self-esteem has been found to heighten susceptibility to the onset of mental illness [10]. Eventually, individuals with mental illnesses are likely to have fluctuating self-esteem levels [11]. Therefore, drawing from the aforementioned explanation, we can conclude that self-esteem is considered a component of self-assessment, which influences mental health and vice versa.

The Rosenberg Self-Esteem Scale (RSES), which was developed by Rosenberg [12], is one of the most extensively used instruments for measuring self-esteem globally [13–17]. Researchers often use the RSES to measure self-esteem in the clinical population, such as eating disorders [18], anxiety, depression [7], attention and emotional disorder [19], schizophrenia and bipolar disorder [20]. Other studies have tested the RSES in specific people, such as ex-prisoners [21], drug users [22], and single mothers [23]. The RSES has been translated and adapted into a number of different languages, including German [24], Dutch [25], Estonian [26], French [27], Portuguese [28], Spanish [29], Japanese [17], and Thai [14]; thus, making it applicable to participants from diverse samples or populations. It has been adapted across 53 nations with distinct ethnic groups and cultures [30]. This finding indicates that the RSES is widely used to measure self-esteem. Supporting this idea, a prior study suggests that the popularity of the RSES can be attributed to its brevity and simplicity, as it comprises only ten questions that can be completed within a short timeframe of 1 to 2 minutes [13].

Multiple countries, including Indonesia, have implemented the RSES to measure the self-esteem of college students and the general population [30]. Some previous studies have shown that self-esteem has been associated with schizophrenia [31–33]. For example, there was a significant correlation between a decrease in the intensity of adverse symptoms and an enhancement in self-esteem, and conversely [34]. However, psychometric analyses, including structural validity and reliability, in patients diagnosed with schizophrenia were not explicitly addressed in previous studies [30, 35].

In a prior study, the factor structure of the RSES was examined using psychometric tests, and it focused on adolescents [36], as they were the original target population of this scale. It has also been tested in adults [37] and the general population [24]. Nevertheless, there is no available evidence supporting the utilization of RSES among individuals diagnosed with schizophrenia in Indonesia. Hence, evaluating the RSES in individuals diagnosed with schizophrenia is imperative to ascertain its psychometric analysis. This study aimed to assess the structural validity of the RSES as a measurement for patients with schizophrenia in Indonesia through confirmatory factor analyses (CFA), as well as assessing internal consistency and reliability.

2. Methods

2.1 Participants

This is an instrumental questionnaire validation study. Two psychiatric hospitals and one psychiatric rehabilitation center in East Java, Indonesia, were visited to obtain the required data. We distributed the questionnaire from August 2018 to February 2019. Participants were recruited using the convenience sampling technique. The following requirements had to be met for someone to be included: (a) they had been diagnosed with schizophrenia; (b) aged ≥ 20 years; (c) hospitalized in a psychiatric ward; and (d) able to speak, read, and write Indonesian. The Mini-Mental State Examination (MMSE) was utilized to screen out participants with cognitive impairment (i.e., MMSE scores < 24).

The size of 200 participants required in this study is acceptable based on recommendations from prior studies [38, 39]. In this study, data was missing from four questionnaires because they were not accurately completed, and 21 participants were excluded because their MMSE score was less than 24. Considering the response rate of 20%, the final sample comprised 260 participants, as presented in the (S1 Dataset). In addition, we recruited an additional 30 individuals to investigate test-retest reliability over two weeks.

2.2 Instruments

The study incorporates many socio-demographic data, including age as a continuous variable. The remaining variables as categorical variables, namely gender (male; female), marital status (single; married; divorced, or widowed), employment status (employed; unemployed), source of income (personal income; family support; personal and family support), education (elementary; junior; high school; university/ college), previous hospitalization (yes; no), and onset of illness (<1 year; 1–5 years; >5 years).

The RSES is not licensed and is available for public use. Information about the scale can easily be gathered, and permission to use this resource can be sought at https://socy.umd.edu/about-us/rosenberg-self-esteem-scale. The scale consists of 10 items evaluated on a 4-point Likert scale from 1 (strongly disagree) to 4 (strongly agree). Scores vary from 10 to 40, with higher scores indicating a more positive self-esteem appraisal. To measure the reverse score, five questions are worded positively (items 1, 3, 4, 7, and 10), while five are worded negatively (items 2, 5, 6, 8, and 9).

The validity and reliability evidence of the RSES were assessed in prior studies, and the obtained results are presented herein. Concerning the evaluation of construct validity, prior studies have demonstrated that the RSES yielded an excellent model fit [21, 40]. According to a previous study, [41] it is suggested to ensure that the Cronbach alpha criteria for each sub-scale is ≥ 0.70. The Cronbach’s alpha coefficients for the positive and negative self-esteem subscales were determined to be 0.96 and 0.98, respectively [21]. A prior study conducted on individuals who are native English speakers has also yielded Cronbach alpha coefficients of 0.87 and 0.75 for the subscales measuring positive and negative self-esteem, respectively [17].

2.3 Translation procedure

Due to their specificity and straightforwardness, we adhered to the parameters suggested by a previous study [42]. Initially, the original questionnaire was translated into Indonesian by two translators, a psychiatrist and a professional translator whose native language was Indonesian, with the author’s approval. Both were bilingual and English-proficient. Second, we compared the two translated versions and created a new draft by combining the terminology and phrases supplied by the two translators in the previous step. Thirdly, the information was back-translated by two more independent translators with the same credentials and qualities as the first translators. Fourth, we compared the original questionnaire with the two back-translations of the questionnaire from the third phase. Considering the distance and time variations, we communicated with all four translators by email at this stage. Fifth, 30 volunteers were selected from a psychiatric hospital to evaluate the clarity of the questionnaire’s instructions, items, and response format. In addition, we asked two professionals (a psychiatrist and a psychologist) for revisions and ideas. In the final phase, the full Indonesian version of the RSES scale was administered to the study sample and tested the evidence of validity and reliability (Fig 1).

2.4 Statistical analysis

This study utilized SPSS and AMOS version 23.0 software (IBM; Armonk, New York, USA) and R Studio version 4.3.2 (R Foundation, Vienna, Austria). All statistical significance was indicated by a p-value < 0.05.

Descriptive analysis

Descriptive statistics were used to present the demographic characteristics of the study. The proportion of participants who obtained minimum and maximum scores is defined as floor and ceiling effect, respectively. Continuous variables are presented as means and standard deviations, whereas categorical variables are expressed as frequencies and percentages. The quantitative characteristics of the RSES were computed as mean, standard deviation (SD), skewness, and kurtosis. A skewness value between −1 and 1 was considered adequate [43]. The degree of vertical spread in the mean distribution corresponded to the kurtosis. The normality was assumed if the kurtosis value was less than 2.5 times the standard error [44].

Structural validity

Structural validity pertains to the extent to which the scores of a Patient-Reported Outcome Measure (PROM) accurately represent the underlying structure of the construct being measured [41]. Assessment of structural validity is typically conducted through the use of CFA [41, 45]. A CFA was carried out to assess how well the RSES model fits the data. The following fit indices were utilized during the evaluation process: X²/df, the comparative fit index (CFI), incremental fit index (IFI), the Tucker–Lewis index (TLI), goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI), the standardized root mean square residual (SRMR), and the root mean square error of approximation (RMSEA). A chi-square with a degree of freedom ratio of less than 5.0 indicated that the model was a good fit [46]. An acceptable model fit was characterized by a GFI greater than 0.80 [47] and an AGFI of 0.80 to 0.90 [48–52]. When the CFI, IFI, and TLI values were all greater than 0.90 [53], the SRMR value was less than 0.08 [53, 54], and the RMSEA value was less than 0.10 [47], the model fit was deemed to be satisfactory. Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to evaluate the alternative model, with lower AIC and BIC values indicating the best model fit [55, 56]. The average variance extracted (AVE) is an integral component of the comprehensive construct validity assessment., and an AVE score greater than 0.50 indicates an adequate result [57].

