The factor analytic structure of the Roberts Apperception Test for Children: a comparison of the standardization sample with a sample of chronically ill children

A confirmatory principal component factor analysis of the Roberts Apperception Test for Children was conducted using the standardization sample and a sample of chronically ill children. An interpretation of three- and four-factor solutions identified the three-factor solution as superior to the four-factor solution as measured by chi-square goodness of fit and coefficients of convergence. A cluster analysis using Ward's minimum variance method was calculated to determine the typical profiles that best describe the chronically ill sample. Results of this analysis reveal two distinct profiles that differ primarily on the level of adaptive psychological functioning.     

Health Status and Peer Relationships in Early Adolescence: The Role of Peer Contact, Self-esteem, and Social Anxiety

We examined associations between children’s health status and the quality of their peer relationships, as well as factors that may account for individual variation in the quality of chronically ill and healthy children’s peer relationships. Our sample included 268 children (138 boys; 130 girls) with 149 European-Americans and 119 African-Americans. There were 91 children with a chronic illness; 35 with asthma, 26 with diabetes, and 30 with obesity. Chronically ill children were characterized by teachers as displaying less prosocial behavior, less overt aggression, and less relational aggression with peers than healthy children. Chronically ill children reported lower levels of peer contact and higher levels of social anxiety than healthy children. Among chronically ill children those with high self-esteem were more prosocial and less aggressive than those with low self-esteem. Our findings suggest that chronically ill children are at risk for peer relationship difficulties, but that self-esteem may serve as a protective factor against poor peer relationships for some chronically ill children.     

Factor solutions of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) in a Swedish population

Culturally validated rating scales for social anxiety disorder (SAD) are of significant importance when screening for the disorder, as well as for evaluating treatment efficacy. This study examined construct validity and additional psychometric properties of two commonly used scales, the Social Phobia Scale and the Social Interaction Anxiety Scale, in a clinical SAD population (n?=?180) and in a normal population (n?=?614) in Sweden. Confirmatory factor analyses of previously reported factor solutions were tested but did not reveal acceptable fit. Exploratory factor analyses (EFA) of the joint structure of the scales in the total population yielded a two-factor model (performance anxiety and social interaction anxiety), whereas EFA in the clinical sample revealed a three-factor solution, a social interaction anxiety factor and two performance anxiety factors. The SPS and SIAS showed good to excellent internal consistency, and discriminated well between patients with SAD and a normal population sample. Both scales showed good convergent validity with an established measure of SAD, whereas the discriminant validity of symptoms of social anxiety and depression could not be confirmed. The optimal cut-off score for SPS and SIAS were 18 and 22 points, respectively. It is concluded that the factor structure and the additional psychometric properties of SPS and SIAS support the use of the scales for assessment in a Swedish population.     

An Examination of the Psychometric Properties and Factor Structure of the Feelings of Stigmatization Questionnaire

As the experience of stigma and its psychological dimensions require careful measurement, the purpose of this study was to examine the psychometric properties and factor structure of the Feelings of Stigmatization Questionnaire (FSQ). A total of 170 participants with psoriasis and 124 with atopic dermatitis (AD) completed the FSQ. AD participants self-rated AD severity, while psoriasis severity was determined by a clinician. Confirmatory (CFA) and exploratory factor analytic (EFA) techniques were used to examine the factor structure of the FSQ. The FSQ total score was not related to age, age at onset, illness duration or psoriasis severity but it was negatively associated with AD severity (r = −.25, p < .01). The original six-factor structure of the FSQ was not replicated in our sample. Using EFA, a fixed three-factor solution proved the most stable, with the dimensions of feeling flawed, anticipation of rejection and secrecy, and positive attitudes towards skin disease being identified.     

The development of a physical education state anxiety scale: a preliminary study

The aim of the present study was to develop a measure of state anxiety for school physical education. The Physical Education State Anxiety Scale was designed to assess the basic anxiety dimensions plus the related cognitive processes. High school students (n = 631) completed the scale just prior to a test on two track and field tasks, in order to create a stressful condition. Data from the sample were randoml y split in two and subjected to exploratory and confirmatory factor analyses, which supported the proposed three-factor structure of Worry, Cognitive Processes, and Somatic Anxiety. Internal consistency coefficients were acceptable. Moderate correlations among the subscale scores supported its construct validity. Results provide preliminary evidence for validity and reliability.     

