Culture and validity of the Symptom Checklist-90-Revised and Profile of Mood States in a New Zealand student sample

Measuring wellbeing: A scoping review of metrics and studies measuring medical student wellbeing across multiple timepoints

PURPOSE

Studies have demonstrated poor mental health in medical students. However, there is wide variation in study design and metric use, impairing comparability. The authors aimed to examine the metrics and methods used to measure medical student wellbeing across multiple timepoints and identify where guidance is necessary.

METHODS

Five databases were searched between May and June 2021 for studies using survey-based metrics among medical students at multiple timepoints. Screening and data extraction were done independently by two reviewers. Data regarding the manuscript, methodology, and metrics were analyzed.

RESULTS

221 studies were included, with 109 observational and 112 interventional studies. There were limited studies (15.4%) focused on clinical students. Stress management interventions were the most common (40.2%). Few (3.57%) interventional studies followed participants longer than 12 months, and 38.4% had no control group. There were 140 unique metrics measuring 13 constructs. 52.1% of metrics were used only once.

CONCLUSIONS

Unique guidance is needed to address gaps in study design as well as unique challenges surrounding medical student wellbeing surveys. Metric use is highly variable and future research is necessary to identify metrics specifically validated in medical student samples that reflect the diversity of today's students.

Predictors of Healthcare Utilization in Family Caregivers of Persons With a Primary Malignant Brain Tumor

ABSTRACT

BACKGROUND: Negative physical health results from the emotional stress of providing care to a family member with a primary malignant brain tumor; however, the downstream effects on caregivers' healthcare utilization (HCU) are unknown. This analysis examined associations between caregivers' emotional health and markers of HCU during the 6 months after patients' diagnoses. METHODS: Caregivers' self-report HCU data from a longitudinal study with 116 neuro-oncology caregivers were analyzed. Healthcare utilization was operationalized as number of prescription medications, reporting visits to primary care providers (PCPs), nature of PCP visit, number of comorbid conditions, and change in comorbid conditions. Potential predictors were caregivers' depressive symptoms (Center for Epidemiologic Studies-Depression Scale), hours providing care per day, mastery (Pearlin and Schooler), and burden (Caregiver Reaction Assessment). Logistic mixed effects modeling were used. RESULTS : Caregivers with higher levels of depressive symptoms ( P < .01), anxiety ( P = .02), burden related to schedule ( P = .02), and abandonment ( P < .01) were more likely to report worsening comorbid conditions. Those with higher mastery ( P = .02) were less likely to report worsening comorbid conditions. Caregivers who had a PCP visit and reported higher burden related to feelings of self-esteem ( P = .03) were more likely to report an illness-related visit. CONCLUSION : Findings suggest a relationship between neuro-oncology caregivers' emotional health and their HCU. Data highlight the importance of caregivers' PCPs identifying caregivers at risk for deteriorating health and increased HCU and intervene to ensure caregivers' self-care.

An AI-based Decision Support System for Predicting Mental Health Disorders

Approximately one billion individuals suffer from mental health disorders, such as depression, bipolar disorder, schizophrenia, and anxiety. Mental health professionals use various assessment tools to detect and diagnose these disorders. However, these tools are complex, contain an excessive number of questions, and require a significant amount of time to administer, leading to low participation and completion rates. Additionally, the results obtained from these tools must be analyzed and interpreted manually by mental health professionals, which may yield inaccurate diagnoses. To this extent, this research utilizes advanced analytics and artificial intelligence to develop a decision support system (DSS) that can efficiently detect and diagnose various mental disorders. As part of the DSS development process, the Network Pattern Recognition (NEPAR) algorithm is first utilized to build the assessment tool and identify the questions that participants need to answer. Then, various machine learning models are trained using participants' answers to these questions and other historical data as inputs to predict the existence and the type of their mental disorder. The results show that the proposed DSS can automatically diagnose mental disorders using only 28 questions without any human input, to an accuracy level of 89%. Furthermore, the proposed mental disorder diagnostic tool has significantly fewer questions than its counterparts; hence, it provides higher participation and completion rates. Therefore, mental health professionals can use this proposed DSS and its accompanying assessment tool for improved clinical decision-making and diagnostic accuracy.

