Modeling Interactions Between Latent Variables in Research on Type D Personality: A Monte Carlo Simulation and Clinical Study of Depression and Anxiety.

Several approaches exist to model interactions between latent variables. However, it is unclear how these perform when item scores are skewed and ordinal. Research on Type D personality serves as a good case study for that matter. In Study 1, we fitted a multivariate interaction model to predict depression and anxiety with Type D personality, operationalized as an interaction between its two subcomponents negative affectivity (NA) and social inhibition (SI). We constructed this interaction according to four approaches: (1) sum score product; (2) single product indicator; (3) matched product indicators; and (4) latent moderated structural equations (LMS). In Study 2, we compared these interaction models in a simulation study by assessing for each method the bias and precision of the estimated interaction effect under varying conditions. In Study 1, all methods showed a significant Type D effect on both depression and anxiety, although this effect diminished after including the NA and SI quadratic effects. Study 2 showed that the LMS approach performed best with respect to minimizing bias and maximizing power, even when item scores were ordinal and skewed. However, when latent traits were skewed LMS resulted in more false-positive conclusions, while the Matched PI approach adequately controlled the false-positive rate.

The Assessment and Impact of Careless Responding in Routine Outcome Monitoring within Mental Health Care.

Careless responding by mental health patients on self-report assessments is rarely investigated in routine care despite the potential for serious consequences such as faulty clinical decisions. We investigated validity indices most appropriate for detecting careless responding in routine outcome monitoring (ROM) in mental health-care. First, we reviewed indices proposed in previous research for their suitability in ROM. Next, we evaluated six selected indices using data of the Brief Symptom Inventory and the Mood and Anxiety Symptom Questionnaire from 3,483 outpatients. Simulations showed that for typical ROM scales the Lmax index, Mahalanobis distance, and inter-item standard deviation may be too strongly confounded with the latent trait value to compare careless responding across patients with different symptom severity. Application of two different classification methods to the validity indices did not converge in similar prevalence estimates of careless responding. Finally, results suggest that careless responding does not have a substantial biasing effect on scale-score statistics. We recommend the lzp person-fit index to screen for random careless responding in large ROM data sets. However, additional research should further investigate methods for detecting repetitive responding in typical ROM data and assess whether there are specific circumstances in which simpler validity statistics or direct screening methods perform similarly as the lzp index.

Longitudinal measurement invariance of the Dutch Outcome Questionnaire-45 in a clinical sample.

PURPOSE: In the absence of measurement invariance across measurement occasions, change scores based on pretest-posttest measurements may be inaccurate representations of real change on the latent variable. In this study, we examined whether measurement invariance held in the Dutch version of Outcome Questionnaire-45 (OQ-45). METHOD: Using secondary data analysis of a sample of N = 540 Dutch outpatients, we tested the stability of the factorial structure (gamma change) and the metric and scalar invariance (beta change) across pretest and posttest measurements using a combination of factor analysis and item response theory methodology. RESULTS: Results revealed a stable factorial structure from pretest to posttest and minor violations of metric invariance for two items in the Dutch OQ-45. CONCLUSION: Even though for two items the assumption of invariance was violated, results suggest that the effects of these violations on practical change assessment using the OQ-45 were negligible.

Comprehensively Measuring Health-Related Subjective Well-Being: Dimensionality Analysis for Improved Outcome Assessment in Health Economics.

BACKGROUND: Allocation of inevitably limited financial resources for health care requires assessment of an intervention's effectiveness. Interventions likely affect quality of life (QOL) more broadly than is measurable with commonly used health-related QOL utility scales. In line with the World Health Organization's definition of health, a recent Delphi procedure showed that assessment needs to put more emphasis on mental and social dimensions. OBJECTIVE: To identify the core dimensions of health-related subjective well-being (HR-SWB) for a new, more comprehensive outcome measure. METHODS: We formulated items for each domain of an initial Delphi-based set of 21 domains of HR-SWB. We tested these items in a large sample (N = 1143) and used dimensionality analyses to find a smaller number of latent factors. RESULTS: Exploratory factor analysis suggested a five-factor model, which explained 65% of the total variance. Factors related to physical independence, positive affect, negative affect, autonomy, and personal growth. Correlations between the factors ranged from 0.19 to 0.59. A closer inspection of the factors revealed an overlap between the newly identified core dimensions of HR-SWB and the validation scales, but the dimensions of HR-SWB also seemed to reflect additional aspects. This shows that the dimensions of HR-SWB we identified go beyond the existing health-related QOL instruments. CONCLUSIONS: We identified a set of five key dimensions to be included in a new, comprehensive measure of HR-SWB that reliably captures these dimensions and fills in the gaps of the existent measures used in economic evaluations.

