Squared Error Of Approximation Research Articles

Adaptation and validation of the children’s cognitive triad inventory for Indonesian students

Depression causes student learning problems. Depressive symptoms are influenced by automatic thoughts that contain a negative cognitive triad. A valid and reliable instrument to measure the cognitive triad in adolescents is essential to identify one of the risk factors for depressive disorders in adolescents. At the same time, Indonesia has no instrument to measure this. This study aims to adapt the children’s cognitive triad inventory (CTI-C) into an Indonesian version and to examine its psychometric properties. Data were collected from 1,184 students aged 13-19 (mean=15.32, SD=1.62) using the 36-item CTI-C. The CTI-C instrument adaptation process refers to the international test commission (ITC). The results of confirmatory factor analysis (CFA) showed comparative fit index (CFI)=0.95, Tucker-Lewis’s index (TLI)=0.94, root mean square error of approximation (RMSEA)=0.071, standardized root mean square residual (SRMR)=0.056, and goodness of fit index (GFI)=0.82, with a load factor range of 0.43-0.80 for the view of self, 0.43-0.68 for the view of the world, and 0.37-0.70 for the view of the future. The Cronbach’s alpha coefficient ranged from 0.81 to 0.84 for the subscales and 0.93 for the total score. Thus, the Indonesian version of the CTI-C can measure the cognitive triad in Indonesian students aged 13-19.

Early maladaptive schemas, distress tolerance and self-injury in Iranian adolescents: serial mediation model of transdiagnostic factors.

Non-suicidal self-injury (NSSI) is prevalent behaviour among adolescents. Although there are different etiological models of NSSI, there is a general lack of evidence-based, comprehensive and transdiagnostic models of NSSI in adolescents. The aim of this study was to investigate a model of transdiagnostic factors of NSSI in adolescents, testing a serial mediation model of the relationship between early maladaptive schemas (EMS), distress tolerance and NSSI through experiential avoidance and rumination. A community sample was identified of 1014 adolescents aged 13-17, of whom 425 had a history of NSSI. A serial mediation path analytic method was utilised to examine the relationships between NSSI and its associated functions as criterion variables, EMS and distress tolerance as predictors, experiential avoidance as the first mediator and rumination as the second mediator. The path analytic model fit indices were good (X2/d.f. = 2.25, goodness of fit index = 0.98, normed fit index = 0.97, comparative fit index = 0.98, root mean square error of approximation = 0.054, standardised root mean squared residual = 0.028). Rumination significantly mediated the relationship between schemas of 'vulnerability to harm', 'emotional deprivation', 'social isolation', 'insufficient self-control', and NSSI frequency and intrapersonal functions. In serial fashion, experiential avoidance mediated the role of rumination in the relationship between social isolation, and insufficient self-control and NSSI frequency and intrapersonal functions. All indirect effects were significant. Key indirect effects were found linking maladaptive schemas and distress tolerance to NSSI frequency, and NSSI intrapersonal functions via experiential avoidance and rumination. Thus, it is important to address these transdiagnostic factors with particular emphasis on the sequential mediating role of experiential avoidance and rumination in conceptualisation and therapeutic interventions for NSSI.

Resilience as a Modulating Factor of Empathy in Medical Students

Introduction: Empathy is a complex and multidimensional attribute. Attempts have been made to explain empathic behavior based on other variables. Empirical evidence shows that empathy could be the product of the influence of several factors. One of these factors could be resilience. There is still no developed theory and consistent empirical evidence demonstrating that empathy depends on resilience. Objective: The aim of this study is to determine if resilience can predict empathic behavior. Methodology: This study is non-experimental and ex post facto with a cross-sectional design. Variables. Dependent: Empathy; Independent: Resilience. Population: Medical students belonging to the Faculty of Health Sciences of the Universidad Autónoma de Santa Ana (UNASA), Santa Ana, El Salvador (N=579). The sample (n=465) consisted of students (both sexes). Convenience sampling. Jefferson Scale of Empathy for Healthcare Professionals, student version (JSE-HPS). Trait Resilience Scale (EEA). A Structural Equation Modelling (SEM) model was used. Additionally, the Comparative Fit Index (CFI) (>0.95), Tucker-Lewis Index (TLI) (>0.95), Root Mean Square Error of Approximation (RMSEA) (<0.08), and Standardized Root Mean Square (SRMR) (<0.08), Confirmatory Factor Analysis (CFA) were employed. The significance level employed was ? < 0.05. Results: All these results show that both measurement models (empathy and resilience) are adequately represented and are suitable for the structural model. Discussion: Individual resilience is a variable that can predict empathic behavior in medical students belonging to a Faculty of Health Sciences. The results constitute indirect empirical evidence that it is possible to define empathy as a dependent variable and resilience as an independent variable.