Internal consistency

Internal consistency refers to “the extent of interrelatedness among the items and is commonly evaluated using Cronbach’s alpha” [58]. Ordinal coefficient alpha is considered a viable alternative coefficient alpha to calculate a reliability estimate using the Likert response data [59, 60]. An alpha equal to or better than 0.70 demonstrates an adequate internal consistency [61, 62]. The composite reliability (CR) was used to measure a robust internal consistency. The values of CR greater than 0.70 indicated a significant result [63].

Reliability

Interclass correlation coefficient (ICC) was used to evaluate the reliability [41]. The ICC score between 0.75 and 0.90 indicated satisfactory reliability and consistency between two-time measurements, and a score greater than 0.90 revealed excellent reliability [64].

2.5 Ethical approval

The Ethics Research Committee approved this research of the University of Muhammadiyah Malang on July 19, 2018 (approval number: E.5.a/239/KEPK- UMM/VII/2018).

3. Results

Table 1 presents the clinical demographics of the study. The mean age of the 260 participants was 38.13 (SD = 9.56). Most participants were men (169, 65%) and single (139, 53.5%). Most were unemployed (173, 66.5%) and received financial support from their families (196, 75.4%). For 127 participants (48.8%), the highest educational level was senior high school. In total, 220 participants (84.6%) had previously been hospitalized, and the illness duration to onset was >5 years for 142 participants (54.6%).

Table 1. Demographic characteristics of the study (n = 260).

Characteristics	Participants (n = 260)
Characteristics	Mean (SD)	n (%)
Age	38.13 (9.56)
Gender
Male		169 (65.00)
Female		91 (35.50)
Marital status
Single		139 (53.46)
Married		81 (31.15)
Divorce or widowed		40 (15.39)
Employment status
Employed		87 (33.50)
Unemployed		173 (66.50)
Source of income
Personal income		30 (11.50)
Family support		196 (75.40)
Personal and family		34 (13.10)
Education
Elementary school		63 (24.23)
Junior high school		44 (16.92)
Senior high school		127 (48.85)
University/college		26 (10.00)
Previous hospitalization
Yes		220 (84.60)
No		40 (15.40)
Onset of illness
<1 year		75 (28.85)
1–5 years		43 (16.54)
>5 years		142 (54.61)

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*missing data = 4

**MMSE score < 24 = 21

SD = standard deviation; MMSE = Mini-Mental State Examination.

Table 2 displays the descriptive statistics, inter-item correlation, and item-total correlation of the RSES. Item 8 and item 3 received the highest and lowest mean scores of 2.57 (SD = 0.87) and 1.92 (SD = 0.81), respectively. The skewness score ranged from 0.39 to 0.90 for the total RSES items, and the kurtosis score ranged from 0.74 to 0.75. The item-total correlation varied from 0.47 to 0.6. Floor and ceiling effect was found at 5.80% - 54.20%, respectively (Table 4).

Table 2. Descriptive statistics, interitem, and item-total correlation of the RSES items (n = 260).

Items		Inter-item correlation (n = 260)
Items		1	2	3	4	5	6	7	8	9	10
RSES 1	On the whole, I am satisfied with myself.	1
RSES 2	At times, I think I am no good at all.	−0.11	1
RSES 3	I feel that I have a number of good qualities.	0.56	−0.12	1
RSES 4	I am able to do things as well as most other people.	0.51	−0.04	0.63	1
RSES 5	I feel I do not have much to be proud of.	−0.03	0.48	−0.13	−0.11	1
RSES 6	I certainly feel useless at times.	−0.00	0.62	−0.04	−0.01	0.48	1
RSES 7	I feel that I’m a person of worth, at least on an equal plane with others.	0.52	−0.01	0.64	0.86	−0.07	0.06	1
RSES 8	I wish I could have more respect for myself.	−0.19	0.71	−0.22	−0.15	0.43	0.50	−0.15	1
RSES 9	All in all, I am inclined to feel that I am a failure.	−0.1	0.85	−0.13	−0.09	0.56	0.63	−0.05	0.71	1
RSES 10	I take a positive attitude toward myself.	0.55	0.01	0.58	0.63	−0.01	−0.03	0.64	−0.08	−0.04	1
Item-total correlation		0.49	0.61	0.50	0.58	0.47	0.59	0.62	0.46	0.61	0.59
Mean		2.05	2.39	1.92	1.98	2.32	2.30	2.02	2.57	2.31	1.97
SD		0.94	0.86	0.81	0.84	0.86	0.91	0.83	0.87	0.83	0.86
Skewness		0.58	−0.02	0.90	0.69	0.32	0.21	0.59	−0.39	0.28	0.72
Kurtosis		−0.55	−0.68	0.75	0.05	−0.47	−0.74	−0.08	−0.53	−0.40	0.00

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SD = standard deviation

Table 4. Reliability analysis for the Indonesian adaptation of the rosenberg self-esteem scale (n = 260).

Items	% floor effect	% ceiling effect	Ordinal alpha	Test-retest reliability		AVE	CR
				ICC	95% CI
Positive self- esteem			0.89	0.93	0.88–0.96	0.69	0.92
RSES 1	9.20	39.60
RSES 3	6.50	54.20
RSES 4	6.50	48.80
RSES 7	5.80	48.80
RSES 10	6.90	46.90
Negative self-esteem			0.88	0.87	0.78–0.93	0.68	0.91
RSES 2	8.50	38.10
RSES 5	10.40	47.30
RSES 6	10.40	40.00
RSES 8	10.80	50.00
RSES 9	8.50	47.70

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CI = confidence interval, ICC = intraclass correlation coefficient, AVE = average variance extracted, CR = composite reliability

3.1 Structural validity

The goodness of indices for all alternative models is shown in Table 3. The AVE values were 0.69 and 0.68, and the square roots of the AVE were 0.83 and 0.82, indicating that each measured variable was significant (Table 4) (Figs 2–5).

Table 3. Goodness of fit indexes of the RSES Indonesian version.

Item	Model 1	Model 2	Model 3	Model 4
X²/df	24.50	2.96	2.93	2.93
GFI	0.55	0.93	0.93	0.93
AGFI	0.30	0.88	0.88	0.88
CFI	0.48	0.97	0.96	0.96
TLI	0.33	0.94	0.95	0.95
IFI	0.48	0.97	0.96	0.96
SRMR	0.19	0.03	0.04	0.04
RMSEA	0.30	0.08	0.08	0.08
AIC	897.634	133.992	141.497	141.497
BIC	968.848	240.812	216.27	216.27

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df = degree of freedom GFI = goodness of fit index; AGFI = adjusted goodness of fit index; CFI = comparative fit index; TLI = Tucker-Lewis index; IFI = incremental fit index; SRMR = standardized root mean square residual; RMSEA = root mean square error of approximation; AIC = Akaike information criterion; BIC = Bayesian information criterion

Fig 2 — This model extracted all items of RSES in the single-factor or uni-dimensional model (Model 1). However, the overall fit criteria were inadequate.

Fig 5 — Adequate fit indexes have been found in this model, similar to model 3. Henceforth, these four models were referred to as M1, M2, M3, and M4 respectively.

Fig 3 — Some modification indices were applied to Model 1. It was utilized to enhance the model fit. The result shows that all fit criteria were significantly adequate (Model 2).

Fig 4 — All fit criteria remained adequate in this model.

3.2 Internal consistency and reliability evidence

The overall score of the RSES has an alpha coefficient of 0.75, as determined by the ordinal alpha approach. The ordinal alpha results for each subscale were 0.89 and 0.88, demonstrating acceptable internal consistency. As presented in Table 4, the CR was calculated for positive and negative factors, and the values were 0.92 and 0.91, respectively. Test-retest reliability exhibited satisfactory results, with an ICC between 0.87 and 0.93 (Table 4).

