Psychometric evaluation of the patient health questionnaire stress scale.

The "Patient Health Questionnaire (PHQ)" is a screening instrument, designed for time-efficient detection and severity assessment of depression, anxiety, and other syndromes in medical settings. Besides the questions on psychological symptoms, there are items on psychosocial functioning, on stressors and critical life events. However, for the stress items there are no psychometric properties available until now. The present study is thought to investigate item characteristics, internal consistency as well as factorial and construct validity of the stress scale of the PHQ. A representative sample of the general population of Germany was collected by a demography consulting company (USUMA, Berlin). Per random-route procedure, households and members of the households were selected. The sample was representative for the German community regarding age, gender, and education. In this investigation the following questionnaires were administered: PHQ-Stress, Questions on Life Satisfaction Modules (FLZ-M), Type-D Scale-14 (DS14). The sample included N = 2396 participants with mean age of 48.50 (SD = 17.75; range = 14 to 92) and 55.2 % being female. Reliability of the PHQ stress scale was acceptable (ω = 0.776), but some factor loadings were comparatively low. Model fit indices showed mixed results, some indicating unacceptable and some indicating acceptable fit of the 10-item stress scale of the PHQ. Correlations with related constructs demonstrated the scale's convergent validity. The results of this validation study indicate that the PHQ stress scale, which provides a one-dimensional total stress score, is a valid, good practical and reliable self-report instrument for assessing the severity of psychosocial stress.

[Physician-assisted interhospital transfer-an analysis from Schleswig-Holstein]. / Arztbegleitete Interhospitaltransporte ­ eine Analyse aus Schleswig-Holstein.

BACKGROUND: The need for interhospital transport (IHT) of intensive care patients is increasing due to changes in the hospital environment. Interhospital transports are challenging and require careful operational planning of personnel and rescue vehicles. OBJECTIVE: To investigate the need for IHT, an analysis was conducted in the service area of the emergency medical service central dispatch center (IRLS) in Schleswig-Holstein. MATERIAL AND METHODS: Emergency physician-assisted IHT were analyzed in the period from 01.10.2021 to 30.09.2022. RESULTS: Of a total of 158,823 documented IRLS missions, 2264 (1.4%) records could be identified and included as IHT: 1389 IHT (61.4%) were managed by specialized ambulances, 875 (38.6%) by primary care ambulances. Primary care ambulances were mainly used for time-critical transfers and outside the duty hours of the intensive care ambulances, 21.2 % were by air. Of all IHT, 43.1% were required to hospitals with a higher level of medical care. CONCLUSION: Emergency physician-assisted IHT are a relevant part of the emergency service's operational spectrum and concern both primary care and specialized rescue vehicles. A relevant number of urgent IHT were recorded outside the duty hours of the intensive care ambulances. For emergency transports during nighttime, an expansion of air-based transfer capacities should be considered due to the time advantage. For less urgent IHT, an adjustment of the capacities of specialized ground-based vehicles in Schleswig-Holstein seems reasonable.

Measuring personality functioning with the 12-item version of the OPD-Structure Questionnaire (OPD-SQS): reliability, factor structure, validity, and measurement invariance in the general population.

Background: The assessment of personality functioning is at the core of current dimensional models of personality disorders. A variety of measures from different clinical and research traditions aim to assess basic psychological capacities regarding the self and others. While some instruments have shown reliability and validity in clinical or other selected samples, much less is known about their performance in the general population. Methods: In three samples representative of the German adult population with a total of 7,256 participants, levels of personality functioning were measured with the short 12-item version of the Operationalized Psychodynamic Diagnosis - Structure Questionnaire (OPD-SQS). We addressed questions of factor structure, reliability, validity, factorial invariance, and provide norm values. Results: Confirmatory factor analysis indicated a satisfactory to good model fit. OPD-SQS models were mostly unaffected by variables such as gender, age, or measurement time. As expected, personality functioning was associated with general psychopathology as well as indices of occupational functioning. Conclusion: The OPD-SQS is a viable measure to assess personality functioning in the general population.

