Cognitive Behavioral Therapy for Sleep Disturbance and Fatigue Following Acquired Brain Injury: Predictors of Treatment Response.

OBJECTIVE: To identify factors associated with treatment response to cognitive behavioral therapy for sleep disturbance and fatigue (CBT-SF) after acquired brain injury (ABI). SETTING: Community dwelling. PARTICIPANTS: Thirty participants with a traumatic brain injury or stroke randomized to receive CBT-SF in a parent randomized controlled trial. DESIGN: Participants took part in a parallel-groups, parent randomized controlled trial with blinded outcome assessment, comparing an 8-week CBT-SF program with an attentionally equivalent health education control. They were assessed at baseline, post-treatment, 2 months post-treatment, and 4 months post-treatment. The study was completed either face-to-face or via telehealth (videoconferencing). Following this trial, a secondary analysis of variables associated with treatment response to CBT-SF was conducted, including: demographic variables; injury-related variables; neuropsychological characteristics; pretreatment sleep disturbance, fatigue, depression, anxiety and pain; and mode of treatment delivery (face-to-face or telehealth). MAIN MEASURES: Pittsburgh Sleep Quality Index (PSQI) and Fatigue Severity Scale (FSS). RESULTS: Greater treatment response to CBT-SF at 4-month follow-up was associated with higher baseline sleep and fatigue symptoms. Reductions in fatigue on the FSS were also related to injury mechanism, where those with a traumatic brain injury had a more rapid and short-lasting improvement in fatigue, compared with those with stroke, who had a delayed but longer-term reduction in fatigue. Mode of treatment delivery did not significantly impact CBT-SF outcomes. CONCLUSION: Our findings highlight potential differences between fatigue trajectories in traumatic brain injury and stroke, and also provide preliminary support for the equivalence of face-to-face and telehealth delivery of CBT-SF in individuals with ABI.

Acceptability of telehealth in post-stroke memory rehabilitation: A qualitative analysis.

Despite evidence of the efficacy of telerehabilitation post-stroke, uptake has lagged behind the development of available technology, slowed by low confidence in user experience. We aimed to explore the issue of acceptability by characterizing the experience of telerehabilitation for service providers and consumers of a memory rehabilitation program. Semi-structured interviews were conducted with nine clinicians (Mage = 33.29; SD = 7.37; range 25-44) and 25 stroke survivors with memory difficulties (Mage = 54.12; SD = 10.99; range 36-82) following a 6-week compensatory memory skills program delivered via in-home videoconferencing. Thematic analysis identified a range of perspectives under three overarching themes: (1) Content and Delivery; (2) Relationship and Connection; and (3) The Role and Benefits of Telerehabilitation. Reports from both respondent groups were overwhelmingly positive about the telerehabilitation experience and identified the benefits of increasing service availability. Videoconferencing technology was usable and occasional reliability issues were not a barrier. Users identified a range of benefits and challenges regarding communication, rapport building, and integration of rehabilitation in the home environment. Furthermore, most stroke survivors reported benefit from the intervention, via the acquisition of memory strategies and improved self-confidence through better understanding of their deficits. Overall, telerehabilitation of memory was acceptable to users.

Zero-sum thinking as mediator of the relationship of national attitudes with (un)willingness to host refugees in own country.

This study examines factors related to willingness to host refugees. We examined the role of national attitudes (patriotism, nationalism), out-group attitudes (classic and modern prejudice), and zero-sum thinking: Belief in a Zero-Sum Game and psychological entitlement in attitudes towards hosting refugees. We proposed including zero-sum thinking as possible mediator between national attitudes and attitudes towards refugees based on assumption that nationalism is a competitive attitude towards out-groups, while patriotism does not. Structural equation modelling based on a Polish national sample (N = 1092) revealed that patriotism is positively associated with willingness to host refugees, through its negative association with prejudice via decreasing zero-sum thinking. Nationalism was negatively associated with willingness to host refugees, through prejudice via increasing zero-sum thinking. Findings are discussed in the context of current refugee policies.

