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Osma J, Martínez-Loredo V, Quilez-Orden A, Peris-Baquero O, Ferreres-Galán V, Prado-Abril J, Torres-Alfosea MA, Rosellini AJ. Multidimensional emotional disorders inventory: Reliability and validity in a Spanish clinical sample. J Affect Disord 2023; 320:65-73. [PMID: 36183816 DOI: 10.1016/j.jad.2022.09.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The categorical approach to diagnosing mental disorders has been criticized for a number of reasons (e.g., high rates of comorbidity; larger number of diagnostic categories and combination). Diverse alternatives have been proposed using a hybrid or totally dimensional perspective. Despite the evidence supporting use of the Multidimensional Emotional Disorders Inventory (MEDI) for assessing the transdiagnostic dimensions of Emotional Disorders using a dimensional-categorical hybrid approach, no data exist on Spanish clinical samples. The present study explores the validity and reliability of the 49-item MEDI in a clinical sample and provides data for its use. METHODS A total of 280 outpatients with emotional disorders attended in different Spanish public Mental Health Units in Spain filled out all questionnaires during the assessment phase and the MEDI again one week after. The instruments used evaluate four main constructs: personality, mood, anxiety and avoidance. RESULTS The nine original factors were confirmed and showed adequate reliability (α: 0.66-0.91) and stability (r = 0.76-0.87). No differences in mean scores by sex were presented in any subscale (p ≥ .07). The MEDI subscales correlated significantly with the scales of each of the selected constructs (0.45 < r < 0.76). LIMITATIONS The main limitations of this study were the limited sample size and not being able to count on MEDI scores post-transdiagnostic intervention. CONCLUSIONS The MEDI demonstrates adequate reliability and validity. It allows to assess diverse symptoms efficiently, thus being of interest for clinical studies and practice.
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Affiliation(s)
- J Osma
- Universidad de Zaragoza, Departamento de Psicología y Sociología, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
| | - V Martínez-Loredo
- Universidad de Zaragoza, Departamento de Psicología y Sociología, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - A Quilez-Orden
- Universidad de Zaragoza, Departamento de Psicología y Sociología, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain; Unidad de Salud Mental Moncayo, Tarazona, Spain
| | - O Peris-Baquero
- Universidad de Zaragoza, Departamento de Psicología y Sociología, Teruel, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - V Ferreres-Galán
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain; Hospital Comarcal de Vinaròs, Castellón, Spain
| | - J Prado-Abril
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain; Hospital Miguel Servet, Zaragoza, Spain
| | | | - A J Rosellini
- Boston University, Department of Psychological and Brain Sciences, Boston, USA
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Rosellini AJ, Liu H, Petukhova MV, Sampson NA, Aguilar-Gaxiola S, Alonso J, Borges G, Bruffaerts R, Bromet EJ, de Girolamo G, de Jonge P, Fayyad J, Florescu S, Gureje O, Haro JM, Hinkov H, Karam EG, Kawakami N, Koenen KC, Lee S, Lépine JP, Levinson D, Navarro-Mateu F, Oladeji BD, O’Neill S, Pennell BE, Piazza M, Posada-Villa J, Scott KM, Stein DJ, Torres Y, Viana MC, Zaslavsky AM, Kessler RC. Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. Psychol Med 2018; 48:437-450. [PMID: 28720167 PMCID: PMC5758426 DOI: 10.1017/s0033291717001817] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors. METHODS The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD. RESULTS 20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2-0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66-55% v. 43%) and later-recovery (75-68% v. 39%). CONCLUSIONS We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.
