10-item Scale Research Articles

Contact with nature may be a remedy for loneliness: A nationally representative longitudinal cohort study

BackgroundNature prescribing – a written recommendation by a health professional for a person to spend more time in nature for health reasons – is being heralded by some as a potential solution to loneliness, defined as a felt deprivation of meaningful connection, companionship, and camaraderie. However, such recommendations currently lack evidence on how much time in natural environments is needed to tackle loneliness and over what timescale. MethodsGeneral, emotional, and social loneliness were measured using De Jong Gierveld's 6-item scale in a nationally representative sample of 3043 Australian participants at baseline (October 2020), with 2421 and 2123 completing follow-ups at 4 months (February 2021) and 16 months (February 2022), respectively. Multilevel logistic regressions examined the odds of change in loneliness status between baseline and follow-up in relation to hours spent in nature in the 7 days prior to the baseline survey, adjusting for confounding factors that influence time spent in nature and the risk of feeling lonely. FindingsRelief from general loneliness in those experiencing it at baseline was 22.4% at month 4 and 29.4% at month 16. The equivalent findings for relief from social loneliness and emotional loneliness were 21.2% and 24.6%, and 34.2% and 41.2% at months 4 and 16, respectively. Incidence of loneliness at 4 months was 21.8% (general), 26.1% (social), and 11.8% (emotional), and at 16 months was 22.7% (general), 25.6% (social), and 12% (emotional). At each time point, the prevalence of loneliness was lower among participants with more time in nature. Just 1–2 h per week in nature (versus <1) was associated with relief from social loneliness at 4 months (Odds Ratio [OR] 1.69, 95%CI 1.10, 2.65) and at 16 months (OR 2.10, 95%CI 1.34, 3.30). Higher odds of relief from emotional loneliness were observed at 3–4 h spent in nature at 4 months (OR 1.84, 95%CI 1.11, 3.06) and at 16 months (OR 1.82, 95%CI 1.09, 3.07). Incidence of loneliness was not associated with nature contact. InterpretationIncreasing time in nature may an effective non-medical prescription for people who are lonely to find durable relief within a relatively short space of time. Findings from this longitudinal study can inform further investigation through randomised trials of co-designed nature prescriptions targeting relief from loneliness in vulnerable populations.

Dementia mindset of caregivers providing residential care for older persons: study protocol for a replication study on the validation of the Dementia Mindset Scale

IntroductionProfessional caregivers’ perspectives on dementia and on people living with dementia (PlwD) can influence their feelings, judgements and behaviours in work situations, for example, how they think about symptoms, disease...

Comparing the EORTC QLQ-LC13, EORTC QLQ-LC29, and the FACT-L for assessment of quality of life in patients with lung cancer - an updated systematic review.

Two commonly used quality of life (QoL) questionnaires in lung cancer patients are the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Lung Cancer 13 (QLQ-LC13) and the Functional Assessment of Cancer Therapy-Lung (FACT-L). More recently, the EORTC QLQ-LC29 was developed. This systematic review compares the EORTC QLQ-LC29, EORTC QLQ-LC13 and FACT-L in terms of the content, validity and psychometric properties in assessing the QoL of lung cancer patients. Fourteen studies were included. The EORTC QLQ-LC29 is a 29-item scale that serves as an update of the EORTC QLQ-LC13 to include symptoms from surgery and new targeted therapies. It shows validity, high internal consistency, test-retest reliability, and sensitivity. The FACT-L continues to assess general quality of life and lung cancer-specific symptoms. The EORTC QLQ-LC29, EORTC QLQ-LC13, and FACT-L were reviewed to assess their validity in measuring QoL of lung cancer patients. All were found to be sufficiently validated, The choice of which to use should depend on the primary goals of the study.

Perceived Discrimination Among Food Pantry Clients in Massachusetts.

