Worry Subscale Research Articles

The Development and Validation of a Spanish Language Version of the Test Anxiety Inventory for Children and Adolescents

This study details the development and validation of a Spanish language version of the Test Anxiety Inventory for Children and Adolescents (TAICA) for elementary and secondary students. In this study, the TAICA was adapted and administered to a sample of 197 students, 87 males and 110 females, aged 9 to 19 years, in Grades 4 to 12. Results of an exploratory factor analysis and item content analysis revealed that the factor structure and the items on the different dimensions of the Test Anxiety Inventory for Children and Adolescents—Spanish version (TAICA-S) were similar to the TAICA. Internal consistency reliability estimates for the TAICA-S scores ranged from .68 to .93 for the total sample and male and female subsamples. Gender differences on the TAICA-S were noted, with females scoring higher than males on the Worry subscale. Implications of the findings for educators and mental health experts who work with Hispanic elementary and secondary students are discussed.

Fear of hypoglycaemia in mothers and fathers of children with Type 1 diabetes is associated with poor glycaemic control and parental emotional distress: a population‐based study

To analyse, in a population-based study, the association between parental fear of hypoglycaemia and (i) the prevalence of hypoglycaemia and diabetes treatment factors in children with Type 1 diabetes and (ii) emotional distress in mothers and fathers. Mothers (n = 103) and fathers (n = 97) of 115 children with Type 1 diabetes (1-15 years old) participated in the study. In addition to demographic and disease-specific data, the participants completed the Hypoglycaemia Fear Survey-Parent version (HFS-P) (worry and behaviour subscales) and the Hopkins Symptom Checklist-25 items (HSCL-25) to measure emotional distress. A higher HFS-P worry score was associated with higher glycated haemoglobin (HbA(1c)), a higher frequency (>or= 7) of what parents experienced as problematic hypoglycaemic events during the past year and co-morbid disease in the child. A higher HFS-P behaviour score was associated with children receiving insulin injections compared with using an insulin pump and a higher frequency (>or= 7 per day) of blood glucose measurements. The mothers had higher scores than the fathers in both the worry and behaviour subscales. The mothers' and the fathers' HFS-P worry scores correlated significantly with their HSCL-25 scores. The association between a higher level of hypoglycaemic-related fear and parental emotional distress and poorer glycaemic control in the child emphasizes the need for programmes to support and guide parents. The results suggest that future interventions should target both the parents' fear and appropriate ways to prevent hypoglycaemia in children with Type 1 diabetes.

Rifaximin Significantly Improves Quality of Life Versus Placebo in Patients with Diarrhea-Predominant Irritable Bowel Syndrome

Purpose: A randomized, double-blind, multicenter, phase 2 trial showed the nonabsorbed antibiotic rifaximin 550 mg twice daily (b.i.d.) significantly improved IBS symptoms versus placebo in patients with diarrhea-predominant IBS (IBS-D). Secondary analyses from that study evaluated the efficacy of rifaximin for improving quality of life (QOL) measures in patients with IBS-D. Methods: Adults diagnosed with IBS-D (Rome II criteria) received rifaximin 550 mg b.i.d. or placebo for 14 days. Both groups received placebo for an additional 14 days after the initial 2-week treatment. Quality of life was assessed with the 34-item IBS-QOL questionnaire at baseline and 4 weeks after initiating treatment. Each item was scored on a 5-point scale (1 = not at all; 2 = slightly; 3 = moderately; 4 = quite a bit; and 5 = extremely or a great deal). Results for composite and subscale scores were converted to a scale ranging from 0 to 100, with higher scores indicating better QOL. Analyses included all randomized patients. Results: A total of 388 patients were treated at 75 centers in the United States; 191 patients received rifaximin and 197 patients received placebo during the 2-week initial treatment period. The mean improvement from baseline in overall QOL scores at week 4 was significantly greater with rifaximin compared with placebo (Table). Patients in the rifaximin group reported significantly greater mean improvement from baseline in QOL scores for dysphoria, body image, health worry, social reaction, and relationship subscales compared with placebo (Table). Rifaximin was well tolerated, with similar incidence of adverse events compared with placebo.Table: Mean Change From Baseline in IBS-QOL Scores at Week 4.Conclusion: In patients with IBS-D, rifaximin 1100 mg/d for 14 days significantly improved QOL measures compared with placebo. These findings, along with previously reported data, suggest a potential therapeutic role for rifaximin 550 mg b.i.d. for improving symptoms and QOL in patients with IBS-D.

