Measures Of Self-esteem Research Articles

Self-esteem, Social and Affective Outcomes of Students with Special Educational Needs in Tertiary Education

The core values of inclusive education (IE) proclaim to provide equal educational opportunities to all students regardless of disabilities or special educational needs (SEN). Nonetheless, there were no consistent indications that IE was beneficial to students with SEN. Despite lacking solid evidence for the efficacy of IE, more and more students with SEN completed their secondary education and pursue their studies in tertiary education. This study was conducted in an institute of tertiary education to investigate psychosocial outcomes of inclusive practice. A total of 91 students with special educational needs participated in this study. Validated outcome measures of global self-esteem, social relationship, and psychological distress were incorporated in a questionnaire for online data collection. Results showed that students with SEN were able to maintain good social relationship with their peers, but their global self-esteem was significantly lower and their psychological distress was higher than their peers without SEN. Students with mental illness or emotional problems were most vulnerable to academic stress of tertiary education, whereas students with physical and sensory impairments were very well adjusted and their psychosocial outcomes were not significantly different from their pees without SEN. Findings of the study were discussed and implications of the findings for IE research considered.

Loneliness and Depressive Symptoms: Moderation and Mediation Model

ABSTRACT Background Due to the impact of COVID-19, loneliness rates among university students have increased. Despite research evidence on the impact of loneliness on depression among university students, only a few studies have focused on the mediating mechanism of this relationship. The investigation of the role of self-esteem and life satisfaction in the association between loneliness and depression among university students still has many gaps. Purpose This study aimed to investigate whether loneliness was associated with higher depressive symptoms among university students through lower life satisfaction and whether the relationship between loneliness and depressive symptoms was moderated by self-esteem. Methods The sample includes 408 university students (341 female students and 67 male students) in Vietnam. Participants completed self-reported measures of loneliness, life satisfaction, self-esteem, and depression symptoms. Results Moderation analyses indicated that self-esteem moderated the relationship between loneliness and depression symptoms. Mediation analyses indicated that loneliness was associated with depression symptoms through life satisfaction. Discussion Self-esteem and life satisfaction are important mechanisms to explain why students with high levels of loneliness may be associated with more depressive symptoms. Translation to Health Education Practice Health educators should consider implementing measures to reduce loneliness and increase self-esteem and life satisfaction to reduce depression in students.

A comparison of the effect of two types of brief psychodynamic group therapy on perfectionism-related attitudes, self-relatedness, and self-esteem

Objective: This randomized controlled trial investigated the efficacy of dynamic relational group therapy (DRT) relative to group psychodynamic supportive therapy (PST) in improving perfectionism-related attitudes and components of the perfectionistic self-relationship. Method: Based on a comprehensive conceptualization of perfectionism, 80 community-recruited, highly perfectionistic individuals were randomly allocated to 12 sessions of group DRT (n = 41; 5 groups) or group PST (n = 39; 5 groups). Patients completed measures of dysfunctional attitudes, self-criticism, self-esteem, and self-reassurance at pre-, mid-, and post-treatment, and six months post-treatment. Results: Multigroup latent growth curve modeling revealed significant (p < .05) decreases in dysfunctional attitudes, concern over mistakes, two types of self-criticism, and self-esteem problems, along with a significant increase in self-reassurance, from pre-treatment to six-month follow-up in both DRT and PST. Moderate-to-large between-group differences favoring DRT over PST were found for dysfunctional attitudes and self-reassurance. A majority of patients in both conditions maintained reliable improvement at six-month follow-up in dysfunctional attitudes, concern over mistakes, and self-criticism focused on inadequacy. Conclusion: Findings provide evidence for the use of psychodynamic group therapy approaches in treating perfectionism-related attitudes and self-relational elements of perfectionism, and support the relative efficacy of DRT for dysfunctional attitudes and self-reassurance.

