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1.
Res Integr Peer Rev ; 6(1): 5, 2021 Mar 01.
Article in English | MEDLINE | ID: mdl-33648609

ABSTRACT

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.

2.
J Pers Soc Psychol ; 120(1): 173-191, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33411558

ABSTRACT

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).


Subject(s)
Interpersonal Relations , Personal Satisfaction , Self Concept , Adult , Female , Humans , Longitudinal Studies , Male , Young Adult
3.
Assessment ; 28(2): 503-517, 2021 03.
Article in English | MEDLINE | ID: mdl-32336114

ABSTRACT

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.


Subject(s)
Sample Size , Computer Simulation , Humans , Regression Analysis
4.
J Cancer Res Clin Oncol ; 147(4): 1157-1167, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33025282

ABSTRACT

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.


Subject(s)
Brain Neoplasms/surgery , Neoplasms/surgery , Quality of Life , Radiosurgery/mortality , Adult , Aged , Aged, 80 and over , Brain Neoplasms/secondary , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Neoplasms/pathology , Prognosis , Prospective Studies , Survival Rate
5.
Assessment ; 28(6): 1735-1750, 2021 09.
Article in English | MEDLINE | ID: mdl-32483976

ABSTRACT

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.


Subject(s)
Regression Analysis , Bias , Humans , Sample Size
6.
Assessment ; 27(2): 373-383, 2020 03.
Article in English | MEDLINE | ID: mdl-28895436

ABSTRACT

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.


Subject(s)
Neuropsychological Tests/statistics & numerical data , Neuropsychological Tests/standards , Adolescent , Adult , Aged , Aged, 80 and over , Child , Cross-Cultural Comparison , Female , Humans , Male , Middle Aged , Netherlands , Socioeconomic Factors , United States , Young Adult
7.
Multivariate Behav Res ; 54(4): 593-611, 2019.
Article in English | MEDLINE | ID: mdl-31001995

ABSTRACT

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.


Subject(s)
Bias , Brief Psychiatric Rating Scale , Mental Disorders/diagnosis , Mental Disorders/therapy , Self Report , Adult , Female , Humans , Male , Models, Statistical , Surveys and Questionnaires , Truth Disclosure
8.
Multivariate Behav Res ; 54(5): 637-665, 2019.
Article in English | MEDLINE | ID: mdl-30977400

ABSTRACT

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.


Subject(s)
Anxiety/epidemiology , Depression/epidemiology , Latent Class Analysis , Type D Personality , Computer Simulation , Humans , Interpersonal Relations , Monte Carlo Method , Multivariate Analysis , Psychiatric Status Rating Scales , Social Behavior
9.
Assessment ; 26(2): 281-293, 2019 03.
Article in English | MEDLINE | ID: mdl-29214860

ABSTRACT

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.


Subject(s)
Narcissism , Personality Inventory , Surveys and Questionnaires , Adolescent , Adult , Aged , Conflict, Psychological , Exhibitionism , Factor Analysis, Statistical , Female , Humans , Interpersonal Relations , Male , Middle Aged , Young Adult
10.
J Psychosom Obstet Gynaecol ; 40(1): 38-47, 2019 03.
Article in English | MEDLINE | ID: mdl-29157055

ABSTRACT

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.


Subject(s)
Complementary Therapies , Delivery, Obstetric/psychology , Fear , Parturition/psychology , Pregnant Women/psychology , Adult , Analysis of Variance , Female , Humans , Intention to Treat Analysis , Internet-Based Intervention , Netherlands/epidemiology , Pregnancy , Prenatal Care
11.
Front Psychiatry ; 9: 292, 2018.
Article in English | MEDLINE | ID: mdl-30087625

ABSTRACT

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.

12.
Psychol Assess ; 30(12): 1652-1662, 2018 Dec.
Article in English | MEDLINE | ID: mdl-29952595

ABSTRACT

This study examined test-retest reliabilities and (predictors of) practice effects of the widely used computerized neuropsychological battery CNS Vital Signs. The sample consisted of 158 Dutch healthy adults. At 3 and 12 months follow-up, 131 and 77 participants were retested. Results revealed low to high test-retest reliability coefficients for CNS VS' test and domain scores. Participants scored significantly higher on the domains of Cognitive Flexibility, Processing Speed, and Reaction Time at the 3-month retest. No significant differences in performance were found over the second interval. Age, education, and retest-interval were not significantly associated with practice effects. These results highlight the need for methods that evaluate performance over time while accounting for imperfect test-retest reliabilities and practice effects. We provided RCI-formulae for determining reliable change, which may be possible solution for future work facing the methodological issues of retesting. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Subject(s)
Cognition , Computers , Neuropsychological Tests/statistics & numerical data , Reaction Time , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Mental Processes , Middle Aged , Netherlands , Reference Values , Reproducibility of Results , Time Factors , Young Adult
13.
Psychometrika ; 83(3): 674-695, 2018 09.
Article in English | MEDLINE | ID: mdl-29713915

ABSTRACT

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.


