Assessing the Psychometric Properties of the Illness Management and Recovery Scale: A Systematic Review Using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN).

The Illness Management and Recovery Scale (IMR-S) is based on the IMR program, developed to assess the recovery process for people with severe mental disorders by considering the perceptions of clients and clinicians involved in it. The aim of this study was to analyze the psychometric properties of the IMR-S so as to determine the reliability and suitability of its scores for evaluating recovery. Two coders searched five databases for studies, published between January 2004 and May 2023, that describe the psychometric assessment of the IMR-S. Studies were assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias checklist. Finally, 46 papers were included. Methodological quality was very good for most of the studies that provide information on internal validity, and limited for those that report on responsiveness. Measurement properties were positive for convergent validity and measurement error. The quality of evidence was high for structural validity studies. Although this study only includes research published in English and may have overlooked certain psychometric properties evaluated in studies published in other languages, our findings suggest that the IMR-S is a valid and reliable instrument, demonstrating its potential to offer guidance for clinical practice.

Evidence of Validity and Reliability for the Spanish Version of the Self-Identified Stage of Recovery.

BACKGROUND: The Self-Identified Stage of Recovery (SISR) () is a scale used to assess both the stage of recovery (SISR-A) and the components of the process of personal recovery (SISR-B). This study aimed to develop the Spanish version of the SISR and obtain evidence of validity and reliability in a sample of 230 users of community mental health services. METHOD: The Spanish version of the SISR was developed following the translation-back translation procedure, with the support of a committee of experienced experts. The SISR was examined in terms of dimensional structure, internal consistency, relationships with other variables (i.e., the Maryland Recovery Assessment Scale [MARS-12] and the Dispositional Hope Scale [DHS]), and temporal stability (n = 66). Differential item functioning (DIF) by gender was analysed. RESULTS: The study confirmed the unidimensionality of the SISR-B and suitable internal consistency of its scores (ω = .83, α = .83). Scores from both SISR-A and SISR-B showed good temporal stability and the SISR-B displayed strong correlations with the MARS-12 (rs = .78) and the DHS (rs = .67). No DIF was found. CONCLUSIONS: This study supports the validity and reliability of the scores of the Spanish version of the SISR.

Testing the latent structure, factorial equivalence, and external correlates of the brief self-control scale in a community sample of Spanish adults.

The Brief Self-Control Scale (BSCS) is a 13-item personality measure capturing how people differ in their capacity to exert self-control. Although the BSCS was originally regarded as a one-dimensional scale, subsequent psychometric studies have provided support for the empirical distinction of two and four interrelated but distinct components of self-control. Using a large sample of Spanish adults (n = 1,558; 914 female, 58.7%), we performed a comprehensive data-driven comparison of the most well-established item-level latent structures for the BSCS. Results showed that the differentiation between general self-discipline and impulse control offered a better fit to the observed data than did the unidimensional representation of self-control. This two-dimensional structure for the BSCS scores was also supported in terms of its internal consistency, measurement invariance across gender and age groups, and meaningful correlations with wellbeing-related indicators and Big Five personality traits. Plausible implications of these findings are discussed.

Exploring the Meanings of Posttraumatic Growth in Spanish Survivors of Clergy-Perpetrated Child Sexual Abuse: A Phenomenological Approach.

A healing and recovery perspective related to child sexual abuse (CSA) has gained attention in the past two decades, a concept that accurately refers to the process is posttraumatic growth (PTG). Scarce empirical research on PTG in clergy-perpetrated CSA survivors shows evidence of the presence of growth after the abusive experience and a tendency to create accounts of trauma as a way to heal. The general aim of the study is to explore the experiences and meanings of PTG as lived by survivors of clergy-perpetrated CSA. Seven clergy-perpetrated CSA survivors were interviewed with semi-structured in-depth interviews conducted in person. Using reflexive thematic analysis, we identified three dominant themes in the participants' stories: (a) the hindering of PTG; (b) the meanings of PTG, and (c) the internal and contextual and facilitators of PTG. The present study brings new insights into the meanings of PTG, the close relationship between damage and growth, and the mechanisms (both internal and contextual) that are involved in healing from clergy-perpetrated CSA in Spanish culture.

