BRIEF REPORTS

Testing the Convergent and Discriminant Validity of the Decisional

Balance Scale of the Transtheoretical Model Using the Multi-Trait
Multi-Method Approach
Boliang Guo, Paul Aveyard, and Antony Fielding
University of Birmingham
Stephen Sutton
University of Cambridge
The authors extended research on the construct validity of the Decisional Balance Scale for smoking in
adolescence by testing its convergent and discriminant validity. Hierarchical confirmatory factor analysis
multi-trait multi-method approach (HCFA MTMM) was used with data from 2,334 UK adolescents, both
smokers and non-smokers. They completed computerized and paper versions of the questionnaire on 3
occasions over 2 years. The results indicated a 3-factor solution; Social Pros, Coping Pros, and Cons fit
the data best. The HCFA MTMM model fit the data well, with correlated methods and correlated trait
factors. Subsequent testing confirmed discriminant validity between the factors and convergent validity
of both methods of administering the questionnaire. There was, however, clear evidence of a method
effect, which may have arisen due to different response formats or may be a function of the method of
presentation. Taken with other data, there is strong evidence for construct validity of Decisional Balance
for smoking in adolescence, but evidence of predictive validity is required.
Keywords: decisional balance, hierarchical confirmatory factor analysis multi-trait multi-method ap-
proach (HCFA MTMM), convergent validity, discriminant validity
Convergent validity is agreement between measures of the same
construct assessed by different methods. Discriminant validity
refers to the distinctiveness of different constructs (Campbell &
Fisk, 1959). Convergent validity and discriminant validity can be
explored by the multi-traitmulti-method (MTMM) analysis, in
which two or more traits are each assessed by two or more
methods (Campbell & Fisk, 1959; Marsh & Grayson, 1992;
Schmitt & Stults, 1986). Different measures of the same trait
should correlate highly with each other but should correlate less
strongly with measures of distinct traits (Widaman, 1985). Camp-
bell and Fiskes decision rules for inferring convergent and dis-
criminant validity from MTMM matrixes were qualitative, and
they used observed variables correlations to draw conclusions
about underlying trait and method factors with little attention to
true trait correlation (Marsh, 1988). More quantitative approaches
to MTMM analysis have been proposed (Hau, Wen, & Cheng,
2005; Kenny & Kashy, 1992; Marsh, 1988, 1990; Marsh & Byrne,
1993; Marsh & Grayson, 1992; Marsh & Hocevar, 1983, 1988;
Stacy, Widaman, Hays, & DiMatteo, 1985; Widaman, 1985).
Confirmatory factor analysis (CFA) is used frequently to analyze
the MTMM matrix (CFA MTMM). With CFA, a priori trait and/or
method factors are posited. Factors defined by different measures
of the same trait suggest construct validity of the trait. Factors
defined by measures assessed by the same method suggest method
effects. CFA MTMM also tests the fit of the overall model to the
data. In CFA MTMM studies, models with method factors only are
fit and compared with models with correlated traits and correlated
methods. Convergent validity is shown if the method only model
does not fit well. There are no universally accepted criteria to
support discriminant validity in CFA MTMM (Marsh, 1988;
Marsh & Hocevar, 1988). Although some have argued that corre-
lation between trait factors provides evidence against discriminant
validity (Widaman, 1985), trait correlation is typical in MTMM
studies. High trait correlations indicate lack of discriminant valid-
ity (Kenny, 1979; Marsh & Hocevar, 1988), while low correlations
between trait factors indicate discriminant validity. In CFA
MTMM analysis, discriminant validity is therefore tested by set-
ting the correlation among trait factors to 1.0, which is the equiv-
alent of a single factor model, to see whether this model fits better
than the model where the trait factor correlations are freely esti-
mated. If it does not, discriminant validity is supported (Kenny,
1979; Marsh & Hocevar, 1988; Stacy et al., 1985).
