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Development and Validation of the Power Imbalance in Couples Scale

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Abstract

Few researchers have quantitatively explored the relationship power-HIV risk nexus in same-sex male couples. We developed and validated the Power Imbalance in Couples Scale (PICS) to measure relationship power among men in same-sex, committed relationships and its association with sexual risk behaviors. We recruited three independent and diverse samples of male couples in the greater San Francisco and New York City metropolitan areas and conducted qualitative interviews (N1 = 96) to inform item development, followed by two quantitative surveys (N2 = 341; N3 = 434) to assess the construct, predictive, convergent, and discriminant validity of the PICS. Exploratory factor analysis of the first survey’s data yielded four factors—overtly controlling partner, supportive partner, conflict avoidant actor, and overtly controlling actor—that accounted for more than 50% of the shared variance among the PICS items. Confirmatory factor analysis (CFA) of the second survey’s data supported these four factors: χ2(1823) = 2493.40, p < .001; CFI = .96, RMSEA = .03 and WRMR = 1.33. Strong interfactor correlations suggested the presence of a higher-order general perception of power imbalance factor; a higher-order factor CFA model was comparable in fit to the correlated lower-order factors’ CFA: χ2(2) = 2.00, p = .37. Internal reliability of the PICS scale was strong: α = .94. Men perceiving greater power imbalances in their relationships had higher odds of engaging in condomless anal intercourse with outside partners of discordant or unknown HIV status (OR 1.27; 95% CI 1.01–1.60; p = .04). The PICS is an important contribution to measuring relationship power imbalance and its sequelae among male couples; it is applicable to research on relationships, sexuality, couples, and HIV prevention.

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Authors and Affiliations

  1. Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, CA, USA

    Torsten B. Neilands, Shari L. Dworkin, Deepalika Chakravarty & Chadwick K. Campbell

  2. Center for Research and Education on Gender and Sexuality, San Francisco State University, 835 Marker St., #523, San Francisco, CA, 94103, USA

    Deepalika Chakravarty & Colleen C. Hoff

  3. Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA

    Shari L. Dworkin & Chadwick K. Campbell

  4. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA

    Patrick A. Wilson & Kirk K. Grisham

  5. Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, Berkeley, CA, USA

    Anu Manchikanti Gomez

  6. School of Nursing and Health Studies, University of Washington, Bothell, WA, USA

    Shari L. Dworkin

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  1. Torsten B. Neilands
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Correspondence to Colleen C. Hoff.

Appendix: Power Imbalance in Couples Scale (PICS)

Appendix: Power Imbalance in Couples Scale (PICS)

For the next set of questions, think about your current relationship with your primary partner.

Response option sets (RS)

RS1

Frequency

1 = Never

2 = Sometimes

3 = About half the time

4 = Most of the time

5 = Always

RS2

How true?

1 = Not at all true

2 = A little true

3 = Moderately true

4 = Very true

5 = Extremely true

Overtly controlling partner

 

Item text

Response set

1

I try to avoid conflict with my partner because I am afraid of him

RS1

2

My partner bullies me to get his way

RS2

3

My partner belittles me to get his way

RS2

4

My partner insults me to get his way

RS2

5

My partner threatens me to get his way

RS2

6

My partner hits me to get his way

RS2

7

When my partner and I disagree, I fear that my partner will hurt me physically

RS2

8

My partner tells me what to wear

RS2

9

My partner tells me I look too feminine

RS2

10

My partner tells me how to act

RS2

11

My partner doesn’t want me to hang out with my friends

RS2

12

My partner forces me to drink alcohol when I don’t want to

RS2

13

My partner forces me to use drugs when I don’t want to

RS2

14

My partner manipulates me by being a drama queen when I want to talk about something important

RS2

15

My partner has control over what I do with my body

RS2

16

My partner denigrates my feminine qualities

RS2

17

My partner belittles me when I act gay

RS2

18

My partner is jealous of most of the people I interact with

RS2

19

My partner threatens me

RS2

20

My partner is controlling

RS2

21

I act less feminine when I’m around my partner than I do at other times

RS2

22

I am afraid of my partner

RS2

23

My partner tries to make me feel guilty

RS2

24

My partner does things to make me feel ugly

RS2

25

My partner says things to make me feel ugly

RS2

26

My partner sabotages my attempts to stay healthy

RS2

Supportive partner

 

Item text

Response set

27

When my partner and I disagree, we sit down and talk through the problem

RS2

28

My partner and I rarely disagree

RS2

29

I feel able to change things in my relationship if I don’t like them

RS2

30

My partner does things to make me feel attractive

RS2

31

My partner says things to make me feel attractive

RS2

32

My partner does things to make me feel desirable

RS2

33

My partner says things to make me feel desirable

RS2

34

My partner makes me feel valued

RS2

35

My partner appreciates my intelligence

RS2

36

My partner supports my endeavors

RS2

37

My partner values what I have to say

RS2

38

My partner looks after my well-being

RS2

39

I can talk to my partner about anything

RS2

40

I feel empowered by my partner

RS2

41

My partner is my equal

RS2

Conflict avoidant actor

 

Item text

Response set

42

I give into my partner to keep him from getting angry

RS1

43

I hold back my feelings in order to avoid conflict with my partner

RS1

44

I watch what I say because my partner might get angry

RS1

45

I avoid conflict with my partner

RS1

46

I get quiet during difficult conversations because I am afraid of what my partner’s reaction might be

RS1

47

I use silence to influence the way difficult conversations go

RS1

48

I avoid disagreeing with my partner

RS2

49

When my partner and I disagree, he usually gets his way

RS2

50

When my partner and I disagree, I am usually quiet

RS2

51

I am afraid to disagree with my partner

RS2

52

When my partner and I disagree, I don’t express my feelings to avoid making my partner angry

RS2

53

When my partner and I disagree, my partner has more say about how we resolve the disagreement

RS2

Overtly controlling actor

 

Item text

Response set

54

My partner gives into keep me from getting angry

RS1

55

I bully my partner to get my way

RS2

56

I belittle my partner to get my way

RS2

57

I insult my partner to get my way

RS2

58

I threaten my partner to get my way

RS2

59

I hit my partner to get my way

RS2

60

My partner is afraid to disagree with me

RS2

61

I prefer to be in charge in my relationship

RS2

62

My partner should feel obligated to me for all the things I do for us

RS2

Scoring

The score for each of the four subscales is calculated as the sum of the individual items in it.

To calculate the overall PICS score, first reverse-score all items in the subscale “Supportive Partner” and sum the reversed items. Add this sum to the total subscale scores of the remaining three subscales.

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Neilands, T.B., Dworkin, S.L., Chakravarty, D. et al. Development and Validation of the Power Imbalance in Couples Scale. Arch Sex Behav 48, 763–779 (2019). https://doi.org/10.1007/s10508-018-1190-y

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