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PubMed1981

Comparison of three psychological defense mechanism questionnaires.

The Defense Mechanisms Inventory (DMI), the Coping Operations Preference Enquiry (COPE), and the scales developed by Joffe and Naditch (J&N) were compared using multitrait-multimethod logic. Convergent validity was tow as measures of the same defense were not highly correlated across instruments. Similar patterns of correlations occurred within instruments but the J&N scales, and particularly the DMI scales, had high interscale correlations so overall discriminant validity was limited. These results suggest that either the defense constructs or at least some of the defense scales studied lack validity. Another possibility is that the scales are valid, but assess different parameters of defensiveness (e.g., intensity versus breadth of use of mechanisms). Comparisons of the scales' predictive validity should help resolve these points.

Journal Article↗

PubMed2006

Contact sports, moral functioning and planned behaviour theory.

The goal was to test the psychometric properties of the Moral Functioning Scale in a Greek athletic context, and to investigate any possible relation between moral functioning and planned behaviour. The sample comprised 384 athletes, 103 from the sport of football (soccer), 97 from basketball, and 184 from water polo. To measure moral functioning the researchers used a scale developed by Gibbons, Ebbeck, and Weiss. Planned Behaviour was assessed with a questionnaire based on Planned Behaviour Theory. Hierarchical regression analysis indicated strong association for Attitudes, Intention, Role Identity, and Perceived Behavioural Control with the four dilemmas of the moral functioning scale. The moral reasoning measure is a promising tool for measuring athletes' moral dilemmas in Greece.

Adolescent↗

PubMed1978

Continuous tracking of behavioral development in infants.

Infant development scales provide a one time measure of the number of scale items an infant performs and his standing relative to his age group. Repeated assessment indicates how many more items he can perform and whether his relative status has altered but does not measure actual changes in the same behaviors as development progresses. This paper discusses the importance of continuously measuring the same behavior over time as an alternative strategy. The developmental information is exemplified by the behavioral records of two infants observed over a 25-week period for changes in frequency and duration of three prone position motor responses.

Child Behavior↗

PubMed1994

Predictors of patient refusal to participate in ambulatory-based comprehensive geriatric assessment.

BACKGROUND: Comprehensive Geriatric Assessment (CGA) in ambulatory settings can be effective only if patients who need this intervention are willing to participate in the evaluation and follow the indicated therapy. METHODS: To learn whether older persons' health beliefs and perceptions influence participation in ambulatory-based CGA, we studied subjects who failed a screening assessment offered through a community-based outreach program and were deemed appropriate for CGA. All subjects were interviewed in person following a structured sequence including questions from the RAND Current Health (CH) and Health Worry/Concern (HWC) scales, the Health Locus of Control Scale (HLC), and scales developed to measure health risks and perceived benefits of geriatric assessment. RESULTS: In univariate analysis, the following variables were associated with refusal to participate in CGA status at the p < .05 level: increased worry on HWC and higher scores on three new scales constructed to measure Global Health Risk (GHR), Perceived Global Health Benefits (PGHB), and Perceived Specific Health Benefits (PSHB). For GHR, higher scores indicate greater risk; for PGHB and PSHB, higher scores indicate greater perceived benefit. In multivariate analysis, only educational level, GHR, PGHB, and PSHB scores were independently predictive of refuser status. Correlations with other established health perceptions scales provided support that global health risk and perceived global and specific health benefits are unique constructs. Furthermore, high scores on these scales predicted participation in health improvement programs. CONCLUSIONS: Patients' beliefs about perceived risk and benefit can be measured and predict willingness to participate in ambulatory-based CGA.

Aged↗

PubMed2004

Group members' assessment of their conductor in small analytic group.