Cross‐cultural development and psychometric evaluation of a patient‐reported health‐related quality of life questionnaire for adults with haemophilia

Co-morbidities of haemophilia, such as arthropathy and blood-borne infections, can adversely affect the quality of life of adult patients with haemophilia. The purpose of this study was to develop and validate a haemophilia-specific health-related quality of life questionnaire for adults (HAEMO-QoL-A). Subjects with varying severities of haemophilia completed the HAEMO-QoL-A at baseline and 4 weeks. Other assessments included the SF-36 and Health Assessment Questionnaire - Functional Disability Index (HAQ-FDI). Two-hundred and twenty-one participants completed the 41-item HAEMO-QoL-A covering six domains (Physical Functioning, Role Functioning, Worry, Consequences of Bleeding, Emotional Impact and Treatment Concerns) and four independent items. Internal consistency was good-to-excellent (Cronbach's alpha-range: 0.75-0.95). Test-retest reproducibility was good, with intraclass correlation coefficients >0.80 except for the Emotional Impact domain (0.79). Concurrent validity between the HAEMO-QoL-A total and subscale scores and all SF-36 subscale scores were generally good (correlations range: 0.13-0.87). Significant correlations between the HAEMO-QoL-A and the HAQ-FDI ranged from -0.14 to -0.69. There were non-significant correlations with the Treatment Concerns subscale and with the Worry subscale. The HAEMO-QoL-A discriminated significantly between adults with haemophilia by severity and HIV status. The Physical Functioning subscale discriminated between patients receiving prophylactic or on-demand therapy. The HAEMO-QoL-A is a valid and reliable instrument for assessing quality of life in haemophilia patients.

NEURAL CORRELATES OF VERBAL EPISODIC MEMORY IN THE AT RISK MENTAL STATE

The Self-Appraisal of Illness Questionnaire (SAIQ) is a self-report instrument designed to assess attitudes toward mental illness among persons receiving psychiatric treatment. This instrument was developed for use in community settings, adapted closely from the Patient's Experience of Hospitalization questionnaire. In order to examine the validity of the SAIQ, a factor analysis was first conducted on the items of this instrument in a sample of 59 outpatients with schizophrenia or schizoaffective illness. Three factors emerged: Need for Treatment, Worry, and Presence/Outcome of Illness. Next, to examine the concurrent validity of these three SAIQ subscales, they were correlated with researcher rated insight scales and neuropsychological tests. Results indicated that the Need for Treatment and Presence/Outcome subscales were significantly correlated with both researcher-rated insight scales and with neuropsychological tests of executive functioning. The Worry subscale was not associated with either researcher-rated insight scales or neuropsychological tests. It was concluded that the Need for Treatment and Presence/Outcome subscales may be used in combination as a brief screening instrument for clients with schizophrenia receiving outpatient psychiatric treatment who may be at risk for treatment non-compliance due to a lack of insight into illness.

Treatment needs and acknowledgement of illness – importance for satisfaction with psychiatric inpatient treatment