Impact of a ground intermediate transport from the helicopter landing site at a hospital on transport duration and patient safety.

BACKGROUND: Helicopter emergency medical service provides timely care and rapid transport of severely injured or critically ill patients. Due to constructional or regulatory provisions at some hospitals, a remote helicopter landing site necessitates an intermediate ground transport to the emergency department by ambulance which might lengthen patient transport time and comprises the risk of disconnection or loss of vascular access lines, breathing tubes or impairment of other relevant equipment during the loading processes. The aim of this study was to evaluate if a ground intermediate transport at the hospital site prolonged patient transport times and operating times or increases complication rates. METHODS: A retrospective analysis of all missions of a German air rescue service between 2012 and 2020 was conducted. Need of a ground transport at the accepting hospital, transfer time from the helipad to the hospital, overall patient transport time from the emergency location or the referring hospital to the accepting hospital and duration of the mission were analyzed. Several possible confounders such as type of mission, mechanical ventilation of the patient, use of syringe infusion pumps (SIPs), day- or nighttime were considered. RESULTS: Of a total of 179,003 missions (92,773 (51,8%) primary rescue missions, 10,001 (5,6%) polytrauma patients) 86,230 (48,2%) secondary transfers) an intermediate transport by ambulance occurred in 40,459 (22,6%) cases. While transfer times were prolonged from 6.3 to 8.8 min for primary rescue cases (p < 0.001) and from 9.2 to 13.5 min for interhospital retrieval missions (p < 0.001), the overall patient transport time was 14.8 versus 15.8 min (p < 0.001) in primary rescue and 23.5 versus 26.8 min (p < 0.001) in interhospital transfer. Linear regression analysis revealed a mean time difference of 3.91 min for mechanical ventilation of a patient (p < 0.001), 7.06 min for the use of SIPs (p < 0.001) and 2.73 min for an intermediate ambulance transfer (p < 0.001). There was no relevant difference of complication rates seen. CONCLUSIONS: An intermediate ground transport from a remote helicopter landing site to the emergency department by ambulance at the receiving hospital had a minor impact on transportation times and complication rates.

Psychometric properties of the job anxiety scale.

Background: Occupational stress and specifically job anxiety are crucial factors in determining health outcomes, job satisfaction as well as performance. In order to assess this phenomenon, the Job Anxiety Scale (JAS) is one of the instruments available. It consists of 70 items that are clustered in 14 subscales and five dimensions. This manuscript is a revised version of a retracted article that analyzed the properties of a short version of the JAS. Rather than shortening the scale, the authors of the JAS recommend to further assess the scale in its current state without modification of the factor structure. Hence, the aim of this paper is to assess the psychometric properties of the original JAS. Methods: The sample consists of 991 - mostly psychosomatic - patients from two different clinics. We applied methods of factor analysis and bivariate correlations to explore and test factor structure and the nomological net of related constructs. Results: The Job Anxiety Scale evinced satisfactory psychometric properties. We found very high internal consistency, and invariance across participant age. It displayed good discriminant validity and we found the expected pattern of convergent correlations. However, the model fit is not convincing. Conclusion: With the Job Anxiety Scale, researchers can assess job related worries in a reliable manner. The questionnaire is particularly useful in large-scale surveys, in therapy or work-related contexts. However, the scale could be modified in order to aim for a better fit and assess job related anxiety in a more efficient way.

Regional differences in the assessment of depressive symptoms in the former German Democratic Republic and Federal Republic of Germany.

