Development and psychometric characteristics of the SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks and short forms and the SCI-QOL Bladder Complications scale

ObjectiveTo describe the development and psychometric properties of the Spinal Cord Injury – Quality of Life (SCI-QOL) Bladder Management Difficulties and Bowel Management Difficulties item banks and Bladder Complications scale.DesignUsing a mixed-methods design, a pool of items assessing bladder and bowel-related concerns were developed using focus groups with individuals with spinal cord injury (SCI) and SCI clinicians, cognitive interviews, and item response theory (IRT) analytic approaches, including tests of model fit and differential item functioning.SettingThirty-eight bladder items and 52 bowel items were tested at the University of Michigan, Kessler Foundation Research Center, the Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital, and the James J. Peters VA Medical Center, Bronx, NY.ParticipantsSeven hundred fifty-seven adults with traumatic SCI.ResultsThe final item banks demonstrated unidimensionality (Bladder Management Difficulties CFI = 0.965; RMSEA = 0.093; Bowel Management Difficulties CFI = 0.955; RMSEA = 0.078) and acceptable fit to a graded response IRT model. The final calibrated Bladder Management Difficulties bank includes 15 items, and the final Bowel Management Difficulties item bank consists of 26 items. Additionally, 5 items related to urinary tract infections (UTI) did not fit with the larger Bladder Management Difficulties item bank but performed relatively well independently (CFI = 0.992, RMSEA = 0.050) and were thus retained as a separate scale.ConclusionThe SCI-QOL Bladder Management Difficulties and Bowel Management Difficulties item banks are psychometrically robust and are available as computer adaptive tests or short forms. The SCI-QOL Bladder Complications scale is a brief, fixed-length outcomes instrument for individuals with a UTI.     

Measuring grief and loss after spinal cord injury: Development,validation and psychometric characteristics of the SCI-QOL Grief and Loss item bank and short form

ObjectiveTo develop an item response theory (IRT) calibrated Grief and Loss item bank as part of the Spinal Cord Injury – Quality of Life (SCI-QOL) measurement system.DesignA literature review guided framework development of grief/loss. New items were created from focus groups. Items were revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis (CFA), graded response IRT modeling and evaluation of differential item functioning (DIF).SettingWe tested a 20-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital.ParticipantsA total of 717 individuals with SCI answered the grief and loss questions.ResultsThe final calibrated item bank resulted in 17 retained items. A unidimensional model was observed (CFI = 0.976; RMSEA = 0.078) and measurement precision was good (theta range between −1.48 to 2.48). Ten items were flagged for DIF, however, after examination of effect sizes found this to be negligible with little practical impact on score estimates.ConclusionsThis study indicates that the SCI-QOL Grief and Loss item bank represents a psychometrically robust measurement tool. Short form items are also suggested and computer adaptive tests are available.     

Measuring positive affect and well-being after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Positive Affect and Well-being bank and short form

ObjectiveTo develop an item response theory (IRT)-calibrated spinal cord injury (SCI)-specific Positive Affect and Well-being (PAWB) item bank with flexible options for administration.DesignQualitative feedback from patient and provider focus groups was used to expand on the Neurological Disorders and Quality of Life (Neuro-QOL) positive affect & well-being item bank for use in SCI. New items were created and revised based on expert review and patient feedback and were then field tested. Analyses included confirmatory factor analysis, graded response IRT modeling and evaluation of differential item functioning (DIF).SettingWe tested a 32-item pool at several rehabilitation centers across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Department of Veterans Affairs hospital.ParticipantsA total of 717 individuals with SCI answered the PAWB questions.ResultsA unidimensional model was observed (Confirmatory Fit Index = 0.947; Root Mean Square Error of Approximation = 0.094) and measurement precision was good (reliability in theta of –2.9 to 1.2 is roughly equivalent to classical reliability of 0.95 or above). Twelve items were flagged for DIF, however, after examination of effect sizes, the DIF was determined to be negligible and would have little practical impact on score estimates. The final calibrated item bank resulted in 28 retained itemsConclusionsThis study indicates that the Spinal Cord Injury – Quality of Life PAWB bank represents a psychometrically robust measurement tool. Short form items are also suggested and a computer adaptive test is available.     

Psychometric characteristics of the mutuality scale in heart failure patients and caregivers

Background

Higher patient-caregiver mutuality is associated with improved patient and caregiver outcomes, but no studies have tested the psychometric characteristics of the mutuality scale (MS) in heart failure (HF) patient and caregiver population.

Psychometric properties of the error‐related negativity in children and adolescents

Error processing is frequently examined using the error‐related negativity (ERN), a negative‐going event‐related potential occurring after the commission of an error at frontal‐central sites, and has been suggested as a neural biomarker that may be useful in characterizing trajectories of risk for anxiety. While the ERN has been shown to have excellent psychometric properties in adults, few studies have examined psychometric properties of the ERN in children and adolescents. The current study examined the 2‐year test‐retest reliability of the ERN in a sample of children and adolescents, and the convergent validity of the ERN using a flanker and go/no‐go task. Results suggest that the ERN is both reliable and stable across 2 years and across tasks. However, results also indicate that the internal consistency obtained using the flanker task is greater than the internal consistency obtained using the go/no‐go task.     

Personality Characteristics of Patients Showing Suboptimal Cognitive Effort

This study examined the relationship between performance on the Portland Digit Recognition Test (PDRT) and the MMPI-2 in a group of veterans who were suspected of having motivation to exaggerate cognitive and/or psychiatric symptoms. Number correct on “easy” trials on the PDRT correlated inversely with MMPI-2 measures of psychopathology, whereas number correct on “hard” trials positively correlated with the same scales. Some individuals performed poorly across both types of PDRT trials and had significant MMPI-2 elevations, whereas others performed poorly only on “hard” PDRT trials and had less extreme MMPI-2 elevations. This study reinforces the need to assess the validity of both cognitive and psychiatric symptom complaints.     