The relationship between parenting stress and parent-child interaction with health outcomes in the youngest patients with type 1 diabetes (0-7 years).

UNLABELLED: To test whether parenting stress and the quality of parent-child interaction were associated with glycemic control and quality of life (QoL) in young children (0-7 years) with type 1 diabetes (T1DM), we videotaped 77 families with a young child with T1DM during mealtime (including glucose monitoring and insulin administration). Parent-child interactions were scored with a specifically designed instrument. Questionnaires assessed general and disease-related parenting stress and (diabetes-specific (DS)) QoL. HbA(1c) (glycemic control) was extracted from the medical records. Both general and disease-related parenting stress were associated with a lower (DS)QoL (r ranged from -0.39 to -0.70, p < 0.05), but not with HbA(1c) levels. Furthermore, with regard to the parent-child interaction, emotional involvement of parents (r = 0.23, p < 0.05) and expressed discomfort of the child (r = 0.23, p < 0.05) were related to suboptimal HbA(1c) levels. There was no clear pattern in the correlations between parent-child interaction and (DS)QoL. CONCLUSION: The results support the notion that diabetes does not only affect the child with T1DM: T1DM is a family disease, as parenting factors (like stress and parent-child interactions) are associated with important child outcomes. Therefore, it is important for health-care providers to not only focus on the child with T1DM, but also on the family system.

Sex Bias in Classifying Borderline and Narcissistic Personality Disorder.

This study investigated sex bias in the classification of borderline and narcissistic personality disorders. A sample of psychologists in training for a post-master degree (N = 180) read brief case histories (male or female version) and made DSM classification. To differentiate sex bias due to sex stereotyping or to base rate variation, we used different case histories, respectively: (1) non-ambiguous case histories with enough criteria of either borderline or narcissistic personality disorder to meet the threshold for classification, and (2) an ambiguous case with subthreshold features of both borderline and narcissistic personality disorder. Results showed significant differences due to sex of the patient in the ambiguous condition. Thus, when the diagnosis is not straightforward, as in the case of mixed subthreshold features, sex bias is present and is influenced by base-rate variation. These findings emphasize the need for caution in classifying personality disorders, especially borderline or narcissistic traits.

Validation of the 4DSQ somatization subscale in the occupational health care setting as a screener.

PURPOSE: Somatoform disorders (physical symptoms without medical explanation that cause dysfunction) are prevalent in the occupational health (OH) care setting and are associated with functional impairment and absenteeism. Availability of psychometric instruments aimed at assessing somatoform disorders is limited. In the OH setting, so far only the Patient-Health-Questionnaire 15 has been validated as screener for somatoform disorder, and has been shown to have moderate validity. The Four-Dimensional Symptom Questionnaire (4DSQ) is frequently used in the OH setting but the Somatization subscale is not validated yet. The aim of this study is to validate the 4DSQ Somatization subscale as screener for DSM-IV somatoform disorder in the OH setting by using the MINI interview as gold standard. METHODS: Employees absent from work due to physical symptoms, for a period longer than 6 weeks and shorter than 2 years, were asked to participate in this study. They filled out the 4DSQ and underwent a MINI interview by telephone for DSM-IV classification. Specificity and sensitivity scores were calculated for all possible cut-off scores and a receiver operator curve was computed for the Somatization subscale. 95 % confidence intervals (95 % CIs) were calculated for sensitivity and specificity. RESULTS: The Somatization subscale of the 4DSQ has an optimal cut point of 9, with specificity and sensitivity equal to 64.3 % [95 % CI (53.6; 73.7 %)] and 60.9 % [95 % CI (40.8; 77.8 %)], respectively. Receiver operator curves showed an area under the curve equal to 0.61 [SE = 0.07; 95 % CI (0.48; 0.75)] for the Somatization subscale of the 4DSQ. CONCLUSION: The 4DSQ Somatization subscale is a questionnaire of moderate sensitivity and specificity.

Type D assessment in patients with chronic heart failure and peripheral arterial disease: evaluation of the experimental DS(3) scale using item response theory.

Type D personality refers to a clustering of 2 stable personality traits, namely negative affectivity and social inhibition. Currently Type D is standardly assessed using the DS14. An experimental Type D personality scale, the DS((3)), was developed to examine an avenue for assessing Type D more efficiently. The DS((3)) differs from the DS14 in its use of a 3-point Likert scale to rate responses, use of all negatively worded items, and a rearranged presentation of items. This article examines the psychometric properties of this questionnaire by examining its dimensionality, item and scale properties, and cutoff scores to screen for Type D personality. Data from 2 clinical samples were analyzed using item response theory. The results suggest that the DS((3)) is a potentially suitable instrument for Type D assessment. It has high reliability, and Type D personality classification based on this scale corresponds well with the current standard Type D assessment based on the DS14.