AIM: The present study investigated regional differences in response behaviour for the Patient Health Quetionnaire-9. We tested for measurement invariance and differential item and test functioning between formerly divided East- and West-Germany: the former German Democratic Republic and Federal Republic of Germany. Diverging socialization experiences in socialist versus capitalist and collectivist versus individualist systems may affect culturally sensitive assessments of mental health. SUBJECT AND METHODS: To test this empirically, we used factor analytic and item-response-theoretic frameworks, differentiating between East- and West-Germans by birthplace and current residence based on several representative samples of the German general population (n = 3 802). RESULTS: Across all survey, we discovered slightly higher depression sum scores for East- versus West-Germans. The majority of items did not display differential item functioning-with a crucial exception in the assessment of self-harm tendencies. The scale scores were largely invariant exhibiting only small amounts of differential test functioning. Nonetheless, they made up on average about a quarter of the observed group differences in terms of effect magnitude. CONCLUSION: We explore possible causes and discuss explanations for the item-level differences. Overall, analyses of East- and West-German depressive symptom developments in the wake of reunification are feasible and statistically grounded.

Effects of Post-awakening Light Exposure on Heart Rate Variability in Healthy Male Individuals.

Light-induced effects on the autonomic nervous system (ANS) are assumed to be mediated by retinal projections to the hypothalamic suprachiasmatic nucleus (SCN) via different routes. Light information for the circadian system is detected by a subset of intrinsically photosensitive retinal ganglion cells (ipRGCs), however, inconsistency exists in research concerning the effects of light exposure on heart rate variability (HRV). Two within-subject experiments were conducted in a standardized sleep laboratory to investigate effects of light intensity (study I, n = 29: 2 days dim vs. bright light) and spectral composition (study II, n = 24: 3 days using red vs. blue vs. green light) on HRV parameters (RMSSD, LF, HF-HRV, LF/HF ratio). Light exposure was conducted for one-hour in the post-awakening phase at 5:00 AM. Results revealed no significant light intensity effect comparing dim light versus bright white light on HRV parameters. Light color of different wavelengths significantly influenced all HRV parameters except the low frequency, with moderate to large effect sizes. RMSSD values were elevated for all three colors compared to norm values, indicating stronger parasympathetic activation. LED light of different spectral compositions demonstrated bidirectional effects on spectral components of the HRV. Red light decreased the LF/HF ratio within 30 min, whereas with blue light, LF/HF ratio consistently increased across 40 min of light exposure.

Functional Somatic Disorders, Their Subtypes, and Their Association With Self-Rated Health in the German General Population.

OBJECTIVE: The heterogeneous conceptualizations and classifications of persistent and troublesome physical symptoms impede their adequate clinical management. Functional somatic disorder (FSD) is a recently suggested interface concept that is etiologically neutral and allows for dysfunctional psychobehavioral characteristics as well as somatic comorbidity. However, its prevalence and impact are not yet known. METHODS: We analyzed 2379 participants (mean age = 48.3 years, 52.5% female) from a representative German community survey using operationalized FSD criteria. These criteria defined FSD types based on somatic symptom count, type, and severity assessed by the Bodily Distress Syndrome Checklist. In addition, the associations of those types with health concerns, comorbidity, psychological distress, and self-rated health were determined. RESULTS: There were four clearly demarcated groups with no relevant bothering symptoms, with one or with few bothering symptoms from one organ system, and with multiple bothering symptoms from at least two organ systems. Psychological distress, health concerns, and comorbidity steadily increased, and self-rated health decreased according to the number and severity of symptoms. Somatic symptom burden, health concerns, and comorbidity independently predicted self-rated health, with no interaction effect between the latter two. CONCLUSIONS: Our data support an FSD concept with two severity grades according to persistent and troublesome symptoms in one versus more organ systems. The delimitation of subtypes with psychobehavioral characteristics and/or with somatic comorbidity seems useful, while still allowing the demarcation of a group of participants with high symptom burden but without those additional characteristics.

Do we need pre-hospital resuscitative endovascular balloon occlusion of the aorta (REBOA) in the civilian helicopter emergency medical services (HEMS)?