4. Discussion

This study aimed to establish the structural validity of the RSES as well as assess internal consistency and reliability. We included patients with schizophrenia in our study, which was not the case in the previous study [30]. The sample size of our study was adequate to perform factor analysis. In addition, the structural validity of the RSES was demonstrated through CFA, an approach that has not been conducted in prior studies in Indonesia.

Through the CFA, we examine four models of structural validity in our study, which are; the single-factor or uni-dimensional model (M1), the single-factor with correlated error (M2), the two-factor model (M3), and the hierarchical model (M4). The findings from M1, suggest that there is insufficient data to support the acceptance of a single factor. Where every model fit criterion failed to meet the required levels. A notable distinction was observed while implementing the correlated error in M2, demonstrating an enhancement in the good fit criteria. This adjustment was done on the negatively worded item. This finding aligns with some prior studies that have examined the presence of method effects related to negative items on the RSES [65–67]. While some of the model fit criteria are met, it is unfortunate that this model also fell outside of other criteria. The BIC value is significantly higher compared to M3 and M4. Following a previous study, the difference in BIC scores greater than 10 provides strong evidence of the model [68]. If the objective is to achieve a goodness of fit, the BIC is the preferred option. Therefore, using BIC is more advantageous when selecting an accurate model [69].

The adequate fit indexes were also obtained in M3 and M4. The two-factor and hierarchical models exhibit comparable model fit in their respective analyses. Based on the findings mentioned above, it is suggested that the RSES can be characterized as two factors, which are positive and negative self-esteem. A previous study also referred to these two factors as positive and negative self-esteem [70]. The influence of wording effect on scale items may result in or contribute to a two-factor model. The wording item effect, then further related to the method effect has been observed in earlier studies [37, 71], which suggests the presence of a two-factor of RSES [71]. In summary, our finding indicates that the RSES scale has an acceptable model fit with two factors. Similar findings were also demonstrated in a previous study that a two-factor model was deemed to have an adequate model fit [21, 36, 72, 73]. Based on our findings, we can conclude that the RSES which is a two-factor model was a valid instrument for people with schizophrenia in Indonesia. Acknowledging the necessity of reassessing the utilization of the RSES and its theoretical foundations in administering the scale to target populations is essential.

The total score on the Indonesian version of the RSES had an ordinal alpha coefficient of 0.75. In contrast, the positive and negative self-esteem subscale had a coefficient of 0.89, and 0.88 respectively. In line with this finding, a previous investigation found satisfactory levels of internal consistency, as measured by a Cronbach’s alpha coefficient that ranged from 0.81 to 0.91 [13, 14, 25, 30]. Our result was consistent with a previous study [74], which was conducted in individuals with severe mental illnesses, not specific only to patients with schizophrenia, and which reported strong internal consistency. To demonstrate more robust internal consistency, composite reliability also exhibits favorable outcomes.

In addition, we looked at the test-retest reliability of the RSES. The ICC values generated were 0.93 and 0.87 for the positive and negative self-esteem respectively. The ICC results were adequate, indicating the stability of each factor of the RSES. Additionally, it was observed that there was a high correlation coefficient between the test-retest reliability and Cronbach’s alpha. In conclusion, the findings of this study provide evidence supporting the robust reliability of the RSES as a reliable instrument for assessing self-esteem in individuals diagnosed with schizophrenia in Indonesia.

The present study also has limitations. Because our study sample included only patients with schizophrenia, these findings cannot be extrapolated to populations with other mental illnesses. Moreover, most of our study’s participants are men, leading to a more prominent interpretation of item scores among this group. Future studies should aim to expand the participant pool by including individuals diagnosed with a diverse range of mental illnesses while also ensuring a balanced representation of both genders. In addition to the limitations mentioned above, it is essential to note that our study produced favorable evidence regarding structural validity, internal consistency, and reliability. Hence establishing the RSES as a valid and reliable questionnaire appropriate for implementation within the tested sample group.

5. Conclusion

The current investigation provided evidence supporting the structural validity, internal consistency, and reliability of the RSES, indicating that the RSES can be considered a valid and reliable measurement. A two-factor model of RSES was an appropriate model to measure self-esteem in our study. This finding suggests that the use of the RSES is beneficial and applicable in assessing levels of self-esteem in individuals diagnosed with schizophrenia in Indonesia. Nevertheless, further research is needed to understand better the characteristics of the method factors for different populations. As previously stated, positive and negative item wording is still a major consideration in psychometric analysis.

Supporting information

S1 Dataset

(XLSX)

pone.0300184.s001.xlsx^{(28.2KB, xlsx)}

Acknowledgments

We would like to acknowledge Wallace Academic Editing Company for editing this manuscript.

Data Availability

All relevant data are within the paper and its S1 Dataset files. Please inform the authors if data are being used.

Funding Statement

The authors did not received any funding for this study.

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PLoS One. doi: 10.1371/journal.pone.0300184.r001

Decision Letter 0

Silvia Escribano Cubas

25 May 2023

PONE-D-23-08354

Construct Validity of the Rosenberg Self-Esteem Scale in patients with Schizophrenia in Indonesia

PLOS ONE

Dear Dr. Chung,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we recommend reconsideration of your manuscript following major revision. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

==============================

ACADEMIC EDITOR:Please respond to and address all the reviewers' recommendations before resubmission. The reviewers have pointed out that the introduction and methodology sections of the paper require improvement. Specifically, a sample of 260 subjects was used to perform an EFA and CFA. It is crucial to take their suggestions and make the necessary revisions to ensure that the paper complies with quality standards of the instruments validation.

==============================

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Reviewers' comments:

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Comments to the Author

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Reviewer #1: Yes

Reviewer #2: Partly

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

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Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Yes

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Reviewer #2: No

Reviewer #3: Yes

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5. Review Comments to the Author

Reviewer #1: Review of PONE-D-23-08354

The submission studies the psychometric properties of an Indonesian version of the Rosenberg Self-Esteem Scale using a sample of inpatients diagnosed with schizophrenia. The Introduction is brief and does not justify the approach of the study sufficiently. Some sentences are confusing, e.g., in the first paragraph when the authors state that SE plays a role in the development of mental illness (i.e., precedent) but also state that this is because SE is a key outcome of mental illnesses (i.e., subsequent).

Some results are confusing, e.g., using the same sample to conduct first an EFA and second a CFA, or describing the psychometric properties as validity. As a reader, I would expect reports of associations with other constructs typically related to SE and some sort of criterion validity. The authors also discuss the two-factor model without acknowledging previous studies on factor-solutions in relation to wording. What is however an interesting finding is the extremely small association between the positive and the negative factor which is not in line with previous research. It might be beneficial to study this further.

The sample is interesting and the psychometric test plausible, but I would expect such tests in such a sample as a first step of a paper on further relevant research questions. The psychometric tests alone do not seem like a substantial contribution to the literature.

Reviewer #2:

ABSTRACT:

-The use of some terms when mentioning types of validity evidence, do not follow the current Standards. For example, the term "construct validity" should be replaced, according to the last versions of the Standards (AERA, APA, & NCME, 1999, 2014).

INTRODUCTION:

-"According to literature [6], self-esteem also plays a crucial role in developing various mental illnesses" -->Please determine the type and characteristics of mental illnesses.

METHODS:

-"This study employed a cross-sectional design"--> Please determine the correct type of study. This is an instrumental questionnaire validation study, not a cross-sectional study.

-"(e) provision of informed consent"-->The following element cannot be considered an inclusion criterion. This aspect should be considered in the ethics section.

