Meditation and Five Precepts Mediate the Relationship between Attachment and Resilience

Psychometric assessment of the 10-item Thai version of the Experience in Close Relationship-Revised for Adolescents (ECR-R-10-AD)

The 18-item version of the Experiences in Close Relationships-revised (ECR-R-18) is a valid and reliable scale used among Thai adolescents. However, it revealed problematic items that impacted the scale's internal consistency. The study aimed to achieve two objectives: (1) develop a new, shorter scale by retaining only highly loaded items equally between attachment anxiety and attachment avoidance, and (2) evaluate the psychometric properties of the shorter ECR-R version compared to the existing 18-item scale. Objective 1 was achieved through Study 1, involving 204 youths aged 16-18 years (64% female). All participants completed the 18-item ECR-R, and exploratory factor analysis was conducted to identify suitable items for the new ECR-R-AD. Objective 2 was fulfilled in Study 2, which included a total of 443 students in grades aged 15-18 years old (88% female) from Thai boarding schools in Northern Thailand. All participants completed both the 18-item ECR-R, and confirmatory factor analysis of both the existing 18-item and the new shorter scale was performed and compared. Additional measures including the Rosenberg Self-Esteem Scale, Perceived Stress Scale-10, and Relationship Questionnaire were completed alongside the ECR-R to assess convergent, discriminant, and criterion validity. The invariance test for the new ECR-R across genders was conducted using multigroup confirmatory factor analysis. For objective 1, Study 1 developed a new scale called "ECR-R-10-AD" with 10 items, comprising 5 for attachment anxiety and 5 for attachment avoidance. The McDonald's omega values were 0.866 for avoidance and 0.823 for anxiety subscales. The corrected correlation between the ECR-R-18 and ECR-R-10-AD was significant. For objective 2, Study 2 found that the first-order two-factor solution model fit the data best for the ECR-R-10-AD. Convergent, discriminant, and criterion validity with other measurements and invariance tests based on sex were established for the ECR-R-AD. The ECR-R-10-AD provided sufficient psychometric properties among Thai adolescents. Factorial validity, convergent validity, and measurement invariance were established. As the ECR-R-10-AD is brief, it can be administered with less burden. Limitations and future research were discussed.

Psychometric assessment of the 10-item, revised experience of close relationship (ECR-R-10) in nonclinical and clinical populations of adults and older adults in Thailand

The experiences of close relationships-revised (ECR-R) is a widely used 36-item self-report measurement for measuring adult attachment. However, various short versions of the ECR-R have been developed and tested psychometrically. Given the cultural impact, a short version of the Thai ECR-R should be derived from the existing Thai version of the ECR-R. This study aimed to develop a 10-item version of the ECR-R that demonstrates comparable psychometric properties to the previous Thai version and the 18-item ECR-R. This study included four studies with a total of 1,322 participants. In study 1, 434 adults in a nonclinical setting were used for the development of the 10-item Thai ECR-R and tested in an independent sample. Studies 2, 3, and 4 were conducted on 312 adults in the clinical setting, 227 older adults in the nonclinical, and 123 older adults in clinical settings. The Cronbach alphas and corrected correlations between the ECR-R-18 and the ECR-R-10 in each study were calculated. Confirmatory factor analysis of the first-order two-factor solution model with fit statistics was examined with each sample. Correlations of the ECR-R-18 and the ECR-R-10 with other measurements were presented and compared. Known-group validity and measurement invariance test were also examined. The Cronbach alphas of the ECR-R-10 among all samples were acceptable, ranging between .77 and .85 for avoidance subscales and between .82 and .86 for anxiety subscales. The corrected correlation between the ECR-R-18 and ECR-R-10 was between .61 (p < .001) and .82 (p < .001). The values of the comparative fit index and Tucker-Lewis index for the model of ECR-R-10 were between .903 and .985, whereas the root-mean-square error of approximation was between .082 and .036, indicating that the model fits were acceptable. The ECR-R-10 was related to the measurements with a similar construct; however, no difference in the magnitude of correlation was observed between ECR-R-18 and ECR-R-10. Known group validity was established. Measurement invariance was successfully established across different age and gender groups, although it was only partially achieved with respect to clinical status. The ECR-R-10 provided equal or superior psychometric properties to the ECR-R-18 across age groups and settings. As it is a briefer scale, the ECR-R-10 can be practically used in general and clinical samples to reduce the burden of assessment, especially with older adults. Further investigation is needed to test the scale's temporal stability.

