New Directions in the Psychology of Human Sexuality:
Research and Theory

Chapter 13:
The AIDS Empathy Scale:
Construction and Correlates

Michelle Wagner, William E. Snell, Jr. and Phillip D. Finney
Southeast Missouri State University
    

Abstract

          The purpose of the Chapter 13 was to examine people's empathy toward those with AIDS.  During the past several years researchers from a variety of disciplines have become increasingly interested in examining many aspects of the disease AIDS and the virus that causes it, HIV.  One particular area on which attention has been focused concerns empathy for those afflicted with AIDS.  The present article describes the development and validation of a self-report questionnaire measuring empathy for people afflicted with AIDS, the AIDS Empathy Scale (AES).  The results provided evidence supporting the reliability and validity of the AES.  The discussion deals with the use of the AES in the investigation of people’s reactions to AIDS-afflicted individuals.

         

        Acknowledgments.  Portions of these data were presented at the xxth annual meeting of the Southwestern Psychological Association, Houston, TX.

        Proper citation:  Wagner, M., Snell, W. E., Jr., & Finney, P. D.  (2001).  Chapter 13:  The AIDS Empathy Scale:  Construction and correlates.  In W. E. Snell, Jr. (Ed.), New directions in the psychology of human sexuality:  Research and theory. Cape Girardeau, MO: Snell Publications. WEB: http://cstl-cla.semo.edu/snell/books/sexuality/sexuality.htm.

Chapter 13:
The AIDS Empathy Scale:
Construction and Correlates


        
What type of reaction do people have to those with AIDS?  Do people take the perspective of AIDS-afflicted individuals and thus imagine what life is like for someone with AIDS?  These questions concern empathy towards AIDS victims.  Empathy has been defined as feelings of warmth, compassion, and concern for others (Davis, 1980).

         People can vary in their empathy for AIDS victims.  People that are more educated on the AIDS virus are more likely to have empathy towards the AIDS syndrome (Royse, Dhooper & Hatch, 1987).

         The purpose of the present research was to develop  and validate an objective self-report measure of empathy  towards individuals with the AIDS virus, the AIDS Empathy  Scale (AES).  The AES measures specific empathy levels  towards the AIDS virus. The psychometric properties of the  AES were evaluated using reliability analysis and factor  analyses.  Several other instruments were also included in  the present investigation for exploratory purposes:  the Masculine Behavior Scale (Snell, 1989); the Sexuality Scale (Snell & Papini, 1989);.and the Multidimensional  Sexuality Questionnaire (Snell & Fisher, 1990).  The Sexual  Relationship Scale (Hughes & Snell, 1990). The Sexual  Attitudes Scale (Hendrick & Hendrick, 1987)

Method

Participants

         The participants in this investigation were drawn  from lower division introductory psychology classes at a  small Midwestern university. Over the course of the  semester, 382 students volunteered to complete a number of  measures as one way to earn partial credit toward their  final grade. Of the total, 265 females completed the  instrument and 117 males completed the instrument. The  average age was 24.08.The present marital status of the  subjects varied. About 70% had never been married.  Approximately 25% were married and 2.9% were divorced. The subjects were 6% Black, 86.2% of the subjects were White and Non-Hispanic and 4% were White and Hispanic.  About 2% of the subjects were oriental and 3% were others.  Also, about 40% were Protestant, 29.7% were catholic, .5%  were Jewish and 10% had no religious affiliation.  The  socioeconomic status was as follows: 10.9% of the subject  families had incomes under 10,000.00, 17% had incomes of  10,000.0 to 19,999.00, 17.6 had incomes of 20,000.00 to  29,999.00, 21% had incomes of 30,000.00 to 39,999.00 and_ 34% had incomes of 40,000.00 or above.

Procedure

         Construction of the AES.  A total of 20 items concerned with AIDS empathy were identified from a review of literature on empathy.  Subjects were asked to respond  to those 20 items using a Likert scale: strongly disagree (-2), slightly disagree (-1), neither agree nor  disagree (0), slightly agree (+1), and strongly agree  (+2).  Subscale scores (discussed below) were computed by averaging the responses to the items assigned to each  individual subscale.  The range of scores on each of the 20 items was from -2 to +2, with negative (positive) scores indicating disagreement (agreement) with the AES statements.