Confirmatory factor analysis of the Tinnitus Impact Questionnaire using data from patients seeking help for tinnitus alone or tinnitus combined with hyperacusis.

A confirmatory factor analysis (CFA) of the Tinnitus Impact Questionnaire (TIQ) was performed. In contrast to commonly used tinnitus questionnaires, the TIQ is intended solely to assess the impact of tinnitus by not including items related to hearing loss or tinnitus loudness. This was a psychometric study based on a retrospective cross-sectional analysis of clinical data. Data were available for 155 new patients who had attended a tinnitus and hyperacusis clinic in the UK within a five-month period and had completed the TIQ. The mean age was 54 years (standard deviation = 14 years). The TIQ demonstrated good internal consistency, with Cronbach's α = 0.84 and McDonald's ω = 0.89. CFA showed that two items of the TIQ had low factor loadings for both one-factor and two-factor models and their scores showed low correlations with scores for other items. Bi-factor analysis gave a better fit, indicated by a relative chi-square (χ2) of 18.5, a Root-Mean Square Error of Approximation (RMSEA) of 0.103, a Comparative Fit Index (CFI) of 0.97, a Tucker Lewis Index (TLI) of 0.92, and a Standardized Root-Mean Residual (SPMR) of 0.038. Total TIQ scores were moderately correlated with scores for the Visual Analogue Scale of effect of tinnitus on life and the Screening for Anxiety and Depression-Tinnitus questionnaire, supporting the convergent validity of the TIQ. The TIQ score was not correlated with the pure-tone average hearing threshold, indicating discriminant validity. A multiple-causes multiple-indicator (MIMIC) model showed no influences of age, gender or hearing status on TIQ item scores. The TIQ is an internally consistent tool. CFA suggests a bi-factor model with sufficient unidimensionality to support the use of the overall TIQ score for assessing the impact of tinnitus. TIQ scores are distinct from the impact of hearing impairment among patients who have tinnitus combined with hearing loss.

Development and initial testing of a brief, generic self-reported disability questionnaire: The Universal Disability Index.

Disability is an important multifaceted construct. A brief, generic self-reported disability questionnaire that promises a broader and more comparable measure of disability than disease-specific instruments does not currently exist. The aim of this study was to develop and evaluate such a questionnaire: the Universal Disability Index (UDI). An online survey was used to collect general population data. Data were randomly divided into training and validation subsets. The dimensionality and structure of eight UDI questionnaire items were evaluated using exploratory factor analysis (EFA, training subset) followed by confirmatory factor analysis (CFA, validation subset). To assess concurrent validity, the UDI summed score from the full dataset was compared to the Groningen Activity Restriction Scale (GARS) and the Graded Chronic Pain Scale (GCPS) disability scores. Internal consistency and discriminant validity were also assessed. Bootstrapping was used to evaluate model stability and generalisability. 403 participants enrolled; 364 completed at least one UDI item. Three single-factor versions of the UDI were assessed (8-item, 7-item, and 6-item). All versions performed well during EFA and CFA (182 cases assigned to each), but none met the RMSEA (Root Mean Square Error of Approximation) criterion (≤ 0.08). All versions of the UDI had high internal consistency (Cronbach's α > 0.90), were strongly correlated (Pearson's r > 0.7) with both GARS and GCPS disability scores, indicating concurrent validity, and could accurately discriminate between upper and lower quartiles of these comparators. Confidence intervals of estimates were narrow, suggesting model stability and generalisability. A brief, generic self-reported disability questionnaire was found to be valid and to possess good psychometric properties. The UDI has a single factor structure and either a 6-item, 7-item or 8-item version can be used to measure disability. For brevity and parsimony, the 6-item UDI is recommended, but further testing of all versions is warranted.

The Chinese version of the general benefit finding scale (GBFS): Psychometric properties in a sample of college students.