In this pilot study the authors present the group members' assessment of their conductor in group analysis--the treatment conducted in accordance with concept >>group-as-a-whole<< of S. H. Foulkes. There will be presented the results obtained by scale for evaluation of characteristics of the group therapist. In the scale, developed by the authors of the study, there were 30 items and by factorial analysis it gave three interpretable factors: authenticity, empathy and distrust. By self-evaluation the members of three small groups, i.e. 20 patients, ranked characteristics of their conductor. The patients, assessing the degree of their accordance with 30 items of the evaluation scale, expressed whether and how much they experienced their conductor as an authentic, empathic and trustworthy person. While in the beginning of the group analytic process the conductor's role was important, his importance decreased as the group-as-a-whole developed. Group experience became more important than the conductor. In other words, the group itself became the therapist, what is one more the proof of the Foulkes' concept of >>the group-as-a-whole<<.

Adult↗

PubMed2003

Effect of pregnancy and menopause on facial wrinkling in women.

Women appear to be at greater risk of developing wrinkles with age than men. To evaluate the effect of pregnancy and menopause on facial wrinkling, a total of 186 Korean women volunteers aged between 20 and 89 years were interviewed for information on menstrual and reproductive factors. An 8-point photographic scale developed for assessing the severity of wrinkles in Asian skin was used. Cumulative sun exposure, both occupational and recreational, was estimated. In Korean women, the risk of facial wrinkling increases significantly with increasing number of full-term pregnancies (OR = 1.835, 95% confidence interval (CI) 1.017-3.314) and menopausal age (number of years since menopause) (OR = 3.909, 95% CI 1.071-14.275), while hormone replacement therapy is associated with a significantly lower risk for the development of facial wrinkling in postmenopausal women (OR = 0.221, 95% CI 0.047-0.949). Hypo-oestrogenism may play a part in the decrease of skin collagen leading to skin wrinkling in postmenopausal women.

Adult↗

PubMed1999

Item response models for longitudinal quality of life data in clinical trials.

Assessment of quality of life is becoming standard in clinical trials. A popular method for measuring quality of life is with instruments which utilize multiple-item subscales, in which each item is scored on a Likert scale. Most statistical methods for the analysis of quality of life data in clinical trials do not explicity consider the properties and psychometric features which were of interest in scale development. In this regard, the measurement and statistical summarization of quality of life data, along with the clinical interpretation, can be somewhat disjoint from the psychometric concerns of the development process. The aim of this paper is to address the complicated issues present in analysing multiple-item ordinal quality of life data in clinical trials while maintaining fidelity to the psychometrical foundations upon which quality of life instruments are built. Accomplishing this will require the development of item response models which recognize the longitudinal aspects of clinical trial designs as well as the potential problem of informatively missing data. A general item response modeling approach is presented for longitudinal multiple-item quality of life data measured on ordinal scales with model components for missing data mechanisms and latent trait regression on treatment indicators and other covariates.

Clinical Trials as Topic↗

PubMed2006

The relationship of adult attachment dimensions to pain-related fear, hypervigilance, and catastrophizing.

Despite the prominence of fear-avoidance models of chronic pain, there is a paucity of research regarding the origins of pain-related fear. Based on the premise that insecure attachment could be a developmentally based origin of elevated fear of pain, associations between adult attachment dimensions and constructs included in fear-avoidance models of chronic pain were investigated. Consistent with Bartholomew and Horowitz's [Bartholomew K, Horowitz LM. Attachment styles among young adults: a test of a four-category model. J Pers Soc Psychol 1991;61:226-44.] model, attachment was conceptualized as being comprised of a model of self dimension (i.e., degree of anxiety regarding rejection based on beliefs of personal unworthiness) and a model of others dimension (i.e., degree of interpersonal mistrust and discomfort with interpersonal closeness). A large university student sample free of chronic pain (N=278) completed a measure of adult romantic attachment (i.e., Experiences in Close Relationships Questionnaire; [Brennan KA, Clark CL, Shaver PR. Self-report measurement of adult attachment: an integrative overview. In: Simpson JA, Rholes WS, editors. Attachment theory and close relationships. New York: The Guilford Press, 1998. p. 46-76.]), the Fear of Pain Questionnaire-III [McNeil DW, Rainwater AJ. Development of the fear of pain questionnaire - III. J Behav Med 1998;21:389-410.], the Pain Vigilance and Awareness Questionnaire [McCracken LM. Attention to pain in persons with chronic pain: a behavioural approach. Behav Ther 1997;28:271-84.], and the Pain Catastrophizing Scale [Sullivan MJ, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess 1995;7:24-532.]. It was hypothesized that insecure attachment would be positively associated with reports of pain-related fear, hypervigilance, and catastrophizing and that the model of self dimension would be the attachment variable most strongly associated with these variables. Correlation and multiple regression analyses supported these hypotheses. The model of self dimension had significant positive associations with each of the fear-avoidance constructs. The model of others dimension had a significant positive association with pain catastrophizing, but was not significantly associated with fear of pain and pain hypervigilance. Future research directions and potential clinical implications are discussed.

