Evaluating a Brief Self-Report Measure of Social-Emotional Learning and Risk Correlates Among Brazilian Students

The Double-Edged Sword Effects of Career Calling on Occupational Embeddedness: Mediating Roles of Work–Family Conflict and Career Adaptability

Why physically active people report lower anxiety than those who are inactive is not well understood. This study examined whether physical self-concept and self-esteem would mediate associations of self-reported physical activity with anxiety disorder symptoms in young women, a population with elevated risk for developing an anxiety disorder. College women (N = 1036, mean ± SD = 19.7 ± 2.9 yr) completed a physical activity recall, the Psychiatric Diagnostic Screening Questionnaire, and the Physical Self-Description Questionnaire. Structural equation modeling was used to test hypotheses. Physical activity had inverse, indirect associations with symptoms of social phobia, generalized anxiety disorder, and obsessive-compulsive disorder that were expressed through its positive association with specific and global physical self-concept and self-esteem. The results were independent of similar relations with symptoms of major depressive disorder as well as the estimates of body fatness and use of psychotropic medications. These correlational findings provide initial evidence to warrant experimental efficacy trials of whether physical activity will reduce the risk of anxiety disorders in young women by positive influences on physical self-concept and self-esteem.

ObjectivesThe Australian Ageing Semantic Differential (AASD) survey was developed to quantify medical student attitudes towards older people. The purpose of this study is to examine psychometric properties of the survey...

The Patient Health Questionnaire-8 (PHQ-8) is a measure of depression symptom severity that is the 8-item version of the more widely used Patient Health Questionnaire-9 (PHQ-9). However, the PHQ-8 lacks the question about suicide ideation and is often used when questions about suicide ideation cannot be administered. A recent review of the literature on the PHQ-9 indicates mixed findings on factor structure, with evidence for both a unidimensional model and a 2-factor model of somatic and non-somatic symptoms. To date, few studies have explored the factor structure of the PHQ-8, and none to our knowledge have examined this in military samples. This secondary analysis examined this in a sample of military sexual assault survivors given their heightened risk for depression. Service members and veterans who experienced assault (N = 346; 49.1% female) completed the PHQ-8 in a previously published study. The parent study was approved by the Utah State University Institutional Review Board (IRB) and secondary analyses were exempted from IRB review by the Arizona State University IRB. Five structural models were tested using confirmatory factor analysis, including 1 unidimensional factor model and 4 2-dimensional factor models. The following goodness of fit statistics were compared between models: Chi-squared testing, Comparative Fit Index (CFI), Tucker Lewis Index (TLI), root mean square error of approximation (RMSEA), Bayesian Information Criterion (BIC) and standardized root mean square residual (SRMR). Strong model fit was determined by a CFI and TLI ≥ .95, RMSEA ≤ .06, and SRMR ≤ .08. The 2-dimensional model with anhedonia, depressed mood, feelings of worthlessness, concentration difficulties, and psychomotor agitation/retardation specified on the non-somatic factor, and sleep difficulties, fatigue, and appetite changes specified on the somatic factor had the most optimal fit (X2 [df] = 46.19 [19], CFI = 0.98, TLI = 0.97, RMSEA = 0.06, SRMR = 0.03, BIC = 6,130.98). Other models had adequate fit, though the fit for the unidimensional model was statistically inferior. The use of 2-factor models of depression might be superior compared to the unidimensional model in samples of military sexual assault survivors which may provide clinical utility in treating specific depression symptom clusters. Studies that wish to examine potential differences in outcomes as a function of somatic and non-somatic depressive symptoms may consider this model. Future studies should examine model fit in samples that may not have been exposed to military sexual assault.

