Validation of the Malay Translation of Brief Core Schema Scale (BCSS-M)

Negative schema of self and others are closely associated with self-esteem and mood disorder. Identifying negative schema is an important step in effective psychotherapy. Brief Core Schema Scale (BCSS) is a validated and reliable scale to assess general perception about themselves and other people. The original scale is available in English. BCSS was translated to Malaysian language (BCSS-M) and validated in this study. This study involved 279 participants attending psychiatry clinic in a public hospital in Malaysia. Each participant filled up the socio-demographic forms and BCSS. The results of the study showed that BCSS-M demonstrated good internal consistency with Cronbach’s α of 0.73. BCSS-M also exhibited good convergent and discriminant validity. Confirmatory factor analysis showed that it best fit into a 4 factor model. In conclusion, BCSS-M demonstrated good psychometric properties.


Introduction
In accordance to Beck's theory of depression, negative experiences during childhood can contribute to the formation of early maladaptive schema [1]. Early maladaptive schema is defined as a pervasive dysfunctional pattern of emotions, thought and sensation regarding relationship with others [2]. Moment to moment evaluations of self and others influence the state of mind, cognition, memory processes and synthesis of past reactions and thus plays an important role in the formation of schema [3]. Early maladaptive schema leads to intense emotions when triggered by live events in later life. Therefore, individuals with negative core beliefs or negative schemas are at an higher risk for depression. Certain schema-congruent stressful life events during adolescence can activate dysfunctional attitudes which would lead to development and continuation of depression. Vulnerability to anxiety has also been explained in a similar process [4]. Cognitive behavioral therapy has been repeatedly proven to be effective treatment for depression. Nevertheless, there are studies that showed up to 50% of individuals do not respond fully. [5]. There are some patients especially the chronic cases of depression and anxiety disorders with underlying emotional dysregulation do not respond to it and continue to experience relapses even after treatment [6]. According to Young, some patients may require a more comprehensive treatment approach as they are poor fir for cognitive therapy due to their difficulty in recognising, accessing and altering their cognitions and emotions [6]. Young's schema theory expands the Beckian theory for the treatment of selective treatment resistant cases whose psychological issues are persistent because of the complex characterological underpinnings and chronic emotional dysregulation [7]. An integrative form of psychotherapy known as schema therapy (ST) have been developed and proposed as the recommended treatment approach [8][9][10].
A research done in Japan studied the relationship of negative and positive evaluation of self, identified using Brief Core Schema Scale, with dysfunctional attitudes in three aspects of life [11]. The study demonstrated that negative self-evaluation was associated with dysfunctional attitude in all three areas i.e. achievement, dependency and self-control [11]. Contrary to common belief, the study indicated positive self-evaluation was actually related to dysfunctional attitude in achievement and selfcontrol [11]. Brief Core Schema Scales (BCSS) is an instrument developed by Fowler et all in order to provide a quick and easily administered measure of four subscales to evaluate the 4 dimensions of negative evaluations of self (negative schema) but also positive evaluations of self and positive and negative evaluations of others [12]. BCSS comprises of 24-item 5-point self-reporting scale (0-4), has good reliability and internal consistency, with Cronbach's α coefficients >.78 [12] BCSS was translated to Malaysian language which is native language for most patients in Malaysia. The psychometric properties of the Malay translation of BCSS (BCSS-M) was examined in this study to ensure that it is a valid and reliable scale for assessment of core beliefs of patients in Malaysia.

Translation Process
The Brief Core Schema Scale (BCSS) was translated in 3 phases.
In phase 1, the original BCSS in English was translated to Malay by a bilingual language expert who was proficient in both English and  Table 1. There were 206 females and 73 males. The mean age of participants was 31.8. 67.6% of the participants were working as professionals, 31.5% were students, 9.6% were in managerial work, 7.2% were teachers and 2.9% were businessman. In the pilot study, all the participants indicated that the wording, sentence construct and semantic properties were clear and appropriate. None of the participants had issues in terms of understanding the wordings or meaning of each item on the scale. All  Table 2. The AVE and MSV of each domain were calculated and the results are available in Table 2. MSV for all domains were found to be lower than AVE thus confirming discriminant validity of the scale. Inter factor correlations were summarized in Table 3

Discussion
This is a validation study for the Malay translation of Brief Core Schema Scale. There were more female participants as compared to male participants. This is in line with literature on mood disorders whereby it is found to be twice more prevalent in female than male [13][14][15][16]. A study on relationship between socio-demographic factors and depression showed that prevalence of depression peaks at age between 20-24 years old and decreases steadily to the lowest level above 70 years old [17]. Similar findings were found in Canadian, Ontario and Australian Health Survey whereby depression rate is higher for 12 to 24 age group in both men and women [18][19][20]. This was also demonstrated in the socio-demographic characteristics of participants in this study. The study on level of education and mood disorders also found that the lifetime prevalence of depression was highest for those with post-secondary education [17]. This was also found to be the same in participants of this study. was done in order to protect self or others [21]. Therefore, hostility on others was less suitable to represent negative perception of others in Asian population.

Conclusion
BCSS-M is a reliable and valid scale to assess schemata associated with self and others. Majority of the population in Malaysia are fluent in Malaysian language. As BCSS-M is now available in Malaysian language, it will be convenient for practitioners to use it to assess core beliefs of patients who are fluent in Malaysian language.