In traditional CFA MTMM analysis, multiple items reflecting
each scale are summed or averaged to scale scores for analysis, and
CFA is used to fit method and trait factors. This assumes that the
actual factor structure accurately reflects the a priori structure,
Boliang Guo and Paul Aveyard, Division of Primary Care & Public
Health, University of Birmingham, Birmingham, United Kingdom; Antony
Fielding, Department of Economics, University of Birmingham; Stephen
Sutton, Department of Public Health and Primary Care, Institute of Public
Health, University Forvie Site, University of Cambridge, Cambridge,
United Kingdom.
This study was supported by Cancer Research UK Grant C9278/A5639.
Correspondence concerning this article should be addressed to Paul
Aveyard, Department of Primary Care and General Practice, University of
Birmingham, Birmingham B15 2TT, United Kingdom. E-mail:
p.n.aveyard@bham.ac.uk
Psychology of Addictive Behaviors Copyright 2008 by the American Psychological Association
2008, Vol. 22, No. 2, 288294 0893-164X/08/$12.00 DOI: 10.1037/0893-164X.22.2.288
288
without testing whether it is actually appropriate (Marsh, 1988).
An alternative approach is hierarchical CFA in MTMM (HCFA
MTMM). This fits a first order factor structure where each factor
loads on its contributory items. Consequently, it can confirm that
the theoretical factor structure is actually supported by the data.
Second order factors representing trait and method are then fit
(Lance, Noble, & Scullen, 2002; Marsh, 1988; Marsh & Hocevar,
1988).
In this study, we use HCFA MTMM to explore the convergent
and discriminant validity of the Decisional Balance Scale of the
Transtheoretical Model (TTM). The TTM holds that individuals
progress through qualitatively distinct stages when changing be-
haviors such as smoking cessation (Prochaska & Velicer, 1997).
Precontemplation is the stage where change is not intended in the
foreseeable future. Contemplation and preparation then lead into
action, for example, stopping smoking, which leads to mainte-
nance when change is consolidated. There are four independent
constructs: self-efficacy, temptation, decisional balance, and the
processes of change. The precise structure of the TTM is not fully
described, but it is clear that all of these independent constructs
cause stage movement. In one article, the TTM developers sug-
gested that the processes of change are the independent variable
and that other cognitive variables, such as decisional balance, are
mediators (Velicer, Rossi, Diclemente, & Prochaska, 1996). Nev-
ertheless, the strong principle of change is that a one standard
deviation increase in pros of health behavior change is necessary to
move from precontemplation to action. The weak principle is that
a half a standard deviation decrease in cons is necessary for the
same move (Prochaska, 1994). Other stage theories exclude the
processes of change, and decisional balance is of even greater
importance as a driver of stage movement (Dijkstra, Conijn, & De
Vries, 2006).
Sutton proposed an important test of stage theory (Sutton,
2005). An ideal study should apply a matched intervention to one
group and a mismatched intervention to another. In these studies,
decisional balance could be used as the basis of the matched/
mismatched intervention (Dijkstra et al., 2006). Assuming the
matched intervention is more effective, a study should further
show that the effect of the intervention was mediated by the
proposed drivers of change, in this case decisional balance. If such
an ideal is to be reached, it is important to show that decisional
balance can be measured validly.
The measure of decisional balance was first derived from the
work of Janis and Mann (1977; Velicer, Diclemente, Prochaska, &
Brandenburg, 1985). Velicer et al. (1985) tested a 24-item ques-
tionnaire of the pros and cons of smoking with two response
formatsfrequency and importance (Velicer et al., 1985). Both
response formats gave nearly identical results on principal com-
ponents analysis and gave a two-component solution. For adults,
the items focus on smokings pharmacological benefits (the pros)
and health risks and embarrassment (cons). The Decisional Bal-
ance Scale has been subsequently used with the importance re-
sponse scales but also with the agreement scales for some behav-
iors in adults (Prochaska et al., 1994).