Adult↗

PubMed1988

Subjective tolerance of respirator loads and its relationship to physiological effects.

Subjective and physiological responses to a variety of respiratory loads were measured in a group of 52 normal volunteers during steady, moderate treadmill exercise. Subjective response (SR) was determined with two visual analogue scales developed for this study: EXERT (perceived limitation of exercise duration) and DISC (perceived discomfort). There was a linear relationship between inspiratory resistance and SR. Expiratory and inspiratory resistance loading produced similar subjective effects. Dead space loading, however, produced very little subjective effect on either scale. The study suggests that subjective response can be measured quantitatively and should be considered in respirator design.

Adult↗

PubMed1999

Validity of scales measuring the psychosocial determinants of HIV/STD-related risk behavior in adolescents.

We examined the content, construct and concurrent validity of scales to assess beliefs and self-efficacy related to adolescents' sexual risk behavior. We addressed content validity in the scale development process by drawing on literature and theory, and by pre-testing items with focus groups. We used confirmatory factor analysis of two models, an intercourse involvement model and a condom use model, to assess construct validity. The final intercourse involvement model included three scales: norms about sexual intercourse, attitudes about sexual intercourse and self-efficacy in refusing sex. The final condom use model included five scales: norms about condoms, attitudes about condom use, self-efficacy in communicating about condoms, self-efficacy in buying/using condoms and barriers to condom use. After two alterations to the models, the chi 2 and other indices indicated that the data fit the models well. Supporting the concurrent validity of the scales, high school students who had never had sexual intercourse had more negative attitudes toward sexual intercourse among teenagers, perceived norms toward sexual intercourse among teenagers to be more negative and expressed greater self-efficacy in refusing sex than did those who had experienced sexual intercourse. Consistent condom users had more positive attitudes and norms about condoms, had higher self-efficacy in communicating about and buying/using condoms, and perceived fewer barriers to condom purchase and use than did inconsistent condom users.

Adolescent↗

PubMedDate not supplied

Developmental assessment: 18 months to 4 1/2 years. Performance tests.

Performance tests of young children in the age range 18 months to 4 1/2 years have been studied in a sample of 425 children living in an inner city area and a rural market town. Our results show that there is a minimum number of cubes built into a tower related to age which may indicate developmental delay. There is a developmental sequence of pencil grasp, and useful development scales in copying cube models, drawing geometric shapes, and the draw-a-man test. Girls are significantly ahead of boys in drawing skills.

Child Development↗

PubMed2003

Telephone counselling for adolescent suicide prevention: changes in suicidality and mental state from beginning to end of a counselling session.

Telephone counselling is an accessible and confidential means by which distressed young people can seek help. Telephone counselling services were funded under Australia's National Youth Suicide Prevention Strategy between 1997 and 2000. In this study, the effectiveness of telephone counselling for young people seeking help in the context of suicidal ideation or intent was evaluated in an investigation of calls made by suicidal young people to a telephone counselling service. Independent raters measured callers' suicidality and mental state at the beginning and end of 100 taped counselling sessions. Changes in suicidality and mental state were measured using a reliable rating scale developed for the study. Significant decreases in suicidality and significant improvement in mental state were found to occur during the course of counselling sessions, suggesting positive immediate impact. Limitations of the study with respect to longer-term outcomes and the relevance of the results for suicide prevention are discussed. Notwithstanding the study limitations, the results lend support for continuing development of hotline services.