-"The participants were informed before signing the written consent form that participation is voluntary and their confidentiality was carefully guarded. The purposes of the study, procedure for filling out questionnaires, potential risk or inconvenient, confidentiality issues and contact detail of the researcher were explained in the written consent forms and informs the participant directly. The researcher also gives an option to the participants to not participate in the study. The participants in this study was vulnerable group (psychiatric patients/ case with mental illness), therefore, additional protection was provided" --> Please review the flow of information in the methods section. From my humble point of view there are certain aspects that are not in the corresponding section (in this case ethics), besides repeating information.

-"The minimum number of participants recommended by Mundfrom, Shaw [29] was 20 times the number of variables, which in this case equaled 200 participants. In this study, data was missing from four questionnaires because they were not accurately completed, and 21 participants were excluded because their MMSE score was less than 24. Considering the response rate of 20%, the final sample comprised 260 participants"--> I seem to remember that the rule of 5 and 20 participants has long been out of use, it is calculated on the basis of expected communalities and items per factor, taking into account the work in statistical analysis under optimal conditions. I refer the authors to the citations of Ferrando-Piera et al. (2022) and Lloret-Segura et al. (2014).

-"Sinclair, Blais [9] found that the dependability of the RSES was satisfactory, with a Cronbach's alpha of 0.91" -->Please determine internal consistency by scales or sub-dimensions, currently presenting internal consistency of total scale scores is a major methodological error. I refer the authors to the citation of Prinsen et al. (2018).

- "Franck, De Raedt [21] tested the construct validity by correlating the RSES score with the NEO Five-Factor Inventory subscales. In line with Tinakon and Nahathai [10], the RSES negatively correlated with the Thai Depression Inventory" --> Please determine the magnitude of the correlations in the different studies. The use of some terms when mentioning types of validity evidence, do not follow the current Standards.

-"In the last phase, the complete Indonesian version of the RSES scale was administered to the study sample, and its validity and reliability were determined" --> The use of some terms when mentioning types of validity evidence, do not follow the current Standards.

-"A Cronbach's alpha equal to or better than 0.70 demonstrates adequate internal consistency [33, 34]" --> From my humble point of view the authors should have calculated the ordinal alpha. The rest of the statistics in categorical response scales underestimate reliability. I refer the authors to the citation of Zumbo et al. (2007).

- "We carried out an EFA (exploratory factor analysis) to examine the construct validity of the scale using a principal component analysis [36, 37] with varimax rotation [38]" -->I seem to remember that the use of orthogonal rotations in highly correlated multidimensional constructs may deform the underlying structure of test item scores. I refer the authors to the citations of Ferrando-Piera et al. (2022), Lloret-Segura et al. (2014) and Prinsen et al. (2018).

- "to determine the number of components, an eigenvalue greater than 1.00 was utilized [43, 44]" --> According to the latest standards it is more correct to use parallel analysis to determine the number of factors. I refer the authors to the citations of Ferrando-Piera et al. (2022) and Lloret-Segura et al. (2014). Adequacy of EFA (KMO; Barteltt's test of sphericity and determinant) should come before "parallel analysis" or "number of factors" to determine the number of factors to be retained, not after as now appears in several places of the text.

-I do not observe the criteria used to retain or discard items in the EFA; the authors should provide scientific evidence in this regard.

-The authors do not make it clear whether they randomly segmented the sample into two halves to perform the CFA and EFA.

-Why do the authors perform an EFA and a CFA with the same sample, what does this contribute to the study?

-I still do not understand why with a sample of 260 participants and without segmenting it the authors perform an EFA and a CFA, taking into consideration that a sample of 130 to perform the different statistical methods would be unstable due to the small size. I refer the authors to the citations of Ferrando-Piera et al. (2022) and Lloret-Segura et al. (2014).

-From my humble point of view it would be more interesting to perform only a CFA with several adjustments: a) congeneric model, b) correlated error model if the modification rates are greater than or equal to 35000 and c) a second order model to assess the existence of a single underlying construct.

-"convergent validity"--> The use of some terms when mentioning types of validity evidence, do not follow the current Standards. I refer the authors to the citation of Prinsen et al. (2018).

RESULTS:

-There are variables that have not been described in the methodology section. The authors should include a section where readers can see all the sociodemographic variables collected. The authors should write the variables more clearly, specifically if they are continuous or categorical variables. In the case of categorical variables, they should include the response options in parentheses. The authors should describe the evaluation instruments more clearly. I recommend writing it with a hyphen, the name of the instrument and its psychometric properties.

-The authors should provide normative and performance data for the scale items (ceiling and floor effects). Based on the results found , if floor and ceiling effects are found, the authors should provide percentiles to facilitate the interpretation of the scores. Authors should explore differences between men and women and provide effect sizes. However, t-test for examining differences in direct score between ratings of men and women should be conducted after demonstrating measurement invariance across this variable, at least at the factor loadings level (weak o metric invariance) and item thresholds/intercepts level (strong or scalar invariance), to ensure that direct scores are operating in the same way and, therefore, are meaningfully comparable.

DISCUSSION:

-"In addition, evidence of the construct validity of the RSES was demonstrated through EFA and CFA, contrary to previous studies conducted in Indonesia" --> Is it appropriate to do this with a total sample of 260 participants?

-"In line with this finding, a previous investigation found satisfactory levels of internal consistency, as measured by a Cronbach's alpha coefficient that ranged from 0.81 to 0.91 [9, 10, 21, 25]" --> What are the implications of obtaining an internal consistency greater than 0.90?

-"Another study indicated that a two-factor model considerably increases the fit compared to a one-factor model [58]" -->The following statement supports my humble opinion of performing a CFA with several adjustments, specifically congeneric and a second-order model.

-Authors should include in the limitations section that the majority of the sample on which we can interpret the item scores are men.

CONCLUSIONS:

-The authors' statements in the conclusions section should be based on the statistical recommendations provided. Are we sure that the structure has not been influenced by orthogonal rotation?

ADDITIONAL COMMENTS:

-"Table 1. Demographic Characteristics of the Study (n = 260)" --> The sum of the percentages exceeds or does not reach 100%, the authors should check the sum of the tables.

BIBLIOGRAPHY:

Ferrando-Piera, P. J., Lorenzo-Seva, U., Hernández-Dorado, A., & Muñiz-Fernández, J. (2022). Decálogo para el Análisis Factorial de los Ítems de un Test. Psicothema. Retrieved from https://hdl.handle.net/11162/217964.

Lloret-Segura, S., Ferreres-Traver, A., Hernández-Baeza, A., & Tomás-Marco, I. (2014). El análisis factorial exploratorio de los ítems: una guía práctica, revisada y actualizada. Psicothema. https://doi.org/6018/analesps.30.3.199361

Prinsen, C. A., Mokkink, L. B., Bouter, L. M., Alonso, J., Patrick, D. L., De Vet, H. C., & Terwee, C.

B. (2018). COSMIN guideline for systematic reviews of patient-reported outcome measures. Quality of life research, 27(5), 1147-1157. https://doi.org/10.1007/S11136-018-1798-3

Zumbo, B.D., Gadermann, A.M., & Zeisser, C. (2007). Ordinal versions of coecients alpha and theta for Likert rating scales. Journal of Modern Applied Statistical Methods,6, 21-29. https://doi.org/10.22237/jmasm/1177992180

Reviewer #3:

It is a ver straightforward article in which the construct validity of the Rosenberg Self-Esteem Scale for schizophrenia patients in Indonesia is assessed.

I have to admit that I was not expecting the length of this article and I received it with great pleasure. Nowadays articles this long are not that easy to find. It is very easy to read and very straightforward as well, which is one of its strong points, in my humble opinion.

However, the introduction section is lacking some depth. Authors state that "self-steem plays a crucial role in developing various mental illnesses" (page 3, line 7). This affirmation makes me think that self-steem triggers some mental disorders. But then, following the previous sentence: "this is because low self-esteem has been postulated to be one of the primary outcomes of mental illness". This part needs some clarification. Also, in the last paragraph of the introduction (page 4, line 2), authors state: "Additionally, some previous studies have shown that self-esteem has been associated with schizophrenia". In which way? In general, although I can guess the intention of the authors of making a short paper, I think the introduction section would benefit from a deeper research.