Stern, Prochaska, Velicer, and Elder (1987) developed the adult
questionnaire into a six-item pros and a six-items cons measure for
adolescent smoking, though details of this process are described in
an unpublished thesis (Stern et al., 1987). Pallonen, Prochaska,
Velicer, Prokhorov, and Smith (1998) investigated the factor struc-
ture of decisional balance for adolescence and found a single cons
factor with two pros factorsCoping Pros and Social Pros (Pal-
lonen et al., 1998)that were each first order factors. Details of
the model fitting and alternative models pursued were not de-
scribed. Migneault, Velicer, Prochaska, and Stevenson (1999) de-
veloped a measure of decisional balance for adolescent drinking
and found that a two-factor solution (Pros and Cons) and a three-
factor solution (Pros, Cons-Potential, and Cons-Actual) fit equally
well (Migneault et al., 1999). The most comprehensive investiga-
tion of decisional balance in adolescent smoking is described by
Plummer et al. (2001). They fit sequentially one-, two-, and
three-factor models for both smokers and non-smokers separately
and found that the three-factor solution was preferred, once again
finding pros divided into Social and Coping Pros. However, fit of
these models was only moderately good, with comparative fit
indices (CFIs) of 0.957 and root-mean-square error of approxima-
tion (RMSEA) of 0.070 for smokers and a CFI of 0.963 and
RMSEA of 0.055 for non-smokers. Other models were not ex-
plored. These investigators found differences in the means of these
constructs between stages in a cross-sectional sample that were
somewhat consonant with expectations from the TTM, as did
Pallonen et al. (1998), which might be interpreted as weak evi-
dence of predictive validity. Thus far, therefore, there is limited
validity testing of this key construct in the TTM in adolescents. We
therefore used CFA MTMM to explore the convergent and dis-
criminant validity of the measure.
Method
Participants
The data were collected as part of a randomized controlled trial
of smoking prevention and cessation (Aveyard et al., 1999, 2001).
In the autumn of 1997, 26 intervention schools Year 9 (ages
1314 years) pupils completed a baseline paper questionnaire and
also used the interactive computer program on the same day.
Decisional Balance and other scales were tested in both the paper
and computer questionnaires. These participants used the program
three times, once in each term of 1997/1998, and were subse-
quently followed up with paper questionnaire tests 1 and 2 years
later. Thus, they participated three times in a computer question-
naire session and three times in a paper questionnaire session.
There were 2,334 of 4,125 (57%) students without any missing
values in Decisional Balance testing available for analysis.
Measures
The items and the associated factors are shown in Table 1. In a
currently unpublished manuscript, we found that a four-factor
solution as outlined in Table 1 fit the data significantly better than
the three-factor solution found by Pallonen et al. (1998) and
Plummer et al. (2001). However, the paper questionnaire omitted
the Aesthetic Cons, so a three-factor solution of Social and Coping
Pros and Health Cons was used in this analysis. The only differ-
ence between the two formats of questionnaire was the response
categoriesagreement in the paper questionnaire, like Pallonen et
al. (1998), and importance in the computerized version, like Plum-
mer et al. (2001).
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BRIEF REPORTS
Analytical Procedure
The data were longitudinal in nature and were accommodated
by stacking measurement occasions so that the measures from each
occasion loaded onto each of the second order trait and method
factors. The models below were set and tested sequentially in our
study with Mplus 4 (Hau, Wen, & Cheng, 2005; Lance et al., 2002;
Lance & Sloan, 1993; Mars & Grayson, 1992, Marsh & Hocevar,
1988; Widaman, 1985).
Model 0 (M0): A first order CFA model as the target model
for subsequent modeling was fit. A test of this model supported the
prior three-factor structure of Pros and Cons and justified the
interpretation of trait factors in subsequent hierarchical CFA mod-
els (Marsh & Hocevar, 1988).
Model 1 (M1): Based on M0, the second model is the HCFA
MTMM correlated trait correlated method model (CTCM). In this
model, the correlations between second order trait factors and
method factors were fixed to zero, but correlation between trait
factors and correlation between method factors were estimated
freely (Lance et al., 2002; Marsh, 1990). The model is shown in
Figure 1, and this model is the basic model for HCFA MTMM
testing and must be supported to allow further testing of discrimi-
nant and convergent validity.
Model 2 (M2): Based on M1, M2 is a method only model, for
which no second order trait factors shown in Figure 1 were
included in the model, and was set for the convergent validity test.
