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Studer M, Guggisberg AG, Gyger N, Gutbrod K, Henke K, Heinemann D. Accelerated long-term forgetting in patients with acquired brain injury. Brain Inj 2024; 38:377-389. [PMID: 38385560 DOI: 10.1080/02699052.2024.2311349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Recent research suggests that patients with neurological disorders without overt seizures may also experience accelerated long-term forgetting (ALF). This term describes unimpaired learning and memory performance after standard retention intervals, but an excessive rate of forgetting over delays of days or weeks. The objective of this retrospective study was to investigate ALF in patients with an acquired brain injury (ABI) and to associate memory performance with executive functions. METHODS Verbal memory performance (short-term recall, 30-min recall, 1-week recall) was assessed in 34 adult patients with ABI and compared to a healthy control group (n = 54) using an auditory word learning and memory test. RESULTS Repeated measure analysis showed significant effects of time and group as well as interaction effects between time and group regarding recall and recognition performance. Patients with ABI had a significantly impaired 1-week recall and recognition performance compared to the healthy control group. Correlations between recall performance and executive functions were nonsignificant. DISCUSSION Our results demonstrate that non-epileptic patients with ABI, especially patients with frontal and fronto-temporal lesions, are prone to ALF. Additionally, our data support the assumption that ALF results from a consolidation impairment since verbal recall and recognition were impaired in patients with ABI.
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Affiliation(s)
- M Studer
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital Basel (UKBB), Basel, Switzerland
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - A G Guggisberg
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - N Gyger
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - K Gutbrod
- Neurozentrum Bern, Bern, Switzerland
| | - K Henke
- Institute of Psychology, University of Bern, Bern, Switzerland
| | - D Heinemann
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
- Department of Neurology, Cantonal Hospital Aarau, Aarau, Switzerland
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Upegui-Arango LD, Mainz V, Gecht J, Mueller CA, Quack V, Heinemann AW, Boecker M. Development of the German social attitude barriers and facilitators to participation-scales: an analysis according to the Rasch model. BMC Musculoskelet Disord 2022; 23:423. [PMID: 35524254 PMCID: PMC9074200 DOI: 10.1186/s12891-022-05339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Social attitudes experienced by people with disabilities can strongly impact upon their health and quality of life. The extent to which social attitude measurement transcends specific cultures is unknown. Thus, the aim of the study was to develop German item banks to assess social attitude barriers and facilitators to participation and compare the construct definition with that developed in the United States. Methods The American version of the two item banks assessing social attitudes that act as barriers and facilitators in persons with disabilities was translated into German and culturally adapted. The sample consisted of 410 in- and outpatients treated for spinal diseases at a German University Hospital. The psychometric properties of the resulting 53 items-item pool were evaluated using Rasch analysis. A special focus was placed on the investigation of unidimensionality, local independence, differential item functioning (DIF) and targeting. To evaluate convergent and divergent validity correlations with perceived social support, depression and pain interference were calculated. Results Unlike the American version, both the barriers and facilitators item banks had to be divided into two subscales assessing attitudes that individuals with disabilities experience as being directed towards them (individual perception) or attitudes that respondents experience as being directed towards people with disabilities as a social group (societal perception). Four unidimensional scales were constructed. Fit to the Rasch model required item deletion and forming testlets to account for extensive local dependence. There was no evidence of DIF with regard to gender or age. Targeting of the subscales was moderate to good. Conclusions Results support a distinction between social attitudes at the individual and societal level, allowing a more specific assessment than is possible when this distinction is ignored. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05339-0.
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Affiliation(s)
- Luz Dary Upegui-Arango
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany
| | - Judith Gecht
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany.,Clinic for Anesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen, Aachen, Germany.,AIXTRA - Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen, Aachen, Germany
| | | | - Valentin Quack
- Department of Orthopaedic Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Allen W Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Maren Boecker
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen University, Aachen, Germany.