Benefit finding has become a central construct in the evolution of positive psychology and attracted attention in recent literature. This study aimed to translate and validate the General Benefit Finding Scale (GBFS) in Chinese college students. Forward- and back-translation of the GBFS was followed by the assessment of semantic equivalence and content validity. A sample of 589 college students was recruited in China to conduct reliability and validity analysis. The construct validity was assessed using exploratory (EFA) and confirmatory factor analysis (CFA). Concurrent validity was assessed using Pearson's correlation coefficients of the GBFS with the Perceived Stress Scale (PSS) and World Health Organization-Five Well-Being (WHO-5). Internal consistency and two-week test-retest reliability were also evaluated. The content validity index for each item ranged from 0.83 to 1.00. EFA revealed a six-factor model, which exhibited acceptable goodness of fit in CFA (standardized root mean square residual = 0.031, root mean square error of approximation = 0.059, goodness-of-fit index = 0.860, comparative fit index = 0.904, Tucker-Lewis index = 0.890, chi-squared/degree of freedom = 2.07). The concurrent validity of the GBFS was supported by its statistically significant correlations with PSS (r = -0.271, p<0.001) and WHO-5 (r = 0.354, p<0.001). Moreover, the internal consistency for the overall scale was satisfactory, with Cronbach's α coefficient of 0.93 and McDonald's omega reliability of 0.94. The test-retest reliability was 0.82. Although the Chinese version of GBFS was examined in a homogeneous convenience sample of college students, it provides a reliable and valid instrument for assessing benefit finding in the Chinese context.

Posttraumatic stress disorder symptomology as measured by PCL-5 and its relationships to resilience, hostility and stress among paramedics and social professionals.

This survey study aimed to contribute to the extensive debate on the dimensionality of the Posttraumatic Stress Disorder Checklist for the DSM-5 (PCL-5) questionnaire by examining the psychometric properties and construct validity of its Hungarian version and relying on the inspection of a conceptual network of related variables, that is, perceived stress, hostility, and resilience. Confirmatory factor analysis (CFA), exploratory structural equation modelling (ESEM) and path analysis were applied on data collected from 177 paramedics and 66 professionals from the social field (58.4% male; Mage=43.5±9.96years). Despite the acceptable fit indices gained with CFA when testing the original four-factor DSM-5 model of PCL-5, strong associations (r=0.69-0.90) between subscales were found. Thus, ESEM was applied and as a result a new, three-factor version of the DSM-5 model of PCL-5 was proposed due to significant crossloadings that was theoretically also supported. The Reexperiencing and Avoidance subscales were merged and named Difficulty with Assimilation of Experience (DAE). In the path analysis only two of the tested associations were not significant using the new factor structure, in which stress fully mediated the relationship between resilience and DAE, and resilience and Hyperarousal. Overall, the hypothesised pathways between variables fit the collected data well. (weighted least squares mean-and variance-adjusted χ2=503.750 (df=270), comparative fit index=0.948, Tucker-Lewis index=0.939, root mean square error of approximation (90% confidence interval)=0.064 (0.055-0.073), weighted root mean square residual=1.024). Our analysis of the Hungarian version of PCL-5 contributes to the testing of a DSM-5-based questionnaire measuring posttraumatic stress disorder symptomology.

Translation, cultural adaptation and validation of the Swahili Pain Catastrophizing Scale among refugees who survived torture and/or war trauma in Kenya: An observational study.

Accurate assessment of any patient relies on the use of appropriate measurements which are culturally- and linguistically-applicable and valid. The following study aimed to translate, cross-culturally adapt and test the nomological validity, structural validity, internal consistency, test-retest reliability, sensitivity-to-change and feasibility of the Swahili version of the Pain Catastrophizing Scale (Swa-PCS) among refugees who survived torture/war trauma living with chronic pain in Kenya. An observational study was conducted. Translation and cultural adaptation of the original PCS for the Swahili-speaking refugee population in Kenya, who survived torture or war trauma was undertaken. Following this process, a validation study was conducted on the newly-adapted instrument, to ascertain the psychometric properties (nomological validity, structural validity, internal consistency, test-retest reliability, sensitivity-to change, and ceiling and floor effects). Fifty participants were included in this study. Correlations between pain catastrophization and fear-avoidance behavior measures were significant (r = 0.538, p < 0.01). Ceiling effects were 42-48% with no floor effects. Standard errors of measurement values were between 0.938 and 3.38. Minimal-detectable-change values were between 2.17 and 7.82. Internal consistency was satisfactory to good, for the whole and subsections respectively (range α = 0.693-0.845). Magnification had the lowest α. Test-retest reliability was also satisfactory to good (range ICC = 0.672-0.878). Confirmatory factor analysis confirmed that the Swa-PCS had three factors which explained the majority of the variance. Root mean square error of approximation and comparative fit index were calculated for goodness-of-fit assessment, and were 0.18 and 0.83, respectively. This study showed that the adapted Swa-PCS displayed overall satisfactory to good internal consistency, test-retest reliability and sensitivity-to-change. Furthermore, the Swa-PCS scores were related to fear-avoidance behavior scores as expected (nomological validity). Structural validation of the Swa-PCS requires further investigation. Further testing of the psychometric properties of the Swa-PCS is however warranted.

