The reliability of a two-item scale: Pearson, Cronbach, or Spearman-Brown?

Psychometric accuracy of the Dutch Child and Adolescent Trauma Screener

Objective: The aim of this study is to investigate the psychometrics of the Dutch version of the Child and Adolescent Trauma Screener (CATS-2). By this, an international recognized instrument to screen symptoms of post-traumatic stress (PTSS) in children and adolescents according to the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5) becomes available for Dutch youth.Procedure and Method: Based on the validated CATS-2 we established the Dutch version, named the KJTS. A total of 587 children and adolescent, age 7-21, and 658 caregivers referred to mental health care services in Amsterdam was included in the study to examine psychometric properties. The construct was tested by confirmatory factor analysis (CFA). Furthermore reliability, convergent-divergent patterns and diagnostic test accuracy were examined.Results: The underlying DSM-5 factor structure with four symptom clusters (re-experiencing, avoidance, negative alterations in mood and cognitions, hyperarousal) was supported by CFA showing a good fit for the selfreport (CFI = .95, TLI = .94), and an acceptable fit for the caregiver report (CFI = .90, TLI = .89). The KJTS showed excellent reliability (alpha = .92) on both selfreport and caregiver report. The convergent-discriminant validity pattern showed medium to strong correlations with measures of internalization problems, such as anxiety and affective problems (r = .44-.72) and low to medium correlations with externalizing symptoms (r = .21-.36). The ROC-curve analysis has proven a good accuracy (AUC = .81; n = 106).Discussion and conclusion: This study demonstrates the psychometric accuracy of the KJTS in a Dutch clinical population. The KJTS reflects adequately the dimensionality of PTSD as described in the DSM-5, with a good fit for selfreports, an acceptable fit for caregiver reports, excellent reliability and sufficient validity. Limitations are described. The outcomes support the use of the KJTS in research and clinical practice for screening and monitoring of PTSS.

Mental health during and after the COVID-19 pandemic - a longitudinal study over 42 months in five European countries

Background: The mental health impact of the COVID-19 pandemic is well documented. However, only a few studies investigated mental health in later phases of the pandemic and after its official end. Moreover, little is known about people's psychological burden related to the pandemic and other global crises post-pandemic.Objective: Study's first objective was to compare mental health outcomes in the general population over the course of the pandemic and ten months post-pandemic. The second objective was to explore people's psychological burden regarding the pandemic, in comparison to current wars, climate crises, inflation, and poor government management and/or corruption in the post-pandemic era.Method: Participants from the general population of Austria, Croatia, Germany, Greece, and Portugal (68.8% female, Mage = 41.55) were assessed online up to four times between June 2020 and March 2024 (baseline sample: N = 7913). Adjustment Disorder New Module - 8 (ADNM-8), Patient Health Questionnaire (PHQ-2), and World Health Organization-Five Well-Being Index (WHO-5) were used to measure adjustment disorder, depression, and well-being. Prevalence rates were calculated and repeated measures ANOVAs applied to assess mental health at four time points. One-way repeated measures ANOVA was run to explore how the different global crises were related to participants' burden.Results: Temporal variations in mental health were evident across four assessment waves, with highest levels of probable adjustment disorder and depression in winter 2020/2021 (T2). A slight improvement of mental health was found at later time points. Current wars and inflation were the greatest sources of psychological burden at the post-pandemic assessment, revealing some cross-country differences.Conclusion: Although mental health differences in the general population were not as pronounced as in the acute phase of the pandemic, psychosocial support is still needed post-pandemic. This is likely to be due to other global crises that take a toll on people's mental health.

The construct validity of screening questions for kinesiophobia, pain catastrophizing, depression, and stress in patients with (sub-)acute non-traumatic neck pain

BACKGROUND

Neck pain is common and may transition from acute to chronic, often influenced by psychological factors like kinesiophobia, pain catastrophizing, depression, and stress. Early screening for these factors in patients with (sub-)acute neck pain is crucial to prevent chronicity.

OBJECTIVES

To examine the construct validity and internal consistency of screening questions for kinesiophobia, pain catastrophizing, depression, and stress in Dutch patients with (sub-)acute, non-traumatic neck pain.