Study of the SCL-90 Scale and Changes in the Chinese Norms

Objective: This study aimed to investigate the Chinese norms for the Symptom Checklist 90 (SCL-90) scale and its application. Methods: In total, 7,489 adults from Tianjin and Qingdao in China were included. Their data were compared with the norm data of 1,388 people published by Jin et al., the combined norms published by Tang et al., the data of 2,808 adults published by Chen and Li, and the data of 1,890 adults from Tong in China. Results: In five different periods, notable changes were observed in each factor of the SCL-90 that significantly differed from the previous norms. The scores of each factor showed an increasing annual trend. Compulsion consistently obtained the highest scores, and phobia consistently obtained the lowest scores. The scores tended to decrease from compulsion to anxiety, and psychosis scored lower than paranoia. There was a significant difference in the detection rate between the critical screening value of two points and the standard score. Using the standard score as the critical value, the detection rate ranged between 13 and 16% and was relatively concentrated. Using two points as the critical value, the detection rate ranged between 38 and 50%. Conclusion: The usual model in China is not consistent with social development. Using two points as the critical value is no longer suitable for the SCL-90. New Chinese norms and measurement standards should be developed. The mean value plus one standard deviation could be used as the new measurement standard.

Coping strategy mediates the relationship between body image evaluation and mental health: A study with Chinese college students with disabilities

BACKGROUND

For students with disabilities, evidence exists of significant links between body image evaluation and mental health status, and between coping strategies and mental health status, yet few investigations have tested body image evaluation, coping strategies and mental health status in one study to reveal their complicated relationships.

OBJECTIVE

The present study investigated the mediation role of coping strategy between body image evaluation and mental health and its variations among Chinese university students with three types of disabilities, physical disability, visual disability and hearing disability.

METHOD

Two hundred and fifty-five Chinese college students (166 males and 89 females) with disabilities completed a battery of self-report questionnaires, including Multidimensional Body-Self Relations Questionnaire (MBSRQ), Coping Style Questionnaire (CQS) and Symptom Checklist 90 (SCL-90). Mediation analyses were conducted in AMOS.

RESULTS

In students with physical disabilities, positive coping strategies played a role in mediating the relation between body image evaluation and mental health (β = -0.190, p < 0.05). In students with hearing disabilities, negative coping strategies played the mediation role (β = -0.089, p < 0.05). No significant mediation effect was found in students with visual disabilities. Meanwhile, the mental health status of all of the three groups were significantly lower than the Chinese norm (M = 129.96; SD = 38.76) (all ps < 0.01).

CONCLUSIONS

In Chinese college students with disabilities, in bridging the link between their body image evaluation and mental health status, coping strategies played a central role and its specific role varied depending upon the type of disability. Practical implications are discussed.

Screening for mental health needs of New Zealand youth in secure care facilities using the MAYSI-2

BACKGROUND

Young people admitted to secure facilities generally have particularly high rates of mental, emotional and behavioural problems, but little is known about the mental health needs of this group in New Zealand.

AIMS

To describe prevalence of probable mental health disorder and related needs among young people in secure facilities in New Zealand.

METHODS

Massachusetts youth screening instrument - second version (MAYSI-2) data were obtained from the records of young people admitted to one secure care facility (n = 204) within a 12 month period. We used descriptive statistics to determine prevalence of problems overall and multivariate analysis of variance to compare MAYSI-2 scores between gender and ethnic groups.

RESULTS

Nearly 80% of these young people scored above the 'caution' or 'warning' cut-off on the MAYSI-2, a substantially higher proportion than reported in studies in other countries. There was a tendency for girls and for Maori and Pacific Islander subgroups to have a higher rate of probable psychopathology.

CONCLUSIONS

Young people in secure facilities in New Zealand have substantial service needs. Early intervention that engages them in services upon first contact with the youth justice system might help reduce this burden. Further validation of the MAYSI-2 in New Zealand may be warranted because of the unique ethnic make-up of these young offenders. Copyright © 2017 John Wiley & Sons, Ltd.