Attachment and negative affect on mental health and pain experience patients with Multiple Sclerosis: mediated by coping strategies and loneliness

BackgroundMultiple sclerosis and its related stressors significantly affect the mental health of people with MS. Considering the progressive and relapsing-remitting nature of the disease and somatic complaint, the Pain experience for MS patients is challenging. We examined the direct effects of Attachment and the negative affect on mental health and pain experience and the indirect effects of Attachment, negative affect, loneliness, and coping strategies on the mental health and pain experience of people with multiple sclerosis. MethodsThree hundred forty-five patients with MS were selected through the Iranian MS Association. Measures included the negative affect (PANAS), Adult Attachment Inventory (AAI), General Health Questionnaire (GHQ28), short-form McGill pain questionnaire (SF-mpq-2), Social and emotional loneliness scale for adults (SELSA-S), Coping Inventory for Stressful Situations(CISS-21). The present study has employed the Structural Equation Model (SEM) to investigate the direct and indirect effects of coping strategies, attachment, loneliness, and negative affect on mental health and pain experienced by individuals with MS. The fit of the model to the data was examined using the Discrepancy Function Divided by Degrees of Freedom (CMIN/DF), Normed Fit Index (NFI), TuckerLewis Index (TLI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA). ResultsThe fit indices results showed that the model's fit was good. Furthermore, findings indicate that 13% (R2=13) of the pain experience Changes and 47% (R2=47) of the mental health Changes are explained via study predictors. Negative affect directly affects mental health and pain experience, and Attachment directly affects mental health. Negative affect indirectly affects coping strategies. Attachment and Negative affect indirectly affect loneliness. Loneliness and coping strategies indirectly affect mental health and pain experience. ConclusionStudy findings contribute to our understanding of the crucial structures that play a role in the mental health and pain experience of individuals with MS. Loneliness and coping strategies as mediating variables play essential roles in these people's mental health and pain experience. In the times ahead, it would be beneficial to prioritize addressing negative affect, attachment, coping strategies, and loneliness in the patients with MS' medical and psychological intervention.

TRADITIONAL AND COMPLEMENTARY MEDICINE BELIEFS INVENTORY IN ADULTS: A METHODOLOGICAL STUDY

Aims: This study was conducted to establish the Turkish validity and reliability of the Complementary and Alternative Medicine Beliefs Inventory (CAMBI) used to measure adults' beliefs about complementary and alternative medicine practices. Methods: The study was designed as a methodological study. The population of the study consisted of individuals receiving services from a family health center in Ankara. The sample consisted of 354 individuals who agreed to participate in the study and met the inclusion criteria. Descriptive statistics (number, percentage, mean, standard deviation, minimum, and maximum) of the data obtained in the study were calculated. Exploratory Factor Analysis and Confirmatory Factor Analysis were conducted to test validity. The reliability of the scale was assessed through item-total correlation, item analysis, Cronbach α, and test-retest correlation. Results: The results of the Exploratory Factor Analysis revealed that there is only one factor with an eigenvalue above 1, explaining 73.11% of the total variance. Additionally, fit indices obtained from the results of the Confirmatory Factor Analysis yielded a χ2/df fit index of 3.214, a Root Mean Square Error of Approximation (RMSEA) of 0.079, a Comparative Fit Index (CFI) of 0.901, and an Adjusted Goodness-of-Fit Index (AGFI) of 0.854. The Cronbach’s α value of the scale in our study was 0.97. Conclusion: The adapted Turkish version of the 16-item scale has been determined to be a measurement tool that adheres to validity and reliability criteria. It serves as an assessment instrument usable by healthcare professionals to evaluate adult individuals' beliefs regarding complementary and alternative medicine (CAM) methods.

