Assessing Complex Emotion Recognition in Children. A Preliminary Study of the CAM-C: Argentine Version / Evaluación del reconocimiento de emociones complejas en niños. Un estudio preliminar del CAM-C: versión argentina

Facial emotion recognition is one of the psychological processes of social cognition that begins during the first year of life, though the accuracy and speed of emotion recognition improves throughout childhood. The objective of this study was to carry out a preliminary study for the adaptation and validation of the CAM-C FACE test in Argentine children from 9 to 14 years old, by measuring hit rates and reaction times. The results of this study show that the unidimensional model is more appropriate when assessing the speed of performance (reaction times), with a satisfactory reliability (ρ = .950). Results also indicated that girls presented more correct answers compared to boys, while boys had longer reaction times. In addition, the group of children from 12 to 14 years old presented more correct answers compared to the group from 9 to 11 years old, while no differences were observed between groups in terms of reaction times. (AU)

El reconocimiento facial de emociones es uno de los procesos psicológicos de la cognición social que comienza durante el primer año de vida, aunque la precisión y la velocidad de reconocimiento emocional mejora a lo largo de la infancia. El objetivo de esta investigación fue realizar un estudio preliminar de la adaptación y validación del test CAM-C FACE en niños argentinos de 9 a 14 años de edad, evaluando las respuestas correctas y los tiempos de reacción. Los resultados mostraron que el modelo unidimensional es el más apropiado cuando se mide la velocidad de ejecución (tiempos de reacción), con una confiabilidad satisfactoria (ρ = .950). Los resultados también indicaron que las niñas presentan más respuestas correctas que los niños, mientras que estos tienen tiempos de reacción más largos. Asimismo, el grupo de niños de 12 a 14 años presentan más respuestas correctas que el de 9 a 11 años, mientras que no se observan diferencias entre grupos de edad en el tiempo de reacción. (AU)

Analysis of the psychometric properties of the Buss-Perry Aggression Questionnaire (AQ) in Colombian adolescents / Análisis de las propiedades psicométricas del cuestionario de agresividad (AQ) de Buss y Perry en adolescentes colombianos

The psychometric properties of the Buss and Perry AQ questionnaire of aggression, one of the most used questionnaires worldwide to measure aggressive behavior, were examined in a sample of adolescents (n=779 participants) from the cities of Barranquilla (n= 410) and Pereira (n= 369), in Colombia. In total, 752 participants (Mean age of 15.3 years, SD = 1.9; 57,4%. women and 42,6 men) completed the Buss and Perry AQ questionnaire. Subsequently, the univariate and multivariate normality of the items was evaluated, and a confirmatory factor analysis (CFA) was performed on the data set. Likewise, the fit of two models was evaluated, a multidimensional a priori model, and a model with a second-order factor (aggressive behavior), which could explain the variance of the items. Finally, the reliability indices of the questionnaire were identified. The results showed acceptable goodness-of-fit indices (X2/df = 2.29, CFI = .977, IFI = .977, GFI = .984, AGFI = .979, RNI = .984, NFI = .972, RMSEA of .047 [90% CI = .016 - .036] and SRMR = .059) for the second-order one-factor model, as well as acceptable reliability indices (α= .55 - .88). In conclusion, these results show that the scale can be applicable to Colombian preadolescents and adolescents, but warn of the limitations of its use for the non-aggression subscale. Nevertheless, the application of the scale in its original version is suggested to determine its psychometric behavior. (AU)

Las propiedades psicométricas del cuestionario de agresión Buss y Perry AQ, uno de los cuestionarios más utilizados mundialmente para medir la conducta agresiva, fue examinado en una muestra de adolescentes (n=779 participantes) de las ciudades de Barranquilla (n= 410) y Pereira (n= 369), en Colombia. En total, 752 participantes (edad media de 15,3 años, DE = 1,9; 57,4%. mujeres y 42,6 hombres) completaron el cuestionario AQ de Buss y Perry. Posteriormente, se evaluó la normalidad univariante y multivariante de los ítems, y se realizó un análisis factorial confirmatorio (AFC) sobre el conjunto de datos. Asimismo, se evaluó el ajuste de dos modelos, un modelo multidimensional a priori, y un modelo con un factor de segundo orden (conducta agresiva), que podría explicar la varianza de los ítems. Por último, se identificaron los índices de fiabilidad del cuestionario. Los resultados mostraron índices de bondad de ajuste aceptables (X2/df = 2,29, CFI = .977, IFI = .977, GFI = .984, AGFI = .979, RNI = .984, NFI = .972, RMSEA de .047 [90% CI = .016 - .036] y SRMR = .059) para el modelo de un factor de segundo orden, así como índices de fiabilidad aceptables (α= .55 - .88). En conclusión, estos resultados muestran que la escala puede ser aplicable a preadolescentes y adolescentes colombianos, pero advierten de las limitaciones de su uso para la subescala de no agresión. No obstante, se sugiere la aplicación de la escala en su versión original para determinar su comportamiento psicométrico. (AU)