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Quack V, Boecker M, Mueller CA, Mainz V, Geiger M, Heinemann AW, Betsch M, El Mansy Y. Psychological factors outmatched morphological markers in predicting limitations in activities of daily living and participation in patients with lumbar stenosis. BMC Musculoskelet Disord 2019; 20:557. [PMID: 31759398 PMCID: PMC6875026 DOI: 10.1186/s12891-019-2918-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 10/29/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recent demographic changes have led to a large population of older adults, many of whom experience degenerative disc diseases. Degenerative lumbar spinal stenosis (DLSS) is associated with considerable discomfort and limitations in activities of daily living (ADL). Symptomatic DLSS is one of the most frequent indications for spinal surgery. The aim of this study was to identify sociodemographic variables, morphological markers, depression as well as fear of movement that predict ADL performance and participation in social life in patients with DLSS. METHODS Sixty-seven patients with DLSS (mean age 62.5 years [11.7], 50.7% females) participated in the study. Predictor variables were age, gender, duration of disease, three morphological markers (severity of the lumbar stenosis, the number of affected segments and presence of spondylolisthesis) as well as self-reported depression and fear of movement. Dependent variables were pain interference with the performance of ADLs, ADLs and participation in social life. Correlations between predictor and dependent variables were calculated before stepwise, linear regression analyses. Only significant correlations were included in the linear regression analyses. RESULTS Variance explained by the predictor variables ranged between 12% (R2 = .12; pain interference-physical) and 40% (R2 = .40; ADL requiring lower extremity functioning; participation). Depression and fear of movement were the most powerful predictors for all dependent variables. Among the morphological markers only stenosis severity contributed to the prediction of ADLs requiring lower extremity functioning. CONCLUSION Depression and fear of movement were more important predictors of the execution of ADLs and participation in social life compared to morphological markers. Elevated depressive symptoms and fear of movement might indicate limited adaptation and coping regarding the disease and its consequences. Early monitoring of these predictors should therefore be conducted in every spine centre. Future studies should investigate whether psychological screening or a preoperative psychological consultation helps to avoid operations and enables better patient outcomes.
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Affiliation(s)
- V. Quack
- Department of Orthopedic Surgery, RWTH Aachen University, Aachen, Germany
| | - M. Boecker
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
- Department of Medical Psychology and Medical Sociology, RWTH Aachen University, Aachen, Germany
| | - C. A. Mueller
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - V. Mainz
- Department of Medical Psychology and Medical Sociology, RWTH Aachen University, Aachen, Germany
| | - M. Geiger
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - A. W. Heinemann
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL USA
| | - M. Betsch
- Department of Orthopedic Surgery, RWTH Aachen University, Aachen, Germany
| | - Y. El Mansy
- Department of Orthopedic Surgery, RWTH Aachen University, Aachen, Germany
- The Orthopedic Department, Alexandria University, Alexandria, Egypt
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The role of childhood abuse for suicidality in the context of the interpersonal theory of suicide: An investigation in German psychiatric inpatients with depression. J Affect Disord 2019; 245:788-797. [PMID: 30448764 DOI: 10.1016/j.jad.2018.11.063] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/27/2018] [Accepted: 11/03/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Several studies provide evidence for a relationship between childhood abuse and suicidality across the lifespan. To examine this association in the context of the Interpersonal Psychological Theory of Suicide (IPTS), we investigated whether its constructs thwarted belongingness, perceived burdensomeness and capability for suicide are potential mediators. METHODS Eighty-four German psychiatric inpatients with unipolar depression (M = 37.6 years, 69% female) and current or lifetime suicidal ideation were included. For the assessment we used the Childhood Trauma Screener (CTS), the Rasch-based Screening for Depression (DESC-I), the Interpersonal Needs Questionnaire (INQ), the German Capability for Suicide Questionnaire (GCSQ), the Beck Scale for Suicide Ideation (BSS) and the Suicide Behaviors Questionnaire-Revised (SBQ-R). Simple and multiple mediator analyses were applied. RESULTS Most patients (70%) had experienced childhood abuse. Emotional abuse showed an indirect association with suicidal ideation via thwarted belongingness and perceived burdensomeness, whereas physical and sexual abuse were indirectly related to suicide risk via capability for suicide. LIMITATIONS The small sample size and the cross-sectional design are limiting factors of the present study. CONCLUSIONS Childhood abuse is a common experience of inpatients with unipolar depression. This study showed its indirect effects on suicidal ideation and risk for suicide, mediated by the constructs of the IPTS. Further research should investigate this issue in other populations and clinicians should be aware of the devastating effects of childhood abuse.
