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The development of a brief scale to measure outcome expectations of reduced consumption among excessive drinkers.

This paper describes the development of a brief scale to measure outcome expectations of reduced consumption among excessive drinkers (low dependence drinkers consuming more than recommended levels). This work, which forms part of a larger matching study of brief intervention, is based on the general proposition that outcome expectations of reduced consumption might be more important than previously thought for understanding and predicting behavior change. Twelve outcomes, derived from interviews with excessive drinkers, formed the basis of a questionnaire, the Excessive Drinker Outcome Expectations Scale (EDOES), which examined not only the valence of each outcome, but a comparison between expectations of reduced consumption versus drinking usual amounts. The questionnaire was administered to 235 hospitalized excessive drinkers. Principal components analysis produced two scales, reflecting the costs and benefits of change. The questionnaire proved to have acceptable levels of test-retest reliability and predictive validity. Analyses of construct validity revealed that outcome expectations of reduced consumption were increasingly positive across stages of change.

Adaptation, Psychological↗

Empirical advances in the assessment of the capacity to consent to medical treatment: clinical implications and research needs.

The clinical evaluation of capacity to consent to treatment occurs in the medical setting and is based on legal foundations of informed consent and capacity. Clinical judgment is still the "gold standard" for capacity determination, although it can be unreliable. In the past 10 years the empirical basis for these assessments has been advanced considerably by the introduction of a number of instruments designed to assess capacity to consent to treatment. In this paper, we review studies, mostly with older adult populations, that consider the cognitive and non-cognitive correlates of consent capacity, rates of impaired capacity in various patient groups, the relation of instrument-based to clinician-based capacity assessment, and the inter-rater and test-retest reliability of consent capacity assessment. We also overview key research focusing on factors influencing, and procedural and processing variables involved in, medical decision-making. We conclude that these studies have yielded quite varied results, and promote no consensus regarding the reliability and validity of instrument-based consent capacity assessment. Overall, the results of these studies provide some guidance for clinicians, but, at present, practitioners should view these instruments as supplemental resources rather than benchmarks for assessment. However, this first generation of instruments provides a good foundation for future research, which should continue to systematically study aspects of reliability and validity, most especially construct validity, in well-defined patient populations.

Attitude↗

Development and validation of a short form of the Chinese version of the State Anxiety Scale for Children.

BACKGROUND: There is a lack of a simplified instrument for use in busy clinical settings to measure and differentiate anxiety levels of children. OBJECTIVES: To develop a short form of the Chinese version of the State Anxiety Scale for Children (CSAS-C) and test psychometric properties of the new form. DESIGN: The study was divided into two phases with phase one aimed at developing a short form of the CSAS-C, while phase two aimed at testing psychometric properties of the new form. A test-retest, within-subjects design was employed. Children (7-12 years of age) admitted for surgery in a day surgery unit during two consecutive years' summer holiday were invited to participate in the study. In phase one, selected participants (N=112) were asked to respond to the CSAS-C. In phase two, selected participants (N=82) were asked to respond to the short form of the CSAS-C. RESULTS: Using exploratory factor analysis, a subset of 10 items, which was highly correlated with scores obtained from the full form (r=0.92) and, which had acceptable internal consistency (r=0.83) was developed. The psychometric properties of this short form have been empirically tested, showing adequate internal consistency reliability, good concurrent validity, and excellent construct validity. CONCLUSION: This study addresses a gap in the literature by developing a 10-item short form of the CSAS-C. Results indicate that this short form is an appropriate and objective assessment tool for measuring anxiety levels of Chinese children in a busy clinical setting where time constraints make unfeasible the use of the full form.

Ambulatory Surgical Procedures↗

Munchausen Syndrome by Proxy/Fabricated and Induced Illness: does the diagnosis serve economic vested interests, rather than the interests of children?

