Support for the Multidimensional Adolescent Stress Questionnaire in a Sample of Adolescents in the United Kingdom

Adolescence is a time of physical, social and emotional development, and this development can be accompanied by feelings of stress. The Adolescent Stress Questionnaire is a 56‐item scale measuring stress in 10 domains. Developed in Australia, the scale has been translated, and its reliability and validity have been tested in a number of countries across Europe, where the 10‐factor, 56‐item version of the scale has received little support. The present study tested the factor structure, construct validity and reliability in a sample (n = 610) of adolescents in the United Kingdom. Support was found for the 10‐factor, 56‐item version of the scale, and correlations with self‐concept measures, sex scores on stress factors and Cronbach's α‐values, suggesting that the scale may be a viable assessment tool for adolescent stress. Results for alcohol‐specific analyses support the domain‐specific nature of the scale. Future work may seek to investigate the stability of age‐specific stress domains (e.g. the stress of Emerging Adult Responsibility) in samples that include younger adolescents. Copyright © 2014 John Wiley & Sons, Ltd.     

Short communication: Reliability testing and applied use of a measure of neutrophil activation in stress research

The purpose of this research was to test the reliability of a measure of neutrophil activation and to apply the measure in stress research. Two studies were carried out with university undergraduates. The first was a test‐retest reliability study of the nitro‐blue tetrazolium (NBT) test, a measure of neutrophil activity. The second was an applied study of its use in stress research. In the first study, finger‐stick blood samples were taken at three points in time (baseline, +1 hour, and at 1 month) from 30 participants. Physiological arousal was monitored (heart rate and blood pressure) before and after samples were taken. Neutrophil activity is determined by their capacity to reduce NBT and is presented as a percentage of NBT positive cells. Highly significant correlations were found between all time points (p = 0.0001) and there were no significant differences between the means. The NBT test was found to be reliable and was used in an examination of the association between neutrophil activity and perceived stress (PSS). Health related issues were also explored. A highly significant positive association was found between NBT and PSS (r = 0.840, p = 0.01). No associations are found between PSS and health. The results confirm and extend findings that stressors, even naturalistic stressors, can activate neutrophils. Copyright © 2004 John Wiley & Sons, Ltd.     

General job stress: a unidimensional measure and its non-linear relations with outcome variables

This article aims to examine the non‐linear relations between a general measure of job stress [Stress in General (SIG)] and two outcome variables: intentions to quit and job satisfaction. In so doing, we also re‐examine the factor structure of the SIG and determine that, as a two‐factor scale, it obscures non‐linear relations with outcomes. Thus, in this research, we not only test for non‐linear relations between stress and outcome variables but also present an updated version of the SIG scale. Using two distinct samples of working adults (sample 1, N = 589; sample 2, N = 4322), results indicate that a more parsimonious eight‐item SIG has better model‐data fit than the 15‐item two‐factor SIG and that the eight‐item SIG has non‐linear relations with job satisfaction and intentions to quit. Specifically, the revised SIG has an inverted curvilinear J‐shaped relation with job satisfaction such that job satisfaction drops precipitously after a certain level of stress; the SIG has a J‐shaped curvilinear relation with intentions to quit such that turnover intentions increase exponentially after a certain level of stress. Copyright © 2011 John Wiley & Sons, Ltd.     

Psychometric evaluation of perceived stress scale for Turkish university students

The purpose of the study was to investigate the applicability of the Perceived Stress Scale (PSS) to a Turkish sample. PSS (Cohen, Kamarck, & Mermelstein, 1983) is a general appraisal instrument that measures the degree to which situations in one's life are appraised as stressful. Five hundred and eight freshman students at the Middle East Technical University at the age of 16–29 filled in the Turkish translation of the PSS. The alpha coefficient for the Turkish version of PSS was found as 0.84, and PSS correlated 0.61 with the General Health Questionnaire. Exploratory and confirmatory factor analysis of the PSS showed that the scale consisted of two factors: Perceived Helplessness factor and Perceived Self‐efficacy. In general, the data indicated that the PSS provides a reliable and valid measure of perceived stress for a Turkish sample. The findings provide useful information for researchers and practitioners wishing to adapt foreign psychological tests to different cultures, especially in relation to the assessment of university students. Copyright © 2008 John Wiley & Sons, Ltd.     

