The development of a scale measuring integrated regulation in exercise

Objectives. This research aimed to develop and validate a measure of integrated regulation based on self‐determination theory (SDT) in an exercise context. Design. Cross‐sectional and prospective surveys were employed. Methods. The measure was developed from first principles from an initial item pool and items were selected using expert evaluators. The validity of the final item pool was tested across a high‐active sample and a lower active sample (N= 488) using single‐ and multi‐sample confirmatory factor analyses (CFAs). Results. Analyses supported the factorial, nomological, discriminant, and predictive validity of the scale. Conclusions. The validity of the integrated regulation measure was supported. Present analyses provide evidence that the scale is a valid and reliable tool that may be used to evaluate the effectiveness of autonomy‐supportive interventions in health‐related behavioural contexts.     

Mokken scaling and principal components analyses of the CORE‐OM in a large clinical sample

In a sample of 543 adult National Health Service (NHS) patients referred to a Psychological Therapies Service, the responses to the Clinical Outcomes in Routine Evaluation‐Outcome Measure (CORE‐OM) self‐report questionnaire were examined using conventional principal components analysis (PCA) and a unique application of Mokken Scaling Procedure (MSP). Following the theoretical views of G. A. Foulds, it was suggested that some items more properly belong to the universe of attitudes and traits rather than that of symptoms and states. Accordingly, the analyses were carried out both with and without the CORE‐OM Risk domain items. Both PCAs produced a very large first component of Psychological distress, while the small second component differs. With all items included, the second component was of Risk. With the risk items excluded, the second component was now Functioning. The MSP results, respectively, were of a five‐item scale of Functioning (impaired by depression) and on the second analysis, a five‐item Functioning scale (impaired by anxiety). There was discussion on the criteria for item selection, the time scale specified in questionnaire instructions and the optimum number of items required for a symptom scale. It was concluded that the CORE‐OM item pool did not conform to its purported face validity domains and subdomains, but predominantly constitutes a large Psychological distress scale with considerable item redundancy. Copyright © 2009 John Wiley & Sons, Ltd.     

Predicting stress in pre‐registration nursing students

Objectives. To determine which variables from a pool of potential predictors predict General Health Questionnaire ‘caseness’ in pre‐registration nursing students. Design. Cross‐sectional survey, utilizing self‐report measures of sources of stress, stress (psychological distress) and coping, together with pertinent demographic measures such as sex, ethnicity, educational programme and nursing specialty being pursued, and age, social class and highest qualifications on entry to the programme. Methods. Questionnaire packs were distributed to all pre‐registration nursing students (N = 1,362) in a large English university. Completed packs were coded, entered into statistical software and subjected to a series of logistic regression analyses. Results. Of the questionnaire packs 1,005 (74%) were returned, of which up to 973 were available for the regression analyses undertaken. Four logistic regression models were considered and, on the principle of parsimony, a single model was chosen for discussion. This model suggested that the key predictors of caseness in the population studied were self‐report of pressure, whether or not respondents had children (specifically, whether these children were pre‐school or school‐age), scores on a ‘personal problems’ scale and the type of coping employed. The overall caseness rate among the population was around one‐third. Conclusion. Since self‐report and personal, rather than academic, concerns predict stress, personal teachers need to play a key role in supporting students through ‘active listening’, especially when students self‐report high levels of stress and where personal/social problems are evident. The work‐life balance of students, especially those with child‐care responsibilities, should be a central tenet in curriculum design in nurse education (and, indeed, the education of other professional and occupational groups). There may be some benefit in offering stress management (coping skills) training to nursing students and, indeed, students of other disciplines.     

Pre‐adolescent gender differences in associations between temperament,coping, and mood

Relationships between temperament, coping, depressive and aggressive mood in 8–12‐year‐old boys (n = 185) and girls (n = 219) were investigated, with a focus on gender differences. Children completed two self‐report questionnaires: the Early Adolescent Temperament Questionnaire‐Revised and Children's Coping Strategies Checklist‐Revised1. Comparing boys and girls on three temperament dimensions, positive affectivity, negative affectivity and effortful control, girls scored higher than boys on the first two dimensions. Girls also scored higher than boys on avoidant coping and depressive mood. For both boys and girls, aggressive and depressive mood were predicted by negative affectivity. Coping did not add towards this prediction. Gender specific models of temperament, coping and depressive mood were tested. For girls, both effortful control and active problem solving, accounted for the variability in depressive mood. For boys, only effortful control accounted for variance in depressive mood. Results showed that gender specific vulnerability to depression in girls is apparent before adolescence and can be linked to temperament and coping. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message:

• Pre‐adolescent girls are more vulnerable to depression than boys. Interventions focussing on self‐control, emotion regulation and active coping are tailored towards vulnerabilities in temperament and coping in girls.