Psychometric properties of the Symptom Checklist-90 in adolescent psychiatric inpatients and age- and gender-matched community youth

BACKGROUND

The Symptom Checklist-90 (SCL-90) is a questionnaire that is widely used to measure subjective psychopathology. In this study we investigated the psychometric properties of the SCL-90 among adolescent inpatients and community youth matched on age and gender.

METHODS

The final SCL-90 respondents comprised three subsets: 201 inpatients at admission, of whom 152 also completed the instrument at discharge, and 197 controls. The mean age at baseline was 15.0 years (SD 1.2), and 73 % were female. Differential SCL-90 item functioning between the three subsets was assessed with an iterative algorithm, and the presence of multidimensionality was assessed with a number of methods. Confirmatory factor analyses for ordinal items compared three latent factor models: one dimension, nine correlated dimensions, and a one-plus-nine bifactor model. Sensitivity to change was assessed with the bifactor model's general factor scores at admission and discharge. The accuracy of this factor in detecting the need for treatment used, as a gold standard, psychiatric diagnoses based on clinical records and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime (K-SADS-PL) interview.

RESULTS

Item measurement properties were largely invariant across subsets under the unidimensional model, with standardized factor scores at admission being 0.04 higher than at discharge and 0.06 higher than those of controls. Determination of the empirical number of factors was inconclusive, reflecting a strong main factor and some multidimensionality. The unidimensional factor model had very good fit, but the bifactor model offered an overall improvement, though subfactors accounted for little item variance. The SCL-90s ability to identify those with and without a psychiatric disorder was good (AUC = 83 %, Glass's Δ = 1.4, Cohen's d = 1.1, diagnostic odds ratio 12.5). Scores were also fairly sensitive to change between admission and discharge (AUC 72 %, Cohen's d = 0.8).

CONCLUSIONS

The SCL-90 proved mostly unidimensional and showed sufficient item measurement invariance, and is thus a useful tool for screening overall psychopathology in adolescents. It is also applicable as an outcome measure for adolescent psychiatric patients. SCL-90 revealed significant gender differences in subjective psychopathology among both inpatients and community youth.

Problem-solving skills training for mothers of children recently diagnosed with autism spectrum disorder: A pilot feasibility study

Problem-solving skills training is an intervention designed to teach coping skills that has shown to decrease negative affectivity (depressive symptoms, negative mood, and post-traumatic stress symptoms) in mothers of children with cancer. The objective of this study was to see whether mothers of children recently diagnosed with autism spectrum disorder would be receptive to receiving problem-solving skills training (feasibility trial). Participants were recruited from a local outpatient developmental clinic that is part of a university department of pediatrics. Participants were to receive eight 1-h sessions of problem-solving skills training and were asked to complete assessments prior to beginning problem-solving skills training (T1), immediately after intervention (T2), and 3 months after T2 (T3). Outcome measures assessed problem-solving skills and negative affectivity (i.e. distress). In total, 30 mothers were approached and 24 agreed to participate (80.0%). Of them, 17 mothers completed problem-solving skills training (retention rate: 70.8%). Mothers of children with autism spectrum disorder who completed problem-solving skills training had significant decreases in negative affectivity and increases in problem-solving skills. A comparison to mothers of children with cancer shows that mothers of children with autism spectrum disorder displayed similar levels of depressive symptoms but less negative mood and fewer symptoms of post-traumatic stress. Data suggest that problem-solving skills training may be an effective way to alleviate distress in mothers of children recently diagnosed with autism spectrum disorder. Data also suggest that mothers of children with autism spectrum disorder were moderately receptive to receiving problem-solving skills training. Implications are that problem-solving skills training may be beneficial to parents of children with autism spectrum disorder; modifications to improve retention rates are suggested.

Exploring spirituality in family caregivers of patients with primary malignant brain tumors across the disease trajectory

PURPOSE/OBJECTIVES

To determine whether the perceived level of spirituality in family caregivers of patients with primary malignant brain tumors (PMBTs) changes across the disease trajectory.