Re-exploring the relationships of humor styles with dark triad and self-esteem using structural equation modelling

Previous relationships between Dark Triad and Humor styles are theoretically difficult to interpret since Dark Triad traits present general and specific sources of variance. In the present study, we used structural equation modelling techniques to allow us to separate the two sources and detect which source of variance of Dark Triad plays the main role in the relationship observed with Humor styles. Similarly, it was tested if relationships among measures of Self-esteem and Humor styles are replicated at structural level. Moreover, the vast majority of previous studies have been conducted with university samples, which represents a limitation. Hence, a series of bi-factor models to test the relationship between Dark Triad and Humor styles and structural models for Self-esteem and Humor styles were fitted on a community sample of 987 Spanish people. Results suggest that the common variance of the Dark Triad traits was mainly responsible for the reported relationships with Humor styles. It is noteworthy that relations reported for Aggressive and Self-defeating humor styles were higher than those observed in previous studies. Similarly, a higher correlation between Self-esteem and Self-defeating was observed at the structural level. Futures studies are suggested to better establish the psychological reasons behind these relationships.

The relationships between name-liking and existing self-esteem measurements

The relationships between name-liking and existing self-esteem measurements

Am I a good person? Academic correlates of explicit and implicit self-esteem during early childhood.

Implicit and explicit self-esteem are not commonly measured in the same children. Using a cross-sectional design, data from 354 Croatian children (184 girls) in Grade 1 (Mage = 7.55 years) and Grade 5 (Mage = 11.58 years) were collected in Spring 2019. All children completed explicit and implicit self-esteem measures; math and language grades were obtained. For the explicit measure, older children showed lower self-esteem than younger children, and girls showed lower self-esteem than boys. For the implicit measure, there were no age effects, and girls showed higher self-esteem than boys. Although both types of self-esteem were positively associated with academic achievement, implicit self-esteem was associated more strongly with language than with math achievement. Discussion is provided about why self-esteem relates to academic achievement during childhood.

Relationship between self-esteem and employment in people with severe mental illness: A systematic review and meta-analysis

BACKGROUND: Results from past research on the association between work outcomes and self-esteem were inconsistent. OBJECTIVE: This study aimed to review and quantify the correlation between employment variables and self-esteem in people with severe mental illness. METHOD: The first electronic database search was performed between November 5 and November 12, 2021. A second search update was completed in September 2023. Studies that reported a correlation between at least one employment-related variable and self-esteem were subsequently verified. Pooled effect sizes were calculated with random-effects models by aggregating Fisher’s Z-to-Pearson r transformed correlations. RESULTS: The database search generated 3,547 reports. Thirteen and seven reports were included in the qualitative review and the meta-analyses, respectively. Meta-analyses results based on data from 1,065 participants suggested a positive albeit small correlation between employment variables and self-esteem in people with severe mental illness (r = 0.26, p = .002 for global self-esteem; r = 0.21, p &lt; 0.001 for total self-esteem). It was found through systematic review that greater confidence in personal capacity, more opportunities on novel activities, and positive affirmation from coworkers were some potential mechanisms underlying self-esteem improvement following work. CONCLUSION: Future research on employment in severe mental illness would benefit from including adapted self-esteem measures and can build on this work by examining the relationships between specific employment variables (e.g., job acquisition, job tenure) and self-esteem.

Positive Orientation and Psychological Distress: An Examination with Psychiatric Outpatients

Introduction: This research was conducted to extend the theoretical construct of positive orientation (PO) to psychiatric outpatients. This research also examined the effect of PO on alleviating stress, anxiety, and depression among psychiatric outpatients. Methods: This cross-sectional survey recruited 301 psychiatric outpatients online. As these respondents have a short attention span, short measures were used to measure PO-related variables (life satisfaction, optimism, self-esteem) and indicators of psychological distress (depression, anxiety, and stress). These outpatients are at the legal age to provide consent for themselves (M = 30.12, SD= 8.11). The majority of them have been identified as male (80.07%). Similarly, the ethnic distribution was unequal, with the majority of these outpatients identified as Malay (85.05%), followed by those who were identified as Chinese (7.31%), Indian (4.32%), and from other ethnic groups (3.32%). Results: Generalized structured component analysis (GSCA) supported that satisfaction with life, optimism, and self-esteem reflect the construct of PO. Furthermore, PO predicted depression, anxiety, and depression negatively. Conclusion: It is possible to replicate the construct of PO with psychiatric outpatients using single item measures for life satisfaction, optimism, and self-esteem. PO is beneficial to psychiatric outpatients as it reduces the severity of depression, anxiety, and stress.

