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Rogers TA, Gorday JY, Bardeen JR, Benfer N. Examining the Factor Structure and Incremental Utility of the Contrast Avoidance Questionnaires via Bifactor Analysis. J Pers Assess 2023; 105:238-248. [PMID: 35674446 DOI: 10.1080/00223891.2022.2081921] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The negative emotional contrast avoidance model posits that pathological worry is maintained by the avoidance of negative emotional shifts. The Contrast Avoidance Questionnaires (CAQ-Worry and CAQ-General Emotion) aim to assess contrast avoidance beliefs and behaviors. Questions remain around the factor structures of the CAQs, whether such structures replicate in nonundergraduate samples, and whether their domain-specific factors are valid for independent use. This study used bifactor analysis in a large community sample (N = 827) to address these gaps in the literature. Results supported bifactor models of both measures. Complementary analyses supported the multidimensionality of the CAQ-Worry, including its strong general factor and independent use of two domain-specific factors, rather than the original three domain-specific factors. The CAQ-General Emotion's general factor was strong, but the merits of the Discomfort domain-specific factor require more exploration, and use of the Avoidance domain-specific factor is discouraged.
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Affiliation(s)
- Travis A Rogers
- Department of Psychological Sciences, Auburn University, Auburn, AL
| | - Julia Y Gorday
- Department of Psychological Sciences, Auburn University, Auburn, AL
| | - Joseph R Bardeen
- Department of Psychological Sciences, Auburn University, Auburn, AL
| | - Natasha Benfer
- Department of Psychological Sciences, Auburn University, Auburn, AL
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2
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Thirup L, Sandager P, Vogel I, Lou S. The importance of information and support following a suspected second-trimester anomaly that is later discarded: A qualitative study of women's experiences. Acta Obstet Gynecol Scand 2021; 101:94-101. [PMID: 34761374 DOI: 10.1111/aogs.14288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/17/2021] [Accepted: 10/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A second-trimester anatomy scan may identify a suspected minor fetal anomaly and/or "soft marker," such as choroid plexus cysts or femoral shortening. Such findings can raise a medical concern, as they could indicate severe fetal disease; however, they are also often transient or a "false alarm." The aim of this study was to explore the experiences of pregnant women, where a medical concern was raised at the second-trimester ultrasound scan and later discarded after follow-up examinations and diagnostic testing. MATERIAL AND METHODS This study consists of qualitative, in-depth interviews with nine women, where a minor anomaly/soft marker was identified at the second-trimester scan and a severe anomaly was later ruled out. Data were analyzed using thematic analysis. RESULTS The main source of worry was uncertainty about the possible implications for the pregnancy and the baby, particularly concerns about potential termination of pregnancy for a severe fetal condition. The women described four strategies to manage worry and uncertainty during the diagnostic process: (a) seeking additional information to feel more in control, and (b) using social networks to share their concerns. Some women tried to (c) mentally distance themselves from the pregnancy during the diagnostic period, while (d) extra scans could relieve worry and support attachment. The women appreciated when the fetal medicine specialist pointed to normal features in the pregnancy and the baby, as this provided some counterbalance to the sense of uncertainty. In general, the women expressed satisfaction with the information received during the diagnostic process. However, all of them were worried during the diagnostic process, and where this process was prolonged, such worry lingered even after the minor anomaly/soft marker had been discarded. CONCLUSIONS Diagnostic uncertainty cannot be avoided in obstetric ultrasound and the women concerned appreciated being informed about the suspected findings even if it caused increased worry. Expedient diagnostic processes may alleviate worry, but are not always possible. Women in a prolonged diagnostic process may benefit from psychological and social support in parallel with, and even beyond, the obstetric investigation. However, further research is warranted.
