The sense of coherence (SOC) scale is widely used and has an extensive history in research. The psychometric properties of the SOC scale have been investigated using classic test theory, but modern test theory enables a more multifaceted investigation of the properties of the SOC scale. The aim of this study was to explore the measurement properties of the SOC scale using the Rasch measurement model.
SOC questionnaires from a sample of 623 healthy adults were analysed using Rasch analysis. Aspects analysed were rating scale functioning, item fit, unidimensionality, differential item functioning (DIF), targeting, and reliability.
Rating scale analysis showed that the seven scale steps were not utilized in the intended manner and that a shortening to five categories would be beneficial. Twelve out of the 13 items showed acceptable goodness-of-fit and 43% of the variance was explained by the SOC dimension in the principal components analysis. There was no DIF between subgroups in the sample. The items were well targeted to the sample SOC level with no ceiling or floor effects. Item and person reliability were good and the person separation index was 2.05 indicating that the scale can separate three different levels of SOC, which corresponds well to its theoretical base.
The SOC scale is generally well functioning; however, the three components of SOC seem to influence the PCA results. The scale would benefit from a reduction from seven to five scale steps, which would need to be investigated further.
The Symptom Checklist (SCL) is used as a screening tool in patient settings, but is also used as a diagnostic proxy for depression and anxiety in public health surveys. However, there are few validation studies based on general population samples. This study aims to validate the SCL subscales for depression and anxiety in a general population sample in Stockholm, Sweden.
We used a stratified random sample answering first a postal questionnaire covering SCL (n=8613) and then a semi-structured psychiatric interview based using Schedules for Clinical Assessment in Neuropsychiatry (SCAN, n=881). Agreement between SCL depression (SCL-DEP) and anxiety (SCL-ANX) scales and their respective DSM-IV disorder was examined by ROC analysis. Discriminant analysis was performed with factor analysis on the SCL depression and anxiety items. The SCL-DEP scale was also compared with the ability of the Major Depression Inventory (MDI) in detecting depressive disorders.
A factor analysis with two factors differentiated the two subscales, with some cross loading items. The SCL-DEP and ANX subscales agreement with depression and anxiety disorders was good. SCL-DEP MDI performed better in detecting DSM-IV depression.
The questionnaire only included the SCL depression, anxiety and hostility subscales and not the full SCL-90. Also, no other anxiety scale was available for comparison.
We conclude that depression and anxiety subscales are suitable instrument for proxies of depression and anxiety disorder in public health surveys.
The development of family-based programs for child weight management requires an understanding of parents' difficulties in managing children's eating and physical activity behaviors; however, knowledge about the specific behaviors that parents find most difficult to address is still limited. The Lifestyle Behavior Checklist (LBC) is an Australian instrument that assesses parents' perceptions of children's obesity-related behaviors (the Problem scale), and parents' self-efficacy in dealing with these behaviors (the Confidence scale). Our aims were 1) to examine the psychometric properties (the factor structure, internal reliability, construct and discriminative validity) of the LBC in parents of preschoolers in Sweden, using the Child Feeding Questionnaire (CFQ) as a criterion measure, 2) to study associations between the LBC and socio-demographic factors.
The LBC and the CFQ (measuring parental feeding practices) were distributed to parents from 25 schools/preschools and to parents starting a childhood obesity intervention. To test the fit of the original four-factor model (misbehavior in relation to food, overeating, emotional correlates of being overweight, physical activity (24 items)) to the data, confirmatory factor analysis (CFA) was performed. Structural equation modelling was used to examine associations between the LBC and the CFQ and socio-demographic factors.
In a sample of 478 parents, a five-factor structure proved best fit to data, after excluding 6 items and allowing two pairs of error terms to correlate (TLI?=?0.899; CFI?=?0.918; RMSEA?=?0.042; SRMR?=?0.055). The Confidence scale indicated unidimensionality, therefore a hierarchical CFA with 5 first order factors and one second order factor was tested showing good fit. The validity of the LBC was proven by relevant associations with the CFQ and child weight status; parental responses differed depending on child weight status. The Confidence scale was not associated with any child or parent variables.
In a large sample of Swedish parents of preschoolers, the LBC showed good psychometric properties, with relevant correlations to similar constructs. A five-factor structure showed best fit to data with moderate to high internal reliability. The LBC was shown to discriminate effectively between parents of normal weight children and parents of overweight/obese children.
Cites: BMJ. 2000 May 6;320(7244):1240-310797032
Cites: Int J Behav Nutr Phys Act. 2011;8:13422152012
Even though the concept of health and its importance has been widely discussed in health care during recent decades, mental health services have been criticised for adopting a biomedical perspective, which does not sufficiently consider the concept of health. The aim of the present study was to investigate the psychometric properties of the Health Questionnaire, a newly developed questionnaire to measure patients' subjective experience of health in mental health services. A cross sectional study was performed using a sample of 139 outpatients in mental health services. A principal component analysis with varimax rotation was used to test the factor structure of the questionnaire. Cronbach's alpha was employed to test internal consistency and Cohen's Kappa assessed test-retest reliability. The final scale, which contained 22 items, derived from three factors (autonomy, social involvement, and comprehensibility) and showed a good reliability in terms of internal consistency. Test-retest reliability was moderate or better for 17 out of 22 items. The Health Questionnaire may enable further empirical studies on subjectively experienced health in mental health services and serve as a measure of outcome and to monitor quality of care.
Investigations of the quality of life of mentally-ill patients can be conducted with illness-specific assessment tools, e.g. Lehmans Quality of Life Interview guide. The present article reviews WHOQOL, which is the questionnaire method of the WHO, developed on the basis of a multidimensional quality of life concept. WHOQOL has been translated into Danish and validated by both patient groups and the Danish population. Data from the population investigations can be used as a reference when interpreting data from groups of patients. The WHOQOL-BREF questionnaire has been used in an investigation of schizophrenic patients.
