The Modified Rush Sexual Inventory: preliminary psychometric findings

A comparison and analysis of seven gun law permissiveness scales

BACKGROUND

Due to the differences in the way gun law permissiveness scales were created and speculation about the politically motivated underpinnings of the various scales, there have been questions about their reliability.

METHODS

We compared seven gun law permissiveness scales, varying by type and sources, for an enhanced understanding of the extent to which choice of a gun law permissiveness scale could affect studies related to gun violence outcomes in the United States. Specifically, we evaluated seven different scales: two rankings, two counts, and three scores, arising from a range of sources. We calculated Spearman correlation coefficients for each pair of scales compared. Cronbach's standardized alpha and Guttman's lambda were calculated to evaluate the relative reliability of the scales, and we re-calculated Cronbach's alpha after systematically omitting each scale to assess whether the omitted scale contributed to lower internal consistency between scales. Factor analysis was used to determine single factor loadings and estimates. We also assessed associations between permissiveness of gun laws and total firearm deaths and suicides in multivariable regression analyses.

RESULTS

All pairs of scales were highly correlated (average Spearman's correlation coefficient r = 0.77) and had high relative reliability (Cronbach's alpha = 0.968, Guttman's lambda = 0.975). All scales load onto a single factor. The choice of scale did not meaningfully change the parameter estimates for the associations between permissiveness of gun laws and gun deaths and suicides.

CONCLUSION

Gun law permissiveness scales are highly correlated despite any perceived political agenda, and the choice of gun law permissiveness scale has little effect on study conclusions related to gun violence outcomes.

Evaluating and Refining the Construct of Sexual Quality With Item Response Theory: Development of the Quality of Sex Inventory

This study took a critical look at the construct of sexual quality. The 65 items of four well-validated self-report measures of sexual satisfaction (the Index of Sexual Satisfaction [ISS], Hudson, Harrison, & Crosscup, 1981; the Global Measure of Sexual Satisfaction [GMSEX], Lawrance & Byers, 1995; the Pinney Sexual Satisfaction Inventory [PSSI], Pinney, Gerrard, & Denney, 1987; the Young Sexual Satisfaction Scale [YSSS], Young, Denny, Luquis, & Young, 1998) and an additional 74 potential sexual quality items were given to 3060 online participants. Using Item Response Theory (IRT), we demonstrated that the ISS, YSSS, and PSSI scales provided suboptimal levels of precision in assessing sexual quality, particularly given the length of those scales. Exploratory factor analyses, IRT, differential item functioning analyses, and longitudinal responsiveness analyses were used to develop and evaluate the Quality of Sex Inventory. Results suggested that, in comparison to existing scales, the QSI (1) offers investigators and clinicians more theoretically focused scales, (2) distinguishes sexual satisfaction from sexual dissatisfaction, and (3) offers greater precision and power for detecting differences with (4) comparably high levels of responsiveness for detecting change over time despite being notably shorter than most of the existing scales. The QSI-satisfaction subscales demonstrated strong convergent validity with other measures of sexual satisfaction and excellent construct validity with anchor scales from the nomological net surrounding that construct, suggesting that they continue to assess the same theoretical construct as prior scales. Implications for research are discussed.

Long-Term Chamomile Therapy of Generalized Anxiety Disorder: A Study Protocol for a Randomized, Double-Blind, Placebo- Controlled Trial

BACKGROUND

Anxiety symptoms are among the most common reasons for consumers to use Complementary and Alternative Medicine (CAM) therapy. Although many botanicals have been proposed as putative remedies for anxiety symptoms, there has been a paucity of controlled trials of these remedies. A preliminary study of the anxiolytic effect of Chamomile (Matricaria recutita) in humans suggests that chamomile may have anxiolytic and antidepressant activity. We now seek to conduct a 5-year randomized, double-blind, placebo-substitution study to examine the short and long-term safety and efficacy of chamomile extract in Generalized Anxiety Disorder (GAD).

METHODS/DESIGN

180 subjects with moderate to severe GAD will receive initial open-label pharmaceutical-grade chamomile extract 500-1,500 mg daily for 8 weeks. Responders to treatment who remain well for an additional 4 weeks of consolidation therapy, will be randomized to double-blind continuation therapy with either chamomile extract 500-1,500 mg daily or placebo for an additional 26 weeks. The primary outcome will be the time to relapse during study continuation therapy in each treatment condition. Secondary outcomes will include the proportion of subjects in each treatment condition who relapse, as well as the proportion of subjects with treatment-emergent adverse events. Quality of life ratings will also be compared between treatment conditions during short and long-term therapy.