20 Using Automated Sentiment Analysis to Examine Self-Evaluation in Youth with Autism Spectrum Disorder

Objective:Individuals diagnosed with autism spectrum disorder (ASD) experience negative self-evaluation, indicated by low levels of self-esteem and describing themselves more negatively to others. Variations in reading comprehension, difficulty identifying emotions, and masking (camouflaging of autistic traits) make it difficult to accurately measure self-evaluation of individuals with ASD using subjective self-report scales such as the Rosenburg Self-Esteem Scale. Therefore, it is important to explore more objective methods of measuring self-evaluation in ASD. Sentiment analysis is a popular Natural Language Processing (NLP) technique used to quantify the emotional content of language programmatically by automatically transforming text into a data frame of words represented as individual values or tokens. Each token can then be categorized as positive or negative with a sentiment dictionary. The current study aims to investigate an automated sentiment analysis approach to evaluate self-evaluation by quantifying implicit linguistic affective valence of ASD participants' verbal self-describing statements in a naturalistic setting. Specifically, we evaluated the frequency of positive or negative words used during a mock job interview in which individuals with ASD were asked to describe themselves. We then examined the relationship between positive and negative word usage and standard self-report measures of self-evaluation.Participants and Methods:Twenty-four young adults with ASD were included in this study with an age range of 15-24 and a mean age of 19.2 years. Participants completed a battery of assessments including a mock job interview in which they were asked to describe themselves as a measure of implicit self-esteem. Self-esteem and knowledge of personal strengths was assessed using the Rosenberg Self-Esteem Scale and Strengths Knowledge Scale, respectively. Interview transcripts were automatically transformed into word token data frames using the tidytext package in Rstudio. Frequencies of positive and negative words were calculated and their ratio to total word count was used to measure the implicit positivity and negativity of transcripts.Results:There was a significant negative correlation between the frequency of negative sentiment in transcripts and measure on the Rosenburg Self-Esteem Scale (r = -.376, p = .035) and the Strengths Knowledge Scale (r = -.387, p = .031) indicating that individuals with higher self-esteem and knowledge of their strengths used fewer negative words when talking during a mock interview.Conclusions:While our results are preliminary, this pilot study represents the first to use automated sentiment analysis to study self-evaluation in individuals with ASD. The use of this technique on natural linguistic data collected through a mock job interview allows researchers to quantitatively analyze the emotionality of transcriptions and create insights that would otherwise be unavailable using more subjective qualitative techniques. Limited research into self-evaluation in this population has yielded inconsistent results, relying too heavily upon qualitative or self-report measures. The ability to programmatically quantify affective valence in transcripts is a time and cost-effective technique for improving validity of future measures of self-evaluation.

Disentangling affect from self-esteem using subliminal conditioning

Across three experiments, participants underwent conditioning sequences where the self-referential term I AM (Conditioned Stimulus, or CS+) or a scrambled counterpart M IA (CS-) was paired with either neutral (Unconditioned Stimulus, or US-) or positive attributes (US+). CS and US were presented under subliminal and/or visible conditions. A normalized indicator of affective shift and an explicit self-esteem measure were deployed as outcome measures. In Experiment 1 (N = 60), subliminal CS+ followed by visible US+ produced a significant affective shift only. Experiment 2 (N = 59) presented CS and US under subliminal conditions, which did not influence either outcome measure. In Experiment 3 (N = 60), visible CS appeared with visible US, which resulted in a significant effect on explicit self-esteem only. These findings highlight the central roles of CS and/or US visibility towards influencing reported affect and self-esteem. We theorize that configural components of subliminally presented stimuli can become perceptually encoded and influence self-related affect non-consciously.

