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Shafierizi S, Basirat Z, Nasiri-Amiri F, Kheirkhah F, Geraili Z, Pasha H, Faramarzi M. Predictors of nonresponse to treatment and low adherence to internet-based cognitive behavioral therapy in depressed/anxious women facing the couple's fertility problems: a secondary analysis of a randomized control trial. BMC Psychiatry 2024; 24:39. [PMID: 38200435 PMCID: PMC10782627 DOI: 10.1186/s12888-023-05484-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The study aimed to examine the predictors of treatment nonresponse and low adherence to Internet-based cognitive behavioral therapy and face-to-face therapy for treating depression and anxiety in women facing the couple's fertility problems. METHODS This is a secondary analysis based on a previous randomized controlled trial including 152 depressed/anxious women facing the couple's fertility problems. The study defines low adherence as receiving less than 4 sessions (out of 8 sessions). Nonresponse to treatment refers to a < 50% reduction in the anxiety and depression total scores. RESULTS A high level of anxiety/depression score before psychotherapy increases the risk of nonresponse to both Internet-based and face-to-face psychotherapies by 1.4 to 2 times in women facing the couple's fertility problems after the treatment and in the 6-month follow-up. However, 4 factors, including diagnosis of mixed anxiety and depression, low education level, long marriage duration, and infertility caused by mixed female/male factors, reduced the risk of nonresponse to psychotherapies. CONCLUSION Women facing the couple's fertility problems with high depression and anxiety scores are at risk of poor prognosis in response to psychotherapy. Psychologists and healthcare providers of infertility centers should pay more attention to the timely identification and referral of depressed/anxious patients to psychologists.
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Affiliation(s)
- Shiva Shafierizi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- Department of Obstetrics and Gynecology, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Nasiri-Amiri
- Department of Midwifery, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Department of Psychiatry, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Geraili
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Pasha
- Department of Midwifery, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of General Courses, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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Juszczyk-Kalina A, Holas P, Farchione TJ. Effectiveness and mediators of change of an online CBT intervention for students with adjustment disorder-study protocol for a randomized controlled trial. Trials 2023; 24:777. [PMID: 38041148 PMCID: PMC10691050 DOI: 10.1186/s13063-023-07744-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 10/24/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Adjustment problems and disorders are highly prevalent among university students worldwide. These problems can cause significant interference in academic and social functioning and increase vulnerability to other mental health disorders. Unfortunately, only half of students in need receive psychological help. Furthermore, few studies have evaluated psychological interventions for adjustment disorders in students. New, more scalable forms of treatment for students with an adjustment disorder need to be developed, evaluated, and implemented. The study aims to determine the effectiveness of an online transdiagnostic cognitive behavioural intervention for students experiencing adjustment disorder and to assess mediators of change. METHOD/DESIGN In this three-arm randomized controlled trial, we plan to recruit 214 Polish students diagnosed with an adjustment disorder. Participants who meet initial eligibility criteria will be randomly assigned to one of three 6-week conditions: (1) online cognitive behavioural therapy intervention based on an existing, empirically supported transdiagnostic protocol, the unified protocol; (2) online progressive muscle relaxation training as an active control group; or (3) waiting-list control group. Both interventions are asynchronous, interactive, and include minimal amount of therapist support. Assessments will consist of self-report questionnaires, daily diary measures, and neurocognitive tasks for evaluating cognitive functioning. These will be conducted at baseline, post-treatment, and 1-month follow-up. Daily diary measures will be taken during the first and last week of treatment (or waitlist period). Primary outcome measures will include adjustment disorder severity; secondary outcome measures will consist of other negative (psychopathology: depression, anxiety, and stress) and positive (life satisfaction) indexes of mental health as well as process measures (e.g. mindfulness, experiential avoidance, cognitive fusion). DISCUSSION To our knowledge, the current study is the first to evaluate the effectiveness of a psychological intervention for students with adjustment disorder. Therefore, it may have important practical implications for students with this disorder. It can potentially guide the development of a scalable, validated treatment option. TRIAL REGISTRATION Clinical Trials, NCT05768308, registered 14 March 2023, https://www. CLINICALTRIALS gov/ct2/show/NCT05768308.