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Affiliation(s)
- A. J. Rosellini
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - H. Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - M. V. Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - S. Aguilar-Gaxiola
- Center for Reducing Health Disparities, UC Davis Health System, Sacramento, CA, USA
| | - J. Alonso
- IMIM-Hospital del Mar Research Institute, Parc de Salut Mar, Pompeu Fabra University (UPF), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - G. Borges
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - R. Bruffaerts
- Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), Campus Gasthuisberg, Leuven, Belgium
| | - E. J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - G. de Girolamo
- IRCCS St John of God Clinical Research Centre/IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - P. de Jonge
- Developmental Psychology, Department of Psychology, Rijksuniversiteit Groningen, Groningen, The Netherlands
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - J. Fayyad
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
| | - S. Florescu
- National School of Public Health, Management and Development, Bucharest, Romania
| | - O. Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain
| | - H. Hinkov
- National Center for Public Health and Analyses, Sofia, Bulgaria
| | - E. G. Karam
- Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon
- Department of Psychiatry and Clinical Psychology, Faculty of Medicine, St George Hospital University Medical Center, Balamand University, Beirut, Lebanon
| | - N. Kawakami
- Department of Mental Health, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - K. C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S. Lee
- Department of Psychiatry, Chinese University of Hong Kong, Tai Po, Hong Kong
| | - J. P. Lépine
- Hôpital Lariboisière-Fernand Widal, Assistance Publique Hôpitaux de Paris, Universités Paris Descartes-Paris Diderot, INSERM UMR-S 1144, Paris, France
| | - D. Levinson
- Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - F. Navarro-Mateu
- UDIF-SM, Subdirección General de Planificación, Innovación y Cronicidad, Servicio Murciano de Salud, IMIB-Arrixaca, CIBERESP-Murcia, Murcia, Spain
| | - B. D. Oladeji
- Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - S. O’Neill
- School of Psychology, Ulster University, Londonderry, UK
| | - B.-E. Pennell
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - M. Piazza
- Universidad Cayetano Heredia, National Institute of Health, Lima, Peru
| | | | - K. M. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, Otago, New Zealand
| | - D. J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, Republic of South Africa
| | - Y. Torres
- Center for Excellence on Research in Mental Health, CES University, Medellín, Colombia
| | - M. C. Viana
- Department of Social Medicine, Federal University of Espírito Santo, Vitoria, Brazil
| | - A. M. Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Kessler RC, Stein MB, Bliese PD, Bromet EJ, Chiu WT, Cox KL, Colpe LJ, Fullerton CS, Gilman SE, Gruber MJ, Heeringa SG, Lewandowski-Romps L, Millikan-Bell A, Naifeh JA, Nock MK, Petukhova MV, Rosellini AJ, Sampson NA, Schoenbaum M, Zaslavsky AM, Ursano RJ. Occupational differences in US Army suicide rates. Psychol Med 2015; 45:3293-3304. [PMID: 26190760 PMCID: PMC4860903 DOI: 10.1017/s0033291715001294] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Civilian suicide rates vary by occupation in ways related to occupational stress exposure. Comparable military research finds suicide rates elevated in combat arms occupations. However, no research has evaluated variation in this pattern by deployment history, the indicator of occupation stress widely considered responsible for the recent rise in the military suicide rate. METHOD The joint associations of Army occupation and deployment history in predicting suicides were analysed in an administrative dataset for the 729 337 male enlisted Regular Army soldiers in the US Army between 2004 and 2009. RESULTS There were 496 suicides over the study period (22.4/100 000 person-years). Only two occupational categories, both in combat arms, had significantly elevated suicide rates: infantrymen (37.2/100 000 person-years) and combat engineers (38.2/100 000 person-years). However, the suicide rates in these two categories were significantly lower when currently deployed (30.6/100 000 person-years) than never deployed or previously deployed (41.2-39.1/100 000 person-years), whereas the suicide rate of other soldiers was significantly higher when currently deployed and previously deployed (20.2-22.4/100 000 person-years) than never deployed (14.5/100 000 person-years), resulting in the adjusted suicide rate of infantrymen and combat engineers being most elevated when never deployed [odds ratio (OR) 2.9, 95% confidence interval (CI) 2.1-4.1], less so when previously deployed (OR 1.6, 95% CI 1.1-2.1), and not at all when currently deployed (OR 1.2, 95% CI 0.8-1.8). Adjustment for a differential 'healthy warrior effect' cannot explain this variation in the relative suicide rates of never-deployed infantrymen and combat engineers by deployment status. CONCLUSIONS Efforts are needed to elucidate the causal mechanisms underlying this interaction to guide preventive interventions for soldiers at high suicide risk.