DESIGN

Cross sectional study.

METHOD

Hypotheses were formulated for convergent and divergent validity. Screening questions were compared with established questionnaires: the Tampa Scale for Kinesiophobia (TSK-11) for kinesiophobia, the Pain Catastrophizing Scale (PCS-6) for pain catastrophizing, and the Depression, Anxiety, and Stress Scale (DASS-21) for depression and stress. When strong convergent validity (r ≥ 0.7) was observed, internal consistency was assessed.

RESULTS

Moderate correlations were observed for kinesiophobia (r = 0.526, TSK-11), depression (r = 0.660 DASS-21 depression), and stress (r = 0.506. DASS-21 distress). Pain catastrophizing showed a strong correlation with the PCS-6 (r = 0.771). Divergent validity was supported by correlations ≤0.5 with unrelated constructs for kinesiophobia, pain catastrophizing, and stress, but not for depression. Internal consistency for pain catastrophizing was 0.692. Scatterplots showed wide dispersion for kinesiophobia and stress. For pain catastrophizing, the scatterplot revealed that low screening scores were associated with high reference standard scores.

CONCLUSIONS

Investigating the complex constructs of kinesiophobia, pain catastrophizing, depression and stress with one or two questions cannot currently be recommended. Further research is needed to confirm the ability to screen for psychological constructs.

Extrinsic Motivation vs. Intrinsic Motivation: Key Factors Influencing Farmers' Land Quality Protection Behavior in China

The crowding effect of individual behavior motivation is a focal point in various disciplines, such as economics and social psychology. Understanding the motivation crowding effect in the context of pro-environmental behavior of farmers is crucial for formulating agricultural environmental policies. However, there is limited knowledge about the motivation crowding effect on farmers' land quality protection behavior, especially in developing countries. This study employs stratified regression models, propensity score matching models, seemingly unrelated regression models, and simple slope analysis methods to analyze the impact of extrinsic motivations (external incentives such as increasing farming income and production yield) and intrinsic motivations (internal drives such as personal satisfaction and responsibility) on farmers' land quality protection behavior, as well as the motivation crowding effect between extrinsic and intrinsic motivations. The analysis is based on survey data from 1064 smallholder farmers in five provinces in China: Zhejiang, Jiangsu, Henan, Shaanxi, and Gansu. The results indicate that both extrinsic and intrinsic motivations have a positive impact on farmers' land quality protection behavior. Notably, extrinsic motivation exhibits a crowding-out effect on intrinsic motivation, suggesting a motivation crowding effect. While promoting farmers' land quality protection behavior through economic incentives is a feasible short-term solution, it may not effectively foster the long-term formation of such behaviors. Given the current context of severe land pollution, alleviating this issue through economic incentives represents a short-term policy approach. Thus, transitioning from short-term to long-term solutions by enhancing farmers' intrinsic motivation to promote farmers' land quality protection behavior is essential for the government to consider in future land protection policy formulation.

Nonzero-Sum Time Perception Is Associated with Greater Willingness to Help

People are less likely to help others when they view time as a scarce resource. Does changing people's perception of time influence their willingness to help? We hypothesized that people would be more willing to help and would allocate more time to helping others when they view time as a nonzero-sum resource (i.e., as a resource that merely exists or that can be created moment-by-moment with their interactions with others) versus a zero-sum resource (i.e., a commodity that can be lost, taken, or given away). Study 1 measured people's perception of time and their willingness to help in hypothetical vignettes. Studies 2 and 3 manipulated the perception of time to examine its effect on people's willingness to help others and the amount of time they wanted to spend helping. Study 3 further examined prosocial motivation as a potential mediator. Across the three studies, we demonstrated that when people perceive time as a nonzero-sum resource versus a zero-sum resource, people are more willing to help others. People's prosocial motivation to reduce others' distress mediated this relationship. We speculate that when people perceive time to be nonzero-sum, time spent helping others is not viewed as costly, but as a resource to invest in to benefit both themselves and others.

