Beyond Difference Scores: Unlocking Insights with Polynomial Regression in Studies on the Effects of Implicit-Explicit Congruency.

The aim of our study was to investigate whether theories of congruence are better tested using polynomial regression analysis, rather than expressing discrepancy between implicit and explicit measures as continuous or categorical difference scores. This paper also aims to make knowledge more accessible by providing a step-by-step explanation of both methods, illustrating differences between them, and making materials openly available for other researchers. In this paper, implicit and explicit measures of self-esteem are used as predictors for depressive symptoms, anxiety, and aggression in a general population sample (N = 135). Explicit self-esteem was measured using the Rosenberg Self-Esteem Scale, implicit self-esteem was measured using the Implicit Association Test, and the Symptom Questionnaire was used to measure depressive symptoms, anxiety, and aggression. The results show those difference score models all imply that the discrepancy between implicit and explicit self-esteem explains depression and anxiety, but not aggression. However, polynomial regression analysis shows that depression and anxiety are not accounted for by the explicit-implicit discrepancy as such, but are foremost explained by explicit self-esteem. Polynomial regression has the potential to evaluate more complex and more detailed hypotheses than what would be possible using statistical approaches based on discrepancy scores. It is therefore recommended for future research aimed at disentangling the roles of explicit and implicit self-esteem in psychological outcomes.

Automatic Associations between Sexual Function Problems and Pursuing Help in Pelvic Physical Therapy Practice: The Psychometric Investigation of an Implicit Association Test.

Not all women experiencing pelvic floor complaints and sexual function problems seek help in pelvic physical therapy practice. Decisions to seek help can result from explicit and implicit cognitive processes. Having found some explicit predictive factors for receiving help in this setting, this study examines possible complementary implicit associations between sexual function problems and pursuing help that might also be predictive. The Pursuing Help for Sexual Problems Implicit Association Test (PHSP-IAT) was specially developed for this purpose. The instrument's reliability and validity were evaluated. High reliability was found (Spearman's Rho = .95). Convergent and divergent validity analyses resulted in low and non-significant correlations between the PHSP-IAT and the chosen self-report measures. The PHSP-IAT was predictive for receiving help in pelvic physical therapy practice. Further research is necessary to determine the PHSP-IAT's validity and its predictive value in other healthcare settings.

Sexual functioning is not, but psychological burden is predictive for receiving help in pelvic physical therapy practice: A cross-sectional study.

Background: Pelvic floor complaints are common among women and often accompanied by sexual dysfunction and psychological burden. They are also associated with pregnancy and childbirth. However, not all women with these complaints receive help in pelvic physical therapy practice. This study explored if pregnancy, parity, pelvic floor complaints, sexual functioning, and psychological burden are predictive of receiving help in pelvic physical therapy practice. Methods: In a cross-sectional exploratory design, women completed an online survey about pelvic floor complaints, sexual function, and psychological burden. Binary logistic analysis was used to analyze the predictive value of the above-mentioned factors. Results: Data from 542 participants were analyzed. Pregnancy and parity, PFC severity, psychological burden, and the interaction between pelvic floor complaints and psychological burden were significant predictors of receiving help. Against expectations, sexual functioning was not predictive of receiving help. Conclusions: Women's psychological burden is an important factor in determining if or when women receive help in PPT practice. More research is needed to unravel the role of sexual functioning in the context of pelvic floor complaints and women's psychological burden. More insight into this area of expertise could possibly improve and enhance pelvic health care for women with pelvic floor complaints.

Women with pelvic floor complaints may also experience sexual dysfunction and psychological burdens. Their complaints can be related to pregnancy and childbirth. However, not all women with pelvic floor complaints receive help in pelvic physical therapy practice. This study explored if pregnancy, childbirth, pelvic floor complaint severity, sexual functioning, and psychological burden predicted women's help-seeking behavior in pelvic physical therapy practice. For that purpose, women were invited to complete an online survey; data from 542 participants were analyzed. Outcomes revealed that pregnancy, childbirth, and pelvic floor complaint severity predicted help-seeking behavior. Against expectations, sexual functioning did not predict this help-seeking behavior. Psychological burden turned out to be an important predictor. More research is needed to unravel the role of sexual functioning in the context of pelvic floor complaints and women's psychological burden. Knowing more about these factors may improve and enhance pelvic health in many women.

Measuring the psychological burden of women with pelvic floor complaints: The psychometric characteristics of a new instrument.