Effectiveness of an e-Health Quasi-Randomized Controlled Universal Prevention Program for Eating Disorders in Spanish Adolescents

Eating disorders (EDs) and sub-threshold conditions are prevalent in the adolescent population. Unfortunately, most preventive interventions have been targeted at emerging adults and the effectiveness of online prevention programs has yet to be determined in adolescents. This study sought to examine the short-term effectiveness of a universal e-Health psychoeducational prevention program for EDs compared to a control (non-intervention) group in Spanish adolescents. Using a quasi-randomized trial design, a total of 161 [% girls: 45.96; Mage(SD) = 12.43 (0.43)] adolescents from 5 participating schools were allocated to two intervention arms: (1) psychoeducational intervention (n = 79) and (2) wait-list control (n = 82). The intervention was delivered over 3 months through 3 modules that were accessible 24/7 and 3 school sessions guided by the students´ tutors focusing on nutrition, promoting a healthy lifestyle, mitigating body concerns, and social pressures. Participants completed an online assessment battery including the Eating Attitudes Test (EAT-26) and measures of self-esteem, family disruption, compliance with the Mediterranean diet, and lifestyle. Correlational analysis showed small to moderate relationships between self-esteem and family function (rho = 0.413, p = 0.001), BMI (body mass index) and the EAT-26 dieting subscale (rho = 0.417, p = 0.001), physical activity and the bulimia subscale (rho = − 0.237, p = 0.003), and self-esteem and the dieting subscale (rho = − 0.223, p = 0.004). At the post-intervention assessment, the intervention group showed a statistically significant reduction in ED risk (EAT-26) (d = − 0.323, p = 0.040) and the oral control subscale (d = 0.327, p = 0.038). The e-health intervention including tutor-led digital components was effective for reducing ED risk in children. Results must be interpreted with caution due to the low statistical power and the limited sample size. Large scale randomized controlled trials with longer follow-ups will be needed to bolster the evidence.

The bidirectional associations between self-esteem and problematic eating behaviors in adolescents.

Theories propose that low self-esteem and problematic eating behaviors (PEBs) negatively impact each other. While previous studies suggested bidirectional associations between self-esteem and PEBs, they did not separate within-person from between-person associations. Therefore, this prospective study investigated the within-person bidirectional associations between self-esteem and four PEBs in adolescence, while accounting for between-person differences. We used two independent longitudinal samples of Dutch adolescents, each including three annually collected waves of data. Sample 1 consisted of 1856 adolescents (Baseline: 50.4% males; Mage = 13.79 years, SDage = 0.72), with measures of self-esteem, emotional eating, restrained eating, and loss of control (LOC) while overeating. Sample 2 consisted of 555 adolescents (Baseline: 49.7% males; Mage = 13.13 years, SDage = 0.68), with measures of self-esteem and LOC eating. The data were analyzed using random intercept cross-lagged panel models (CLPMs). Within persons, lower self-esteem was associated with higher emotional and restrained eating (both Sample 1) one year later, and vice versa. Self-esteem did not predict, nor was predicted by, LOC while overeating (Sample 1) or LOC eating (Sample 2). Between persons, self-esteem was negatively correlated with all PEBs (Samples 1 and 2). We found within-person bidirectional associations between low self-esteem and emotional and restrained eating (but not LOC while overeating/LOC eating), and between-person correlations between low self-esteem and all PEBs. These results have theoretical and practical implications. Within-person processes clarify underlying mechanisms that explain the occurrence of PEBs; between-person associations are important to identify adolescents at risk of PEBs. While theories indicate that low self-esteem and PEBs are inversely associated within individuals, empirical studies have not disentangled within-person processes from between-person differences. This study addressed this disparity, finding that lower self-esteem was bidirectionally associated with higher emotional and restrained eating (but not LOC eating) within persons. These findings suggest that enhancing self-esteem is a viable option for prevention and intervention.