Measurement invariance of the Belief in a Zero-Sum Game scale across 36 countries.

In this paper, we examined the psychometric properties of cross-cultural validation and replicability (i.e. measurement invariance) of the Belief in a Zero-Sum Game (BZSG) scale, measuring antagonistic belief about interpersonal relations over scarce resources. The factorial structure of the BZSG scale was investigated in student samples from 36 countries (N = 9907), using separate confirmatory factor analyses (CFAs) for each country. The cross-cultural validation of the scale was based on multigroup confirmatory factor analyses (MGCFA). The results confirmed that the scale had a one-factor structure in all countries, in which configural and metric invariance between countries was confirmed. As a zero-sum belief about social relations perceived as antagonistic, BZSG is an important factor related to, for example, social and international relations, attitudes toward immigrants, or well-being. The paper proposes different uses of the BZSG scale for cross-cultural studies in different fields of psychology: social, political, or economic.

UPPS-P facets of impulsivity and alcohol use patterns in college and noncollege emerging adults.

BACKGROUND: Alcohol use and related problems reach a peak in emerging adulthood. Impulsivity is a multifaceted construct known to be involved in emerging adult alcohol use. Few studies have examined impulsivity and alcohol use across both college attending and noncollege attending emerging adults. OBJECTIVES: To clarify the multifaceted nature of impulsivity and its links to emerging adult alcohol use, this study investigated whether the five distinct facets of the UPPS-P model of impulsivity were predictive of three different behavioral outcomes: alcohol intake, alcohol related problems and binge drinking. In addition, the moderating effects of college attendance were tested. METHODS: A community sample comprising 273 Australian college and noncollege attendees (58.6% women; 41.4% men) aged between 18 and 30 years (Mage = 23.71, SD = 2.81). RESULTS: Multiple regression analyses demonstrated that lack of premeditation predicted alcohol intake and binge drinking behavior, whilst positive and negative urgency predicted alcohol related problems. Moderation analyses revealed that the effects of impulsivity on alcohol patterns were consistent for college and noncollege attending emerging adults. CONCLUSION: These findings highlight the importance of impulsive urgency (both positive and negative) in emerging adult problematic alcohol use, and support the generalizability of college samples to broader emerging adult populations. Emerging adults may use alcohol to avoid negative mood states and further enhance positive mood states. Improved emotional regulation may help both college and non-college emerging adults reduce their alcohol use.

Psychometric properties of the MHC-SF: An integration of the existing measurement approaches.

OBJECTIVE: The purpose of the current study is to test the factorial structure of the Mental Health Continuum-Short Form (MHC-SF) in Asian population. METHOD: The study was conducted across three different Vietnamese samples (N = 2741). We present a comparison of the existing measurement models of the MHC-SF using two methodological approaches: confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) (both in exploratory-using bi-geomin rotation; and in confirmatory variant-using target rotation). RESULTS: The current report supported the targeted bifactor ESEM solution as better describing the factorial structure of the MHC-SF than the originally assumed three-factor solution in all samples. CONCLUSION: The structure of the MHC-SF is best represented as combination of the bifactor and ESEM model.

The mental health continuum-short form: The structure and application for cross-cultural studies-A 38 nation study.

OBJECTIVE: The Mental Health Continuum-Short Form (MHC-SF) is a brief scale measuring positive human functioning. The study aimed to examine the factor structure and to explore the cross-cultural utility of the MHC-SF using bifactor models and exploratory structural equation modelling. METHOD: Using multigroup confirmatory analysis (MGCFA) we examined the measurement invariance of the MHC-SF in 38 countries (university students, N = 8,066; 61.73% women, mean age 21.55 years). RESULTS: MGCFA supported the cross-cultural replicability of a bifactor structure and a metric level of invariance between student samples. The average proportion of variance explained by the general factor was high (ECV = .66), suggesting that the three aspects of mental health (emotional, social, and psychological well-being) can be treated as a single dimension of well-being. CONCLUSION: The metric level of invariance offers the possibility of comparing correlates and predictors of positive mental functioning across countries; however, the comparison of the levels of mental health across countries is not possible due to lack of scalar invariance. Our study has preliminary character and could serve as an initial assessment of the structure of the MHC-SF across different cultural settings. Further studies on general populations are required for extending our findings.