Dimensionality and scale properties of the Edinburgh Depression Scale (EDS) in patients with type 2 diabetes mellitus: the DiaDDzoB study.

BACKGROUND: Depression is a common complication in type 2 diabetes (DM2), affecting 10-30% of patients. Since depression is underrecognized and undertreated, it is important that reliable and validated depression screening tools are available for use in patients with DM2. The Edinburgh Depression Scale (EDS) is a widely used method for screening depression. However, there is still debate about the dimensionality of the test. Furthermore, the EDS was originally developed to screen for depression in postpartum women. Empirical evidence that the EDS has comparable measurement properties in both males and females suffering from diabetes is lacking however. METHODS: In a large sample (N = 1,656) of diabetes patients, we examined: (1) dimensionality; (2) gender-related item bias; and (3) the screening properties of the EDS using factor analysis and item response theory. RESULTS: We found evidence that the ten EDS items constitute a scale that is essentially one dimensional and has adequate measurement properties. Three items showed differential item functioning (DIF), two of them showed substantial DIF. However, at the scale level, DIF had no practical impact. Anhedonia (the inability to be able to laugh or enjoy) and sleeping problems were the most informative indicators for being able to differentiate between the diagnostic groups of mild and severe depression. CONCLUSIONS: The EDS constitutes a sound scale for measuring an attribute of general depression. Persons can be reliably measured using the sum score. Screening rules for mild and severe depression are applicable to both males and females.

Precision and Sample Size Requirements for Regression-Based Norming Methods for Change Scores.

To interpret a person's change score, one typically transforms the change score into, for example, a percentile, so that one knows a person's location in a distribution of change scores. Transformed scores are referred to as norms and the construction of norms is referred to as norming. Two often-used norming methods for change scores are the regression-based change approach and the T Scores for Change method. In this article, we discuss the similarities and differences between these norming methods, and use a simulation study to systematically examine the precision of the two methods and to establish the minimum sample size requirements for satisfactory precision.

Bias and Precision of Continuous Norms Obtained Using Quantile Regression.

Continuous norming is an increasingly popular approach to establish norms when the performance on a test is dependent on age. However, current continuous norming methods rely on a number of assumptions that are quite restrictive and may introduce bias. In this study, quantile regression was introduced as more flexible alternative. Bias and precision of quantile regression-based norming were investigated with (age-)group as covariate, varying sample sizes and score distributions, and compared with bias and precision of two other norming methods: traditional norming and mean regression-based norming. Simulations showed the norms obtained using quantile regression to be most precise in almost all conditions. Norms were nevertheless biased when the score distributions reflected a ceiling effect. Quantile regression-based norming can thus be considered a promising alternative to traditional norming and mean regression-based norming, but only if the shape of the score distribution can be expected to be close to normal.

Steps toward preregistration of research on research integrity.

BACKGROUND: A proposal to encourage the preregistration of research on research integrity was developed and adopted as the Amsterdam Agenda at the 5th World Conference on Research Integrity (Amsterdam, 2017). This paper reports on the degree to which abstracts of the 6th World Conference in Research Integrity (Hong Kong, 2019) reported on preregistered research. METHODS: Conference registration data on participants presenting a paper or a poster at 6th WCRI were made available to the research team. Because the data set was too small for inferential statistics this report is limited to a basic description of results and some recommendations that should be considered when taking further steps to improve preregistration. RESULTS: 19% of the 308 presenters preregistered their research. Of the 56 usable cases, less than half provided information on the six key elements of the Amsterdam Agenda. Others provided information that invalidated their data, such as an uninformative URL. There was no discernable difference between qualitative and quantitative research. CONCLUSIONS: Some presenters at the WCRI have preregistered their research on research integrity, but further steps are needed to increase frequency and completeness of preregistration. One approach to increase preregistration would be to make it a requirement for research presented at the World Conferences on Research Integrity.

Self-esteem and satisfaction with social relationships across time.

