Psychometric evaluation of the Swedish version of the pure procrastination scale, the irrational procrastination scale, and the susceptibility to temptation scale in a clinical population

Trajectories of procrastination among Swedish University students over one academic year: a cohort study

BACKGROUND

Procrastination is common among university students and associated with adverse outcomes such as physical and mental health problems. According to the Temporal motivation theory procrastination may vary over time depending on the temporal proximity to goals and deadlines.

AIMS

To determine if mean procrastination levels among university students varies over an academic year, and if trajectories of procrastination are moderated by gender identity, perfectionistic strivings, and/or perfectionistic concerns.

SAMPLE

Swedish university students (n = 1410).

METHODS

The cohort was followed with web-surveys at four time-points over one academic year (Late semester, Mid semester, After semester, and Early semester). Generalized Estimating Equations were used to estimate mean levels of self-rated procrastination at the different time-points.

RESULTS

We found only small fluctuations in mean procrastination levels over the academic year. Participants with high perfectionistic concerns demonstrated higher mean procrastination levels at all time-points, but neither gender identity, perfectionistic concerns nor perfectionistic strivings affected the slope of the mean procrastination trajectories.

CONCLUSIONS

In this cohort of Swedish university students, self-rated procrastination levels were stable over the academic year. Perfectionistic concerns, but not gender identity or perfectionistic strivings, was associated with higher levels of procrastination.

Effects of a single session low-threshold digital intervention for procrastination behaviors among university students (Focus): Findings from a randomized controlled trial

Introduction

Procrastination behaviors are common among university students, and have been found to be associated with stress, symptoms of depression, anxiety, and poorer academic performance. There is a need for interventions that can reach students at scale, and therefore this study aimed to estimate the effects of a single session low-threshold digital intervention (Focus) for procrastination behaviors among university students in Sweden.

Methods and analysis

A two-arm, parallel groups (1:1), single blind randomized controlled trial was conducted between February 8 to April 26, 2023. The study used email to invite university students across Sweden to participate in the trial. Both the intervention and the control group were invited to assess their current procrastination behaviors using the Pure Procrastination Scale (PPS). The intervention group immediately received feedback and behavior change advice by means of an interactive website, while the control group was shown their total PPS score without any further feedback. Students were included in the study if they scored 20 points or more on the PPS. Our primary outcome was procrastination behavior measured at 2 months post-randomization. Analyses were conducted using multilevel regression models estimated with Bayesian inference.

Results

A total of 2209 participants (intervention: 1109, control: 1100) were randomized. The average age of participants was 26.4 years (SD = 7.8) and 65 % were women (n = 1442). The mean PPS score at baseline was 35.6 points (of a maximum of 60). Primary outcome data were available for 45 % (n = 498) of the intervention group and 55 % (n = 601) of the control group. The evidence suggested no marked difference between groups regarding any of the outcomes, although there was weak evidence of lower physical activity in the intervention group. Qualitative findings from open-ended responses uncovered a variety of views on procrastination and perceived problems that may follow. Those not feeling supported by Focus explained having troubles adopting the advice given and converting their intentions into action without more continuous support.

Conclusions

Access to a single session of feedback and behavior change advice by means of an interactive website did not produce differential self-reported procrastination among university students who took the opportunity to self-assess their behaviors. The findings are limited by assessment reactivity due to screening at baseline and attrition to follow-up.

Treating perfectionism via the Internet: a randomized controlled trial comparing cognitive behavior therapy to unified protocol

Perfectionism can be problematic when your self-worth is dependent on achievements and leads to inflexible standards, cognitive biases, and rigid behaviors. Cognitive behavior therapy for perfectionism is shown to be effective, including for targeting psychiatric symptoms and when delivered via the Internet (iCBT-P). However, few studies have compared it to an active comparator. The current study randomly assigned 138 participants seeking help for perfectionism to iCBT-P or Internet-based Unified Protocol (iUP). Both treatments provided guidance on demand from a therapist and were eight weeks in duration. The results indicated large within-group effects of Cohen's d 2.03 (iCBT) and 2.51 (iUP) on the Clinical Perfectionism Questionnaire at post-treatment, and maintained effects at 6- and 12-month follow-up, but no between-group difference (β = 0.02, SE = 1.04, p = .98). Secondary outcomes of depression, anxiety, quality of life, self-compassion, procrastination, and stress ranged from small to large, with no differences between the conditions. Both treatments were deemed credible, relevant, of high quality, and well-adhered by the participants. Further research needs to be conducted, but the findings could indicate a lack of specificity, perhaps suggesting there is no need to differentiate between different treatments that are transdiagnostic in nature.

Spanish validation of the pure procrastination scale: dimensional structure, internal consistency, temporal stability, gender invariance, and relationships with personality and satisfaction with life

The objective of the current study was to adapt and validate the pure procrastination scale (PPS) for the Spanish adult population. Procrastination can have numerous consequences in daily life, making it essential to have reliable and valid instruments for measuring procrastination. Thus, this study was conducted to address this need. The sample consisted of 596 adults aged 18-83 years (M = 35.25, SD = 13.75). In addition to the PPS, participants completed two procrastination measures, namely the irrational procrastination scale and the decisional procrastination questionnaire, alongside the Big Five inventory and the satisfaction with life scale. The results of the confirmatory factor analysis revealed a three-factor structure of the PPS. The examination of the reliability of scores in terms of internal consistency and temporal stability showed satisfactory results for the PPS scores. Moreover, gender invariance was observed at the scalar level. Finally, the PPS scores correlated with other measures of procrastination, personality traits, and satisfaction with life in the expected direction and magnitude. In conclusion, the Spanish PPS offers valid and reliable scores when administered to adult population.