Análisis de las propiedades psicométricas de un cuestionario para medir la actitud hacia el humor en los profesionales sanitarios / Analysis of the psychometric properties of a questionnaire to measure the attitude towards humor in healthcare professionals

Objetivo principal: Analizar las propiedades psicométricas de un instrumento diseñado específicamente para evaluar la actitud ante el humor en profesionales sanitarios. Métodos: Estudio de validación, transversal. Se determinó la fiabilidad con el índice de discriminación, el coeficiente de correlación intraclase e ítem-total, el α de Cronbach y el índice de Pearson. La validez de constructo se analizó con el análisis factorial exploratorio. Resultados principales: La Escala Multidimensional del Humor en Profesionales Sanitarios (EMHUPS) consta de 35 ítems y 8 factores: humor con el paciente, en el trabajo, en los cuidados, en el entorno privado, formación en humor, en el entorno sanitario, demanda de formación en humor y humor y ocio. Presenta una varianza del 60,99% y una fiabilidad de 0,88. Conclusión principal: La escala EMHUPS presenta unas propiedades psicométricas aceptables en la medida del humor en profesionales sanitarios. (AU)

Objective: To evaluate the psychometric properties of an instrument designed specifically designed to determine attitude towards humor in health professionals. Methods: A cross-sectional and a validation study. The reliability study analysed the discrimination capacity of the items with discrimination index, the intraclass and item-total correlation coefficient, the Cronbach's α coefficient and the Pearson's correlation coefficient. In the validation study, the Exploratory Factor Analysis was carried out. Results: The Multidimensional Scale of Humor in Healthcare Professionals (EMHUPS) consists of 35 items divided into 8 factors: humor with the patient, humor at work, humor and care, humor in the private environment, training in humor, humor and the sanitary environment, demand for training in humor and humor and leisure. These factors explained a total variance of 60.99% with overall reliability of 0.88. Conclusions: EMHUPS presents acceptable psychometric properties in the measurement of humor in healthcare professionals. (AU)

How do you Behave as a Psychometrician? Research Conduct in the Context of Psychometric Research

The identification of fraudulent and questionable research conduct is not something new. However, in the last 12 years the aim has been to identify specific problems and concrete solutions applicable to each area of knowledge. For example, previous work has focused on questionable and responsible research conducts associated with clinical assessment, measurement practices in psychology and related sciences; or applicable to specific areas of study, such as suicidology. One area of study that merits further study of questionable and responsible research behaviors is psychometrics. Focusing on psychometric research is important and necessary, as without adequate evidence of construct validity the overall validity of the research is at least debatable. Our interest here is to (a) identifying questionable research conduct specifically linked to psychometric studies; and (b) promoting greater awareness and widespread application of responsible research conduct in psychometrics research. We believe that the identification and recognition of these conducts is important and will help us to improve our daily work as psychometricians. (AU)

Traducción y adaptación transcultural al castellano de la escala Perinatal Bereavement Care Confidence Scale (PBCCS) / Translation and cross-cultural adaptation into Spanish of the Perinatal Bereavement Care Confidence Scale (PBCCS)

Objetivo: Realizar la adaptación transcultural de la escala Perinatal Bereavement Care Confidence Scale (PBCCS) al contexto español, así como evaluar la validez de contenido. Método: La traducción y la adaptación transcultural se realizaron mediante la técnica de traducción y retrotraducción, con la participación de un panel de diez expertas. La evaluación de la validez de contenido se llevó a cabo por el mismo grupo de expertas; se calcularon el índice de validez de contenido (CVI), el coeficiente estadístico Kappa (K) y la razón de validez de contenido (CVR) a partir de los resultados de la evaluación. El proceso se realizó en comunicación constante con los autores de la escala original. Resultados: La versión castellana obtenida, la Escala de Confianza frente al Cuidado del Duelo Perinatal (ECCDP), obtuvo un S-CVI/Ave de 0,93 y consta de un total de 43 ítems, clasificados en cuatro dimensiones, manteniendo la misma estructura que la escala original. De los 43 ítems, 37 mostraron un I-CVI con valores por encima de 0,78, y 42 ítems tuvieron un valor de CVR positivo. Conclusiones: La escala ECCDP mantiene la equivalencia con la versión original y es un instrumento con suficiente validez de contenido para medir el nivel de confianza de las matronas y enfermeras en la atención al duelo perinatal en España. Se recomienda un estudio multidisciplinar de validación para evaluar el resto de las propiedades psicométricas del instrumento. (AU)