Evidence of Validity and Reliability for the Spanish Version of the Self-Identified Stage of Recovery / Evidencia de la Validez y Fiabilidad de la Versión en Español de la Etapa deRecuperación Autoidentificada

Background: The Self-Identified Stage of Recovery (SISR) (Andresen, 2007) is a scale used to assess both the stage of recovery (SISR-A) and the components of the process of personal recovery (SISR-B). This study aimed to develop the Spanish version of the SISR and obtain evidence of validity and reliability in a sample of 230 users of community mental health services. Method: The Spanish version of the SISR was developed following the translation–back translation procedure, with the support of a committee of experienced experts. The SISR was examined in terms of dimensional structure, internal consistency, relationships with other variables (i.e., the Maryland Recovery Assessment Scale [MARS-12] and the Dispositional Hope Scale [DHS]), and temporal stability (n = 66). Differential item functioning (DIF) by gender was analysed. Results: The study confirmed the unidimensionality of the SISR-B and suitable internal consistency of its scores (ω = .83, α = .83). Scores from both SISR-A and SISR-B showed good temporal stability and the SISR-B displayed strong correlations with the MARS-12 (rs = .78) and the DHS (rs = .67). No DIF was found. Conclusions: This study supports the validity and reliability of the scores of the Spanish version of the SISR.(AU)

Antecedentes: La Self-Identified Stage of Recovery (SISR) (Andresen, 2007) es una escala que evalúa tanto la etapa de recuperación (SISR-A) como los componentes del proceso de recuperación personal (SISR-B). El objetivo del estudio fue desarrollar la versión en español de la SISR y obtener evidencias de validez y fiabilidad en una muestra de 230 usuarios de servicios comunitarios de salud mental. Método: La versión en español se desarrolló siguiendo el procedimiento de traducción-retrotraducción, con el apoyo de un comité de expertos por experiencia. Se examinó la estructura dimensional, consistencia interna, relaciones con otras variables (Escala de Evaluación de la Recuperación de Maryland [MARS-12] y Escala de Esperanza Disposicional [DHS]) y estabilidad temporal (n = 66). Se analizó el funcionamiento diferencial del ítem (DIF) por género. Resultados: El estudio confirmó la unidimensionalidad de la SISR-B y una adecuada consistencia interna de sus puntuaciones (ω = .83, α = .83). Las puntuaciones de la SISR-A y la SISR-B presentaron estabilidad temporal y la SISR-B mostró correlaciones elevadas con la MARS-12 (rs = .78) y la DHS (rs = .67). No se encontró DIF. Conclusiones: Este estudio apoya la validez y fiabilidad de las puntuaciones de la versión española de la SISR.(AU)

Breastfeeding and the quality of the sibling relationship.

OBJECTIVE: To examine the association between the type of breastfeeding practiced and the quality of the sibling relationship. DESIGN: Cross-sectional study. METHOD: Participants were recruited between July and December 2019 through parenting associations and parenting support groups. They comprised a total of 149 mothers with two children between 2 and 7 years of age, who had practiced the same type of feeding with both children. Sibling relationship quality was assessed using the conflict/rivalry and warmth dimensions of the Parents' Expectations and Perceptions of Sibling Relationships with their Children (PEPC-SRQ) questionnaire. Analyses of covariance were used to identify any differences in these two dimensions of the PEPC-SRQ between the study groups (formula feeding, breastfeeding, non-prolonged breastfeeding, prolonged breastfeeding and tandem breastfeeding). RESULTS: No significant differences were observed between any of the groups regarding the conflict/rivalry dimension; in contrast, significant differences were found in the warmth dimension between the breastfeeding and formula feeding groups. CONCLUSIONS: Breastfeeding, regardless of its duration and simultaneity, was associated with higher scores in the dimension of warmth of the sibling relationship. IMPLICATIONS FOR PRACTICE: This information should be considered by healthcare professionals when providing advice on breastfeeding.

Symptoms and functioning: a content analysis of the PANSS under the ICF framework.