Methods, results and discussion sections are great. They are short and straightforward, like the rest of the paper.

My main concern is the fact that references do not follow the APA format. Please revise it carefully.

==============================

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PLoS One. 2024 May 10;19(5):e0300184. doi: 10.1371/journal.pone.0300184.r002

Author response to Decision Letter 0

4 Oct 2023

Dear Editor and Reviewer

Manuscript ID:

Manuscript Title: “Construct Validity of the Rosenberg Self-Esteem Scale in Patients with Schizophrenia in Indonesia”

We sincerely thank the editor and all reviewers for their valuable suggestions and for giving us a great opportunity to revise our manuscript entitled “Construct Validity of the Rosenberg Self-Esteem Scale in Patients with Schizophrenia in Indonesia”. We have incorporated all the suggested changes into the manuscript and have highlighted the revised sections. Hereby, our responses and revisions are based on the editor and reviewer’s comments.

--------------------------------------------------------------------------------------------------

EDITORIAL COMMENTS:

Please respond to and address all the reviewers' recommendations before resubmission. The reviewers have pointed out that the introduction and methodology sections of the paper require improvement. Specifically, a sample of 260 subjects was used to perform an EFA and CFA. It is crucial to take their suggestions and make the necessary revisions to ensure that the paper complies with the quality standards of the instrument validation.

Response: Thank you for your correction. The necessary amendments and recommendations provided by the reviewers have been incorporated into our work.

REVIEWER #1 COMMENTS:

1. The submission studies the psychometric properties of an Indonesian version of the Rosenberg Self-Esteem Scale using a sample of inpatients diagnosed with schizophrenia. The Introduction is brief and does not justify the approach of the study sufficiently. Some sentences are confusing, e.g., in the first paragraph when the authors state that SE plays a role in the development of mental illness (i.e., precedent) but also state that this is because SE is a key outcome of mental illnesses (i.e., subsequent).

Response: Thank you for your corrections. We want to explain that self-esteem and mental illnesses have a bidirectional pattern. Low self-esteem makes people more vulnerable to the development of mental illnesses, and mental illness, in turn, lowers self-esteem. The paragraph has been revised to enhance the reader's comprehension of the author's intended message.

(Page 3)

There exists a reciprocal relationship between self-esteem and mental illnesses. A previous study found that self-esteem plays a pivotal role in developing diverse mental illnesses and social problems encompassing a range of internalizing issues, such as depression, suicidal tendencies, eating disorders, and anxiety, as well as externalizing problems, including violence and substance abuse [6]. Conversely, it has been hypothesized that mental illnesses can lead to low self-esteem as a significant consequence [7]. Consistent with prior research [8] low self-esteem has been found to heighten susceptibility to the onset of mental illness. In contrast, the existence of mental illness subsequently diminishes self-esteem. Eventually, individuals with mental illnesses are likely to have fluctuating self-esteem levels. Hence, self-esteem is considered a component of self-assessment, which influences mental health and vice versa.

2. Some results are confusing, e.g., using the same sample to conduct first an EFA and second a CFA, or describing the psychometric properties as validity. As a reader, I would expect reports of associations with other constructs typically related to SE and some sort of criterion validity. The authors also discuss the two-factor model without acknowledging previous studies on factor solutions in relation to wording. What is however an interesting finding is the extremely small association between the positive and the negative factor which is not in line with previous research. It might be beneficial to study this further.

Response: Thank you for your corrections. We have made the necessary revisions to our work. As a result, we have decided to exclusively focus on presenting confirmatory factor analysis (CFA) in order to demonstrate validity evidence of the RSES. (Statistical analysis; Page 7); (Results; Page 8); (Discussion; Page 9).

3. The sample is interesting and the psychometric test plausible, but I would expect such tests in such a sample as a first step of a paper on further relevant research questions. The psychometric tests alone do not seem like a substantial contribution to the literature.

Response: Thank you for your corrections. As previously stated, the RSES has been widely used as a scale to measure self-esteem in a variety of populations; but, to the best of our knowledge, there has been no previous research employing the RSES in schizophrenia patients, particularly in Indonesia. As a result of our hypothesis, the RSES psychometric test in our study can make a significant contribution. In addition, we revised and added more information in the last paragraph of the introduction section to describe our novelties.

(Page 4)

Multiple countries, including Indonesia, have implemented the RSES to measure the self-esteem of college students and the general population [26]. Interestingly, some previous studies have shown that self-esteem has been associated with schizophrenia [27-29]. For example, there was a significant correlation between a decrease in the intensity of adverse symptoms and an enhancement in self-esteem, and conversely, [30]. Unfortunately, the scale for people diagnosed with schizophrenia was not evaluated using psychometric testing in a prior study [26]. Additionally, they only focused on internal consistency and factor structure invariance.

REVIEWER #2 COMMENTS:

ABSTRACT:

1. The use of some terms when mentioning types of validity evidence, do not follow the current Standards. For example, the term "construct validity" should be replaced, according to the last versions of the Standards (AERA, APA, & NCME, 1999, 2014).

Response: Thank you for your corrections. We have corrected and changed it following the current standards.

(Page 2)

We examined the validity and reliability evidence of the RSES by measuring confirmatory factors among patients with schizophrenia in Indonesia

INTRODUCTION:

2. According to literature [6], self-esteem also plays a crucial role in developing various mental illnesses" -->Please determine the type and characteristics of mental illnesses.

Response: Thank you for your corrections. According to the intended literature, we amended and added information about the types and characteristics of mental illnesses.

(Page 3)

3. The use of some terms when mentioning types of validity evidence, do not follow the current Standards. For example, the term "construct validity" should be replaced, according to the last versions of the Standards (AERA, APA, & NCME, 1999, 2014).

Response: Thank you for your corrections. We have corrected and changed it following the current standards.

(Page 4)

Hence, evaluating the RSES in individuals diagnosed with schizophrenia is imperative to ascertain its validity and reliability

METHODS:

4. This study employed a cross-sectional design"--> Please determine the correct type of study. This is an instrumental questionnaire validation study, not a cross-sectional study.

Response: Thank you for your correction. We have corrected and replaced it in accordance with your suggestions.

(Page 5)

This is an instrumental questionnaire validation study.

5. (e) provision of informed consent"-->The following element cannot be considered an inclusion criterion. This aspect should be considered in the ethics section.

Response: Thank you for your correction. We have corrected it in accordance with your suggestions.

6. The participants were informed before signing the written consent form that participation is voluntary and their confidentiality was carefully guarded. The purposes of the study, procedure for filling out questionnaires, potential risk or inconvenient, confidentiality issues and contact detail of the researcher were explained in the written consent forms and informs the participant directly. The researcher also gives an option to the participants to not participate in the study. The participants in this study was vulnerable group (psychiatric patients/ case with mental illness), therefore, additional protection was provided" --> Please review the flow of information in the methods section. From my humble point of view there are certain aspects that are not in the corresponding section (in this case ethics), besides repeating information.

Response: Thank you for your correction. This section has been moved to incorporate an ethics section.

7. The minimum number of participants recommended by Mundfrom, Shaw [29] was 20 times the number of variables, which in this case equaled 200 participants. In this study, data was missing from four questionnaires because they were not accurately completed, and 21 participants were excluded because their MMSE score was less than 24. Considering the response rate of 20%, the final sample comprised 260 participants"--> I seem to remember that the rule of 5 and 20 participants has long been out of use, it is calculated on the basis of expected communalities and items per factor, taking into account the work in statistical analysis under optimal conditions. I refer the authors to the citations of Ferrando-Piera et al. (2022) and Lloret-Segura et al. (2014).