The influence of seriousness and contagiousness of disease on emotional reactions to ill persons

Abstract

Extends research on illness cognition by arguing that two major dimensions of illness cognition - seriousness and contagiousness of disease - are responsible for different emotional responses to ill persons, and that the activation of these dimensions is dependent on type of contact with these persons. Using a vignet methodology, nursing students (N = 333) were asked to imagine having different types of contact with patients with diseases differing in seriousness and contagiousness. When participants imagined personal contact with the patient, their anxiety responses and self-efficacy expectations were primarily determined by seriousness of disease. In contrast, when they anticipated close physical contact with the patient, subjects' anxiety reactions and self-efficacy expectations were primarily influenced by contagiousness of disease. Seriousness of disease appeared to be a major determinant of feelings of pity, poweriessness, sadness, and motivation to psychologically support the patient. Theoretical and practical implications are discussed.     

The Teaching and Learning of Psychotherapy by Rudolf Ekstein and R. S. Wallerstein

The homogeneous group has been the most common form of group therapy for chronically physically ill children and adolescents. The goals of these groups have included the provision of peer support, adaptation to the realities of physical illness, and acceptance of and cooperation with the medical management of the disease. The refinement of the theory of developmental ego psychology suggests that the heterogeneous group has potential for aiding the emotional maturation of the chronically physically ill. This paper presents examples of groups of latency-age children, early adolescents, and middle adolescents that included chronically physically ill with physically healthy peers. The groups were planned under the assumption that despite external differences, children and adolescents of a similar age identify with peers in terms of normal age-specific developmental needs and conflicts.     

How can I connect with thee? Let me count the ways

Two studies were conducted to examine mental representations of loneliness and social connectedness. In Study 1, young adults (N = 2,531) completed the revised UCLA Loneliness Scale (R-UCLA scale) and demographic questionnaires. An exploratory factor analysis of the R-UCLA scale on half the sample revealed a three-dimensional conceptual structure that generalized across gender. This mental representation consisted of correlated facets labeled Isolation, Relational Connectedness, and Collective Connectedness. A confirmatory factor analysis on the other half of the sample corroborated this three-factor solution. In Study 2, a population-based sample of 197 older males and females (M(age) = 57.5 years) completed the R-UCLA scale and measures of objective social circumstances. The confirmatory factor analysis supported the three-factor structure in this diverse and older adult sample. Each facet was uniquely predicted by theoretically related social circumstances. These findings suggest how humans make meaning of their social relationships in their mental representations of loneliness and connectedness.     

Performance-psychologic cross-sectional study of young schizophrenic patients with a subchronic and chronic disease course

According to ICD-9 and DSM-III-R-criteria 14 subchronic schizophrenic male patients (duration of illness less than 2 years) and 17 chronically ill male schizophrenics (duration of illness between 5 to 12 years) matched for sex, age, education, type of illness, and medication were with the aid of 4 tests investigated with respect to time characteristics of performance parameters. Whereas subchronic patients revealed performance scores within the normal range of reference scores, chronically ill patients showed dissociative variations in performance (high scores in reasoning, low scores in speed factor). This can be interpreted as instability of brain functioning which characterizes schizophrenics suffering from a long duration of illness. Correlations between prolonged reactions to "crossmodal" choices and subjective basic symptoms in subchronic patients are hints at well established introspection ability of self regarded complaints.     

Investigation of the factorial structure and psychometric properties of the Persian version of the Toronto Alexithymia Scale-20 in patients with psychiatric disorders

The aims of this study were to assess the factor structure, validity, and reliability of the Persian translation of the Toronto Alexithymia Scale-20 (TAS-20) and to examine different models of the TAS-20 in Iranian patients with various psychiatric disorders. Participants were 839 patients with psychiatric disorders, including obsessive-compulsive disorder (OCD) (n = 80), schizophrenia (n = 82), bipolar disorder (BD) (n = 100), alcohol dependence (n = 81), major depressive disorder (MDD) (n = 95), psychosomatic disorders (n = 92), anxiety disorders (n = 85), post-traumatic stress disorder (PTSD) (n = 90), attention deficit hyperactivity disorder (ADHD) (n = 55), and suicide attempts (n = 79). Results indicated that the three-factor TAS-16 fit the data well, after removing four items from the externally-oriented thinking (EOT) subscale. In addition, the total score and subscales had strong internal consistency and concurrent validity. An alternative three-factor model and a four-factor model, which both allow the reverse-coded EOT items to load on a separate factor, also had an acceptable fit. The results suggest that after deleting four items from the EOT subscale, the 16-item TAS is a reliable scale among Iranian psychiatric patients. Moreover, the alternative three-factor and four-factor structures may be appropriate to apply among Iranian patients.