BackgroundPatient satisfaction is an important, but controversial part of health service evaluation. This study dealt with how acknowledgement of illness and treatment needs effected the distribution of positive, neutral and negative evaluations in a group of first time admitted patients to a psychiatric hospital.MethodThe participants filled out a standardized user satisfaction form before discharge. The number of positive, neutral and negative evaluations for each participant was calculated and used as dependent variables in analyses (Classification Tree) where acknowledgement of illness (The Patients' Experience of Hospitalisation Questionnaire) and treatment needs (HoNOS) were used as explanatory variables in addition to a number of potential confounders.ResultsDifferent constellations of variables explained the three dependent variables. The number of positive scores was a function of age and worry (PEH); neutral scores were explained by HoNOS rated social needs and GAF (functional scale), both at admission. Outcome (GAF functional scale) and age explained the number of negative scores.Conclusion(1) Moderately high negative correlations between positive and neutral scores, and between positive and negative scores, together with a positive correlation between the number of negative and neutral ratings was interpreted to mean that neutral scores sometimes function as undercommunicated negative evaluations. These could better be studied by qualitative methods. (2) The worry subscale (PEH) was important in identifying the majority of patients with the highest numbers of positive scores (patients older than 27.5 yrs with high worry score at admission.). The most dissatisfied group was characterised by denial of both mental problems and need for treatment. (3) Patients with high scores on the HoNOS Social subscale had the highest number of neutral scores. To the extent that neutral evaluations have negative connotations, treatment should focus more effectively on the patients' social needs. (4) The smallest number of negative scores was found among older patients with high functional improvement (GAF F). (5) Increasing age consistently predicted higher satisfaction. A better understanding of why younger patients are more dissatisfied is needed.

Hypoglycaemia in patients with type 2 diabetes treated with a combination of metformin and sulphonylurea therapy in France

Hypoglycaemia from antihyperglycaemic drugs may have a significant impact on patients' health-related quality of life. Combination use of metformin and a sulphonylurea has become increasingly common; yet, the impact of hypoglycaemia on quality of life in these patients is not well documented. To examine patient-reported experience of hypoglycaemia, worry about hypoglycaemic symptoms and the impact of hypoglycaemia on patients' quality of life associated with use of sulphonylurea co-administered with metformin. This was an observational, cross-sectional, multi-centre study. A total of 98 primary care centres in France during October to December 2005. A total of 400 patients with type 2 diabetes, who were > or = 35 years old and who had been treated with metformin and a sulphonylurea for at least 6 months, completed questionnaires during their usual primary care office visit. Frequency and severity of hypoglycaemic symptoms in the past 6 months, the Worry subscale of the Hypoglycaemic Fear Survey-II (HFS-II) and the EuroQol-5 Dimensions (EQ-5D) questionnaire. A total of 136 (34%) patients reported experiencing hypoglycaemia, of whom 78 (58%) experienced mild, 40 (30%) experienced moderate and 16 (12%) experienced severe or very severe symptoms. Mean score on the HFS-II Worry scale was higher for patients who reported having hypoglycaemia than for those who did not (19.0 vs. 10.2; p < 0.0001) and increased with severity of hypoglycaemic symptoms. In linear regression analyses, more severe symptoms of hypoglycaemia were significantly associated with higher scores on the HFS-II Worry scale (p = 0.0162) among patients with hypoglycaemic symptoms. Summary scores on the EQ-5D were lower for patients who reported hypoglycaemia than for those who did not (p = 0.0001) and, in multivariate analysis, the experience of hypoglycaemia was negatively associated with the EQ-5D summary score (p < 0.0001). The occurrence and severity of hypoglycaemic symptoms were associated with increased patient worry about hypoglycaemia and lower health-related quality of life among type 2 diabetic patients being treated with both metformin and a sulphonylurea.

Distinguishing worry from rumination in older people: A preliminary investigation

Anxiety and depression are common mental health problems in later life. Since worry and rumination are thought to underpin the respective primary cognitive processes in anxiety and depression, we developed a measure to distinguish worry from rumination in later life. The Ruminative Response Scale was adapted to include items that characterise the cognitive features of worry. We examined its properties using 92 clinical and non-clinical participants, aged over 65. Factor analysis demonstrated a three-factor structure: brooding, reflection and worry with internal consistencies of α = 0.72, α = 0.67 and α = 0.55 respectively. We found no evidence for concurrent validity of these factors using the Penn State Worry Questionnaire. Modest but significant associations between reflection and brooding (r = 0.36) and reflection and worry (r = 0.2) were found. Brooding and worry sub-scales remained unrelated. We suggest that it is possible to distinguish worry from rumination in older people and that differentiating between their key underlying characteristics in the assessment of mood problems may enhance the targeting and evaluation of cognitive–behavioural therapy for anxiety and depression in later life. Future research with a substantial clinical sample is needed to explore the underlying dimensions and correlates of worry in later life.

Group cognitive behavioural therapy for children with anxiety disorder - an evaluation of the 'Friends for Youth' programme.

