Assessing perceptions of stigmatization by others for seeking help in China: psychometric characteristics and measurement invariance across gender and therapy experience.

The stigma of social networks may be more noticeable in collectivist societies like China, but research in this area has largely been overlooked due to a lack of reliable measurement. To address this gap, this study tested the psychometric properties of the Chinese version of the Perceptions of Stigmatization by Others for Seeking Help (PSOSH) scale in the Chinese general population, and tested its invariance across gender and prior therapy experience. In a national online survey, 640 adults completed the PSOSH and conceptually related scales: Self-stigma of Seeking Help (SSOSH), Stigma of Seeking Professional Psychological Help Scale (SSPPH, i.e., public stigma) and Attitudes toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF). Confirmatory factor analysis supported the unidimensional structure of the original PSOSH. The Cronbach's α coefficient was 0.84 and the 3-week test-retest reliability of was 0.77. The PSOSH showed moderate correlations with the three conceptually related scales, supporting its concurrent validity. Importantly, the PSOSH significantly predicted self-stigma scores, even when considering demographic variables and public stigma, supporting its incremental validity. The scale also demonstrated scalar invariance across gender and across subgroups who had vs. did not have previous therapy experience, supporting comparisons of latent means across these groups. The PSOSH is a reliable and valid instrument for assessing social network stigmatization of professional help-seeking in Chinese community samples.

Culture matters: Chinese mental health professionals' fear of losing face in routine outcome monitoring.

OBJECTIVE: The culturally salient fear of losing face might influence Chinese therapists' attitudes toward and use of routine outcome monitoring (ROM). We tested a model wherein self-face concern is associated with ROM use by way of attitudes toward ROM, and whether this process is weakened when therapists report high counseling self-efficacy and perspective-taking. METHOD: A national sample of Chinese mental health professionals (N = 371) completed questionnaires on their fear of losing face, attitudes toward ROM, ROM use, counseling self-efficacy, and perspective-taking. RESULTS: Regression-based analyses showed that fear of losing face was linked to greater negative attitudes toward ROM and lower ROM use. Greater negative attitudes mediated the relationship between fear of losing face and ROM use. However, neither counseling self-efficacy nor perspective-taking mitigated the relationship between self-face concern and ROM use; instead, they exacerbated this relationship through different paths. In the mediated pathway, counseling self-efficacy in coping with clients with difficult problems interacted with self-face concern to predict negative attitudes toward ROM. Perspective-taking served as a moderator that exacerbated the direct relationship between self-face concern and ROM use. CONCLUSIONS: Findings suggest the importance of considering culturally salient factors in implementing ROM in China and other non-Western contexts.

The Cooper-Norcross Inventory of Preferences: Measurement invariance across & international datasets and languages.

OBJECTIVE: The Cooper-Norcross Inventory of Preferences (C-NIP) is a brief, multidimensional measure of clients' therapy preferences. This study aimed to examine the factor structure and measurement invariance of the C-NIP. METHOD: Fifteen datasets (N = 10,088 observations) representing the C-NIP in nine language versions were obtained from authors of psychometric studies. Confirmatory factor analysis and exploratory structural equation modeling were used to analyze the data. RESULTS: None of the proposed models adequately fit the data. Therefore, a new model was developed that sufficiently fit most of the C-NIP version 1.1 datasets. The new model was invariant up to the strict and means levels across genders, ages, and psychotherapy experience but only up to the metric level across translations. CONCLUSIONS: The C-NIP can be used to compare men and women, people of diverse ages, and people with some vs. no experience with psychotherapy. Lower reliabilities of the C-NIP scales are a limitation.

Extended validation of the Relational Depth Frequency Scale: Retest reliability, divergent validity, criterion validity with psychotherapy satisfaction, and measurement invariance in UK- and US-stratified samples.

BACKGROUND: The Relational Depth Frequency Scale (RDFS) assesses moments of profound connection in psychotherapy, associated with therapeutic benefit. To date, the RDFS has not been tested for its retest reliability, divergent and criterion validity, and measurement invariance, nor has it been tested in stratified samples of psychotherapy patients. METHODS: Two stratified online samples of United Kingdom (n = 514) and United States (n = 402) psychotherapy patients filled out the RDFS, the Brief Social Desirability Scale (BSDS); and the Satisfaction with Therapy and Therapist Scale-revised (STTS-R). Two subsamples of patients (United Kingdom: n = 50 and United States: n = 203) filled out the RDFS again after 1 month. RESULTS: Reliability for the six-item RDFS were excellent in United Kingdom and United States samples (Cronbach's α = 0.91 and 0.92; retest r = 0.73 and r = 0.76). Divergent (r = 0.10 and r = 0.12) and criterion validity (r = 0.69; and r = 0.70) were good. Full scalar invariance was established across countries, genders, and time. CONCLUSION: This contributes important evidence to the validity of the RDFS. Future research should assess predictive validity against psychotherapy outcomes and replicate these analyses in diverse samples.