Research on driving factors of consumer purchase intention of artificial intelligence creative products based on user behavior

With the continuous advancement of artificial intelligence (AI) technology, AIGC (AI-generated content) has increasingly permeated various sectors, leading to a significant transformation in the design industry. This study aims to explore user purchase intention and the influencing factors of AI-generated cultural and creative products, thereby formulating strategies to enhance user satisfaction. Based on the stimulus-organism-response theory, the theory of planned behavior, the value adoption model, the innovation diffusion theory, and the unified theory of acceptance and use of technology 2, a comprehensive model is constructed. The model also incorporates external variables such as perceived value (PV), perceived price (PP), social influence, hedonic motivation (HM), and cultural experience (CE). Additionally, self-innovation is considered as a key moderator to explore its role in moderating the relationships between PV, PP, and user perceived behavioral control. Using 526 valid samples, this study employs structural equation modeling to conduct exploratory factor analysis and confirmatory factor analysis, and further verifies the importance of variables through artificial neural networks. The findings indicate that behavioral attitude, HM, PP, PV, and generative quality are the primary factors influencing user purchase intention. In the decision-making process, users not only consider the price and quality of the products but also place significant importance on the pleasurable experience and cultural uniqueness they offer. This study extends the theoretical application of AIGC in the field of cultural and creative consumption, enriches the user behavior research model, and provides practical insights for companies to optimize AI-generated cultural products, enhance user experience, and improve market acceptance.

Sources of stress in online learning scale: development and validation of an instrument to evaluate students' stressors associated with the online learning

Introduction

Since transitioning to online teaching and learning was forced to happen in the shortest ever time span during the COVID-19 pandemic, the opportunity arose for educational researchers to reflect on tools and means for measuring and explaining students' and teachers' relevant experiences related to the change. One of our responses to this challenge was to elaborate, administer and evaluate the psychometric properties of an instrument - Sources of Stress in Online Learning Scale (SSOLS) - that would help educational professionals assess students 'perceptions upon sources of stress regarding their online learning. Furthermore, SSOLS's factors would allow educators to predict students' learning engagement due to the valid predictive association.

Methods

The present research aimed to develop and test an instrument assessing the sources of stress in the context of academic online learning and to articulate its psychometric properties. The study focused on the responses of more than 500 university students regarding perceived stressors pertaining to the experience of online learning.

Results

Our analysis demonstrated that the instrument (SSOLS) is reliable and valid in measuring the sources of stress associated with online learning. Also, the dimensions of SSOLS were shown to be valid predictors for academic engagement.

Discussion

The significance of this study lies also in its contribution to both theoretical understanding and practical applications regarding academic stress in online learning environments.

Nonlinear trajectories of emotion dysregulation across the perinatal period: Associations with prenatal and birth experiences

BACKGROUND

Emotion dysregulation is a transdiagnostic correlate of psychopathology. However, longitudinal changes in emotion dysregulation have been understudied during the transition to parenthood. Additionally, less is known about whether prenatal and birth experiences may be associated with changes in emotion dysregulation across time.

METHODS

Data were collected from a longitudinal study of 385 pregnant individuals from their third trimester through to 18 months postpartum. Participants self-reported their emotion dysregulation at their prenatal visit, birth, 7 months, and 18 months postpartum. Additionally, participants reported on prenatal life stress, pregnancy-related hassles, and childbirth experiences through self-report measures and a semi-structured interview.

RESULTS

Results show non-linear decreases in emotion dysregulation from pregnancy to 18 months postpartum. On average, there was a significant decrease in self-reported emotion dysregulation from pregnancy to birth, followed by rank stability higher from birth through 18 months postpartum. More stress during pregnancy was associated with levels of emotion dysregulation and birth experiences characterized by fear were associated with more stability in emotion dysregulation from pregnancy to birth.

LIMITATIONS

We only assessed emotion dysregulation once prenatally, so our findings do not account for changes across pregnancy. Additionally, our measures are all self-report through questionnaires and a semi-structured interview.

CONCLUSIONS

Our study is consistent with literature on trajectories of psychopathology across the perinatal period. Assessing emotion dysregulation can help identify those at higher risk for psychopathology during the transition to parenthood. Our findings highlight the importance of prenatal and birth experiences, and the need to support mental health during this sensitive period.