A modified QuickDASH-9 provides a valid outcome instrument for upper limb function

Background  

The 30-item Disabilities Arm Shoulder and Hand (DASH) questionnaire was introduced to facilitate assessment of upper limb functional limitations. To improve practicality and eliminate item redundancy a modified instrument was needed. The 11-item QuickDASH was developed to fulfil these requirements and translated into several languages. However, prospective investigations of psychometric and practical characteristics are limited. No published study investigated readability or used concurrent validation with a standardized upper limb criterion measure. The validity of the QuickDASH has been questioned as the results for factor structure are conflicting, and the English-language version has not yet had factor structure reported. A shortened 9-item version, the QuickDASH-9, that addresses these issues is proposed.     

Development and validation of the Workplace Interruptions Measure

In 3 studies, we developed and tested the first comprehensive, self‐report measure of workplace interruptions. The Workplace Interruptions Measure (WIM) is based on a typology of interruptions that included intrusions, distractions, discrepancy detections, and breaks. The four‐factor structure was reduced to a 12‐item measure in Study 1 (N = 317) and confirmed in a diverse sample of employees in Study 2 (N = 160). Study 3 (N = 323) further examined the psychometric properties of the WIM in a sample of university faculty and staff. Studies 2 and 3 demonstrated that both effort‐enhancing interruptions (intrusions, distractions, and discrepancy detections) and recovery‐enhancing interruptions (breaks) were associated with stressors and strains. Distractions, discrepancy detections, and breaks uniquely predicted strain outcomes beyond other workplace stressors (i.e., quantitative workload, interpersonal conflict, and role conflict). We discuss implications of the WIM for the theory and practice of interruptions research.     

Evaluations of stressful transactions: what's in an appraisal?

Appraisals are the portal to emotional experience and action. Past research has demonstrated that challenge and threat appraisals have different implications for psychological, physiological, and behavioural responses, typically relying on two‐item assessments of appraisals. The present study investigated the predictive utility of a theoretically expanded appraisal measure. Both indexes were used to classify participants as either challenged (task demands were rated as commensurate with coping resources) or threatened (task demands were rated as exceeding resources). Group differences in stress responses were examined. The lengthened appraisal assessment was reliable. Furthermore, compared with the two‐item measure, the expanded measure better distinguished differences in emotional experience and performance. Similar findings were obtained for cardiovascular stress responses. Enhancing the assessment of individual differences in stressor appraisals facilitates our understanding their nature and potential for modification, and the nature of the stress process. Copyright © 2008 John Wiley & Sons, Ltd.     

Validation of the four‐dimensional symptom questionnaire (4DSQ) and prevalence of psychological symptoms in orthopedic shoulder patients

Psychological problems are common in shoulder patients. A validated psychological questionnaire measuring clinically relevant psychological symptoms (including distress, depression, anxiety, and somatization) in shoulder patients is lacking. The Four‐Dimensional Symptom Questionnaire (4DSQ) is a self‐report questionnaire to identify distress, depression, anxiety, and somatization which has been validated in primary care populations. The aim of this study was to validate the 4DSQ in orthopedic shoulder patients. We assessed whether the 4DSQ measures these four constructs the same way in an orthopedic population with shoulder problems compared to a general practice population. We also investigated the prevalence of psychological symptoms in shoulder patients. The shoulder group consisted of 200 consecutive patients and the general practice group comprised 368 patients, matched for gender and age. Differential item functioning analysis showed that the 4DSQ measures the different psychological symptoms in orthopedic shoulder patients the same way as in general practice patients. The shoulder patients tended to score higher on the somatization scale, resulting in a new cut‐off point for somatization. The prevalence of distress, somatization, anxiety, and depression in the shoulder group was 23%, 14%, 10%, and 8%, respectively. It can be concluded from this study that the 4DSQ in orthopedic shoulder patients measures the same constructs as in general practice patients and can therefore be used in orthopedic practice to measure psychological symptoms in patients with shoulder complaints. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:683–691, 2016.     

Characteristics of the Children's Revised Impact of Event Scale in a Clinically Referred Dutch Sample

Early identification of posttraumatic stress disorder (PTSD) in children is important to offer them appropriate and timely treatment. The Children's Revised Impact of Event Scale (CRIES) is a brief self‐report measure designed to screen children for PTSD. Research regarding the diagnostic validity of the CRIES is still insufficient, has been restricted to specific populations, and sample sizes have often been small. This study evaluated the reliability and validity of the 8‐item (CRIES‐8) and 13‐item (CRIES‐13) versions of the CRIES in a large clinically referred sample. The measure was completed by 395 Dutch children (7–18 years) who had experienced a wide variety of traumatic events. PTSD was assessed using the Anxiety Disorders Interview Schedule for DSM‐IV: Child and Parent version. A cutoff score of 17 on the CRIES‐8 and 30 on the CRIES‐13 emerged as the best balance between sensitivity and specificity, and correctly classified 78%–81% of all children. The CRIES‐13 outperformed the CRIES‐8, in that the overall efficiency of the CRIES‐13 was slightly superior (.81 and .78, respectively). The CRIES appears to be a reliable and valid measure, which gives clinicians a brief and user‐friendly instrument to identify children who may have PTSD and offer them appropriate and timely treatment.     