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Affiliation(s)
- Lina Thirup
- DEFACTUM-Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark.,Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark
| | - Puk Sandager
- Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.,Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ida Vogel
- Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
| | - Stina Lou
- DEFACTUM-Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark.,Center for Fetal Diagnostics, Aarhus University Hospital, Aarhus, Denmark
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Development of the Perth Adolescent Worry Scale (PAWS). Res Child Adolesc Psychopathol 2021; 50:521-535. [PMID: 34415493 PMCID: PMC8940868 DOI: 10.1007/s10802-021-00853-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2021] [Indexed: 11/05/2022]
Abstract
Tools to assess worry among adolescents exist but do not capture the content of worries. This study reports on the development of a brief, psychometrically sound measure of worry for use with adolescents. Phase 1 involved identification of 27 potential items from existing instruments as well as item generation identified in interviews with students, teachers, school psychologists, and parents. In Phase 2, the candidate items were completed by 835 Australian adolescents (317 males, 508 females, 10 unspecified; Mean age = 13.55, SD = 1.31) from Grades 5 to 10. These data were randomly split in half, and an exploratory factor analysis on the first half identified a two-factor solution with 12 items: Peer Relationships (6 items) and Academic Success and the Future (6 items). On the second half of the data, confirmatory factor analyses supported the factor structure and supported strong invariance across age, socioeconomic status, and presence/absence of a diagnosed neurodevelopmental disorder. Weak invariance was evident across sex. Differences across groups are reported as are correlations with indicators of psychological wellbeing. In conclusion, the Perth Adolescent Worry Scale provides both applied professionals and researchers with a short, easy-to-administer, and psychometrically strong instrument to evaluate adolescents’ everyday worries.
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Voegtline K, Payne JL, Standeven LR, Sundel B, Pangtey M, Osborne LM. Using the Penn State Worry Questionnaire in the Peripartum. J Womens Health (Larchmt) 2021; 30:1761-1768. [DOI: 10.1089/jwh.2020.8669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Kristin Voegtline
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer L. Payne
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lindsay R. Standeven
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bridget Sundel
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meeta Pangtey
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lauren M. Osborne
- Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Freeman D, Bird JC, Loe BS, Kingdon D, Startup H, Clark DM, Ehlers A, Černis E, Wingham G, Evans N, Lister R, Pugh K, Cordwell J, Dunn G. The Dunn Worry Questionnaire and the Paranoia Worries Questionnaire: new assessments of worry. Psychol Med 2020; 50:771-780. [PMID: 30947766 PMCID: PMC7168652 DOI: 10.1017/s0033291719000588] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/31/2019] [Accepted: 03/04/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The cognitive process of worry, which keeps negative thoughts in mind and elaborates the content, contributes to the occurrence of many mental health disorders. Our principal aim was to develop a straightforward measure of general problematic worry suitable for research and clinical treatment. Our secondary aim was to develop a measure of problematic worry specifically concerning paranoid fears. METHODS An item pool concerning worry in the past month was evaluated in 250 non-clinical individuals and 50 patients with psychosis in a worry treatment trial. Exploratory factor analysis and item response theory (IRT) informed the selection of scale items. IRT analyses were repeated with the scales administered to 273 non-clinical individuals, 79 patients with psychosis and 93 patients with social anxiety disorder. Other clinical measures were administered to assess concurrent validity. Test-retest reliability was assessed with 75 participants. Sensitivity to change was assessed with 43 patients with psychosis. RESULTS A 10-item general worry scale (Dunn Worry Questionnaire; DWQ) and a five-item paranoia worry scale (Paranoia Worries Questionnaire; PWQ) were developed. All items were highly discriminative (DWQ a = 1.98-5.03; PWQ a = 4.10-10.7), indicating small increases in latent worry lead to a high probability of item endorsement. The DWQ was highly informative across a wide range of the worry distribution, whilst the PWQ had greatest precision at clinical levels of paranoia worry. The scales demonstrated excellent internal reliability, test-retest reliability, concurrent validity and sensitivity to change. CONCLUSIONS The new measures of general problematic worry and worry about paranoid fears have excellent psychometric properties.
