The animated assessment of theory of mind for people with schizophrenia (AToMS): development and psychometric evaluation.

Theory of mind (ToM) deficits in people with schizophrenia have been reported and associated with impaired social interactions. Thus, ToM deficits may negatively impact social functioning and warrant consideration in treatment development. However, extant ToM measures may place excessive cognitive demands on people with schizophrenia. Therefore, the study aimed to develop a comprehensible Assessment of ToM for people with Schizophrenia (AToMS) and evaluate its psychometric properties. The AToMs was developed in 5 stages, including item formation, expert review, content validity evaluation, animation production, and cognitive interviews of 25 people with schizophrenia. The psychometric properties of the 16-item AToMS (including reliability and validity) were then tested on 59 people with schizophrenia. The newly developed animated AToMS assesses 8 ToM concepts in the cognitive and affective dimensions while placing minimal neurocognitive demands on people with schizophrenia. The AToMS presented satisfactory psychometric properties, with adequate content validity (content validity index = 0.91); mostly moderate item difficulty (item difficulty index = 0.339-0.966); good discrimination (coefficients = 0.379-0.786), internal consistency (Cronbach's α = 0.850), and reliability (intraclass correlation coefficient = 0.901 for test-retest, 0.997 for inter-rater); and satisfactory convergent and divergent validity. The AToMS is reliable and valid for evaluating ToM characteristics in people with schizophrenia. Future studies are warranted to examine the AToMS in other populations (e.g., people with affective disorders) to cross-validate and extend its utility and psychometric evidence.

The psychometric properties of the cervical nonorganic signs in patients with neck pain: an assessment of pain expression.

PURPOSE: Neck pain is a common cause of disability. This study investigated the psychometric properties of the cervical nonorganic signs (CNOS), a tool for assessing abnormal illness behaviors in patients with neck pain. METHODS: The CNOS was administered on patients with neck pain. Reliability and validity analyses were used to evaluate the psychometric properties. Exploratory factor analysis was used to investigate the dimensionality. Correlations with the Short Form-36 were used to investigate the convergent validity. RESULTS: The results supported the reliability (inter-rater reliability intra-class correlation: 0.920), validity (correlated with body pain (|ρ|=0.31) and vitality (|ρ| =0.30), and two-factor dimensionality (χ2= 5.904, p= 0.66; χ2/df = 0.738; RMSEA< 0.001; CFI = 1.000; TLI = 1.024; SRMR = 0.047) of the scale. The two factors were pain (severe pain) and vitality (poor vitality) expressed by the patients. CONCLUSION: The CNOS is a reliable and valid instrument for assessing pain and vitality problems. It helps patients to express severe pain and lack of vitality. The rehabilitation discipline could use the scale to understand pain expression and to design proper rehabilitation programs. Implications for Rehabilitation The cervical nonorganic signs has two domains (pain and vitality). The scale is reliable and valid for patients with neck pain. Patients with high scores on the pain domain have severe body pain that may interfere with normal social activities. Clinicians should understand their suffering and try to help them to alleviate the pain.

Confirmatory Factor Analysis of the Boston Carpal Tunnel Questionnaire.

PURPOSE: Carpal tunnel syndrome (CTS) is one of the most common hand problems and a major cause of work disability. The purpose of this study was to use confirmatory factor analysis (CFA) to assess the factor structure of the Boston Carpal Tunnel Questionnaire (BCTQ) in patients with CTS. METHODS: One hundred and twenty-three patients with CTS were recruited from two hospitals. Each patient completed the functional status scale and the symptom severity scale of the BCTQ. CFA was used to assess the model fit between the data and pre-established theoretical measurement models. RESULTS: CFA showed that all three-factor models were better than the original two-factor model. Among the three-factor models, the simplified model, with 11 items assessing daytime pain, nocturnal numbness/tingling, and hand function was the best, for the model fit the data better than did the other models. Specifically, the Comparative Indices were larger than 0.95 (Tucker-Lewis Index and Comparative Fit Index values), and the Absolute Fit Indices and information-theoretic measures were the smallest. Moreover, all factor loadings were significant and high in magnitude (ranging from 0.66 to 0.99), the composite reliabilities exceeded 0.60 (ranging from 0.78 to 0.94), and the average variance extracted exceeded 0.50 (ranging from 0.61 to 0.89). CONCLUSION: The simplified model showed the highest reliability and validity, and the factor structure was the simplest/clearest one. The simplified model is recommended for clinical use due to its convenience and precision for assessing the problems of patients with CTS.

Measurement precision of the disability for back pain scale-by applying Rasch analysis.