Food insecurity is defined as inconsistent access to enough food to meet nutritional needs. Discrimination is associated with food insecurity and poor health, especially among racial and ethnic minoritized and sexual or gender minoritized groups. We examined the demographic associations of perceived everyday discrimination and food pantry discrimination in Massachusetts. From December 2021 through February 2022, The Greater Boston Food Bank conducted a cross-sectional, statewide survey of Massachusetts adults. Of the 3,085 respondents, 702 were food pantry clients for whom complete data on food security were available; we analyzed data from this subset of respondents. We used the validated 10-item Everyday Discrimination Scale to measure perceived everyday discrimination and a 10-item modified version of the Everyday Discrimination Scale to measure perceived discrimination at food pantries. Logistic regression adjusted for race and ethnicity, age, gender identity, sexual orientation, having children in the household, annual household income, and household size assessed demographic associations of perceived everyday discrimination and discrimination at food pantries. Food pantry clients identifying as LGBTQ+ were more likely than those identifying as non-LGBTQ+ to report perceived everyday discrimination (adjusted odds ratio [AOR] = 2.44; 95% CI, 1.24-4.79). Clients identifying as Hispanic (AOR = 1.83, 95% CI, 1.13-2.96) were more likely than clients identifying as non-Hispanic White to report perceived discrimination at food pantries. To equitably reach and serve households with food insecurity, food banks and pantries need to understand experiences of discrimination and unconscious bias to develop programs, policies, and practices to address discrimination and create more inclusive interventions for food assistance.

A - 1 Informant Report of Practical Judgment Is Associated with Mild Cognitive Impairment and Measures of Brain Structure in a Nondemented Sample of Older Adults

Abstract Objective Given the potential risks associated with compromised judgment in older adulthood, we examined whether informant-reported practical judgment abilities were associated with cognitive impairment and measures of brain structure. Method 97 community-dwelling older adults with informants (Mage = 74.64 ± 7.42, Medu = 15.76 ± 2.42, 74%female, 92%white) underwent neuropsychological evaluation, including the Test of Practical Judgment-Informant (TOP-J-INF), a 15-item informant-reported scale of judgment ability. Participants were diagnosed with mild cognitive impairment (MCI; n = 33) or as neuropsychologically unimpaired (n = 64). Participants completed an MRI study including T1-weighted image processed with FreeSurfer software (v 6.0.0) to obtain estimates of gray matter volume and cortical thickness (parcellated with the Desikan-Killiany atlas). Logistic and linear models analyzed the association of TOP-J-INF with MCI diagnosis and brain volume/thickness (in separate models). To better support the exploratory nature of this analysis of associations with structural brain variables, we did not apply correction for multiple comparisons. Results Each additional point on the TOP-J-INF increased the odds of MCI diagnosis by 16.8% (OR = 1.168, p = 0.004). Worse judgment was associated with reduced brain volume in the right parahippocampal gyrus (β = −11.688, p = 0.032), superior temporal gyrus (β = −51.330, p = 0.040), rostral anterior cingulate cortex (β = −25.704, p = 0.004); and reduced thickness of the left transverse temporal gyrus (β = −0.010, p = 0.041). Conclusions To our knowledge, this is the first study to investigate the relationship between informant report of judgment and measures of brain structure, providing support that informant concerns about a loved one’s compromised judgment is associated with volume/thickness reduction in key brain regions. Assessing practical judgment abilities via informants could provide critical clinical information when working with vulnerable older individuals.

B - 130 Application of Item Response Theory to the MMPI-2-RF Response Bias Scale-19 (RBS-19)

Abstract Objective RBS is a cognitive overreporting scale on the MMPI-family of instruments. Recent efforts to refine the scale removed nine items lacking conceptual and empirical relationships to cognitive dysfunction (Ingram et al., 2024; Ratcliffe et al., 2022). This revised scale version (RBS-19) demonstrated improved utility and classification accuracy, although the improvements were small. Albertorio et al (2024) found that the RBS could be reduced to 14 items and identified potential “critical items”. This study uses IRT in a database of Active-Duty personnel to explore reduced item RBS forms. Method Using a 2-parameter IRT model, we examined cognitive overreporting across the 19-item MMPI-2-RF RBS-19 Scale. Participants (n = 326; 96% male) were divided into pass-all vs fail 2+ standalone PVTs for criterion-based comparisons (e.g., ROC analysis and mean difference), with indetermined profiles removed. Results Results indicate good theta coverage. Two items (24 and 26) were removed due to low α (2). RBS-14/17/19 all had similar AUC (0.72 vs 0.71 vs 0.72) and similar effect sizes between groups. Conclusions IRT analyses supported a 17-item RBS scale rather than the 14 or 19 item versions in this sample. However, no “critical items” emerged in this sample. Such differences may reflect changes in factor structure based on referral reason (Boress et al., 2023).