Evaluating the effectiveness of a brief digital procrastination intervention targeting university students in Sweden: study protocol for the Focus randomised controlled trial

INTRODUCTION

The concept of procrastination can be described as a conscious, yet irrational, postponement of important tasks or decisions-despite awareness that the delay may lead to negative consequences. Procrastination behaviours are common among university students and is often described as a failure of self-regulation, and the behaviour is associated with stress, symptoms of depression and anxiety, poorer academic performance and negative effects on overall health and well-being.

METHODS AND ANALYSIS

A two-arm, parallel groups (1:1), single-blind randomised controlled trial will be conducted to assess the effectiveness of a brief digital procrastination intervention (Focus) among university students in Sweden. The intervention consists of a screening and feedback component based on Pure Procrastination Scale (PPS) score, allowing intervention participants to assess their current procrastination behaviours and receive behaviour change advice. Participants in the control group will be shown their total PPS score without any further feedback. Monte Carlo simulations (assuming a standardised effect of 0.35 Cohen's d of the intervention on the primary outcome, to at least 80% of the time estimate a posterior probability of effect of at least 95%) indicated that data from 1000 participants are required for analysis, meaning that 2000 participants are required to be randomised when assuming a 50% attrition rate. The primary outcome will be procrastination behaviour measured at 2 months postrandomisation. Secondary outcomes will be anxiety and stress symptoms and lifestyle behaviours. Outcomes will be analysed using multilevel regression models estimated using Bayesian inference.

ETHICS AND DISSEMINATION

The study was approved by the Swedish Ethical Review Authority on 2022-08-24 (dnr 2022-00353). Students will be asked to give informed consent before participation and after having been given information about the study. The results will be submitted for publication in open access, peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ISRCTN13533793.

Diagnostic criteria to differentiate pathological procrastinators from common delayers: a re-analysis

Detection and treatment of clinically relevant forms of procrastination would be greatly facilitated by diagnostic criteria as formulated for psychological disorders in the Diagnostic and Statistical Manual (DSM-5). In the present article, the steps for deriving and validating diagnostic criteria for pathological procrastination are described. In an online survey of a random sample of N = 10,000 German university students, 990 answered 13 items derived from the attempts in the literature to define procrastination, the Aitken Procrastination Inventory (API) and the Patient Health Questionnaire (PHQ-9). A subset of six items related to the first factor onset delay of the API was selected by Best Subset Multiple Regression (BSMR). A latent class analysis (LCA) of these six items sorted the students into six clusters. A cluster of pathological procrastinators (10%) was separated from the clusters of less impaired habitual, average, and occasional delayers. In addition, a cluster of unconcerned delayers (10%), with strong procrastination tendencies but little personal disadvantages, and a small cluster of fast performers (2%) emerged. The pathological procrastinators differed from all other clusters significantly on nine of the 13 items. They were older, had studied longer but had fulfilled less of their study obligations and were more depressed. The answer options of the six questions were collapsed into two categories (procrastination feature present for at least half a year or absent). These criteria were used for the clinical diagnosis of pathological procrastination. For a diagnosis, two fixed criteria (delaying important tasks needlessly and strong interference with personal goals) plus at least two of four additional criteria (time spent procrastinating, time pressure, physical and psychological complaints, below performance potential) must be met. This diagnostic rule captured 92% from the cluster of pathological procrastinators and 10% of the habitual delayers, but no one from the remaining clusters. Using these diagnostic criteria for clinical diagnosis and intervention decisions will facilitate the comparison and integration of the results from future studies of procrastination.

Pilot data findings from the Gothenburg treatment for gaming disorder: a cognitive behavioral treatment manual

Background

Gaming disorder (GD) is a new diagnosis included in the latest edition of the International Classification of Disease -11. Recently conducted international studies suggest a prevalence rate close to 2% for GD, highlighting the need for effective treatments for this patient population. Internationally there are few studies investigating effective treatments specifically designed for this condition. In this pilot study, we wanted to test a newly developed method, the Gothenburg Treatment for Gaming Disorder (GOT-TO-GO) manual; a 15-week cognitive behavioral therapy treatment for GD.

Method

This study utilized a single group design with pretest, post-test and a three- and six-month follow-up, with measures of severity of GD and mood. The participants (n = 28) were treatment-seeking adults with GD, aged 17 to 49 years.

Results

The results show a statistically significant decrease in symptoms of GD after treatment. Hours of gaming per week also decreased concomitantly with a 100% increase in non-gaming leisure hours. The decrease in symptoms of GD was maintained at the 3-months follow-up after treatment. Correspondingly we saw a decrease in both depression and anxiety that also was upheld 3 months after treatment.

Conclusion

As GD is a new diagnostic concept more research is needed, also taking psychiatric comorbidity into consideration, to arrive at evidence-based conclusions regarding effective treatments. Considering the promising results in this small pilot study with large behavioral changes and reduced symptoms of GD, upheld at least 3 months after treatment, a larger randomized controlled study is warranted.Clinical Trial Registration: https://www.clinicaltrials.gov/ct2/show/study/NCT05328596?term=NCT05328596&draw=2&rank=1, identifier NCT05328596.