DISCUSSION

Many individuals with mental disorders decline conventional therapy and seek CAM therapies for their symptoms. Thus, the identification of effective CAM therapy is of relevance to reducing the burden of mental illness. This study builds upon our prior findings of significant superiority of chamomile versus placebo in reducing GAD symptoms. We now extend these preliminary findings by conducting a randomized long-term safety and efficacy study of chamomile in GAD.

Rhodiola rosea therapy for major depressive disorder: a study protocol for a randomized, double-blind, placebo- controlled trial

BACKGROUND

Rhodiola rosea (R. rosea), a botanical of both western and traditional Chinese medicine, has been used as a folk remedy for improving stamina and reducing stress. However, few controlled clinical trials have examined the safety and efficacy of R. rosea for the treatment of major depressive disorder (MDD). This study seeks to evaluate the safety and efficacy of R. rosea in a 12-week, randomized, double-blind, placebo-controlled, parallel group study design.

METHODS / DESIGN

Subjects with MDD not receiving antidepressant therapy will be randomized to either R. rosea extract 340-1,360 mg daily; sertraline 50-200 mg daily, or placebo for 12 weeks. The primary outcome measure will be change over time in the mean 17-item Hamilton Depression Rating score. Secondary outcome measures will include safety and quality of life ratings. Statistical procedures will include mixed-effects models to assess efficacy for primary and secondary outcomes.

DISCUSSION

This study will provide valuable preliminary information on the safety and efficacy data of R. rosea versus conventional antidepressant therapy of MDD. It will also inform additional hypotheses and study design of future, fully powered, phase III clinical trials with R. rosea to determine its safety and efficacy in MDD.

Should questionnaires of female sexual dysfunction be used in routine clinical practice?

AIMS

The aim of this paper is to explore the potential value of questionnaires in routine clinical practice to assess female sexual dysfunction (FSD), and to identify if this could increase the competence of a physician in the initial management of women with these problems. The rationale to encourage Health Care Professionals (HCPs) to engage women in dialogue about their sexual health is that it may enhance a woman's quality of life (which may lead to improved general health) and might lead to timely interventions and possible preventative measures for certain diseases.

METHOD

A short literature review of the most relevant publications was undertaken evaluating current practice.

RESULTS

FSD can have a negative impact on women's well-being and can also be an early symptom of underlying disease. Many HCPs do not broach the subject, consequently women do not get the opportunity either to voice their sexual concerns or access appropriate services. Review of currently available FSD questionnaires suggests that many but not all are generally inappropriate for use in routine clinical practice. Kriston et al.'s STEFFI-2 may be an appropriate starting point. Evidence suggests that this would facilitate discussion of sexual matters between the HCP and the women, and increase the likelihood of FSD being diagnosed.

CONCLUSIONS

Following this review of the literature, the authors strongly recommend that HCPs include FSD questionnaires as part of their routine engagement with women. However, the questionnaire would need to be used as part of the overall assessment and cannot replace a detailed case history and examination, which should lead to effective treatment and management of FSD. The authors recommend further research in the following areas: • Effective training for HCPs. • FSD as an early presentation of sub-clinical disease. • The cost-benefit of early treatment of FSD. • A standardised, validated FSD screening tool. • Benefits of using FSD screener in routine clinical practice.

Adverse effects of antipsychotics as outcome measures

BACKGROUND

Antipsychotic drugs are associated with adverse effects that can lead to poor medication adherence, stigma, distress and impaired quality of life.

AIMS

To review the use of adverse effects of antipsychotic drugs as outcome measures, with a particular emphasis on methodological issues.

METHOD

Review of data on adverse effects from sources including randomised controlled trials (RCTs), post-marketing surveillance and naturalistic studies.

RESULTS

All have advantages and disadvantages and the best overview comes from considering all sources of data together. Adverse effects are inconsistently reported, hampering cross-study comparisons. Many outcome measures lack clinical meaning. In both naturalistic studies and RCTs adverse effects often account for less treatment discontinuation than lack of efficacy.

CONCLUSIONS

Standardisation in the reporting of adverse effects is needed. Patients' subjective experience of medication should be given more consideration. Total discontinuation rates provide a useful global outcome measure that incorporates tolerability and efficacy as well as patient and clinician viewpoints. Patients should be informed of common side-effects prior to treatment and monitored for their occurrence during treatment.