Performance and psychometric properties of the Interpersonal Support Evaluation List (ISEL) in older adults with Complicated Grief

Abstract Background Complicated Grief (CG) is a recently recognized bereavement-related mental health disorder. Social support is commonly measured with the Interpersonal Support Evaluation List (ISEL), a 40-item, 4-factor, self-report measure. Though the ISEL has been well-studied, no identified research has examined its psychometric properties or performance in older adults with CG. Methods We examined the psychometric properties of the ISEL in adults age ≥60 who enrolled in a psychotherapy treatment study for CG in New York City. We also examined the association of ISEL scores with CG severity, and with clinical and sociodemographic variables. Results Internal consistency of the ISEL was high (α=0.95). Confirmatory factor analysis indicated that most of the ISEL items loaded strongly (>0.45) on the original 4 factors. Mean ISEL score was 68.1, which indicated lower social support than population norms. ISEL scores were significantly but modestly negatively correlated with grief severity. ISEL total scores also varied by sociodemographic and clinical variables; never being married, depression or anxiety diagnosis, and living alone were all associated with lower ISEL scores. Limitations A clinical help-seeking sample, with low sociodemographic and geographic variability, may limit the generalizability of the findings. Also, analyses were cross-sectional and directionality of associations could not be determined. Conclusions The 40-item ISEL may be a useful measure for those studying social support in the context of CG. Given the strikingly low levels of social support, intervention strategies for CG should include components addressing social support.