     

The impact of psychotherapy sessions: Internal structure of the Dutch Session Evaluation Questionnaire (SEQ)

The Session Evaluation Questionnaire (SEQ), intended to measure the impact of psychotherapy sessions, is a self‐rating instrument consisting of 21 bipolar adjective scales in semantic differential format. The SEQ may be conceived as a bridge between psychotherapy process and outcome. Since its introduction in 1980, the original American SEQ has been translated in different languages. However, the reliability and validity of the SEQ have only been assessed for the American SEQ so far. Objectives. The present study attempted to replicate the dimensional structure of the American SEQ for the Dutch version. Design. SEQ data were collected in a heterogeneous convenience sample of 96 patients, producing 2074 SEQ ratings, with each patient completing at least four SEQ forms over the course of her/his treatment. Methods. Exploratory factor analyses (principal component analyses with varimax rotation) were used to establish the dimensional structure of the Dutch SEQ. In the American and English studies, factor analyses were only performed on each of the SEQ parts (session evaluation and post‐session mood) separately. No factor analyses were run with all 21 items included in the analyses. Different from the English and American studies, the internal structure of the Dutch SEQ was not only established for the separate parts, but was also determined by treating the SEQ as a single 21 item rating scale. Results. Replicating the American and English data analyses, the Depth dimension could convincingly be replicated in the Dutch sample. Moreover, the Smoothness and Positivity dimensions could be recovered in the Dutch sample to a large extent. Different from the American SEQ, the Arousal dimension did not appear as a distinct dimension at all. Factor analyses of all 21 items yielded no more than two interpretable dimensions, encompassing about half of the SEQ items. Conclusion. The basic psychological concepts in which the American SEQ is rooted‐evaluation and mood‐ also appear in the Dutch SEQ version. However, the results of the current study do not justify a simple transfer of the four American SEQ dimensions to the Dutch SEQ version.     

Evaluating the “C” and “B” in brief cognitive behaviour therapy for distressing voices in routine clinical practice in an uncontrolled study

Brief and single‐symptom forms of cognitive behaviour therapy (CBT) for distressing voices may increase access to evidence‐based psychological therapy and transcend diagnostic barriers. The current study evaluated the “C” and “B” in CBT for distressing voices in a transdiagnostic voices clinic. The B module (component of therapy) sought to enhance coping with voices, and the C module evaluated the accuracy of negative beliefs about the self and voices. The aims of the study were to investigate (a) whether modules B and/or C led to significant and clinically meaningful improvements on the primary outcome of voice‐related distress, and (b) if changes in beliefs about self and voices (proposed change mechanisms) underpinned changes in voice distress across module C. Each module consisted of four sessions, individually tailored yet manualized, and designed with ease of staff training and delivery in mind. Assessment measures were administered at baseline (T1), post‐module B (T2), and post‐module C (T3). The results (N = 62) showed statistically significant medium‐sized pre‐ and post‐effects for voice‐related distress from T1 to T2 and from T2 to T3, with large effects from T1 to T3. Just over half of the clients reported clinically meaningful improvements from T1 to T3. Neither beliefs about self nor voices were found to mediate improvements in voice distress during module C. The findings from this study suggest that both the B and C in CBT for voices can contribute to positive outcomes within routine clinical practice.     

Self-evaluative appraisals of coping capability and posttraumatic distress following motor vehicle accidents

This study tested the importance of coping self-efficacy (CSE) perceptions and change in perceptions of CSE for recovery from motor vehicle accident (MVA) trauma. Data were collected 7 days following the accident (Time 1; n = 163), 1 month after the accident (Time 2; n = 91), and 3 months after the accident (Time 3; n = 70). Early changes in CSE (i.e., from Time 1 to Time 2) predicted posttraumatic distress at 3 months after MVA trauma, even after controlling for Time 1 or Time 2 posttraumatic distress and other trauma-related variables (i.e., accident responsibility, litigation involvement, and peritraumatic dissociation). Early changes in CSE perceptions, however, neither moderated nor mediated the effects of early posttraumatic distress (Time 1) on 3-month posttraumatic distress. Time 2 CSE levels, however, did mediate the relationship between acute posttraumatic distress (Time 1) and 3-month posttraumatic distress (Time 3). These findings highlight the importance of early interventions aimed at strengthening self-efficacy after MVA trauma.     