Objective: To carry out the cross-cultural adaptation of the scale Perinatal Bereavement Care Confidence Scale (PBCCS) to the Spanish context, as well as to evaluate its content validity. Methodology: The translation and cross-cultural adaptation were carried out using the translation and back-translation technique with the participation of a panel of ten experts. The evaluation of content validity was carried out by the same group of experts; the content validity index (CVI), the Kappa statistical coefficient (K) and the content validity ratio (CVR) were calculated. The process was carried out in constant communication with the original scale authors. Results: The Spanish version obtained (ECCDP, Escala de Confianza frente al Cuidado del Duelo Perinatal) had an S-CVI/Ave of 0.93 and consisted of 43 total items, classified into four dimensions, maintaining the same structure as the original scale. 37 of 43 items showed an I-CVI with values above 0.78. Forty-two items had a positive CVR value. Conclusions: The ECCDP scale preserves the equivalence with the original version and is an instrument with sufficient content validity to measure the level of confidence of midwives and nurses in perinatal bereavement care in Spain. A multidisciplinary validation study is recommended to evaluate the remaining psychometric properties of this scale. (AU)

Development and Psychometric Validation of the Perinatal Bereavement Care Competence Scale for Midwives.

PURPOSE: The aim of this paper is to develop a scale for measuring the perinatal bereavement care competence of midwives and assess its psychometric properties. METHODS: The Perinatal Bereavement Care Competence Scale was developed in four phases. (1) Item generation: 75 items were formulated based on a literature review and interviews with midwives. (2) Delphi expert consultation: 15 experts evaluated whether the items were clear/appropriate/relevant to the questionnaire dimensions, and the items were optimized. (3) Pilot test: The comprehensibility, acceptability, and time required to complete the questionnaire by midwives were assessed. (4) Evaluation of reliability and validity: The scale was validated by initial item analysis, exploratory and confirmatory factor analyses, and internal consistency reliability and test-retest reliability. RESULTS: The final scale consisted of six dimensions and 25 items: maintaining belief (three items), knowing (four items), being with (six items), preserving dignity (four items), enabling (five items), and self-adjustment (three items). Exploratory factor analysis yielded a six-factor structure that was consistent with the theoretical framework and explained 70.8% of the total variance. Confirmatory factor analysis indicated a good fit for the six-factor model. Cronbach's α for the scale was 0.931, and the test-retest reliability coefficient was 0.968. CONCLUSION: The Perinatal Bereavement Care Competence Scale is a valid and reliable instrument for measuring the competence of midwives in caring for bereaved parents who have experienced perinatal loss.

Content Validity through Expert Judgment for the Depression Clinical Evaluation Test / Validez de contenido mediante juicio de expertos para el Test de Evaluación Clínica de la Depresión

AbstractBackground/Objective: The evaluation of depression requires valid and reliable measuring instruments, which collect a wide spectrum of symptoms that this disorder displays, in order to carry out an accurate and differential diagnosis. The objective of this work is the construction of the Depression Clinical Evaluation Test (DCET), where affective, somatic, cognitive, behavioral and interpersonal symptoms are considered and also analyze its content validity through an expert judgment. Method: Based on different diagnostic and manual classifications, a specification table for a depression test was established. In its evaluation, 16 experts in psychological evaluation, psychometry and/or psychopathology participated. A total of 300 items were created. The experts had to assess the items according to the criteria of Content, Relevance, Clarity, Comprehension, Sensitivity and Offensiveness. In addition, 50 adults, evaluated the compression of the items. Results: The degree of understanding for all the items was high and the expert judgment favoured the suppression of 104 items, thus obtaining a shorter measuring instrument with a total of 196 items for ease of application. Conclusions: The content validity of the test is adequate and fits the agreed definition of depression.

Antecedentes La evaluación de la depresión requiere de instrumentos de medida válidos, fiables y que recojan el amplio espectro de síntomas que este trastorno conlleva, para poder llevar a cabo un diagnóstico certero y diferencial. El objetivo de este trabajo es la construcción del Test de Evaluación Clínica de la Depresión (TECD), que contempla síntomas afectivos, somáticos, cognitivos, conductuales e interpersonales, y analizar su validez de contenido a través de un juicio de expertos. Método A partir de diferentes clasificaciones diagnósticas y manuales se estableció la tabla de especificación del test para este cuestionario de depresión. En la evaluación de este participaron 16 expertos en Evaluación Psicológica, Psicometría y/o Psicopatología. Se crearon 300 ítems en total, que los expertos tuvieron que valorar atendiendo a los criterios de Contenido, Relevancia, Claridad, Comprensión, Sensitividad y Ofensividad. Además, 50 adultos, valoraron la compresión de los items. Resultados El grado de comprensión de todos los ítems fue elevado y el juicio de expertos supuso la supresión de 104 ítems, obteniendo así un instrumento de medida más breve, con 196 ítems en total, lo que facilitará su aplicación. Conclusiones La validez de contenido del test es adecuada y se adapta a la definición de depresión establecida.