Pre-hospital resuscitative endovascular balloon occlusion of the aorta (REBOA) can be a life-saving procedure for patients with non-compressible torso hemorrhage. We aimed to evaluate the potential eligibility for REBOA in trauma patients of a civilian helicopter emergency medical service (HEMS) using a stepwise approach. A retrospective analysis using the electronic database (HEMSDER) of "DRF Luftrettung" HEMS covering the period from January 2015 to June 2021 was performed. Trauma patients aged ≥ 16 years and with a National Advisory Committee for Aeronautics (NACA) score of ≥ 4 were assessed for potential REBOA eligibility using two different decision trees based on assumed severe bleeding due to injuries of the abdomen, pelvis, and/or lower extremities and different vital signs on the scene and at hospital handover. Non-parametric statistical methods were used for comparison. A total of 22.426 patients met the inclusion criteria for data analysis. Of these, 0.15-2.24% were possible candidates for pre-hospital REBOA. No significant differences between groups on scene and at hospital handover regarding demographics, assumed injuries, and pre-hospital interventions were found. In the on-scene group, 21.1% of the patients remained unstable even at hospital handover despite pre-hospital care. In the handover group, 42.8% of the patients seemed initially stable but then deteriorated during the pre-hospital course. The number of potential pre-hospital REBOA in severely injured patients with a NACA score of ≥ 4 is < 3% or can be even < 1% if more strict criteria are used. There are some patients who may benefit from pre-hospital REBOA as a life-saving procedure. Further research on earlier diagnosis of life-threatening bleeding and proper indications of REBOA in trauma patients is needed.

The inflammatory immune system after wake up in healthy male individuals: A highly standardized and controlled study.

This study investigates the effects of two light conditions on innate proinflammatory IL-6 cytokines and the cortisol awakening response. The between-subject experiment was conducted with 55 healthy adult-males (aged M bright = 24.40, SD = 4.58; M dim = 25.47, SD = 4.96) in a standardized sleep laboratory setting with 60-min light exposure post-awakening. Cortisol significantly increased with bright light exposure as compared to dim light (significant interaction effect). As for IL-6, the main effects of time and light condition were significant, however, the interaction effect between light and time was insignificant. Results replicate stimulatory effects of bright light on cortisol. In general, IL-6 concentrations decreased in both light conditions; however, bright light graphically showed higher concentrations 45-90 min after exposure in comparison to dim light, thus bright light has a potential stimulatory effect on IL-6 production.

Quality of Life Domains in Breast Cancer Survivors: The Relationship Between Importance and Satisfaction Ratings.

Objectives: Quality of life (QoL) has been the focus of increasing interest in oncology. QoL assessment instruments implicitly assume that each QoL domain has the same meaning for each patient. The objective of this study was to analyze the importance of and the satisfaction with QoL domains and to analyze the relationship between the two. Methods: A sample of 308 breast cancer survivors was examined twice with a three-month time interval. The women completed the two QoL questionnaires Questions of Life Satisfaction (FLZ-M), which measures participants' satisfaction with eight QoL domains and the subjective importance of those domains to them, and the EORTC QLQ-C30. A sample of 1,143 women from the general population served as controls. Results: Compared with the general population sample, the patients were less satisfied with their health and more satisfied with all other QoL domains. The subjective importance of health was lower in the patients' sample (Effect size: d = 0.38). Satisfaction with health and importance of health were slightly positively correlated (r between 0.05 and 0.08). The effect of QoL domain importance on general QoL was small (beta between -0.05 and 0.11), and interaction effects between domain importance and satisfaction on the prediction of global QoL were negligible. Conclusion: In addition to satisfaction with QoL dimensions, the subjective importance of these dimensions is relevant for psychooncological research and treatment. Health is not the only relevant QoL domain in breast cancer survivors, other domains such as finances also deserve health care providers' attention.

Supplementary data for the mediation effect of personality functioning - Gender differences, separate analyses of depression and anxiety symptoms and inferential statistics of the relationship between personality functioning and different types of child maltreatment.