Model 3 (M3): M3 is based on M2. All second order trait
factor correlations were fixed to 1 for the discriminant validity test.
Judgment of the goodness of fit was based on indices used in
structural equation modeling. Non-significant
2
generally indi-
cates the model fits the data well. However,
2
is sensitive to large
sample size effects. Consequently, we also used CFI, non-normed
fit index (NNFI), RMSEA, standardized root-mean-square residual
(SRMR), and Akaike information criterion (AIC) as model fit
indices (Hagenaars & McCutcheon, 2002; Hau et al., 2005; Wen,
Hau, & Marsh, 2004). Values of CFI and NNFI larger than 0.90
indicate acceptable fit. Values of RMSEA and SRMR less than
0.08 also indicate good fit. A model with a smaller AIC is pre-
ferred to one with a larger AIC.
Results
All model fit indices are shown in Table 2. For M0, although
2
was significant, indicating lack of perfect fit, this was expected due
to the large sample size (Hau et al., 2005; Vandenberg & Lance,
2000; Wen et al., 2004). Thus this should not be taken as a poor
fit of the underlying approximate model. Other model fit indices
satisfied the general guidelines for a reasonable fitting model.
Inspection of the factor loadings and the factors variance/
covariance indicated that each first order factor was well defined,
indicating that HCFA MTMM should continue.
M1 showed that the HCFA MTMM CTCM model fit the data
acceptably. The CFI was 0.903, NNFI was 0.896, RMSEA was
0.039, and SRMR was 0.049 (Table 2). Based on the modification
index, we correlated the second and third occasion paper question-
naire item 6. This is justified because those two items were
repeated measures (Joreskog & Sorbom, 1993). Doing this, both
CFI and NNFI were greater than 0.900, RMSEA was 0.038, and
the SRMR was 0.049. The AIC decreased to 301,339 from
301,564. All factor loadings on the second order trait factors and
second order method factor were statistically significantly differ-
ent from zero. The variance/covariance of trait factors and method
factor were also statistically significant. Detailed results are shown
in Tables 3,4, and 5. M1 indicated that the two measures of the
same item, one from the computer questionnaire and one from the
paper questionnaire, loaded on a single trait factor for each of the
three decisional balance factors. In other words, the three-factor
solution of Social Pros, Coping Pros, and Health Cons was sup-
ported when either the paper or the computerized questionnaire
was used. Furthermore, the model also showed evidence of method
factors, in that measures by the same format of questionnaire also
significantly loaded on a single method factor.
M2 tested convergent validity by testing the fitting of the
method only model and comparing its model fitting with the fitting
shown in M1. The method only model did not fit the data as well
as the low CFI and NNFI values indicated. Thus, convergent
validity for Decisional Balance was supported.
In M3, we constrained all correlations between trait factors to 1
to test the discriminant validity. The latent variable covariance
matrix in this model was not positive, indicating the one trait factor
model is not appropriate. Hence the results supported discriminant
validity of traits in the Decisional Balance Scale.
Discussion
For adolescent smoking, we found that a three-factor solution fit
the data best, as others have found (Pallonen et al., 1998; Plummer
et al., 2001). Thus far, research has proposed then confirmed
factorial validity. These results extend these findings by producing
evidence of convergent validity. Whether assessed by the comput-
erized questionnaire or the paper questionnaire, and whether the
response format was agreement or importance, the items loaded on
the first order trait factors. The fit indices showed strong evidence
of convergent validity. However, there was clear evidence also of
discriminant validity, as shown by lack of fit when all correlations
among trait factors were constrained to be one.
Plummer et al. (2001) showed a high correlation between the
Social Pros and Coping Pros factors, as might be expected (Plum-
mer et al., 2001). If we follow traditional MTMM principles as
Table 1
Items in the Adolescent Smoking Decisional Balance Scale and
Their Associated Factors
Item Factor
Smoking makes people get more respect from others. Social Pros
Teenagers who smoke have more friends. Social Pros
Teenagers who smoke have more boy/girlfriends. Social Pros
Smoking helps people to cope better with
frustrations. Coping Pros
Smoking cigarettes is pleasurable. Coping Pros
Smoking cigarettes relieves tension. Coping Pros
Smoking can affect the health of others. Health Cons
Smoking cigarettes is hazardous to peoples health. Health Cons
Cigarette smoke bothers other people. Health Cons
Smoking stinks.
a
Aesthetic Cons
Smoking is a messy habit.
a
Aesthetic Cons
Smoking makes teeth yellow.
a
Aesthetic Cons
a
Not included in the paper questionnaire so omitted from these analyses.