This study evaluated the effectiveness of group cognitive behavioural therapy (GCBT) for the treatment of anxiety disorders in children over an initial period of 12 weeks and to one-month follow-up. Parents of the children receiving GCBT participated in adjunctive psycho-education sessions and the effect of these sessions on parental anxiety was also evaluated. Participants were 12 children, six male and six female, aged between 11 and 15 years who were attending a child mental health service. Participants were interviewed with their parents and anxiety symptoms assessed, using the following measures: Anxiety Disorder Interview Schedule - revised, the Children's Depression Inventory, the Revised Children's Manifest Anxiety Scale, the Coopersmith Self-Esteem Inventory and the Child Behaviour Checklist. Parental anxiety levels were assessed using the Depression, Anxiety and Stress Scale. The 12 children were randomly assigned into two age- and sex-matched groups. While the first group received therapy, the second group acted as a treatment-as-usual control (TAU) group. The second group began group cognitive behavioural therapy after the 10-week waiting period. All participants and their parents provided structured feedback on the intervention. Group cognitive behavioural therapy was significantly effective in reducing both child-reported depressive symptoms, and anxiety on the physiological, worry and total anxiety subscales of the Revised Children's Manifest Anxiety Scale. There were associated significant increases in the childrens' subjective levels of general and total self-esteem, that relating to their self-confidence with peers and when engaging in social and academic pursuits. Diagnosis of anxiety disorder reduced by an average of 67% immediately post-treatment, and by 72% by the onemonth follow-up period. Parents reported significant reductions in their children's levels of internalising symptoms, thought and attention problems. However, parents reported no significantly positive changes in their own levels of depression, anxiety and stress symptoms. Group cognitive-behavioural therapy is a useful and clinically effective intervention for the treatment of anxiety disorder in children.

Temperament and character profile as risk factor of depression and anxiety syndromes induced by interferon and ribavirin treatment in chronic hepatitis c patients

Background:The aim of this study was to examine the temperament and character profile as risk factors of interferon and ribavirin (IFN+RBV) induced psychopathology in chronic hepatitis C patients. According to the Cloninger's biosocial model (TCI), the temperament dimension harm avoidance (HA) is suggested to indicate central serotonergic turnover, which is further correlated with depressive/anxiety states.Methods:198 patients with chronic hepatitis C in treatment with IFN+RBV were evaluated at baseline and 4, 12 and 24 weeks of treatment. All subjects were assessed by the Patient Health Questionnaire (PHQ), the Hospital Scale of Anxiety and Depression (HADS) and the Temperament and Character Inventory-revised (TCI-R) questionnaire (at basal level).Results:At baseline, 32 patients had a psychiatric syndrome (16.1%). During the first six months of IFN+RBV treatment the incidence of depression/anxiety syndromes was 37.9% (n=63/166). The personality factors associated (p<0.001, corrected) were: HA dimension; fatigability subscale (HA4), anticipatory worry subscale (HA1); self-directedness dimension (SD); congruent subscale (SD5); and; social acceptance subscale (C1). By logistic regression analysis the independent variables that most predict the induced cases (PHQ+) (dependent variable) were: previous history of mood disorder (p<0.001; Exp(b)=5.655), and both HA4 (p<0.001; Exp(b)=1,104) and C1 (p<0.001; Exp(b)=0.845) subscales.Conclusion:The assessment of personality traits (HA, C) and previous history of psychiatric disorders before start the IFN+RBV treatment in chronic hepatitis C patients might identify the patients at risk of induced depression/anxiety disorders during the treatment.This study has been done in part with grants: Instituto-Carlos III (G03/02) (Red-Hepatologia) and (GO3/184) (Red-Genotipacion/Psiquiatria Genetica).

