The 18-item Swedish version of Ryff's psychological wellbeing scale: psychometric properties based on classical test theory and item response theory.

Background: Psychological wellbeing is conceptualized as the full engagement and optimal performance in existential challenges of life. Our understanding of psychological wellbeing is important for us humans to survive, adapt, and thrive during the challenges of the 21st century. Hence, the measurement of psychological wellbeing is one cornerstone for the identification and treatment of both mental illness and health promotion. In this context, Ryff operationalized psychological wellbeing as a six-dimensional model of human characteristics: self-acceptance, positive relations with others, environmental mastery, personal growth, autonomy, and purpose in life. Ryff's Psychological Wellbeing Scale has been developed and translated into different versions. Here, we examine and describe the psychometric properties of the 18-item Swedish version of Ryff's Psychological Wellbeing Scale using both Classical Test Theory (CTT) and Item Response Theory (IRT). Methods: The data used in the present study was earlier published elsewhere and consists of 768 participants (279 women and 489 men). In addition to the 18-item version of the scale, participants answered the Temporal Satisfaction with Life Scale, the Positive Affect Negative Affect Schedule, and the Background and Health Questionnaire. We examined, the 18-item version's factor structure using different models and its relationship with subjective wellbeing, sociodemographic factors (e.g., education level, gender, age), lifestyle habits (i.e., smoking, frequency of doing exercise, and exercise intensity), and health issues (i.e., pain and sleeping problems). We also analyzed measurement invariance with regard to gender. Moreover, as an addition to the existing literature, we analyzed the properties of the 18 items using Graded Response Model (GRM). Results: Although the original six-factor structure showed a good fit, both CTT and IRT indicated that a five-factor model, without the purpose in life subscale, provided a better fit. The results supported the internal consistency and concurrent validity of the 18-item Swedish version. Moreover, invariance testing showed similar measurement precision by the scale across gender. Finally, we found several items, especially the purpose in life's item "I live life one day at a time and do not really think about the future," that might need revision or modification in order to improve measurement. Conclusion: A five-factor solution is a valid and reliable measure for the assessment of psychological wellbeing in the general Swedish population. With some modifications, the scale might achieve enough accuracy to measure the more appropriate and correct six-dimensional theoretical framework as detailed by Ryff. Fortunately, Ryff's original version contains 20 items per subscale and should therefore act as a perfect pool of items in this endeavor.

Effectiveness of unified protocol for trans diagnostic treatment in children with anxiety disorders: A randomized control trial.

BACKGROUND: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children (UP-C) is a theory-derived approach that can target the common underlying processes, such as the cognitive, emotional, and behavioral processes in emotional disorders in children aged 8-12 years. This study aimed to investigate UP-C's efficacy in treating children's anxiety disorders compared to cognitive behavior therapy (CBT). MATERIALS AND METHODS: In this randomized control trial (RCT), with pre-test, post-test, and follow-up, 34 participants aged 8-12 with anxiety disorders were selected through the restricted randomization method and allocated to intervention (UP-C) or control (CBT) groups by random allocation rule. UP-C group consisted of 15 weekly individual sessions, and CBT included 16 weekly individual sessions. The Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA) and The Screen for Child Anxiety Related Disorders (SCARED-71) were completed in the pre-test, post-test, and three-month follow-up stages. The data of participants were analyzed using the repeated measure analysis of variance. A P- value under. 05 was regarded as significant. RESULTS: Based on the repeated measures ANOVA, UP-C, and CBT significantly reduced anxiety symptoms (P = .002) and emotional suppression (P = .032). Moreover, UP-C and CBT significantly increased emotion regulation (P = .000) and cognitive reappraisal (P = .000). CONCLUSION: The individual UP-C can be effective as anxiety-oriented CBT in treating anxiety disorders. Also, in the three months follow-up, the UP-C's effects were more stable and progressive than the CBT.

Assessing the content based on ICF and quality based on COSMIN criteria of patient-reported outcome measures of functioning in breast cancer survivors: a systematic review.

PURPOSE: To identify currently used patient-reported outcome measures (PROMs) to evaluate disability in breast cancer survivors (BC) and critically evaluate their content and measurement properties. METHODS: Four electronic databases (PubMed, EMBASE, CINAHL, Scopus and Google Scholar) were searched from 2001 to February 2021. PRISMA guidelines were followed. The content of the included PROM was evaluated by linking the items of the questionnaires to the International Classification of Functioning, Disability and Health (ICF) Core Set for BC using standard linking rules. Methodological quality and measurement properties were assessed using the COSMIN checklist. Qualitative synthesis was used to summarize the evidence on content validity and measurement properties. The overall quality of evidence on each measurement property was provided using GRADE principles. RESULTS: Ten eligible studies reported measurement properties of seven PROMs. The content of included PROMs mostly focused on disability (70% of items), and less on body function and structure (23%) or environmental factors (6%). There was high linkage to The Comprehensive Core Set for BC, Q-DASH (100%), UEFI (95%) and DASH (92%). The Core Set Unique Disability Representation for DASH, and WHODAS2 was 39% and BCSQ-BC, Lymph-ICF was 34%. BCSQ-BC, and Lymph-ICF represented 32, and 20% of the content of the Core Set for BC, respectively, however, the other questionnaires covered less than 20% of the content of the Core Set. High quality of evidence supports sufficient results for internal consistency, testretest, and measurement error for BCSQ-BC, Lymph-ICF, DASH and WHODAS2. CONCLUSIONS: Despite a lack of evidence on all-important clinical measurement, two generic (DASH and WHODAS2) and two disease-specific (BCSQ-BC, Lymph-ICF) PROM demonstrated emerging evidence of adequate measurement properties. The stronger alignment of the BCSQ-BC to the breast cancer ICF core set makes it preferable is a disease-specific measure. The Lymph-ICF is recommended where lymphedema is a specific focus. The DASH and WHODAS2 might be most useful where patients with a variety of upper extremity conditions, including breast cancer survivors, are being evaluated in the clinic or research study.

Prevalence, Demographic Correlates, and Medical Correlates of Cognitive Impairment Among Iranian People Living With HIV: A Cross-sectional Survey Study.

ABSTRACT: While taking antiretroviral therapy, 30%-60% of people living with HIV (PLWH) experience neurocognitive impairment (NCI). To determine NCI prevalence among Iranian PLWH, by the computerized Vienna Test System, 63 adults living without HIV and 63 Iranian PLWH aged 18-50 years ( M = 35.3, SD = 7.9) were assessed for cognitive function. NCI was determined by receiver operating characteristic curve cutoff points based on the adults living without HIV. Associations between demographics, HIV serostatus markers, and mean T-scores were investigated. Performance differences were tested by including significant covariates in an analysis of covariance. NCI prevalence rates were 57.14% in PLWH and 19.05% in adults living without HIV. Global neurocognitive performance and all cognitive domains were significantly different between the groups, except for visual memory and selective attention. In Iran, NCI prevalence parallels that reported in PLWH worldwide. There should be a strategy to screen Iranian PLWH for NCI.