Cognitive behavioural therapy versus health education for sleep disturbance and fatigue after acquired brain injury: A pilot randomised trial.

BACKGROUND: Sleep disturbance and fatigue are highly prevalent after acquired brain injury (ABI) and are associated with poor functional outcomes. Cognitive behavioural therapy (CBT) is a promising treatment for sleep and fatigue problems after ABI, although comparison with an active control is needed to establish efficacy. OBJECTIVES: We compared CBT for sleep disturbance and fatigue (CBT-SF) with a health education (HE) intervention to control for non-specific therapy effects. METHODS: In a parallel-group, pilot randomised controlled trial, 51 individuals with traumatic brain injury (n = 22) and stroke (n = 29) and clinically significant sleep and/or fatigue problems were randomised 2:1 to 8 weeks of a CBT-SF (n = 34) or HE intervention (n = 17), both adapted for cognitive impairments. Participants were assessed at baseline, post-treatment, and 2 and 4 months post-treatment. The primary outcome was the Pittsburgh Sleep Quality Index; secondary outcomes included measures of fatigue, sleepiness, mood, quality of life, activity levels, self-efficacy and actigraphy sleep measures. RESULTS: The CBT-SF led to significantly greater improvements in sleep quality as compared with HE, during treatment and at 2 months [95% confidence interval (CI) -24.83; -7.71], as well as significant reductions in fatigue maintained at all time points, which were not evident with HE (95% CI -1.86; 0.23). HE led to delayed improvement in sleep quality at 4 months post-treatment and in depression (95% CI -1.37; -0.09) at 2 months post-treatment. CBT-SF led to significant gains in self-efficacy (95% CI 0.15; 0.53) and mental health (95% CI 1.82; 65.06). CONCLUSIONS: CBT-SF can be an effective treatment option for sleep disturbance and fatigue after ABI, over and above HE. HE may provide delayed benefit for sleep, possibly by improving mood. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry: ACTRN12617000879369 (registered 15/06/2017) and ACTRN12617000878370 (registered 15/06/2017).

A Measurement Invariance Investigation of the Polish Version of the Dual Filial-Piety Scale (DFPS-PL): Student-Employee and Gender Differences in Filial Beliefs.

Filial beliefs are defined as a cognitive script or even a contextualized personality construct for social exchanges, which shapes the attitudes of individuals. In the given study, we investigate the factorial structure of the Polish version of the Dual Filial Piety Scale (DFPS-PL) and verify whether measurement of filial piety is invariant among students and employees, and among men and women. Two studies were conducted on different age samples: 489 students aged 18-24 and 849 employees aged 25-64. In order to verify the hypotheses, the DFPS-PL was administered. As a result of confirmatory factor analyses (CFA), it has been demonstrated that the structure of filial piety measured by the DFPS-PL among students and employees, and men and women, could be interpreted as two-factorial, and that there is partial scalar measurement invariance for the tested model across these groups (MGCFA). The comparison of the average latent mean scores suggests that employees declare a lower level of AFP (Authoritarian Filial Piety; need of social belonging and collective identity) than students. There were no significant differences between students and employees when RFP (Reciprocal Filial Piety; need of interpersonal relatedness) was compared. In addition, the results showed that women score higher in RFP than men. The given findings are discussed in the context of values transition in non-Asian countries. The main contribution is to confirm the factorial structure of the DFPS-PL and introduce the novel Eastern concept of Filial Piety to Western culture.