The factor structure of the 12-item General Health Questionnaire in a literate Kenyan population

The study evaluated the factorial structure of the 12‐item General Health Questionnaire (GHQ‐12) in a population of Kenyan adults and adolescents. A sample of 1216 people aged 12–60 years completed the English version of the GHQ‐12. To evaluate the factor structure of the GHQ‐12, a confirmatory analysis using MPLUS was carried out. A unidimensional model of GHQ‐12 as originally conceptualized did not provide a good fit for the data (Comparative Fit Index = 0.843, Tuckler Lewis Index = 0.841, Root Mean Square of Error Approximation = 0.078, Standardized Root Mean Square Residual = 0.063). Unidimensional models, which partial out the effects of negative wording showed an adequate fit to the data. Additionally, multidimensional models showed an excellent fit to the data. Based on the principles of parsimony, pattern of item loading and the correlation between identified factors in the multidimensional models, it was concluded that the GHQ?12 is a unidimensional measure whose structure is significantly influenced by wording effects. The GHQ‐12, when applied to a literate population in Africa, showed similar factor structure as in other regions of the world; hence, it can be recommended for use as a screening tool for general symptoms of psychological distress. Copyright © 2011 John Wiley & Sons, Ltd.     

The factorial validity and measurement invariance of the Maslach Burnout Inventory for human services

This paper first examines the factorial validity of the Maslach Burnout Inventory for human services professions (MBI‐HSS). The authors test the original 22‐item version and a shortened 20‐item version. Model fit is evaluated with confirmatory factor analysis starting with data collected from a sample of hospital nurses (n = 2515) and a sample of nurses and assistants working in residential welfare institutions (n = 1639). Only the fit of the 20‐item MBI‐HSS was good in both samples. Next the hypothesis of measurement invariance of the 20‐item MBI‐HSS across the samples is examined, but this hypothesis does not hold. Partial invariance at the level of the subscales also could not be confirmed. The authors conclude that for hospital nurses the MBI‐HSS factors mean something other than what they mean for professionals working in welfare institutions, and suggest that future research could focus upon this difference. Copyright © 2006 John Wiley & Sons, Ltd.     

Development of the Impact of Nighttime Urination (INTU) questionnaire to assess the impact of nocturia on health and functioning

Aims

This study describes development of the Impact of Nighttime Urination (INTU) questionnaire to assess nocturia impacts on health and functioning.

Methods

Development of the questionnaire followed an iterative patient‐directed process as recommended by current guidance for patient‐reported outcome (PRO) measures. An initial 15‐item questionnaire was devised based on reviewing the published literature, and then modified through four rounds of semi‐structured interviews of 28 individuals with nocturia. In each round, open‐ended concept elicitation, followed by cognitive debriefing, was used to assess the questionnaire. Items were modified based on participants’ responses and incorporated into the next round of interviews.

Results

In all rounds, participants reported that their experiences were easy to recall and report on a daily basis and that the burden of completing the questionnaire was low. The final questionnaire has a same‐day recall period. It includes six daytime impact items—having limited concentration, a sense of feeling tired, difficulty getting things done, irritability, not feeling rested, and drowsiness—and four items that measure the nighttime impact of nocturia—patient concern, waking up too early, difficulty getting enough sleep, and feeling bothered by having to get up at night to void. Responses follow a 5‐ or 4‐point scale. The final INTU captures the key concepts associated with nocturia as confirmed by cognitive debriefing.

Conclusions

Development of the 10‐item INTU, a nocturia‐specific PRO measure, was based on direct input and feedback from patients and has demonstrated that it captures the patient‐reported impacts of nocturia.     

Measurement Invariance of the Perceived Stress Scale and Latent Mean Differences across Gender and Time

Measurement invariance of the 2‐factor model of the Perceived Stress Scale—10‐item version (Cohen & Williamson, 1988) was tested across men and women at two time points and in the combined total sample over a 2‐year time frame (n = 871). Measurement invariance results indicated that the scale measured the latent factors, stress and counter‐stress, equivalently in men and women and over time. With measurement invariance demonstrated, differences in latent means were tested. Results indicated that men had lower levels of frequencies of stressors, and at one time point, higher levels of counter‐stress, when compared with women. When examining change in frequencies of stressors and counter‐stress over 2 years with the combined male and female sample, stressors remained stable, yet counter‐stress increased over time. These findings may aid in the interpretation of results when examining stressors and counter‐stress in clinical samples where one would expect stress to increase, whereas positive psychological states decrease. Copyright © 2012 John Wiley & Sons, Ltd.     