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Forkmann T, Kroehne U, Wirtz M, Norra C, Baumeister H, Gauggel S, Elhan AH, Tennant A, Boecker M. Adaptive screening for depression--recalibration of an item bank for the assessment of depression in persons with mental and somatic diseases and evaluation in a simulated computer-adaptive test environment. J Psychosom Res 2013; 75:437-43. [PMID: 24182632 DOI: 10.1016/j.jpsychores.2013.08.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study conducted a simulation study for computer-adaptive testing based on the Aachen Depression Item Bank (ADIB), which was developed for the assessment of depression in persons with somatic diseases. Prior to computer-adaptive test simulation, the ADIB was newly calibrated. METHODS Recalibration was performed in a sample of 161 patients treated for a depressive syndrome, 103 patients from cardiology, and 103 patients from otorhinolaryngology (mean age 44.1, SD=14.0; 44.7% female) and was cross-validated in a sample of 117 patients undergoing rehabilitation for cardiac diseases (mean age 58.4, SD=10.5; 24.8% women). Unidimensionality of the itembank was checked and a Rasch analysis was performed that evaluated local dependency (LD), differential item functioning (DIF), item fit and reliability. CAT-simulation was conducted with the total sample and additional simulated data. RESULTS Recalibration resulted in a strictly unidimensional item bank with 36 items, showing good Rasch model fit (item fit residuals<|2.5|) and no DIF or LD. CAT simulation revealed that 13 items on average were necessary to estimate depression in the range of -2 and +2 logits when terminating at SE≤0.32 and 4 items if using SE≤0.50. Receiver Operating Characteristics analysis showed that θ estimates based on the CAT algorithm have good criterion validity with regard to depression diagnoses (Area Under the Curve≥.78 for all cut-off criteria). CONCLUSION The recalibration of the ADIB succeeded and the simulation studies conducted suggest that it has good screening performance in the samples investigated and that it may reasonably add to the improvement of depression assessment.
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Affiliation(s)
- Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Germany.
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Vehren T, Boecker M, Norra C, Wirtz M, Gauggel S, Forkmann T. Cross-sectional validation of the Rasch-based Depression Screening (DESC) in a mixed sample of patients with mental and somatic diseases. Compr Psychiatry 2013; 54:1082-9. [PMID: 23751247 DOI: 10.1016/j.comppsych.2013.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2012] [Revised: 04/18/2013] [Accepted: 05/02/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The study aimed to cross-validate the psychometric properties of the two parallel versions of the "Rasch-based Depression Screening (DESC)" in a mixed clinical sample of patients with mental disorders and somatic diseases. Additionally, it was intended to confirm the initially proposed cut-off scores. METHODS One hundred eleven inpatients from the Departments of Psychiatry (n=50), Cardiology (n=39) and Otorhinolaryngology (n=22) were examined. Accordance to Rasch model assumptions was determined by analyzing item infit and outfit as well as unidimensionality and local independence via residual principal components factor analysis (PCFA). Furthermore, separation, reliability and the targeting were considered. Differential item functioning (DIF) was investigated with regard to gender, age and clinical group. Finally, receiver operating characteristics (ROC) curves analyses were conducted and parallel test reliability was calculated. RESULTS Item and person separation and reliability were good with separation values being above 2.90 and reliability exceeding being .90. Rasch model fit was good for all items except for the two items "sad" and "hopeless" displaying slight misfit. Targeting was appropriate with a person mean of -1.6 (DESC-I) and -1.5 (DESC-II) reflecting as expected that the two DESC versions were in average to easy for a mixed sample of patients with mental disorders and somatic. PCFA showed unidimensionality and local independence: The Rasch dimension "depression" explained 84.8% (DESC-I) and 82.2% (DESC-II) of the observed variance. No DIF was found. ROC curves confirmed the proposed cut-off score of 12 points. The area under the curve amounted to .91 for both DESC forms. The Youden index was 75.5 for DESC-I and 75.7 for DESC-II. A high parallel test reliability of .94 showed virtual equivalence of both DESC forms. CONCLUSIONS Results of the present study support the good psychometric properties of both DESC forms in patients with mental disorders and somatic diseases. This study confirmed the cut-off scores that had already been determined in former patient samples. Thus, both DESC forms can be used validly as screening instruments for depression in clinical practice.
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Affiliation(s)
- Thomas Vehren
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Pauwelsstr. 19, 52074 Aachen, Germany.
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Forkmann T, Böcker M, Wirtz M, Norra C, Gauggel S. Entwicklung, Validierung und Normierung des Rasch-basierten Depressionsscreenings. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2012. [DOI: 10.1026/1616-3443/a000116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Vor dem Hintergrund hoher Prävalenzraten für depressive Störungen bei somatisch Erkrankten sowie artifizieller Effekte bei wiederholten Messungen wurde das Rasch-basierte Depressionsscreening (DESC) entwickelt. Fragestellung: Der Entwicklungs-, Validierungs- und Normierungsprozess des Verfahrens wird zusammengefasst und die Nützlichkeit für die klinische Praxis diskutiert. Methoden: Ausgehend von der Aachener Depressionsitembank ( Forkmann et al., 2009 ) wurde das DESC anhand von N = 333 psychisch/somatisch erkrankten Patienten (Alter M = 43,6 Jahre; 46,2% Frauen) mittels Strukturmodellierung und Rasch-Analyse entwickelt, an verschiedenen klinischen Stichproben überprüft und bevölkerungsrepräsentativ normiert (N = 2 .509). Ergebnisse: Eindimensionalität und Rasch-Modellkonformität der Parallelformen wurden bestätigt und Cut-Off-Werte mit guter Sensitivität und Spezifität bestimmt. Die Paralleltestreliabilität war in allen Stichproben >0.9. Schlussfolgerungen: Mit dem DESC steht ein neues Verfahren mit guten psychometrischen Eigenschaften zur Verfügung, das das Instrumentarium zur Depressionsdiagnostik sinnvoll ergänzt.