DESIGN

Ongoing descriptive, longitudinal study.

SETTING

Southwestern Pennsylvania.

SAMPLE

50 family caregivers of patients with PMBT.

METHODS

Caregivers and care recipients were recruited at time of diagnosis. Participants were interviewed at two subsequent time points, four and eight months following diagnosis.

MAIN RESEARCH VARIABLES

Care recipients' symptoms, neuropsychologic status, and physical function, as well as caregiver social support.

FINDINGS

Results showed no significant difference in spirituality scores reported at baseline and eight months (p = 0.8), suggesting that spirituality may be a stable trait across the disease trajectory.

CONCLUSIONS

Spirituality remains relatively stable along the course of the disease trajectory. Reports of caregiver depressive symptoms and anxiety were lower when paired with higher reports of spirituality.

IMPLICATIONS FOR NURSING

Clinicians can better identify caregivers at risk for negative outcomes by identifying those who report lower levels of spirituality. Future interventions should focus on the development and implementation of interventions that provide protective buffers such as increased social support.

KNOWLEDGE TRANSLATION

Spirituality is a relatively stable trait. High levels of spirituality can serve as a protective buffer from negative mental health outcomes. Caregivers with low levels of spirituality may be at risk for greater levels of burden, anxiety, and stress.

Does a first-born female child bring mood risks to new Asian American mothers?

OBJECTIVE

To define the relationship between gender of the first-born child and mood in Asian American mothers.

DESIGN

A secondary analysis was used to address the objectives of the study.

SETTING

The sample was obtained from the Pregnancy Risk Assessment Monitoring System (PRAMS) of 40 states in the United States.

PARTICIPANTS

The sample included 1,310 women of Asian origin who delivered their first children during the prior 2- to 4-month period.

METHODS

Based on data from the PRAMS survey mailed 2- to 4-months postpartum, participants were selected for inclusion in the study sample from those who had given birth to their first children and were of Chinese, Japanese, Filipino, or other Asian origin. Chi squared analyses and an independent sample t test were used to assess the relationship between the child's sex and the mother's response to three PRAM mood questions; a single score was generated by summing the responses to the three questions.

RESULTS

There were no significant (p > .05) differences in rate of mood symptoms or the means of the aggregated score related to a child's gender.

CONCLUSION

The study findings are similar to those reported in the United Kingdom and suggest that the cultural preference for a son is not a significant mood risk in Asian American women.

Psychological distress and its correlates among dental students: a survey of 17 Colombian dental schools

BACKGROUND

Links between the demanding nature of studies in the health sciences, students' personality traits and psychological distress have been well-established. While considerable amount of work has been done in medicine, evidence from the dental education arena is sparse and data from Latin America are lacking. The authors conducted a large-scale investigation of psychological distress among dental students in Colombia and sought to determine its curriculum and student-level correlates.

METHODS

The Spanish version of the Derogatis' Symptoms Checklist Revised (SCL-90-R) was administered to all students officially registered and attending classes or clinics in 17 dental schools in 4 geographic districts of Colombia between January and April 2012. Additional information was collected on participants' socio-demographic information and first career choice, as well as school's characteristics such as class size. The Global Severity Index (GSI) score, a measure of overall psychological distress, served as the primary analytical endpoint. Analyses relied on multilevel mixed-effects linear and log-binomial regression, accounting for study design and sample characteristics.

RESULTS

A total of 5700 dental students completed the survey, a response rate of 67%. Pronounced gradients were noted in the association between socio-economic status and psychological distress, with students in higher strata reporting fewer problems. After adjustment for all important covariates, there was an evident pattern of increasing psychological distress corresponding to the transition from the didactic, to the preclinical and clinical phases of training, with few differences between male and female students. Independent of other factors, reliance on own funds for education and having dentistry as the first career choice were associated with lower psychological distress.

CONCLUSIONS

Levels of psychological distress correlated with students' socio-economic and study-level characteristics. Above and beyond the influence of person-level factors, variations in levels of distress paralleled specific transitional stages of the 5-year dental curriculum, providing opportunities for targeted interventions.