ABSTRACTOBJECTIVE:To assess the Functional Index Questionnaire (FIQ) structure using confirmatory factor analysis (CFA) in Brazilian patients with anterior knee pain.METHODS:Brazilian patients of both sexes (n = 100), aged ≥ 18 years, with anterior knee pain for at least 3 months were included. Eligible participants completed an online form that collected personal and clinical data as well as responses to the assessment tools. We used CFA and the following fit indices: chi-square/degrees of freedom (DF), comparative fit index (CFI), Tucker–Lewis index (TLI), root mean square error of approximation (RMSEA), and standardized root mean square residuals (SRMR).RESULTS:The majority of the respondents were women, young adults, overweight, with incomplete higher education, were physically active, and had pain in sitting or squatting positions. The mean duration of pain was 38.24 months, and the mean pain intensity was 4.54 points. The model fit indices were as follows: χ2/DF = 2.08, TLI = 0.978, CFI = 0.969, RMSEA = 0.104, and SRMR = 0.077. Therefore, the one-dimensional structure with eight items yielded an RMSEA value above the 0.08 cutoff point, suggesting a poorer fit and more residual error than is acceptable for a well-fitting model. Using the modification indices within the CFA, we observed a correlation between Items 2 (climbing up two flights of stairs [16 steps]) and 6 (climbing up four flights of stairs [32 steps]) and Items 3 (squatting) and 4 (kneeling), indicating the similarity in the response pattern for these items. After adding these correlations to the model, we obtained improved fit indices (χ2/DF = 1.51, TLI = 0.990, CFI = 0.985, RMSEA = 0.072, and SRMR = 0.061).CONCLUSION:This version of the FIQ should be used with caution, as the unidimensional model demonstrates substantial residuals, mainly because of item redundancy.

BackgroundThe Maslach Burnout Inventory (MBI) is an instrument commonly used to evaluate burnout syndrome. The goal of the present study was to assess the internal reliability and the performance of the items and the subscales of the MBI-HSS (the version for professionals working in human services) by validating its factorial structure in Spanish urgency healthcare personnel.MethodsCross-sectional study including 259 healthcare emergency professionals (physicians and nurses) in the Spanish health region of Lleida and the Pyrenees. Burnout was measured using the Spanish validated version of the MBI-HSS. Internal reliability was estimated using Cronbach’s alpha coefficient. The sampling adequacy was assessed using the Kaiser-Meyer-Olkin measure along with the Bartlett’s test of sphericity. A principal axis exploratory factor analysis with an oblique transformation of the solution and a confirmatory factor analysis with maximum likelihood estimation were performed. Goodness-of-fit was assessed by means of the chi-square ratio by the degrees of freedom, the standardized root mean square residual (SRMR), the root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI).ResultsThe three subscales showed good internal reliability with Cronbach’s alpha coefficients exceeding the critical value of 0.7. Exploratory factor analysis revealed five factors with eigenvalues greater than 1. Nevertheless, confirmatory factor analysis showed a relatively satisfactory fit of the three-factor structure (χ2/df = 2.6, SRMR = 0.07, RMSEA = 0.08, TLI = 0.87, CFI = 0.89), which was improved when several items were removed (χ2/df = 1.7, SRMR = 0.04, RMSEA = 0.05, TLI = 0.97, CFI = 0.98).ConclusionsAlthough it is necessary exploring new samples to get to more consistent conclusions, the MBI-HSS is a reliable and factorially valid instrument to evaluate burnout syndrome in health professionals from the Spanish emergency services.