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Affiliation(s)
| | - P Holas
- Department of Psychology, University of Warsaw, Warsaw, Poland
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3
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Shafierizi S, Faramarzi M, Nasiri-Amiri F, Chehrazi M, Basirat Z, Kheirkhah F, Pasha H. Therapist-guided internet-based cognitive behavioral therapy versus face-to-face CBT for depression/anxiety symptoms in infertile women with adjustment disorders: A randomized controlled trial. Psychother Res 2023:1-17. [PMID: 36628473 DOI: 10.1080/10503307.2022.2158763] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective: The present study compared the effectiveness of ICBT to face-to-face CBT on the improvement of adjustment disorder symptoms in infertile women.Method: In a pragmatic, multi-center (public or private), single-blinded, non-inferior randomized controlled trial (RCT), 152 patients with AD (100 women in public center and 52 women in private canter) were assigned to ICBT and CBT. Primary outcomes were Adjustment Disorder New Module-20 (ADNM-20) and Hospital Anxiety and Depression (HADS). Secondary outcomes were the Fertility Problem Inventory (FPI) and Fertility Adjustment Scale (FAS).Results: "Peaceful mind" ICBT was feasible and accessible for delivering the treatment to infertile women with AD. At end-of-treatment, improvements in ICBT were non-inferior to CBT for symptoms of AD, anxiety, and depression. Additionally, the non-inferiority of ICBT to CBT was maintained at a three-month follow-up.Conclusions: ICBT was non-inferior to CBT in improving mental symptoms in infertile women with AD.
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Affiliation(s)
- Shiva Shafierizi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Nasiri-Amiri
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Basirat
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Farzan Kheirkhah
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hajar Pasha
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
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Svärdman F, Sjöwall D, Lindsäter E. Internet-delivered cognitive behavioral interventions to reduce elevated stress: A systematic review and meta-analysis. Internet Interv 2022; 29:100553. [PMID: 35781929 PMCID: PMC9240371 DOI: 10.1016/j.invent.2022.100553] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 12/02/2022] Open
Abstract
Background Face-to-face cognitive behavioral therapy (CBT) is the most promising treatment to reduce stress, but access to CBT is limited. Internet-delivered CBT (ICBT) enables large-scale dissemination at low costs. Evidence suggests that ICBT can reduce stress in subclinical and mixed diagnostic samples, but less is known about the effect of ICBT in targeted samples suffering from elevated perceived stress or stress-related disorders. Objective To investigate the efficacy of ICBT specifically aimed at reducing stress in adults with elevated perceived stress or stress-related disorders. Methods We searched for randomized controlled trials comparing ICBT with a control group in PubMed, Web of Science, and PsycInfo between 2010 and 2021. A meta-analysis of 14 comparisons (total N = 1831) was performed, and Cohen's d was calculated to assess the difference between intervention and control groups at posttest for the primary outcome self-rated stress. Effects on secondary outcomes of anxiety and depression were also investigated. Results The pooled mean effect size for self-rated stress at posttest was d = 0.78 [CI 95 % 0.66-0.90]. For anxiety and depression, the effects were d = 0.69 [95 % CI 0.52-0.86] and d = 0.65 [95 % CI 0.56-0.75] respectively. The heterogeneity of results between studies was overall low to moderate. Subgroup analyses were not conducted due to the limited number of studies eligible for inclusion. Conclusions Results provide evidence of the efficacy of ICBT to reduce stress, anxiety, and depressive symptoms in adults suffering from elevated stress or stress-related disorders. Findings have important implications for the development of safe and evidence-based treatment guidelines in the face of a rapid digital expansion.This study was preregistered at Open Science Framework (osf.io) with DOI 10.17605/OSF.IO/BQAZ3.
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Affiliation(s)
- Frank Svärdman
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Douglas Sjöwall
- Center for Psychiatry Research, Region Stockholm, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), CAP Research Center, Gävlegatan 22B, SE-11330 Stockholm, Sweden
- Department of Women's and Children's Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Karolinska Institutet, Stockholm, Sweden
- Habilitation & Health, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Elin Lindsäter
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Quero S, Palau-Batet M, Tur C, Mor S, Campos D, Rachyla I, Grimaldos J, Marco JH. Effect of an internet-based intervention for adjustment disorder on meaning in life and enjoyment. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03177-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Abstract
Introduction
Positive psychological variables, such as meaning in life and the capacity for enjoyment, are important resilience factors against negative behaviors and symptoms. These constructs are related to better emotional regulation strategies, a greater perception of control over one’s life, and better mental health in general. Adjustment disorder (AjD) is a prevalent condition defined as the failure to adapt to a stressful event.
Objective
This study presents secondary analysis data on the effect of an Internet-delivered cognitive-behavioral therapy intervention (iCBT) for AjD on meaning in life and capacity for enjoyment, compared to a control group.