Effectiveness of a guided internet-based intervention for procrastination among university students - A randomized controlled trial study protocol

Procrastination is a widespread problem that is highly prevalent among the young adult population and is associated with several negative consequences. However, current evidence on the effectiveness of e-health interventions for procrastination either lack a comparison to an inactive control, do not include a student population or are of poor quality. This protocol describes the design of a trial that will overcome these limitations and examine the effectiveness of a guided internet-based intervention (GetStarted) to reduce problematic procrastinating behaviors in college students compared to a waitlist control. This study will be a two-armed randomized controlled trial with a calculated sample size of N = 176. Participants will be students from seven universities in the Netherlands. The intervention group will receive a four-week e-coach-guided intervention for procrastination. The waitlist control group will get access to treatment four weeks after randomization. Assessments will take place at baseline, post-test (4 weeks post-baseline) and follow-up (6 months post-baseline). Data will be analyzed with an intent-to-treat principle. The primary outcome is change in procrastination behaviors measured on the Irrational Procrastination scale (IPS). Secondary outcomes are depression, anxiety, stress, and quality of life. Additionally, sociodemographic characteristics of the participants, satisfaction with treatment, program usability, satisfaction with e-coach and treatment adherence will be examined as potential moderators. The results from this study can build evidence for the effectiveness of a guided internet-based intervention for treating procrastination in college students. Should it be effective, GetStarted could provide a flexible, low-intense and cost-effective treatment for procrastination and prevent common mental health problems in college students.

Trial registration

This trial is registered at ClinicalTrials.gov Protocol Registration and Results System (Trial number: NCT05478096).

Associations Between Procrastination and Subsequent Health Outcomes Among University Students in Sweden

IMPORTANCE

Procrastination is prevalent among university students and is hypothesized to lead to adverse health outcomes. Previous cross-sectional research suggests that procrastination is associated with mental and physical health outcomes, but longitudinal evidence is currently scarce.

OBJECTIVE

To evaluate the association between procrastination and subsequent health outcomes among university students in Sweden.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study was based on the Sustainable University Life study, conducted between August 19, 2019, and December 15, 2021, in which university students recruited from 8 universities in the greater Stockholm area and Örebro were followed up at 5 time points over 1 year. The present study used data on 3525 students from 3 time points to assess whether procrastination was associated with worse health outcomes 9 months later.

EXPOSURE

Self-reported procrastination, measured using 5 items from the Swedish version of the Pure Procrastination Scale rated on a Likert scale from 1 ("very rarely or does not represent me") to 5 ("very often or always represents me") and summed to give a total procrastination score ranging from 5 to 25.

MAIN OUTCOMES AND MEASURES

Sixteen self-reported health outcomes were assessed at the 9-month follow-up. These included mental health problems (symptoms of depression, anxiety, and stress), disabling pain (neck and/or upper back, lower back, upper extremities, and lower extremities), unhealthy lifestyle behaviors (poor sleep quality, physical inactivity, tobacco use, cannabis use, alcohol use, and breakfast skipping), psychosocial health factors (loneliness and economic difficulties), and general health.

RESULTS

The study included 3525 participants (2229 women [63%]; mean [SD] age, 24.8 [6.2] years), with a follow-up rate of 73% (n = 2587) 9 months later. The mean (SD) procrastination score at baseline was 12.9 (5.4). An increase of 1 SD in procrastination was associated with higher mean symptom levels of depression (β, 0.13; 95% CI, 0.09-0.17), anxiety (β, 0.08; 95% CI, 0.04-0.12), and stress (β, 0.11; 95% CI, 0.08-0.15), and having disabling pain in the upper extremities (risk ratio [RR], 1.27; 95% CI, 1.14-1.42), poor sleep quality (RR, 1.09, 95% CI, 1.05-1.14), physical inactivity (RR, 1.07; 95% CI, 1.04-1.11), loneliness (RR, 1.07; 95% CI, 1.02-1.12), and economic difficulties (RR, 1.15, 95% CI, 1.02-1.30) at the 9-month follow-up, after controlling for a large set of potential confounders.

CONCLUSIONS AND RELEVANCE

This cohort study of Swedish university students suggests that procrastination is associated with subsequent mental health problems, disabling pain, unhealthy lifestyle behaviors, and worse psychosocial health factors. Considering that procrastination is prevalent among university students, these findings may be of importance to enhance the understanding of students' health.

Hybrid brain model accurately predict human procrastination behavior

Procrastination behavior is quite ubiquitous, and should warrant cautions to us owing to its significant influences in poor mental health, low subjective well-beings and bad academic performance. However, how to identify this behavioral problem have not yet to be fully elucidated. 1132 participants were recruited as distribution of benchmark. 81 high trait procrastinators (HP) and matched low trait procrastinators (LP) were screened. To address this issue, we have built upon the hybrid brain model by using hierarchical machine learning techniques to classify HP and LP with multi-modalities neuroimaging data (i.e., grey matter volume, fractional anisotropy, static/dynamic amplitude of low frequency fluctuation and static/dynamic degree centrality). Further, we capitalized on the multiple Canonical Correlation Analysis (mCCA) and joint Independent Component Analysis algorithm (mCCA + jICA) to clarify its fusion neural components as well. The hybrid brain model showed high accuracy to discriminate HP and LP (accuracy rate = 87.04%, sensitivity rate = 86.42%, specificity rate = 85.19%). Moreover, results of mCCA + jICA model revealed several joint-discriminative neural independent components (ICs) of this classification, showing wider co-variants of frontoparietal cortex and hippocampus networks. In addition, this study demonstrated three modal-specific discriminative ICs for classification, highlighting the temporal variants of brain local and global natures in ventromedial prefrontal cortex (vmPFC) and PHC in HP. To sum-up, this research developed a hybrid brain model to identify trait procrastination with high accuracy, and further revealed the neural hallmarks of this trait by integrating neuroimaging fusion data.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11571-021-09765-z.