BackgroundThe NIH Toolbox was designed to provide brief, reliable, and valid measures of neurological and behavioral functions. Emotion assessment using the NIH Toolbox Emotion Battery has recently received significant attention given emerging evidence that emotional health is predictive of physical health and overall well‐being. The purpose of this study is to examine whether the modified emotion toolbox model is associated with cognition in sample of cognitively healthy adults.MethodParticipants were 529 enrollees in the Wisconsin ADRC who had normal cognition. The majority of participants were female (65.8%) and White (78.3%). Average age was 63.69 (SD = 8.37). NIH Toolbox Emotion Battery factors and a measure of executive function, Trail Making Test (TMT) Parts A & B were examined using SEM. To evaluate the overall goodness‐of‐fit, we used the following criteria: χ2 nonsignificant, χ2/df between1‐3, comparative fit index (CFI)>0.95, Tucker–Lewis index (TLI)>0.95, standardized root mean square residual (SRMR)<0.05, and the root mean square error of approximation (RMSEA)<0.08.ResultThe initial SEM results indicated a non‐acceptable fit for the data: χ2(51,N = 529) = 275.99, p<.01 (should be not significant), χ2/df = 5.41 (<3), CFI = 0.92(>.95), TLI = 0.90 (>.95), SRMR = 0.05, and RMSEA = 0.09 (<.08), 90% confidence interval (CI) = [0.08, 0.10] based on previously reported goodness‐of‐fit criteria. Based on modification indices, conceptually and statistically meaningful correlated error terms were added to the model (e,g., proximity between emotional support and friendship; emotional support and instrumental support; stress and sadness). After correlating some error terms based on theoretical background and modification indices, the modified SEM results indicated an acceptable fit for the data: χ2/df = 2.52 (<3), CFI = 0.98, TLI = 0.97, SRMR = 0.03 and RMSEA = 0.05, 90% confidence interval (CI) = [0.04,0.06].ConclusionOur modified model using the NIH Toolbox Emotion Battery had an acceptable fit for the data in a cognitively healthy cohort. Although we did not include all emotion toolbox variables, our modified model still had a great fit to the data. We specifically found that positive emotions including social satisfaction measures were correlated with cognition. We did not find any correlation between negative affect and cognition, which could be due to limited sample size. Measuring and identifying positive and negative emotions are important in clinical and research practice.

BackgroundFew validated brief scales are available to measure constructs that may hinder mpox-related prevention and care engagement, such as knowledge and stigma. Both are highly salient barriers to infectious disease care and disease understanding, precursors to evaluating one’s risk and need to, for example, accept vaccination. To address this gap, we developed and validated the Mpox Stigma Scale (MSS) and Mpox Knowledge Scale (MKS).MethodsAs part of a full-scale clinical trial, we offered an optional mpox survey to participants who self-identified as African American or Black, were 18–29 years old, and lived in Alabama, Georgia, or North Carolina (2023, N = 330). We calculated psychometric properties through confirmatory factor analyses (CFA) and applied Comparative Fit Index (CFI), Goodness of Fit Index (GFI), and Tucker-Lewis Index (TLI) values equal to or exceeding 0.90 and Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) values less than 0.08 to determine adequate model fit. We computed internal reliability using Cronbach’s alpha and calculated Pearson or Spearman correlation coefficients between the MSS and MKS and related variables.ResultsFor the MSS, CFA results showed that the one-factor model fit the data well (χ2(df = 5, N = 330) = 34.962, CFI = 0.97, GFI = 0.99, TLI = 0.94, RMSEA = 0.13, SRMR = 0.03). For the MKS, the one-factor model provided a good fit to the data (χ2(df = 6, N = 330) = 8.44, CFI = 0.99, GFI = 0.99, TLI = 0.95, RMSEA = 0.15, SRMR = 0.02). Cronbach’s alphas were MSS = 0.91 and MKS = 0.83, suggesting good to excellent reliability. The MSS was correlated with the MKS (r = .55, p < .001), stigmatizing attitudes (r = .24, p < .001), attitudes towards mpox vaccination (r=-.12, p = .030), and worry about contracting mpox (r = .44, p < .001). The MKS was correlated with worry about contracting mpox (r = .30, p < .001) and mpox disclosure (r=-.16, p = .003).ConclusionsThe MSS and MKS are reliable and valid tools for public health practice, treatment and prevention research, and behavioral science. Further validation is warranted across populations and geographic locations.Trial RegistrationClinicalTrials.gov NCT05490329.