Self-esteem buffers the stress sensitizing effect of childhood maltreatment on adolescent nonsuicidal self-injury

BackgroundAdversity in childhood increases the risk of psychopathology, perhaps by influencing sensitivity to recent stressful life events (SLEs). However, little is known about the stress-sensitizing effect of childhood adversity on nonsuicidal self-injury (NSSI), whether stress sensitization exists in specific types of SLEs, and the stress-buffering effect of self-esteem. This study aimed to investigate whether exposure to child maltreatment increases adolescent's vulnerability to the effects of dependent and independent SLEs on later NSSI and whether self-esteem buffers this risk. MethodsWe conducted a two-wave study with 18-month intervals. 601 Chinese adolescents completed self-report measures of child maltreatment, SLEs, self-esteem, and NSSI. ResultsResults supported the stress sensitization hypothesis for child maltreatment regarding dependent SLEs, with dependent SLEs significantly predicting later NSSI only in maltreated adolescents. Moreover, self-esteem buffered the relationship between dependent SLEs and NSSI in maltreated adolescents but amplified the relationship in non-maltreated adolescents. In the maltreated group, dependent SLEs predicted increased NSSI only in those with low self-esteem. In contrast, in the control group, dependent SLEs were significantly associated with NSSI in individuals with high self-esteem. LimitationsWe did not collect information on the timing of exposure to child maltreatment. Future studies that assess child maltreatment during critical periods of development may be able to identify sensitive period in which maltreatment sensitizes individuals to stress in adolescents. ConclusionFindings provide preliminary evidence that child maltreatment has a stress-sensitizing effect on adolescent NSSI. Improving self-esteem may mitigate the associations between SLEs and NSSI in adolescents exposed to child maltreatment.

Validation of the Chinese version of the Rosenberg Self-Esteem Scale: evidence from a three-wave longitudinal study

BackgroundThe 10-item Rosenberg Self-Esteem Scale (RSES) is a widely used tool for individuals to self-report their self-esteem; however, the factorial structures of translated versions of the RSES vary across different languages. This study aimed to validate the Chinese version of the RSES in the Chinese mainland using a longitudinal design.MethodsA group of healthcare university students completed the RSES across three waves: baseline, 1-week follow-up, and 15-week follow-up. A total of 481 valid responses were collected through the three-wave data collection process. Exploratory factor analysis (EFA) was performed on the baseline data to explore the potential factorial structure, while confirmatory factor analysis (CFA) was performed on the follow-up data to determine the best-fit model. Additionally, the cross-sectional and longitudinal measurement invariances were tested to assess the measurement properties of the RSES for different groups, such as gender and age, as well as across different time points. Convergent validity was assessed against the Self-Rated Health Questionnaire (SRHQ) using Spearman’s correlation. Internal consistency was examined using Cronbach’s alpha and McDonald’s omega coefficients, while test–retest reliability was assessed using intraclass correlation coefficient.ResultsThe results of EFA revealed that Items 5, 8, and 9 had inadequate or cross-factor loadings, leading to their removal from further analysis. Analysis of the remaining seven items using EFA suggested a two-factor solution. A comparison of several potential models for the 10-item and 7-item RSES using CFA showed a preference for the 7-item form (RSES-7) with two factors. Furthermore, the RSES-7 exhibited strict invariance across different groups and time points, indicating its stability and consistency. The RSES-7 also demonstrated adequate convergent validity, internal consistency, and test–retest reliability, which further supported its robustness as a measure of self-esteem.ConclusionsThe findings suggest that the RSES-7 is a psychometrically sound and brief self-report scale for measuring self-esteem in the Chinese context. More studies are warranted to further verify its usability.

