Adult Toolbox Social Relationship Scale

Abstract

The Adult Toolbox Social Relationship Scale (ATSRS) is a comprehensive psychological scale developed as a core component of the National Institute of Health (NIH) Toolbox initiative in 2013. Its primary function is to provide an efficient and standardized assessment of various dimensions of social functioning and relationship distress in adult populations. The scale measures both positive aspects of social connections, such as the availability of support and companionship, and negative aspects, including subjective experiences of rejection and hostility.

Designed for use in large-scale research, clinical trials, and population health studies, the ATSRS offers robust psychometric properties derived from Item Response Theory (IRT) methodologies, ensuring measurement consistency and precision across diverse adult groups.

Keywords

NIH Toolbox, Social Support, Emotional Support, Instrumental Support, Friendship, Loneliness, Perceived Rejection, Hostility, Psychological Assessment, Adult Social Relationships, Health Psychology.

Authors

Cyranowski, J. M., Zill, N., Bode, R., Butt, Z., Kelly, M. A. R., Pilkonis, P. A., Salsman, J. M., Cella, D.

Purpose

The primary purpose of the ATSRS is to standardize and modernize the assessment of social relationship constructs within large-scale research studies and clinical settings. It was created to efficiently capture the complexity of an individual’s social environment and their subjective experience of relatedness and distress over the past month, using a brief, easily administered format.

By encompassing a broad spectrum of social domains, ranging from positive resources (support, companionship) to negative stressors (rejection, hostility), the scale provides researchers with a balanced and nuanced tool for assessing social health, facilitating improved measurement consistency and comparability across diverse scientific investigations.

Construct

The ATSRS is a multidimensional instrument assessing six distinct, yet interrelated, constructs critical to adult social functioning. These constructs were conceptualized to cover the essential components of social resources and social distress.

The six measured dimensions are:

• Emotional Support: The perceived availability of trusted individuals for emotional disclosure, listening, and helpful advice.
• Instrumental Support: The perceived availability of practical assistance, such as help with errands, transportation, meals, or medical needs.
• Friendship: The subjective feeling of companionship, belonging, and having people with whom to relax and have fun.
• Loneliness: The negative emotional state characterized by feelings of isolation, being left out, and feeling disconnected from others.
• Perceived Rejection: The subjective experience that others are dismissive, unavailable, or act as if the respondent’s problems are unimportant.
• Perceived Hostility: The experience of negative, antagonistic interactions from others, including arguing, criticism, anger, and mean-spirited teasing.

Validity

The development of the ATSRS involved rigorous psychometric procedures, including the application of Item Response Theory (IRT), which ensures item precision and reduced measurement error across the latent trait continuum. The scale exhibits strong content validity, as items were derived from established measures and refined through expert consultation and cognitive interviewing to maximize clarity and cultural relevance.

The original validation study (Cyranowski et al., 2013) demonstrated robust construct validity by confirming the hypothesized six-factor structure through factor analytic techniques. Furthermore, validity was supported through correlations with other standard measures of social functioning and related psychological distress, showing expected patterns of convergence and divergence among the subscales.

Reliability

The ATSRS demonstrates excellent internal consistency, indicating high reliability for all six subscales. The measurement precision is notably high, with all Cronbach’s Alpha coefficients exceeding 0.93, which is significantly above the standard acceptable threshold for clinical research instruments.

The specific reliability coefficients reported are:

• Emotional Support: α = 0.969
• Instrumental Support: α = 0.947
• Friendship: α = 0.945
• Loneliness: α = 0.939
• Perceived Rejection: α = 0.932
• Perceived Hostility: α = 0.941

Factor Analysis

The factor structure of the Adult Toolbox Social Relationship Scale was established through extensive factor analysis, confirming a clear differentiation between the six hypothesized dimensions. This analysis supported the theoretical model that social relationships must be assessed across both positive relational resources (support and friendship) and negative relational experiences (loneliness, rejection, and hostility).