Validating the use of the revised childbirth experience questionnaire in Hong Kong.

OBJECTIVE: To evaluate the psychometric properties of the traditional Chinese version of the Childbirth Experience Questionnaire (CEQ 2.0) and assess the childbirth experiences of Chinese women. METHODS: A cross-sectional survey was conducted in Hong Kong from July 2020 to February 2021. In total, 975 mothers, who could read traditional Chinese and gave birth in 2020 or 2021, were included in the analysis. Data were fitted into the model proposed by the original developers using the confirmatory factor analysis. The data were then randomly split into training and validation sets for exploratory and confirmatory factor analyses. Childbirth experiences were assessed. Factor structure, internal construct validity, internal consistency, and known-group validity were assessed. RESULTS: The originally proposed CEQ2.0 model showed a poor fit. An exploratory factor analysis identified a revised four-factor model (CEQ2.0-R) on a randomly split sample, which showed a satisfactory fit (CFI=0.912; TLI=0.884; SRMR=.053; RMSEA=0.072) on the other split sample. The revised scale comprised 13 items and four domains: (1)"Own capacity" (6 items), (2) "General support" (3 items), (3) "Perceived safety" (2 items), and (4) "Professional support" (2 items). CEQ2.0-R showed high internal construct validity and reliability. It can differentiate between participants with different characteristics, including parity, oxytocin augmentation, and companionship during labour. The childbirth experiences of the participants were merely positive, and participants reported that more support from midwives is needed. CONCLUSIONS: CEQ2.0-R can adequately describe the childbirth experiences of women in Hong Kong. The questionnaire is easy to be administer and can be used to assess several domains of the childbirth experiences. It may be useful to evaluate the aspects of support needed during childbirth.

Development and validation of preconception care improvement scale (PCIS) in a resource-limited setting.

BACKGROUND: Preconception care helps to close the gaps in a continuum of care. It is of paramount importance to reduce maternal and child adverse pregnancy outcomes, increase the utilization of services such as antenatal care, skilled delivery care, and post-natal care, and improve the lives of future generations. Therefore, a validated instrument is required. The purpose of this study was to develop and validate the preconception care improvement scale (PCIS) in a resource-limited setting. METHODS: A mixed-method study was carried out from 02, March to 10, April 2019 in Manna district, Oromia region, Ethiopia to test the reliability and validity of the scale. Items were generated from literatures review, in-depth interviews with different individuals, and focused group discussions with women of reproductive age groups. A pretested structured questionnaire was used and a survey was conducted among 623 pregnant women in the district. The collected data were entered into EPI-data version 3.1 software and exported to SPSS version 23 software and data were analyzed for internal consistency and validity using reliability analysis and factor analysis. RESULTS: The PCIS has 17 items loaded into six factors: Substance-related behaviors, screening for common non-communicable and infectious diseases, micronutrient supplementation and vaccination, seeking advice, decision and readiness for conception, and screening for sexually transmitted diseases. Factor analysis accounted for 67.51% of the observed variance. The internal consistency (Cronbach's alpha) of the scale was 0.776. Diversified participants of the qualitative study and experts' discussions assured the face and content validity of the scale. Factor loading indicated the convergent validity of the scale. Three of the PCIS subscale scores had a positive and significant association with the practice of preconception care and antenatal care visits, which confirmed the predictive validity of the scale. CONCLUSION: The PCIS exhibited good reliability, face validity, content validity, convergent validity, and predictive validity. Thus, the scale is valid and helps to improve preconception care, especially in resource-limited settings.

Trait Anhedonia in Schizophrenia: A Systematic Review and Comparative Meta-analysis.

Anhedonia, the reduced capacity to experience pleasure, has long been considered a prominent feature of schizophrenia spectrum disorders. Many domain-specific conceptualizations of anhedonia and pleasure capacity have been developed, and there currently exist a variety of self-report assessment tools that purport to assess these various domains. The current systematic review and meta-analysis (PROSPERO: CRD42020156169) aimed to quantify overall and domain-specific self-reported anhedonia in people with schizophrenia compared to nonpsychiatric controls. We performed a literature search of PsycINFO, MEDLINE, and Embase databases for dissertations and peer-reviewed articles published in English prior to June 2021. Studies employing a psychometrically validated self-report measure of anhedonia, pleasure experience or affect in people with schizophrenia, schizoaffective, or schizophreniform disorders; studies utilizing at least one clearly defined healthy or community control group for comparison; and studies providing sufficient data to calculate effect sizes were included in this review. Random and mixed effects meta-analyses, meta-regressions, and subgroup comparisons were run across domains of anhedonia to explore weighted mean effect sizes and their associated moderators. In total, 146 studies met inclusion criteria, yielding 390 Hedges' g effect sizes from the included comparisons. People with schizophrenia reported moderate-to-large elevations in overall and domain-specific anhedonia. A sensitivity analysis accounting for high risk of bias studies did not significantly impact results. Lastly, patient sex, education, negative symptom severity, antipsychotic class, and trait negative affect differentially moderated effect sizes across domains of anhedonia. Despite the heterogeneity inherent in schizophrenia spectrum disorders, self-reported anhedonia is ubiquitously reported across self-report measures in this population.