Paternalistic Involvement in Career Choice Aspiration and its Impact on Self-Esteem

The major purpose of the study was to determine the paternalistic involvement of parents in students’ self-esteem and career aspirations. The quantitative research method was used to examine the paternalistic involvement of parents in self-esteem and career choice. The Social Context Questionnaire (Skinner, Regan, &amp; Wellborn, 1986) was adopted as a measure of paternalistic involvement, whereas the Rosenburg (1965) self-esteem scale was adopted as a measure of self-esteem. Using a convenient sampling technique, responses were obtained from 379 students (male and female) studying at the University of Sargodha. It was found that paternalistic involvement and self-esteem were strongly negatively correlated. Moreover, paternalistic involvement and career choice had a strong negative correlation. The study demonstrated that girls face more paternalistic involvement from their parents, which leads to lower self-esteem among them as compared to boys. Moreover, paternalistic involvement creates dependency and weakens decision-making power among female children. Keeping in view the aforesaid findings, parents should adopt alternative ways to accomplish their own desires and understandings without restricting the liberty of adult children, even though it may involve inconvenience, expense, and apparently irrational acts. In addition, parents should respect their ideas so that children can abstain from deviant behaviour.

Daily aggression domains differentially relate to daily affect and self-esteem.

How do daily fluctuations in aggression relate to daily variability in affect and self-esteem? Although research has examined how trait aggression relates to affect and self-esteem, state aggression has received little attention. To this end, we had 120 US undergraduates participate in a 14-day daily diary study where they responded to state-level measures of aggression, affect, and self-esteem. Crucially, we used multifaceted state measures of both aggression (anger, hostility, verbal aggression, physical aggression) and affect (positive vs. negative, activated vs. deactivated). Multilevel models revealed that daily anger and hostility related positively to daily negative affect and negatively to daily positive affect. Similarly, daily anger and hostility related negatively to daily self-esteem. In contrast, daily verbal and physical aggression were largely unrelated to daily affect and self-esteem; however, unexpectedly, daily physical aggression related positively to daily positive activated affect, but only when controlling for the other daily aggression domains. Overall, daily attitudinal aggression measures-anger and hostility-related to daily affect and self-esteem in theoretically consistent ways, whereas daily behavioral aggression measures-verbal and physical aggression-did not. Our findings support expanding the General Aggression Model to incorporate state-level processes.

Family functioning, well-being, and mental health among new immigrant families.

The present study was conducted to identify latent profiles of adolescent-reported and parent-reported family functioning, as well as their links with adolescent and parent well-being and mental health, among recent immigrants from the Former Soviet Union to Israel. A sample of 160 parent-adolescent dyads completed measures of parent-adolescent communication, parental involvement, positive parenting, family conflict, self-esteem, optimism, depressive symptoms, and anxiety. Results indicated four latent profiles-Low Family Functioning, Moderate Family Functioning, High Family Functioning, and High Parent/Low Adolescent Family Functioning (i.e., discrepant reports of family functioning). Adolescent depressive symptoms and anxiety were highest in the discrepant profile and lowest in the High Family Function profile; adolescent self-esteem and optimism were highest in the High Family Function profile and lowest in the Low Family Function profile; and parent depressive symptoms and anxiety were highest in the Low Family Function profile and lowest in the High Family Function profile. Parent self-esteem and optimism did not differ significantly across profiles. These results are discussed in terms of cultural and developmental contexts of adolescence and parenting within immigrant families, in terms of family systems theory, and in terms of the need for clinical services among families with discrepant reports of family functioning between parents and adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Implementing the framed portrait experience with Italian breast cancer survivors: a pilot study assessing short term effects of an existential approach to body image, coping skills, and self-efficacy