The Homeostasis-Enrichment-Plasticity (HEP®) Approach for Premature Infants with Developmental Risks: A Pre-Post Feasibility Study.

Background: The environmental enrichment (EE) framework has inspired several early intervention (EI) approaches. This study evaluated the feasibility, safety, caregiver acceptance, and satisfaction of implementing the HEP Approach intervention, a novel EI model based on the EE paradigm. Outcome measures for motor development, individual functional goals, sensory functions, caregiver-provided environmental affordances, and motivation for movement were examined. Methods: A pre-post-study design examined 18 premature infants (<33 weeks six days gestation) with a corrected age of 4-10 months. A 21-item Likert scale survey assessed the feasibility, safety, acceptability, and satisfaction of implementing the HEP Approach intervention. The Peabody Developmental Motor Scales-2, Test of Sensory Functions in Infants, Affordances in the Home Environment for Motor Development, and Infant Movement Motivation Questionnaire were used for outcomes. The goal attainment scale measured progress toward parent goals. The HEP Approach consisted of 12 one-hour sessions implemented over three months. Results: Most participating parents found the HEP Approach intervention feasible, safe, acceptable, and satisfactory. GAS scores demonstrated significant gains with a mean t-score of 67.75 (SD = 2.00). Results found significant improvement (p ≤ 0.05) in all outcome measures. Conclusions: Results suggest that the HEP Approach intervention is safe, feasible, and acceptable to implement. Outcome measures were meaningful and sensitive in identifying improved motor development, individualized parental goals, sensory functions, caregivers' use of environmental opportunities, and movement motivation in premature at-risk infants. Results suggest further studies on the HEP Approach are feasible, and highlight the potential of this intervention to inspire and guide future research in this field.

SAÚDE MENTAL, ENFRENTAMENTO RESILIENTE E ESPERANÇA ENTRE RESIDENTES PAULISTANOS DURANTE O DISTANCIAMENTO SOCIAL DA COVID-19

The COVID-19 pandemic has globally impacted mental health. This study, conducted in Sao Paulo, investigated levels of anxiety, depression, resilient coping, and hope during the pandemic. The objective was to analyze the pandemic's effects on the mental health of São Paulo's population and explore coping strategies and hope. Data were collected among 1,434 adults between July 8 and August 8, 2020, using an online questionnaire that included sociodemographic data and scales to measure anxiety (Patient-Reported Outcomes Measurement Information System Adult (PROMIS®) Short Form v1.0-Anxiety 4a), depression (PROMIS® Short Form v1.0-depression 4a), resilient coping (4-item Brief Resilient Coping Scale), and hope (12-item Herth Hope Index). The results showed that being young, female, having suicidal thoughts, and adhering to quarantine policies were associated with higher levels of anxiety. Higher scores in resilient coping (-0.24) and hope (-0.06) correlated with lower anxiety. The data also revealed that being young, female, having suicidal thoughts, and living with elderly individuals increased depression scores. Conversely, higher scores in resilient coping (-0.35) and hope (-0.14) were related to lower levels of depression. These findings indicate that the pandemic significantly affected mental health in São Paulo. Resilient coping strategies and hope demonstrated potential to alleviate psychological distress, highlighting the importance of effective public mental health policies to address future crises. Therefore, investing in programs that promote resilience and hope may be crucial for mitigating adverse psychological impacts in emergency health situations.