Response: Thank you for your correction and suggestions. We have corrected it in accordance with your suggestions.

(Page 5)

The size of 200 participants required in this study is acceptable based on recommendations from prior studies [31, 32].

8. Sinclair, Blais [9] found that the dependability of the RSES was satisfactory, with a Cronbach's alpha of 0.91" -->Please determine internal consistency by scales or sub-dimensions, currently presenting internal consistency of total scale scores is a major methodological error. I refer the authors to the citation of Prinsen et al. (2018).

Response: Thank you for your correction. We have corrected and changed it in accordance with your suggestions.

(Page 6)

The validity and reliability of the RSES were assessed in prior studies, and the obtained results are presented herein. According to a previous study [33] it is suggested to ensure that the Cronbach alpha criteria for each sub-scale is ≥ 0.70. The Cronbach's alpha coefficients for the positive and negative self-esteem subscales were determined to be 0.96 and 0.98, respectively [19]. A prior study conducted on individuals who are native English speakers has also yielded Cronbach alpha coefficients of 0.87 and 0.75 for the subscales measuring positive and negative self-esteem, respectively [14]. Concerning the evaluation of validity evidence (construct validity), prior studies have demonstrated that the RSES yielded an excellent model fit [19, 34].

9. Franck, De Raedt [21] tested the construct validity by correlating the RSES score with the NEO Five-Factor Inventory subscales. In line with Tinakon and Nahathai [10], the RSES negatively correlated with the Thai Depression Inventory" --> Please determine the magnitude of the correlations in the different studies. The use of some terms when mentioning types of validity evidence, do not follow the current Standards.

Response: Thank you for your correction. We have corrected and changed it in accordance with your suggestions.

(Page 6)

Concerning the evaluation of validity evidence (construct validity), prior studies have demonstrated that the RSES yielded an excellent model fit [19, 34].

10. In the last phase, the complete Indonesian version of the RSES scale was administered to the study sample, and its validity and reliability were determined" --> The use of some terms when mentioning types of validity evidence, do not follow the current Standards.

Response: Thank you for your correction. We have corrected and changed it in accordance with your suggestions.

(Page 6-7)

In the final phase, the full Indonesian version of the RSES scale was administered to the study sample and tested the evidence of validity and reliability.

11. A Cronbach's alpha equal to or better than 0.70 demonstrates adequate internal consistency [33, 34]" --> From my humble point of view, the authors should have calculated the ordinal alpha. The rest of the statistics in categorical response scales underestimate reliability. I refer the authors to the citation of Zumbo et al. (2007).

Response: Thank you for your correction and suggestion. In this section, we adhere to the same content as our initial composition. To the best of our knowledge, ordinal alpha is merely a measure of hypothetical reliability and does not reflect the actual reliability of the test. Herewith is an article pertaining to the misconceptions and the limited usefulness of ordinal alpha.

Reference: Chalmers, R. P. (2018). On misconceptions and the limited usefulness of ordinal alpha. Educational and Psychological Measurement, 78(6), 1056-1071.

12. We carried out an EFA (exploratory factor analysis) to examine the construct validity of the scale using a principal component analysis [36, 37] with varimax rotation [38]" -->I seem to remember that the use of orthogonal rotations in highly correlated multidimensional constructs may deform the underlying structure of test item scores. I refer the authors to the citations of Ferrando-Piera et al. (2022), Lloret-Segura et al. (2014) and Prinsen et al. (2018).

Response: Thank you for your correction. After conducting a comprehensive assessment of the relevant literature, we have made the necessary revisions to our work. As a result, we have decided to exclusively focus on presenting confirmatory factor analysis (CFA) in order to demonstrate validity evidence of RSES. Therefore, EFA analysis is not performed in our revision.

13. to determine the number of components, an eigenvalue greater than 1.00 was utilized [43, 44]" --> According to the latest standards it is more correct to use parallel analysis to determine the number of factors. I refer the authors to the citations of Ferrando-Piera et al. (2022) and Lloret-Segura et al. (2014). Adequacy of EFA (KMO; Barteltt's test of sphericity and determinant) should come before "parallel analysis" or "number of factors" to determine the number of factors to be retained, not after as now appears in several places of the text.

14. I do not observe the criteria used to retain or discard items in the EFA; the authors should provide scientific evidence in this regard.

15. The authors do not make it clear whether they randomly segmented the sample into two halves to perform the C

PLoS One. doi: 10.1371/journal.pone.0300184.r003

Decision Letter 1

Silvia Escribano Cubas

20 Nov 2023

PONE-D-23-08354R1Construct Validity of the Rosenberg Self-Esteem Scale in patients with Schizophrenia in IndonesiaPLOS ONE

Dear Dr. Chung,

==============================

ACADEMIC EDITOR: Please insert comments here and delete this placeholder text when finished. Be sure to:

Please note that the discussion, as it is now, is confusing. On the one hand they state that the scale is unidimensional, but then conclude that the best structure is the two-factor model. Furthermore, in order to reach a conclusion on this, other parameters, such as factor loadings, should be taken into consideration. Factor loadings below 0.30 should not be included in these items because they do not explain enough variance.

==============================

Please submit your revised manuscript by Jan 04 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

We look forward to receiving your revised manuscript.

Kind regards,

Silvia Escribano Cubas

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: (No Response)

Reviewer #3: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #2: Partly

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: N/A

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #2: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #2: No

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: I appreciate the authors' time spent in enhancing the manuscript. Statistically, it seems they have done an acceptable job. Nevertheless, there are still certain concerns I have regarding the manuscript's writing (Attached is a PDF where I've highlighted in red the elements that strike me as discordant in the text):

INTRODUCTION

1. In summary, self-esteem is a pivotal psychological construct that controls several facets of an individual's existence,

encompassing mental well-being, accomplishments, interpersonal engagements, and coping abilities-->Evidence is needed for this statement.

2. There exists a reciprocal relationship between self-esteem and mental illnesses. A previous study found that self-esteem plays a pivotal role in developing diverse mental illnesses and social problems encompassing a range of internalizing issues, such as depression, suicidal tendencies, eating disorders, and anxiety, as well as externalizing problems, including violence and substance abuse -->Evidence is needed for this statement. A visual representation or diagram displaying the relationship between constructs/variables would be interesting for the reader.

3. Researchers often use the RSES to measure self-esteem in the clinical population [15]--> Please add the characteristics of the population, diagnosis...

General Overview: The repetition of some ideas and the lack of a smooth transition between paragraphs make it difficult to read. Ensure that the citations are correctly referenced and that there is coherence in the bibliography throughout the text. Some key statements lack specific citations or references, which compromises the credibility of the text. Through a brief search, I find a large number of validations, such as those in Spanish, which the authors have not included in the relevant section of the introduction. An exposition of the structural differences and psychometric properties of the tool in the target population of the study should be made, in this case, in patients with schizophrenia.

METHODS

2.2. Instruments-->Remove the numbering from the categorical variables. Is the instruments section appropriate to discuss the known evidence of internal consistency?

2.3. Translation procedure-->Include an explanatory diagram/figure of the process.

2.4 Statistical Analysis--> Please remove the sub-sections and write in a simpler manner.

2.4.3 Validity evidence--> What estimator have you used for the CFA? ULS, WLSMV?

General Overview: Please present structural validity section before reliability and internal consistency. I refer you to COSMIN. The data on internal consistency cannot be interpreted before data on structural validity.

RESULTS:

General Overview: Please provide the evidence for structural validity before internal consistency and reliability. According to COSMIN (reference provided in the first review), internal consistency and reliability cannot be interpreted without first having evidence of structural validity.