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Affiliation(s)
- R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - M. B. Stein
- Departments of Psychiatry and Family and Preventive Medicine, University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | - P. D. Bliese
- Darla Moore School of Business, University of South Carolina, Columbia, SC, USA
| | - E. J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - W. T. Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - K. L. Cox
- US Army Public Health Command, Aberdeen Proving Ground, MD, USA
| | - L. J. Colpe
- Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD, USA
| | - C. S. Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, USA
| | - S. E. Gilman
- Departments of Social and Behavioral Sciences, and Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - M. J. Gruber
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - S. G. Heeringa
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | | | - J. A. Naifeh
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, USA
| | - M. K. Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - M. V. Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - A. J. Rosellini
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - M. Schoenbaum
- Office of Science Policy, Planning and Communications, National Institute of Mental Health, Bethesda, MD, USA
| | - A. M. Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, USA
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4
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Street AE, Gilman SE, Rosellini AJ, Stein MB, Bromet EJ, Cox KL, Colpe LJ, Fullerton CS, Gruber MJ, Heeringa SG, Lewandowski-Romps L, Little RJA, Naifeh JA, Nock MK, Sampson NA, Schoenbaum M, Ursano RJ, Zaslavsky AM, Kessler RC. Understanding the elevated suicide risk of female soldiers during deployments. Psychol Med 2015; 45:717-726. [PMID: 25359554 PMCID: PMC4869515 DOI: 10.1017/s003329171400258x] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) has found that the proportional elevation in the US Army enlisted soldier suicide rate during deployment (compared with the never-deployed or previously deployed) is significantly higher among women than men, raising the possibility of gender differences in the adverse psychological effects of deployment. METHOD Person-month survival models based on a consolidated administrative database for active duty enlisted Regular Army soldiers in 2004-2009 (n = 975,057) were used to characterize the gender × deployment interaction predicting suicide. Four explanatory hypotheses were explored involving the proportion of females in each soldier's occupation, the proportion of same-gender soldiers in each soldier's unit, whether the soldier reported sexual assault victimization in the previous 12 months, and the soldier's pre-deployment history of treated mental/behavioral disorders. RESULTS The suicide rate of currently deployed women (14.0/100,000 person-years) was 3.1-3.5 times the rates of other (i.e. never-deployed/previously deployed) women. The suicide rate of currently deployed men (22.6/100,000 person-years) was 0.9-1.2 times the rates of other men. The adjusted (for time trends, sociodemographics, and Army career variables) female:male odds ratio comparing the suicide rates of currently deployed v. other women v. men was 2.8 (95% confidence interval 1.1-6.8), became 2.4 after excluding soldiers with Direct Combat Arms occupations, and remained elevated (in the range 1.9-2.8) after adjusting for the hypothesized explanatory variables. CONCLUSIONS These results are valuable in excluding otherwise plausible hypotheses for the elevated suicide rate of deployed women and point to the importance of expanding future research on the psychological challenges of deployment for women.
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Affiliation(s)
- A. E. Street
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - S. E. Gilman
- Departments of Social and Behavioral Sciences, and Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - A. J. Rosellini
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - M. B. Stein
- Departments of Psychiatry and Family and Preventive Medicine, University of California San Diego, La Jolla, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | - E. J. Bromet
- Department of Psychiatry, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - K. L. Cox
- US Army Public Health Command, Aberdeen Proving Ground, MD, USA
| | - L. J. Colpe
- Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, MD, USA
| | - C. S. Fullerton
- Department of Psychiatry, Uniformed Services University School of Medicine, Center for the Study of Traumatic Stress, Bethesda, MD, USA
| | - M. J. Gruber
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - S. G. Heeringa
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | | | - R. J. A. Little
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - J. A. Naifeh
- Department of Psychiatry, Uniformed Services University School of Medicine, Center for the Study of Traumatic Stress, Bethesda, MD, USA
| | - M. K. Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - M. Schoenbaum
- Office of Science Policy, Planning and Communications, National Institute of Mental Health, Bethesda, MD, USA
| | - R. J. Ursano
- Department of Psychiatry, Uniformed Services University School of Medicine, Center for the Study of Traumatic Stress, Bethesda, MD, USA
| | - A. M. Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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