     

Measuring test anxiety in children: Scale development and internal construct validation

Given the increased testing of school-aged children in the United States there is a need for a current and valid scale to measure the effects of test anxiety in children. The domain of children's test anxiety was theorized to be comprised of three dimensions: thoughts, autonomic reactions, and off-task behaviors. Four stages are described in the evolution of the Children's Test Anxiety Scale (CTAS): planning, construction, quantitative evaluation, and validation. A 50-item scale was administered to a development sample (N=230) of children in grades 3–6 to obtain item analysis and reliability estimates which resulted in a refined 30-item scale. The reduced scale was administered to a validation sample (N=261) to obtain construct validity evidence. A three-factor structure fit the data reasonably well. Recommendations for future research with the scale are described.     

Subjective, Autonomic, and Endocrine Reactivity during Social Stress in Children with Social Phobia

Reports of exaggerated anxiety and physiological hyperreactivity to social-evaluative situations are characteristic of childhood social phobia (SP). However, laboratory research on subjective, autonomic and endocrine functioning in childhood SP is scarce, inconsistent and limited by small sample sizes, limited breadth of measurements, and the use of non-standardized stressor tasks. We exposed 8–12-year-old children with DSM-IV SP (n = 41) and matched healthy control children (HC; n = 40) to the Trier Social Stress Test for Children (TSST-C) while measuring subjective anxiety, heart rate (HR) and salivary alpha-amylase (sAA) as well as salivary cortisol. The SP children showed heightened reactivity to the TSST-C on subjective anxiety compared to the HC children but not a heightened reactivity in HR, sAA or cortisol. However, the SP children showed chronically elevated HR levels throughout the whole laboratory session. Whereas subjective anxiety seems to respond specifically to social-evaluative stress in childhood SP, HR levels may be chronically elevated suggesting a more generalized autonomic hyperreactivity.     

The Male Body Attitudes Scale: A confirmatory factor analysis with a sample of gay men

The Male Body Attitudes Scale (MBAS; Tylka, Bergeron, & Schwartz, 2005) is a recently created instrument which assesses males’ attitudes regarding their muscularity, body fat, and height. Although the MBAS was created via exploratory and confirmatory factor analyses, its factor structure has yet to be replicated with more diverse samples. The aim of the current study was to conduct a confirmatory factor analysis of the MBAS with a sample of gay men. Results from an online sample of 207 self-identified gay men revealed that the original three-factor structure of the MBAS, as well as a two-factor structure, consisting of muscularity and body fat, displayed strong factorial validity. These findings suggest that either a two- or three-factor structure may be used when assessing body image concerns in gay men.     

Awareness of Death Among Children: Does a Life-Threatening Illness Alter the Process of Discovery?

The authors review studies on death awareness among children who are healthy, chronically ill, and terminally ill. The review suggests that children with life-threatening diseases demonstrate increased understanding of death compared with children who are either healthy or chronically ill. In particular, children with terminal illness, especially during the end stage of their disease, show an advanced understanding of the death concepts of irreversibility and finality. In contrast, healthy and chronically ill children appear to require certain age, cognitive developmental level, or intelligence thresholds to understand these concepts. Possible explanations for the findings in this literature are discussed. The implications of death awareness research for counselors are used as a base for suggesting counseling strategies.     

Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

Factor structure of the Behavior Rating Inventory of Executive Functions (BRIEF-P) at age three years

The preschool period is an important developmental period for the emergence of cognitive self-regulatory skills or executive functions (EF). To date, evidence regarding the structure of EF in preschool children has supported both unitary and multicomponent models. The aim of the present study was to test the factor structure of early EF as measured by the Behavior Rating Inventory of Executive Function-Preschool version (BRIEF-P). BRIEF-P consists of five subscales and three broader indexes, hypothesized to tap into different subcomponents of EF. Parent ratings of EF from a nonreferred sample of children recruited from the Norwegian Mother and Child Cohort Study (N = 1134; age range 37–47 months) were subjected to confirmatory factor analyses (CFA). Three theoretically derived models were assessed; the second-order three-factor model originally proposed by the BRIEF-P authors, a “true” first-order one-factor model and a second-order one-factor model. CFA fit statistics supported the original three-factor solution. However, the difference in fit was marginal between this model and the second-order one-factor model. A follow-up exploratory factor analysis (EFA) supported the existence of several factors underlying EF in early preschool years, with a considerable overlap with the five BRIEF-P subscales. Our results suggest that some differentiation in EF has taken place at age 3 years, which is reflected in behavior ratings. The internal consistency of the BRIEF-P five clinical subscales is supported. Subscale interrelations may, however, differ at this age from those observed in the preschool group as a whole.     