Psychological effect of COVID-19 pandemic among women undergoing infertility care, a French cohort - PsyCovART Psychological effect of COVID-19: PsyCovART.

PURPOSE: To assess psychological state of women who experienced postponement of ART care during the first COVID-19 wave in a French public ward of reproductive medicine. METHODS: An online anonymous survey was emailed between July and August 2020 to all women whose infertility care, including the first consultation for infertility, have been delayed at the beginning of the COVID-19 pandemic. Anxiety, depression, and stress were assessed using Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS-10). Feelings about COVID-19 outbreak, lockdown and suspension of fertility care were assessed by Multiple-Choice Questions and Visual Analog Scales. RESULTS: 435 women answered to the survey (response rate 34.6%). Mean levels of the HADS-A (anxiety), HADS-D (depression) and PSS10 were respectively 7.58(±3.85), 4.51(±3.48), and 27(±6.75). Prevalence of stress was 50.8% and almost half of women presented clear or suggestive anxiety symptoms (respectively 21.6% and 25.7%). Stress and anxiety rates were much higher than those expected in infertile population. Increased stress was observed in women above 35 years and those stopped 'in cycle' or during pre-treatment for in-vitro fertilization or frozen embryo transfer. Patient with history of depression or anxiety had a higher prevalence of perceived stress (p = 0.0006). Postponement was perceived as 'unbearable' for women experiencing stress (p = 0.0032). After the first wave of pandemic, pregnancy desire remained the same and 84.3% of women wanted to resume fertility care as soon as possible. CONCLUSION: Stopping fertility care during the COVID-19 pandemic had a significant psychological impact on women with an increase of stress, and anxiety. Psychological counseling should always be offered especially during this difficult period.

Development and validation of a novel patient-reported outcome measure in people with episodic migraine and chronic migraine: The Activity Impairment in Migraine Diary.

OBJECTIVE: To evaluate the content validity and psychometric properties of the Activity Impairment in Migraine Diary (AIM-D). BACKGROUND: Measuring treatment effects on migraine impairment requires a psychometrically sound patient-reported outcome (PRO) measure developed consistent with U.S. Food and Drug Administration guidance. METHODS: The AIM-D was created from concepts that emerged during qualitative interviews with five clinicians experienced in treating migraine and concept elicitation (CE) interviews with 40 adults with episodic migraine (EM) or chronic migraine (CM). The initial version was refined based on three waves of cognitive interviews with 38 adults with EM or CM and input from a panel of clinical and measurement experts. The AIM-D was psychometrically evaluated using data from 316 adults with EM or CM who participated in a 13-week prospective observational study. Study participants completed PRO assessments including the AIM-D and a daily headache diary. Exploratory and confirmatory factor analysis were used to determine the factor structure. The reliability, validity, and responsiveness of the AIM-D were assessed. Additional PRO measures including the Patient Global Impression - Severity (PGI-S), Migraine Specific Quality of Life Questionnaire, Version 2.1 Role Function-Restrictive domain, and Headache Impact Test were used for psychometric evaluation of the AIM-D. RESULTS: Based on CE interviews with adults with migraine and input from an expert panel, activity impairment was identified as the target in the preliminary conceptual framework, which had two domains: performance of daily activities (PDAs) and physical impairment (PI). Revision of the draft AIM-D through multiple rounds of cognitive interviews and expert panel meetings resulted in a content valid 11-item version. Exploratory factor analysis supported both one- and two-domain structures for the AIM-D, which were further supported by confirmatory factor analysis (factor loadings all >0.90). The AIM-D domains (PDA and PI) and total score showed high internal consistency reliability (Cronbach's alpha 0.95-0.97), acceptable test-retest reliability for weekly average scores (intraclass correlation coefficient >0.60 for participants with no change in PGI-S between baseline and week 2), and good convergent and known-groups validity. There was evidence of responsiveness based on changes in PGI-S score and monthly migraine days. CONCLUSION: The AIM-D is a content valid and psychometrically sound measure designed to evaluate activity impairment and is suitable for use in clinical trials of preventive treatments for EM or CM.