Resiliency amid the COVID-19 pandemic: engagement in meaningful activities as a mediator between coping ability and depressive symptoms among older adults

Objectives This study investigated the longitudinal association between coping ability and depressive symptoms from before to during and after the COVID-19 pandemic and whether engagement in meaningful activities plays a mediating role in this association. Method Individuals aged 75, 80, and 85 years (n = 1021) were interviewed in 2017–2018 (T1, pre-pandemic). Of these persons, 608 were interviewed in 2020 (T2, first wave) and 2021–2022 (T3, partly post-pandemic). Coping ability, depressive symptoms, and engagement in meaningful activities were assessed using the 10-item Connor-Davidson Resilience Scale, 10-item Center for Epidemiologic Studies Depression Scale, and 17-item activity subscore of the University of Jyväskylä Active Aging Scale, respectively. Structural equation modeling was used for the mediation analyses. Results Higher coping ability was associated with decreased depressive symptoms, partly mediated by higher activity scores between T1 and T2. From T2 to T3, higher coping ability reduced the depressive symptoms, but the activity scores did not mediate the changes during this period. Conclusion Good coping ability may help older people sustain good mental well-being. With good coping ability, active engagement in meaningful activities contributed to the low level of depressiveness during the early phases of the pandemic, when many social activities were restricted.

Association between emotional intelligence and mental health status based on sex differences among undergraduates in Vietnam

Public health concerns about mental health problems have recently received attention, particularly since the COVID-19 pandemic. Emotional intelligence (EI) is a significant factor linked to mental health status, including depression, anxiety, and stress (DAS), with sex playing a significant role in both DAS and EI status. This study aimed to describe DAS and EI status and assess sex differences in the associations between EI and DAS among undergraduate students. A cross-sectional study was conducted across three educational institutions in Dong Thap province, southern Vietnam, using the validated Schutte Self-Report Emotional Intelligence Test (SSEIT) and the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Spearman correlation analysis was used to identify correlations between DAS and EI, and the sex differences in the associations between DAS and the four SSEIT constructs - emotion perception (EP), utilizing emotion (UE), managing self-relevant emotion (MSE), and managing others' emotion (MOE) - were examined using linear regression models. Among the 674 participants, 51.6% experienced mental health problems (64.1% for females, 35.9% for males), 47.0% experienced anxiety, 32.5% experienced depression, and 27.4% experienced stress. The average EI score was 119.3 ± 18.9 (120.0 ± 19.1 for females, 118.0 ± 18.5 for males), with 58.9% of participants having normal EI, while 29.2% and 11.9% had low and high EI, respectively. Negative correlations were observed between EI scores and depression (R=-0.16, p&lt;0.001) and anxiety (R=-0.09, p=0.020), especially among females. Findings indicated that MSE showed significant associations with DAS, especially in females (all β&lt;-0.318, all p&lt;0.001). Our study highlights the importance of considering sex in mental health prevention programs targeting EI skills to manage students' self-relevant emotions better.

Translation, Cultural Adaptation, and Psychometric Properties of Hindi Rosenberg Self-esteem Scale in University Nursing Students

Background: Rosenberg’s Self-esteem Scale (RSES) has been widely used without proper translation, cultural adaptation, and testing psychometric properties in Indian studies. The study aimed to translate and culturally adapt the 10-item Rosenberg Self-esteem Scale into Hindi and find psychometric properties. Material and Methods: We have translated the scale using World Health Organization (WHO) guidelines. Using a cross-sectional design, the translated scale was administered to 143 undergraduate nursing students randomly selected. Content validity index (CVI) was used to assess content validity. Exploratory factor analysis (EFA) with principal axis factoring was used to estimate the construct validity. Cronbach’s alpha (α) and intraclass correlation coefficient (ICC) were used to check internal consistency and test re-test reliability. Results: The S-CVI for the Hindi RSES was 0.98. Kaiser-Meyer-Olkin (KMO) (=0.79), and Bartlette’s test for sphericity was significant ( χ2 = 425.06, df = 45, P &lt; .001). EFA extracted three common factors, explaining 62.62% of the total variance. The factor loading of all items suggests a good representation of their underlying construct; all items &gt;0.47, except item 1 (= –0.373). The test re-test, an ICC was r = 0.76 ( P &lt; .001), and Cronbach’s alpha (α) after deletion of item 1 was 0.81, suggesting excellent reliability. Conclusion: The Hindi Rosenberg self-esteem scale is a psychometrically tested scale to assess self-esteem in the Hindi-speaking adult population. These findings provide empirical judgment for using the translated Hindi RSES to measure self-esteem among the adult population. The authors recommend verifying the psychometric properties in a more extensive and varied population.