Anxiety sensitivity cognitive concerns drive the relation between anxiety sensitivity and symptoms of depression

Depression is typically treated as a homogeneous construct despite evidence for distinct cognitive, affective, and somatic symptom dimensions. Anxiety sensitivity (AS; the fear of consequences of anxiety symptoms) is a cognitive risk factor implicated in the development of depressive symptoms. However, it is unclear how lower order AS dimensions (i.e. physical, cognitive, and social concerns) relate to depressive symptom factors. Confirmatory factor analysis, followed by structural equation modeling, were conducted to examine the factor structure of depression and to then examine the relations between these factors and the lower order factors of AS. This study was conducted in a sample of 374 adults (M age = 35.5, 54.3% female) with elevated levels of psychopathology (89.2% meeting criteria for at least one DSM-5 diagnosis, 25.6% primary depressive disorder). In this study a two-factor model of depression, composed of Cognitive and Affective/Somatic factors, was superior to one- and three-factor solutions. AS cognitive concerns were related to both cognitive and affective/somatic symptoms of depression. Neither of the other AS dimensions was related to depression symptom dimensions. These findings provide a better understanding of the relations between AS and depression symptoms.     

Money does not bring well‐being,but it does help! The relationship between financial resources and life satisfaction of the chronically ill mediated by social deprivation and loneliness

Chronically ill people have lower incomes and higher illness‐related costs than the general population. Therefore, their financial situation can be considered vulnerable, like their health. The aims of this study were (1) to assess the strength of the relationship between financial resources and life satisfaction of patients with chronic physical illness and (2) to investigate the mediating roles of social deprivation and loneliness in this relationship. Data were used of 1265 patients diagnosed with one or more somatic chronic disease(s), aged 25 years and older, who were recruited from 56 general practices in The Netherlands. GPs provided data on diagnoses and illness duration; chronically ill patients provided data on their functional status, financial situation, social deprivation, loneliness and life satisfaction. Data were analysed by means of correlation and linear regression analyses as well as LISREL path analysis. Available income correlates 0.13 with life satisfaction, which is similar to correlations found in general Western populations. The effect of available income on life satisfaction is mainly an indirect effect that can be explained by the mediating roles of social deprivation and loneliness. Policy should pay specific attention to income support of the chronically ill and disabled in order to improve their opportunities for social participation and increase the quality of their life. Copyright © 2007 John Wiley & Sons, Ltd.     

Family and childhood adjustment in cystic fibrosis

Family adaptation has been commonly associated with the psychological adjustment of chronically ill children. However, few studies have attempted to systematically evaluate this association and its relationship to illness severity. We studied 44 children ages 7 to 15 and their families at a large cystic fibrosis center and obtained measures of 1) impact of illness on the family; 2) family functioning; 3) behavioral adjustment; 4) social competence; 5) ratings of anxiety, depressive, and eating disorder symptoms; and 6) ratings of illness severity and duration. Impact of illness on the family and overall family dysfunction were significantly correlated with illness severity, but not duration. However, impact of illness on the family was significantly correlated with internalizing behavioral symptoms, while family dysfunction was correlated with depressive symptomatology. These findings suggest that illness-related stress is primarily reflected in general emotional and behavioral symptoms, with familial adaptation either ameliorating or exacerbating their development into depressive symptomatology.     

Comparison of impulsiveness, venturesomeness and empathy (I7) structure in English and Spanish samples: Analysis of different structural equation models

The present study analyzed the factorial structure of the I₇ Impulsiveness questionnaire (Impulsiveness, Venturesomeness and Empathy) with a Spanish sample of 742 males and 1.075 females, through exploratory and confirmatory factorial analysis. In relation to the original English data, a three-factor structure showed global congruency coefficients of 0.92 and 0.94 for men and women. Venturesomeness had a modest congruency for males (0.83). A cross-validation analytical strategy showed that the 24-item I₇ was invariant only for the female sample. A subsequent exploratory factor analysis with 24 items showed a sound factor structure. The 24-item version showed the best and most robust structure and similar internal consistency coefficients in regard to the 54-item version. No important differences were founded between I₇ long and short versions with impulsiveness scales of ZKPQ, BIS-10 and SPSRQ.