PURPOSE: The study aimed to compare the content of the Positive and Negative Syndrome Scale (PANSS) with that of the International Classification of Functioning, Disability, and Health (ICF) and to examine the extent to which PANSS items are represented in the ICF Core Sets (ICF-CS) for schizophrenia. METHODS: The 30 items of the PANSS were linked to the ICF using established rules by two health professionals experienced in applying the ICF conceptual framework. RESULTS: PANSS items were linked to 42 unique ICF categories, corresponding mainly to the Body functions component; categories b160 Thought functions and b152 Emotional functions from this component were the most frequently linked. Regarding the Activities and participation component, the second-level category d720 Complex interpersonal interactions was the most frequently linked to PANSS items. Overall, PANSS items covered 18% and 40% of the categories included, respectively, in the Comprehensive and Brief versions of the ICF-CSs for schizophrenia. No PANSS items were linked to categories from the Body structures or Environmental factors components. CONCLUSIONS: The PANSS broadly covers the content of the ICF, especially as regards mental and movement-related functions, although it also covers some aspects of interpersonal relationships.

Breastfeeding and maternal attachment: The moderating roles of maternal stress and child behavior.

PURPOSE: This study examined the effect of breastfeeding on maternal attachment, and explored the moderating role of maternal stress and child behavior in this relationship, in a sample of Spanish mothers with children aged between 2 and 7 years. DESIGN AND METHODS: A total of 432 mothers participated in a cross-sectional online survey. A three-way interaction model was used to test the moderating role of maternal stress and child behavioral problems in the relationship between breastfeeding and maternal attachment. RESULTS: The full model accounted for 19% of the variance of maternal attachment. Breastfeeding was significantly associated with mother-rated attachment, and the moderated moderation analysis confirmed the moderating effects of maternal stress and child behavior on the relationship between breastfeeding and maternal attachment. CONCLUSIONS: This study adds to the existing literature that supports the contribution that breastfeeding makes in enhancing maternal attachment, and may help to clarify the role of breastfeeding in shaping maternal attachment. Our findings suggest that breastfeeding is a factor in enhancing maternal attachment, and also identify maternal stress and child behavior as moderators of this relationship. PRACTICE IMPLICATIONS: Understanding the mechanisms by which breastfeeding affects maternal attachment will help generate recommendations to improve breastfeeding and maternal attachment.

Spanish validation of the pure procrastination scale: dimensional structure, internal consistency, temporal stability, gender invariance, and relationships with personality and satisfaction with life.

The objective of the current study was to adapt and validate the pure procrastination scale (PPS) for the Spanish adult population. Procrastination can have numerous consequences in daily life, making it essential to have reliable and valid instruments for measuring procrastination. Thus, this study was conducted to address this need. The sample consisted of 596 adults aged 18-83 years (M = 35.25, SD = 13.75). In addition to the PPS, participants completed two procrastination measures, namely the irrational procrastination scale and the decisional procrastination questionnaire, alongside the Big Five inventory and the satisfaction with life scale. The results of the confirmatory factor analysis revealed a three-factor structure of the PPS. The examination of the reliability of scores in terms of internal consistency and temporal stability showed satisfactory results for the PPS scores. Moreover, gender invariance was observed at the scalar level. Finally, the PPS scores correlated with other measures of procrastination, personality traits, and satisfaction with life in the expected direction and magnitude. In conclusion, the Spanish PPS offers valid and reliable scores when administered to adult population.

Effectiveness of a recovery workshop implemented in community mental health services in Catalonia (Spain): study protocol for a non-randomized controlled trial.