Validation of the Learner Engagement Instrument for Continuing Professional Development.

Learner engagement is the energy learners exert to remain focused and motivated to learn. The Learner Engagement Instrument (LEI) was developed to measure learner engagement in a short continuing professional development (CPD) activity. The authors validated LEI scores using validity evidence of internal structure and relationships with other variables. Participants attended 1 of 4 CPD courses (1 in-person, 2 online livestreamed, and 1 either in-person or online) in 2018, 2020, 2021, and 2022. Confirmatory factor analysis was used to examine model fit for several alternative structural models, separately for each course. The authors also conducted a generalizability study to estimate score reliability. Associations were evaluated between LEI scores and Continuing Medical Education Teaching Effectiveness (CMETE) scores and participant demographics. All statistical methods accounted for repeated measures by participants. 415 unique participants attended 203 different CPD presentations and completed the LEI 11,567 times. The originally hypothesized 4-domain model of learner engagement (domains: emotional, behavioral, cognitive in-class, cognitive out-of-class) demonstrated best model fit in all 4 courses, with Comparative Fit Index ≥0.99, Standardized Root Mean Square Residual ≤0.031, and Root Mean Square Error of Approximation ≤0.047. The reliability for overall scores and domain scores were all acceptable (50-rater G-coefficient ≥ 0.74) except for the cognitive-in-class domain (50-rater G-coefficient 0.55 to 0.66). All findings were similar for both in-person and online delivery modalities. Correlation of LEI scores with teaching effectiveness was confirmed (rho 0.58), and a small correlation was found with participant age (rho 0.19); other associations were small and not statistically significant. Using these findings, we generated a shortened 4-item instrument, the LEI Short Form. This study confirms a 4-domain model of learner engagement, and provides validity evidence that supports using LEI scores to measure learner engagement in both in-person and livestreamed CPD activities.

Psychometric properties of the Thai Qualifications Framework for Higher Education instrument among Royal Thai Air Force nurse stakeholders.

The Thai Qualifications Framework for Higher Education (TQF: HEd) serves as a framework to enhance the quality of higher education in Thailand. However, no valid and reliable TQF: HEd instrument is available to measure the quality of graduates among Royal Thai Air Force Nurses. This study aimed to assess the psychometric properties of the TQF: HEd instrument among graduate nurses of the Royal Thai Air Force. Psychometric testing of the instrument was conducted. The instrument's validity was evaluated through a review by a panel of five experts, providing a content validity index (CVI). Construct validity was assessed using Confirmatory Factor Analysis (CFA) with a sample size of 308, and Cronbach's α coefficient was utilized to measure the scale's internal consistency. The Scale-Content Validity Index (S-CVI) was 0.88. CFA yielded the following fit indices: χ2 = 265.861, p = 0.068, df = 233, χ2/df ratio = 1.141, Comparative fit index (CFI) = 0.996, Tucker Lewis Index (TLI) = 0.993, Root Mean Square Error of Approximation (RMSEA) = 0.021, and Standardized Root Mean Square Residual (SRMR) = 0.033. The scale reliability was acceptable, with a Cronbach's alpha coefficient of 0.93 and 0.85-0.92 for the six factors. The TQF: HEd instrument demonstrates satisfactory psychometric properties, which will be valuable for those in charge of the curriculum in utilizing the instrument to measure graduate competency and guide curriculum development.

Validity of the Korean Version of the Brief Irritability Test in Psychiatric Patients.

This study aimed to investigate the validity and reliability of the Korean version of the Brief Irritability Test (BITe) and adapt it for Korean patients with psychiatric disorders. A total of 296 patients at the Department of Psychiatry of Hanyang University Guri Hospital completed the BITe, Korean Beck Depression Inventory-II, Korean Beck Anxiety Inventory, the Korean version of the State-Trait Anger Expression Inventory, and Barratt Impulsiveness Scale-11. Construct validity was confirmed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Reliability testing included assessments of internal consistency (Cronbach's α) and item-total correlations. Convergent validity was examined through correlational analyses with variables such as anxiety, depression, anger, and impulsivity. First, the scale had good internal consistency with a Cronbach's α of 0.88. Second, EFA indicated a single dimensionality of the BITe, and CFA demonstrated a reasonable fit for the single-factor model (comparative fit index=0.97, Tucker-Lewis Index=0.95, normed fit index=0.97, goodness-of-fit index=0.96, root mean square error of approximation=0.12, standardized root mean residual=0.03). Finally, the convergent validity analysis revealed a significant positive correlation with depression, anxiety, and anger, except for anger control, which is a sub-variable of anger. The results showed that the Korean version of the BITe had good psychometric properties, and might serve as a valuable tool for assessing irritability in Korean patients with psychiatric disorders.

