In the initial development of the ETMCQ, we gathered a scale of 60 self-descriptor items covering three content categories: Epistemic Trust, Epistemic Mistrust and Epistemic Credulity. For example, a high Trust item is “I find information easier to trust and absorb when it comes from someone who knows me well”. An example of a high Mistrust item is “If you put too much faith in what people tell you, you are likely to get hurt”. A high Credulity item is “When I speak to different people, I find myself easily persuaded even if it is not what I believed before”. Responses were rated across a 7-point Likert scale anchored as “strongly disagree” (= 1) to “strongly agree” (= 7) and neither agree nor disagree in the center (= 4). High Epistemic Trust, Mistrust and Credulity was indicated on polar response items by either strong agreement (= 7) or strong disagreement (= 1) with the statement.

The sixty items were independently rated by six expert judges (clinicians and academics familiar with theories concerning ET) who indicated whether they thought each statement captured Trust, Mistrust or Credulity. In order to produce a questionnaire with six items per factor, 42 items were rejected on the basis of being badly worded, ambiguous, repetitious, or irrelevant. The expert judges’ decisions to retain items were based on their qualitative assessment of how well each item fitted the relevant factor. The eighteen remaining items were re-examined by the same expert judges and two additional expert judges. Following their feedback, items were refined to enhance clarity, relevance and readability; eighteen items were retained, six for each subscale. The items were then reviewed by ten non-experts (colleagues within the UCL psychoanalysis unit working on unrelated areas), who were asked to elaborate on their understanding of each item. Following their responses, the expert group re-examined the scale, adjusted some wording and replaced one item. This led to an 18-item version of the scale which was used in both studies.

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