The discourse of Munchausen Syndrome by Proxy/Fabricated and Induced Illness posits the widespread incidence of a highly dangerous form of child abuse in which illness and developmental delay in children, is caused by their parents or carers. The discourse has been linked to false allegations of child abuse, hostile adoptions and miscarriages of justice. It has also stimulated concerns that the children's real medical and developmental needs are neglected when their conditions are misdiagnosed as child abuse. This study examines the critical claims that have been levelled against the Munchausen discourse. They provide explanations of the children's problems that compete with the discourse. The claim of the discourse to scientific validity is thereby shown to be questionable. The explanations have been distilled into specific hypotheses, to stimulate further research. The literature from which the hypotheses were derived, identifies problems in the MSbP/FII discourse in five broad areas of science, regarding: the test validity of techniques; construct validity; statistical methods; evidentiary standards and adverse impacts. The main conclusion is that the detailed critical hypotheses, cohere around the central claim that the discourse of Munchausen Syndrome by Proxy/Fabricated and Induced Illness serves economic vested interests, rather than the interests of children. The hypotheses predict adverse health and social outcomes, as a result of the discourse. Consequently, the continued deployment of the discourse would probably be "unsafe and therefore unwise".

Child↗

Questionnaire as diagnostic tool in chronic pelvic pain (CPP): a pilot study.

OBJECTIVES: No standard screening instrument is available enabling physicians to assign the diagnosis chronic pelvic pain (CPP) to women with lower abdominal pain. Therefore, our aim was to evaluate an easy-to-use questionnaire, which can be applied as a validated primary screening test for diagnosing CPP. STUDY DESIGN: From the general female population, 577 women completed a questionnaire addressing chronic symptoms in the pelvic region. Included were (amongst others) questions on lower abdominal pain, low back pain, voiding symptoms, dyspareunia, pelveo-perineal dysesthetic feelings and evacuation problems. Serious chronic lower abdominal pain of unknown origin was considered as CPP. Three criteria were applied to validate the questionnaire: construct validity, comparison with results of a previous study and content validity. In addition, the internal consistency was checked to ascertain the reliability of the questionnaire. RESULTS: All items, with the exception of those concerning voiding symptoms and dyspareunia, withstood the validity tests applied, were interrelated and occurred significantly more often in women with CPP than those without. There were no significant differences in the frequency of the occurrence of low back pain, dyspareunia and evacuation problems between CPP women in the current community study and outpatients diagnosed with CPP in an earlier study performed at the University Hospital Rotterdam. Compared to our current study group, pelveo-perineal dysesthesia (PPD) and voiding symptoms were significantly more often reported by the CPP outpatients. CONCLUSION: The CPP questionnaire can be considered as a validated tool for primary screening of CPP.

Adult↗

Development of a psychometrically valid and reliable sports nutrition knowledge questionnaire.

The present range of sports nutrition knowledge questionnaires have inadequate psychometric validation, and few are up to date in a rapidly changing discipline. The purpose of this study was to design a sports nutrition questionnaire that satisfied acceptable psychometric criteria of validity (content and construct) and reliability (test-retest). The questionnaire was designed by an expert panel of six sports dietitians and distributed to five groups, selected for their expected variation in sports nutrition knowledge. Dietitians, university business staff and nutrition students received questionnaires via e-mail. The response rates obtained were 21.3% (n = 49), 34.4% (n = 33), and 72.0% (n = 18), respectively. University business and fitness students completed questionnaires during class time. Response rates were 52.3% (n = 23) and 75.4% (n = 49), respectively. The questionnaire was administered a second time to the business staff and the dietitians to assess test-retest reliability. Two methods were used: 1, Pearson's product-moment correlation; and 2, a percentage calculation of questions answered in an identical manner on both test occasions. Reliability was acceptable with Method 1 yielding acceptable values (r = 0.74-0.93), aside from the fluid sub-category (r = 0.52). Method 2 showed good test-retest concordance with 81.2% duplication of responses of all questions. Construct validity was high, as indicated by significant mean knowledge score differences between the groups (p = 0.0001). Dietitians and nutrition students achieved significantly greater mean scores than the remaining groups. The findings of this study indicate that the questionnaire is suitably valid and reliable to be used in research and practice to determine sports nutrition knowledge.

Dietetics↗

The classification of bulimic eating disorders: a community-based cluster analysis study.