BACKGROUND: Many countries today are undergoing a paradigm shift in mental health policies towards a recovery-oriented and rights-based approach. From this perspective, self-determination and self-management are fundamental factors for recovery. Despite this shift, there is still a lack of evidence on the effectiveness of training programmes aimed at promoting self-determination and self-management in recovery processes implemented in southern European or Spanish-speaking countries. The aim of this paper is to present a study protocol that evaluates the effectiveness of a 12-session recovery workshop implemented in community mental health services in Catalonia (Spain). METHODS/DESIGN: This is a 12-week follow-up multi-centre non-randomized controlled trial design. At least 160 users will be recruited from 13 Community Rehabilitation Services (CRS) in Catalonia. Eligible participants are adult (≥ 18 years old) users of a CRS, who sign a written consent to participate. The experimental group participates in a recovery workshop, in which people learn to develop and implement their own plan of personal recovery, which includes a Wellness Toolbox, a Maintenance Toolkit, a Personal Growth Plan, a Mirror of Relapses, a Crisis Plan, and a Learning Agenda. The control group participates in the usual activities of the CRS. Data is collected using a questionnaire of sociodemographic characteristics, personal recovery, empowerment, hope and perceived social support. The users' measurements are taken at the baseline and one week after the end of the workshop. The primary outcome measures include the Self-Identified Stage of Recovery and the Maryland Assessment of Recovery in Serious Mental Illness Scale (short version). The secondary outcome measures include the Netherlands Empowerment List, Dispositional Hope Scale, and Multidimensional Scale of Perceived Social Support. Descriptive statistics for characterizing the sample size will be performed. Multivariate analyses for repeated measures designs will be used to evaluate the primary and secondary outcomes. Between-group and within-subject comparisons will be conducted. DISCUSSION: The results of the study will provide information on the usefulness of recovery workshops in a Mediterranean cultural context. Additionally, if this workshop is effective, it will be proposed for inclusion within the portfolio of community mental health services in Catalonia. TRIAL REGISTRATION: ISRCTN11695542 (Registration date: 5 July 2022).

Proposing Necessary but Not Sufficient Conditions Analysis as a Complement of Traditional Effect Size Measures with an Illustrative Example.

Even though classic effect size measures (e.g., Pearson's r, Cohen's d) are widely applied in social sciences, the threshold used to interpret them is somewhat arbitrary. This study proposes necessary condition analysis (NCA) to complement traditional methods. We explain NCA in light of the current limitations of classical techniques, highlighting the advantages in terms of interpretation and translation into practical terms and recognizing its weaknesses. To do so, we provide an example by testing the link between three independent variables with a relevant outcome in a sample of 235 subjects. The traditional Pearson's coefficient was obtained, and NCA was used to test if any of the predictors were necessary but not sufficient conditions. Our study also obtains outcome and condition inefficiency as well as NCA bottlenecks. Comparison and interpretation of the traditional and NCA results were made considering recommendations. We suggest that NCA can complement correlation analyses by adding valuable and applicable information, such as if a variable is needed to achieve a certain outcome level and to what degree.

Network Analysis of the Brief ICF Core Set for Schizophrenia.

Background: The International Classification of Functioning, Disability, and Health Core Sets (ICF-CSs) for schizophrenia are a set of categories for assessing functioning in persons with this health condition. This study aimed to: a) estimate the network structure of the Brief ICF-CS for schizophrenia, b) examine the community structure (categories strongly clustered together) underlying this network, and c) identify the most central categories within this network. Methods: A total of 638 health professionals from different backgrounds and with a significant role in the treatment of individuals with schizophrenia participated in a series of Delphi studies. Based on their responses we used the Ising model to estimate the network structure of the 25-category Brief ICF-CS, and then estimated the degree of centrality for all categories. Finally, the community structure was detected using the walktrap algorithm. Results: The resulting network revealed strong associations between individual categories within components of the ICF (i.e., Body functions, Activities and participation, and Environmental factors). The results also showed three distinct clusters of categories corresponding to the same three components. The categories e410 Individual attitudes of immediate family members, e450 Individual attitudes of health professionals, d910 Community life, and d175 Solving problems were among the most central categories in the Brief ICF-CS network. Conclusion: These results demonstrate the utility of a network approach for estimating the structure of the ICF-CSs. Implications of these results for clinical interventions and development of new instruments are discussed.

The Spanish Posttraumatic Growth Inventory - Short Form in Adult Survivors of Child Sexual Abuse.

BACKGROUND: Child sexual abuse (CSA) survivors can experience psychological changes and growth as a consequence of their victimization experience, known as posttraumatic growth (PTG). The purpose of this study was to evaluate the dimensionality, reliability and validity of the Spanish version of the Posttraumatic Growth Inventory - Short Form (PTGI-SF) (Tedeschi & Calhoun, 1996) in a sample of 104 adult survivors of CSA. METHOD: Different models of PTGI-SF validated in different languages and samples were tested using Confirmatory Factor Analysis. RESULTS: The results showed that the original five-factor model exhibited the best goodness of fit. Internal consistency was adequate for the general scale, and acceptable for the five different factors. Furthermore, positive correlations were found between the PTGI-SF total score and psychosocial and mental health problems, as well as gender differences, with women tending to report more PTG than men. CONCLUSIONS: These results suggest that the Spanish PTGI-SF is a brief, reliable, valid self-report measure for assessing PTG experienced by CSA survivors.