BACKGROUND: Brief screening instruments for co-morbid personality disorders could potentially have great value in substance abuse treatment settings. METHODS: We assessed the psychometric properties of the 8-item Standardised Assessment of Personality - Abbreviated Scale (SAPAS) in a sample of 58 methadone maintenance patients. RESULTS: Internal consistency was modest, but similar to the original value (alpha = 0.62), and test-retest correlation at four months follow-up was moderately encouraging for a short instrument such as this (n = 31, test retest intraclass correlation = 0.58), and change at the mean level was minimal, but marginally significant (from an average of 3.3 to 3.8, p = 0.06). Analyses of nurse ratings of patients' behaviour at the clinic showed that SAPAS was significantly correlated with nurse ratings of externalizing behaviour (r = 0.42, p = 0.001), and Global Assessment of Functioning (r = -0.36, p = 0.006), but unrelated to intoxication (r = 0.02, NS), or withdrawal (r = 0.20, NS). CONCLUSION: There is evidence that the SAPAS is a modestly valid and relatively reliable brief screening measure of personality disorders in patients with ongoing substance abuse undergoing methadone maintenance. It can be used in situations where limited resources are available, and researchers or others wish to get an impression of the degree of personality pathology in a clinical population, as well as for screening purposes.
Experiences of stigma among people with severe mental illness. Reliability, acceptability and construct validity of the Swedish versions of two stigma scales measuring devaluation/discrimination and rejection experiences.
Stigma has been identified as one of the most important obstacles for a successful integration of people with mental illness into the society. Research about stigma has shown negative attitudes among the public towards people with mental illness. Studies so far have, however, put little emphasis on how these negative attitudes are perceived by the mentally ill persons. The aim of the present study was to investigate acceptability and internal consistency of the Swedish versions of two stigma scales, the Devaluation and Discrimination scale and the Rejection experiences scale. Forty individuals were subject to an interview, which also comprised assessments of needs for care, quality of life, therapeutic relationship and empowerment. The results showed that both the Devaluation and Discrimination scale and the Rejection experiences scale had a good internal consistency and acceptability. Stigma in terms of perceived devaluation and discrimination was found to be most markedly associated with empowerment and rejection experiences was found to be most associated with the number of previous psychiatric admissions. It is concluded that the Swedish versions of the Devaluation and Discrimination scale and the Rejection experiences scale may well be used in further studies of stigma among people with mental illness.
OBJECTIVES: To evaluate whether depressive symptoms (DS) in elderly patients with heart failure (HF) in the community is associated with increased mortality. DESIGN: A cohort of 510 elderly patients (65-82 years) in a primary healthcare setting with symptoms associated with HF underwent a clinical and echocardiographic examination. A left ventricular ejection fraction (LVEF) or = 50% and normal left ventricular diastolic function with and without DS. CONCLUSION: DS in elderly patients with HF is independently associated with increased mortality. Screening for DS is recommended as part of the clinical routine in managing patients with HF.
The job demands-control model developed by Karasek has greatly influenced research on psychosocial factors at work and health. Validity of the English version of the psychological demands and decision latitude scales is documented. Psychometric qualities of the French version are investigated here in a representative sample of the general population, including blue-collars and white-collars.
The French translation of the psychological demand and decision latitude scales was administered by interview in a representative sample of the Quebec working population (N = 1,110). Internal consistency and factorial validity of the instrument were studied among white-collars and blue-collars separately. Discriminant validity was assessed for the whole population.
Cronbach alpha coefficients, varying between 0.68 and 0.85, support the internal consistency of the scales. Demographic distribution of the scales and intercorrelations were consistent with the English version. Results of the factor analysis were consistent with the two dimensions expected from the theory. Mean scale scores and variations in the prevalence of high psychological demands combined with low decision latitude by age, sex, education, and job category support the discriminant validity of the instrument.
Results support internal consistency, factorial validity, and discriminant validity of the French version of the psychological demands and decision latitude scales of the Karasek "Job Content Questionnaire" for white-collars and for blue-collars of the general population.
Prevalence rates of depression based on the GMS-AGECAT system are markedly higher than rates of major depression diagnosed using DSM-III and DSM-III-R criteria. Interpreting this finding is difficult since AGECAT diagnostic criteria have not been published.
We conducted a survey in Edmonton, Canada, in which 1119 community residents aged 65 years or older were administered the Geriatric Mental State (GMS) questionnaire. Depression was diagnosed using AGECAT and also according to criteria for DSM-IV major depression and minor depression. We identified 57 items in the GMS relating to major and minor depression which were then grouped into dysphoric, somatic and cognitive categories. The relationship of these symptoms to AGECAT depression was investigated by recording symptoms to absent (nullifying) and recalculating the number of AGECAT cases. Data were weighted to reflect the underlying population.
There were 143 cases of AGECAT depression (prevalence rate = 11.4%), 14 cases of major depression (prevalence rate = 0.86%) and 44 cases of minor depression (prevalence rate = 3.6%). Of the 154 subjects with either AGECAT or DSM-IV depression, only 47 (31%) were depressed according to both diagnostic systems. Nullifying all dysphoric symptoms reduced the number of AGECAT cases to eight, whereas nullifying somatic and cognitive symptoms reduced the numbers of cases only to 138 and 142, respectively. By themselves, dysphoric symptoms accounted for 77 of the 143 cases of AGECAT depression, while somatic and cognitive symtpoms alone accounted for no cases.
AGECAT depression is more inclusive than DSM-IV major or minor depression and AGECAT case status is determined mainly by the proportion of dysphoric symptoms.