A New Measure of Feeling Safe: Developing Psychometric Properties of the Neuroception of Psychological Safety Scale (NPSS)

Objective: Psychological safety is increasingly recognized as central to mental health, wellbeing and posttraumatic growth. To date, there is no psychometrically supported measure of psychological safety combining psychological, physiological and social components. The current research aimed to develop and establish the neuroception of psychological safety scale (NPSS), informed by Polyvagal Theory. Method: The study comprised of 3 stages: (a) item generation, (b) item reduction, and (c) assessment of factor structure and internal consistency. Exploratory and confirmatory factor analysis was conducted from 2 samples who completed a survey online (exploratory n = 342, confirmatory n = 455). Results: Initially, 107 items were generated. Item reduction and exploratory factor analysis resulted in a 29-item NPSS with subscales of compassion, social engagement and body sensations. The NPSS was found to have a consistent factor structure and internal consistency. Conclusion: The NPSS is a novel measure of psychological safety which can be used across a range of health and social care settings. This research provides a platform for further work to support and enhance understandings of the science of safety through the measurement of psychological, relational and physiological components of safety. The NPSS will help shape new approaches to evaluating trauma treatments, relational issues and mental health concerns. Research to establish the convergent, discriminant and concurrent validity of the NPSS and to explore its use with diverse community and clinical populations is underway. Clinical Impact Statement Psychological safety is recognized as central to mental health, wellbeing, posttraumatic growth, therapeutic engagement and an understanding of trauma related conditions and trauma informed practices. The Polyvagal Theory (PVT) offers a comprehensive explanation of psychological safety grounded in an evidence-base of neurophysiology, psychology and evolutionary theory and the current study aimed to develop a self-report measure, the Neuroception of Psychological Safety Scale (NPSS) informed by the PVT. The NPSS integrates psychological, relational and physiological components of safety and has applicability across a range of health and social care contexts, such as shaping new approaches to evaluating trauma treatments as well as broader relational issues and mental health concerns.