Measures

         Sexual Attitudes Scale.  The Sexual Attitudes Scale was constructed to assess the criterion and content validity of the following  subscales:  Sexual Permissiveness defined as an attitude endorsing open sexual behavior; Sexual Practices defined as attitudes endorsing safe and responsible sexual  practices; Sexual Communion, defined as a naive view of  sexual relations, and sexual Instrumentality, defined as a self-centered physical orientation towards sex. These  subscales proved to be psychometrically pure (Hendrick, 1987).

         Masculine Behavior Scale.  The Masculine Behavior Scale (MBS) was designed to measure four behavioral tendencies stereotypical  imputed more to male vs. female:  restrictive emotionalism, defined as the tendency to hold in the public expression of one's privately felt emotions; Inhibited affection defined as the inhibition of feelings of love and  tenderness for loved ones; success dedication, defined as being dedicated to the pursuit of success in one's life;  and exaggerated self-reliance, defined as the tendency to be preoccupied with being self-reliant and maintaining independent control over one's life.  Psychometric analyses confirmed the reliability and validity of the four  subscales (Snell, 1989).

         Sexuality Scale.  The Sexuality Scale (SS) was designed to measure three aspects of human sexuality: sexual-esteem, defined as positive regard for and confidence in the capacity to  experience one's sexuality in a satisfying and enjoyable way; sexual-depression, defined as the experience of feelings of depression regarding one's own sex life; and sexual-preoccupation, defined as the tendency to think about sex to an excessive degree. Item analyses confirmed validity and a factor analyses established factorial validity. The results indicated that the three subscales were psychometrically sound (Snell & Papini, 1989).

         Sexual Relationship Scale.  The Sexual Relationship Scale (SRS) was developed to   serve as an  objective self-report instrument measuring communal and exchange approaches to sexual relations.  Reliability analyses indicated that the two SRS scales designed to measure communal and exchange approaches to  sexual relations had reasonably strong internal validity.  It was also found that the SRS correlated in predictable ways with measures of relationship orientation. Additional evidence indicated that women's and men's relationship  satisfaction was influenced by their tendency to approach sexual relationships from a communal or exchange point of view.

         Multidimensional Sexuality Questionnaire.  The Multidimensional Sexuality Questionnaire (MSQ) was designed to measure psychological tendencies  associated with sexual relations. Results indicated that the MSQ subscales had high internal consistency, test-retest reliability, and were very independent of  social desirability tendencies. These subscales are as  follows:  sexual-esteem, defined as a generalized tendency to positively evaluate one's capacity to relate sexual with another person; Sexual-preoccupation, defined as the tendency to become absorbed in, obsessed with, and  engrossed with the sexual aspects of life; internal  sexual control, defined as the belief that the sexual aspects of one's life are determined by one's own personal control; sexual consciousness, defined as the tendency to think and reflect about the nature of one's sexuality;  sexual motivation, defined as the desire to be involved in  a sexual relationship; sexual anxiety, defined as the tendency to feel tension, discomfort, and anxiety about the sexual aspects of one's life; sexual assertiveness,  defined as the tendency to be assertive about the sexual  aspects of one's life; sexual depression, defined as the tendency to feel depressed about the sexual aspects of one's life; external sexual control, defined as the belief  that human sexuality is determined by influences outside  of one's own personal control; sexual monitoring, defined as the tendency to be aware of the public image which  one's sexuality makes on others; fear of sexual relations, defined as a fear of engaging in sexual relations with another individual; and sexual-satisfaction, defined as the tendency to be highly satisfied with the sexual  aspects of one's life.

Results

Factor Analysis Results

         These data were analyses using factorial analysis. The  reliability results indicated that the items assigned to  the two subscales on the AES were all internally coherent and consistent across time. An additional psychometric  issue deals with the presumed two clusters represented by  the new items written for the AES. Do the 20 items on the  AES actually form two separate factors, constituted by the  assigned sets of five items?  To address this question, the 20 items on the AES were subjected to principle axis  factor analysis, using varimax rotation. Varimax rotation  was used, since it was desired to determine whether the  empathetic tendencies associated with AIDS empathy and blaming those with the AIDS syndrome, were independent  rather than being related to each other. Factor 1 had high  loadings for empathy towards AIDS victims (.80, .78, .76,  .68, .61, .58, .54,). The highest loadings on factor 2  were associated with blaming those with the AIDS syndrome,  (.62, .61, .56, .55, .51,).  The eigenvalue for Factor 1  was 6.43 (32.2%) and for Factor 2, 1.26 (6.3%).

