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Table 3 Summary of items and potential interpretations which caused bias in the student sample

From: Enhancing rigour in the validation of patient reported outcome measures (PROMs): bridging linguistic and psychometric testing

Item Score Statement Welsh translation (lit.) Potential interpretation Potential scoring impact
6.Punishment feelings 0 I don’t feel I am being punished I don’t feel I am being punished   
  1 I feel I may be punished 1Rydw i’n teimlo y gallwn i gael fy nghosbi (I feel I may/can be punished) Welsh translation reflects stronger punishment feelings Underscoring of item in Welsh BDI-II
  2 I expect to be punished I expect to be punished   
  3 I feel I am being punished I feel I am being punished   
9.Suicidal thoughts 0 I don’t have any thoughts of killing myself 2Dydw i ddim yn meddwl am ladd fy hun (I am not thinking of killing myself) Welsh translation reflects stronger suicidal thoughts Underscoring of item in Welsh BDI-II
  1 I have thoughts of killing myself but I would not carry them out 3Rydw i wedi meddwl am ladd fy hun ond fyddwn i byth yn gwneud (I have thought of killing myself but I would never do it) Welsh translation reflects stronger suicidal thoughts Underscoring of item in Welsh BDI-II
  2 I would like to kill myself I would like to kill myself   
  3 I would kill myself if I had the chance I would kill myself if I had the chance   
15.Loss of energy 0 I have as much energy as ever I have as much energy as ever   
  1 I have less energy than I used to have I have less energy than I used to have   
  2 I don’t have enough energy to do very much 4Does gen i ddim digon o egni i wneud fawr o ddim (I don’t have enough energy to do much of anything) Welsh translation reflects greater loss of energy Underscoring of item in Welsh BDI-II
  3 I don’t have enough energy to do anything I don’t have enough energy to do anything   
  1. 1Gallwn’ is a derivative of the auxillary verb ‘gallu’ (may/can/be able to). 2 3The literal translation of ‘thoughts of killing myself’ is ‘meddyliau am ladd fy hun’ but the plural form is not a natural expression in Welsh. Hence the adoption of the singular form ‘meddwl” (thought). 4’Gwneud fawr o ddim’ (lit. do much of anything) is a natural expression in Welsh meaning’do very much’.