PurposeBreast cancer (BC) and its treatments significantly impact the psychological wellbeing of women. Interventions offered during cancer survivorship have documented positive consequences for quality of life. However, limited evidence is available regarding the implementation of therapeutic photography. This study investigated the efficacy of the framed portrait experience (FPE) when implemented to BC survivors.MethodsA quasi-experimental study was conducted. Participants were enrolled in a non-randomized pre-post intervention with a comparison group. Forty BC survivors were recruited using a convenience sampling approach; of these, 20 were subsequently allocated to the intervention (FPE group) and 20 to the comparison group. Participants were assessed at pretest and posttest (3 weeks later) using self-reported measures of body image, coping, self-esteem, and self-efficacy. Independent samples t-tests compared group composition at pretest. Mixed between-within 2 × 2 repeated-measures ANOVAs examined pretest–posttest changes in the variables of interest.ResultsNo differences were detected between groups at pretest. A significant interaction effect on body image, problem-focused coping, emotion-focused coping, and in self-efficacy competence subscale (p < 0.05) was identified. Post hoc pairwise comparisons with the Bonferroni correction indicated improvement on these domains in the FPE group vs. comparison group. Additionally, significant main effects of time on self-efficacy total score and magnitude subscale (p < 0.05) were found.ConclusionsPreliminary results support the efficacy of FPE, but further research is needed.Implications for Cancer SurvivorsExistential approaches inclusive of self-portraits and illness narratives can be utilized to support BC survivors in the management of the psychological consequences of the illness.

Factors associated with reintegration trajectory following female genital fistula surgery in Uganda

A female genital fistula, primarily caused by prolonged obstructed labor or after cesarean delivery in resource-limited countries, affects 500,000 to 2,000,000 women worldwide. Fistula is preventable with timely access to high-quality obstetrical care. Access to surgical repair of a female genital fistula has greatly increased over time. However, research surrounding postrepair reintegration, the process of returning to an individual's normal life, remains limited, and further efforts are needed to understand the factors shaping women's ability to rebuild their relationships and lives following repair. This study aimed to characterize the 12-month reintegration trajectory after female genital fistula repair by participant sociodemographic and clinical characteristics. This study analyzed quantitative survey and medical record data of women (N=60) participating in a longitudinal cohort study assessing recovery after genital fistula repair in Uganda, with baseline and 4 quarterly follow-up assessments in 12 months. The primary outcome of reintegration was assessed using a 19-item postfistula repair reintegration instrument (range, 0-100) where a higher score represents better reintegration. Predictors of interest included parity and living children, quality of life, depressive symptoms at baseline, self-esteem, stigma, trauma, physical symptoms, and social support. We described participant baseline characteristics using means and proportions and estimated a series of mixed-effects linear regression models, including interactions of characteristics with time to understand how these characteristics influence reintegration trajectory in the 12 months after repair. The participants' physical and psychosocial morbidities at baseline were high; more than 80% of participants reported fistula-related physical symptoms, 82% of participants described their general health as poor, and measures of self-esteem, overall social support, and overall quality of life were low. The mean reintegration score at baseline was 33 (standard deviation, 20), which increased to 78 (standard deviation, 19) at 12 months after fistula repair. The participant sociodemographic characteristics statistically associated with reintegration included any living children (β, 1.08; 95% confidence interval, -0.08 to 2.23). Moreover, psychosocial factors significantly affected reintegration with steeper trajectories for women with depressive symptoms (β, 0.89; 95% confidence interval, 0.02-1.75) or women experiencing internalized stigma (β, 0.05; 95% confidence interval, -0.00 to 0.11) and less steep for those with higher self-esteem (β, -0.11; 95% confidence interval, -0.24 to 0.01), overall social support (β, -0.06; 95% confidence interval, -0.12 to -0.01), and partner support (β, -0.21; 95% confidence interval, -0.35 to -0.07). Understanding the prominent factors associated with differences in reintegration trajectories across the year after genital fistula surgery has the potential to inform interventions that mitigate challenges and improve women's postrepair recovery experiences.

Assessing Attitudes Toward Trans and Gender Diverse People: Adapting the ‘Transgender Attitudes and Beliefs’ Scale

ABSTRACT This study aimed to update the gender-based terminology of a measure used to assess attitudes toward trans and gender diverse people (the Transgender Attitudes and Beliefs Scale; TABS) in order to reflect appropriate and inclusive language standards and conventions while maintaining the psychometric integrity of the tool. The updated TABS was administered to 247 heterosexual, cisgender adults in the UK. Participants also completed the original TABS as well as measure of self-esteem and social desirability to test construct validity. We demonstrate that after updating the language of the TABS to reflect best-practice, the psychometric properties of the TABS were unaffected.