Predictors of oral health quality of life in older adults

There is limited information regarding oral health status and other predictors of oral health-related quality of life. An association between oral health status and perceived oral health-related quality of life (OHQOL) might help clinicians motivate patients to prevent oral diseases and improve the outcome of some dental public health programs. This study evaluated the relationship between older persons' OHQOL and their functional dentition, caries, periodontal status, chronic diseases, and some demographic characteristics. A group of 733 low-income elders (mean age 72.7 [SD = 4.71, 55.6% women, 55.1% members of ethnic minority groups in the U.S. and Canada) enrolled in the TEETH clinical trial were interviewed and examined as part of their fifth annual visit for the trial. OHQOL was measured by the Geriatric Oral Health Assessment Index (GOHAI); oral health and occlusal status by clinical exams and the Eichner Index; and demographics via interviews. Elders who completed the four-year assessment had an average of 21.5 teeth (SD = 6.9), with 8.5 occluding pairs (SD = 4.6), and 32% with occlusal contacts in all four occluding zones. Stepwise multiple regressions were conducted to predict total GOHAI and its subscores (Physical, Social, and Worry). Functional dentition was a less significant predictor than ethnicity and being foreign-born. These variables, together with gender, years since immigrating, number of carious roots, and periodontal status, could predict 32% of the variance in total GOHAI, 24% in Physical, 27% in Social, and 21% in the Worry subscales. These findings suggest that functional dentition and caries influence older adults' OHQOL, but that ethnicity and immigrant status play a larger role.

Self-Confidence as a Mediator of the Relationship Between Competitive Anxiety Intensity and Interpretation

The aim of this study was to examine whether self-confidence mediated the relationship between competitive anxiety intensity and direction. Elite (n = 102) and nonelite (n = 144) participants completed the self-confidence subscale of the Competitive Trait Anxiety Inventory-2 and the worry and somatic subscales from the Sport Anxiety Scale. Consistent with procedures recommended by Baron and Kenny (1986), linear regression analyses were used. The findings for elite athletes revealed worry intensity to significantly predict self-confidence and worry direction. However, when self-confidence was controlled, worry intensity did not predict worry direction over that which was significantly predicted by self-confidence. Within the analysis for somatic symptoms, only self-confidence was found to predict somatic symptom direction. For the nonelite athletes, worry and somatic symptom intensity predicted both self-confidence and direction, and direction when self-confidence was controlled. The findings for the elite athletes suggest self-confidence mediates the relationship between performers' worry symptoms and subsequent directional interpretations. However, the findings suggest that high levels of self-confidence and low symptom intensity are needed for nonelite athletes to demonstrate a less debilitative interpretation.

Factorial Integrity of the Sport Anxiety Scale: A Methodological Note and Revised Scoring Recommendations

Results of several recent studies have called into question the factorial integrity of the Sport Anxiety Scale (SAS; Smith, Smoll, &amp; Schutz, 1990) because two items (14 and 20) that loaded on the Concentration Disruption subscale in our validation and cross-validation samples have loaded or cross-loaded on the Worry subscale in other samples. We agree that this is a serious problem, and we evaluate proposed modifications of the SAS on both conceptual and empirical grounds. For researchers currently using the SAS, we recommend a new scoring system that deletes two troublesome Concentration Disruption items and one Somatic Anxiety item, preserving separate and factorially consistent Somatic, Worry, and Concentration Disruption subscales. We present evidence that our original Worry scale provides a better CFA fit than a suggested “cognitive anxiety” alternative that combines the two concentration disruption items with the Worry scale items. We also describe nonreplication of the SAS three-factor structure in child samples and caution researchers against computing subscale scores for child samples.

How Do Mothers Feel About Their Very Low Birth Weight Infants? Development of a New Measure.

The early relationship between a mother and her very low birth weight (VLBW; <1.5 kg) infant may be difficult to evaluate. Therefore, we aimed to develop a useful and practical method to describe a mother's early relationship with her VLBW infant. Mothers (mean age=27 years, 46% married) of 119 singleton VLBW infants (mean BW=1,056 g, mean GA=28 weeks) admitted to the neonatal ICU at Rainbow Babies and Children's Hospital completed a novel questionnaire regarding their feelings about their infant at 3 weeks' postnatal age, and at 35 weeks', 40 weeks' (term), and 4 months' postmenstrual ages. Factor analysis of initial interview data was used to construct subscales to measure unique domains hypothesized to underpin the beginning maternal-infant relationship. Three subscales were identified: (a) The Worry subscale focuses on the mother's concerns about her infant's current medical condition and future development, (b) the Enjoyment subscale examines the mother's positive feelings about and responsiveness to her infant, and (c) the Separation Anxiety subscale examines the mother's mental anxiety about being physically separated from her infant. Statistical and clinical validation of the subscales produced positive supporting evidence that the subscales are a meaningful measure of the mother-infant relationship. We have developed a unique and practical measure for describing the early mother-VLBW infant relationship.