There is controversy over how best to classify eating disorders in which there is recurrent binge eating. Many patients with recurrent binge eating do not meet diagnostic criteria for other of the two established eating disorders, anorexia nervosa or bulimia nervosa. The present study was designed to derive an empirically based, and clinically meaningful, diagnostic scheme by identifying subgroups from among those with recurrent binge eating, testing the validity of these subgroups and comparing their predictive validity with that of the DSM-IV scheme. A general population sample of 250 young women with recurrent binge eating was recruited using a two-stage design. Four subgroups among the sample were identified using a Ward's cluster analysis. The first subgroup had either objective or subjective bulimic episodes and vomiting or laxative misuse; the second had objective bulimic episodes and low levels of vomiting or laxative misuse; the third had subjective bulimic episodes and low levels of vomiting or laxative misuse; and the fourth was heterogeneous in character. This cluster solution was robust to replication. It had good descriptive and predictive validity and partial construct validity. The results support the concept of bulimia nervosa and its division into purging and non-purging subtypes. They also suggest a possible new binge eating syndrome. Binge eating disorder, listed as an example of Eating Disorder Not Otherwise Specified within DSM-IV, did not emerge from the cluster analysis.

Adolescent↗

Comparison of embedded and isolated administrations of the California Psychological Inventory's Socialization subscale.

Alternate administration methods were tested for the Socialization (So) subscale of the California Psychological Inventory (CPI; H. G. Gough, 1994; H. G. Gough & P. Bradley, 1996) in 437 young adult men. One method administered the 46 CPI-So items in isolation from the CPI, whereas the 2nd method administered the 46 items embedded in the CPI. External validity measures of antisociality were also administered over the 2 sessions. Isolated administration produced somewhat higher internal consistency and significantly better concurrent validity and demonstrated construct validity as a measure of antisociality. Additional factor analytic studies of the CPI-So and CPI revealed that the 2 CPI-So versions had different factorial structures and that the embedded CPI-So subscale did not retain factorial integrity or an appreciable amount of reliable and uniquely interpretable variance.

Adult↗

The Derriford Appearance Scale (DAS59): a new psychometric scale for the evaluation of patients with disfigurements and aesthetic problems of appearance.

The DAS59 has been designed and developed to meet the need for an objective measure of the spectrum of psychological distress and dysfunction that is characteristic of disfigurements, deformities and aesthetic problems of appearance. Content validity has been assured by basing the scale's items on a detailed autobiographical study of representative patients. Internal consistency is high (0.98) and test-retest reliabilities are good (general population: 0.75; clinical population: 0.86). Correlations with other appropriate standardised tests show good criterion validity and good construct validity. Factor analysis of 2741 data sets (general population and clinical population) identified three factors that are not feature specific and two that are (bodily and sexual features, facial features). The DAS59 thus generates a full-scale score and five factorial sub-scale scores. The DAS59 has been standardised on the clinical population across a range of patient groups and on the general population subdivided into those concerned and those not concerned about appearance. The DAS59 is highly sensitive as a measure of change following treatment with large and significant preoperative-postoperative reductions in full-scale and factorial scores of patients treated for facial features or bodily/sexual features. The DAS59 offers benefits for patient selection in both cosmetic and reconstructive plastic surgery and in the evaluation of outcome. It provides valid and reliable data for clinical audit and governance and for evaluating the merits of one treatment protocol against another.

Adult↗

Psychometric properties of the Beck Scale for Suicide Ideation: a Norwegian study with university students.

This study presents the psychometric properties of the Norwegian language version of the Beck Scale for Suicide Ideation (BSI). The participants were 314 university students (71 males and 243 females) enrolled in one of the introductory courses in psychology or sociology at the Norwegian University of Science and Technology, Norway. The results revealed satisfactory internal consistency and good temporal stability. Moderately high correlations with other measures of suicide ideation suggested satisfactory concurrent validity. Similarly, the construct validity was evidenced by moderate correlations among the BSI, the Hopkins Symptom Check List (HSCL-25) depressive scale, and the Beck Hopelessness Scale (BHS). In general, the findings suggest that the BSI is a reliable and valid instrument to assess severity of suicide ideation in college students.

Adolescent↗

Development and psychometric testing of Korean language versions of 4 neck pain and disability questionnaires.