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BRIEF REPORTS
Figure 1. Hierarchical confirmatory factor analysis multi-trait multi-method correlated trait correlated method
model. Soc first order Social Pros; Cop first order Coping Pros; Health first order Health Cons; PC
computer questionnaire; Paper paper questionnaire; 1 Time 1; 2 Time 2; 3 Time 3.
Table 2
Fit Indices for Alternative Models in HCFA MTMM Analysis
Model df
2
p
2
CFI NNFI RMSEA SRMR
First order CFA 1224 4,974.528 .000 .940 .929 .036 .032
HCFA MTMM CTCM 1337 6,004.474 .000 .903 .896 .039 .049
Method only 1358 8,678.078 .000 .847 .839 .048 .074
One trait factor
a
1345 9,814.377 .000 .823 .812 .052 .564
Note. HCFA MTMMhierarchical confirmatory factor analysis multi-trait multi-method; CFI comparative
fit index; NNFI non-normed fit index; RMSEA root-mean-square error of approximation; SRMR
root-mean-square residual; CFA confirmatory factor analysis; CTCM correlated trait correlated method
model.
a
Model 3: The latent variable covariance matrix is not positive definite.
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BRIEF REPORTS
described by Campbell and Fisk (1959), high correlations are
evidence against discriminant validity. However, CFA indicates
that the Social and Coping Pros are distinct trait factors (Plummer
et al., 2001). The lack of precision and the subjective judgment
inherent in the traditional MTMM framework make it difficult to
apply to situations where there are high correlations between traits.
Applying HCFA MTMM as we did confirms the distinctiveness of
the Social and Coping Pros.
One concern in our approach arises from the longitudinal nature
of the data. One approach to this is to allow correlations between
the same items from same type of questionnaire across adjacent
measurement occasions. This approach is equivalent to measure-
ment invariance testing across measurement occasions. However,
fitting a measurement invariance model within an HCFA MTMM
structure resulted in the model not being identified. This is ex-
pected. In MTMM analysis, large sample sizes and an MTMM
design larger than the minimal three-trait three-method matrix
have been recommended to avoid convergent and inadmissible
solution problems (Lance et al., 2002). Marsh and Hocevar (1983)
suggested setting the error term variance to a predetermined value
based on the observed data to attain a stable result in a study that
only had two methods. However, they recommended a minimum
of three traits and three methods. In our study, with three traits and
two methods, this was insufficient for a single MTMM analysis.
However, in Guo, Aveyard, Fielding, and Sutton (in press), we
found measurement invariance across occasions, suggesting that
order effects would not be distorting our results. Other authors
have also struggled with this. For example, Metzler, Biglan, Ary,
and Li (1998) treated measurement occasion as a method factor
(Metzler et al., 1998). We treated each measurement occasion as a
separate test, which led to the model being identified. This ap-
proach models the correlation of first order factors between mea-
surement occasions as second order method or trait factors. It does
not allow direct estimation of the correlations between first factors
Table 3
Second Order Factor Loading and Variance/Covariance in
Confirmatory Factor Analysis Multi-Trait Multi-Method
Correlated Trait Correlated Method Model
Variable Social Pros Coping Pros Health Cons PC Paper
Loadings of items on traits and methods
SOC-PC1 .291 .540
SOC-Paper1 .768 .275
SOC-PC2 .214 .791
SOC-Paper2 .630 .522
SOC-PC3 .078 .917
SOC-Paper3 .564 .472
COP-PC1 .762 .276
COP-Paper1 .284 .493
COP-PC2 .733 .472
COP-Paper2 .149 .882
COP-PC3 .606 .591
COP-Paper3 .119 .754
HEAL-PC1 .747 .141
HEAL-Paper1 .477 .058
HEAL-PC2 .768 .264
HEAL-Paper2 .559 .321
HEAL-PC3 .631 .446
HEAL-Paper3 .445 .288
Variancecovariance matrixes of traits and methods factors
Social Pros .025
Coping Pros .095 .377
Health Cons .027 .126 .203
PC 0 0 0 .086
Paper 0 0 0 .037 .042
Note. Diagonals in lower part of Table 3 are variances and covariances in
off diagonals. Covariances across traits and methods are constrained to
zero. SOC first order Social Pros; PC computer questionnaire (num-
bers time points); Paper paper questionnaire (numbers time points);
COP first order Coping Pros; HEAL first order Health Cons.