 

Table 1

Factor Analysis Loadings for the AIDS Empathy Scale


Items on the AIDS Empathy Scale                                   I           II


 

   12. Lack of Empth for AIDS patients.                            .80*      .24

   10. Lack of care for AIDS patients                                .78*      .12

   13. Indifference to AIDS patients                                  .76*     .16

   19. Desire compassion for AIDS patients                      .68*     .12

   7.   Desire more Empth for AIDS patients  .                   .61*      .17

   18. Lack of concern if AIDS does not affect me             .58*      -.05

   2.   AIDS patients deserved to get AIDS                        .55       .48

   17. Desire more compassion for AIDS patients              .54*     .26

   14. AIDS patients should  blame themselves                 .48        .48

   20. Exposure to AIDS is a attention-getter                    .44       .26

   16. Unconscious desire to get AIDS with hg-rsk sex      .44        .37

   1.   Denial of AIDS from homo-sex are lying                  .37       .35

   3.   Unconscious desire for AIDS by AIDS pat.              .32       .30

   4.   Deserving of AIDS contr.by high-rsk sex behavior    .x5        .62*

   5.   Conscience exposure deserv. of AIDS                     .18        .61*

   15. Resposn. for AIDs on AIDS patient                         .39        .56*

   8.   Sex with stranger asking for AIDS                         -.00        .55*

   11.  Having cas.sex willing to get AIDs                          .17        .51*

   6.   If AIDS patient is promiscuous                               .22        .31

   9.   Can prevent getting AIDS                                      -.04       .23


Note.  The eigenvalue for Factor 1 was 6.43 (32.2%) and for Factor 2 it was 1.26 (6.3%).  Items used to construct the two AES subscales are indicated by asterisks.

 

Reliability Results

         Internal consistency analysis were conducted for the 2 subscales on the AES. The standardized alpha coefficients ranged from .87 to .75.

Gender Comparisons

         A two-group (male versus females) MANOVA was  conducted on the 2 AES subscales to determine whether women or men have different levels of empathy towards AIDS  victims.  The overall gender effect was highly significant, multivariate-F(2,375)=28.77, p < 001.  Several univariate  analyses were then conducted to determine whether women  and men actually differ in their empathy levels measured by the AES.  To answer this question, t-tests were conducted to determine whether women's and men's scores on the two subscales were significantly different from one another.  The women scored significantly higher on both of the AES subscales indicating greater empathy for those with AIDS and a greater tendency not to blame those with AIDS for their situation.

 

Table 2

Means and Standard Deviation on the AES for Males and Females


Gender                                                  AIDS                 AIDS

                                                            EMPATHY        BLAMING


 

MALES     (n= 116)                             4.67                  1.99

                                                             (6.07)                (4.54)

FEMALES (n=262)                             8.28                  1.38

                                                             (5.10)                (4.69)

F(1, 376)                                             35.74****             1.40


Note.  Multivariate F(2, 375)=28.77, p < .001. Standard deviations are enclosed in parentheses.  Higher scores on the AIDS empathy subscale indicate greater empathy for those with AIDS: lower scores on the AIDS blaming subscale correspond to a greater tendency to blame those with AIDS for their situation.

*p < .05.            **p < .01.          ***p < .005.       ****p < .001.

 

Validity Results

         To examine the validity of the AES, Pearson correlations were completed between the AES subscales and (1) the MBS, (2) the MSQ, and (3) several subscales concerned with sexuality.

         Masculine Behavior Scale Results.  In the results of the Masculine Behavior Scale, it was found that behavioral  measures of success dedication and exaggerated  self-reliance were positively correlated with instrumental  personality  attributes , while restrictive  emotionality  and inhibited affection behavioral tendencies were  negatively correlated with expressive personality  attributes. It was also indicated that both males and  female subjects attributed restrictive emotionality,  inhibited affection, success dedication, and exaggerated  self-reliance more to males that to females.  Table 3 shows the correlations between the AES and the  MBS.

