Neuroception of psychological safety scale (NPSS): validation with a UK based adult community sample

Nicola Cogan, Liza Morton, Linda Irvine Fitzpatrick , Danielle Lamb, Johannes Hannes De Kock, Ali Alisha , David Young, Stephen Porges

Research output: Contribution to journalArticlepeer-review


Background: Psychological safety is important for rest, restoration and social bonding, yet a traumatic history can bias individuals towards sensing threat and danger. Research on the neuroception of safety has suggested that a lack of psychological safety might be the biopsychosocial hallmark of posttraumatic stress disorder (PTSD). Persistent feelings of threat and danger are associated with a lack of psychological safety and may be predictive of PTSD. Our pioneering work reported on the development of the neuroception of psychological safety (NPSS), rooted in polyvagal theory. and consists of social engagement, compassion, and body sensations dimensions. Understanding more about the dimensionality of the NPSS and further establishing its psychometric properties was our priority.

Objective: Our current research aimed to validate and test the reliability and dimensionality of the NPSS, using a large community sample (n = 2035) of adults resident in the UK
Method: We examined the internal and test-retest reliability, convergent, discriminant, and concurrent validity as well as dimensionality of the NPSS.

Results: The 3-factor structure of the NPSS was replicated with regard to the absolute fit indices. Internal consistencies ranged from acceptable to excellent across the NPSS’s subscales. Providing support for the validity of the NPSS, scores were predictably related to team psychological safety, wellbeing, post-traumatic stress, burnout, body awareness, and personality, with effect sizes typically in the high to medium range. The NPSS was found to show good test-retest reliability.

Conclusions: This study demonstrates the validity, reliability and dimensionality of the NPSS with an adult sample. Further work is underway to support and enhance understandings of psychological safety with diverse clinical populations impacted by trauma. The NPSS has applicability across a range of health and social care contexts, such as shaping new approaches to evaluating trauma treatments and enhancing trauma informed care.
Original languageEnglish
JournalEuropean Journal of Psychotraumatology
Publication statusSubmitted - 24 Apr 2024


  • psychological safety
  • polyvagal theory
  • neuroception
  • psychometric validation
  • measure development
  • trauma
  • post-traumatic growth
  • mental health


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