IntroductionDigital health has the potential to support health care in rural areas by overcoming the problems of distance and poor infrastructure, however, rural areas have extremely low use of digital health because of the lack of interaction with technology. There is no existing tool to measure digital health literacy in rural China. This study aims to test and validate the digital health readiness questionnaire for assessing digital readiness among patients in rural China.MethodsDue to the different Internet environments in China compared to Belgium, a cultural adaptation is needed to optimize the use of Digital Health Readiness Questionnaire in China. Then, a prospective single-center survey study was conducted in rural China among patients with hypertension. Confirmatory factor analysis was computed to test the measurement models.ResultsA total of 330 full questionnaires were selected and included in the analysis. The model-fit measures were used to assess the model's overall goodness of fit (Chi-square/degrees of freedom = 5.060, comparative fit index = 0.889, Tucker–Lewis index (TLI) = 0.869, root mean square error of approximation (RMSEA) = 0.111, standardized root mean square residual (SRMR) = 0.0880). TLI is a little bit lower than the borderline (more than 0.9) and RMSEA is higher than it (less than 0.08 means good model fit). We deleted two items 2 and 4 and the result shows a better goodness of fit (Chi-square/degrees of freedom = 4.897, comparative fit index = 0.914, TLI = 0.895, RMSEA = 0.109, SRMR = 0.0765)ConclusionTo increase applicability and generalizability in rural areas, it should be considered to use the calculation of only the parts Digital skills, Digital literacy and Digital health literacy which are equally applicable in a Belgian population as in a rural Chinese population.

The Knee Injury and Osteoarthritis Outcome Score (KOOS) is well known and commonly used to assess young, active patients with ACL injuries. However, this application of the outcome measure has been called into question. There is currently no evidence supporting the structural validity of the KOOS for this patient population. Structural validity refers to whether a questionnaire meant to provide scores on different subscales behaves as intended in the populations of interest. Structural validity should be assessed for all questionnaire measures with multiple items or subscales. Does the KOOS demonstrate adequate structural validity in young, active patients with ACL tears, when evaluated using (1) exploratory and (2) confirmatory factor analyses? Between January 2014 and March 2017, 1033 patients were screened for eligibility in the Stability 1 randomized controlled trial from nine centers in Canada and Europe. Patients were eligible if they had an ACL deficient knee, were between 14 and 25 years old, and were thought to be at higher risk of reinjury based on the presence of two or more of the following factors: participation in pivoting sports, presence of a Grade 2 pivot shift or greater, generalized ligamentous laxity (Beighton score of 4 or greater), or genu recurvatum greater than 10°. Based on this criteria, 367 patients were ineligible and another 48 declined to participate. In total, 618 patients were randomized into the trial. Of the trial participants, 98% (605 of 618) of patients had complete baseline KOOS questionnaire data available for this analysis. Based on study inclusion criteria, the baseline KOOS data from the Stability 1 trial represents an appropriate sample to investigate the structural validity of the KOOS, specifically for the young, active ACL deficient population.A cross sectional retrospective secondary data analysis of the Stability 1 baseline KOOS data was completed to assess the structural validity of the KOOS using exploratory and confirmatory factor analyses. Exploratory factor analysis investigates how all questionnaire items group together based on their conceptual similarity in a specific sample. Confirmatory factor analysis is similar but used often in a second stage to test and confirm a proposed structure of the subscales. These methods were used to assess the established five-factor structure of the KOOS (symptoms [seven items], pain [nine items], activities of daily living [17 items], sport and recreation [five items], and quality of life [four items]) in young active patients with ACL tears. Incremental posthoc modifications, such as correlating questionnaire items or moving items to different subscales, were made to the model structure until adequate fit was achieved. Model fit was assessed using chi-square, root mean square error of approximation (RMSEA) and an associated 90% confidence interval, comparative fit index (CFI), Tucker-Lewis index (TLI), as well as standardized root mean square residual (SRMR). Adequate fit was defined as a CFI and TLI > 0.9, and RMSEA and SRMR < 0.08. Structural validity of the KOOS was not confirmed when evaluated using (1) exploratory or (2) confirmatory factor analyses. The exploratory factor analysis, where the 42 KOOS items were allowed to group naturally, did not reflect adequate fit for a five-factor model (TLI = 0.828). Similarly, the confirmatory factor analysis used to investigate the KOOS structure as it was originally developed, revealed inadequate fit in our sample (RMSEA = 0.088 [90% CI 0.086 to 0.091]). Our analysis suggested a modified four-factor structure may be more appropriate in young, active ACL deficient patients; however, the final version presented here is not appropriate for clinical use because of the number and nature of post-hoc modifications required to reach adequate fit indices. The established five-factor structure of the KOOS did not hold true in our sample of young, active patients undergoing ACL reconstruction, indicating poor structural validity. We question the utility and interpretability of KOOS subscale scores for young, active patients with ACL tears with the current form of the KOOS. A modified version of the KOOS, adjusted for this patient population, is needed to better reflect and interpret the outcomes and recovery trajectory in this high-functioning group. A separate analysis with a defined a priori development plan would be needed to create a valid alternative.