Acute Stress among Nurses in Sweden during the COVID-19 Pandemic

Sweden was hit hard in the beginning of the COVID-19 pandemic with deaths per capita among the highest in Europe. The pandemic was a stressful time especially for healthcare workers caring for COVID-19 patients. Various studies have evaluated whether nurses caring for these patients had higher levels of acute stress, but typically with measures that either used older DSM-IV criteria for Acute Stress Disorder (ASD) or general measures of acute stress. We recruited an online sample (N = 101) of nurses in Sweden from COVID-19 specialized units (ICU), Emergency (ER), and other units (Other), and asked them to answer questionnaires retrospectively to the peak of infections in Sweden. We aimed to evaluate: 1) the psychometric properties of the translation of the Stanford Acute Stress Reaction Questionnaire-II (SASRQ-II, which follows DSM-5 criteria for ASD) into Swedish, 2) whether nurses in COVID-19 units had experienced more acute stress than nurses in other units, and 3) the extent of potential acute stress disorder. The SASRQ-II evidenced good construct, convergent and divergent validity, and good reliability. It showed that ICU nurses reported significantly more acute stress than the other two groups, a difference that could not be accounted for by demographic or other variables. A retrospective diagnosis of ASD using the SASRQ-II suggested that 60% of nurses might have fulfilled ASD criteria, but no differences across groups were found.

Procrastination Among University Students: Differentiating Severe Cases in Need of Support From Less Severe Cases

Procrastination refers to voluntarily postponing an intended course of action despite expecting to be worse off for this delay, and students are considered to be especially negatively affected. According to estimates in the literature, at least half of the students believe procrastination impacts their academic achievements and well-being. As of yet, evidence-based ideas on how to differentiate severe from less severe cases of procrastination in this population do not exist, but are important in order to identify those students in need of support. The current study recruited participants from different universities in Sweden to participate in an anonymous online survey investigating self-rated levels of procrastination, impulsivity, perfectionism, anxiety, depression, stress, and quality of life. Furthermore, diagnostic criteria for pathological delay (PDC) as well as self-report items and open-ended questions were used to determine the severity of their procrastination and its associated physical and psychological issues. In total, 732 participants completed the survey. A median-split on the Pure Procrastination Scale (PPS) and the responses to the PDC were used to differentiate two groups; "less severe procrastination" (PPS ≤ 2.99; n = 344; 67.7% female; M age = 30.03; SD age = 9.35), and "severe procrastination" (PPS ≥ 3.00; n = 388; 66.2% female; M age = 27.76; SD age = 7.08). For participants in the severe group, 96-97% considered procrastination to a problem, compared to 42-48% in the less severe group. The two groups also differed with regard to considering seeking help for procrastination, 35-38% compared to 5-7%. Participants in the severe group also reported more problems of procrastination in different life domains, greater symptoms of psychological issues, and lower quality of life. A thematic analysis of the responses on what physical issues were related to procrastination revealed that these were characterized by stress and anxiety, e.g., tension, pain, and sleep and rest, while the psychological issues were related to stress and anxiety, but also depression, e.g., self-criticism, remorse, and self-esteem. The current study recommends the PPS to be used as an initial screening tool, while the PDC can more accurately determine the severity level of procrastination for a specific individual.

Sustainable UNiversity Life (SUN) study: protocol for a prospective cohort study of modifiable risk and prognostic factors for mental health problems and musculoskeletal pain among university students

INTRODUCTION

Mental health problems and musculoskeletal pain are common health problems among young adults including students. Little is known about the aetiology and prognosis of these problems in university students. We aim to determine the role of personal, sociodemographic, academic and environmental factors for risk and prognosis of symptoms of depression, anxiety and stress as well as musculoskeletal pain in university students. The constructs that will be studied are based on the biopsychosocial model and psychopathology associated with disabling pain. This model acknowledges illness to consist of interrelated mechanisms categorised into biological, psychological, environmental and social cues.

METHODS AND ANALYSIS

This cohort study aims to recruit around 5000 Swedish full-time students. Data will be collected using five online surveys during one academic year. A subgroup (n=1851) of the cohort, recruited before the COVID-19 pandemic, receive weekly text messages with three short questions assessing mood, worry and pain, sent through the web-based platform SMS-track . Statistical analyses will include Kaplan-Meier estimates, Cox regression analyses, multinomial logistic regression analyses and generalised estimating equations. We will assess effect measure modification when relevant and conduct sensitivity analyses to assess the impact of lost to follow-up.

PROTOCOL AMENDMENTS

Due to opportunity and timing of the study, with relevance to the outbreak of the COVID-19 pandemic, this study further aims to address mental health problems, musculoskeletal pain and lifestyle in university students before and during the pandemic.