Table 4
Factor Loading of Computer Questionnaire Items on the First Order Factor
Item
SOC
PC1
COP
PC1
HEAL
PC1
SOC
PC2
COP
PC2
HEAL
PC2
SOC
PC3
COP
PC3
HEAL
PC3
Q1. Smoking makes people get more
respect from others. .697 .708 .794
Q3. Teenagers who smoke have more
friends. .773 .772 .858
Q11. Teenagers who smoke have more
boy/girlfriends. .695 .742 .808
Q5. Smoking helps people to cope
better with frustrations. .790 .805 .846
Q7. Smoking cigarettes is pleasurable. .724 .753 .766
Q9. Smoking cigarettes relieves
tension. .847 .837 .866
Q4. Smoking can affect the health of
others. .694 .791 .803
Q6. Smoking cigarettes is hazardous to
peoples health. .696 .719 .814
Q8. Cigarette smoke bothers other
people. .684 .683 .741
Note. SOC first order Social Pros; PC computer questionnaire (numbers time points); COP first order Coping Pros; HEAL first order Health
Cons.
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BRIEF REPORTS
in second order CFA, but as this is not the focus of CFA MTMM
analysis, this is not a major concern.
Although the convergent and discriminant validity of the Deci-
sional Balance Scale are supported, results on the HCFA MTMM
CTCM model have loadings on both second order Paper and
Computer method factors that are statistically significant. The
second order method factor variances are also statistically signif-
icant. This indicates that the undesirable influence of a particular
method biases the responses given and inflates the correlation
among the different traits measured with the same method. In this
study, there are two possible reasons, which are impossible to
distinguish. The first is that response formats to the scales varied,
agreement in one and importance in the other. A second possibility
is what is termed the method halo effect (Marsh & Grayson, 1992),
meaning that people give responses to a computerized question-
naire that they would not give to the paper version. It would of
course have been preferable to have had the same response format
to both questionnaires. This is potentially of importance because
these questionnaires have been incorporated, as in our study, into
computerized interventions. Knowing whether there are true
method factor effects or not would be important in understanding
the effects of these interventions on smoking status, particularly if
we are able to examine mediation by decisional balance.
Taking all studies of decisional balance for smoking in adoles-
cence together, they consistently point to either a three-factor
(Pallonen et al., 1998; Plummer et al., 2001) or, in our unpublished
manuscript, a four-factor solution, and not the simple two-factor
solution found so consistently in adults (Prochaska et al., 1994).
These results indicate good factorial validity. Taken together,
studies seem to indicate that response format seems to matter much
less than might be supposed. Construct validity is indicated by the
convergent and discriminant validity demonstrated here. Some
evidence of concurrent validity is shown in cross-sectional data
demonstrating differences in mean scores between stages for the
pros and cons (Plummer et al., 2001). Bearing in mind the strong
and weak principles of change, the key construct that needs to be
demonstrated is predictive ability. Those with higher scores in
cons and lower scores in pros should be more likely to move stage
and hence stop smoking. A match/mismatch trial showed some
evidence in adults that interventions affecting pros and cons had
different effects in different stages, as predicted in a variant of the
TTM (Dijkstra et al., 2006). The key task, therefore, in future
research, is to test the predictions of the TTM, that pros and cons
cause stage movement.
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Received February 28, 2007
Revision received July 23, 2007
Accepted August 5, 2007
294
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