Subject(s)
Multilevel Analysis , Psychometrics/methods , Humans
14.
Front Psychiatry ; 9: 111, 2018.
Article in English | MEDLINE | ID: mdl-29740350

ABSTRACT

INTRODUCTION: The Bermond-Vorst Alexithymia Questionnaire (BVAQ) has been validated in student samples and small clinical samples, but not in the general population; thus, representative general-population norms are lacking. AIM: We examined the factor structure of the BVAQ in Longitudinal Internet Studies for the Social Sciences panel data from the Dutch general population (N = 974). RESULTS: Factor analyses revealed a first-order five-factor model and a second-order two-factor model. However, in the second-order model, the factor interpreted as analyzing ability loaded on both the affective factor and the cognitive factor. Further analyses showed that the first-order test scores are more reliable than the second-order test scores. External and construct validity were addressed by comparing BVAQ scores with a clinical sample of patients suffering from somatic symptom and related disorder (SSRD) (N = 235). BVAQ scores differed significantly between the general population and patients suffering from SSRD, suggesting acceptable construct validity. Age was positively associated with alexithymia. Males showed higher levels of alexithymia. DISCUSSION: The BVAQ is a reliable alternative measure for measuring alexithymia.

15.
Assessment ; 25(7): 917-928, 2018 10.
Article in English | MEDLINE | ID: mdl-27630204

ABSTRACT

The aim of this study was to assess the extent to which discrepancy between self-reported and clinician-rated severity of depression are due to inconsistent self-reports. Response inconsistency threatens the validity of the test score. We used data from a large sample of outpatients ( N = 5,959) who completed the self-report Beck Depression Inventory-II (BDI-II) and the clinician-rated Montgomery-Åsberg Depression Rating Scale (MADRS). We used item response theory based person-fit analysis to quantify the inconsistency of the self-report item scores. Inconsistency was weakly positively related to patient-clinician discrepancy (i.e., higher BDI-II scores relative to MADRS scores). The mediating effect of response inconsistency in the relationship between discrepancy and demographic (e.g., ethnic origin) and clinical variables (e.g., cognitive problems) was negligible. The small direct and mediating effects of response inconsistency suggest that inaccurate patient self-reports are not a major cause of patient-clinician discrepancy in outpatient samples. Future research should investigate the role of clinician biases in explaining clinician-patient discrepancy.


Subject(s)
Physicians , Self Report , Severity of Illness Index , Adolescent , Adult , Aged , Depressive Disorder/diagnosis , Female , Humans , Male , Middle Aged , Models, Theoretical , Psychiatric Status Rating Scales , Self-Assessment , Young Adult
16.
Qual Life Res ; 26(6): 1473-1481, 2017 06.
Article in English | MEDLINE | ID: mdl-28194617

ABSTRACT

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.


Subject(s)
Patient Outcome Assessment , Surveys and Questionnaires , Ethnicity , Factor Analysis, Statistical , Female , Humans , Longitudinal Studies , Male , Netherlands , Outpatients , Psychometrics/methods , Quality of Life , Reproducibility of Results , Self Report
17.
Value Health ; 19(2): 167-75, 2016.
Article in English | MEDLINE | ID: mdl-27021750

ABSTRACT

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.


Subject(s)
Health Care Costs , Health Services Research/economics , Health Status Indicators , Health Status , Quality of Life , Quality-Adjusted Life Years , Activities of Daily Living , Adult , Cost-Benefit Analysis , Delphi Technique , Emotions , Factor Analysis, Statistical , Female , Humans , Male , Mental Health , Middle Aged , Models, Economic , Personal Satisfaction , Reproducibility of Results , Self Concept , Social Behavior , Surveys and Questionnaires
18.
Appl Psychol Meas ; 40(2): 128-141, 2016 Mar.
Article in English | MEDLINE | ID: mdl-29881043

ABSTRACT

Latent class (LC) cluster analysis of a set of subscale lz person-fit statistics was proposed to explain person misfit on multiscale measures. The proposed explanatory LC person-fit analysis was used to analyze data of students (N = 91,648) on the nine-subscale School Attitude Questionnaire Internet (SAQI). Inspection of the class-specific lz mean and variance structure combined with explanatory analysis of class membership showed that the data included a poor-fit class, a class showing good fit combined with social desirability bias, a good-fit class, and two classes that were more difficult to interpret. A comparison of multinomial logistic regression predicting class membership and multiple regression predicting continuous person fit showed that LC cluster analysis provided information about aberrant responding unattainable by means of linear multiple regression. It was concluded that LC person-fit analysis has added value to common approaches to explaining aberrant responding to multiscale measures.

19.
Appl Psychol Meas ; 40(8): 559-572, 2016 Nov.
Article in English | MEDLINE | ID: mdl-29881070

ABSTRACT

Clinical psychologists are advised to assess clinical and statistical significance when assessing change in individual patients. Individual change assessment can be conducted using either the methodologies of classical test theory (CTT) or item response theory (IRT). Researchers have been optimistic about the possible advantages of using IRT rather than CTT in change assessment. However, little empirical evidence is available to support the alleged superiority of IRT in the context of individual change assessment. In this study, the authors compared the CTT and IRT methods with respect to their Type I error and detection rates. Preliminary results revealed that IRT is indeed superior to CTT in individual change detection, provided that the tests consist of at least 20 items. For shorter tests, however, CTT is generally better at correctly detecting change in individuals. The results and their implications are discussed.

20.
Eur J Pediatr ; 175(3): 329-38, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26438336

ABSTRACT

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.


Subject(s)
Diabetes Mellitus, Type 1/psychology , Parent-Child Relations , Parenting/psychology , Parents/psychology , Quality of Life/psychology , Stress, Psychological/psychology , Blood Glucose , Child , Child, Preschool , Female , Glycated Hemoglobin/analysis , Humans , Male , Surveys and Questionnaires
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