Development and initial psychometric properties of the University of Texas at San Antonio Future Disposition Inventory

We describe the development and initial psychometric properties of a 24‐item self‐report measure, the University of Texas at San Antonio Future Disposition Inventory (UTSA FDI). This instrument is designed to evaluate future related thoughts and feelings that are associated with suicide‐related risk behaviors: positive focus, suicide orientation, and negative focus. The items were generated by clinical and nonclinical samples. The structure of the instrument was defined in a sample of 350 university undergraduate students (Study 1). Using CFA, we confirmed the fit of the 3‐factor solution in an independent sample of college age students (n=452; Study 2). Scale reliability estimates were good (all ρ's≥.80) in both studies. Known‐groups validation analyses showed that scores on each scale were useful in differentiating the responses of the study groups. Correlates for the scales were identified when scores on measures of suicide‐related risk and general psychological symptoms were included as validation self‐report instruments. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66: 1–20, 2010.     

Psychosocial Functioning of Carcinoid Cancer Patients: Test of a Stress and Coping Mediated Model1

This study examined a mediated‐effects stress and coping model among cancer patients with carcinoid tumors to identify specific pathways with a view toward determining (a) which coping strategies predict more positive adjustment, (b) which strategies predict less positive adjustment, and (c) whether coping would mediate the effect of optimism on psychosocial outcomes. Coping strategies partially mediated the effects of optimism on the psychological adjustment in cancer patients with carcinoid tumors. Specifically, self‐blame and active coping significantly predicted outcomes of distress. Thirty‐seven percent of the respondents met criteria for elevated depressive symptoms warranting intervention. Generalizability of the mediated‐effects stress and coping model and findings unique to the carcinoid population are discussed.     

The prevalence and predictors of psychological distress in men with prostate cancer who are seeking support

Objective: The incidence of prostate cancer has risen sharply in the last decade, yet knowledge about the psychological health of men with this disease is still limited. A study was therefore undertaken to identify (1) the prevalence of psychological distress in these males, and (2) factors predicting psychological distress. Design: Retrospective cross‐sectional survey design by means of a self‐administered questionnaire. Method: A sample of 94 men with various stages of prostate cancer completed the Functional Assessment of Cancer Therapy—Prostate Instrument (FACT‐P), the Hospital Anxiety Depression Scale (HADS) and items measuring satisfaction with medical care. Results: We detected a prevalence rate of 38% of participants reporting psychological distress corresponding to a HADS cut‐off score at or above 15. A standard multivariate regression analysis revealed social/family well‐being, physical well‐being and functional well‐being as significant inverse predictors of psychological distress. Conclusions: Health professionals should be aware of the potential for psychological distress in patients exhibiting poor physical functioning and those with apparent deficits in social or family support in this under‐studied group of patients. Strategies for psychosocial intervention are implied.     

Determinants of Psychological Distress and Its Course in the First Year After Diagnosis in Rheumatoid Arthritis Patients

In order to examine determinants of psychological distress and its course in the first year after diagnosis in rheumatoid arthritis patients, self-report data and clinical and laboratory measures were collected in 91 patients (70% female, mean age 57 years) shortly after diagnosis and 1 year later. Multiple regression analysis indicated that sex, pain and functional status, disease impact on daily life, life events, and perceived social support were related to psychological distress (anxiety and depressed mood) shortly after diagnosis. Coping strategies were related to distress levels only 1 year later. Multiple regression analysis of change in anxiety and depressed mood revealed that a decrease of psychological distress after 1 year could be predicted by male sex, an initially less severe inflammatory activity and an initially more extended social network. In addition, a decrease in distress was related to parallel improvements in clinical status. Results indicate the importance of a multimodal assessment of demographic variables, clinical and life stressors and social resources for the understanding of distress and the identification of risk factors in the first stage of the disease. Personal coping resources appear to become more important predictors of distress in a later phase of the disease.     

Coping with ovarian cancer risk: The moderating effects of perceived control on coping and adjustment

Objective. Although perceived control and coping have been studied across various health conditions, these relationships have been less well studied in the context of coping with cancer risk over time. The present study was a longitudinal study of the effects of perceived control and problem‐focused coping on changes in psychological adjustment and behavioural outcomes among women at increased risk for ovarian cancer. Design and methods. Eighty women enrolled in a familial cancer risk assessment programme participated in this study. Assessments of problem‐focused coping, perceived control and distress were collected upon entry into the programme and again at 3‐month follow‐up. Behavioural adherence to screening during the 12‐month period following programme entry was obtained from clinic records. Results. Using hierarchical regression analysis, we observed a significant interaction between perceived control and problem‐focused coping for psychological distress, β = 0.94, p <.05. Specifically, problem‐focused coping was associated with increasing distress over time among women who perceived high control. A significant control by coping interaction was also observed for behavioural adherence to pelvic ultrasound and CA125 screening, such that women who perceived high control and utilized problem‐focused coping were less likely to undergo screening. Conclusions. Under conditions of high perceived control, problem‐focused coping was associated with increasing distress as well as poorer behavioural adherence. Thus, perceived control and problem‐focused coping may not always yield positive psychological or behavioural health outcomes. These findings contribute to a greater understanding of how problem‐focused coping and perceived control may influence the course of adjustment to cancer risk over time.     