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Affiliation(s)
- Thomas Forkmann
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum der RWTH Aachen University
| | - Maren Böcker
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum der RWTH Aachen University
| | - Markus Wirtz
- Abteilung Forschungsmethoden, Institut für Psychologie, Pädagogische Hochschule Freiburg i.Br
| | - Christine Norra
- Psychiatrie – Psychotherapie – Psychosomatik – Präventivmedizin, LWL-Universitätsklinikum, Ruhr-Universität Bochum
| | - Siegfried Gauggel
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum der RWTH Aachen University
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Wirtz M, Boecker M, Forkmann T, Neumann M. Evaluation of the "Consultation and Relational Empathy" (CARE) measure by means of Rasch-analysis at the example of cancer patients. PATIENT EDUCATION AND COUNSELING 2011; 82:298-306. [PMID: 21256692 DOI: 10.1016/j.pec.2010.12.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 12/08/2010] [Accepted: 12/12/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The aims of this study are: (1) analysis of unidimensionality of the German version of the "Consultation and Relational Empathy" (CARE) measure and (2) identification of moderating variables affecting the scale structure. METHODS The CARE-measure was evaluated by means of Rasch-analysis in a sample of N=326 cancer patients. Association of diagnosis and treatment as well as patients' characteristics was analyzed by person-fit measures and Differential Item Functioning. RESULTS Nine of the original 10 CARE items fit to the Rasch-model. For breast and prostate cancer, as well as for patients taking complementary and alternative medicine treatment, item biases affect the scale structure. Furthermore, older patients and patients with higher social support exhibit substantial deviations from model predictions. CONCLUSIONS Only the nine-item version of the CARE-measure allows for the unidimensional assessment of physician empathy. Especially for specific diagnosis and treatment groups, the CARE-items indicate variations in the underlying latent construct of physician empathy. PRACTICE IMPLICATIONS The CARER-measure provides a theory-based and psychometrically sound basis for the assessment of PE. It can be used to enhance the fairness of the assessment and to further identify valuable information about the influence of patient characteristics on the structure of the construct PE.
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Affiliation(s)
- Markus Wirtz
- Department of Research Methods, Institute of Psychology, University of Education Freiburg, Freiburg, Germany.
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Forkmann T, Boecker M, Wirtz M, Glaesmer H, Brähler E, Norra C, Gauggel S. Validation of the Rasch-based Depression Screening in a large scale German general population sample. Health Qual Life Outcomes 2010; 8:105. [PMID: 20858272 PMCID: PMC2954976 DOI: 10.1186/1477-7525-8-105] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 09/21/2010] [Indexed: 01/27/2023] Open
Abstract
Background The study aimed at presenting normative data for both parallel forms of the "Rasch-based Depression Screening (DESC)", to examine its Rasch model conformity and convergent and divergent validity based on a representative sample of the German general population. Methods The sample was selected with the assistance of a demographic consulting company applying a face to face interview (N = 2509; mean age = 49.4, SD = 18.2; 55.8% women). Adherence to Rasch model assumptions was determined with analysis of Rasch model fit (infit and outfit), unidimensionality, local independence (principal component factor analysis of the residuals, PCFAR) and differential item functioning (DIF) with regard to participants' age and gender. Norm values were calculated. Convergent and divergent validity was determined through intercorrelations with the depression and anxiety subscales of the Hospital Anxiety and Depression Scale (HADS-D and HADS-A). Results Fit statistics were below critical values (< 1.3). There were no signs of DIF. The PCFAR revealed that the Rasch dimension "depression" explained 68.5% (DESC-I) and 69.3% (DESC-II) of the variance, respectively which suggests unidimensionality and local independence of the DESC. Correlations with HADS-D were rDESC-I = .61 and rDESC-II = .60, whereas correlations with HADS-A were rDESC-I = .62 and rDESC-II = .60. Conclusions This study provided further support for the psychometric quality of the DESC. Both forms of the DESC adhered to Rasch model assumptions and showed intercorrelations with HADS subscales that are in line with the literature. The presented normative data offer important advancements for the interpretation of the questionnaire scores and enhance its usefulness for clinical and research applications.
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Affiliation(s)
- Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany.
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