BACKGROUND: The Oswestry Disability Index (ODI) is widely used for patients with back pain. However, few studies have examined its psychometric properties using modern measurement theory. The purpose of this study was to investigate the psychometric properties of the ODI in patients with back pain using Rasch analysis. METHODS: A total of 408 patients with back pain participated in this cross-sectional study. Patients were recruited from the orthopedic, neurosurgery, rehabilitation departments and pain clinic of two hospitals. Rasch analysis was used to examine the Chinese version of ODI 2.1 for unidimensionality, item difficulty, category function, differential item functioning, and test information. RESULTS: The fit statistics showed 10 items of the ODI fitted the model's expectation as a unidimensional scale. The ODI measured the different levels of functional limitation without skewing toward the lower or higher levels of disability. No significant ceiling and floor effects and gaps among the items were found. The reliability was high and the test information curve demonstrated precise dysfunction estimation. CONCLUSIONS: Our results showed that the ODI is a unidimensional questionnaire with high reliability. The ODI can precisely estimate the level of dysfunction, and the item difficulty of the ODI matches the person ability. For clinical application, using logits scores could precisely represent the disability level, and using the item difficulty could help clinicians design progressive programs for patients with back pain.

Development of the Chinese version of the Hooper Visual Organization Test: normative data.

The present study consisted of two phases: development and psychometric validation of a Chinese version of the Hooper Visual Organization Test (HVOT) using Rasch analysis and the provision of normative data on the basis of a representative sample of the Chinese-speaking population. The HVOT was administered to 1008 healthy adults aged 15-79 years, 60 patients with stroke, and 60 patients with schizophrenia. The results indicated that with 12 items removed, the resulting 18-item scale was found to be unidimensional, with satisfactory internal consistency and no evidence of differential item functioning or bias for age, sex and educational level. There were significant differences between each of the two patient groups and normal controls on the scores of the Rasch-developed measure. All test-retest coefficients exceeded 90 in patient samples. As performance on the Chinese version decreases with age and lower years of education, regression-based normative data that took age and education into account were established. A cut-off score of 21.5, out of an x-y range, the higher the better, resulted in a sensitivity of 0.86 and a specificity of 0.68. The normative data presented here will enable clinicians to determine different levels of visuosynthetic impairments more precisely.

A small sample test of the factor structure of postural movement and bilateral motor integration using structural equation modeling.

The goal of this study was to examine the relationship between the validity of postural movement and bilateral motor integration in terms of sensory integration theory. Participants in this study were 61 Chinese children ages 48 to 70 months. Structural equation modeling was applied to assess the relation between measures tapping postural movement and bilateral motor integration: for postural movement, the measures involve the Monkey Task, Side-Sit Co-contraction, Prone on Elbows, Wheelbarrow Walk, Airplane, and Scooter Board Co-contraction from the DeGangi-Berk Test of Sensory Integration, and Standing Balance with Eyes Closed/Opened in Southern California Sensory Integration Tests. For bilateral motor integration, the measures chosen were the Rolling Pin Activity, Jump and Turn, Diadokokinesis, Drumming, and Upper Extremity Control from the DeGangi-Berk Test of Sensory Integration, and Cross the Midline in Southern California Sensory Integration Tests (SCSIT). Postural movement was highly correlated with the bilateral motor integration. The factor structure fit the theoretical conceptualization, classifying postural movement and bilateral motor integration together in the same category. Therapists could combine two separate objectives (postural movement and bilateral motor integration) of intervention in an activity to improve the adaptive skills based on the vestibular-proprioceptive integration.

Longitudinal effects of educational expectations and achievement attributions on adolescents' academic achievements.

This study used nationwide data from the Taiwan Education Panel Survey (TEPS) to examine the longitudinal effects of educational expectations and achievement attributions on the academic achievements of adolescents. The sample included 2,000 Taiwanese secondary school students, each of whom completed three waves of questionnaires and cognitive tests: the first in grade 7 (in 2001), the second in grade 9 (in 2003), and the third in grade 11 (in 2005). Through multilevel longitudinal analysis, the results showed: (1) educational expectations accounted for a moderate amount of the variance in academic achievements; (2) students with high educational expectations and effort attribution exhibited higher growth rates in their academic achievements; and (3) studentswith lower educational expectations and those attributing success to others showed significantly fewer academic achievements and significantly lower growth rates in such achievements. The results demonstrated that adolescents' educational expectations and achievement attributions play crucial roles in the long-term course of academic accomplishments. Implications for educational practice and further studies are also discussed.

The role of cognition and adaptive behavior in employment of people with mental retardation.

Few studies have specifically investigated the cognitive correlates of employment for persons with mental retardation. To evaluate the relationship of cognitive and adaptive functioning to work status, 56 competitively employed and 55 unemployed individuals with mental retardation underwent a comprehensive neuropsychological and adaptive behavioral evaluation. Results of multivariate analysis of covariance (MANCOVA) revealed significant group differences in cognitive and adaptive behavioral domains controlling for gender and severity of mental retardation. Follow-up ANCOVAs showed that the employed group performed significantly better than the unemployed group on measures of attention, memory, verbal comprehension, visual perception, and adaptive behavior. Using discriminant function analysis, 73.2 percent of the employed and 76.4 percent of the unemployed people were predicted correctly. These results suggest that adaptive behavior and specific aspects of cognitive functioning are significant predictors of successful employment for persons with mental retardation.