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Affiliation(s)
- Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jessica C. Bird
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Bao S. Loe
- The Psychometrics Centre, University of Cambridge, Cambridge, UK
| | - David Kingdon
- Academic Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
| | | | - David M. Clark
- Oxford Health NHS Foundation Trust, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Anke Ehlers
- Oxford Health NHS Foundation Trust, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Emma Černis
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Gail Wingham
- Academic Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nicole Evans
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Rachel Lister
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | | | - Graham Dunn
- Centre for Biostatistics, Institute of Population Health, University of Manchester, Manchester, UK
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Rodakowski J, Golias KW, Reynolds CF, Butters MA, Lopez OL, Dew MA, Skidmore ER. Preventing disability in older adults with mild cognitive impairment: A Strategy Training intervention study. Contemp Clin Trials Commun 2019; 15:100368. [PMID: 31111114 PMCID: PMC6512744 DOI: 10.1016/j.conctc.2019.100368] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/02/2019] [Accepted: 04/25/2019] [Indexed: 11/26/2022] Open
Abstract
Non-pharmacological interventions designed to change cognitive function in older adults with Mild Cognitive Impairment have shown mixed results. Few studied interventions directly address preclinical disability. Slowing changes in disability are critical preserve independence and health related quality of life in older adults with Mild Cognitive Impairment. In this study, we discuss the design of the trial, challenges encountered, and solutions generated to guide future trials designed to prevent the onset of disability among at-risk older adults. We compared Strategy Training to enhanced-usual care in 30 older adults with Mild Cognitive Impairment. We recruited 79.7% (n = 188) of the potential participants through direct-to-consumer recruitment. We refined a three-step screening process, including a phone screen, initial in-person screening, and full in-person screening. This screening processes resulted in a high percentage of older adults completing the neuropsychological battery and adjudication of Mild Cognitive Impairment. Conducting a disability prevention among individuals without overt disability is a novel approach. Nevertheless, one of the greatest limitations to our project is the fact that follow-up is restricted to 1 year. Findings from this study can inform the design and conduct of future clinical trials that seek to slow progression of disability in older adults with Mild Cognitive Impairment.
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Affiliation(s)
- Juleen Rodakowski
- Department of Occupational Therapy, University of Pittsburgh, USA.,Clinical and Translational Science Institute, University of Pittsburgh, USA
| | - Katlyn W Golias
- Department of Occupational Therapy, University of Pittsburgh, USA
| | | | | | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh, USA
| | - Mary Amanda Dew
- Clinical and Translational Science Institute, University of Pittsburgh, USA.,Department of Psychiatry, University of Pittsburgh, USA.,Department of Biostatistics, University of Pittsburgh, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, University of Pittsburgh, USA.,Clinical and Translational Science Institute, University of Pittsburgh, USA
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Choosing Pre-conception Planning for Women/Families: Counselling and Informed Consent (Part 2) – Pre-conception Reproductive Planning, Lifestyle, Immunization, and Psychosocial Issues. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41:666-678. [DOI: 10.1016/j.jogc.2017.08.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/25/2017] [Accepted: 08/28/2017] [Indexed: 11/23/2022]
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Schroder HS, Clark DA, Moser JS. Screening for Problematic Worry in Adults With a Single Item From the Penn State Worry Questionnaire. Assessment 2017; 26:336-346. [PMID: 29214862 DOI: 10.1177/1073191117694453] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
As the rapid assessment of mental health is a growing need, a quick and valid tool for the early detection of symptoms that can be flexibly deployed across a range of contexts may be especially beneficial. This is particularly true of anxiety problems, which when undetected contribute to health care costs and lost work productivity. Data from more than 10,000 respondents (primarily female undergraduates) were used to test whether a single item from the popular Penn State Worry Questionnaire could serve as a screening tool in settings where administration of the full scale is undesirable. Items were evaluated by examining item response theory models, screening capabilities, stability over time, convergence with other anxiety and depression measures, and a response time analysis that assessed how quickly participants responded to each item. Item 15 ("I worry all the time") emerged as the strongest item: It was the most discriminating and reliable item, had sensitivity and specificity similar to the full scale, had the highest 1-month and 1-year retest coefficients, the highest convergent correlations with measures of anxiety and depression, and was responded to significantly faster than any other item. We suggest that in time-limited contexts, this item is suitable for screening.
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