Adolescent↗

PubMed1998

Development of spontaneous seizures over extended electrical kindling. I. Electrographic, behavioral, and transfer kindling correlates.

The present study was aimed at evaluating an extended kindling model of spontaneous epilepsy. Behavioral and electrographic responses to repeated kindling of either the perforant path or amygdala were monitored for up to 300 trials. Kindling initially led to generalized convulsions equivalent to the level 5 seizure on the rating scale developed by Racine. The evoked seizures became progressively more complex with additional kindling, which was described by a 10-stage classification system. The highest stage (stage 10) was achieved when the kindling stimulation evoked two or more bouts of level 5 seizures combined with running and jumping fits. These more complex seizures developed over the course of amygdala, but not perforant path kindling. Electrographic seizures from both the amygdala and dentate gyrus increased in duration and amplitude during the early phase of kindling, but did not correlate with motor seizure development beyond level 5. During the late phase of kindling, the dentate gyrus afterdischarge amplitude decreased and became dissociated from the behavioral seizures. Manifestations of spontaneously recurring seizures were seen in the majority of animals, but spontaneous seizures of level 4 or greater were observed in only five rats. The second part of this study examined kindling transfer effects, the efficacy of kindling a new site after the completion of the initial (in this case extended) kindling protocol. The effect depended on both primary and secondary site location. When the amygdala served as primary site, perforant path transfer was complete in some animals but absent in others. No transfer occurred in the opposite direction, from the perforant path to the amygdala. Finally, transfer effects in the dentate gyrus, which was tested as tertiary site, were complete. Previous studies have found weaker transfer effects in the dentate when kindling to the standard stage 5 level.

Animals↗

PubMed1989

Development of a scale to measure interpersonal sensitivity.

We describe the development of a self-report measure (the Interpersonal Sensitivity Measure or IPSM). The IPSM generates a total score as well as five sub-scale scores: interpersonal awareness, need for approval, separation anxiety, timidity and fragile inner-self. Its reliability is demonstrated by high internal consistency in two separate groups, and by stability in scores over time in a non-clinical group. Studies of a clinical group of depressives showed change in scale scores following improvement in the depressive state, suggesting some sensitivity of the measure to mood state. The IPSM appears related to measures of neuroticism and to low self-esteem but not to a modified concept of neuroticism, emotional arousability. The constructs contributing to interpersonal sensitivity and their relevance to depression are considered. Some preliminary findings of higher scores in depressives compared to non-depressives are reported.

Adaptation, Psychological↗

PubMedDate not supplied

Derivation and validation of criteria for determining the appropriateness of nonemergency ambulance transports.

OBJECTIVE: Nonemergency ambulance transports (NETs) represent a substantial proportion of all ambulance transports. Recently, the medical necessity of a substantial number of NETs has been questioned. The purpose of the study was threefold: 1) to formulate criteria for NET using a multidisciplinary panel; 2) to develop a structured implicit review instrument (SIRI) for the evaluation of NET from the criteria formulated; and 3) to evaluate the reliability and validity of the SIRI. Previously, a validated instrument has not been available to assess NET appropriateness. METHODS: Using a modified Delphi process and scale development techniques, a panel of ten multidisciplinary health care professionals determined criteria for NET and developed a SIRI consisting of two dimensions: 1) ambulation status and 2) medical care requirements. A convenience sample of 50 cases (occurring January through May 1996) were retrospectively reviewed by individual panel members and two panels, and categorized as either: 1) definitely appropriate NET; 2) possibly appropriate NET; 3) patient did not require ambulance transport; 4) patient required emergency transport; and 5) indeterminate. Reliability of the SIRI was assessed using percent agreement among individual panels and weighted kappa for the two panels. Interitem consistency of the SIRI was measured by Cronbach's alpha. Criterion validity was assessed by comparing percent agreements between the SIRI and Medicare reimbursement guidelines. RESULTS: Percent agreement among individual panel members was 62%. Percent agreement among the two panels was 74%, with a kappa of 0.43. Cronbach's alpha for individual panel member item response ranged from 0.647 to 0.960. Percent agreement with Medicare reimbursement guidelines was 92%. CONCLUSION: Consensus criteria and an associated SIRI were developed for determining the appropriateness of NETs. Further research is needed to build on the validity and reliability of this instrument.