The Delay and Worry Experience of African American Women With Breast Cancer

To examine the delay in seeking treatment and worry experiences of African American women with breast cancer. Descriptive, correlational. Urban northeastern United States. 60 African American women diagnosed with breast cancer. Consenting participants completed the worry subscale of the Ware Health Perception questionnaire and a Demographic and Illness-Related Information Sheet during a one-hour personal interview. Data analysis consisted of descriptive statistics and Pearson correlations. Delay in seeking treatment, worry about breast cancer and symptoms, and sociodemographic characteristics. Contrary to the literature, participants reported short patient and provider delay. As a result of little variability in delay, predicting those for whom worry was a deterrent or a motivator to seek prompt treatment was not possible. Although delay does exist, African American women with sociodemographic characteristics similar to white women who do not delay are likely to have similarly short symptom durations. Further study to determine who is helped and who is hurt by worry and other possible intervening factors would be useful. Including biologic characteristics such as tumor staging and hormone receptor information in future studies would allow for a closer examination of stage at diagnosis and biologic influence. Interventions with African American women cannot assume that delay exists. Strategies that consider both individual and cultural group differences are essential to the early seeking of a diagnosis and treatment for breast cancer symptoms among African American women.

Quality of life and diabetes knowledge of young persons with type 1 diabetes: Influence of treatment modalities and demographics

ObjectiveThe primary objective of this descriptive study was to assess the perception of quality of life and diabetes knowledge among young persons with type 1 diabetes. The secondary objectives were to examine the influence of treatment modality (continuous subcutaneous insulin infusion vs multiple daily injections) and demographics on quality of life and diabetes knowledge of these young persons and to determine the associations between the study variables. Research design and methodsParticipants aged 9 to 17 years (n=103) completed the diabetes-specific measure of quality of life and a diabetes knowledge test. Parents of these young persons completed a history questionnaire. Descriptive statistics, independent t tests, and Pearson’s correlations were used to analyze the data. ResultsOverall, diabetes-specific measure of quality-of-life scores indicated good quality of life among the study population. Mean scores on the impact, worry, and satisfaction subscales did not indicate negative perceptions of the disease. Body mass index was significantly inversely correlated with the satisfaction scale (r=−0.247, P=.023). Self-rated health was negatively correlated with the impact (r=−0.221, P=.038) and worry scale (r=−0.294, P=.004) and positively correlated with the satisfaction scale (r=0.291, P=.004). Seventy-two percent correct responses were given on the diabetes knowledge test. Knowledge was significantly correlated to diabetes diagnosis age (r=0.276, P=.009) and current age (r=0.453, P=.0005). No significant differences were observed between participants using continuous subcutaneous insulin infusion vs multiple daily injections in regard to diabetes-specific measure of quality of life and diabetes knowledge test. ConclusionsIn our study, young persons with type 1 diabetes had a positive perception of their quality of life and above-average diabetes knowledge, which were influenced by several factors, such as self-rated health, body mass index, and age at diagnosis. Dietetics professionals should assess perceived quality of life and knowledge among young persons with type 1 diabetes because these factors can potentially influence disease management and treatment compliance.

Biopsychosocial Predictors of Health-Related Quality of Life in Patients With Chronic Hepatitis C