Quick MSA-QoL: A validated, abbreviated health-related quality of life questionnaire for use in Multiple System Atrophy

BackgroundHealth-related quality of life is an important patient-reported outcome, which can be assessed using instruments such as the Multiple System Atrophy (MSA) Quality of Life (MSA-QoL) scale. However, at 40-items its length can prove burdensome, particularly to patients with a disease such as MSA. This can contribute to respondent burden and poor-quality response data. ObjectiveThe objective of this study was to develop an abbreviated MSA-QoL scale for use in clinical practise and trials (Quick MSA-QoL). MethodsA single-factor 15-item scale was developed with data from 310 patients with MSA, using exploratory factor analysis (EFA). A separate dataset (n = 279) was used for analysis of psychometric properties and for confirmatory factor analysis. ResultsMissing data was minimal, with even distribution of scores and negligible floor/ceiling effects (0/0.4%). Reliability was high (Cronbach alpha 0.870, test-retest reliability 0.950). Good item-total scale correlations were observed (r = 0.402–0.618), and the overall scale correlated well with other validated questionnaires including the original MSA-QoL (r = 0.862). Confirmatory factor analysis demonstrated acceptable model fit indices. Responsiveness data from re-administration of the Quick MSA-QoL 10 months from baseline testing found the overall scale to be sensitive to change. ConclusionsThese data suggest that the Quick MSA-QoL is a suitable and efficient scale for use in clinical trials, minimising respondent burden and maintaining data quality.

Development and psychometric evaluation of the catheter assessment, management and performance (CAMP) scale for nurses

AimTo develop and test the psychometric properties of a self-administered scale to assess the knowledge, skills, attitudes and behaviour of nurses to support the self-management of patients living with indwelling urinary catheters. BackgroundNurses are pivotal in supporting patients with urinary catheter self-management to prevent potentially avoidable hospital presentations. However, no validated scale is available to assess nurses’ attitudes and readiness for this task. DesignA quasi-experimental design was used to collect survey data both at baseline and after the completion of the intervention. A total of 128 participants were recruited from the Western Sydney region (New South Wales, Australia), who were working in community healthcare settings. Research Electronic Data Capture (REDCap™) database was used to manage the survey data collected for data analysis purposes. This study has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN126210 0 0683831) MethodsUsing a three-stage process of concept identification, item construction and pilot testing to develop the Catheter Assessment, Management and Performance (CAMP) scale, followed by factorial and discriminant validity and reliability testing. This 23-item CAMP scale is theoretically informed by the COM-B (Capability, Opportunity, Motivation-Behaviour) model, recognised for its effectiveness in understanding and influencing behaviour change. The scale was distributed to nurses working in three community health care settings to assess their knowledge, attitude and behaviour regarding catheter management and performance. ResultsFour factors were identified using scree plot, accounting for 63.36 % of total explained variance, which reflected the four dimensions of the COM-B model. Cronbach's alpha of the overall CAMP scale (0.93) and subscales (0.92, 0.87, 0.85 and 0.86) indicate good internal consistencies. The CAMP scale was able to detect changes in nurses’ self-reported behaviour change following educational intervention (85.53 versus 95.98, p < 0.001). ConclusionThe CAMP scale is valid and reliable scale, capable of assessing nurses’ capability, opportunity and motivation to support patients, through delivery of catheter self-management education that can potentially prevent catheter-related complications and avoid hospital presentations. Future research could explore using CAMP scale among non-specialist nurses and in various clinical settings to enhance its effectiveness and generalisability.

Study protocol of a proposed Neurofeedback-Assisted Mindfulness Training Program on symptoms of anxiety and psychological distress associated with smartphone use in young adults: a randomized controlled trial.

