Diagnosing depression in patients with physical diseases using the beck depression inventory (BDI)

Abstract

Four-hundred-and-forty-three patients with a physical illness (355 with coronary heart disease and 88 with chronic pain), 150 unemployed persons and 623 subjects from the normal population in Jämtland, Sweden were tested using the BDI (Beck Depression Inventory). The aim of the study was to investigate whether scores on both the physical and non-physical components of the BDI differed between the patients and the other groups, or whether only the physical component was significantly higher in the patient group, and in such a case whether this could be interpreted as symptomatic of physical disease and not of depression. A cutoff score of ≥ 10 to determine mild depression and two different alternative physical and non-physical components were used. Forty-three percent of the patients with coronary heart disease and 50% of patients with chronic pain were categorized as being at least mildly depressed. Factor analyses indicated that a physical component comprising five items was the most meaningful and could best discriminate the physical symptoms. The patients' scores were significantly higher than those of the other two groups on the physical component but only higher than the normal population sample on the nun-physical component. This supports the idea that the items for physical symptoms in the BDI might be confounding when determining depression in patients with physical diseases. The non-physical component seems to be the best indicator of depression and is recommended as a complement to the total BDI scale when determining the degree of depression in patients suffering from a physical disease.     

Measuring Change in Depression-Related Interpretation Bias: Development and Validation of a Parallel Ambiguous Scenarios Test

Depressed mood is associated with making negatively biased interpretations of ambiguous everyday events. Experimental modification towards a more optimistic interpretation has become a focus of recent research. However, to date, no measures exist that have been tested with respect to their psychometric properties that justify repeated administration to capture change. We aimed to develop and evaluate a pragmatic assessment instrument, consisting of a 30-item questionnaire (long version) and two 15-item parallel short versions (A and B). Items were generated as ambiguous sentences, reflecting three relevant content areas based on Beck's cognitive triad. The sentences were rated for pleasantness, and this emotional appraisal task indicates the emotional valence of the interpretation. Due to the intention to develop a parallel test version, item-twins were generated. All three versions of the instrument were found to be structurally stable, internally consistent and valid. In line with Beck's cognitive triad in depression, confirmatory factor analyses determined a three-factor solution (i.e. self, experiences and future). Significant correlations were found between all scales and depressive mood. The two short versions represent the same underlying constructs, share identical psychometric properties and possess high parallel-test reliability. This study is the first to evaluate and confirm the factorial validity as well as the parallel-test reliability of an interpretation bias measure. It is suitable to measure bias modification and has therefore great potential for research and clinical practice.     

The Illness/Injury Sensitivity Index: Validation of a German Version of the ISI-R

Three fundamental fears—anxiety sensitivity, fear of negative evaluation, and illness/injury sensitivity—are considered integral components of anxiety-related psychopathology and also bear connections with chronic pain. Scales measuring the first two fears, the Anxiety Sensitivity Index and the Fear of Negative Evaluation Scale, have been translated into German; however, the nine-item Illness/Injury Sensitivity Index-Revised (ISI-R) that measures fears of injury and illness has not been available in German language yet. The aim of this study therefore was a translation of the ISI-R into German language and an initial validation of the translated scale in two different samples. The German ISI-R was translated by both professionals and laypersons, and a final version was decided on by consensus. In Study 1, participants included 96 undergraduate students (85% women) who completed the German version of the ISI as part of a larger study. An exploratory factor analysis with oblique rotation was conducted and suggested a two-factor-solution with one factor representing fears of illness and the other fears of injury. This factor structure was confirmed via a confirmatory factor analysis (CFA) in Study 2. Participants included 117 community members (79% women). Convergent validity was supported using a visual analogue scale for fear of illness in both samples and the German translation of the Whiteley Index in Study. Overall, the results supported the German translation of the ISI-R. Comprehensive results, limitations, and directions for future research are discussed.     

The multidimensionality of test anxiety: A test of different models

Abstract

Confirmatory factor analysis was employed to test the multidimensional structure of test anxiety. Starting with the traditional two-factor model, it was of interest whether additional dimensions could still be represented by a single higher-order factor of test anxiety or whether the additional dimensions represented correlates of test anxiety. The Revised Test Anxiety (RTA) scale and the German Test Anxiety Inventory (TAI-G) were combined collecting data from a binational sample of 218 American and 218 German university students. Considering the statistical and theoretical aspects of model fit, they indicated that a model consisting of three primary factors (worry, emotionality, and lack of confidence) fit the data best. While distraction and self-efficacy may be regarded as correlates of test anxiety, lack of confidence was substantiated as a component of test anxiety. Implications for the conceptualization of the content domain and hence area of test anxiety were discussed.     