The Implications of Filial Piety in Study Engagement and Study Satisfaction: A Polish-Vietnamese Comparison.

Even in psychological literature, which describes many determining variables related to the school domain, few studies have investigated the universal (i.e., etic) mechanism underlying parent-child relations, which is a prototype matrix for future student-teacher relations. The role of the imprinted schema of children's obligations toward parents seems to be crucial for school functioning in classroom society. The Dual Filial Piety Model (DFPM; Yeh, 2003) is comprised of two higher-order factors that correspond to the two focal filial piety attributes: reciprocal (need of interpersonal relatedness) and authoritarian (need of social belonging and national identity), which have been shown to have distinct implications on social adaptation and individuals' psychological functioning. In this study, we investigate the relationship between filial piety and student attitudes (study engagement and satisfaction) in a more individualistic and egalitarian culture (Poland, N = 310) and in a more collectivistic and hierarchical society (Vietnam, N = 297). The measurement invariances of three scales, i.e., the Vietnamese adaptation of DFP Scale, the Utrecht Work Engagement Scale (UWES-S9), and the Study Satisfaction Scale, were improved in the MLM analyses. Our results show that in more individualistic cultures, the RFP (reciprocal mode) is a stronger predictor of study engagement and study satisfaction; however, the AFP (authoritarian mode) is a better factor to predict study engagement in more collectivistic cultures. What is more, only RFP positively correlates with study satisfaction in individualistic culture. Our findings revealed that in different cultures, different aspects of filial piety should be emphasized by parents in the context of the future academic achievements of their children. The conclusion is that the prevention and intervention strategies or techniques intended for children with school problems should be culturally appropriate and addressed to the parents of kindergarten and later to very early-stage education teachers. The results of studies based on the DFPM may stimulate practical applications and policy development within the domain of success and failure in the academic environment.

The Body as an Object of Stigmatization in Cultures of Guilt and Shame: A Polish-Vietnamese Comparison.

The aim of this paper is to examine cross-cultural differences in body stigmatization between the individualistic Christian culture of guilt (Poland) and the collectivistic Buddhist/Confucian culture of honor and shame (Vietnam). The study included 1290 university students from Poland (n = 586) and Vietnam (n = 704). Subjects filled in the body esteem scale and the perceived stigmatization questionnaire, and body measurements were collected to calculate anthropometric indices. Participants from Vietnam were less satisfied with their appearance than their Polish peers. Men in both countries assessed themselves more favorably. No anthropometric index predicted body esteem in Vietnamese women, while only indices related to fat levels were predictors in Polish women. Men with a V-shaped body assessed themselves as stronger and as having a better physical condition. A possible explanation of the observed cross-cultural differences is that interdependent self-construal makes young adults in collectivistic societies more susceptible to criticism, and the Confucian values of modesty and shame lead to them not perceiving their bodies as sexual objects. The Christian sense of guilt does not influence the perception of sexuality. Absence of friendly behavior mediated the relation between anthropometric indices and body esteem in both cultures.

A test of construct isomorphism of the Belief in a Zero-Sum Game scale: A multilevel 43-nation study.