Validation of the Cooper-Norcross Inventory of Preferences (C-NIP) in Chinese lay clients and mental health professionals: Factor structure, measurement invariance, and scale differences.

The Cooper-Norcross Inventory of Preferences (C-NIP) is one of the most widely used measures of psychotherapy preferences. However, its psychometric properties have not been examined in non-Western samples. Research on disparities between the preferences of mental health professionals and their clients is also limited. We evaluated the C-NIP's psychometric properties and measurement invariance in Chinese lay clients and mental health professionals and evaluated the latent mean differences between clients' and professionals' scores on the C-NIP's four scales (preference for therapist vs. client directiveness, emotional intensity vs. emotional reserve, past vs. present orientation, and warm support vs. focused challenge). This cross-sectional investigation involved 301 lay clients and 856 mental health professionals who completed the Chinese version of the C-NIP. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to examine the factor structure of the C-NIP. ESEM provided stronger evidence than CFA for the four-factor model in both samples. The four scales had adequate internal consistency in both the lay clients (αs = .68-.89) and the mental health professionals (αs = .70-.80). Partial scalar invariance was established across these two populations. Chinese mental health professionals preferred less therapist directiveness, past orientation, and warm support-but more emotional intensity-than Chinese lay clients (ds = 0.25-0.90). Culture-specific cutoff values (norms) to identify strong therapy preferences were established. This study supports the application of the C-NIP to non-Western populations and suggests that discrepancies between the preferences of lay clients and mental health professionals are a cross-cultural phenomenon. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How Work-Nonwork Conflict Affects Remote Workers' General Health in China: A Self-Regulation Theory Perspective.

Difficulty in balancing the demands of work and nonwork has been shown to be associated with lower physical and psychological health. Grounded on the self-regulation theory, we examined the effect of work-nonwork conflict on general health among employees who transitioned to remote work (remote workers), and we tested whether this association was mediated by impaired self-control capacity. The study further examined the perceived boundary control as a moderator of these associations. We collected two waves of questionnaire data with a one-month interval from 461 remote workers, and the results of regression-based analyses revealed that work-nonwork conflict was negatively related to remote workers' general health through increased self-control capacity impairment. In addition, this indirect effect was weaker for remote workers with higher perceived boundary control than those with lower perceived boundary control. These findings expand our understanding of remote workers' work-nonwork conflict and have practical implications for promoting the general health of remote workers who are experiencing work-nonwork conflict.

Psychometric Evaluation of the Cooper-Norcross Inventory of Preferences-Therapist Version.

The Cooper-Norcross Inventory of Preferences (C-NIP) is a commonly used and psychometrically validated measure of client preferences in therapy. However, the C-NIP version for therapists (C-NIP-T) has not yet been validated. This study aimed to develop a Chinese version of the C-NIP-T and test its factor structure, reliability, and concurrent validity. A national sample of 1,054 Chinese mental health professionals completed the C-NIP-T and provided relevant demographic information. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to examine the factor structure of the C-NIP-T. ESEM provided stronger evidence than CFA for the hypothesized four-factor model. Internal consistency coefficients (Cronbach's α) of the four subscales ranged between .60 and .76. Full or partial scalar invariance was established across therapists' therapeutic orientations, gender, personal therapy, and clinical experience. There were significant differences in subscale scores among therapists who identified as cognitive/cognitive-behavioral, psychoanalytic/psychodynamic, and humanistic/client-centered, supporting the concurrent validity of the C-NIP-T. The C-NIP-T is a psychometrically sound measure that can be used to assess therapists' preferences about therapy.

Correction: Effect of the "Art Coloring" Online Coloring Game on Subjective Well-Being Increase and Anxiety Reduction During the COVID-19 Pandemic: Development and Evaluation.

[This corrects the article DOI: 10.2196/37026.].

Grief and growth among Chinese parents who lost their only child: the role of positive and negative experiences of social support from different sources.