Development of an interactive tool of early social responsiveness to track autism risk in infants and toddlers.

AIM: To evaluate the psychometric properties of a 4-minute assessment designed to identify early autism spectrum disorder (ASD) status through evaluation of early social responsiveness (ESR). METHOD: This retrospective, preliminary study included children between 13 and 24 months (78 males, 79 females mean age 19.4mo, SD 3.1) from two independent data sets (an experimental/training sample [n=120] and a validation/test sample [n=37]). The ESR assessment examined social behaviors (e.g. eye contact, smiling, ease-of-social-engagement) across five common play activities (e.g. rolling a ball, looking at a book). Data analyses examined reliability and accuracy of the assessment in identifying ESR abilities and in discriminating children with and without ASD. RESULTS: Results indicated adequate internal consistency and test-retest reliability of the ESR assessment. Receiver operator curve analysis identified a cutoff score that discriminated infants with ASD-risk from peers in the training sample. This score yielded moderate sensitivity and high specificity for best-estimate ASD diagnosis in the validation sample. INTERPRETATION: Preliminary findings indicated that brief, systematic observation of ESR may assist in discriminating infants with and without ASD, providing concrete evidence to validate or supplement parents', pediatricians', or clinicians' concerns. Future studies could examine the utility of ESR 'growth curves'.

Fear of hypoglycemia in children with type 1 diabetes and their parents: Validation of the Italian version of the Hypoglycemia Fear Survey for Children and for Parents.

BACKGROUND: Currently, Italian versions of the Hypoglycemia Fear Survey for Children (CHFS) and for Parents (PHFS) quantifying Fear of Hypoglycemia (FoH) in pediatric diabetes are not available. OBJECTIVE: To validate the Italian version of the CHFS and PHFS. SUBJECTS AND METHODS: One hundred and seventy-four children with type 1 diabetes aged 6-18 and 178 parents completed the CHFS and PHFS, the PedsQL 3.0 Diabetes module and the KIDSCREEN-10. Internal consistency was good (α = 0.85 for CHFS, α = 0.88 for PHFS); validity was supported by correlations of CHFS total score (CHFS-T r = -0.50; p < 0.001, CI = -0.62 to -0.35) and Worry subscale (CHFS-W r = -0.49; p < 0.001, CI = -0.62 to -0.32) with measures of health-related quality of life (QoL), which were not related to PHFS scores. Factor analyses justified the structure and the separate scoring of Behavior and Worry subscales. Children's age was negatively correlated with CHFS-T (r = -0.16; p = 0.03, CI = -0.36 to 0.00), CHFS-W (r = -0.29; p = 0.02, CI = -0.39 to -0.07), PHFS-T (r = -0.20; p = 0.006, CI = -0.35 to -0.04), PHFS-B (r = -0.30; p = 0.001, CI = -0.43 to -0.17). Mean (SD) item scores of CHFS-T (1.47 ± 0.56 vs. 1.27 ± 0.57; p < 0.05) and CHFS-W (1.20 ± 0.73 vs. 0.96 ± 0.68; p < 0.05) were higher in children with HbA1c ≥7.5%. Higher levels of distress for upsetting hypoglycemia were associated with lower child's QoL scores as perceived by children (Peds-QL: 72.6 ± 12.8 vs. 80.4 ± 11.9; p < 0.001) and parents (Peds-QL: 70.6 ± 13.8 vs. 75.8 ± 12.9; p < 0.05). CONCLUSION: The Italian version of CHFS and PHFS appears to be a valid measure to assess FoH in clinical practice and factor analysis supports separate scoring for the Worry and Behavior subscales.

Assessing Multisensory Sensitivity Across Scales: Using the Resulting Core Factors to Create the Multisensory Amplification Scale.

Multisensory sensitivity (MSS), observed in some chronic pain patients, may reflect a generalized central nervous system sensitivity. While several surveys measure aspects of MSS, there remains no gold standard. We explored the underlying constructs of 4 MSS-related surveys (80 items in total) using factor analyses using REDCap surveys (N = 614, 58.7% with pain). Four core- and 6 associated-MSS factors were identified from the items assessed. None of these surveys addressed all major sensory systems and most included additional related constructs. A revised version of the Somatosensory Amplification Scale was developed, encompassing 5 core MSS systems: vision, hearing, smell, tactile, and internal bodily sensations: the 12-item Multisensory Amplification Scale (MSAS). The MSAS demonstrated good internal consistency (alpha = 0.82), test-retest reliability (ICC3,1 = 0.90), and construct validity in the original and in a new, separate cohort (R = 0.54-0.79, P < .0001). Further, the odds of having pain were 2-3.5 times higher in the highest sex-specific MSAS quartile relative to the lowest MSAS quartile, after adjusting for age, sex, BMI, and pain schema (P < .03). The MSAS provides a psychometrically comprehensive, brief, and promising tool for measuring the core-dimensions of MSS. PERSPECTIVE: Multiple multisensory sensitivity (MSS) tools are used, but without exploration of their underlying domains. We found several measures lacking core MSS domains, thus we modified an existing scale to encompass 5 core MSS domains: light, smell, sound, tactile, and internal bodily sensations using only 12 items, with good psychometric properties.