Anxiety, characterized by an unpleasant state of anticipatory unease, manifests in approximately 19% of adolescents and children within the Lebanese population. Given the major influence of traditional mindset and the stigma concerning mental health in Lebanon, children often express anxiety differently that can go unnoticed, and leading to underreported anxiety symptoms. Having a parental perspective in a collectivist culture is important. Lebanon is known to have a strong family-oriented culture where parents have an important role in shaping children’s emotional and psychological wellbeing. Therefore, the Spence Children’s Anxiety Scale-Parent (SCAS) might be an appropriate tool to aid in the identification of anxiety. This study aims to validate the SCAS-Parent in the Arabic language, assessing reliability, validity and consistency of the scale. This cross-sectional study enrolled 502 adult parents from all over Lebanon. The data was collected through a Google form and using snowball technique during November 2023. The questionnaire included sociodemographic data, the Brief version of the Spence Children’s Anxiety Scale for the Parents (SCAS-P- 8) and the Depression Anxiety Stress Scale (DASS- 8). A confirmatory factor analysis (CFA) was conducted; calculated fit indices were the normed model chi-square (χ²/df), the root mean square error of approximation (RMSEA), the standardized root mean square residual (SRMR), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values ≤ 5 for χ²/df, ≤ 0.08 for RMSEA, ≤ 0.05 for SRMR and ≥ 0.95 for CFI and TLI indicate good fit of the model to the data. CFA results indicated that fit of the one-factor model of the SCAS-P- 8 scale was acceptable: χ2/df = 84.53/20 = 4.23, RMSEA = 0.080 (90% CI 0.063, 0.098), SRMR = 0.035, CFI = 0.966, TLI = 0.952. The standardized estimates of factor loadings were all adequate. The reliability of the scale was good (ω = 0.90/α = 0.90). Higher parental depression (r = 0.61; p < 0.001), anxiety (r = 0.62; p < 0.001) and stress (r = 0.48; p < 0.001) were significantly associated with higher anxiety in the child. The study validates the SCAS-P- 8 for its application in the Lebanese population, demonstrating high internal consistency, reliability, and validity, indicating its potential as a screening tool for anxiety in children in the hands of psychologists and health-care professionals. Anxious parents will most likely have anxious children, leading to a vicious cycle. Early screening of anxiety in children can potentially impact the quality of life and developmental status of children. Additionally, assessing several aspects of anxiety can help prevent its long-term consequences that can affect academic performance, social relationships, and overall well-being.

Objectives: This paper is to culturally adapt and confirm the validity and reliability of a job motivation scale among health workers in hospitals in Vietnam. Methods: We used data from two studies of health workers’ job motivation which were conducted at two public hospitals in Vietnam. These studies were conducted in 2016 in 2018. Exploratory factor analysis (EFA) was used to identify the motivation factors and confirmatory factor analysis (CFA) was then used to certify the elementary factors produced by EFA using Comparative Fit Index (CFI), Tucker Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA) and the Standardized Root Mean Square Residual (SRMR). Results: The results demonstrate that two factors of job motivation, namely ‘Satisfaction and Commitment’ and ‘Conscientiousness’ were identified by EFA with Cronbach’'s Alpha of 0.88 and 0.89 respectively. The whole scale of job motivation was reliable, with Cronbach’'s Alpha of 0.87. The result was confirmed by CFA where the motivation item corresponds as CFI (0.91), TLI (0.88) and RMSEA (0.087), SRMR (0.06) are good fit indices. Conclusions: Job motivation scale should be widely applied for measuring the health workers’ motivation in other hospitals in Vietnam. The necessary solutions should be implemented to improve health workers’ job motivation.

