Table 2.

Results of the content analysis: concerns about the questionnaire.

Where in the Questionnaire	Content of Concern	Italy		Germany		Spain
		GP	PwMS	GP	PwMS	GP	PwMS
Item 2—One of my big goals is to be free from painful emotions	- Item too vague		1		1
	- Unclear expression: “big goal”				1
Item 3—I rush through meaningful activities without being really attentive to them	- Unclear item					1
	- Unclear expression: “meaningful activities”			1
Item 4—I try to stay busy to keep thoughts or feelings from coming	- Unclear item - Unclear expressions: “thoughts” and “feelings”	2		1
Item 5—I act in ways that are consistent with how I wish to live my life	- Item too vague				1
Item 6—I get so caught up in my thoughts that I am unable to do the things that I most want to do	- Unclear item, too nested			1		1
Item 13—I am willing to fully experience whatever thoughts, feelings and sensations come up for me, without trying to change or defend against them	- Unclear expression: “to fully experience”.	1
Item 20—Thoughts are just thoughts–they don’t control what I do	- Unclear item		1			1
	- Unclear expression: “thoughts do not control what I do”		1
	- Unclear expression: “thoughts are just thoughts”	2	1
Item 22—I can take thoughts and feelings as they come, without attempting to control or avoid them	- Unclear expression: “take thoughts and feeling as they come”.	1
Response options	- Difficult to understand the response gradient - Option 3 (“Neither agree nor disagree”) is not useful		1			1	2
	- Use number instead of label					1
General comments	- Too long statements (items)						2
	- Unclear item, too nested			1		1
	- Concerns on possible comprehension difficulties for people with cognitive impairment						2
	- Identical items	1	2		1	1
	- Include examples to clarify items	1

Note: GP = general population; PwMS = people with multiple sclerosis. Numbers indicated the frequency of each concern.