Background: In China, bereaved parents who have lost their only child are known as Shidu parents, and they tend to present high levels of prolonged grief reactions. To date, a widespread focus has been placed on positive social support, while potential negative experiences have been relatively neglected. Additionally, the role of social support from different sources (i.e. close family members [partner, siblings, grandchildren], peers, and others [relatives, friends, colleagues]) has not been examined thoroughly. Objective: The present study investigated whether social support from different sources has a differential impact on postloss adaptation (i.e. prolonged grief and growth). The loss-orientated and restoration-orientated coping strategies of the dual process model were also tested for their mediating roles. Methods: A total of 277 Chinese Shidu parents were recruited to complete a series of questionnaires including social support from different sources, prolonged grief symptoms, posttraumatic growth, and dual process coping strategies. Correlation analyses, paired sample t tests and structural equation modelling were conducted. Results: More positive support were related to less prolonged grief symptoms and more posttraumatic growth, while more negative support was only related to more prolonged grief. Positive support from close family members and others was significantly related to prolonged grief/growth, and negative support from these sources was significantly positively associated with prolonged grief. Positive or negative support from people who shared a similar experience was unrelated to prolonged grief/growth. Positive and negative support were related to prolonged grief and growth through loss-oriented coping strategies. Conclusion: Overall, the present study indicated that positive and negative support experiences from different sources functioned differently in the recovery of Chinese Shidu parents and that loss-oriented coping played a mediating role. These findings highlight the importance of differentiating social support by traits in coping with grief and the crucial mediating role of loss-oriented coping. HIGHLIGHTS: More positive support correlated with less prolonged grief and more growth, while more negative support correlated with more prolonged grief.Support from family members and friends was more potent than that from peers.Social Support correlated with prolonged grief/growth through loss-oriented coping.

Antecedentes: En China, los padres en duelo que han perdido a su único hijo se conocen como padres Shidu y tienden a presentar altos niveles de reacciones de duelo prolongado. Hasta la fecha, se ha puesto general atención en el apoyo social positivo, mientras que las posibles experiencias negativas se han descuidado relativamente. Además, el papel del apoyo social de diferentes tipos (es decir, familiares cercanos [pareja, hermanos, nietos], compañeros y otros [parientes, amigos, colegas]) no se ha examinado a fondo.Objetivo: El presente estudio investigó si el apoyo social de diferentes tipos tiene un impacto diferencial en la adaptación posterior a la pérdida (es decir, duelo prolongado y crecimiento). Las estrategias de afrontamiento orientadas a la pérdida y orientadas a la restauración del modelo de proceso dual también fueron probadas por sus roles de mediación.Métodos: Un total de 277 padres chinos Shidu fueron reclutados para completar una serie de cuestionarios que incluían apoyo social de diferentes tipos, síntomas de duelo prolongado, crecimiento postraumático y estrategias de afrontamiento de procesos duales. Se realizaron análisis de correlación, pruebas t de muestras pareadas y modelos de ecuaciones estructurales.Resultados: Más apoyo positivo se relacionó con síntomas de duelo menos prolongados y mayor crecimiento postraumático, mientras que un apoyo mas negativo solo se relacionó con duelo más prolongado. El apoyo positivo de familiares cercanos y otras personas se relacionó significativamente con el duelo/crecimiento prolongado, y el apoyo negativo de estos tipos se asoció significativamente de manera positiva con el duelo prolongado. El apoyo positivo o negativo de personas que compartieron una experiencia similar no estuvo relacionado con el duelo/crecimiento prolongado. El apoyo positivo y negativo se relacionó con el duelo prolongado y el crecimiento a través de estrategias de afrontamiento orientadas a la pérdida.Conclusión: En general, el presente estudio indicó que las experiencias de apoyo positivas y negativas de diferentes tipos funcionaron de manera diferente en la recuperación de los padres chinos Shidu y que el afrontamiento orientado a la pérdida desempeñó un papel mediador. Estos hallazgos resaltan la importancia de diferenciar el apoyo social por rasgos para afrontar el duelo y el papel mediador crucial del afrontamiento orientado a la pérdida.

Effect of the "Art Coloring" Online Coloring Game on Subjective Well-Being Increase and Anxiety Reduction During the COVID-19 Pandemic: Development and Evaluation.