Validation of the intolerance of uncertainty scale as a screening tool for perinatal anxiety.

BACKGROUND: To date, there is a significant lack of research validating clinical tools for early and accurate detection of anxiety disorders in perinatal populations. Intolerance of uncertainty was recently identified as a significant risk factor for postpartum anxiety symptoms and is a key trait of non-perinatal anxiety disorders. The present study aimed to validate the Intolerance of Uncertainty Scale (IUS) in a perinatal population and evaluate its use as a screening tool for anxiety disorders. METHODS: Psychiatric diagnoses were assessed in a sample of perinatal women (n = 198), in addition to completing a self-report battery of questionnaires. Psychometric properties including internal consistency and convergent and discriminant validity were assessed. Determination of an optimal clinical cut-off score was measured through a ROC analysis in which the area under the curve, sensitivity, specificity, as well as positive and negative predictive values were calculated. RESULTS: The IUS demonstrated excellent internal consistency (α = 0.95) and an optimal clinical cut-off score of 64 or greater was established, yielding a sensitivity of 89%. The IUS also demonstrated very good positive (79%) and negative (80%) predictive values. CONCLUSIONS: These findings suggest that the IUS represents a clinically useful screening tool to be used as an aid for the early and accurate detection of perinatal anxiety.

Body Image and Sexual Function Improve after Both Myomectomy and Hysterectomy for Symptomatic Fibroids.

OBJECTIVES: To determine the factors that influence the choice of myomectomy, uterine fibroid embolization (UFE), or hysterectomy in women with symptomatic uterine fibroids and to assess women's perception of body image and sexual functioning before and after treatment. METHODS: In this prospective observational cohort pilot study, women scheduled to undergo hysterectomy, myomectomy, or UFE were surveyed before surgery and again at 3 to 6 months after their procedure to assess body image and sexual function using the validated 10-item Body Image Scale and 19-item Female Sexual Function Index. Logistic regression was used to determine predictive factors for surgery choice and paired t tests were used to determine changes in perceived sexual function and body image. RESULTS: Of the 71 women surveyed, 69 underwent their scheduled procedure and 68 participants completed the preoperative questionnaire completely (98%). A total of 33 participants completed the postoperative questionnaire (49%). The predictive factor for hysterectomy versus myomectomy/UFE was older age (odds ratio 1.13, P = 0.017, 95% confidence interval [CI] 1.02-1.24). Regardless of surgery type, there were significant improvements in perceived body image and sexual function, including an increase in the overall sexual satisfaction of the participant (mean difference 0.50, P = 0.021, 95% CI 0.92-0.08) and less likely to feel less sexually attractive because of their menstrual bleeding problem (P < 0.0001, 95% CI 0.637-1.675). CONCLUSIONS: Women of older age are more likely to choose hysterectomy over myomectomy or UFE for the treatment of symptomatic uterine fibroids. In addition, women who underwent any treatment for fibroids have increases in perception of body image and sexual functioning after their procedure.

Predicting Concussion Recovery with PHQ-9 and GAD-7.

OBJECTIVE: To determine whether scores obtained from Patient Health Questionnaire-9 (PHQ-9) or the General Anxiety Disorder-7 (GAD-7) instruments administered following a concussion can be used to predict recovery time. METHOD: Retrospective cohort study in a university-based specialty concussion center of 502 concussed participants. Participants completed a PHQ-9 and GAD-7 during their initial visit and subsequent visits during the recovery period (ie, at 14, 28, 56, and 84 days). RESULTS: The median recovery time from a concussion was 21 days from the initial clinical evaluation; however, individuals with a PHQ-9 score ≤ 6 (n = 262) had a median recovery time of 17 (95% confidence interval [CI] 15-19) days, whereas those with PHQ-9 scores >6 (n = 240) had a median recovery time of 33 (95% CI 28-37) days and a hazard ratio of 0.525 (95% CI 0.438-0.629, P < 0.0001). For individuals with a GAD-7 score ≤ 4 (n = 259), the median recovery was 19 (95% CI 17-21), days whereas for those with a GAD-7 score > 4 (n = 243), the median recovery was 32 (95% CI 28-36) days with a hazard ratio of 0.554 (95% CI 0.462-0.664, P < 0.00). CONCLUSIONS: Scores obtained from PHQ-9 and GAD-7 screening tools appear to be predictive of an individual's recovery and may help identify those subjects who may benefit from early psychological interventions.