ETHICS AND DISSEMINATION

The Sustainable UNiversity Life study was approved by the Swedish ethics authority (2019-03276; 2020-01449). Results will be disseminated through peer-reviewed research papers, reports, research conferences, student theses and stakeholder communications.

TRIAL REGISTRATION NUMBER

NCT04465435.

Alcohol Use and Gambling Associated with Impulsivity among a Swedish University Sample

Excessive alcohol use and gambling can have negative consequences. Across countries, the risk of excessive alcohol use is more common in university populations than in the general population. However, few studies have investigated the prevalence of both alcohol use and gambling in this group. This study explores these behaviours in a Swedish university setting. In addition, this study investigates how impulsivity affects alcohol use and gambling. In total, 794 Swedish students answered an online survey. Data were analysed using descriptive statistics to determine prevalence, and multinomial logistic regression was used to determine the contribution of impulsivity, age, and sex to alcohol use and gambling. Compared to the Swedish national prevalence, the prevalence was higher for excessive alcohol use, but the prevalence of gambling was at the same level or lower. High levels of impulsivity and male sex increased the risk of excessive alcohol use, while older age lowered the risk of excessive alcohol use and gambling. The results indicate that primarily young men could benefit from primary prevention in a university setting. Also, screening for impulsivity in men might be one way to identify risk groups in a university population.

A feasibility study of a cognitive behavioral based stress management intervention for nursing students: results, challenges, and implications for research and practice

Background

Stress related psychological problems are growing in nursing education and constitute an essential challenge for educators. This makes research about strategies and interventions to meet these problems important. Stress management interventions need to be tested for feasibility and acceptability, before conducting large scale RCTs. The objective of our study was to assess the feasibility and acceptability of a newly developed cognitive behavioral stress management intervention for nursing students.

Methods

Data were collected using a combination of standardized measurements and newly created questionnaires in combination with qualitative data. Our data included recruitment capability, sample characteristics, intervention acceptability and preliminary evaluation of participant psychological changes.

Results

Findings suggested that the feasibility of conducting a full-scale evaluation was confirmed for intervention acceptability, data collection procedures, and adherence. However, difficulties relating to recruitment capability and homework were identified. All aspects taken together, the intervention was found feasible and acceptable to nursing students, and thus a potential stress management intervention for the nurse education context.

Conclusions

Overall, this study provides an insight into the challenges and complexities of developing and evaluating a new brief cognitive behavioral based stress management training intervention in a nurse education setting.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00761-6.

Mental health in individuals with self-reported psychiatric symptoms during the COVID-19 pandemic: Baseline data from a swedish longitudinal cohort study

OBJECTIVE

Individuals with psychiatric disorders may be both vulnerable and sensitive to rapid societal changes that have occurred during the COVID-19 pandemic. To fully understand these impacts, repeated measurements of these individuals are warranted. The current longitudinal study set out to perform monthly assessment of individuals with common psychiatric disorders using established questionnaires with a possibility for them to self- rate their symptoms, over time.

METHODS

Recruitment of individuals who identified themselves as struggling with mental health problems, living in Sweden between July 2020 and June 2021 using an online survey. The individuals answered questions on demographics, psychiatric history, current psychiatric symptoms (e.g., Patient Health Questionnaire, PHQ-9; General Anxiety Disorder, GAD-7), somatic health, health-care contacts and any changes therein during the pandemic. Monthly, longitudinal assessments are still ongoing (consenting participants provide data for 1 year), and here we present descriptive statistics from the baseline measurement. All measurements from baseline (>400 items), and follow-ups are presented in detail.

RESULTS

A total of 6.095 participants (average age 35 years) submitted complete baseline data. Marital status (43% single) and number of years of education (48% highest degree being high school) were evenly distributed in this population. The most common lifetime psychiatric disorder in the sample was depressive disorder (80.5%) and generalized anxiety disorder (45.9%), with a substantial proportion having severe symptoms of depression. (30.5%) and anxiety (37.1%). Lifetime suicidal ideation (75.0%) and non-suicidal self-harm (57.7%) were prevalent in the group and 14.5% reported drug use during the pandemic. Allergies (36.8%) were the most common somatic condition, followed by irritable bowel syndrome (18.7%). For those having experienced a traumatic event, 39% showed symptoms during the pandemic indicating PTSD. Regarding contact with mental health services during the pandemic, 22% had established a new contact, and 20% reported to have increased their psychiatric medication compared to before the pandemic.

CONCLUSION

Baseline data collected during the pandemic from individuals in Sweden with pre-existing psychiatric disorders demonstrate that this sample represents a population suitable for an investigation on the long-term impact of the pandemic, as intended by the longitudinal investigation that is ongoing. Follow-up questionnaires over a 12-month period are being collected and will indicate how the health and well-being of this population was impacted during the changes and uncertainties that have been characteristic of the past 2 years.

Psychometric Properties of the Chinese Irrational Procrastination Scale: Factor Structure and Measurement Invariance Across Gender

The present paper reports on the preliminary validation of a Chinese version of Steel's Irrational Procrastination Scale (IPS). To this end, the nine items of the IPS were translated into Chinese and data were collected from a sample of 2,361 mainland Chinese college students. Confirmatory factor analysis (CFA) was used to examine the dimensional structure of the IPS, and multigroup CFA (MG CFA) was carried out to evaluate the measurement invariance across gender. Results revealed that the Chinese IPS had adequate internal consistency reliability, adhered to the one-factor structure, and exhibited strong or scalar invariance across the two gender subgroups, thereby providing support for the internal construct validity of the scale. Additionally, the IPS scores were found to be strongly and negatively related to the Conscientiousness personality trait while showing weak correlations with the other traits, which provided some support for the convergent and divergent validity of the Chinese IPS. Study limitations and future research directions (e.g., expanding the empirical evidence for the scale's criterion-related validity) are discussed.