DISCUSSION

General Overview: The discussion still requires further development. Currently, the flow of information is disorganized. I also encourage the authors to delve into the results they have obtained and provide an explanation and reasoning behind their findings. They do not discuss the advantages of obtaining a single factor or the disadvantages of not obtaining it... I'm also unsure whether the studies they are comparing with have clinical or non-clinical samples. There is anthropomorphic language that should be removed. The writing needs to be revised as it still does not adhere to AERA, APA, NMCE, COSMIN standards.

Next, I copy fragments of the discussion that bother me when reading:

"Surprisingly", "can be conceptualized as comprising two distinct constructs", "In short, the evidence from our study shows that the RSES scale construct fits well", Our sample size was adequate to perform factor analysis", "Our results were consistent with a previous study by [54], conducted in", "individuals with severe mental illnesses, not specific only to patients with schizophrenia and reported strong internal consistency".......

Reviewer #3: Authors have successfully adressed all of my concerns. The manuscript can be considered for its publication now.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Reviewer #3: No

**********

Attachment

Submitted filename: PONE-D-23-08354_R1.pdf

pone.0300184.s002.pdf^{(1.5MB, pdf)}

PLoS One. 2024 May 10;19(5):e0300184. doi: 10.1371/journal.pone.0300184.r004

Author response to Decision Letter 1

3 Jan 2024

Dear Editor and Reviewer

Manuscript ID: PONE-D-23-08354R1

Manuscript Title: “Structural Validity of the Rosenberg Self-Esteem Scale in Patients with Schizophrenia in Indonesia”

We sincerely thank the editor and all reviewers for their valuable suggestions and for allowing us to revise our manuscript entitled “Construct Validity of the Rosenberg Self-Esteem Scale in Patients with Schizophrenia in Indonesia”. We have incorporated all the suggested changes into the manuscript and have highlighted the revised sections. At this moment, our responses and revisions are based on the editor and reviewer’s comments.

--------------------------------------------------------------------------------------------------

EDITORIAL COMMENTS:

Please note that the discussion, as it is now, is confusing. On the one hand they state that the scale is unidimensional, but then conclude that the best structure is the two-factor model. Furthermore, in order to reach a conclusion on this, other parameters, such as factor loadings, should be taken into consideration. Factor loadings below 0.30 should not be included in these items because they do not explain enough variance.

Response: Thank you for your correction. The necessary amendments and recommendations provided by the reviewers have been incorporated into our work. The discussion section of our study has been revised.

(Page 10)

The adequate fit indexes were also obtained in Models 2 and 3. The two-factor and hierarchical models exhibit comparable model fit in their respective analyses. Based on the findings mentioned above, it is suggested that the RSES can be characterized as two factors, which are positive and negative self-esteem. A previous study also referred to these two factors as positive and negative self-esteem [69]. The influence of wording effect on scale items may result in or contribute to a two-factor model. The wording item effect, then further related to the method effect has been observed in earlier studies [37, 70], which suggests the presence of a two-factor of RSES [70]. In summary, our finding indicates that the RSES scale has an acceptable model fit with two factors, Similar findings were also demonstrated in a previous study that a two-factor model was deemed to have an adequate model fit [21, 36, 71, 72]. Based on our finding, we can conclude that the RSES with is a two-factor model was a valid instrument for people with schizophrenia in Indonesia. Acknowledging the necessity of reassessing the utilization of the RSES and its theoretical foundations in administering the scale to target populations is essential.

(Page 12; conclusion).

With respect to loading factors, the initial manuscript we submitted details that our study employed loading factors ranging from 0.69 to 0.92, indicating that all loading factors exceeded 0.30. As previously mentioned in the last revision, our analysis was limited to CFA without EFA. We therefore do not report any factor loading in our recent revision.

REVIEWER #1 COMMENTS: No comments.

REVIEWER #2 COMMENTS:

I appreciate the authors' time spent in enhancing the manuscript. Statistically, it seems they have done an acceptable job. Nevertheless, there are still certain concerns I have regarding the manuscript's writing (Attached is a PDF where I've highlighted in red the elements that strike me as discordant in the text):

INTRODUCTION:

1. In summary, self-esteem is a pivotal psychological construct that controls several facets of an individual's existence, encompassing mental well-being, accomplishments, interpersonal engagements, and coping abilities-->Evidence is needed for this statement.

Response: Thank you for your correction. We have corrected and replaced it following your suggestions.

(Page 3; paragraph 1)

In summary, self-esteem is a pivotal psychological construct [6] that controls several facets of an individual's existence, encompassing mental well-being, accomplishments, interpersonal engagements, and coping abilities [3, 4].

Response: Thank you for your correction and suggestion. We have corrected and replaced it following your suggestions.

(Page 3; paragraph 2)

There is a reciprocal relationship between self-esteem and mental illnesses [7].

3. Researchers often use the RSES to measure self-esteem in the clinical population [15]--> Please add the characteristics of the population, diagnosis...

Response: Thank you for your correction and suggestion. We have corrected and replaced it following your suggestions.

(Page 3; paragraph 3)

Researchers often use the RSES to measure self-esteem in the clinical population, such as eating disorders [18], anxiety, depression [7], attention and emotional disorder [19], schizophrenia and bipolar disorder [20]. Other studies have tested the RSES in specific people, such as ex-prisoners [21], drug users [22], and single mothers [23].

4. General Overview: The repetition of some ideas and the lack of a smooth transition between paragraphs make it difficult to read. Ensure that the citations are correctly referenced and that there is coherence in the bibliography throughout the text. Some key statements lack specific citations or references, which compromises the credibility of the text. Through a brief search, I find a large number of validations, such as those in Spanish, which the authors have not included in the relevant section of the introduction. An exposition of the structural differences and psychometric properties of the tool in the target population of the study should be made, in this case, in patients with schizophrenia.

Response: Thank you for your correction and suggestion. We have corrected and replaced it following your suggestions, including the substitution of multiple sentences in the introduction to make it easier for readers to fully understand our idea. (See page 3-4; paragraph 1-5)

(Page 3-4; paragraph 3)

The RSES has been translated and adapted into a number of different languages, including German [24], Dutch [25], Estonian [26], French [27], Portuguese [28], Spanish [29], Japanese [17], and Thai [14]; thus, making it applicable to participants from diverse samples or populations.

METHODS:

5. Instruments-->Remove the numbering from the categorical variables. Is the instruments section appropriate to discuss the known evidence of internal consistency?

Response: Thank you for your correction and suggestion. We have corrected and replaced it following your suggestions. This section aims to elucidate the rationale for the utilization of this questionnaire. It will accomplish this by providing information about the questionnaire's developer, the scale employed, its interpretation, and the questionnaire's validity and reliability evidence, as established by prior research.

(Page 5)

The remaining variables as categorical variables, namely gender (male; female), marital status (single; married; divorced, or widowed), employment status (employed; unemployed), source of income (personal income; family support; personal and family support), education (elementary; junior; high school; university/ college), previous hospitalization (yes; no), and onset of illness (<1 year; 1-5 years; >5 years).

6. Translation procedure-->Include an explanatory diagram/figure of the process.

Response: Thank you for your correction and suggestion. We have provided the flow diagram of the translation procedure (see: Figure 1)

(Figure 1)

7. Statistical Analysis--> Please remove the sub-sections and write in a simpler manner.

Response: Thank you for your correction and suggestion. We have corrected and replaced it following your suggestions. (Page 7-8).

8. Validity evidence--> What estimator have you used for the CFA? ULS, WLSMV?

Response: Thank you for your correction and suggestion. Unweighted Least Squares (ULS) was used in our analysis, since our data meet the assumption as a continuous and normally distributed.

9. General Overview: Please present structural validity section before reliability and internal consistency. I refer you to COSMIN. The data on internal consistency cannot be interpreted before data on structural validity.

Response: Thank you for your correction and suggestion. We have corrected and replaced it following your suggestions, as mentioned based on the COSMIN.