Experiences of Work-Family Conflict and Mental Health Symptoms by Gender Among Physician Parents During the COVID-19 Pandemic.

Importance: The COVID-19 pandemic has placed increased strain on health care workers and disrupted childcare and schooling arrangements in unprecedented ways. As substantial gender inequalities existed in medicine before the pandemic, physician mothers may be at particular risk for adverse professional and psychological consequences. Objective: To assess gender differences in work-family factors and mental health among physician parents during the COVID-19 pandemic. Design, Setting, and Participants: This prospective cohort study included 276 US physicians enrolled in the Intern Health Study since their first year of residency training. Physicians who had participated in the primary study as interns during the 2007 to 2008 and 2008 to 2009 academic years and opted into a secondary longitudinal follow-up study were invited to complete an online survey in August 2018 and August 2020. Exposures: Work-family experience included 3 single-item questions and the Work and Family Conflict Scale, and mental health symptoms included the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 scale. Main Outcomes and Measures: The primary outcomes were work-to-family and family-to-work conflict and depressive symptoms and anxiety symptoms during August 2020. Depressive symptoms between 2018 (before the COVID-19 pandemic) and 2020 (during the COVID-19 pandemic) were compared by gender. Results: Among 215 physician parents who completed the August 2020 survey, 114 (53.0%) were female and the weighted mean (SD) age was 40.1 (3.57) years. Among physician parents, women were more likely to be responsible for childcare or schooling (24.6% [95% CI, 19.0%-30.2%] vs 0.8% [95% CI, 0.01%-2.1%]; P < .001) and household tasks (31.4% [95% CI, 25.4%-37.4%] vs 7.2% [95% CI, 3.5%-10.9%]; P < .001) during the pandemic compared with men. Women were also more likely than men to work primarily from home (40.9% [95% CI, 35.1%-46.8%] vs 22.0% [95% CI, 17.2%-26.8%]; P < .001) and reduce their work hours (19.4% [95% CI, 14.7%-24.1%] vs 9.4% [95% CI, 6.0%-12.8%]; P = .007). Women experienced greater work-to-family conflict (ß = 2.79; 95% CI, 1.00 to 4.59; P = .03), family-to-work conflict (ß = 3.09; 95% CI, 1.18-4.99; P = .02), and depressive (ß = 1.76; 95% CI, 0.56-2.95; P = .046) and anxiety (ß = 2.87; 95% CI, 1.49-4.26; P < .001) symptoms compared with men. We observed a difference between women and men in depressive symptoms during the COVID-19 pandemic (mean [SD] PHQ-9 score: 5.05 [6.64] vs 3.52 [5.75]; P = .009) that was not present before the pandemic (mean [SD] PHQ-9 score: 3.69 [5.26] vs 3.60 [6.30]; P = .86). Conclusions and Relevance: This study found significant gender disparities in work and family experiences and mental health symptoms among physician parents during the COVID-19 pandemic, which may translate to increased risk for suicide, medical errors, and lower quality of patient care for physician mothers. Institutional and public policy solutions are needed to mitigate the potential adverse consequences for women's careers and well-being.

Reliability of the Telemedicine Application of the Gross Motor Function Measure-88 in Patients With Leukodystrophy.

BACKGROUND: Leukodystrophies are a rare class of disorders characterized by severe neuromotor disability. There is a strong need for research regarding the functional status of people with leukodystrophy which is limited by the need for in-person assessments of mobility. The purpose of this study is to assess the reliability of the Gross Motor Function Measure-88 (GMFM-88) using telemedicine compared with standard in-person assessments in patients with leukodystrophy. METHODS: A total of 21 subjects with a diagnosis of leukodystrophy (age range = 1.79-52.82 years) were evaluated by in-person and by telemedicine evaluations with the GMFM-88 by physical therapists. Inter-rater reliability was assessed through evaluation of the same subject by two independent raters within a three-week period (n = 10 encounters), and intrarater reliability was assessed through blinded rescoring of video-recorded assessments after a one-week time interval (n = 6 encounters). RESULTS: Remote assessments were performed by caregivers in all 21 subjects using resources found in the home with remote guidance. There was agreement between all paired in-person and remote measurements (Lin's concordance correlation ≥0.995). The Bland-Altman analysis indicated that the paired differences were within ±5%. Intrarater and inter-rater reliability demonstrated an intraclass correlation coefficient of >0.90. CONCLUSIONS: These results support that remote application of the GMFM-88 is a feasible and reliable approach to assess individuals with leukodystrophy. Telemedicine application of outcome measures may be of particular value in rare diseases and those with severe neurologic disability that impacts the ability to travel.