 

Table 3

Correlations between the AES and the MBS


                                                                            AES                   .

MBS Subscales                                 Empathy          Blaming


Success Dedication                             -.09                        .19****

Restrictive Emotionality                      -.17****                  -.00

Inhibited Affection                                -.13**                      .02

Exaggerated Self-Reliance                -.11*                       .10*


Note.  N = 375-377.  Higher scores on the MBS correspond to  greater success dedication, restrictive emotionality,  inhibited affection and exaggerated self-reliance. 

* p < .05     ** p < .01     *** p < .005   **** p < .001

 

         Multidimensional Sexuality Questionnaire. These  results indicated that people who were more likely to take  a quid-pro-quo approach to sex and to keep tabs on their  sexual activities were quite obsessed with sex and in  addition they approach their sexual relations from an  external perspective where sexual activities were  viewed as due to chance and luck. in contrast, individuals  who approached their sexual relations from a more  interpersonal perspective which emphasized caring and mutual concern not only viewed themselves in a highly  favorable manner but they also described themselves as  sexual assertive and as sexually aware individual.  It was  also found that individuals who were preoccupied with sex  and those with an "external" perspective on sex held more  permissive attitudes endorsing open , free , and casual  sex; In addition they endorsed manipulative attitudes  toward sex.  In contrast, those individuals whose sex  attitudes were more communal and responsible in nature,  regarded themselves as being quite sexually aware,  motivated, and internally controlled.  Table 4 indicates the correlations between the AES and the MSQ.

 

Table 4

Correlations between the AES and the MSQ


MSQ                                                                          AES                 .

Subscales                                               Empathy                 Blame


1. Sexual-Esteem                                        -.08                      -.02

2. Sexual-Preoccupation                            -.22****                  .03

3. Internal-Sexual-Control                            .19****                  .03

4. Sexual-Consciousness                           .17****                  .02

5. Sexual-Motivation                                     -.10*                    .08

6. Sexual-Anxiety                                           -.01                       .01

7. Sexual-Assertiveness                               -.06                      .03

8. Sexual-Depression                                    .02                      .04

9. External-Sexual-Control                           -.15**                  -.05x

10. Sexual-Monitoring                                  -.12**                   -.05

11. Fear-of-Sexual-Relationships                -.06                      -.05

12. Sexual-Satisfaction                                 .00                      -.04


Note.  N = 373-377.  Higher scores on the MSQ correspond to greater amounts of each of the 12 sexuality tendencies measured by this instrument.

* p < .05.    ** p < .01.    *** p < .005.    **** p < .001.

 

         Sexuality Scale. In the results of this measure, sexual-esteem was strongly correlated (in a negative  direction) with sexual-depression among both women and  men.  The negative correlation between sexual-esteem and sexual-depression tended to be slightly stronger among the  men subjects.  Two gender-specific correlations were also  statistically significant.  Among women,  sexual-preoccupation was positively correlated with  sexual-esteem, whereas among men, sexual-preoccupation was positively correlated with sexual-depression.  No other  significant correlations were found. The correlations between the AES and other measures of sexuality are found in Table 5.

 

Table 5

Correlations between the AES and other measures of sexuality


Sexuality-related                                      AES Subscales   .

Measures                                           Empathy        Blaming


Sexuality Scale (SS):

         Sexual-Esteem                              .05                 .02

         Sexual-Depression                       .04                -.00

         Sexual-Preoccupation                 -.12**              .09

Sexual Attitudes Scale (SAS): 

         Sexual Permissiveness               -.14**              .28****

         Sexual Practices                           .30****            .22****

         Communion                                    .12*              -.03

         Instrumentality                               -.18****            .07

Sexual Relationship Scale (SRS):   

         Sexual Communion                       .09*              -.04

         Sexual Exchange                         -.24***            -.02


Note.  N= 371-378.  Higher scores on the Sexuality Scale  indicate greater sexual-esteem, sexual-depression, and  sexual-preoccupation; lower scores on the Sexual Attitudes  Scale indicate greater sexual permissiveness, safe sexual_ practices, interpersonal (communal) sexual attitudes, and  self-focused sexuality; higher scores on the Sexual  Relationship Scale correspond to an interpersonal (caring)  and an exchange (quid-pro-quo) approach to sex. 