Work engagement and voluntary absence: The moderating role of job resources

The present study examined the moderating role of job resources, namely, organizational trust, the quality of employees’ relationship with their manager, and the motivating potential of jobs, on the negative relationship between work engagement and voluntary absence. Employee survey results and absence records collected from the Human Resources department of a construction and consultancy organization in the United Kingdom (n = 325) showed that work engagement was negatively related to voluntary absence, as measured by the Bradford Factor. Furthermore, the results showed that organizational trust and the quality of employees’ relationships with their line managers ameliorated the negative effect of relatively low levels of engagement on voluntary absence. Theoretical and practical implications of the findings are discussed.     

The effect of response style bias on the measurement of transformational,transactional, and laissez-faire leadership

Transformational, transactional, and laissez-faire leadership are considered to be three distinct leadership styles. In this research we argue that response style behaviour in the form of acquiescence and extreme response style can distort the measurement of these dimensions of leadership. Using a sample of 864 employees selected from 135 work teams, this research demonstrates that (1) response styles affect measurement; (2) divergent validity of the three dimensions increases when response styles are taken into account; (3) gender is spuriously related to leadership upon response styles; and (4) team ratings substantially change when controlling for response styles bias. As a secondary topic of this research, we elaborate on a relatively new approach in diagnosing response styles, i.e., a confirmatory latent-class factor analysis. We explain the advantages of this approach and illustrate the steps a researcher has to take in conducting this type of analysis.     

Longitudinal Changes in Memory Performance and Processing Speed in Old Age abstract Keywords

The speed theory of cognitive aging posits that an age-related slowing of processing speed leads to impairments in higher order cognitive functions, such as memory. However, only few studies have examined the relationship between longitudinal changes in processing speed and longitudinal changes in memory performance. In the present study, data of 474 older adults (T1: 59–65 years) from the Interdisciplinary Longitudinal Study on Adult Development (ILSE) were used to investigate whether changes in speed and in memory were associated over a 4-year period. Performance changes in both constructs were analyzed using latent change factor models. Results show that latent changes in processing speed and latent changes in memory performance correlated with 0.61. This association is considerably lower than what would have been expected from cross-sectional data. Our longitudinal results suggest that although speed changes explain a substantial proportion of variance in memory changes, additional explanatory factors must be taken into consideration.     

Adult age differences in subjective and objective measures of strategy use on a sequentially cued prediction task

Differences in strategy use are thought to underlie age-related performance deficits on many learning and decision-making tasks. Recently, age-related differences in learning to make predictions were reported on the Triplets Prediction Task (TPT). Notably, deficits appeared early in training and continued with experience. To assess if age differences were due to early strategy use, neural networks were used to objectively assess the strategies implemented by participants during Session 1. Then, the relationship between these strategies and performance was examined. Results revealed that older adults were more likely to implement a disadvantageous strategy early in learning, and this led to poorer task performance. Importantly, the relationship between age and task performance was partially mediated by early strategy use, suggesting that early strategy selection played a role in the lower quality of predictions in older adults.     

Actuarial Criminology: Meeting Current Challenges in Southern Africa

South African prisons were overcrowded by more than sixty-three percent in 2005. Overcrowding and poor prison conditions have enormous implications for rehabilitation efforts made by the South African Department of Correctional Services. The South African White Paper on Corrections (2005) commits the Department of Correctional Services to provide needs-based rehabilitation processes and a framework of continuous evaluation to measure the impact and success of such processes. It also acknowledges that monitoring the rates of recidivism is a critical indicator of the success, the effectiveness of needs-based rehabilitation, and improved service. A reliable system for monitoring recidivism will have to be developed and put in place. In this respect, actuarial criminology can make a vital contribution. This article poses a strategic alternative to the correctional industry in Southern Africa that can be used for the realization of correctional ideals, especially where retribution and overcrowding are still the main features of correctional institutions.     

Factor structure of the construct of adaptive behavior in children with and without intellectual disability

Although the presence of significant limitations in adaptive behavior constitutes one of the three necessary criteria for diagnosing intellectual disability, adaptive behavior structure has always been the subject of considerable controversy among researchers. The main goal of this study is to extend previous research results that provide further support to a multidimensional structure of conceptual, social, and practical skills compared to the unidimensional structure. One-factor and 3-correlated factors models as measured by 15 observable indicators were analyzed by means of confirmatory factor analysis (CFA), as well as their relationships with one second-order factor (i.e., adaptive behavior). To that end, 388 children with and without intellectual disabilities were assessed with the Diagnostic Adaptive Behavior Scale (DABS). Results of CFA indicated that the 3 first-order factors solution provides the best fit to the data. Reliability and validity of the multidimensional model were also analyzed through different methods such as the composite reliability and the average variance extracted. Finally, implications of these findings and possible directions for future research are discussed.