Examining the Indirect Effect of Dementia Caregiving Status on Mental Health Through Coping Resources

Caregivers of older adults with dementia generally report poorer mental health than those caring for other chronic conditions. Research indicates that coping resources such as resilience and perceived gains can improve mental health. This study examined the indirect effects of dementia caregiving status on mental health through coping resources. Participants were 2242 caregivers of Medicare enrollees aged 65 and older from the 2017 National Study of Caregiving. Path analysis was conducted to examine the study aim. Dementia caregiving was associated with higher levels of resilience, which in turn, was associated with reduced psychological distress and increased psychological well-being. Perceived gains were negatively associated with psychological distress and positively associated with psychological well-being. The study highlighted resilience as a mechanism underlying differential mental health outcomes between dementia and non-dementia caregivers, as well as the role of perceived gains in enhancing well-being. Interventions should promote resilience and help caregivers recognize caregiving gains.

On the road to comfort: Evaluating the influence of motion predictability on motion sickness in automated vehicles

Automated vehicles could increase the risk of motion sickness because occupants are not involved in driving and do not watch the road. This paper aimed to investigate the influence of motion predictability on motion sickness in automated vehicles, as better motion anticipation is believed to mitigate motion sickness. In a simulator-based study, twenty participants experienced two driving conditions differing only in turn directions. The repetitive condition featured a repeating turn direction pattern. The non-repetitive condition contained pseudo-randomly ordered turn directions. To mimic an 'eyes-off-the-road' setting and prevent visual motion anticipation, road visuals were omitted. No significant differences in sickness or head motion, a metric for motion anticipation, were found between the conditions. No participant recognised the repeating turn pattern. This suggests no increased motion anticipation in the repetitive condition, possibly due to a reduced ability to recognise a repeating motion pattern in one degree of freedom within more complex motion.

Enhancing stroke response in school children: Efficacy of the HOBIT program - a cluster randomized trial

Objective: Stroke treatment is often hampered by delayed Emergency Medical Services activation. Public campaigns to improve the response to stroke symptoms are either costly or not working. We evaluate the effectiveness of a school-based HOBIT program in improving Emergency Medical Services activation. Methods: This cluster randomized trial was conducted from May to June 2023 at 13 schools in the South Moravian region of Czechia. Schools were randomized to the HOBIT intervention or control group with a 3:1 ratio. Both groups had knowledge assessments at baseline and follow-up. The primary outcome was the percentage change from the pretest to the follow-up test in the intervention group compared to the control group in 4 domains: 1) knowledge, 2) self-efficacy, 3) outcome expectations, 4) behavioral intentions. Results: The baseline knowledge was greater than 50 % in most metrics except for knowledge of the FAST test, which was only 16 %. The intervention effect was 16 % (95 % CI 12-21) for knowledge, 10 % (95 % CI 4-15) for self-efficacy,10 % (95 % CI 5-15) for outcome expectations, 8 % (95 % CI 2-11) for behavioral intentions. Conclusions: In school children, even those with high baseline, "HOBIT" intervention can improve determinants and behavioral intentions of Emergency Medical Services activation for suspected stroke.

A randomised pilot trial for bedtime procrastination: Examining the efficacy and feasibility of the Reducing Evening Screen Time online intervention (REST-O)

Bedtime procrastination is associated with inadequate sleep and is a novel intervention target to improve sleep health. Formative work indicates that pre-sleep electronic device use, a ubiquitous bedtime procrastination behaviour, may be targeted using a behaviour change approach. This pilot study aimed to examine (1) the acceptability and feasibility of the Reducing Evening Screen Time online program (REST-O) in new career starters, and (2) the preliminary effect of the program on daily pre-sleep electronic device use and sleep duration, as well as weekly measures of bedtime procrastination, excessive device use, and sleep quality and duration. Participants (N = 55) were randomised into three arms; an active Control (n = 19), Prevent (n = 18) and Substitute (n = 18), who used behavioural substitution at different times of day. Daily assessments were conducted for two weeks, and weekly measures at baseline, pre-intervention, post-intervention, and follow-up (end of Week Three). All groups experienced a reduction in daily pre-sleep device use (M = 23.4 min per day) and an increase in daily sleep duration (M = 12.7 min per day) post-intervention. Continued reductions in bedtime procrastination, excessive device use, and improvements in sleep quality and duration were observed at follow-up. The program appears feasible and acceptable to participants with a high daily completion rate (M = 84.7 %). Reductions in habit strength and hedonic motivation suggest potential mechanisms of change. Findings provide preliminary evidence for behaviour change interventions in targeting pre-sleep electronic device use and bedtime procrastination, with broader implications for sleep health.