* p < .05.    ** p < .01.    *** p < .005.    **** p < .001.

 

         Sexual Attitudes Scale.  The Sexual Attitudes Scale had moderate and conceptually consistent correlations with  previous scales (e.g., male and female premarital sexual  permissiveness scales).  Significant relationships were  found between Ss' sexual attitudes and relevant  demographic/psychosocial variables.

         Sexual Relationship Scale.  These results of the correlations between the SRS subscales were computed for each gender separately and for the combined groups.   The only statistically significant correlation was a weak positive correlation between the Sexual Communion and the Sexual Exchange subscale.

Discussion

         The  AIDS Empathy Scale was developed in the  present investigation to measure empathy towards those  with the AIDS syndrome.  The findings in this article  indicate acceptable levels of internal consistency for the two subscales on the AES. Additional findings revealed  that men scored lower on both subscales of the AES ( i.e.,  The scales relating to AIDS blame and AIDS empathy).  More  specifically, Females were less likely to blame AIDS  afflicted individuals for their plight. This work  corresponds with the findings of the Empathy Questionnaire  (Davis, 1980).  Empathy Scale reporting that women  exhibited higher levels of empathetic behavior in  situations.  This instrument would be useful in the study  of peoples willingness to fund medical care for AIDS  Victims.  In addition it might be helpful in the study of  stereotypes that people might put upon an individual with  the AIDS virus, in regard to whether they blame that  individual for having the disease.  Researchers could also  use this measure in the study of whether or not people attribute the AIDS virus to only homosexuals versus  heterosexuals.
    


References

Austin, D. , Hong, S. M. , & Hunter, W.  (1989).  Some determinants of fear about AIDS among Australian college students.  Psychological Reports, 6, 1239-1244. 

Bouton, R. A. , Galleher, P.E. , Gallinghouse, P. A. , &  Leal, T.  (1989).  Demographic variables associated with fear  of AIDS and homophobia.  Journal of Applied Psychology, 19, 885-901. 

Davis, M.  (1980).  A Multidimensional Approach to Individual  Differences in Empathy.  Catalog of Selected Documents in Psychology, 10, 85.

Hughes, T. G., & Snell, W. E., Jr.  (1990).  Communal and exchange approaches to sexual Relations.  Annals of Sex Research, 3, 149-163. 

Merrill, J. M. , Laux, L., & Thornby, J. I.  (1989).  Attitudes towards AIDS.  Hospital and Community Psychiatry, 40, 857.

Royse, D. D., Dhooper, S. S., & Tran, T. V.  (1987).  Undergraduate and graduate students attitudes towards AIDS.  Psychological Reports, 60, 1185-1186 

Snell, W. E., Jr.  (1989).  Development and validation for the Masculine Behavior Scale: A measure of behaviors attributed to males versus females.  Sex Roles,  21, 749-765.

Snell, W. E., Jr., & Fischer T. D.  (1990, April).  The Multidimensional  Sexuality Questionnaire:  An objective report measure on  psychological tendencies associated with sexuality.  Presented at the meeting of the Southwestern Psychological  Association, New Orleans , LA , Sept. 1990.

Snell, W. E., Jr., & Papini, P. R.  (1989).  The Sexuality Scale:  An instrument to measure sexual-esteem, sexual-depression, and sexual-preoccupation.  The Journal of Sex Research, 26, 256-263.

Stevens, L. A. , & Muskins, P. R.  (1987).  Techniques of  reversing the failure of empathy towards AIDS patients.  Journal of the American Academy of Psychoanalysis, 15, 539-555.
    


The Multidimensional AIDS Empathy Questionnaire (MAEQ)

INSTRUCTIONS:  The items listed below concern the topic of AIDS (i.e., acquired immune deficiency syndrome).  For each statement, you will be asked to indicate how much you agree or disagree with it.  As such, there are no right or wrong answers, only your own responses.  To provide your responses, use the following scale:

*******************************************************************************************
                     
A                   B                      C                   D                      E
__________________________________________________________

                     
Agree     Slightly           Neither           Slightly        Disagree
                      
              
Agree                                   Disagree

*******************************************************************************************

NOTE:            Remember to respond to all items, even if you are not completely sure.
                     