Method
The sample consisted of 68 participants with AjD. 34 in the iCBT condition and 34 in the control group). Meaning in life was assessed by the Purpose-in-Life Test-10, and the Environmental Rewards Observation Scale was used to assess the capacity for enjoyment. The iCBT intervention focused on acceptance and processing of the stressful event. Intent-to-treat mixed-model analyses without any ad hoc imputations and using Cohen’s d effect comparisons were conducted.
Results
The results revealed a significant main effect of time and a significant group x time interaction in all the measures. Significantly higher pre-post score differences were found in the treatment condition.
Discussion
Meaning in life and capacity for enjoyment can change after an iCBT intervention for AjD. Therapeutic implications of the results and future lines of research about the role of meaning in life in AjD are discussed.
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While AE, Clark LL. Management of work stress and burnout among community nurses arising from the COVID-19 pandemic. Br J Community Nurs 2021; 26:384-389. [PMID: 34343046 DOI: 10.12968/bjcn.2021.26.8.384] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The COVID-19 pandemic has increased workload demands for many NHS staff including those working in the community. Nurse managers can make a difference by being authentic leaders, nurturing a supportive organisation where the workload is managed participatively and self-kindness is legitimate. Unfortunately some staff may experience burnout and this article presents a personal management plan to address the symptoms of burnout and aid recovery, although it cannot promote a total recovery if the cause of the symptoms remains unaddressed.
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Affiliation(s)
- Alison E While
- Emeritus Professor of Community Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London; Fellow of the Queen's Nursing Institute
| | - Louise L Clark
- Visiting Lecturer, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London
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Hegy JK, Brog NA, Berger T, Znoj H. Web-based Self-help Program for Adjustment Problems After an Accident (SelFIT): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e21200. [PMID: 33331830 PMCID: PMC7775196 DOI: 10.2196/21200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/12/2020] [Accepted: 11/10/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Accidents and the resulting injuries are among the world's biggest health care issues, often causing long-term effects on psychological and physical health. With regard to psychological consequences, accidents can cause a wide range of burdens including adjustment problems. Although adjustment problems are among the most frequent mental health problems, there are few specific interventions available. The newly developed program SelFIT (German acronym: Selber wieder fit nach einem Unfall; "fit again after an accident") aims to remedy this situation by offering a low-threshold, web-based self-help intervention for psychological distress after an accident. OBJECTIVE The overall aim is to evaluate the efficacy and cost-effectiveness of the SelFIT program plus care as usual (CAU) compared to only CAU. Furthermore, the program's user-friendliness, acceptance, and adherence are assessed. We expect that the use of SelFIT will be associated with a greater reduction in psychological distress, greater improvement in mental and physical well-being, and greater cost-effectiveness compared to CAU. METHODS Adults (n=240) experiencing adjustment problems due to an accident they had between 2 weeks and 2 years before entering the study will be randomized into either the intervention or control group. Participants in the intervention group receive direct access to SelFIT. The control group receives access to the program after 12 weeks. There are 6 measurement points for both groups (baseline as well as after 4, 8, 12, 24, and 36 weeks). The main outcome is a reduction in anxiety, depression, and stress symptoms that indicate adjustment problems. Secondary outcomes include well-being, optimism, embitterment, self-esteem, self-efficacy, emotion regulation, pain, costs of health care consumption, and productivity loss, as well as the program's adherence, acceptance, and user-friendliness. RESULTS Recruitment began in December 2019 and will continue at least until January 2021, with the option to extend this for another 6 months until July 2021. As of July 2020, 324 people have shown interest in participating, and 48 people have given their informed consent. CONCLUSIONS To the best of our knowledge, this is the first study examining a web-based self-help program designed to treat adjustment problems resulting from an accident. If effective, the program could complement the still limited offerings for secondary and tertiary prevention of psychological distress after an accident. TRIAL REGISTRATION ClinicalTrials.gov NCT03785912; https://clinicaltrials.gov/ct2/show/NCT03785912. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/21200.