Nomophobia is a specific phobia characterized by the appearance of anxiety, nervousness, discomfort and distress when the mobile phone is not used and is considered an emerging public health problem because of the negative consequences on the physical and mental health of young people and adolescents, especially women. Neurofeedback-Assisted Mindfulness Training Programs may prove beneficials for improving self-control abilities, a key ability in addressing addictive behaviors. The main objective of this study is to evaluate the impact, in a young population aged 18-35 years, of an intervention based on Neurofeedback-Assisted Mindfulness Training Program (NAMTP) on disorders associated with problematic use of mobile phones. The effect of the intervention on the total score in the nomophobia test and habits of internet and social network use, as well as on signs of depression, anxiety and stress will be analyzed. As a secondary objective, the effect of the intervention on signs of insomnia will be analyzed. Randomized, controlled clinical-trial with two-parallel groups. 40 young adults (18-35 years) will be included and randomly assigned to Intervention Group-NAMTP or Control Group (CG). The NAMTP will include a total of 25 sessions (2-3/week) during 3-months. Each session will have a duration of 10/15 min. The instrument to be used for the neurofeedback sessions is MUSE® (InteraXon Inc.). Study variables will be collected at the baseline visit and at the final visit (3-months after randomization). During these visits, questionnaires will be administered to evaluate the main and secondary variables that will include the Smartphone Addiction Scale-Short Version, Nomophobia Questionnaire, Depression, Anxiety and Stress Scale 21-item (DASS-21) and Athens Insomnia Scale. This trial will make an important contribution to the need for evidence of effective education programs and other primary care interventions through new non-invasive interventions in reducing the risk of developing addictions to new technologies and alleviating the symptoms of discomfort associated with this problem. The project was approved by the Clinical Research Ethics Committee of the Salamanca Health Area (CEIm Code: PI 2023 071340). ClinicalTrials.gov, http://www.Clinicaltrials.gov/ct2/show/NCT06188910.

Approach and withdrawal from cognitively effortful activities: Development, validation, and transdiagnostic clinical utility of a cognitive motivation scale

BackgroundDeficits in cognition and motivation predict functioning in depressive and psychotic disorders. However, experimental tasks of cognitive motivation are inconsistently correlated with functioning, time-intensive, and not intuitive in clinical practice. We aimed to develop and validate a self-report instrument to assess motivation processes pertinent to engagement with cognitive activities in daily life. MethodFollowing item generation, scale dimensionality, reliability, and validity were evaluated iteratively over Studies 1–3 with online general adult participants (n1 = 205; n2 = 235; n3 = 181). The 20-item Cognitive Motivation scale was also validated in a Study 3 sub-sample reporting high levels of depressive symptoms (n = 74) and Study 4 early psychosis outpatients (n = 25). ResultsTwo-factor model of cognitive approach and cognitive withdrawal, each with good internal consistency, convergent validity, discriminant validity was supported. Cognitive withdrawal showed stronger associations with cognitive difficulties, depressive symptoms, and functional impairments than traditional motivation scale. Participants reporting high depression levels showed more severe difficulties with cognitive motivation than participants reporting low depression levels. In early psychosis outpatients, correlations with functioning and cognitive effort expenditure provided support for scale validity. LimitationsCross-sectional data collection restricted evaluation of repeated administration psychometric properties. Scale validation was mostly established in online community samples and a small patient sample during the COVID-19 pandemic, thereby limiting generalizability of clinical applications. ConclusionsCognitive Motivation scale is a promising tool for future intervention trials seeking to target motivational processes associated with functioning in the general population and potentially across patient groups with amotivation symptoms.

Network Structure of Interpersonal Sensitivity in Patients With Mood Disorders: A Network Analysis.

Interpersonal sensitivity, characterized by a heightened awareness of others' behavior and emotions, is linked to mood disorders. However, current literature lacks a comprehensive analysis of how some items of the Interpersonal Sensitivity Measure (IPSM) interrelate and contribute to the overall construct. This study constructed a network for interpersonal sensitivity symptomatology to identify core IPSM items in patients with mood disorders. The IPSM, a 36-item self-report scale, was utilized to evaluate interpersonal sensitivity symptoms in 837 participants (major depressive disorder [MDD], n=265; bipolar I disorder [BD I], n=126; and bipolar II disorder [BD II], n=446). We performed exploratory graph analysis, employing regularized partial correlation models to estimate the network structure. Centrality analysis identified core IPSM symptoms for each mood disorder group. Network comparison tests assessed structural differences between the MDD and BD subgroups. Network analysis detected five communities. Item 10 ("I worry about being criticized for things that I have said or done") showed the highest value in strength. Multiple items on "Interpersonal Worry/Dependency" and "Low Self-Esteem" showed high strength centrality. Network structure invariance and global strength invariance test results indicated no significant differences between the MDD and BD subgroups. Our findings emphasize the importance of addressing "Interpersonal Worry/Dependency" and "Low Self-Esteem" in the IPSM network among mood disorder patients based on core items of the network. Additionally, targeted treatments and comprehensive strategies in this aspect could be crucial for managing mood disorders.