Spanish Version of the Bedtime Procrastination Scale: Cross-Cultural Adaptation and Psychometric Evaluation in a Sample of Nursing Students

A recent line of research concerns bedtime procrastination, its effects on sleep quality and duration, and the associated repercussions for health and wellbeing. The Bedtime Procrastination Scale is a brief, self-report instrument developed by Kroese et al. with the aim of evaluating this behavior and exploring its association with insufficient sleep, and hence with health. The aim was to develop and validate a Spanish version of the Bedtime Procrastination Scale (BPS-Sp) and to examine the relationship between bedtime procrastination and both general procrastination and self-control. The original BPS was translated from English into Spanish in accordance with international guidelines on the cross-cultural adaptation of measurement instruments. The sample for the validation study comprised 177 nursing students who completed a questionnaire requesting demographic data and which included the following instruments: the newly developed BPS-Sp, the Tuckman Procrastination Scale, and the Brief Self-Control Scale. Statistical analysis involved tests of normality (Kolmogorov-Smirnov), reliability (Cronbach's alpha, test-retest), construct validity, and confirmatory factor analysis. Scores on the BPS-Sp showed excellent internal consistency (α = .83) and temporal stability (test-retest r = .84), as well as significant correlations with general procrastination (r = .26; p < .01) and self-control (r = -.17; p < .05). Confirmatory factor analysis showed an adequate fit for the single-factor solution proposed by Kroese et al. The results suggest that the BPS-Sp is a valid and reliable instrument for assessing bedtime procrastination in the Spanish-speaking population.

Latent Variable Models and Networks: Statistical Equivalence and Testability

Networks are gaining popularity as an alternative to latent variable models for representing psychological constructs. Whereas latent variable approaches introduce unobserved common causes to explain the relations among observed variables, network approaches posit direct causal relations between observed variables. While these approaches lead to radically different understandings of the psychological constructs of interest, recent articles have established mathematical equivalences that hold between network models and latent variable models. We argue that the fact that for any model from one class there is an equivalent model from the other class does not mean that both models are equally plausible accounts of the data-generating mechanism. In many cases the constraints that are meaningful in one framework translate to constraints in the equivalent model that lack a clear interpretation in the other framework. Finally, we discuss three diverging predictions for the relation between zero-order correlations and partial correlations implied by sparse network models and unidimensional factor models. We propose a test procedure that compares the likelihoods of these models in light of these diverging implications. We use an empirical example to illustrate our argument.

Neural markers of procrastination in white matter microstructures and networks

More than 15% of adults suffer from pathological procrastination, which leads to substantial harm to their mental and psychiatric health. Our previous work demonstrated the role of three neuroanatomical networks as neural substrates of procrastination, but their potential interaction remains unknown. Three large-scale independent samples (total n = 901) were recruited. In sample A, tract-based spatial statistics (TBSS) and connectome-based graph-theoretical analysis was conducted to probe association between topological properties of white matter (WM) network and procrastination. In sample B, the above analysis was reproduced to demonstrate replicability. In sample C, machine learning models were built to predict individual procrastination. TBSS results showed a negative association between procrastination and WM integrity of limbic-prefrontal connection, and a positive relationship between intra-connection within the limbic system and procrastination. Also, both the efficiency and integrity of limbic WM network were found to be linked to procrastination. The above findings were all confirmed to replicate in an independent sample; prediction models demonstrated that these WM features can predict procrastination accurately in sample C. In conclusion, this study moves forward our understanding of procrastination by clarifying the role of interplay of self-control and emotional regulation with it.

A Rasch Analysis of the Irrational Procrastination Scale (IPS)

The present study analyses the psychometric properties of the irrational procrastination scale (IPS; Steel, 2002, 2010) in a sample of United States college students using the Rasch modeling approach. Results showed that the IPS items had a high level of reliability, good content validity, structural validity, and substantive validity, and no differential item functioning (DIF) effects in terms of gender. The IPS was found to be unidimensional, supporting the originally proposed theoretical structure by Steel (2002, 2010). Finally, psychometric implications derived from the results and study limitations are discussed; recommendations for future investigations are also offered.

A large-scale experiment on New Year's resolutions: Approach-oriented goals are more successful than avoidance-oriented goals

Despite the popularity of New Year’s resolutions, current knowledge about them is limited. We investigated what resolutions people make when they are free to formulate them, whether different resolutions reach differing success rates, and whether it is possible to increase the likelihood of a resolution’s success by administering information and exercises on effective goal setting. Participants (N = 1066) from the general public were randomized into three groups: active control, some support, and extended support. The most popular resolutions regarded physical health, weight loss, and eating habits. At a one-year follow-up, 55% of responders considered themselves successful in sustaining their resolutions. Participants with approach-oriented goals were significantly more successful than those with avoidance-oriented goals (58.9% vs. 47.1%). The group that received some support was exclusively and significantly more successful compared to the other two. This study reveals that New Year’s resolutions can have lasting effects, even at a one-year follow-up.

