Patients' care dependency in mental health care: Development of a self-report questionnaire and preliminary correlates.

OBJECTIVES: Patients' dependency on the therapist or treatment has received little empirical attention. To examine care dependency, we aimed to develop a theory-driven questionnaire based on three hypothetical dimensions (passive-submissive dependency; active-emotional dependency; and lack of perceived alternatives) and to provide a preliminary exploration of several correlates of care dependency. METHOD: Care dependency, perceived social support, therapeutic alliance, remoralization, and symptom severity were measured in a large cross-sectional sample of 742 outpatients with various psychiatric disorders. Test-retest reliability was established in a smaller patient sample. RESULTS: Findings indicated a reliable questionnaire measuring three unidimensional subscales of care dependency (i.e., submissive dependency, need for contact, and lack of perceived alternatives; α's .74, .81, and .86 respectively; rt1,t2 's .78, .76, and .80, respectively). These subscales were all positively correlated with each other and with patients' self-proclaimed care dependency, but divergent from patients' trait dependency and symptoms of a dependent personality disorder. Moreover, higher levels of care dependency were correlated with lower levels of remoralization and more symptoms severity, and with a better therapeutic alliance. CONCLUSIONS: A reliable and valid questionnaire was developed to measure patients' care dependency. Future studies are needed to determine whether care dependency covers an unwanted side-effect or a crucial ingredient of an effective treatment.

Mindful Parenting Assessed Further: Psychometric Properties of the Dutch Version of the Interpersonal Mindfulness in Parenting Scale (IM-P).

Psychometric properties of the Dutch version of the Interpersonal Mindfulness in Parenting Scale (IM-P) were studied in a general population sample of mothers of adolescents (n=866) (study 1). A six-factor structure (29 items) emerged using exploratory factor analysis. A main difference from the original IM-P was that aspects of compassion and emotional awareness were separated into different factors for the self and the child, instead of combined into one factor. In a second general population sample of mothers of adolescents (n=.99), the six-factor structure was confirmed using confirmatory factor analysis (study 2). The proposed 29-item version of the IM-P and its subscales were shown to have good internal consistencies, apart from the sixth factor. As expected, a high correlation was found with general mindfulness questionnaires (FFMQ and FMI). Furthermore, the IM-P correlated positively as expected with quality of life and optimism and negatively with depression and dysfunctional parenting styles. These expected indications of construct validity were found in study 2, as well as in mothers (n=112) of adolescents with type 1 diabetes mellitus (study 3) which was added to examine whether the Dutch version of the IM-P was also valid in a pediatric population. Overall, these three studies present good psychometric properties of the Dutch translation of the first measure of mindful parenting.