To assess biopsychosocial predictors of health-related quality of life (HRQOL) in patients with chronic hepatitis C. In 94 consecutive patients with chronic hepatitis C attending a liver center, HRQOL was assessed by the Medical Outcome Study Short Form Health Survey 36 (SF-36) and by the German version of the Chronic Liver Disease Questionnaire. The predictive effect on HRQOL of disease-related worries measured by the worry subscale of the Chronic Liver Disease Questionnaire, psychiatric comorbidity (defined by at least one Hospital Anxiety and Depression Scale German Version Score > or =11), the Child-Pugh score in case of cirrhosis, interferon therapy, and active medical comorbidities was assessed by a multiple regression analysis. From 88 patients (age, 48.6 +/- 14.6 years; 50% female), 62 (70%) had no cirrhosis, 15 (17%) Child A, 5 (6%) Child B, and 6 patients (7%) Child C cirrhosis. The mental summary score of SF-36 was predicted by the amount of disease-related worries (corrected R2 = 0.33; beta = 3.2; p < .001) and psychiatric comorbidity (corrected R2 = 0.42; beta = -9.0; p < .001), by the physical summary score of SF-36 by the amount of disease related worries (corrected R2 = 0.33; beta = 4.0; p < .001), and by the number of active medical comorbidities (corrected R2 = 0.39; beta = -2.0; p = .006). The HRQOL in chronic hepatitis C is not determined by the severity of the liver disease but by psychiatric and medical comorbidities and disease-related worries.

Quality of life improvement with conversion to lamotrigine monotherapy

This report describes the effect on patient-reported quality of life (QOL) after reduction from two drugs to monotherapy with lamotrigine. Patients taking lamotrigine (LTG) with an enzyme-inducing drug were converted to LTG monotherapy for a 12-week follow-up. Changes in QOLIE-31 between baseline and follow-up were compared with physicians' global change ratings and patient-reported health status. Total QOLIE-31 scores increased 10.7 points for patients rated by physicians as having mild improvement, and 17 points for those reported as having moderate to marked improvement. Subscale scores also increased by minimum important change (MIC) amounts (⩾11.76), with the largest change in Cognition, Energy, Medication Effects, and Seizure Worry subscales. The data also support ⩾11 MIC as a clinically important change in total score for the QOLIE-31. Exploratory analyses also provide information about MIC for individual subscales (8–18 for physician rated global change, 10–26 for patient-rated global health status change). This study demonstrates the value of reduction to monotherapy from the patients' and physicians' perspectives.

Development of a Short Form of the Test Anxiety Inventory (TAI)

The Test Anxiety Inventory (TAI) is widely used in research and practical settings and has particular application to the assessment and treatment of test anxiety in student populations. However, there are a number of instances in which a short version of the TAI would be more appropriate, especially when time constraints preclude the use of the full form. Similar short forms have been developed for other measures such as the State scale of the State-Trait Anxiety Inventory (STAI; T. M. Marteau & H. Bekker, 1992). The authors of the present study aimed to develop a short form of the TAI. The TAI was completed by 333 undergraduate psychology students. Item–remainder correlations were used to compare short forms with varying numbers of items. Internal consistency and concurrent and construct validity were assessed in hypothetical and actual examination conditions. A 5-item short form produced optimal reliability and validity, and a balance of items from the Worry and Emotionality subscales of the TAI. Further research is needed to replicate these results, but the 5-item short form of the TAI shows promise, particularly for contexts in which time demands preclude the use of longer versions.

Specificity of Measures of Thought Control

The rebound effect (D. M. Wegner, 1994) essentially involves the persistence of thought when an effort has been made to suppress the cognitive activity. Some of the research in this area has been directed at determining personal factors that predict differential levels of rebound. To this end, measures of thought control have emerged. In the present study the authors examined the properties of 2 measures of thought control: the Thought Control Questionnaire (TCQ; A. Wells & M. I. Davies, 1994) and the White Bear Suppression Inventory (WBSI; D. M. Wegner & S. Zanakos, 1994). Each measure was examined in relation to measures of obsessive–compulsive symptoms and worry, as well as combined factorial structure. Scores generally indicated that items on the Worry and Punishment subscales of the TCQ were highly related to worry and obsessive–compulsive symptoms, whereas scores on the WBSI showed an association between Worry and 1 sub-scale (Slowness) of obsessive–compulsive symptoms. Results of a principal components analysis indicate that, in the aggregate, the items from the TCQ and WBSI form 2 factors: Dysfunctional and Functional Thought Control Strategies. From these data, it appears that the TCQ possesses greater potential to predict performance in rebound experiments and has greater clinical usefulness. Future research directions involving the TCQ are recommended.