Resilience, Perceived Stress from Adapted Medical Education Related to Depression among Medical Students during the COVID-19 Pandemic

The COVID-19 pandemic disrupted several routine teaching methods in clinical settings which causing psychological distress among medical students. This study aims to explore the association of perceived stress related to the adapted medical education, resilience, and depression among medical students at a medical school in northern Thailand during the COVID-19 outbreak. A total of 437 medical students were recruited in January 2022. Data were obtained using self-administered online questionnaires, including demographic data, perceived challenges in learning online classes, the Resilience Inventory (RI-9), and the Patient Health Questionnaire 9 (PHQ-9). Binary logistic regression analysis was employed to explore factors associated with depression (PHQ-9 ≥ 9). A total of 27% of the participants were identified as having depression. Logistic regression revealed that the presence of previous psychiatric conditions (ß = 2.80, p < 0.05), stress from lack of in-person contact with peers (ß = 1.48, p < 0.05), stress from lack of in-person communication with teachers (ß = 1.49, p < 0.05), and level of resilience (ß = 0.88, p < 0.001) were independently associated factors for depression among medical students. Level of resilience was negatively correlated with depressive symptoms (r = −0.436, p < 0.001). The rate of depression among medical students was higher during the pandemic. Resilience was associated with depression. Strengthening resilience might have an important implication for depression among medical students.

Buffering Effect of Perseverance and Meditation on Depression among Medical Students Experiencing Negative Family Climate

Background and objective: Thirty percent of Thai medical students experienced depression. Two of the crucial factors related to depression involved borderline personality disorder symptoms and adverse family experiences, while positive strengths were documented to prevent depression. This study aimed to investigate the role of perseverance and meditation on depression; Methods: Two hundred and forty−three medical student participants completed the following measurements: the core symptom index (CSI−D) to measure depression, the family climate questionnaire to measure family experience, the personality disorder questionnaire to measure borderline personality disorder symptoms, and the inner strength−based inventory to measure perseverance and meditation. In the analysis, depression served as an outcome, adverse family climate as a predictor and borderline personality disorder symptoms as a mediator. In contrast, perseverance and meditation were moderators in the mediation model. Mediation and moderation analysis using PROCESS was applied for testing the direct and indirect effects; Results: Among all, 49.38% were male, and the mean age was 22.76 years. Borderline personality disorder symptoms significantly mediated the relationship between adverse family climate and depression, B = 0.0608 (95%CI, 0.0301 to 0.1052). The variance explained by the mediation model was 43%. Meditation moderated the relationship between adverse family climate and borderline personality symptoms, whereas perseverance and meditation were found to be significant moderators for borderline personality disorder symptoms and depression. With two moderators in the mediation model, the indirect effect index was B = 0.0072 (95%CI, 0.0002 to 0.0160). The 49% of variances of depression were explained by the moderated mediation model; Conclusion: Borderline personality disorder symptoms are a crucial variable involving depression. Meditation practice has been demonstrated to be a buffer between negative family climate to borderline personality disorder symptoms and depressive symptoms, whereas perseverance buffers the effect of borderline personality disorder symptoms of depression. Further research on cultivating meditation and perseverance should be encouraged among those with negative family experiences.

Borderline Personality Disorder Symptoms and Its Clinical Correlates among Chinese University Students: A Cross-Sectional Study

Borderline personality disorder (BPD) is common among young adults. Related studies showed a wide range of prevalence among university students. Few studies regarding BPD symptoms and their correlations with different variables have been reported in the Chinese population. A cross-sectional, online survey was conducted on a sample of university students in China between November 2021 and January 2022. Sociodemographic questionnaires, the Screening Instrument for Borderline Personality Disorder (SI-Bord), the 18-item Experience in Close Relationships-Revised (ECR-R-18), the Meaning In Life Questionnaire (MLQ), the 10-item Perceived Stress Scale (PSS-10), the Patient Health Questionnaire (PHQ-9), the Rosenberg Self-Esteem Scale (RSES) and the Resilience Inventory (RI-9) were completed. Data were analyzed using Pearson’s correlation methods. Among 767 participants, mean age was 20.33 ± 1.495 years, and the majority were males (53.5%). According to the SI-Bord’s cut-off score >7, BPD symptoms were found in 17.5% of participants. Attachment anxiety, avoidance, depression, perceived stress, lack of meaning in life, resilience and self-esteem were significantly correlated with BPD symptoms with r’s of 0.473, 0.180, 0.451, 0.481, −0.148, −0.238 and −0.388, respectively (all p’s < 0.01). The prevalence of BPD symptoms is high among Chinese university students and significantly associated with mental health outcomes, suggesting that an early detection of BPD symptoms is necessary for this population.