Assessing Electronic Health Literacy in Individuals With the Post-COVID-19 Condition Using the German Revised eHealth Literacy Scale: Validation Study.

The eHealth Literacy Scale (eHEALS) is a widely used instrument for measuring eHealth literacy (eHL). However, little is known so far about whether the instrument is valid for the assessment of eHL in persons who are affected by the post-COVID-19 condition. This is particularly important as people with the post-COVID-19 condition are frequently affected by false information from the internet. The objective of our study was to evaluate the validity and reliability of the German Revised eHealth Literacy Scale (GR-eHEALS) in individuals with the post-COVID-19 condition. A cross-sectional study was conducted from January to May 2022. The self-assessment survey consisted of the GR-eHEALS, health status- and internet use-related variables, sociodemographic data, and (post)-COVID-19-related medical data. Confirmatory factor analysis (CFA), correlational analyses, and tests of measurement invariance were deployed. In total, 330 participants were included in the statistical analyses. CFA revealed that the 2-factor model reached an excellent model fit (comparative fit index=1.00, Tucker-Lewis index=0.99, root mean square error of approximation=0.036, standardized root mean square residual=0.038). Convergent validity was confirmed by significant positive correlations between eHL and knowledge of internet-based health promotion programs, experience in using these programs, and the duration of private internet use. In addition, a significantly negative relationship of eHL with internet anxiety supported convergent validity. Further, significant relationships of eHL with mental health status and internal health locus of control confirmed the criterion validity of the instrument. However, relationships of eHL with physical health status and quality of life could not be confirmed. The 2-factor model was fully measurement invariant regarding gender. Regarding age and educational level, partial measurement invariance was confirmed. The subscales as well as the overall GR-eHEALS reached good-to-excellent reliability (Cronbach α≥.86). The GR-eHEALS is a reliable and largely valid instrument for assessing eHL in individuals with the post-COVID-19 condition. Measurement invariance regarding gender was fully confirmed and allows the interpretation of group differences. Regarding age and educational level, group differences should be interpreted with caution. Given the high likelihood that individuals with the post-COVID-19 condition will be confronted with misinformation on the Internet, eHL is a core competency that is highly relevant in this context, in both research and clinical practice. Therefore, future research should also explore alternative instruments to capture eHL to overcome shortcomings in the validity of the GR-eHEALS.

Autonomy, Resilience and Life Satisfaction among Badminton Paralympians.

People with disabilities are marginalised in mainstream culture and they also experience increased restrictions in a variety of areas, such as sport. The barriers they encounter may adversely affect their life satisfaction, especially if they have a low perceived sense of autonomy and resilience. The purpose of this study was to investigate the relationship between autonomy, resilience and life satisfaction in para-badminton athletes and the mediating role of resilience in the relationship between autonomy and life satisfaction. Data were collected from 137 para-badminton athletes (male: 65.0% and female: 35.0%). Self-reported measures were used to assess the participants' autonomy, resilience and life satisfaction levels. A structural equation model analysis was performed; the model had sufficient fit indices (comparative fit index [CFI] = 0.94, root mean square error of approximation [RMSEA] = 0.06, standardised root mean square residual [SRMR] = 0.07). The findings showed that autonomy had a significant effect on resilience (β = 0.32, P = 0.001). Further, resilience had a significant effect on life satisfaction (β = 0.19, P = 0.011) and significantly mediated the effect of autonomy on life satisfaction (β = 021, P = 0.033). This study revealed that autonomy fosters resilience among athletes, in turn allowing them to achieve greater life satisfaction. Therefore, society and sport communities should actively seek ways to improve the autonomy and resilience levels of athletes with disabilities.

Evaluating the Psychometric Properties of the Sexual and Gender Minority Adverse Childhood Experiences Scale Among Sexual Minority Men and Women.