Assessing attitudes toward mental health illnesses in Saudi Arabia: A national cross-sectional study.

The study aimed to assess the national attitudes toward individuals with mental health illnesses in Saudi Arabia, exploring the relationship between these attitudes and various sociodemographic factors. A cross-sectional design with computer-assisted telephone interviews was employed, covering all 13 administrative regions in Saudi Arabia. A total of 4,533 adults agreed to participate, and their attitudes toward people with mental illnesses (PWMI) were measured using an 11-item scale. The translation of the original English version of the PWMI to Arabic was validated and published previously. The scale used level of agreement on a 5-point Likert scale. The score varies from 11 to 55, where a higher score signifies higher stigma. The associations between total PWMI scores and sociodemographic variables were analyzed using linear regression. The mean age of participants was 35.92 ± 12.84, with equal distribution across regions. The linear regression model showed significant associations between total PWMI scores and gender, education level, marital status, living with, or being friends with someone diagnosed with a mental illness, and working in healthcare. No significant associations were found with age, income level, and previous mental health diagnosis. The study suggests that negative stereotypes about mental illness may be more prevalent in Saudi Arabia, while Saudi participants had a more optimistic view regarding the recovery and outcomes of mental illnesses. The study highlights the importance of assessing mental health stigma and its associations with sociodemographic factors in Saudi Arabia. The significant associations found point to the need for targeted interventions and public health campaigns to address misconceptions and stereotypes surrounding mental health, ultimately improving the societal acceptance and well-being of individuals with mental health illnesses.

Construction and Psychometric Evaluation of the Critical Thinking Disposition Assessment Questionnaire Among Medical Undergraduate Students in West Bengal, India.

Introduction Assessing the critical thinking disposition of students with a valid tool in an Indian setting was a prerequisite to introducing critical thinking under the undergraduate medical curriculum, as it was shaped by society, culture, and language. The study planned to design and assess the psychometrics of the Critical Thinking Disposition Assessment Questionnaire (CTDAQ) in the Indian setting. Methods The study was conducted among undergraduate students at a medical college in West Bengal, India. A 30-item scale was initially designed through the review of relevant literature and discussion with experts. Through two rounds of the Delphi technique, a 20-item CTDAQ was formulated, and the content validity index (CVI) was calculated. The test-retest agreement was calculated after administering the tool twice among 25 students with a gap of three weeks using the weighted kappa coefficient. Then, principal component analysis was conducted to extract component structure with rotation. The internal consistency was measured using Cronbach's alpha. Results Item-wise and scale CVIs were more than 0.80 and 0.90, respectively. All items had a weighted kappa coefficient of ≥0.75. A three-component model was extracted from 20 items, with a minimum factor loading of 0.30. It explained 50.3% of the total variance. Cronbach's alpha of the scale, the conversance and systematicity component with seven items, the analyticity and flexibility component with nine items, and the maturity component with four items were 0.783, 0.789, 0.825, and 0.797, respectively. Conclusions The 20-item CTDAQ is psychometrically a valid, stable, and internally consistent scale to assess critical thinking disposition in the Indian context.

Prospective Clinical Study: Full-Body Blue Irradiation in the Treatment of Atopic Dermatitis.