Quality of life and procrastination in post-H1N1 narcolepsy, sporadic narcolepsy and idiopathic hypersomnia, a Swedish cross-sectional study

OBJECTIVE/BACKGROUND

A cross-sectional study of health-related quality of life (HRQoL), procrastination and the relation to sleepiness, depression and fatigue in post-H1N1 narcolepsy type 1 (NT1), sporadic NT1 and idiopathic hypersomnia (IH).

PATIENTS/METHODS

Participants with NT1 and IH were enrolled from the Department of Neurology, Sahlgrenska University Hospital in Gothenburg (Sweden). All participants completed questionnaires about medication, employment, studies, transfer income, sleepiness, HRQoL, depression, fatigue and three questionnaires for procrastination.

RESULTS

Post-H1N1, sporadic NT1 and IH all scored higher than healthy controls on Epworth Sleepiness Scale (ESS), Patient Health Questionnaire (PHQ-9) and Fatigue Severity Scale (FSS), whereas EQ-5D-5L index and VAS was lower than for healthy individuals, but with no difference between groups. Post-H1N1 NT1 had a larger proportion of participants prescribed with sodium oxybate (44% vs. 9%, p = 0.003) and dexamphetamine (62% vs. 17%, p = 0.03) compared to sporadic NT1. The latter also in significantly higher doses than in sporadic NT1 (46 ± 12 vs. 25 ± 10 and 47.5 ± 21 mg, p < 0.0001). Post-H1N1 NT1 also had significantly higher scores on Pure Procrastination Scale (PPS), Irrational Procrastination Scale (IPS) and Susceptibility to Temptation Scale (STS), indicating a higher degree of procrastination. Multivariate analysis showed that depression, and to some extent fatigue, were predictors in NT1 for both HRQoL and procrastination.

CONCLUSIONS

The results show that health-related quality of life is impaired and tendency to procrastinate is higher in patients suffering from NT1 and both attributes can in part be explained by depressive symptoms. These findings highlight the impact of symptoms other than sleep and wakefulness regulation in patients with NT1.

Treating perfectionism using internet-based cognitive behavior therapy: A study protocol for a randomized controlled trial comparing two types of treatment

Perfectionism is characterized by setting high standards and striving for achievement, sometimes at the expense of social relationships and wellbeing. Despite sometimes being viewed as a positive feature by others, people with perfectionism tend to be overly concerned about their performance and how they are being perceived by people around them. This tends to create inflexible standards, cognitive biases, and performance-related behaviors that maintain a belief that self-worth is linked to accomplishments. Cognitive behavior therapy has been shown to be a viable treatment for perfectionism, both in terms of reducing levels of perfectionism and improving psychiatric symptoms. Furthermore, a number of recent studies indicate that it can be successfully delivered via the Internet, both with regular support and guidance on demand from a therapist. In the present study protocol, a clinical trial for perfectionism is described and outlined. In total, 128 participants will be recruited and randomized to either a treatment that has already been demonstrated to have many benefits, Internet-based Cognitive Behavior Therapy for perfectionism (iCBT-P), or an active comparison condition, Internet-based Unified Protocol (iUP), targeting the emotions underlying depression and anxiety disorders. The results will be investigated with regard to self-reported outcomes of perfectionism, psychiatric symptoms, self-compassion, and quality of life, at post-treatment and at six- and 12-month follow-up. Both iCBT-P and iUP are expected to have a positive impact, but the difference between the two conditions in terms of their specific effects and adherence are currently unknown and will be explored. The clinical trial is believed to lead to a better understanding of how perfectionism can be treated and the specificity of different treatments.

Brain Morphological Dynamics of Procrastination: The Crucial Role of the Self-Control, Emotional, and Episodic Prospection Network

Globally, about 17% individuals are suffering from the maladaptive procrastination until now, which impacts individual's financial status, mental health, and even public policy. However, the comprehensive understanding of neuroanatomical understructure of procrastination still remains gap. 688 participants including 3 independent samples were recruited for this study. Brain morphological dynamics referred to the idiosyncrasies of both brain size and brain shape. Multilinear regression analysis was utilized to delineate brain morphological dynamics of procrastination in Sample 1. In the Sample 2, cross-validation was yielded. Finally, prediction models of machine learning were conducted in Sample 3. Procrastination had a significantly positive correlation with the gray matter volume (GMV) in the left insula, anterior cingulate gyrus (ACC), and parahippocampal gyrus (PHC) but was negatively correlated with GMV of dorsolateral prefrontal cortex (dlPFC) and gray matter density of ACC. Furthermore, procrastination was positively correlated to the cortical thickness and cortical complexity of bilateral orbital frontal cortex (OFC). In Sample 2, all the results were cross-validated highly. Predication analysis demonstrated that these brain morphological dynamic can predict procrastination with high accuracy. This study ascertained the brain morphological dynamics involving in self-control, emotion, and episodic prospection brain network for procrastination, which advanced promising aspects of the biomarkers for it.