Research on the longitudinal association between self-esteem and satisfaction with social relationships has led to ambiguous conclusions regarding the temporal order and strength of this relation. Existing studies have examined this association across intervals ranging from days to years, leaving it unclear as to what extent differences in timing may explain differences across studies. In the present study, we used continuous time structural equation models (i.e., CT-SEM) to examine cross-lagged relations between the constructs, and also distinguished between-person differences from within-person processes (i.e., RI-CT-SEM). We analyzed 10 years of annual data from the Longitudinal Internet Studies of the Social Sciences (N = 14,741). When using CT-SEM, we found a bidirectional positive relation between self-esteem and satisfaction with social relationships, with larger effects over longer intervals. When using RI-CT-SEM, we found the largest effects of self-esteem and satisfaction with social relationships across intervals of 1 year, with smaller effect sizes at both shorter and longer intervals. In addition, the effect of fluctuations in people's satisfaction with social relationships on fluctuations in their self-esteem was greater than the reverse effect. Our results highlight the importance of considering time when examining the relation between self-esteem and interpersonal outcomes and likely psychological constructs in general. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Health-related quality of life after Gamma Knife radiosurgery in patients with 1-10 brain metastases.

PURPOSE: Increasingly more patients with multiple (> 4) brain metastases (BM) are being treated with stereotactic radiosurgery (SRS). Preserving patients' health-related quality of life (HRQoL) is an important treatment goal. The aim of this study was to assess (individual) changes in HRQoL in patients with 1-10 BM over time. METHODS: A total of 92 patients were assessed before (n = 92) and at 3 (n = 66), 6 (n = 53), and 9 (n = 41) months after Gamma Knife radiosurgery (GKRS), using the Functional Assessment of Cancer Therapy-Brain (FACT-Br). The course of HRQoL was analyzed using linear mixed models. Clinical minimally important differences were used to evaluate individual changes. RESULTS: At group level, patients' physical well-being worsened, whereas emotional well-being improved over 9 months. Scores on other HRQoL subscales did not change significantly. Number (1-3 versus 4-10) and volume (small, medium, and large) of BM did not influence HRQoL over time, except for the subscale additional concerns; medium intracranial tumor volume was associated with less additional concerns. On the individual level as well, physical well-being declined while emotional well-being improved in most patients over 9 months after GKRS. At patient level, however, most patients had both declines as well as improvements in the different HRQoL aspects. CONCLUSION: Our results indicate that even in patients with up to 10 BM, both at group and individual subscale level, aspects of HRQoL remained stable over nine months after GKRS, except for an improvement in emotional well-being and a decline in physical well-being. Nevertheless, HRQoL scores varied considerably at the individual patient level. TRAIL REGISTRATION NUMBER: ClinicalTrials.gov Identifier: NCT02953756, November 3, 2016.

Evaluation of Normative Data of a Widely Used Computerized Neuropsychological Battery: Applicability and Effects of Sociodemographic Variables in a Dutch Sample.

Introduction: Central Nervous System Vital Signs (CNS VS) is a computerized neuropsychological battery that is translated into many languages. However, published CNS VS' normative data were established over a decade ago, are solely age-corrected, and collected in an American population only. Method: Mean performance of healthy Dutch participants on CNS VS was compared with the original CNS VS norms (N = 1,069), and effects of sociodemographic variables were examined. Results:z tests demonstrated no significant differences in performance on four out of seven cognitive domains; however, Dutch participants (N = 158) showed higher scores on processing and psychomotor speed, as well as on cognitive flexibility. Although the original CNS VS norms are solely age-corrected, effects of education and sex on CNS VS performance were also identified in the Dutch sample. Discussion: Users should be cautious when interpreting CNS VS performance based on the original American norms, and sociodemographic factors must also be considered.

Haptotherapy as a new intervention for treating fear of childbirth: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of haptotherapy on severe fear of childbirth in pregnant women. DESIGN: Randomized controlled trial. SETTING: Community midwifery practices and a teaching hospital in the Netherlands. POPULATION OR SAMPLE: Primi- and multigravida, suffering from severe fear of childbirth (N = 134). METHODS: Haptotherapy, psycho-education via Internet and care as usual were randomly assigned at 20-24 weeks of gestation and the effects were compared at 36 weeks of gestation and 6 weeks and 6 months postpartum. Repeated measurements ANOVA were carried out on the basis of intention to treat. Since there were crossovers from psycho-education via Internet and care as usual to haptotherapy, the analysis was repeated according to the as treated principle. MAIN OUTCOME MEASURES: Fear of childbirth score at the Wijma Delivery Expectancy/Experience Questionnaire. RESULTS: In the intention to treat analysis, only the haptotherapy group showed a significant decrease of fear of childbirth, F(2,99) = 3.321, p = .040. In the as treated analysis, the haptotherapy group showed a greater reduction in fear of childbirth than the other two groups, F(3,83) = 6.717, p < .001. CONCLUSION: Haptotherapy appears to be more effective in reducing fear of childbirth than psycho-education via Internet and care as usual.