Background: To be able to optimize pelvic healthcare, it would be helpful to specifically assess women's psychological burden with pelvic floor complaints. In the absence of such an instrument, a new instrument was developed to measure this burden in women who seek help. In previous research, a comprehensive overview was yielded of women's restrictions and distress with pelvic floor complaints, and a conceptual model was developed of seven types of distress that were reflected by 33 statements. The present study was performed to investigate the psychometric properties of the new instrument, termed the Pelvic Floor Complaint-related Psychological Burden Inventory (PFC-PBI). Methods: In an online survey data was collected from women with and without pelvic floor complaints on the 33 statements. The internal consistency of the types of distress was tested using item-total correlation analysis, Principal Component and Confirmatory Factor Analyses were performed, and the convergent and divergent validity of the types of distress was examined against existing questionnaires using the Multi-Trait Multi-Method methodology. Results: Based on the factor analyses, a 10-item instrument was tested. Outcomes show excellent internal consistency of this instrument, comprising a single component. The PFC-PBI demonstrated satisfactory convergent and divergent validity. Conclusions: This new measure appears to be a promising tool to inventory the psychological burden of women suffering from pelvic floor complaints. Research into its further development, implementation, and clinical use appears warranted.

To be able to optimize pelvic healthcare for women, it would help to be able to specifically assess women's psychological burden with pelvic floor complaints. There is no instrument to measure this burden in women who seek help. Previous research by the same research group has clarified this burden in a model that reflects seven types of distress and provided 33 statements that represent this burden. This follow-up study investigated which statements were most representative of women's psychological burden and that together formed a reliable instrument to assess it. The new instrument is termed the Pelvic Floor Complaint-related Psychological Burden Inventory (PFC-PBI). Women with and without pelvic floor complaints scored these 33 statements in an online survey. Statistical analyses were performed to assess the characteristics and combination of statements that most accurately represent women's psychological burden with pelvic floor complaints. Based on these analyses, a 10-item instrument was tested. The outcomes were excellent regarding reliability and satisfactory regarding validity, and the PFC-PBI was found valid and reliable. This new instrument appears to be a promising tool to inventory the psychological burden of women suffering from pelvic floor complaints. Research into its further development, implementation, and clinical use appears justified.

Initial development and validation of item banks to measure problematic hypersexuality.

Background: Problematic Hypersexuality (PH) is defined as a distress caused by hypersexuality, to the extent that seeking treatment is considered. PH was previously measured with instruments stemming from different perspectives on problems related to hypersexuality. These instruments might best be analyzed in unison to discover the most optimal set of characteristics to measure PH. Methods: A total of 58 items were investigated with Item Response Theory (IRT). We included 1211 participants (592 women, 618 men, 1 other) from a representative Dutch general population sample of 18 years or older. In addition, 371 participants (116 women, 253 men, 2 other) in a web-based survey who sought information on their current level of PH were included. This latter group was divided into those that did or did not consider treatment and group differences in item averages were assessed. Results: After item selection, 26 out of 58 items were retained and divided in two scales: Emotion Dysregulation-PH - 9 items representing the distressing emotional patterns coinciding with hypersexual preoccupation - and Negative Effects-PH - 17 items representing the negative consequences of patterns of hypersexual thoughts and behavior. Assumptions for IRT analyses were met (unidimensionality, local independence and monotonicity). After an IRT graded response model was fit, the scales showed sufficient reliability for the target population of hypersexual individuals. In the general population the scales showed large floor effects and were less reliable. Conclusions: With this study a first step is taken in validating two complementary item banks to measure PH. Further development of the item banks should include the investigation of responsiveness. New items should be constructed to assess less-explored areas of PH and improve differentiating power of the scales. This study showed that diagnostic accuracy for PH is currently difficult to attain with a survey, even when using an extended item set representing the most unique characteristics of PH.

A survey to investigate hypersexuality was developed. The survey intends to distinguish between those experiencing problems due to hypersexuality (Problematic Hypersexuality; PH) and others who are also hypersexual but don't experience problems (Non-problematic Hypersexuality; NH). We investigated 58 items for final inclusion in the survey, of which 26 adequately distinguished between PH and NH. These 26 items were divided in two scales: Emotion Dysregulation-PH, measuring the negative emotional patterns that can occur in hypersexuality, and Negative Effects-PH, measuring the negative consequences that can occur in hypersexuality. Psychometric characteristics of each item were investigated and all items showed sufficient validity to be included in the scales. The survey should specifically be used to assess the level of problems hypersexual individuals experience, and is of less use in the general population. In future studies it needs to be investigated if progress in therapy can be measured with this instrument. Our study showed that even when the most optimal set of items is used to measure problems due to hypersexuality, it still is hard to distinguish between hypersexual individuals experiencing problems and those not experiencing problems due to hypersexuality. The survey can offer a quick descriptive assessment of the level of problematic hypersexuality that is experienced and thus can efficiently aid health care providers working with people experiencing problems due to hypersexuality.