A psychometric study of recovery among Certified Peer Specialists

The recovery model is wielding a welcome influence in the mental healthcare system. Despite its potential impact, systematic studies of the recovery construct as viewed by consumers and former consumers of mental health services have only recently begun to permeate the literature. We have embarked on an ongoing collaboration with the Georgia Mental Health Consumer Network to study the recovery experiences of Certified Peer Specialists (CPSs). As a first step, we evaluated the psychometric characteristics of a new measure of the recovery construct in CPSs. CPSs (N=84) enrolled in the GMHCN completed the Maryland Assessment of Recovery in Serious Mental Illness (MARS) along with measures of resilience, coping styles, community living, social support, internalized stigma, psychopathology, and personality. Recovery as measured by the MARS was associated with resilience, coping behaviors, quality of social support, community living, internalized stigma, and severity of psychopathology. Recovery did not demonstrate a statistically significant association with personality. Recovery appeared to mediate the effect of psychopathology and episodic stressors on community functioning. Our psychometric study supports the psychometric soundness of the MARS and the construct validity of recovery.     

From inhibition to activation,from emotional hyporeactivity to emotional hyperreactivity: Two pathways to discriminate mood in bipolar disorders

To better explore the clinical heterogeneity of bipolar mood states, we developed a dimensional scale for assessing all mood episodes (depressive, hypomanic, manic, mixed states) using the same tool. The Multidimensional Assessment of Thymic States (MATHYS) (Henry et al., 2008) provides two scores, a total score measuring a level of activation and a sub-score of emotional reactivity. The aim of this study was to establish the appropriate cut-off in total activation versus inhibition and in the emotional reactivity sub-score in bipolar disorders. Patients (n=187) during an acute episode and controls (n=89) filled in the MATHYS. Receiver Operating Characteristic (ROC) curves were obtained to estimate the sensitivity and specificity of the global score and the emotional reactivity sub-score of the MATHYS, in order to differentiate patients from controls. ROC curves showed very satisfactory sensitivity and specificity levels both for the total score and the sub-score of emotional reactivity, thus providing an appropriate cut-off. Concerning the total score between 0 and 200, patients with a score lower than 91 had significant global inhibition and those with a score higher than 109 had significant global activation. Regarding the emotional reactivity sub-score between 0 and 40, patients with a score lower than 16 had significant emotional hyporeactivity and those with a score higher than 24 had significant emotional hyperreactivity. Our results provide cut-offs for the MATHYS to identify patients in an acute phase.     

心理测评与团体心理治疗纳入社区卫生服务中心管理的应用

目的了解上海市浦东新区社区卫生服务中心内员工的整体心理状况,探索缓解医务人员心理压力、提升心理健康水平和掌握自我情绪管理能力的效果。方法选取上海市浦东新区3家社区卫生服务中心,采用GHQ-12、SAS、SDS和MBIGS等量表评估中心内员工的心理状况,对存在焦虑、抑郁或职业倦怠者开展团体心理治疗,干预人群基本情况相匹配且无心理问题的医务人员作为对照组,评价干预效果。结果机构员工12项一般健康问卷总分为(22.17±5.24)分,焦虑自评量表标准分为(40.67±10.82)分,抑郁自评量表标准分为(41.14±11.95)分,Maslach职业倦怠调查普适量表总分为(19.79±15.77)分。团体心理治疗干预前两组人群在SAS、SDS、GHQ-12以及MBI-GS量表各因子中均具有显著差异(P0.01)。干预后两组人群在SDS、MBI-GS的情绪衰竭、工作态度和总均分/总分等因子中仍存在显著差异(P0.01),其余量表与因子则无差异。结论基层社区卫生服务中心员工的心理状况与普通人群接近,医疗业务、预防保健、行政等科室以及工龄较高且职称较低的员工是心理弱势群体,团体心理治疗能够明显改善心理异常员工的焦虑并提升其成就感。     

A study on craniofacial morphology of Japanese subjects with normal occlusion and esthetic profile

This study was designed to properly characterize the cephalometric values of Japanese individuals with both normal occlusion and esthetic profiles. Multivariate statistics were applied to analyze the collected data. Cephalometric values identified are expected to help in the simplification of orthodontic diagnosis. Lateral cephalometric radiographs from 50 men and 50 women with normal occlusion were traced and the dimensions of hard and soft tissues recorded. The corresponding values were classified by cluster analysis, and selected representative values were subjected to principal component analysis. From these values, characteristics of hard and soft tissue morphology were extracted. The subjects were grouped by sex, and subdivided into esthetic and unesthetic profile groups. The principal component scores from each group were plotted on a scattergram and the characteristics of each group investigated. The hard tissue characteristics in men with esthetic profiles were primarily vertical factors, including a tendency for smaller lower facial heights, a smaller mandibular plane angle, and a larger Nasion-ANS/ANS-Menton (N-ANS/ANS-Me). Soft tissue features included a more posteriorly placed maxilla and a high nasal crest. These features yield a less marked maxillary prognathism and a greater nose prominence. In females, hard tissue characteristics associated with esthetic profiles primarily involved the cranial base and posterior facial area. These included a smaller saddle angle, larger articulare angle, and smaller Sella-Articulare/Articlare-Gonion (S-Ar/Ar-Go). Female soft tissue characteristics primarily included retracted upper and lower lips, a shallow inferior sulcus with a smaller lower lip-Frankfort plane angle, and a shorter mentolabial sulcus and subnasale perpendicular-upper lip.