The Associations Between Coping Self‐Efficacy and Posttraumatic Stress Symptoms 10 Years Postdisaster: Differences Between Men and Women

The mediating role of coping self‐efficacy (CSE) perceptions between disaster‐related posttraumatic stress symptoms (PSS) in the intermediate term (4 years postevent) and PSS in the long term (10 years postevent) were examined. Participants were 514 adult Dutch native residents affected by the Enschede fireworks disaster. The disaster (May, 2000) was caused by a massive explosion in a fireworks storage facility that destroyed a residential area. Multiple regression analysis and path analysis were used to examine the mediating role of CSE and whether the mediating role was the same for men and women. Age, education, disaster exposure, home destruction, optimism, and stressful life events were also taken into account. Regression analysis showed that the former variables were not associated with PSS at 10 years postevent, in contrast to PSS at 4 years, and were therefore omitted from the path analyses. CSE assessed at 10 years postdisaster partially mediated the relationship between PSS at 4 and PSS at 10 years postdisaster. Post hoc multigroup analysis showed that this effect was significantly stronger for men, whereas the association between PSS at 4 and 10 years postevent was stronger for women. PSS at 10 years postevent were better predicted among men (explained variance 59.5% vs 50.8%).     

Validation of a single‐item measure of burnout against the Maslach Burnout Inventory among physicians

The measurement of burnout among physicians is important because physician well‐being has the potential to affect workforce stability and quality of care. In this study, a single‐item measure of burnout was validated against the sub‐scales of the Maslach Burnout Inventory (emotional exhaustion, depersonalization, and personal accomplishment). Survey items included the 22‐item Maslach Burnout Inventory, a single‐item measure of burnout, and other questions regarding demographics, practice characteristics, and occupational satisfaction. The surveys were mailed to Texas Tech University School of Medicine Alumni classes of 1980–1989. The response rate was 43 per cent (n = 307). Pearson correlation coefficients and ANOVA were used to determine the association between the Maslach Burnout Inventory scores and the single‐item burnout question. The single‐item was correlated at r = 0.64 (p < 0.0001) with emotional exhaustion and the ANOVA yielded an R² of 0.5 (p < 0.0001). Hence, in surveys of physicians where emotional exhaustion is the primary sub‐scale of interest, a single‐item measure of burnout may be used as an alternative to the Maslach Burnout Inventory in order to abbreviate survey material and potentially increase response rates among physicians. Copyright © 2004 John Wiley & Sons, Ltd.     

The DASH questionnaire. French translation of a trans-cultural adaptation

The DASH (Disability of Arm-Shoulder-Hand) is a self-administered questionnaire developed in 1994 by representatives of the Institute for Work & Health (IWH) and the American Academy of Orthopaedic Surgeons (AAOS). It measures the physical disability and symptoms for all upper limb disorders in a heterogeneous population and for acute as well as chronic disorders. The original american version has been already tested for reliability and validity. Interest in the DASH was raised by several European publications. It appeared that the DASH could provide a common measure for upper extremity physical disability in Northern America and European countries. For this cross-cultural adaptation, we followed the guidelines developed by the Institute for Work & Health and American Academy of Orthopaedic Surgeons. Five translations and two "back-translations" were compared, aiming to semantic, idiomatic, experimental and conceptual equivalence. The final version has been tested in 223 patients presenting a variety of traumatic or non traumatic disorders. 208 questionnaires (93%) were valid because there was less than 4 missing answers. This final version has been proposed to American Academy of Orthopaedic Surgeons in order to be endorsed as an official translation. This could improve assessment for international studies by establishing standard measures.     