The psychometric properties of the parenting scale for Spanish mothers with children aged between 2 and 7 years.

PURPOSE: This study aimed to evaluate the psychometric properties of the Spanish version of the Parenting Scale in a large sample of Spanish mothers. DESIGN AND METHODS: A two-stage cross-sectional study of the adaptation and cultural validation of the Parenting Scale in a Spanish-speaking environment. In Stage I, the Parenting Scale was translated and back-translated and its semantic, linguistic and contextual equivalence was assessed. In Stage II, the Spanish-language version was validated after its application to 662 Spanish mothers with healthy children aged between 2 and 7 years. Several factor structure models of the Parenting Scale were compared by confirmatory factor analysis. Convergent validity, internal consistency and test-retest reliability were also examined. RESULTS: The model of Irvine et al. (1999) presented the best fit to our data. This model demonstrated adequate reliability (internal consistency and stability). The total score and each factor of the Parenting Scale correlated positively with perceived stress in mothers, difficulties in mother-child bonding and child hyperactivity, and negatively with child prosocial behavior. CONCLUSIONS: The Spanish version of the Parenting Scale is a valid and reliable measure that can be used by healthcare professionals and scientists to assess dysfunctional parenting in Spanish mothers of children aged 2 to 7 years. PRACTICE IMPLICATIONS: This study will allow the use of the Parenting Scale in epidemiological and cross-cultural studies in a variety of applied contexts. Additionally, health professionals who work with families in Spain will have access to a valid and reliable instrument for the assessment of mothers' parenting styles.

Psychometric Validation of the Spanish Gaming Disorder Test (GDT): Item Response Theory and Measurement Invariance Analysis.

Gaming Disorder (GD) has been recently added to the eleventh revision of the International Classification of Diseases (ICD-11) by the World Health Organization (WHO), as such, psychometrically sound psychological measures are required to assess this disorder. The objective of this study was to investigate the psychometric properties of the Spanish Gaming Disorder Test (GDT) by assessing its dimensionality, reliability, convergent validity, and associations with other variables of importance through polytomous Item Response Theory (IRT) and Measurement Invariance (MI) analysis across genders. To achieve this, a sample of 538 gamers (42.94% female, meanage = 23.29 years, SD = 7.24) was recruited. The results obtained supported a one-factor structure for the Spanish GDT with adequate reliability and convergent validity. Furthermore, satisfactory goodness of fit in the partial credit model (PCM) with more precise scores at high trait levels to assess GD was found, and strict invariance across genders was supported. These findings attest to the suitability of the Spanish GDT for clinical assessment and research on disordered gaming beyond community samples. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-021-00704-x.

Functioning Problems in Persons with Schizophrenia in the Russian Context.

Assessing functionality in schizophrenia from a biopsychosocial perspective is essential to generate treatments that respond to the needs of the individual in his/her context. This research aims to assess the prevalence of functioning problems and their association with socio-demographic and clinical variables in a sample of Russian individuals with schizophrenia, using the International Classification of Functioning, Disability, and Health as a framework. An empirical cross-sectional study assessed the functioning of 40 individuals with schizophrenia using the International Classification of Functioning, Disability, and Health Core Set for schizophrenia. For the Body functions component, the highest prevalence of problems was found in b144 Memory functions (75%) and b140 Attention functions (70%). In the Activities and participation component, the greatest limitations were in d770 Intimate relationships (79.3%) and d240 Handling stress and other psychological demands (82.5%). In the Environmental factors, the most frequent problems were in e110 Products or substances for personal consumption (25%) and e460 Societal attitudes (22.5%); when scored as facilitators, the highest rated categories were e125 Products and technology for communication (100%) and e165 Assets (100%). These results may guide the design of specific treatments for these individuals and serve as a starting point for further studies in similar contexts and in other regions in Russia.

An Integrated Account of Expert Perspectives on Functioning in Schizophrenia.