STUDY DESIGN: Cohort study. OBJECTIVES: To develop and establish the psychometric properties of Korean versions of 4 neck pain and disability questionnaires: the Neck Disability Index, Neck Pain and Disability Scale, Functional Rating Index, and Short Form McGill Pain Questionnaire (SFMPQ). SUMMARY OF BACKGROUND DATA: To our knowledge, there are no published Korean language neck pain and disability measures. METHODS: Versions of each questionnaire in idiomatic modern Korean were developed with a process involving initial independent translation, synthesis of the translations, independent back translation, and review by an expert committee to achieve equivalence with the original English. Psychometric testing of the questionnaires with 261 subjects was undertaken to examine test-retest reliability, internal consistency, discriminative validity, and longitudinal construct validity. RESULTS: Test-retest reliability of the translated versions of the 3 disability questionnaires was excellent (intraclass correlation coefficient[2,1] = 0.86-0.90). High internal consistency was found in the 3 disability questionnaires (Cronbach-alpha ranged from alpha = 0.88 for the Functional Rating Index to alpha = 0.96 for the Neck Pain and Disability Scale, and 0.82 for the SFMPQ). The visual analog scale subscale of the SFMPQ was the most responsive of the subscales (effect size = 1.44, standardized response mean = 1.37). The visual analog scale was also the most responsive pain and disability index in internal responsiveness analysis, although disability indexes showed marginally better responsiveness when compared with external standards. No floor or ceiling effects were observed. CONCLUSIONS: We conclude that the questionnaires were successfully translated and show acceptable measurement properties, and, as such, are suitable for use in clinical and research applications.

Adolescent↗

The revised Personal Lifestyle Questionnaire for early adolescents.

The purposes of this study were to revise the Personal Lifestyle Questionnaire (PLQ), a measure of positive health practices, for use with early adolescents and to provide evidence of reliability and validity for the revised PLQ instrument. The sample consisted of 224 seventh and eighth graders who responded to the revised PLQ and instruments measuring three theoretically relevant variables. Relative to the revised PLQ, content validity was established, construct validity was determined by support of three hypotheses derived from theoretical propositions, and a two-factor solution was accepted in factor analysis procedures using principal components analysis with Varimax rotation. Acceptable reliabilities were obtained on the total revised PLQ and Factor 1; the reliability for Factor 2 fell slightly below the acceptable standard.

Adolescent↗

A breast cancer fear scale: psychometric development.

Fear of breast cancer has been inversely associated with participation in screening. However, investigators have generally used only one item or global scales to measure fear. This report describes development of a fear scale specific to breast cancer. Data from a large study involving mammography adherence were used to test the breast cancer fear scale for validity and reliability. Construct validity was verified through factor analysis and regression analysis predicting mammography. All items loaded on a single factor and theoretical relationships were verified by linear and logistic regression. The Cronbach alpha for the scale was.91.

Aged↗

An illustration of issues in factor extraction and identification of dimensionality in psychological assessment data.

Structural validity has long been regarded as critical to psychological measurement. However, in practical application, issues central to structural validity are often neglected. The purpose of this study was to illustrate the importance of several crucial choices that face researchers attempting to evaluate the structure of data from a given scale. In this study, I compared the structural solutions derived via principal components analysis and principal axis factoring using eigenvalues, scree plots, and traditional parallel analyses with data from the Purpose in Life Test (Crumbaugh & Maholick, 1964). I discuss the importance of structural validity for overall construct validity and the importance of carefully considering factor analytic methodology. I provide recommendations for uses of factor analysis.

Adult↗

Internal validity of attention deficit hyperactivity disorder, oppositional defiant disorder, and overt conduct disorder symptoms in young children: implications from teacher ratings for a dimensional approach to symptom validity.

Uses a dimensional approach to evaluate the internal validity of the attention deficit hyperactivity disorder (ADHD) inattention (I) and hyperactivity/impulsivity (H/I), oppositional defiant disorder (ODD), and overt conduct disorder (CD) symptoms (i.e., whether a symptom has a stronger correlation with its own dimension than the other three dimensions). In Study 1, teachers rated 1,445 children on the DSM-III-R I, H/I, ODD, and overt CD symptoms. In Study 2, teachers rated 1,711 children on the DSM-IV I, H/I, ODD, and overt CD symptoms. All the I symptoms showed internal validity in both studies. In contrast, the H/I symptoms and the ODD symptoms, especially the H/I symptoms, showed weaker internal validity. All the overt CD symptoms showed internal validity except the DSM-IV bullies others symptom, with this symptom being more strongly related to the ODD dimension. Confirmatory factor analysis provided support for a 4-factor model consisting of I, H/I, ODD, and overt CD factors. Finally, the importance of internal validity for the construct validation of the disruptive behavior symptoms is discussed.