Trauma‐Exposed Community‐Dwelling Women and Men Respond Similarly to the DAR‐5 Anger Scale: Factor Structure Invariance and Differential Item Functioning

Anger is associated with the development of posttraumatic stress disorder (PTSD) and with poor treatment outcomes. The Dimensions of Anger Reactions Scale‐5 (DAR‐5) has demonstrated preliminary evidence of unitary factor structure and sound psychometric properties. Gender‐based differences in psychometric properties have not been explored. The current study examined gender‐based factor structure invariance and differential item functioning of the DAR‐5 and gender differences in PTSD symptoms as a function of anger severity using a community sample of adults who had been exposed to trauma. Data were collected from 512 trauma‐exposed community‐dwelling adults (47.9% women). Confirmatory factor analyses, Mantel‐Haenszel χ² tests and a comparison of characteristic curves, and 2‐way analyses of variance, respectively, were used to assess gender‐based factor structure invariance, gender‐based response patterns to DAR‐5 items, and gender differences in PTSD symptoms as a function of anger. The unitary DAR‐5 factor structure did not differ between men and women. Significant gender differences in the response pattern to the DAR‐5 items were not present. Trauma‐exposed individuals with high anger reported greater overall PTSD symptoms (p < .001), regardless of gender. The DAR‐5 can be used to assess anger in trauma‐exposed individuals without concern of gender biases influencing factor structure or item functioning. Findings further suggested that the established relationship between anger and PTSD severity did not differ by gender.     

The factorial structure of the GHQ‐12

This paper studies the factorial structure of the 12‐item version of the General Health Questionnaire (GHQ‐12), Dutch translation, in a large Belgian sample (n = 9442) that is representative of the general population. Data was collected from the 2001 Belgian Health Interview Survey. In total, 11 factor‐structure models are tested by means of confirmatory factor analysis. Two models, a two‐factorial model without cross‐loadings and a three‐factorial model with cross‐loadings, prove to have acceptable model‐fit. Given parsimony and the uni‐dimensionality of the subscales, the authors prefer the two‐factorial model over the three‐factorial one. In a next step, it is examined whether a general, second‐order factor can be seen underlying both the two‐ and three‐factorial models. This, however, was only true for the three‐factorial model. Based on correlations with other scales (the revised Symptom Checklist 90, SCL‐90‐R; the MOS Social Support Survey, MOS‐SSS) and a variable on social contacts, the authors suggest that the ‘social dysfunction’ subscale be renamed ‘dysfunction’. Copyright © 2005 John Wiley & Sons, Ltd.     

Longitudinal Measurement Invariance of Posttraumatic Stress Disorder in Deployed Marines

The meaningful interpretation of longitudinal study findings requires temporal stability of the constructs assessed (i.e., measurement invariance). We sought to examine measurement invariance of the construct of posttraumatic stress disorder (PTSD) as based on the Diagnostic and Statistical Manual of Mental Disorders indexed by the PTSD Checklist (PCL) and the Clinician‐Administered PTSD Scale (CAPS) in a sample of 834 Marines with significant combat experience. PTSD was assessed 1‐month predeployment (T0), and again at 1‐month (T1), 5‐months (T2), and 8‐months postdeployment (T3). We tested configural (pattern of item/parcel loadings), metric (item/parcel loadings on latent factors), and scalar (item/parcel‐level severity) invariance and explored sources of measurement instability (partial invariance testing). The T0 best‐fitting emotional numbing model factor structure informed the conceptualization of PTSD's latent factors and parcel formations. We found (1) scalar noninvariance for the construct of PTSD as measured by the PCL and the CAPS, and for PTSD symptom clusters as assessed by the CAPS; and (2) metric noninvariance for PTSD symptom clusters as measured by the PCL. Exploratory analyses revealed factor‐loading and intercept differences from pre‐ to postdeployment for avoidance symptoms, numbing symptoms (mainly psychogenic amnesia and foreshortened future), and the item assessing startle, each of which reduced construct stability. Implications of these findings for longitudinal studies of PTSD are discussed.     

Psychometric Evaluation of a Coping Questionnaire in Two Independent Samples of People with Diabetes

The study examines internal item/scale structure and concurrent validity of a newly developed 48‐item questionnaire [General Coping Questionnaire (GCQ)] that measures 10 aspects of coping with chronic illness (self‐trust, problem‐reducing actions, change of values, social trust, minimization, fatalism, resignation, protest, isolation and intrusion). The tests were performed in two independent samples of persons with diabetes mellitus. The first sample consisted of 119 subjects with type I diabetes and the second sample of 184 subjects with type II diabetes. Concurrent validity was examined by comparisons with measures of health‐related quality of life (SF‐36), a measure of metabolic control (HbA1c) and incidence of diabetic complications. The item/scale structure was found to be similar and very good in both samples. The 10 dimensions correlated as expected with the measure of mental health, although the ‘negative’ dimensions of the GCQ correlated higher compared with the ‘positive’ dimensions. Weaker relations with metabolic control were also found in one of the samples. These tests provide further evidence that GCQ is a well‐structured, relevant and reliable instrument for assessing coping reactions in chronic somatic conditions. Copyright © 2012 John Wiley & Sons, Ltd.