The AIDS Empathy Scale:
Construction and Correlates
William E. Snell, Jr. and
Southeast Missouri State University
purpose of the Chapter 13 was
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
Acknowledgments. Portions of these data were presented at the xxth annual meeting of the Southwestern Psychological Association, Houston, TX.
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.
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,
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
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)
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.
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.
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
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
Sexual Attitudes Scale.
The Sexual Attitudes Scale was constructed to assess the
criterion and content validity of the following
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
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,
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
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.
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%).
Internal consistency analysis were conducted for the 2 subscales
on the AES. The standardized alpha coefficients ranged from .87 to .75.
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.
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
, 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
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.
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.
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
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
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).
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
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.
D. , Hong, S. M. , & Hunter, W.
determinants of fear about AIDS among Australian college students. Psychological Reports, 6, 1239-1244.
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.
A Multidimensional Approach to Individual Differences in Empathy.
Catalog of Selected Documents in Psychology, 10,
T. G., & Snell, W. E., Jr. (1990).
Communal and exchange approaches to sexual Relations.
Annals of Sex Research, 3, 149-163.
J. M. , Laux, L., & Thornby, J. I.
towards AIDS. Hospital
and Community Psychiatry, 40, 857.
D. D., Dhooper, S. S., & Tran, T. V.
and graduate students attitudes towards AIDS.
Psychological Reports, 60, 1185-1186
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.
W. E., Jr., & Fischer T. D. (1990,
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.
W. E., Jr., & Papini, P. R. (1989).
The Sexuality Scale: An
instrument to measure sexual-esteem, sexual-depression, and
Journal of Sex Research, 26, 256-263.
L. A. , & Muskins, P. R. (1987).
Techniques of reversing the failure of empathy towards AIDS patients.
Journal of the American Academy of Psychoanalysis, 15,
Multidimensional AIDS Empathy
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:
People who deny that they caught AIDS from a homosexual are
People with AIDS deserve what they get.
People who have AIDS often had an unconscious desire to get the
People who engage in "high-risk" sexual behaviors
deserve to get AIDS.
If people expose themselves to AIDS, it's their own fault if they
catch the disease.
In the majority of AIDS cases, the person probably engaged in
"high-risk" sexual behavior.
It's important for people to be more empathic toward those with
When people go around engaging in sex with strangers, they are
just asking to get AIDS.
Anyone who tries hard enough can avoid getting AIDS.
I don't really care what happens to people who have contacted
Any person who engages in casual sex is willing to get AIDS.
I really don't have much empathy for people who have AIDS.
I am relatively indifferent to what happens to AIDS victims.
People with AIDS have only themselves to blame for their disease.
People with AIDS are responsible for bringing it upon themselves.
People who engage in high-risk sexual behaviors unconsciously
want to get AIDS.
People who get AIDS should be shown a lot of compassion.
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.
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.
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
6. In the
majority of AIDS cases, the person probably engaged in promiscuous,
"high-risk" sexual behavior.
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.
INSTRUCTIONS FOR 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.