BACKGROUND: We examined the equivalence of the individual and the country-level factor structure of the Belief in a Zero-Sum Game (BZSG) scale, a tool designed to measure antagonistic beliefs about social relations (i.e., perceived social antagonism) in the struggle for limited resources. AIMS: In this article we focused on a test of construct isomorphism in a multilevel modeling approach. It was hypothesized that the BZSG measure satisfies all requirements for a strong level of configural isomorphism, and thus that it is useful to investigate BZSG at both the individual and the country levels. The relationships between the BZSG at a country level with other macro-socio-economic indicators were also investigated. METHOD: Multilevel confirmatory factor analysis (MCFA) was carried out on a cross-country sample composed of 11,368 participants from 43 different countries. We also used the country-level latent BZSG factor in each country as an indicator of a property that we attributed to a particular culture: cultural dimension (collectivism-individualism), macroeconomic indicators (GDP per capita and GNI per capita) and macrosocial indicators (Human Development Index and Democracy Index) describing societies. RESULTS: The results revealed an isomorphic factor structure of perceived social antagonism (measured by BZSG scale), defined in terms of the equivalence factor structure at the both individual and country levels. Furthermore, the relationship between the perceived social antagonism, gross national income per capita, and collectivism were confirmed. CONCLUSIONS: Our study supports the usefulness of the BZSG scale for cross-cultural comparison, in the case of its isomorphic structure. At the country level, antagonistic beliefs emerge in hierarchical collectivist societies with lower income. The main contribution of this article is the presentation of the test of construct isomorphism. We made an effort to present a full perspective on construct isomorphism putting together two different but very recent approaches.

A Warrior Society: Data From 30 Countries Show That Belief in a Zero-Sum Game Is Related to Military Expenditure and Low Civil Liberties.

The aim of this paper was to investigate the relationship between a perceived antagonistic view of social relations (as a struggle for limited resources), measured by the Belief in a Zero-Sum Game (BZSG) Scale, national military expenditure, and civil liberties. We used multi-level modeling to analyze data on 5,520 participants from 30 countries, testing the hypothesis that a country's level of militarization and civil liberties would be associated with its people's belief in a zero-sum game. We hypothesized that BZSG is more typical of countries that try to gain more resources or defend their interests and thus have high military expenditure but low civil liberties. The results confirmed the stated hypothesis and showed that a country's high military expenditure and low level of civil liberties correlates positively with citizens' BZSG. The use of multi-level modeling to account for within- and across-country variation is a main contribution of the study. In conclusion, the reported triad of individual beliefs, military expenditure, and civil liberties seems to be beneficial in linking individual-level data with national-level indices that have major importance for the wellbeing of the world.

Genome-wide analysis of glucocorticoid receptor binding regions in adipocytes reveal gene network involved in triglyceride homeostasis.

Glucocorticoids play important roles in the regulation of distinct aspects of adipocyte biology. Excess glucocorticoids in adipocytes are associated with metabolic disorders, including central obesity, insulin resistance and dyslipidemia. To understand the mechanisms underlying the glucocorticoid action in adipocytes, we used chromatin immunoprecipitation sequencing to isolate genome-wide glucocorticoid receptor (GR) binding regions (GBRs) in 3T3-L1 adipocytes. Furthermore, gene expression analyses were used to identify genes that were regulated by glucocorticoids. Overall, 274 glucocorticoid-regulated genes contain or locate nearby GBR. We found that many GBRs were located in or nearby genes involved in triglyceride (TG) synthesis (Scd-1, 2, 3, GPAT3, GPAT4, Agpat2, Lpin1), lipolysis (Lipe, Mgll), lipid transport (Cd36, Lrp-1, Vldlr, Slc27a2) and storage (S3-12). Gene expression analysis showed that except for Scd-3, the other 13 genes were induced in mouse inguinal fat upon 4-day glucocorticoid treatment. Reporter gene assays showed that except Agpat2, the other 12 glucocorticoid-regulated genes contain at least one GBR that can mediate hormone response. In agreement with the fact that glucocorticoids activated genes in both TG biosynthetic and lipolytic pathways, we confirmed that 4-day glucocorticoid treatment increased TG synthesis and lipolysis concomitantly in inguinal fat. Notably, we found that 9 of these 12 genes were induced in transgenic mice that have constant elevated plasma glucocorticoid levels. These results suggested that a similar mechanism was used to regulate TG homeostasis during chronic glucocorticoid treatment. In summary, our studies have identified molecular components in a glucocorticoid-controlled gene network involved in the regulation of TG homeostasis in adipocytes. Understanding the regulation of this gene network should provide important insight for future therapeutic developments for metabolic diseases.