Aged↗

PubMed1992

Measurement standards for interdisciplinary medical rehabilitation.

Rehabilitation must address problems inherent in the measurement of human function and health-related quality of life, as well as problems in diagnosis and measurement of impairment. This educational document presents an initial set of standards to be used as guidelines for development and use of measurement and evaluation procedures and instruments for interdisciplinary, health-related rehabilitation. Part I covers general measurement principles and technical standards, beginning with validity, the central consideration for use of measures. Subsequent sections focus on reliability and errors of measurement, norms and scaling, development of measures, and technical manuals and guides. Part II covers principles and standards for use of measures. General principles of application of measures in practice are discussed first, followed by standards to protect persons being measured and then by standards for administrative applications. Many explanations, examples, and references are provided to help professionals understand measurement principles. Improved measurement will ensure the basis of rehabilitation as a science and nourish its success as a clinical service.

Disability Evaluation↗

PubMed2006

Limitations in activities of daily living and instrumental activities of daily living capacity in a representative sample: disentangling dementia- and mobility-related effects.

A representative sample of the Leipzig population aged 75 years and older showed 61.8% of the participants with relevant deficits in their capacity for independent living, according to a combined activities of daily living/instrumental activities of daily living (ADL/IADL) scale. The quantity and quality of care needed almost exponentially increases above 85 years of age. Looking at potential reasons for ADL/IADL limitations, 44% of variance in single ADL/IADL activities and 75% of the combined ADL/IADL sum score could come from a minimal set of predictor variables. Most important are dementia- or mobility-related declines, but living conditions also explain small but significant amounts of variance. These seem initially impressive, yet analyses showed about half the explained variances shared among the mobility and dementia indicators, limiting the use not only of ADL/IADL sum scores but of many single ADL/IADL items as well. Before deriving specific conclusions from variations in ADL/IADL instruments, one must note that the data suggest that interpretations of covariations--whether for health/mobility or dementia--are useful and substantial only if both indicators/predictors are verified. The information given captures the mobility- and dementia-related variance if ADL/IADL items, facilitating more specific scale developments.

Activities of Daily Living↗

PubMed2000

Validation of the Edmonton Symptom Assessment Scale.

BACKGROUND: The Edmonton Symptom Assessment Scale (ESAS) is a nine-item patient-rated symptom visual analogue scale developed for use in assessing the symptoms of patients receiving palliative care. The purpose of this study was to validate the ESAS in a different population of patients. METHODS: In this prospective study, 240 patients with a diagnosis of cancer completed the ESAS, the Memorial Symptom Assessment Scale (MSAS), and the Functional Assessment Cancer Therapy (FACT) survey, and also had their Karnofsky performance status (KPS) assessed. An additional 42 patients participated in a test-retest study. RESULTS: The ESAS "distress" score correlated most closely with physical symptom subscales in the FACT and the MSAS and with KPS. The ESAS individual item and summary scores showed good internal consistency and correlated appropriately with corresponding measures from the FACT and MSAS instruments. Individual items between the instruments correlated well. Pain ratings in the ESAS, MSAS, and FACT correlated best with the "worst-pain" item of the Brief Pain Inventory (BPI). Test-retest evaluation showed very good correlation at 2 days and a somewhat smaller but significant correlation at 1 week. A 30-mm visual analogue scale cutoff point did not uniformly distinguish severity of symptoms for different symptoms. CONCLUSIONS: For this population, the ESAS was a valid instrument; test-retest validity was better at 2 days than at 1 week. The ESAS "distress" score tends to reflect physical well-being. The use of a 30-mm cutoff point on visual analogue scales to identify severe symptoms may not always apply to symptoms other than pain.

Activities of Daily Living↗