To guide measure development, National Institutes of Health-supported Patient reported Outcomes Measurement Information System (PROMIS) investigators developed a hierarchical domain framework. The framework specifies health domains at multiple levels. The initial PROMIS domain framework specified that physical function and symptoms such as Pain and Fatigue indicate Physical Health (PH); Depression, Anxiety, and Anger indicate Mental Health (MH); and Social Role Performance and Social Satisfaction indicate Social Health (SH). We used confirmatory factor analyses to evaluate the fit of the hypothesized framework to data collected from a large sample. We used data (n=14,098) from PROMIS's wave 1 field test and estimated domain scores using the PROMIS item response theory parameters. We then used confirmatory factor analyses to test whether the domains corresponded to the PROMIS domain framework as expected. A model corresponding to the domain framework did not provide ideal fit [root mean square error of approximation (RMSEA)=0.13; comparative fit index (CFI)=0.92; Tucker Lewis Index (TLI)=0.88; standardized root mean square residual (SRMR)=0.09]. On the basis of modification indices and exploratory factor analyses, we allowed Fatigue to load on both PH and MH. This model fit the data acceptably (RMSEA=0.08; CFI=0.97; TLI=0.96; SRMR=0.03). Our findings generally support the PROMIS domain framework. Allowing Fatigue to load on both PH and MH improved fit considerably.

This study aimed to assess the validity of two models which integrate the cognitive (satisfaction with life) and affective (symptoms of anxiety and depression) aspects of subjective well-being within the framework of rational emotive behaviour therapy (REBT) theory; specifically REBT's theory of psychopathology and theory of psychological health. 397 Irish and Northern Irish undergraduate students completed measures of rational/irrational beliefs, satisfaction with life, and anxiety/depression symptoms. Structural equation modelling techniques were used in order to test our hypothesis within a cross-sectional design. REBT's theory of psychopathology (χ2 = 373.78, d.f. = 163, p < .001; comparative fit index (CFI) = .92; Tucker Lewis index (TLI) = .91; root mean square error of approximation (RMSEA) = .06 (95% CI = .05 to .07); standardized root mean square residual (SRMR) = .07) and psychological health (χ2 = 371.89, d.f. = 181, p < .001; CFI = .93; TLI = .92; RMSEA = .05 (95% CI = .04 to .06); SRMR = .06) provided acceptable fit of the data. Moreover, the psychopathology model explained 34% of variance in levels of anxiety/depression, while the psychological health model explained 33% of variance. This study provides important findings linking the fields of clinical and positive psychology within a comprehensible framework for both researchers and clinicians. Findings are discussed in relation to the possibility of more effective interventions, incorporating and targeting not only negative outcomes, but also positive concepts within the same model.

BackgroundProcesses of change (POC) comprise one of the psychological constructs in the Transtheoretical Model. The objective of this study is to test the validity and reliability of the Malay version of the POC scale among university students by using a confirmatory approach.MethodA cross-sectional study design with a convenience sampling method using a self-administered questionnaire was carried out. University undergraduate students were approached to fill in the questionnaire, which consisted of demographic information and a POC scale. The POC scale consisted of 30 items and two main factors (i.e., cognitive and behavioural). The POC scale was translated into the Malay language using a standard procedure of forward and backward translation. Confirmatory factor analysis (CFA) was performed, and composite reliability was computed using Mplus version 8.ResultsA total of 620 respondents with a mean age of 20 years (standard deviation = 1.15) completed the questionnaire. Most of the participants were female (74.7%) and Malay (78.2%). The initial CFA model of the POC scale did not exhibit fit based on several fit indices (comparative fit index (CFI) = 0.880, Tucker Lewis index (TLI) = 0.867, standardised root mean square residual (SRMR) = 0.075 and root mean square error of approximation (RMSEA) = 0.058). Several re-specifications of the model were conducted and the modification included adding correlation between the items’ residuals. The final model for the Malay version of the POC scale showed acceptable values of model fit indices (CFI = 0.922, TLI = 0.911, SRMR = 0.064 and RMSEA = 0.048). The composite reliability of both the cognitive and behavioural processes was acceptable at 0.856 and 0.752, respectively.ConclusionThe final model presented acceptable values of the goodness of fit indices, indicating that the scale is fit and acceptable to be adopted for future study.