An integrated and interdisciplinary care system for individuals with schizophrenia is essential, which implies the need for a tool that assesses the difficulties and contextual factors of relevance to their functioning, and facilitates coordinated working across the different professions involved in their care. The International Classification of Functioning, Disability and Health Core Sets (ICF-CS) cover these requirements. This study aimed to evaluate the content validity of the ICF-CSs for schizophrenia from the perspective of experts. Six three-round Delphi studies were conducted with expert panels from different professional backgrounds which have played a significant role in the treatment of individuals with schizophrenia (psychiatry, psychology, nursing, occupational therapy, social work and physiotherapy). In total, 790 experts from 85 different countries participated in the first round. In total, 90 ICF categories and 28 Personal factors reached expert consensus (reached consensus from four or more professional perspectives). All the categories in the brief version of the ICF-CS for schizophrenia reached consensus from all the professional perspectives considered. As for the comprehensive version, 89.7% of its categories reached expert consensus. The results support the worldwide content validity of the ICF-CSs for schizophrenia from an expert perspective and underline the importance of assessing functioning by considering all the components implied.

Occupational Therapists' Perspective on the International Classification of Functioning, Disability and Health Core Sets (ICF-CS) for Schizophrenia.

IMPORTANCE: The International Classification of Functioning, Disability and Health (ICF) Core Sets (CSs) for schizophrenia are sets of ICF categories that are relevant specifically to the functioning and disability of people with schizophrenia. OBJECTIVE: To identify the problems occupational therapists commonly encounter when treating people with schizophrenia and to validate the ICF-CSs for schizophrenia from their perspective. DESIGN: Three-round Delphi study using online surveys distributed to occupational therapists worldwide. Participants were asked which problems with functioning they considered most relevant when treating people with schizophrenia. PARTICIPANTS: Occupational therapists experienced in the treatment of people with schizophrenia. MEASURES: Responses were linked to the ICF categories by two trained health professionals, and a statistical measure of agreement and κ coefficient were calculated. RESULTS: Ninety-two occupational therapists from 29 countries in all six World Health Organization regions named 2,527 meaningful concepts. After the linking process, 121 ICF categories and 31 Personal Factors were presented to the expert panel, who reached consensus (agreement of ≥75%) on 97 ICF categories and 27 Personal Factors. Consensus was reached on the 25 categories in the Brief ICF-CS for schizophrenia and 89 of the 97 categories in the Comprehensive ICF-CS for schizophrenia. CONCLUSIONS AND RELEVANCE: The ICF Core Sets for schizophrenia were validated from the perspective of occupational therapists and are potentially useful tools for clinical practice because they cover a wide variety of problems that occupational therapists deal with in interventions with people with schizophrenia. WHAT THIS ARTICLE ADDS: The ICF-CSs for schizophrenia are useful guides for describing and classifying functioning, disability, and health to aid occupational therapy intervention with people with schizophrenia. Occupational therapists are essential in the rehabilitation of this client population, and their perspective has contributed to the development and enrichment of the ICF-CSs for schizophrenia.

The Maternal Attachment Inventory: Development and validation of a short form.

AIMS: To translate and adapt the Maternal Attachment Inventory (MAI) into Spanish; to develop a short form of the instrument that can be used during early childhood; and to test its psychometric properties in a large sample of Spanish mothers. DESIGN: Cross-sectional study of adaptation and cultural validation of instruments. METHODS: Data were collected between February and September 2018. In Stage I, the instrument was culturally adapted using a standardized translation and back-translation method. In Stage II, the factor structure of the Spanish version was tested in a sample of 300 mothers with children aged between 2 and 7 years, and on the basis of the findings a short form of the instrument was developed. Finally, in Stage III, in a second sample of 356 mothers, confirmatory factor analyses of first-, second-order and bi-factor structure were conducted to find the optimal factor structure of the short form of the Spanish MAI. Convergent validity, internal consistency and test-retest reliability were also examined. RESULTS: A bi-factor structure with four sub-scales and 17 items emerged from the factor analyses conducted in Stages II and III. Scores on the short form were negatively correlated with mother-to-infant bonding disorders. The short form presented adequate internal consistency and test-retest reliability. CONCLUSIONS: The Spanish MAI short form is a valid and reliable measure for assessing maternal attachment in mothers of children aged between 2 and 7 years. IMPACT: We present a short version of the MAI for healthcare professionals, adapted for application in a new age range and validated for use with Spanish mothers.