The analysis confirmed that each subscale is largely independent while contributing uniquely to the overall assessment of social health, thereby validating the instrument’s utility in distinguishing between various aspects of an individual’s social world.

Instrument

Test Type: Self-report psychological scale

Format: 5-point Likert scale (1 = never, 2 = Rarely, 3 = Sometimes, 4 = Usually, 5 = always)

Language Available: Primarily English; developed under the NIH Toolbox which includes extensive translation and cultural adaptation efforts.

Population Group: Adults

Age Group: 18 years and older

Population Details: Developed and validated using large, diverse samples intended to be representative of the U.S. adult population.

Test Methodology: Respondents are instructed to rate how often they experienced the described social interactions or feelings over the preceding month.

Keywords

Social Functioning, Psychological Assessment, NIH, Relationship Quality, Psychometrics, Internal Consistency, Item Response Theory, Likert Scale, Social Isolation.

Authors

Author ORCID Identifier: Not provided in source.

Affiliation Email addresses: Not provided in source.

Correspondence Address: Not provided in source.

Permissions & Fee and Test Year

The Adult Toolbox Social Relationship Scale was published in 2013. As part of the NIH Toolbox, it is generally intended to be broadly accessible for non-commercial research purposes. Users should always confirm the current usage guidelines and any required licensing with the official NIH Toolbox administration.

The primary source material detailing the instrument’s development and psychometric properties can be found online at the National Center for Biotechnology Information (NCBI) website:

Primary Source Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3759525/

Reference’s

Cyranowski, J. M., Zill, N., Bode, R., Butt, Z., Kelly, M. A. R., Pilkonis, P. A., Salsman, J. M., & Cella, D. (2013). Assessing social support, companionship, and distress: National Institute of Health (NIH) toolbox adult social relationship scales. Health Psychology, 3, 293-301.

The instrument documentation and full study details are available via the NIH and NCBI resources.

Items of the Adult Toolbox Social Relationship Scale

In the past month, please rate how often . . .

Response Scale: 1 = never, 2= Rarely, 3= Sometimes, 4= Usually, 5 = always

Emotional Support

1. I have someone who understands my problems
2. I have someone who will listen to me when I need to talk
3. I feel there are people I can talk to if I am upset
4. I have someone to talk with when I have a bad day
5. I have someone I trust to talk with about my problems
6. I have someone I trust to talk with about my feelings
7. I can get helpful advice from others when dealing with a problem
8. I have someone to turn to for suggestions about how to deal with a problem

Instrumental Support

1. Someone is around to make my meals if I am unable to do it myself
2. I have someone to take me shopping if I need it
3. I have someone to help me if I’m sick in bed
4. I have someone to pick up medicine for me if I need it
5. I have someone to take me to the doctor if I need it
6. There is someone around to help me if I need it
7. I can find someone to drive me places if I need it
8. I can get help cleaning up around my home if I need it

Friendship

1. I get invited to go out and do things with other people
2. I have friends I get together with to relax
3. There are people around with whom to have fun
4. I can find a friend when I need one
5. I feel like I have lots of friends
6. I have friends who will have lunch with me when I want
7. I feel close to my friends
8. I feel like I’m part of a group of friends

Loneliness

1. I feel alone and apart from others
2. I feel left out
3. I feel that I am no longer close to anyone
4. I feel alone
5. I feel lonely

Perceived Rejection

1. Don’t listen when I ask for help
2. Act like my problems aren’t that important
3. Let me down when I am counting on them
4. Act like they don’t have time for me
5. Act like they don’t want to hear about my problems
6. Act like they don’t care about me
7. Act like they can’t be bothered by me or my problems
8. Avoid talking to me

Perceived Hostility

1. Argue with me
2. Act in an angry way toward me
3. Criticize the way I do things
4. Yell at me
5. Get mad at me
6. Blame me when things go wrong
7. Act nasty to me
8. Tease me in a mean way