RESULTS:

10. General Overview: Please provide the evidence for structural validity before internal consistency and reliability. According to COSMIN (reference provided in the first review), internal consistency and reliability cannot be interpreted without first having evidence of structural validity.

Response: Thank you for your correction and suggestion. We have corrected and replaced it following your suggestions.

(Page 9)

Structural validity.

The goodness of indices for all alternative models is shown in Table 3. Considering the single-factor or uni-dimensional model (M1a), the overall fit criteria were inadequate (See Figure 2). However, after some modification indices (See Figure 3), all fit criteria were significantly adequate (M1b). The adequacy of all fit criteria remained satisfactory when the two-factor model (M2) and hierarchical model (M3) were applied (See Figures 4 and 5). The AVE values were 0.69 and 0.68, and the square roots of the AVE were 0.83 and 0.82, indicating that each measured variable was significant (Table 4).

Internal consistency and reliability evidence.

The RSES had an alpha coefficient of 0.75, according to Cronbach's method. The results of Cronbach's alpha, which measures internal consistency, came in at 0.89 and 0.88 for each subscale (factor), indicating acceptable internal consistency. As presented in Table 4, the CR was calculated for positive and negative factors, and the values were 0.92 and 0.91, respectively. Test-retest reliability exhibited satisfactory results, with an ICC between 0.87 and 0.93 (Table 4).

DISCUSSION:

11. General Overview: The discussion still requires further development. Currently, the flow of information is disorganized. I also encourage the authors to delve into the results they have obtained and provide an explanation and reasoning behind their findings. They do not discuss the advantages of obtaining a single factor or the disadvantages of not obtaining it... I'm also unsure whether the studies they are comparing with have clinical or non-clinical samples. There is an anthropomorphic language that should be removed. The writing needs to be revised as it still does not adhere to AERA, APA, NMCE, COSMIN standards.

Response: Thank you for your correction and suggestion. We have corrected and replaced it following your suggestions. Such as; construct validity was replaced specifically as structural validity; and reliability was replaced and divided as internal consistency and reliability. The details are on pages 9-11.

Next, I copy fragments of the discussion that bother me when reading:

Response: Thank you for your correction and suggestion. We have also improved the discussion section to make it easier for readers to understand what we mean in our study. The details are in the discussion section (pages 9-11). Furthermore, this manuscript was edited by Wallace Academic Editing Company to help us in providing writing corrections to our manuscript so that it complies with journal standards.

REVIEWER #3 COMMENTS:

1. Authors have successfully adressed all of my concerns. The manuscript can be considered for its publication now.

Response: We express our gratitude for your kind attention.

Attachment

Submitted filename: Response to Reviewers (2)_20231229.docx

pone.0300184.s003.docx^{(42.3KB, docx)}

PLoS One. doi: 10.1371/journal.pone.0300184.r005

Decision Letter 2

Silvia Escribano Cubas

9 Jan 2024

PONE-D-23-08354R2Structural Validity of the Rosenberg Self-Esteem Scale in Patients with Schizophrenia in IndonesiaPLOS ONE

Dear Dr. Chung,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Feb 23 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

We look forward to receiving your revised manuscript.

Kind regards,

Silvia Escribano Cubas

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #2: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: N/A

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #2: Yes

**********

6. Review Comments to the Author

Reviewer #2: In the attached document I make some recommendations to improve the scientific quality of the article.

The authors argued in previous reviews that the use of ordinal alpha was inadequate, using a critique by Chalmers. I provide a reference for you to reflect on and assess whether it would be relevant to modify the internal consistency estimator.

Zumbo, B. D., & Kroc, E. (2019). A Measurement Is a Choice and Stevens' Scales of Measurement Do Not Help Make It: A Response to Chalmers. Educational and psychological measurement, 79(6), 1184–1197. https://doi.org/10.1177/0013164419844305

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

**********

Attachment

Submitted filename: PONE-D-23-08354_R2_reviewer.pdf

pone.0300184.s004.pdf^{(1.9MB, pdf)}

PLoS One. 2024 May 10;19(5):e0300184. doi: 10.1371/journal.pone.0300184.r006

Author response to Decision Letter 2

22 Feb 2024

Dear Editor and Reviewer

Manuscript ID:

Manuscript Title: “Structural Validity of the Rosenberg Self-Esteem Scale in Patients with Schizophrenia in Indonesia”.

We sincerely thank the editor and all reviewers for their valuable suggestions and for allowing us to revise our manuscript entitled “Structural Validity of the Rosenberg Self-Esteem Scale in Patients with Schizophrenia in Indonesia”. We have incorporated all the suggested changes into the manuscript and have highlighted the revised sections. At this moment, our responses and revisions are based on the editor and reviewer’s comments.

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EDITORIAL COMMENTS:

Response: Thank you for your suggestion. We have verified the references in our manuscript and confirmed that the cited papers are still relevant.

REVIEWER #2 COMMENTS:

In the attached document I make some recommendations to improve the scientific quality of the article. The authors argued in previous reviews that the use of ordinal alpha was inadequate, using a critique by Chalmers. I provide a reference for you to reflect on and assess whether it would be relevant to modify the internal consistency estimator.

Response: Thank you for your correction. We have corrected and replaced it following your suggestions. As a consideration, both Cronbach’s and Ordinal alpha methods produce similar results of reliability alpha.

(Page 7)

This study utilized SPSS and AMOS version 23.0 software (IBM; Armonk, New York, USA) and R Studio version 4.3.2 (R Foundation, Vienna, Austria).

(Page 8)

Ordinal coefficient alpha is considered a viable alternative coefficient alpha to calculate a reliability estimate using the Likert response data [59, 60].

(Page 9)

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PLoS One. doi: 10.1371/journal.pone.0300184.r007

Decision Letter 3

Silvia Escribano Cubas

23 Feb 2024

Structural Validity of the Rosenberg Self-Esteem Scale in Patients with Schizophrenia in Indonesia

PONE-D-23-08354R3

Dear Dr. Chung,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Academic Editor

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Data Availability Statement

All relevant data are within the paper and its S1 Dataset files. Please inform the authors if data are being used.

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PERMALINK

Structural validity of the Rosenberg self-esteem scale in patients with schizophrenia in Indonesia

Muhammad Muslih

Min-Huey Chung

Roles

Abstract

Background

Objectives

Methods

Results

Conclusions

1. Introduction

2. Methods

2.1 Participants

2.2 Instruments

2.3 Translation procedure

Fig 1. Illustrates a flow diagram step-by-step parameters translation process of RSES, following the suggestions from the previous study.

2.4 Statistical analysis

Descriptive analysis

Structural validity

Internal consistency

Reliability

2.5 Ethical approval

3. Results

Table 1. Demographic characteristics of the study (n = 260).

Table 2. Descriptive statistics, interitem, and item-total correlation of the RSES items (n = 260).

Table 4. Reliability analysis for the Indonesian adaptation of the rosenberg self-esteem scale (n = 260).

3.1 Structural validity

Table 3. Goodness of fit indexes of the RSES Indonesian version.

Fig 2. Shows a single-factor model of the RSES.

Fig 5. Presents the hierarchical factor model as a second-order model (Model 4).

Fig 3. Shows a single-factor model with correlated error.

Fig 4. Illustrates a two-factor model (Model 3) that divides RSES into two different factors, namely positive and negative self-esteem respectively.

3.2 Internal consistency and reliability evidence

4. Discussion

5. Conclusion

Supporting information

Acknowledgments

Data Availability

Funding Statement

References

Decision Letter 0

Silvia Escribano Cubas

Roles

Author response to Decision Letter 0

Decision Letter 1

Silvia Escribano Cubas

Roles

Author response to Decision Letter 1

Decision Letter 2

Silvia Escribano Cubas

Roles

Author response to Decision Letter 2

Decision Letter 3

Silvia Escribano Cubas

Roles

Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

PERMALINK

RESOURCES

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