Adolescent↗

An evaluation of the Waterlow pressure ulcer risk-assessment tool.

The National Institute for Clinical Excellence (NICE, 2001) stated that in order to achieve clinical governance strategies, risk management in the form of pressure ulcer risk assessment will contribute to improved quality of patient care. Risk-assessment tools must display high-predictive values, be highly sensitive and specific, reliable, and easy and convenient to use. Despite their extensively documented poor performance, pressure ulcer risk-assessment scales play a primary role in the prevention and management of pressure ulcers. The tools attempt to determine patients' risk status by quantifying a range of the most commonly recognized risk factors. Although there are over 40 different assessment tools, the Waterlow pressure ulcer risk-assessment tool is the tool that is most widely used in the UK. This article aims to review studies relating to the reliability, content validity, predictive validity, concurrent validity and the construct validity of the Waterlow pressure ulcer risk-assessment tool.

Attitude of Health Personnel↗

A conceptual framework for achieving performance enhancing drug compliance in sport.

There has been, and continues to be, widespread international concern about athletes' use of banned performance enhancing drugs (PEDs). This concern culminated in the formation of the World Anti-Doping Agency (WADA) in November 1999. To date, the main focus on controlling the use of PEDs has been on testing athletes and the development of tests to detect usage. Although athletes' beliefs and values are known to influence whether or not an athlete will use drugs, little is known about athletes' beliefs and attitudes, and the limited empirical literature shows little use of behavioural science frameworks to guide research methodology, results interpretation, and intervention implications. Mindful of this in preparing its anti-doping strategy for the 2000 Olympics, the Australian Sports Drug Agency (ASDA) in 1997 commissioned a study to assess the extent to which models of attitude-behaviour change in the public health/injury prevention literature had useful implications for compliance campaigns in the sport drug area. A preliminary compliance model was developed from three behavioural science frameworks: social cognition models; threat (or fear) appeals; and instrumental and normative approaches. A subsequent review of the performance enhancing drug literature confirmed that the overall framework was consistent with known empirical data, and therefore had at least face validity if not construct validity. The overall model showed six major inputs to an athlete's attitudes and intentions with respect to performance enhancing drug usage: personality factors, threat appraisal, benefit appraisal, reference group influences, personal morality and legitimacy. The model demonstrated that a comprehensive, fully integrated programme is necessary for maximal effect, and provides anti-doping agencies with a structured framework for strategic planning and implementing interventions. Programmes can be developed in each of the six major areas, with allocation of resources to each area based on needs-assessment research with athletes and other relevant groups.

Australia↗

Determinants of relapse among alcoholics: a cross-cultural replication study.

This study reports on a replication of Marlatt and Gordon's (1980) findings concerning relapse determinants among alcoholics. It was undertaken in a somewhat different drinking culture (Sweden) and with a group of alcoholics also containing patients relapsing after a longer period of abstinence than those in the Marlatt and Gordon study. The difference in drinking culture is reflected in the finding that most subjects in this study took their first drink at home. The group studied by Marlatt and Gordon in Seattle most frequently started to drink in a bar or restaurant. In spite of the differences between the groups, we arrive at a similar picture when it comes to the distribution of relapse determinants according to the model proposed by Marlatt and Gordon. The categories not only have face validity but also construct validity, reflected in meaningful correlations with results on an intelligence test and a personality inventory. A descriptive analysis shows that subjects with poorer results on the intelligence test and having a high tendency to muscle tension and somatized anxiety tended to relapse in intrapersonal situations. Patients who do not readily adjust to other persons' opinions relapsed in interpersonal conflicts, and patients who are more impulsive could not resist social pressure to drink.

Adult↗