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Affiliation(s)
- Julia Katharina Hegy
- Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Noemi Anja Brog
- Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Thomas Berger
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Bern, Bern, Switzerland
| | - Hansjoerg Znoj
- Department of Health Psychology and Behavioral Medicine, Institute of Psychology, University of Bern, Bern, Switzerland
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8
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Rachyla I, Mor S, Cuijpers P, Botella C, Castilla D, Quero S. A guided Internet-delivered intervention for adjustment disorders: A randomized controlled trial. Clin Psychol Psychother 2020; 28:313-324. [PMID: 32959481 DOI: 10.1002/cpp.2518] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 12/11/2022]
Abstract
Evidence of self-help interventions for adjustment disorder (AjD) is limited. This study aims at testing in a randomized controlled trial (RCT) the effectiveness of a disorder-specific, Internet-delivered cognitive-behavioural therapy (ICBT) intervention for AjD. Participants were randomly allocated to either an ICBT with brief weekly telephone support (n = 34) or a waiting list group (n = 34). Beck's inventories for depression and anxiety were used as primary outcomes. The secondary outcomes were AjD symptoms, post-traumatic growth, positive and negative affect, and quality of life. In all, 76.5% of the participants completed the intervention. Compared with the control group, participants in the intervention condition showed significantly greater improvement in all outcomes (Cohen's d ranged from 0.54 to 1.21) except in anxiety symptoms measured by Beck Anxiety Inventory (d = 0.27). Only ICBT group showed a significant improvement in post-traumatic growth, positive and negative affect, and quality of life. The number of cases that achieved clinically meaningful change in all outcome measures was also higher in the ICBT group. All therapeutic gains were maintained at 3-, 6- and 12-month follow-ups. The current study provides evidence on the effectiveness of ICBT interventions to reduce the impact of AjD. Results suggest that brief self-help intervention with minimal therapist support is more effective than the mere passage of time in reducing the distress symptoms associated to the disorder and also can confer additional benefits.
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Affiliation(s)
- Iryna Rachyla
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Sonia Mor
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cristina Botella
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,CIBER of Physiopathology of Obesity and Nutrition (CIBERObn), Madrid, Spain
| | - Diana Castilla
- CIBER of Physiopathology of Obesity and Nutrition (CIBERObn), Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Universidad de Valencia, Valencia, Spain
| | - Soledad Quero
- Department of Basic, Clinical Psychology and Psychobiology, Universitat Jaume I, Castellón, Spain.,CIBER of Physiopathology of Obesity and Nutrition (CIBERObn), Madrid, Spain
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Kazlauskas E, Eimontas J, Olff M, Zelviene P, Andersson G. Adherence Predictors in Internet-Delivered Self-Help Intervention for Life Stressors-Related Adjustment Disorder. Front Psychiatry 2020; 11:137. [PMID: 32231597 PMCID: PMC7083090 DOI: 10.3389/fpsyt.2020.00137] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 02/14/2020] [Indexed: 12/19/2022] Open
Abstract
Background: There is a growing body of evidence to show that low-intensity self-help internet-delivered interventions are effective in the treatment of mental disorders. Despite the promising effectiveness of internet-delivered interventions, there is still a challenge for mental health services to implement internet-delivered interventions in routine health care. The aim of this study was to analyze the predictors of adherence to a self-help internet-delivered intervention for adjustment disorder. Methods: This was a secondary report of data, including unpublished data, from a randomized controlled trial of an internet-delivered self-help intervention for adjustment disorder. The study included 1,077 participants who had completed online baseline assessments. All participants had experienced significant life stressors over the last 2 years and had high levels of adjustment disorder symptoms. We analyzed the role of sociodemographic variables, pre-treatment adjustment disorder symptoms, outcome expectations, and perceived barriers to mental health services on the use of the intervention. Results: We found that usage of internet-delivered self-help intervention and higher adherence was associated with female gender, greater age, higher pre-intervention outcome expectations, exposure to other forms of psychological therapy in addition to the internet-intervention at the time of the study, and reported perceived barriers to mental health services by the study participants. Conclusions: The findings of the study indicated the importance of non-specific therapeutic factors on adherence during internet-delivered intervention. Perceived barriers to mental health services were associated with higher adherence to self-help intervention, which indicated that communities with restricted access to mental health services could benefit from low-intensity internet-delivered interventions.