BACKGROUND: COVID-19 has spread worldwide and generated tremendous stress on human beings. Unfortunately, it is often hard for distressed individuals to access mental health services under conditions of restricted movement or even lockdown. OBJECTIVE: The study first aims to develop an online digital intervention package based on a commercially released coloring game. The second aim is to test the effectiveness of difference intervention packages for players to increase subjective well-being (SWB) and reduce anxiety during the pandemic. METHODS: An evidence-based coloring intervention package was developed and uploaded to an online coloring game covering almost 1.5 million players worldwide in January 2021. Players worldwide participated to color either 4 rounds of images characterized by awe, pink, nature, and blue or 4 rounds of irrelevant images. Participants' SWB and anxiety and the perceived effectiveness of the game in reducing anxiety (subjective effectiveness [SE]) were assessed 1 week before the intervention (T1), after the participants completed pictures in each round (T2-T5), and after the intervention (T6). Independent 2-tailed t tests were conducted to examine the general intervention (GI) effect and the intervention effect of each round. Univariate analysis was used to examine whether these outcome variables were influenced by the number of rounds completed. RESULTS: In total, 1390 players worldwide responded and completed at least 1 assessment. Overall, the GI group showed a statistical significantly greater increase in SWB than the general control (GC) group (N=164, t162=3.59, Cohen d=0.59, 95% CI 0.36-1.24, P<.001). Compared to the control group, the best effectiveness of the intervention group was seen in the awe round, in which the increase in SWB was significant (N=171, t169=2.51, Cohen d=0.39, 95% CI 0.10-0.82, P=.01), and players who colored all 4 pictures had nearly significant improvements in SWB (N=171, F4,170=2.34, partial ŋ2=0.053, P=.06) and a significant decrease in anxiety (N=171, F4,170=3.39, partial ŋ2=0.075, P=.01). CONCLUSIONS: These data indicate the effectiveness of online psychological interventions, such as coloring games, for mental health in the specific period. They also show the feasibility of applying existing commercial games embedded with scientific psychological interventions that can fill the gap in mental crises and services for a wider group of people during the pandemic. The results would inspire innovations to prevent the psychological problems caused by public emergencies and encourage more games, especially the most popular ones, to take more positive action for the common crises of humankind.

Job crafting and employee life satisfaction: A resource-gain-development perspective.

Job crafting has been shown to be associated with multiple positive work-related outcomes. However, whether and how it affects nonwork-related outcomes has been less examined. Grounded on the resource-gain-development perspective and conservation of resources theory, the present study investigated the effects of job crafting on employee life satisfaction via work-nonwork facilitation and work-nonwork conflict. Further, the present study examined the moderating roles of workload on these relationships. We collected two waves of data with a 1-month lag from 481 fulltime Chinese employees. The results of regression analyses revealed that job crafting was positively related to employee life satisfaction through higher work-nonwork facilitation and lower work-nonwork conflict. In addition, these indirect effects were stronger for employees with higher workload than those with lower workload. The results extend job crafting research by examining the effects of job crafting on employee life satisfaction and have clear applied value for employers who have high workload.

Does COVID-19 threat increase xenophobia? The roles of protection efficacy and support seeking.

BACKGROUND: In response to the COVID-19 pandemic, people in many countries have shown xenophobia toward China, where the pandemic began. Within China, xenophobia has also been observed toward the people of Wuhan, the city where the first cases were identified. The relationship between disease threat and xenophobia is well established, but the reasons for this relationship are unclear. This study investigated the mediation role of perceived protection efficacy and moderation role of support seeking in the relationship between perceived COVID-19 risk and xenophobia within China. METHODS: An online survey was administered to a nationally representative sample (N = 1103; 51.7% women; ages 18 to 88) of Chinese adults during the early stage of the COVID-19 pandemic. Participants completed questionnaires about their perceived COVID-19 risk, perceived protection efficacy in reducing risk, support seeking, and xenophobic attitudes toward people of the Wuhan area. RESULTS: Regression based analyses showed that the perceived COVID-19 risk positively predicted xenophobia. Low perceived protection efficacy partly mediated the relationship between perceived COVID-19 risk and xenophobic attitudes, and this indirect effect was moderated by support seeking. Specifically, the indirect effect was weaker among individuals who sought more social support. CONCLUSIONS: Under disease threat, xenophobia can appear within a country that otherwise seems culturally homogeneous. This study extends the extant research by identifying a possible psychological mechanism by which individuals' perception of disease threat elicits xenophobia, and by addressing the question of why this response is stronger among some people than others. Increasing the public's perceived efficacy in protecting themselves from infection, and encouraging support seeking, could reduce xenophobic attitudes.

Job crafting promotes internal recovery state, especially in jobs that demand self-control: a daily diary design.

