AMIKA: psychometric evaluation of a photo-based scale for the assessment of fear avoidance beliefs in elderly individuals

Confrontation therapy proved to be effective in the treatment of fear avoidance beliefs (FAB). Prior to treatment, it is necessary to establish a hierarchy of activities according to their perceived health hazards. For this purpose, we developed the AMIKA scale, which consists of 50 photos showing elderly individuals engaged in daily activities, and investigated its psychometric properties. We conducted a cross-sectional study with repeated measurement after 4 weeks. At the time of both measurements, apart from AMIKA, we assessed pain, disability, FAB, and physical activity. Furthermore, we used ultrasound topometry for the assessment of flexion and extension of the lumbar spine. At t1, a total of 103 elderly individuals with chronic low back pain participated in the study. Their average age was 71.41 years (SD = 5.2). Of these, 67 attended the t2 assessment. Retest reliability amounted to r=0.63 and internal consistency was alpha=0.97. Correlations of the AMIKA scores with pain and disability demonstrated large effect sizes, whereas effect sizes regarding other related FAB scales remained in the medium range. No correlations at all were found with respect to the objective ultrasound measurements and to self-reported physical activity. The results allow the use of AMIKA as an instrument for the generation of a FAB hierarchy in the context of confrontation treatment.