New Zealand youth that sexually offend: improving outcomes for Māori rangatahi and their whānau

Māori youth are overrepresented in criminal justice statistics and youth forensic services. Māori youth that engage in sexual offending behaviors have a higher risk of dropping out of treatment than Pākehā(1) youth. Research into Māori mental health is important to inform ongoing service development and is essential to strive for equity in mental health outcomes and offending rates among Māori. In this study, the researchers investigated the coexisting emotional and behavioral problems and victimization histories of an age-matched sample of Māori (n = 75) and Pākehā (n = 75) youth who were referred to a community treatment program for sexual offending in Auckland between 1996 and 2008. The Child Behavior Checklist was used to investigate ethnic differences. After controlling for socioeconomic deprivation, Māori youth scored significantly higher than Pākehā youth on the Delinquent Behaviors syndrome scale. Māori youth were also more likely than Pākehā youth to have a background of physical abuse. Implications of these findings are discussed, with regard to the unique needs of Māori youth and appropriate interventions.

A Comparison of International and Domestic Tertiary Students in Australia

In this study international and domestic students were compared on variables such as accommodation and financial satisfaction, social support, mismatched expectations, academic stress, dysfunctional coping, and psychological distress. International and domestic students (N= 86 for each group), enrolled at a large Australian university based in a capital city, completed a battery of questionnaires. Results demonstrate that in comparison to domestic students, international students had less social support, used more dysfunctional coping strategies and had greater incongruence between their expectations and experiences of university life. The results endorse the significance of providing high quality supportive and orientation programs to international students, to enhance their social support and coping strategies, which, as demonstrated, are lacking.

Relationships among depressive mood symptoms and parent and peer relations in collegiate children of alcoholics

Relationships among adult children of alcoholics (ACOAs) and parent and peer relations and depressive mood were examined among 136 ACOAs and 436 non-ACOAs. As compared to non-ACOAs, ACOAs reported less positive relationships to mothers, fathers, and peers, and more depressive mood; however, more positive relationships to parents and peers significantly reduced the strength of the association between ACOA categorization and depressive mood. Examination of data from ACOAs alone revealed that maternal alcoholism was related to less positive relationships to their mothers and to their peers; however, paternal alcoholism did not predict the quality of the relationship to fathers, mothers, or peers. Attachment to parents and peers and the gender of the alcohol-abusing parent were associated with depressive symptoms among ACOAs.

The reliability and validity of a Japanese version of symptom checklist 90 revised

Objective

To examine the validity and reliability of a Japanese version of the Symptom Checklist 90 Revised (SCL-90-R (J)).

Methods

The English SCL-90-R was translated to Japanese and the Japanese version confirmed by back-translation. To determine the factor validity and internal consistency of the nine primary subscales, 460 people from the community completed SCL-90-R(J). Test-retest reliability was examined for 104 outpatients and 124 healthy undergraduate students. The convergent-discriminant validity was determined for 80 inpatients who replied to both SCL-90-R(J) and the Minnesota Multiphasic Personality Inventory (MMPI).

Results

The correlation coefficients between the nine primary subscales and items were .26 to .78. Cronbach's alpha coefficients were from .76 (Phobic Anxiety) to .86 (Interpersonal Sensitivity). Pearson's correlation coefficients between test-retest scores were from .81 (Psychoticism) to .90 (Somatization) for the outpatients and were from .64 (Phobic Anxiety) to .78 (Paranoid Ideation) for the students. Each of the nine primary subscales correlated well with their corresponding constructs in the MMPI.

Conclusion

We confirmed the validity and reliability of SCL-90-R(J) for the measurement of individual distress. The nine primary subscales were consistent with the items of the original English version.

A pilot study on mindfulness based stress reduction for smokers

BACKGROUND

Mindfulness means paying attention in the present moment, non-judgmentally, without commentary or decision-making. We report results of a pilot study designed to test the feasibility of using Mindfulness Based Stress Reduction (MBSR) (with minor modifications) as a smoking intervention.