BACKGROUND: Research on how employees recover from work has focused primarily on recovery during non-work hours (external recovery) rather than recovery during work hours (internal recovery). Using the conservation of resources theory as a conceptual framework, we tested whether job crafting promotes an internal recovery state, and examined the processes that explain this association. METHODS: Using the daily diary method, 120 full-time employees provided information before and after work for 5 days by rating job crafting, ego depletion, self-control demands at work, fatigue and vigor. RESULTS: The results of multilevel modeling showed that after controlling for employees' fatigue and vigor before work, daily job crafting predicted significantly better internal recovery (greater vigor and lower fatigue at the end of workday), and this association was mediated by lower ego depletion. The links between job crafting and internal recovery were stronger for employees with high self-control demands at work. CONCLUSIONS: This study extends recovery research by examining internal recovery as well as job crafting as its antecedent. Further, the present study suggests that managers may consider encouraging and offering job crafting interventions for employees to achieve internal recovery state.

Three Versions of the Perceived Stress Scale: Psychometric Evaluation in a Nationally Representative Sample of Chinese Adults during the COVID-19 Pandemic.

(1) Background: The COVID-19 outbreak has created pressure in people's daily lives, further threatening public health. Thus, it is important to assess people's perception of stress during COVID-19 for both research and practical purposes. The Perceived Stress Scale (PSS) is one of the most widely used instruments to measure perceived stress; however, previous validation studies focused on specific populations, possibly limiting the generalization of results. (2) Methods: This study tested the psychometric properties of three versions of the Chinese Perceived Stress Scale (CPSS-14, CPSS-10, and CPSS-4) in the Chinese general population during the COVID-19 pandemic. A commercial online survey was employed to construct a nationally representative sample of 1133 adults in Mainland China (548 males and 585 females) during a one-week period. (3) Results: The two-factor (positivity and negativity) solution for the three versions of the CPSS showed a good fit with the data. The CPSS-14 and CPSS-10 had very good reliability and the CPSS-4 showed acceptable reliability, supporting the concurrent validity of the CPSS. (4) Conclusions: All three versions of the CPSS appear to be appropriate for use in research with samples of adults in the Chinese general population under the COVID-19 crisis. The CPSS-10 and CPSS-14 both have strong psychometric properties, but the CPSS-10 would have more utility because it is shorter than the CPSS-14. However, the CPSS-4 is an acceptable alternative when administration time is limited.

Alliance-outcome relation and progress feedback: Secondary data analyses of a randomized clinical trial study in China.

Objective: This study examined the alliance-outcome relation and the possible moderation effect of receiving progress feedback on a sample of Chinese clients. Method: One hundred and fifty-nine clients recruited from a university counseling center in central China filled out the Session Rating Scale (SRS) and the Outcome Rating Scale (ORS) each session. Participants were randomly assigned to either the progress feedback group or non-feedback group. Therapists working with clients in the feedback group received their clients' SRS and ORS scores weekly and were asked to plot their scores in a chart. The alliance-outcome and moderator effects were tested with disaggregated cross-lagged panel modeling of SRS and ORS. Results: The findings indicated a strong reciprocal relation between SRS and ORS, but the moderator effect due to feedback was not supported. Conclusion: Results affirm the cross-cultural stability of the session-by-session reciprocal effects of the alliance-outcome model in a Chinese sample. The issue of whether feedback moderates the within-person alliance-outcome relationship needs to be studied further.

Client feedback in China: A randomized clinical trial in a college counseling center.

Although client feedback has been demonstrated to improve psychotherapy outcomes in over a dozen randomized clinical trials, no studies to date have investigated the feedback effect outside of the United States or Europe. This study examined the impact of a client feedback intervention, the Partners for Change Outcome Management System, in a college counseling center in Wuhan, China (N = 186). Using a randomized design within routine care, treatment as usual (TAU; n = 85) was compared with a feedback condition (n = 101) in which therapists had access to client-generated outcome and alliance information at each session. Clients in the feedback condition demonstrated significantly greater improvement than those in the TAU condition at posttreatment. Not-on-track (n = 60) clients also demonstrated significantly more improvement at 6 times the rate of reliable change compared with the TAU condition. Survival analysis revealed that 66.7% of the clients in the feedback condition achieved reliable and clinically significant change after a median of 4 sessions whereas 57.0% of the clients in the TAU condition achieved reliable and clinically significant change after a median of 6 sessions. Alliance scores improved significantly more across treatment and were higher at posttreatment in the feedback condition. Although preliminary, this study suggests that the positive effects of improved outcomes and increased efficiency associated with systematic client feedback can also occur in a college counseling setting in China. (PsycINFO Database Record (c) 2018 APA, all rights reserved).