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Affiliation(s)
- Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Jonas Eimontas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Miranda Olff
- Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Arq Psychotrauma Expert Group, Diemen, Netherlands
| | - Paulina Zelviene
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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10
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Díaz-García A, González-Robles A, Mor S, Mira A, Quero S, García-Palacios A, Baños RM, Botella C. Positive and Negative Affect Schedule (PANAS): psychometric properties of the online Spanish version in a clinical sample with emotional disorders. BMC Psychiatry 2020; 20:56. [PMID: 32039720 PMCID: PMC7008531 DOI: 10.1186/s12888-020-2472-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 01/30/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The Positive and Negative Affect Schedule (PANAS) is the most widely and frequently used scale to assess positive and negative affect. The PANAS has been validated in several languages, and it has shown excellent psychometric properties in the general population and some clinical samples, such as forensic samples, substance users, and adult women with fibromyalgia. Nevertheless, the psychometric properties of the scale have not yet been examined in clinical samples with anxiety, depressive, and adjustment disorders. In addition, the proliferation of Internet-based treatments has led to the development of a wide range of assessments conducted online with digital versions of pen and paper self-report questionnaires. However, no validations have been carried out to analyze the psychometric properties of the online version of the PANAS. The present study investigates the psychometric properties of the online Spanish version of the PANAS in a clinical sample of individuals with emotional disorders. METHODS The sample was composed of 595 Spanish adult volunteers with a diagnosis of depressive disorder (n = 237), anxiety disorder (n = 284), or adjustment disorder (n = 74). Factor structure, construct validity, internal consistency, and sensitivity to change were analyzed. RESULTS Confirmatory factor analysis yielded a latent structure of two independent factors, consistent with previous validations of the instrument. The analyses showed adequate convergent and discriminant validity, good internal consistency as well as sensitivity to change. CONCLUSIONS Overall, the results obtained in this study show that the online version of the PANAS has adequate psychometric properties for the assessment of positive and negative affect in a Spanish clinical population.
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Affiliation(s)
- Amanda Díaz-García
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Alberto González-Robles
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Sonia Mor
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Adriana Mira
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
| | - Soledad Quero
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
| | - Rosa María Baños
- Department of Personality, Evaluation and Psychological Treatments, Universidad de Valencia, Valencia, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
| | - Cristina Botella
- Department of Basic and Clinical Psychology, and Psychobiology, Universitat Jaume I, Castellón, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Carlos III, Madrid, Spain
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Zelviene P, Kazlauskas E, Maercker A. Risk factors of ICD-11 adjustment disorder in the Lithuanian general population exposed to life stressors. Eur J Psychotraumatol 2020; 11:1708617. [PMID: 32002141 PMCID: PMC6968697 DOI: 10.1080/20008198.2019.1708617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/09/2019] [Accepted: 12/06/2019] [Indexed: 11/16/2022] Open
Abstract
Background: A new definition of adjustment disorder symptoms has been included in the 11th edition of the International Classification of Diseases (ICD-11). However, little is known about risk factors of ICD-11 adjustment disorder. Objective: The study aimed to analyse risk factors of adjustment disorder in a sample of the Lithuanian general population exposed to life-stressors. Method: In total, the study included 649 adult participants from the general population with various recent significant life-stressor experiences. ICD-11 adjustment disorder symptoms were measured using the Adjustment Disorder New Module-8 (ADNM-8) scale. Results: The prevalence of the ICD-11 adjustment disorder diagnosis in the sample was 16.5%. Job-related stressors and health-related stressors were significantly associated with adjustment disorder. Other risk factors for adjustment disorder in this study were female gender, greater age, and university education. Conclusions: We conclude that stressor type and demographic characteristics are associated with the risk of developing an adjustment disorder.
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Affiliation(s)
- Paulina Zelviene
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Andreas Maercker
- Division of Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland
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ZIEL: Internet-Based Self-Help for Adjustment Problems: Results of a Randomized Controlled Trial. J Clin Med 2019; 8:jcm8101655. [PMID: 31614528 PMCID: PMC6832125 DOI: 10.3390/jcm8101655] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/30/2019] [Accepted: 10/05/2019] [Indexed: 11/16/2022] Open
Abstract
Adjustment Disorder (AjD) represents a healthcare paradox. On the one hand, it is one of the most diagnosed mental disorders worldwide. On the other hand, AjD and its possible treatment options remain a severely neglected field of research. In this context, we developed a self-guided online intervention for adjustment problems, named ZIEL, and tested its efficacy. It is based on and extends a bibliotherapeutic treatment approach for symptoms of AjD. In our study, a total of 98 individuals who had experienced a life event in the last two years, were randomly assigned to care as usual (CAU) or an online intervention group (CAU + online intervention). The primary endpoint was AjD symptom severity measured by Adjustment Disorder–New Module 20 (ADNM-20). Secondary endpoints were depressive symptoms, quality of life and other variables such as satisfaction and usability. Both the intervention and the control group improved comparably well regarding the severity of adjustment disorder symptoms post-treatment. However, participants in the intervention group showed significantly fewer depressive symptoms and a significantly higher quality of life (Cohen’s d: 0.89 (BDI) and −0.49 (SF-12)). The intervention was well-received by users with an above average usability rating. Overall, the results suggest that the ZIEL intervention has the promise to contribute to the treatment of AjD and reduce symptom burden by means of a scalable low-barrier approach.
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