METHODS

MBSR instructors provided instructions in mindfulness in eight weekly group sessions. Subjects attempted smoking cessation during week seven without pharmacotherapy. Smoking abstinence was tested six weeks after the smoking quit day with carbon monoxide breath test and 7-day smoking calendars. Questionnaires were administered to evaluate changes in stress and affective distress.

RESULTS

18 subjects enrolled in the intervention with an average smoking history of 19.9 cigarettes per day for 26.4 years. At the 6-week post-quit visit, 10 of 18 subjects (56%) achieved biologically confirmed 7-day point-prevalent smoking abstinence. Compliance with meditation was positively associated with smoking abstinence and decreases in stress and affective distress.

DISCUSSIONS AND CONCLUSION

The results of this study suggest that mindfulness training may show promise for smoking cessation and warrants additional study in a larger comparative trial.

Psychometric evaluation of the arabic language version of the profile of Mood States

We estimated the psychometrics of the parent and a short form of the Arabic language version of the Profile of Mood States (POMS). A sample of 537 Arab immigrants completed the POMS and a battery of other measures. Data analyses included confirmatory factor analyses and tests of reliability and concurrent validity. The fit of the proposed factor structure was acceptable if 14 pairs of error terms were allowed to correlate, but a better fit was obtained by creating a short form. The short form demonstrated good reliability and concurrent validity, but some factors were highly correlated. High factor correlations were not explainable by group differences in education or level of distress.

Mental distress in the Danish general population

OBJECTIVE

To present data on mental distress in the Danish general population using recently validated Hopkins symptom checklist (SCL) subscales and compare with data from other countries. To evaluate associations between mental distress and biopsychosocial factors.

METHOD

Questionnaires were sent to a gender- and age-stratified random sample comprising 2040 Danes. Mean SCL subscale scores were calculated. Cases were defined in accordance with the traditional criteria, and Danish and US raw score cut-offs were compared. A multiple regression model was developed to describe associations between biopsychosocial factors and SCL scores.

RESULTS

The response rate was 58%. The Danish mean scores were significantly higher than reported for a US non-patient sample, and Danish raw score cut-offs for caseness were higher. The Danish scores were closer to Nordic mean scores. Age, gender, social status, somatic disorder and traumatic life events in the past year in work life as well as personal life were significantly associated with the level of mental distress. SCL scores were compared with scores on the Major Depression Inventory.

CONCLUSION

The SCL mean scores of the Danish general population were relatively high, but similar to data from the Nordic countries. Consequently, interpretation of the Danish SCL requires Danish norms and Danish cut-off scores for caseness.

Sleep quality in patients with irritable bowel syndrome

AIM: To investigate the sleep quality in patients with irritable bowel syndrome(IBS) and its relationship with the patients psychiatric symptoms.

METHODS: The quality of sleep and psychiatric symptoms in consecutive 41 patients with IBS according to Rome II criteria were measured by Pittsburgh sleep quality index(PSQI) and symptom checklist-90(SCL-90), respectively. In the meantime, 37 matched heath controls and 35 patients matched patients with peptic ulcer diseases as controls were also evaluated. The relationship between PSQI and psychiatric symptoms was investigated by regression analysis.

RESULTS: Compared with health controls, IBS patients had more psychiatric symptoms(40.2±4.5, t = 2.63, P = 0.047), and higher scores of depression(0.64±0.24, t = 2.53, P = 0.020) and anxiety(0.67±0.30, t = 2.16, P = 0.016). Among IBS patients, the quality of sleep and daily functions significantly decreased. PSQI and sleep disturbances as well as soporific using was markedly increased. The scores of obsessive-compulsive(t = 2.60, P = 0.037), and mental factor(t = 2.71, P = 0.028) were higher in IBS patients than that in patients with peptic ulcer diseases. Multiple regression analysis showed negative relarionship between the quality of sleep and many psychiatric symptoms(R>0.195, P<0.05, respectively).

CONCLUSION: IBS patients have sleep disturbances associated psychiatric symptoms.