Can illness perceptions and coping predict psychological distress amongst allergy sufferers?

Objective. The aim of the present study was to measure the extent to which illness perceptions and coping strategies are associated with the levels of psychological distress amongst allergy sufferers. Design and method. One hundred and fifty‐six allergy sufferers (all members of Allergy U.K.) completed a postal survey consisting of the Revised Illness Perception Questionnaire (IPQ‐R) and the COPE. Psychological distress was measured using the General Health Questionnaire (GHQ‐28) and the Perceived Stress Scale (PSS). Results. Multiple regression analyses indicated that illness perceptions explained between 6 and 26% of variance on measures of psychological distress; coping strategies explained between 12 and 25%. A strong illness identity and emotional representations of the allergy were associated with higher levels of psychological distress; as were less adaptive coping strategies such as focusing on and venting of emotions. Strong personal control beliefs were associated with the lower levels of distress, as were adaptive coping strategies such as positive reinterpretation and growth. Coping partially mediated the link between the illness perceptions and the outcome; however, illness identity, emotional representations and personal control retained an independent significant association with psychological distress. Conclusion. The findings support a role for illness perceptions and coping in explaining levels of psychological distress amongst allergy sufferers. This has implications for targeted health interventions aimed at reducing the strength of illness identity and emotional representations and increasing a sense of control and the use of more adaptive coping strategies.     

Compassionate Attention and Regulation of Eating Behaviour: A pilot study of a brief low‐intensity intervention for binge eating

A low‐intensity 4‐week intervention that included components of compassion, mindfulness, and acceptance was delivered to women diagnosed with binge eating disorder. Participants were randomly assigned to 1 of 2 conditions: intervention (n  = 11) or waiting list control (n  = 9). Participants in the intervention condition were invited to practise mindfulness, soothing rhythm breathing, and compassionate imagery practices with a focus on awareness and acceptance of emotional states and triggers to binge eating and engagement in helpful actions. Results revealed that, in the intervention group, there were significant reductions in eating psychopathology symptoms, binge eating symptoms, self‐criticism, and indicators of psychological distress; there were significant increases in compassionate actions and body image‐related psychological flexibility. Data suggest that developing compassion and acceptance competencies may improve eating behaviour and psychological well‐being in individuals with binge eating disorder.     

Religious coping among jews: development and initial validation of the JCOPE

Numerous studies have underscored the importance of religious coping in psychological health and illness; however, the majority of research in this area has been conducted with Christian samples and knowledge about other religious groups is lacking. Although recent investigations have developed scales to measure religious coping among Hindus and Muslims, the potential for future research in Jewish populations remains limited as no measures of religious coping have been validated in the general Jewish community. This two‐part study reports on the development and validation of the 16‐item Jewish Religious Coping Scale (JCOPE). In Study 1, an exploratory factor analysis identified two factors reflecting positive and negative religious coping strategies, and the concurrent validity for the measure was evaluated by examining correlations with indices of Jewish beliefs and practices. In Study 2, a confirmatory factor analysis (CFA) verified the JCOPE's 2‐factor structure, and the scale's incremental validity was evaluated by examining Jewish religious coping as a predictor of psychological distress over and above significant covariates. Results suggest that the JCOPE has good psychometric properties, and that religious coping is a significant predictor of psychological distress among Jews. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1–14, 2009.     

Psychometric properties of a Turkish version of the difficulties in emotion regulation scale

This study aimed to examine the psychometric properties of the Difficulties in Emotion Regulation Scale (DERS; developed by Gratz & Roemer, 2004 ) in a Turkish sample. For this purpose, first, the factor structure of the scale was examined with a sample of 338 university students, and an identical factor structure with the original scale was obtained with the exclusion of a single item. Following the confirmation of the 6‐factor structure of the scale with the current Turkish sample, the whole scale's and its six subscales' reliability coefficients were examined via internal consistency and test‐retest reliability coefficients. These reliability analyses indicated satisfactory coefficients. As for the concurrent validity, the correlations of DERS and its subscales with measures of psychological distress were examined. This examination generally revealed strong correlations, although the awareness factor of DERS had relatively weaker correlations with the measures of psychological distress. Finally, concerning the criterion validity, all the measures of DERS could significantly differentiate the participants with “high psychological distress” from those with “low psychological distress”; however, for the awareness subscale the effect size was small. These findings were discussed in line with the relevant literature. © 2010 Wiley Periodicals, Inc. J Clin Psychol 66:1–14, 2010.     