Your answers will be kept in the strictest confidence.
                     
Also, please be honest in responding to these statements.

*******************************************************************************************

 

1. People who deny that they caught AIDS from a homosexual are probably lying.

2. People with AIDS deserve what they get.

3. People who have AIDS often had an unconscious desire to get the disease.

4. People who engage in "high-risk" sexual behaviors deserve to get AIDS.

5. If people expose themselves to AIDS, it's their own fault if they catch the disease.

6. In the majority of AIDS cases, the person probably engaged in promiscuous,

    "high-risk" sexual behavior.

7. It's important for people to be more empathic toward those with AIDS.

8. When people go around engaging in sex with strangers, they are just asking to get AIDS.

9. Anyone who tries hard enough can avoid getting AIDS.

10.   I don't really care what happens to people who have contacted AIDS.

11.   Any person who engages in casual sex is willing to get AIDS.

12.   I really don't have much empathy for people who have AIDS.

13.   I am relatively indifferent to what happens to AIDS victims.

14.   People with AIDS have only themselves to blame for their disease.

15.   People with AIDS are responsible for bringing it upon themselves.

16.   People who engage in high-risk sexual behaviors unconsciously want to get AIDS.

17.   People who get AIDS should be shown a lot of compassion.

18.   As long as AIDS does not affect me, my family, or my friends, I have little concern about it.

19.   People ought to have more compassion for those individuals with AIDS.

20.   One reason people become exposed to AIDS is that they often have a desire to draw attention to themselves.
 


SCORING INSTRUCTIONS
 for 
The Multidimensional AIDS Empathy Questionnaire (MAEQ)

         The items on the Multidimensional AIDS Empathy Questionnaire (MAEQ) concerns people's tendency to be empathetic with the personal plight of those individuals with AIDS.  People who endorse these items are those who have sympathy with the personal circumstances confronted by those with AIDS, and who in general take an open-minded rather than a "blaming" orientation toward those with AIDS.

      1.   People who deny that they caught AIDS from a homosexual are probably lying. (R)

      2.   People with AIDS deserve what they get.  (R)

      3.   People who have AIDS often had an unconscious desire to get the disease.  (R)

      4.   People who engage in "high-risk" sexual behaviors deserve to get AIDS.  (R)

      5.   If people expose themselves to AIDS, it's their own fault if they catch the disease.  (R)

      6.   In the majority of AIDS cases, the person probably engaged in promiscuous,

            "high-risk" sexual behavior.  (R)

      7.   It's important for people to be more empathic toward those with AIDS.

      8.   When people go around engaging in sex with strangers,

            they are just asking to get AIDS.  (R)

      9.   Anyone who tries hard enough, can avoid getting AIDS.  (R)

    10.   I don't really care what happens to people who have contacted AIDS.  (R)

    11.   Any person who engages in casual sex is willing to get AIDS.  (R)

    12.   I really don't have much empathy for people who have AIDS.  (R)

    13.   I am relatively indifferent to what happens to AIDS victims.  (R)

    14.   People with AIDS have only themselves to blame for their disease.  (R)

    15.   People with AIDS are responsible for bringing it upon themselves.  (R)

    16.   People who engage in high-risk sexual behaviors unconsciously want to get AIDS.  (R)

    17.   People who get AIDS should be shown a lot of compassion.

    18.   As long as AIDS does not affect me, my family, or my friends,

            I have little concern about it.  (R)

    19.   People ought to have more compassion for those individuals with AIDS.

    20.   One reason people become exposed to AIDS is that they often have a desire

            to draw attention to themselves.  (R)

 

CODING INSTRUCTIONS FOR ITEMS

Items that are designated with an "(R)" are first recoded so that A = E, B = D, C = C, D = B, and E = A.  Then the items are coded so that A = 0; B = 1; C = 2; D = 3; and E = 4.  Next, they are summed so that higher scores correspond to greater empathy for individuals with AIDS.

 

 

Copyright  ©  2002
William E. Snell, Jr., Ph.D.
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