Ultraviolet-free (UV-free) blue light phototherapy has emerged as a promising option due to its reported efficacy and minimal adverse effects. This study aims to evaluate the effectiveness of full-body blue light irradiation in both adult and pediatric patients with atopic dermatitis (AD), assessing its impact on skin condition and mood regulation by investigating serum concentrations of serotonin and kynurenine pathway metabolites. 20 patients (age 9-45) with moderate and severe AD were included in the study. Treatment consisted of 10 irradiations with Full Body Blue device (453nm). Serum concentrations of serotonin, quinolinic acid, kynurenic acid, tryptophan, and kynurenine were measured before and after irradiations. After 10 sessions of full blue light therapy (453nm) statistically significant improvements were observed in Eczema Area Severity Index (EASI 13.16 vs. 8.65; p = 0.00016), SCORing Atopic Dermatitis (SCORAD 44.99 vs. 23.73; p < 0.00001), Visual Analogue Scale (VAS 6.53 vs. 3.95; p = 0.00251), 10-item pruritus severity scale (13.32 vs. 7.05; p < 0.00001). Moreover, statistically significant decrease in Dermatology Life Quality Index (DLQI) was noted (14.37 vs. 7.42; p = 0.00351). Additionally, increase in the serum concentration of serotonin was observed after completing 10 irradiation sessions (median 139.77mg/ml vs. 274.92mg/ml; p < 0.00001). Blue light may be a promising and safe treatment in patients with AD. It might also positively influence mood. Further investigations are needed to confirm those findings. ClinicalTrials.gov identifier, NCT06516783.

Conversion practice recall and mental health symptoms in sexual and gender minority adults in the USA: a cross-sectional study.

Conversion practices are associated with psychological morbidity, yet few studies have evaluated differences between efforts to change gender identity, sexual orientation, or both. We aimed to examine the individual and joint association of conversion practice recall targeted at gender identity or sexual orientation, or both, with current mental health symptoms among sexual and gender minority people. This cross-sectional study used data from The PRIDE Study, a US-based, online, prospective cohort study of sexual and gender minority adults who were recruited through social media, digital advertisements, and sexual and gender minority community-based events and organisations. For this analysis, we included participants who completed a lifetime questionnaire in 2019-20 and a subsequent annual questionnaire in 2020-21 without missing outcome data. All questionnaires were in English. The exposure was lifetime recall of conversion practice targeting gender identity alone, sexual orientation alone, or both (versus no conversion practice). Mental health outcomes were continuous measures: Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire 9-item (depression) scale, Post-Traumatic Stress Disorder Checklist 6-item scale, and Suicide Behaviors Questionnaire-Revised scale. We used linear regression to analyse the associations of conversion practice recall and mental health symptoms, controlling for demographic and childhood factors and stratified between cisgender and transgender and gender diverse groups. Sensitivity analyses evaluated the potential impact of unmeasured confounding. Analyses were conducted in R. We included people with related lived experience in the design and implementation of this study. Of 6601 participants who completed the lifetime questionnaire in 2019-20, 4440 completed the subsequent annual questionnaire in 2020 or 2021, and 4426 did not have missing outcome data. Of the 4426 included participants, 4073 (92·0%) identified as White (either alone or in combination with other ethnoracial options), 460 (10·4%) identified with multiple ethnoracial identities, and 1923 (43·4%) were transgender and gender diverse. Participants' age ranged from 18 years to 84 years (median 31·7 years, IQR 25·5-44·1). 149 (3·4%) participants reported sexual orientation-related conversion practice alone, 43 (1·0%) reported gender identity-related conversion practice alone, and 42 (1·0%) reported both. Recalling both forms of conversion practice was most strongly associated with greater post-traumatic stress disorder (PTSD; β 2·84, 95% CI 0·94-4·74) and suicidality (2·14, 0·95-3·32) symptoms. Recall of only sexual orientation-related conversion practice was associated with greater symptoms of PTSD (1·10, 0·22-1·98). Recall of gender identity-related conversion practice alone was most strongly associated with greater depressive symptoms (3·24, 1·03-5·46). Only associations for suicidality differed between cisgender and transgender and gender diverse participants, although the latter showed higher mental health symptoms overall. Findings were moderately robust to potential sources of unmeasured confounding in sensitivity analysis. Recall of conversion practice exposure was associated with a range of mental health symptoms among sexual and gender minority people. These findings support calls to ban conversion practices because of their effects as a structural determinant of mental health. Gill Foundation, Dona Rockstand, and Patient-Centered Outcomes Research Institute.