A Comparison of Unidimensionality and Measurement Precision of the Narcissistic Personality Inventory and the Narcissistic Admiration and Rivalry Questionnaire.

The current study compares the closeness to unidimensionality (CU) and measurement precision (MP) of the Narcissistic Personality Inventory (NPI)-with either a pairwise forced-choice or 5-point Likert-type scale response format-to the Narcissistic Admiration and Rivalry Questionnaire (NARQ). Minimum rank factor analysis and item information curves from item response models were utilized. The results mainly confirmed our expectations that NPI subscales are lower in CU and MP compared with NARQ subscales when the NPI was administered with its traditional forced-choice response format. When the NPI was administered with a 5-point Likert-type scale response format, the NPI subscale Leadership/Authority and NPI Grandiose Exhibitionism showed similarly high levels of CU and MP as the two NARQ subscales. While the NPI subscale Entitlement/Exploitativeness had a higher CU than the NARQ subscales it showed considerably lower levels of MP.

Detection and validation of unscalable item score patterns using item response theory: an illustration with Harter's Self-Perception Profile for Children.

We illustrate the usefulness of person-fit methodology for personality assessment. For this purpose, we use person-fit methods from item response theory. First, we give a nontechnical introduction to existing person-fit statistics. Second, we analyze data from Harter's (1985) Self-Perception Profile for Children (Harter, 1985) in a sample of children ranging from 8 to 12 years of age (N = 611) and argue that for some children, the scale scores should be interpreted with care and caution. Combined information from person-fit indexes and from observation, interviews, and self-concept theory showed that similar score profiles may have a different interpretation. For some children in the sample, item scores did not adequately reflect their trait level. Based on teacher interviews, this was found to be due most likely to a less developed self-concept and/or problems understanding the meaning of the questions. We recommend investigating the scalability of score patterns when using self-report inventories to help the researcher interpret respondents' behavior correctly.

Review of Issues About Classical Change Scores: A Multilevel Modeling Perspective on Some Enduring Beliefs.

Change scores obtained in pretest-posttest designs are important for evaluating treatment effectiveness and for assessing change of individual test scores in psychological research. However, over the years the use of change scores has raised much controversy. In this article, from a multilevel perspective, we provide a structured treatise on several persistent negative beliefs about change scores and show that these beliefs originated from the confounding of the effects of within-person change on change-score reliability and between-person change differences. We argue that psychometric properties of change scores, such as reliability and measurement precision, should be treated at suitable levels within a multilevel framework. We show that, if examined at the suitable levels with such a framework, the negative beliefs about change scores can be renounced convincingly. Finally, we summarize the conclusions about change scores to dispel the myths and to promote the potential and practical usefulness of change scores.

Alexithymia Has No Clinically Relevant Association With Outcome of Multimodal Treatment Tailored to Needs of Patients Suffering From Somatic Symptom and Related Disorders. A Clinical Prospective Study.

Introduction: Alexithymia may moderate the effectiveness of treatment and may predict impaired general functioning of patients suffering from somatic symptom and related disorders (SSRD). Aim: We compared alexithymia levels in a clinical prospective study with 234 consecutive patients suffering from SSRD from the Centre of Excellence for Body, Mind, and Health, Tilburg using the Bermond-Vorst Alexithymia Questionnaire, with general population norm scores. Second, we explored treatment outcomes of a multimodal treatment tailored to patient needs by Shared Decision Making (SDM) and Patient Related Outcome Monitoring (PROM) in patients with SSRD. Third, we explored whether alexithymia is associated with treatment outcome. Fourth, we explored if the presence of a chronic medical condition (e.g., diabetes mellitus, cardiovascular diseases) affects the association of alexithymia with treatment outcomes. Results: Compared to norm scores, SSRD patients showed elevated scores on the subscales identifying, verbalizing, and fantasizing, and on the cognitive dimension. All patients benefited from treatment in terms of anxiety, depression, and physical symptoms. The association of alexithymia with treatment outcome was significant, but the effect size was negligible (range odds ratios 1.02-1.25). The association between alexithymia and treatment outcome was stronger in patients suffering from chronic medical conditions compared to patients without chronic medical conditions. However, the effect size of this association was negligible (range odds ratio 0.94-1.12). Discussion: Alexithymia scores are elevated in patients with SSRD compared to general population scores, but the level of alexithymia has no clinically relevant association with treatment outcome both in SSRD patients with and without comorbid chronic medical conditions.