Validation of a gender-specific binary depression screening version (GIDS-15) in two German samples

Objective

Findings from depression research increasingly suggest a gender-dependent clinical appearance of relevant symptoms. At the same time, there is a lack of gender-sensitive screening procedures in clinical practice to better identify hidden depression in men. The present study examines the factor structure and psychometric characteristics of the translated version of the Gender Inclusive Depression Scale (GIDS) based on two large German-speaking mixed-sex samples, and assess sex and age effects.

Methods

The preliminary exploratory validation of the German GIDS version was initially carried out using exploratory factor analysis with an online recruited non-clinical sample (N = 1173). The established factor structure was replicated with confirmatory factor analysis in a separate sample (participants of an alcohol prevention study; N = 418). Psychometric properties were calculated.

Results

The exploratory factor analysis resulted in a 5-factor solution, and was confirmed in the second analysis. A screening version comprises 15 items. Overall, psychometric properties are satisfactory, with only two subscales (aggressiveness, substance use) with critical values. The majority of sex effects could be established.

Conclusions

The GIDS-15 is a solid, multidimensional depression screening instrument that should be complemented by a gender assessment tool. There is further evidence that the inclusion of additional criteria alters the gender ratio in depression screening. After further studies to validate the GIDS-15, implementation in primary care could be indicated. Gender beyond the binary should be analysed in further studies.

Sympathy towards people infected with COVID-19 mediates relations between media use and death anxiety

The COVID-19 pandemic threatened mental health. This study examined the longitudinal associations among pandemic-related media use, sympathy for people infected with COVID-19 (PIWC), and death anxiety. 132 Chinese adults completed measures three times, one week apart during the initial phase of COVID. The results showed that media use, sympathy, and death anxiety decreased significantly over the first month of the outbreak. Pandemic-related media use predicted increased future sympathy for PIWC, and sympathy predicted increased future death anxiety. The study identified the short-term effects of media use on sympathy and death anxiety, and suggests that reduced media exposure may be beneficial.

The Public Service Motivation's Impact on Turnover Intention in Korean Public Organizations: Do Perceived Organizational Politics Matter?

Increasing turnover intention among public employees in Korean public sector organizations endangers both organizational sustainability and public service quality. Although prior research highlights job stress, compensation systems, and organizational culture as key drivers of turnover, scholars in limited empirical studies directly examine the role of public service motivation. In this study, we address this gap by investigating whether public service motivation reduces turnover intention and how perceived organizational politics may moderate this relationship. Using survey data from the 2023 Korean Public Employee Viewpoints Survey-conducted by the Korea Institute of Public Administration and including responses from central and local government employees-we employ stereotype logistic regression for analysis. Results show that public service motivation significantly lowers turnover intention, but its positive effect diminishes when employees perceive high levels of organizational politics. When employees believe that power and resources are distributed based on political interests rather than merit, they experience diminished reciprocity toward their organization. As a result, their intention to leave the organization increases. These findings underscore the need to sustain and enhance public service motivation while mitigating perceived organizational politics. Enhancing fairness, transparency, and trust-while reducing political interference-can preserve public service motivation's positive impact and reduce turnover intention within public sector organizations.

COPSOQ III in China: Preliminary Validation of an International Instrument to Measure Psychosocial Work Factors

BACKGROUND

The Copenhagen Psychosocial Questionnaire (COPSOQ) is an international instrument designed for the assessment and improvement of psychosocial conditions in workplaces and for research purposes. After the International COPSOQ Network took over responsibility for the development of COPSOQ, a new version was published in 2019 (COPSOQ III). However, there is no widely recognized instrument for measuring psychosocial work factors, and insufficient research exists regarding the use of COPSOQ III within the Chinese setting. This study seeks to conduct a preliminary validation of the Chinese long version of COPSOQ III.

