Construction and evaluation of a self rating scale for stress‐induced Exhaustion Disorder,the Karolinska Exhaustion Disorder Scale

Prolonged stress (≥ six months) may cause a condition which has been named exhaustion disorder (ED) with ICD‐10 code F43.8. ED is characterised by exhaustion, cognitive problems, poor sleep and reduced tolerance to further stress. ED can cause long term disability and depressive symptoms may develop. The aim was to construct and evaluate a self‐rating scale, the Karolinska Exhaustion Disorder Scale (KEDS), for the assessment of ED symptoms. A second aim was to examine the relationship between self‐rated symptoms of ED, depression, and anxiety using KEDS and the Hospital Anxiety and Depression Scale (HAD). Items were selected based on their correspondence to criteria for ED as formulated by the Swedish National Board of Health and Welfare (NBHW), with seven response alternatives in a Likert‐format. Self‐ratings performed by 317 clinically assessed participants were used to analyse the scale's psychometric properties. KEDS consists of nine items with a scale range of 0–54. Receiver operating characteristics analysis demonstrated that a cut‐off score of 19 was accompanied by high sensitivity and specificity (each above 95%) in the discrimination between healthy subjects and patients with ED. Reliability was satisfactory and confirmatory factor analysis revealed that ED, depression and anxiety are best regarded as different phenomena. KEDS may be a useful tool in the assessment of symptoms of Exhaustion Disorder in clinical as well as research settings. There is evidence that the symptom clusters of ED, anxiety and depression, respectively, reflect three different underlying dimensions.     

第二类有中介的调节模型

心理学研究常用有中介的调节模型揭示调节作用通过中介变量间接实现的现象。介绍了第二类有中介的调节模型(meMO-II)的概念及优势; 将meMO-II与其它中介调节混合模型进行了辨析; 给出了meMO-II的建模方法和分析流程, 并用一个实例演示; 介绍了基于潜变量的meMO-II的分析方法、meMO-II建模方法的新进展以及meMO-II的变式。研究有助于推动调节机制研究的发展。     

乳腺病变的常规影像学筛查方法的合理性分析

乳腺癌是妇女最常见的恶性肿瘤之一,在我国,乳腺癌的发病率和死亡率已成为城市女性恶性肿瘤的首位,且每年以3％～5％速度增长。目前乳腺癌防治日益受到重视。然而,为了阻断高危险性的乳腺向乳腺癌发展,乳腺影像学筛查正在被越来越多的女性接受。本文就各种影像检查手段对乳腺疾病特别是乳腺癌诊断的优缺点进行简要的总结,旨在指导临床医师...     

Diagnostic efficiency of several methods of identifying socially rejected children and effect of participation rate on classification accuracy

Social rejection is associated with a wide variety of negative outcomes. Early identification of social rejection and intervention to minimize its negative impact is thus important. However, sociometric methods, which are considered high in validity for identifying socially rejected children, are frequently not used because of (a) procedural challenges, (b) community apprehension, and (c) sensitivity to missing data. In a sample of 316 students in grades K through 8, we used receiver operating characteristics (ROC) analyses to compare the diagnostic efficiency of several methods for identifying socially rejected children. When not using least-liked nominations, (a) most-liked nominations yielded the greatest diagnostic efficiency (AUC = .96), (b) peer ratings were more efficient (AUC = .84 to .99) than teacher ratings (AUC = .74 to .81), and (c) teacher report of social status was more efficient (AUC = .81) than scores from teacher behavior rating scales (AUC = .74 to .75). We also examined the effects of nominator non-participation on diagnostic efficiency. At participation as low as 50%, classification of sociometric rejection (i.e., being rejected or not rejected) was quite accurate (κ = .63 to .77). In contrast, at participation as high as 70%, classification of sociometric status (i.e., popular, average, unclassified, neglected, controversial, or rejected) was significantly less accurate (κ = .50 to .59).     

Second order change and evidence‐based practice

Since its inception, family therapy (FT) has been distinguished by its explicit theoretical and practical focus on families and relationships as systems, with an emphasis on second order rather than first order change. As a result of these conceptual underpinnings we suggest that FT needs to look for manifestations of change which differ from individually focused disciplines such as clinical psychology. Studies of second order change have most commonly appeared in the form of conceptual papers and doctoral dissertations. We begin by revisiting the conceptual underpinnings of second order change. Building on this framework, we develop these aspects of change within the framework of recent developments in the empirical study of change. Finally, we point towards some promising directions for further evaluative work of FT as well as ways to incorporate some of these principles into training of FT students.     

A randomised trial of the effect of appearance versus health-framed messages on engagement with an online brief screening and alcohol reduction intervention

Objectives: To compare the impact of appearance versus health-framed messages on engagement in a brief web-based risk screening and alcohol reduction intervention.

Design: Randomised trial delivered via Drinkaware’s website. Visitors were exposed to appearance (n?=?51,588) or health-framed messages (n?=?52,639) directing them towards an AUDIT-C risk screening questionnaire. Users completing this questionnaire were given feedback on their risk level and extended frame-congruent information.

Outcomes: The primary outcome is completion of the AUDIT-C questionnaire. The secondary outcome is whether the participant accessed any of four further resources.

Results: The appearance-framed message led to a small but significant increase in the number of users completing the AUDIT-C compared to the health-framed message (n?=?3,537, 6.86% versus n?=?3,355, 6.37%, p?<?0.01). Conversely, following subsequent risk feedback, users exposed to extended health-framed information were more likely to access further resources (n?=?1,146, 2.17% versus n?=?942, 1.83%, p?<?0.01).

Conclusions: Physical appearance-framed messages increased the likelihood of engagement with an online alcohol screening and brief intervention tool, whereas health-framed messages increased the likelihood of accessing further resources. This highlights the potential for the use of multi-level approaches in alcohol reduction interventions.