This article provides supplementary data for the original research article 'The Mediation Effect of Personality Functioning Between Different Types of Child Maltreatment and the Development of Depression/Anxiety Symptoms - a German Representative Study' [1]. The representative data were acquired as part of a broader survey on different aspects of mental health in the German population. This supplementary data article contains the statistical analyses of the relationship between the different subtypes of child maltreatment (CM) and impairments of personality functioning, which were only presented as a diagram in the original article. Additionally, the analyses conducted separately for symptoms of depression and anxiety as well as gender are provided. For the mediation analyses, the variables of depression/anxiety symptoms, personality functioning and CM types were standardized. The data may be useful for discussion, further insights and as a starting point for the development of further studies.

Evaluating the psychometric properties of the German adaptation of the client attachment to therapist scale.

BACKGROUND: The present study examines the psychometric properties of the German adaptation of the Client Attachment to Therapist Scale (CATS). The validity of the scale as originally proposed has recently been brought into question, as patients were identified as "pseudosecure". METHODS: We examined the measure's factorial structure, as well as reliability and validity towards related measures using a clinical sample of N = 354 participants. RESULTS: We found the original model, consisting of 36 items to be lacking in terms of model fit and construct validity. A shortened 12-item version exhibited markedly improved model fit and reliability. Correlations to related constructs demonstrated that none of the scale's validity was lost by shortening it. Furthermore, we showed scalar invariance across groups of age and sex. CONCLUSIONS: The shortened CATS-S can be recommended for future use in clinical research in German-speaking populations as a valid, reliable, and economical alternative to the longer version.

Measuring physical, cognitive, and emotional aspects of exhaustion with the BOSS II-short version - results from a representative population-based study in Germany.

BACKGROUND: The aim of the present study was the construction and psychometric evaluation of a shortened version of the Burnout Screening Scales II (BOSS II), a measure for exhaustion and burnout. METHODS: To this end, among a representative sample of the German general population (N = 2429, 52.9% women), we shortened the scale from 30 to 15 items applying ant-colony-optimization, and calculated item statistics of the short version (BOSS II-short). To estimate its reliability, we used McDonald's Omega (ω). To demonstrate validity, we compared the correlation between the BOSS II-short and the BOSS II, as well as their associations with depression, anxiety, and quality of life. Furthermore, we evaluated model fit and measurement invariance across respondent age and gender in confirmatory factor analyses (CFA). Finally, we present adapted norm values. RESULTS: The CFA showed an excellent model fit (χ2 = 223.037, df = 87, p < .001; CFI = .975; TLI = .970; RMSEA [90%CI] = .036 [.031;.040]) of the BOSS II-short, and good to very good reliability of the three subscales: 'physical' (ω = .76), 'cognitive' (ω = .89), and 'emotional' (ω = .88) symptoms. There was strict measurement invariance for male and female participants and partial strict invariance across age groups. Each subscale was negatively related to quality of life ('physical': r = -.62; 'cognitive': r = -.50; 'emotional': r = -.50), and positively associated with depression ('physical': r = .57; 'cognitive': r = .67; 'emotional': r = .73) and anxiety ('physical': r = .50; 'cognitive': r = .63; 'emotional': r = .71). CONCLUSIONS: Overall, the BOSS II-short proved to be a valid and reliable instrument in the German general population allowing a brief assessment of different symptoms of exhaustion. Norm values can be used for early detection of exhaustion.

Psychometric properties and validation of the English version Giessen Subjective Complaints List (GBB-8).

BACKGROUND: The present study investigated the psychometric properties of the newly developed English version of the Giessen Subjective Complaint List-8 (GBB-8), a questionnaire assessing psychosomatic symptoms with regard to exhaustion, gastrointestinal, musculoskeletal and cardiovascular. METHODS: A U.S. sample of 638 participants (47.6% female) was recruited by MTurk to participate in this cross-sectional online survey. Validation instruments included the Patient Health Questionnaire-4, Perceived Stress Scale, short version of the Trier Inventory for Chronic Stress. RESULTS: Reliability was high with ω's between .80 and .86 for all subscales. Confirmatory factor analyses yielded comparable good model fit for a four-dimensional model as well as a higher order model. Multi-group confirmatory factor analyses confirmed measurement invariance of the GBB-8 across sex and age. Regarding convergent validity, correlations with other instruments were highly significant and of large magnitude as expected. CONCLUSION: The English version of the GBB-8 has shown excellent psychometric properties. Therefore, it can be recommended for the assessment of psychosomatic complaints in contexts where short screening instruments are necessary.