METHODS

A cross-sectional questionnaire survey was conducted with a large sample in a medical consortium in China. Item analysis, reliability, and validity were explored.

RESULTS

The data management platform showed that 1067 respondents who met the inclusion criteria completed the questionnaire, among which 1054 questionnaires were valid. The content validity results showed that the I-CVI and S-CVI/AVE of each item ranged from 42.86 to 100.00, and the S-CVI/AVE was 92.52, indicating that the Chinese long version of COPSOQ III had good content validity. An exploratory factor analysis (EFA) extracted seven factors, which explained 63.96% of the variation. The results of confirmatory factor analysis (CFA) indicated that the model was well fit (χ2/df = 4.50, CFI = 0.910, TLI = 0.897, IFI = 0.910, RMSEA = 0.058). The Cronbach alpha coefficient of the questionnaire was 0.92.

CONCLUSIONS

The Chinese long version of COPSOQ III is of good reliability and validity, like the original, and can be used to assess psychosocial work factors in China.

Can Expressing Feelings About Violence be a Protective Buffer in the Linkage Between Bullying Victimization and Delinquent Activities?

The current study explores whether expressing feelings about violence through journal or notebook and/or school assignment might be associated with a decrease in delinquent activities, such as substance use, theft of property, and assaultive behaviors. A cross-sectional study with purposive sampling was conducted. The participants were comprised of African American adolescents in four Chicago's Southside neighborhoods. Measures included bullying victimization, substance use, theft of property, assaultive behavior, expressing feelings about violence, and the covariates (age, biological sex, and government assistance). Analyses were univariate analyses and a two-step hierarchical multiple regression. Regarding the study sample, the average age was 15.84 years, 45.6% were males, and 75.7% received government assistance. Bullying victimization was positively associated with substance use, and expressing feelings about violence moderated the association between the two. Bullying victimization was also positively associated with theft of property, and expression feelings about violence moderated the association between the two. Although bullying victimization was positively associated with assaultive behavior, expressing feelings about violence did not moderate the association between the two. Findings suggest a significant role of expressing feelings about violence in buffering the adverse outcomes of bullying victimization among adolescents in low-resourced neighborhoods. Expressing feelings about violence may serve as an effective coping mechanism for adolescents who are consistently exposed to violence.

Is a stimulating work environment related to job satisfaction and retention among care professionals? A cross-sectional study in Dutch nursing homes

PURPOSE

This study aims to examine how care professionals of different occupational groups perceive organizational conditions for voice behavior and whether these conditions are related to job satisfaction and retention as was experienced at nursing home (NH) facilities.

DESIGN/METHODOLOGY/APPROACH

An online survey study was conducted among care professionals, (middle) managers and policy officers of 175 Dutch nursing home (NH) facilities (N = 3,932 respondents). Data were collected between November 2020 and January 2022. Organizational conditions were clustered into four categories: dealing with incidents, formal opportunities, supportive management and teams' improvement orientation.

FINDINGS

Certified nurse assistants (CNAs) and registered nurses (RNs) were more critical about the organizational conditions than other respondents from the same NH facility. Linear mixed effect models showed that organizational conditions were positively related to job satisfaction and perceived employee retention (p < 0.001). Hierarchical multiple regression models show that "teams' improvement orientation" and "supportive management" are strong independent predictors of job satisfaction and perceived employee retention (p < 0.001).

PRACTICAL IMPLICATIONS

It is important that leaders realize that their own perspectives may not correspond with those of frontline care workers. This emphasizes the importance of capturing different perspectives on organizational conditions and the important role of middle managers who are in the position to create stimulating working environments to retain care professionals for NH care.

ORIGINALITY/VALUE

This study has the unique opportunity to examine the relation between organizational conditions and job satisfaction among different occupational groups in Dutch NHs. Showing that care professionals were considerably more critical about the conditions and their job satisfaction compared to management and policy officers.

German version of the specific phobia of vomiting inventory (SPOVI): psychometric properties and correlates in a clinical and non-clinical sample

BACKGROUND

The Specific Phobia of Vomiting Inventory (SPOVI) is a 14-item instrument measuring behavioral avoidance and threat monitoring associated with emetophobia. The current study aimed to provide a German translation of the SPOVI and examine its psychometric properties and correlates.