Social networking site addiction and undergraduate students' irrational procrastination: The mediating role of social networking site fatigue and the moderating role of effortful control

With the popularity of social networking sites (SNSs), the problems of SNS addiction have been increasing. Research has revealed the association between SNS addiction and irrational procrastination. However, the mechanism underlying this relation is still unclear. The present study aimed to examine the mediating role of social networking site fatigue and the moderating role of effortful control in this link among Chinese undergraduate students. The Social Networking Site Addiction Scale, Social Networking Service Fatigue Scale, Effortful Control Scale and Irrational Procrastination Scale were completed by 1,085 Chinese undergraduate students. Results indicated that SNS addiction, SNS fatigue and irrational procrastination were positively correlated with each other, and negatively correlated with effortful control. Further analyses revealed that, SNS addiction has a direct effect on irrational procrastination. SNS fatigue mediated the relationship between SNS addiction and irrational procrastination. Both direct and indirect effects of SNS addiction on irrational procrastination were moderated by effortful control. Specifically, this effect was stronger for people with lower effortful control. These findings help clarify the mechanism underlying the association between SNS addiction and irrational procrastination, which have potential implications for intervention.

Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic Randomized Controlled Trial Comparing Treatment Delivered via the Internet or in Groups

Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen's d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further.

Validation of the Spanish version of the Irrational Procrastination Scale (IPS)

The present study is centered in adapting and validating a Spanish version of the Irrational Procrastination Scale (IPS). The sample consists of 365 adults aged 18–77 years (M = 37.70, SD = 12.64). Participants were administered two measures of procrastination, the IPS and the Decisional Procrastination Questionnaire, as well as the Big Five Inventory, and the Satisfaction With Life Scale. First, the factor and replication analysis revealed that the internal structure of the scale is clearly one-dimensional, supporting the idea that IPS seems to measure general procrastination as a single trait. Second, the internal consistency is satisfactory as is the temporal stability of the IPS scores. Third, the correlations encountered between the IPS scores and other measures of procrastination, personality traits and satisfaction with life are all in the expected direction and magnitude. Finally, consistent with previous research, procrastination is related to age, with the youngest being the most procrastinating group. This study represents the first attempt in adapting and validating the IPS measure of procrastination into Spanish. Results suggest that the Spanish version of the IPS offers valid and reliable scores when applied to adult population.

Irrational Delay Revisited: Examining Five Procrastination Scales in a Global Sample

Scales attempting to measure procrastination focus on different facets of the phenomenon, yet they share a common understanding of procrastination as an unnecessary, unwanted, and disadvantageous delay. The present paper examines in a global sample (N = 4,169) five different procrastination scales - Decisional Procrastination Scale (DPS), Irrational Procrastination Scale (IPS), Pure Procrastination Scale (PPS), Adult Inventory of Procrastination Scale (AIP), and General Procrastination Scale (GPS), focusing on factor structures and item functioning using Confirmatory Factor Analysis and Item Response Theory. The results indicated that The PPS (12 items selected from DPS, AIP, and GPS) measures different facets of procrastination even better than the three scales it is based on. An even shorter version of the PPS (5 items focusing on irrational delay), corresponds well to the nine-item IPS. Both scales demonstrate good psychometric properties and appear to be superior measures of core procrastination attributes than alternative procrastination scales.

Overcoming procrastination: one-year follow-up and predictors of change in a randomized controlled trial of Internet-based cognitive behavior therapy

Procrastination is a common self-regulatory failure that can have a negative impact on well-being and performance. However, few clinical trials have been conducted, and no follow-up has ever been performed. The current study therefore aimed to provide evidence for the long-term benefits and investigate predictors of a positive treatment outcome among patients receiving Internet-based cognitive behavior therapy (ICBT). A total of 150 self-recruited participants were randomized to guided or unguided ICBT. Self-report measures of procrastination, depression, anxiety, and quality of life were distributed at pre-treatment assessment, post-treatment assessment, and one-year follow-up. Mixed effects models were used to investigate the long-term gains, and multiple linear regression for predictors of a positive treatment outcome, using the change score on the Irrational Procrastination Scale as the dependent variable. Intention-to-treat was implemented for all statistical analyses. Large within-group effect sizes for guided and unguided ICBT, Cohen's d = .97-1.64, were found for self-report measures of procrastination, together with d = .56-.66 for depression and anxiety. Gains were maintained, and, in some cases, improved at follow-up. Guided and unguided ICBT did not differ from each other, mean differences -.31-1.17, 95% CIs [-2.59-3.22], and none of the predictors were associated with a better result, bs -1.45-1.61, 95% CIs [-3.14-4.26]. In sum, ICBT could be useful and beneficial in relation to managing procrastination, yielding great benefits up to one year after the treatment period has ended, with comparable results between guided and unguided ICBT.

On the Measurement of Procrastination: Comparing Two Scales in Six European Countries

Procrastination is a common problem, but defining and measuring it has been subject to some debate. This paper summarizes results from students and employees (N = 2893) in Finland, Germany, Italy, Norway, Poland, and Sweden using the Pure Procrastination Scale (PPS) and the Irrational Procrastination Scale (IPS; Steel, 2010), both assumed to measure unidimensional and closely related constructs. Confirmatory factor analyses indicated inadequate configural fit for the suggested one-factor model for PPS; however, acceptable fit was observed for a three-factor model corresponding to the three different scales the PPS is based on. Testing measurement invariance over countries and students-employees revealed configural but not strong or strict invariance, indicating that both instruments are somewhat sensitive to cultural differences. We conclude that the PPS and IPS are valid measures of procrastination, and that the PPS may be particularly useful in assessing cultural differences in unnecessary delay.