[A Short Version of the Body Experience Questionnaire (FBeK): Results of Clinical and Non-Clinical Samples]. / Eine Kurzversion des Fragebogens zur Beurteilung des eigenen Körpers (FBeK): Ergebnisse aus klinischen und bevölkerungsrepräsentativen Stichproben.

OBJECTIVES: The aim of this study was the development and evaluation of a short (9-item) version of the body experience questionnaire (FBeK-9). METHOD: Based upon a representative survey from 1996, a 15-item version of the FBeK was constructed which was then evaluated in another representative sample (n=2510) as well as three clinical groups, namely patients with depressive disorders (n=106), patients with eating disorders (N=107), and patients suffering from pain (N=90). Depressive and anxiety symptoms and pain disability (PHQ-9, PHQ-4, PDI) were also assessed. Item selection and the determination of the factor structure were performed using exploratory and confirmatory factor analysis and led to the development of the FBeK-9. The final three subscales were tested for invariance related to sex, age and disorder. In addition, convergent validity was assessed and norms were provided. RESULTS: Models of confirmatory factor analyses revealed acceptable fit indices ((CFI) =0.982,(ω ) =0.020) in all samples. The subscales "uncertainty/impaired sensation","attractiveness/self-confidence" and "accentuation of the body/sensitivity" indicated acceptable reliability (ω=0.707) and correlated with depressive and anxiety symptoms and pain in an expected manner. We also could show differences between the normative sample and the clinical groups. Measurement invariance was shown for age and sex. CONCLUSIONS: It can be concluded that the 9-item version of the body experience questionnaire also provides a reliable, valid and economically efficient measure that can be used in studies of body experience in non-clinical and clinical samples. In the future, more validity studies should be performed.

The mediation effect of personality functioning between different types of child maltreatment and the development of depression/anxiety symptoms - A German representative study.

BACKGROUND: Child maltreatment (CM) is associated with an increased risk to develop symptoms of depression/anxiety across an individual's lifespan. Recent studies indicated that impairments in personality functioning might mediate this association. The purpose of this study is to add evidence of this mediating effect by regarding different types of CM (emotional, physical and sexual abuse as well as emotional and physical neglect) in the general population. METHODS: A representative sample of the German population (N = 2,354) completed a set of standardized measures (OPD-SQS: Operationalized Psychodynamic Diagnosis - Structure Questionnaire Short, PHQ-4: Patient Health Questionnaire, CTQ: Childhood Trauma Questionnaire). Mediation analyses were carried out to examine the association between CM types, symptoms of depression/anxiety, and personality functioning. RESULTS: Up to two-thirds of the associations between CM types and symptoms of depression/anxiety are mediated by personality functioning [indirect effect: emotional abuse (ß = 0.219, 95%-CI: 0.187-0.251, p < .001), physical abuse (ß = 0.151, 95%-CI: 0.123-0.178, p < .001), sexual abuse (ß = 0.163, 95%-CI: 0.138-0.188, p < .001), emotional neglect (ß = 0.131, 95%-CI: 0.104-0.159, p < .001) and physical neglect (ß = 0.102, 95%-CI: 0.078-0.127, p < .001)]. LIMITATIONS: Symptoms of depression/anxiety were measured with screening instruments and results are based on cross-sectional data. CONCLUSIONS: The present investigation expands the evidence on the mediating effect of personality functioning in the association between CM and depression/anxiety symptoms based on data of the general population. Our results show the relevance of types, as the mediating effects are slightly stronger in CM abuse types than in CM neglect types. Knowledge about impaired personality might be an angle for clinical interventions and inspire future research.

Psychological and Socio-Economical Determinants of Health: The Case of Inner German Migration.