METHODS

N = 441 adults from the general population and N = 465 outpatients with mental disorders completed the SPOVI and other self-report measures. Factor structure, reliability, convergent, and discriminant validity, as well as clinical utility, were investigated.

RESULTS

The German version of the SPOVI had a one-factor structure and high internal consistency in both samples (ωs > 0.90). Large correlations (rs > 0.50) with questionnaires assessing phobic anxiety, general anxiety, illness-related anxiety, and disgust sensitivity supported convergent validity, while relatively low correlations with questionnaires assessing depression, eating disorders or paranoid ideation supported discriminant validity. Among outpatients, those with a specific phobia diagnosis had the highest SPOVI scores.

CONCLUSION

The German translation of the SPOVI has sound psychometric properties and is a potentially practical clinical screening instrument for emetophobia. PRE-REGISTRATION: https://aspredicted.org/5y6zb.pdf .

Longitudinal network analysis of depression, anxiety, and post-traumatic stress disorder comorbidities among adolescents in regional China

Purpose

The network theory of mental disorders offers a new perspective for the understanding of comorbidities, but the research on the comorbidities among depression, anxiety, and post-traumatic stress disorder (PTSD) is still insufficient. The aim of this study was to explore the internal relationship by establishing and analyzing the comorbidity networks, and to provide suggestions for the intervention after traumatic events.

Methods

We utilized data from the second and third wave of the Chengdu Positive Child Development cohort (N = 3,189, 47.79% female), we estimated to network models of depression, anxiety and PTSD. To assess difference in global connectivity between the two networks, we conducted invariance test.

Results

K27 (Somatic 10), K37 (Generalized Anxiety 9), K15 (Somatic 5), K33 (Generalized Anxiety 7), K24 (Somatic 9) were the most central nodes in both networks, P13 (Sleep problem) had the highest Bridge Expected Influence value. The structural difference between the two networks was statistically significant (M = 0.229, p = 0.010), and the global strength of the network at wave 2 was higher than the network at wave 3 (35.1 vs. 33.9, S = 1.20, p = 0.010).

Conclusion

The correlation in symptoms of the three disorders underscores the need for more comprehensive treatment options for intervention after traumatic events. Central and bridge nodes could inform targeted interventions or policy decisions. Anxiety disorders, especially Som and Gen dimensions, should be the focus of intervention. The Arousal dimension in PTSD, especially sleep disorders, may contribute to the comorbidities. In addition, this study highlights the importance of staged post-traumatic interventions.

Comprehensive drug policies increase trust in local government: an analysis of authorities' and residents' perspectives in rural US Appalachian and Midwestern counties

BACKGROUND

In many rural US Appalachian and Midwestern counties, stigma surrounding harm reduction interventions has led health professionals and policymakers to approach drug policy implementation with caution, fearing potential backlash from politically conservative communities. One concern is that the public's disapproval of harm-reduction policies may erode the public's trust in its government.

METHODS

This study examined how the public's trust in the local government-as both self-reported and authority-assessed-is influenced by the perceived governmental support of comprehensive drug policies (i.e., inclusive of both drug treatment and harm reduction). Survey data gathered from 138 community authorities and 6,609 community residents from 13 Appalachian and Midwestern states between 2019 and 2023 were analyzed using a multiple regression approach. Furthermore, in an online experiment conducted in 2024, we experimentally simulated the role of authority vs. resident and manipulated the level of perceived governmental support for comprehensive drug policies (high vs. low) to assess their effects on trust and perceived governmental effort and feelings of optimism as possible mediators.

RESULTS AND CONCLUSION

In both the field surveys and the experiment, trust was positively associated with perceptions of governmental support for comprehensive drug policies. In addition, authorities (both real and experimentally simulated roles) consistently assessed the public's trust in them to be higher than did residents. Both effects were mediated by participants' beliefs in the government's effort to reduce drug use problems and optimism that drug use issues could be improved.