Adverse childhood experiences (ACEs) are known determinants of negative health outcomes. Sexual and gender minority (SGM) individuals have higher ACE scores than non-SGM individuals. The SGM-ACE scale was developed to better assess this population but is not yet validated in SGM subgroups. This study aims to validate the sexual and gender minority adverse childhood experiences (SGM-ACE) scale among sexual minority men (SMM) and sexual minority women (SMW), while testing measurement invariance across both groups. A cross-sectional survey included 530 sexual minority adults (265 men, 265 women) in the United States. Cronbach's alpha established internal consistency reliability. Validity was assessed via confirmatory factor analysis (CFA) for the SGM-ACE's theoretical structure and Pearson's correlations for concurrent validity with substance use outcomes (alcohol, cannabis, and drugs). Multigroup structural equation modeling (SEM) determined measurement invariance between SMM and SMW. The CFA of the original model exhibited good fit. Fit was improved after removing the institutionalization item, chi-square (χ2) = 14.26, degrees of freedom (df) = 9, p = 0.113, minimum discrepancy (CMIN/df) = 1.59, comparative fit index (CFI) = 0.99, root mean square error of approximation (RMSEA) = 0.03, 90% confidence interval (CI): (0.00-0.06), and standardized root mean square residual (SRMR) = 0.02. Internal consistency reliability was established (α = 0.78). SGM-ACE exhibited weak, yet significant relationships with each substance use outcome. Multigroup SEM indicated measurement invariance between SMM and SMW. This study provides psychometric validation of the SGM-ACE, establishing measurement invariance between SMM and SMW. Future research should explore its utility in diverse SGM minority subgroups.

The relationship between maternal-infant bonding and postpartum depression/anxiety: moderating effect of childhood psychological abuse and validation of the Mother-to-Infant Bonding scale (MIBS-8) in Arabic

BackgroundThe emotional bond that a mother senses to her infant is essential to their social, emotional, and cognitive development. Understanding the level of mother-infant bonding plays an imperative role in the excellence of care. However, in Lebanon, there is a paucity of information about mother-infant bonding in the postpartum period. Given that Lebanese pregnant women constitute an important part of the population to look at, the objectives of the study were to (1) validate the Arabic version of the mother–infant bonding scale and (2) the relation between mother-infant bond and postpartum depression/anxiety; (3) the moderating effect of child abuse in the association between mother-infant bond and postpartum depression/anxiety.MethodsThis cross-sectional study was conducted from September 2022 until June 2023, enrolling 438 women 4–6 weeks after delivery (mean age: 31.23 ± 5.24 years). To examine the factor structure of the mother-infant bond scale, we used an Exploratory-Confirmatory (EFA-CFA) strategy. To check if the model was adequate, several fit indices were calculated: the normed model chi-square (χ2/df), the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI).ResultsEFA was conducted on the first subsample. Three items were removed. The five items remaining loaded on one factor, which explained 73.03% of the common variance (ω = .91 / α = .90). After adding a correlation between residuals for items 2–7 and 5–8, fit indices of the CFA results were acceptable: χ2/df = 6.97/3 = 2.32, RMSEA = .068 (90% CI .001, .135), SRMR = .017, CFI = .996, TLI = .988. The interaction maternal-infant bonding by child psychological abuse was significantly associated with depression and anxiety respectively. At low, moderate and high levels of child psychological abuse, higher maternal-infant bonding scores (greater difficulty in bonding) were significantly associated with higher depression and higher anxiety respectively.ConclusionThis study provides, for the first time, a specific Arabic scale to assess mother-infant bonding reliably and validly. Furthermore, our study has suggested the existence of factors that have additive effects in potentiating the risk for depression and anxiety among Lebanese postpartum women, namely a history of psychological child abuse. Therefore, laborious awareness programs and healthcare services need to be implemented in order to prevent maternal mental health disorders from being unrecognized and left untreated.

Meta-analysis of the Difficulties in Emotion Regulation Scale and its short forms: Atwo-part study.