A substantial body of research has shown worse health conditions for East- vs. West-Germany in the wake of reunification. In the present study, we investigate how these differences between the two formerly divided regions developed and what maintains them. Specifically, we consider the associations between health status, income satisfaction, and health-related locus of control. In a quasi-experimental and longitudinal study design, we are particularly interested in the differences between individuals who stayed in East-Germany and those who were born in the East but migrated to West-Germany. To this end, we examined data from seven waves of the Saxony Longitudinal Study (2003-2009). Specifically, we tested a cross-lagged panel model with random effects, which evinced very good model fit. Most parameters and processes were equivalent between individuals who stayed in East-Germany vs. moved to West-Germany. Crucially, there was the expected pattern of positive correlations between health, income, and locus of control. In addition, we found substantially lower values for all three of these variables for the individuals who stayed in East-Germany (vs. moved to West-Germany). A possible explanation is the increase in socio-economic status that the internal migrants experienced. These findings present an important contribution of research in order to foster a better understanding on the social dynamics in Germany related to internal/domestic migrants and implications in the context of health outcomes (e.g., significantly more unemployment in East vs. West-Germany), especially since almost 20-25% of East-German citizens migrated to West-Germany. Until now, there are no similar studies to the Saxony longitudinal project, since the data collection started in 1987 and almost every year an identical panel has been surveyed; which can be particularly useful for health authorities. The study mainly focuses on social science research and deals with the phenomenon of reunification, approaching several subjects such as mental and physical health, quality of life and the evaluation of the political system. Yet even though many people have experienced such a migration process, there has been little research on the subjects we approach. With our research we deepen the understanding of the health consequences of internal migration.

Revised Short Screening Version of the Profile of Mood States (POMS) From the German General Population.

The present study was conducted with the aim of constructing and validating a short form of the Profile of Mood States (POMS). The POMS is a widely-applied measure for the assessment of an individual's mood. Thus, it is of great relevance for many research questions in clinical and social psychology. To develop the short scale, we first examined psychometric properties and found the optimal 16-item solution among all valid combinations of the full POMS in an exploratory subsample (n = 1,029) of our complete representative sample of the German general population. We then validated this model in a confirmatory subsample (n = 977). Additionally, we examined its invariance across age groups and sex, as well as its reliability. Our results indicate that the POMS-16 is a valid and reliable measure of mood states with minimal losses compared to the 35-item version. Particularly where brevity and an economical assessment is desired, the POMS-16 should be considered.

Fibromyalgia revisited: do latent class analyses of symptom profiles in the general population confirm 2016 fibromyalgia diagnostic criteria?

OBJECTIVES: The definition of the 2016 diagnostic criteria of fibromyalgia (FM) syndrome and of FM severities was based on studies with clinical samples. We tested if somatic symptom profiles consistent with the symptom pattern of the FM 2016 diagnostic criteria and of severities of FM can be found in the general population. METHODS: Somatic symptom burden was measured by the Somatic Symptom Scale - 8 in 2,531 persons aged ≥14 years representative for the general German population. We used latent class analysis of SSS-8 items to identify somatic symptom profiles. The profiles were described by their association with age, gender, self-reported disabling somatic disease, psychological symptom burden, illness worries and self-perceived health. RESULTS: We identified five somatic symptom profiles. The majority of the population (40.9%) had a profile characterised by the absence of bothering symptoms. 5.9% had a profile defined by "considerable bothering" back and extremities pains, fatigue and sleep problems. This symptom profile was associated with older age, self-reported somatic diseases, psychological symptom burden and fair to poor general health. 63.2% of persons meeting FM 2016 criteria belonged to this profile. 17.8% of the sample were characterized by little perturbation by multiple somatic symptoms and good to fair general health. 36.8% of persons meeting FM 2016 criteria belonged to this profile. CONCLUSIONS: Two somatic symptom profiles consistent with the 2016 FM diagnostic criteria were identified in the general German population. These symptom profiles differed in somatic and psychological symptom burden and general health supporting the distinction of FM severities.