The effects of dyadic strength and coping styles on psychological distress in couples faced with prostate cancer

Dyadic adjustment and coping styles have been shown to predict levels of psychological distress following cancer diagnoses. This study examined the relationship between coping and distress in couples faced with prostate cancer, considering dyadic functioning as a third variable that potentially moderated or mediated the relationship. To investigate its influence on the success of patients' and spouses' coping efforts, both moderational and mediational models were tested using couples' composite dyadic adjustment scores. Only the moderational model was supported for patients: dyadic strength moderated the effects of avoidant coping and intrusive thinking on mood disturbance. Despite maladaptive coping, patients that were members of stronger dyads reported less distress than those in more dysfunctional relationships. Findings suggest that the relationship between coping and distress depends on the quality of dyadic functioning. Being part of a strong dyad may serve as a buffering factor, implying the need for psychosocial intervention for couples in maladjusted relationships.     

Communication avoidance,coping and psychological distress of women with breast cancer

This study examined the relationship between communication avoidance of cancer-related topics with psychological distress, and the mediating role of coping strategies, in women with breast cancer. Women diagnosed with breast cancer (N = 338) completed an online survey including measures of self- and perceived-partner communication avoidance, psychological distress (depression, anxiety and stress), and coping strategies. Linear regression analyses indicated that women’s and perceived-partner’s communication avoidance was associated with anxiety, depression, and stress in the cancer-affected women. Bootstrapping analyses showed significant mediation effects of self- and perceived-partner communication avoidance on all distress outcomes through greater disengagement coping, and on anxiety through lower engagement coping. Emotionally valenced topics (i.e., disease progression and sexuality) were most avoided and practical issues were least avoided. Enhancing couple communication about cancer and women’s adaptive coping skills (i.e., discourage use of disengagement coping strategies and promote use of engagement coping strategies) may be important targets for psychosocial intervention.     

Development of the Counseling Center Assessment of Psychological Symptoms‐Japanese version: Pilot study

There is currently no reliable and valid multidimensional instrument for measuring psychological symptoms among Japanese university students. The purpose of this pilot study was to translate the Counseling Center Assessment of Psychological Symptoms‐62 (CCAPS‐62) into Japanese and evaluate its validity and reliability. Following robust translation procedures, the CCAPS‐Japanese was created. In the validation study, 2,758 undergraduate students from 11 universities (mean age = 19.08 ± 1.85 years) completed the CCAPS‐Japanese. The results of confirmatory factor analysis supported the theoretical eight‐factor structure model of the CCAPS‐Japanese with the exclusion of seven items. The decision to retain/remove items was made by evaluating factor loadings and model fit indices while considering cultural equivalence and structural validity. Using the finalized 55‐item CCAPS‐Japanese, further analyses demonstrated that the eight subscales had acceptable to good internal consistencies (α = .61–.89). Thus, the tool's validity and reliability were established. The CCAPS‐Japanese may be appropriate for assessing the psychological concerns of Japanese university students.     

医学生情绪调节自我效能感与社会支持、应对方式的关系

目的:探讨医学生情绪调节自我效能感、社会支持、应对方式三者间的关系,为医学生的心理咨询和心理健康教育提供科学依据,从而提高医学生的心理健康水平。方法:通过情绪调节自我效能感量表、领悟社会支持量表、应对方式问卷对某医科大学的319名医学生进行调查。结果:医学生的总体情绪调节自我效能感总体上处于中等偏上水平,但在结构上有所失衡:医学生感受和调节正性情绪的效能感比较高,而调节沮丧/痛苦情绪效能感和调节生气/愤怒情绪效能感比较低;女医学生感受正性情绪效能显著高于男医学生(t=2.83,P0.01);而男医学生调节沮丧痛苦情绪效能感和调节生气愤怒情绪效能感显著高于女生(t=4.78,2.19;P0.01);情绪调节自我效能感总分及各维度分均与消极应对都呈显著负相关,与社会支持呈显著正相关,感受正性情绪效能感和领悟社会支持对应对方式有一定的负向预测作用。结论:医学院校应采取各种有效方式加强心理健康的教育,提高医学生对情绪的调节效能感以及领悟社会支持的能力,改变认知,从而更好应对压力。