The Difficulties in Emotion Regulation Scale (DERS) is the most used self-report questionnaire to assess deficits in emotion regulation (ER), composed of 6 dimensions and 36 items. Many studies have evaluated its factor structure, not always confirming the original results, and proposed different factor models. A possible way to try to identify the dimensionality of the DERS could be through a meta-analysis with structural equation models (MASEM) of its factor structure. The MASEM indicated that a six-factor model with 32 items (DERS-32) was the most suitable to represent the dimensionality of the DERS (χ2 = 2095.96, df = 449, p < .001; root mean square error of approximation[RMSEA] = 0.024, 95% confidence interval [CI]: 0.023-0.025; comparative fit index[CFI] = 0.97; Tucker Lewis index[TLI] = 0.96; standardized root mean squared residual[SRMR] = 0.04). This result was also confirmed by a confirmatory factor analysis (χ2 = 3229.67, df = 449, p < 0.001; RMSEA = 0.075, 95% CI: 0.073-0.078; CFI = 0.94; TLI = 0.93; SRMR = 0.05) on a new sample (1092 participants; mean age: 28.28, SD = 5.82 years) recruited from the Italian population. Analyses and results from this sample are reported in the second study of this work. The DERS-32 showed satisfactory internal consistency (i.e., ordinal α, Molenaar Sijtsma statistic,and latent class reliability coefficient)for all its dimensions and correctly categorized individuals with probable borderline symptomatology. In conclusion, the DERS-32 has demonstrated to be the best model for the DERS among all the others considered in this work, as well as a reliable tool to assess deficits in ER.

Measuring General Health Literacy in Chinese adults: validation of the HLS19-Q12 instrument.

Health literacy measurement lays a solid foundation to identify associations with health outcomes and monitor population health literacy levels over time. In mainland China, most existing health literacy instruments are either knowledge-based or practice-based, making health literacy results incomparable between China and other countries. This study aimed to examine the reliability and validity of the 12-item Health Literacy Population Survey (HLS19-Q12) in a general population of Chinese adults. A cross-sectional study was conducted to recruit primary carers of students from 11 schools in Zhengzhou, Henan Province, using convenience cluster sampling. Participants completed an online self-administered survey that collected information on key sociodemographics, health literacy (HLS19-Q12 and a comparison tool: Health Literacy Questionnaire (HLQ)), and health-related outcomes. Using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist as a guideline, we tested internal consistency, test-retest reliability, content validity, structural validity, concurrent predictive validity, and convergent validity of the HLS19-Q12. Overall, 14,184 participants completed the full survey. The HLS19-Q12 showed excellent internal consistency (Cronbach's α = 0.93), moderate test-retest reliability (intra-class correlation coefficient = 0.54), satisfactory content validity (based on the 12-matrix health literacy model), and strong structural validity (comparative fit index = 0.94, Tucker and Lewis's index of fit = 0.93, root mean square error of approximation = 0.095). Concurrent predictive validity results showed health literacy was associated with both health determinants and health-related outcomes. The HLS19-Q12 had weak to strong correlations (coefficients = 0.24 to 0.42) with the nine scales of the HLQ. Respondents had an average score of 81.6 (± 23.0) when using the HLS19-Q12, with 35.0% and 7.5% having problematic and inadequate levels of health literacy, respectively. The HLS19-Q12 is a reliable and valid instrument to measure health literacy in our sample. Further validation is needed with a more nationally representative sample of Chinese adults. The HLS19-Q12 could be used as a comprehensive, skills-based, and easy-to-administer health literacy assessment tool integrated into population surveys and intervention evaluations.

Associations of eating out and dietary diversity with mild cognitive impairment among in community-dwelling older adults.

Dementia is a critical later life health issue that occurs among members of aging societies. This study examined the relationships between eating out, dietary diversity, and mild cognitive impairment (MCI) among community-dwelling older adults. We analyzed data from 597 older adults (median age 73.0 years [interquartile range 69.0-78.0] and 62.6% females). We applied the Food Frequency Score (FFS) to evaluate diet variety and the weekly consumption frequencies of ten food items were determined. The Functional Assessment Tool from the National Center for Geriatrics and Gerontology was used to evaluate MCI. Finally, we asked the participants how often they ate out each month; those who replied 'none' were categorized into the "non-eating out" group. The overall prevalence of MCI was 122 (20.4%), with a higher prevalence in the low dietary diversity group than in the high dietary diversity group (28.6% vs. 18.6%). After adjusting for covariates, the participants who self-described as not eating out were independently associated with low dietary diversity (odds ratio [OR]: 1.97, 95% confidence interval [CI]: 1.20-3.20), while low dietary diversity was associated with MCI (OR: 1.72, 95% CI: 1.02-2.87). Structural equation models revealed that not eating out had no direct effect on MCI but was associated with MCI via low dietary diversity (root mean square error of approximation = 0.030, goodness-of-fit index=0.999, and adjusted goodness-of-fit index = 0.984). Although non-eating out may not have a direct effect on MCI, an indirect relationship may exist between eating-out habits and MCI via dietary diversity status.