Development and preliminary validation of the evaluation scale for nurses' core emergency response abilities in sudden major infectious disease outbreaks

BACKGROUND

In recent years, the escalating frequency and intensity of infectious disease outbreaks have underscored the profound severity and global ramifications of public health challenges confronting healthcare systems. As frontline responders during emerging infectious disease crises, nurses' core emergency response competencies critically influence the timeliness and efficacy of outbreak prevention and control measures. Currently, standardized assessment instruments for evaluating nurses' core emergency response capabilities during major infectious disease outbreaks remain underdeveloped.

AIMS

This study aimed to construct and psychometrically validate a Core Emergency Response Competency Evaluation Scale for nurses during major infectious disease outbreaks.

METHODS

A convenience sample of nurses was recruited from eight tertiary hospitals in Henan Province, China. The three-phase study comprised: (1) item generation (Delphi survey and pilot testing), (2) scale development (item analysis and exploratory factor analysis), and (3) scale validation (reliability and validity assessments).

RESULTS

The finalized 45-item scale encompasses eight dimensions: Fundamental Nursing Knowledge, Legal Policy & Ethical Practice, Core Nursing Skills, Disease Assessment & Monitoring, Emergency Response Coordination, Infection Prevention & Control, Nurse Personal Attributes, and Rehabilitation & Recovery. Exploratory factor analysis demonstrated an 83.353% cumulative variance contribution for the eight-factor model. Confirmatory factor analysis indicated excellent model fit (χ²/df = 1.943, RMR = 0.020, RMSEA = 0.050, IFI = 0.951, TLI = 0.947, CFI = 0.951, PNFI = 0.835). The scale exhibited strong reliability (Cronbach's α = 0.987, split-half = 0.956, test-retest = 0.977) and validity (I-CVI = 0.875-1.00; S-CVI = 0.974). Convergent validity was supported by AVE values (0.611-0.778) and CR values (0.903-0.955).

CONCLUSION

The psychometrically robust Core Emergency Response Competency Evaluation Scale for Sudden Major Infectious Diseases demonstrates excellent reliability and validity, providing a scientifically validated tool for assessing nurses' emergency preparedness in infectious disease crises.

Effects and functional mechanisms of digital fitness platforms on online fitness payment behavior under the perspective of "She-economy"

Women have become an important force for economic development. Online fitness payment behavior is an important part of women's pursuit of "beautiful skin and healthy body", and is also an important embodiment of the integration of the digital industry and the fitness industry. Based on Stimuli-Organism-Response and Technology Acceptance Model theories, this study systematically explored the relationship and mechanism of action between digital fitness platforms and online fitness payment behavior through a survey of 259 women using Structural Equation Modeling and Fuzzy Set Qualitative Comparative Analysis. It was found that women's perceived use of digital fitness platforms was positively related to satisfaction, continued use intention, and online fitness payment behavior, except for the relationship between perceived usefulness and satisfaction, which was not significant. With the exception of satisfaction, which did not mediate between perceived enjoyment and online fitness payment behavior, satisfaction, and continued using intention mediated and chained mediation between the other independent variables and the dependent variable. The "comprehensive" digital fitness platforms were the most popular and favorite among women, followed by the "hedonic" and "pragmatic" platforms. On this basis, corresponding countermeasures and recommendations are proposed to promote the healthy, sustainable, and stable development of the digital fitness industry.

Prepartum working conditions predict mental health symptoms 14 months postpartum in first-time mothers and their partners - results of the prospective cohort study "DREAM"

BACKGROUND

During the vulnerable transition to parenthood, (expectant) parents may be particularly susceptible to the negative effects of adverse working conditions. However, research on the influence of work-related factors on peripartum mental health issues is scarce. This study aims to enhance our understanding of work-related risk factors for the adjustment of parents in the transition to parenthood by investigating the role of prepartum precarious employment, abusive supervision, job insecurity, and job demand on postpartum mental health symptoms in first-time mothers and their partners.

METHODS

In the prospective-longitudinal cohort study "DREAM", N = 1,259 mothers and N = 811 male and female partners were asked about their working conditions during pregnancy and their mental health 14 months postpartum. We conducted several hierarchical multiple regression analyses with prepartum precarious employment, abusive supervision, job insecurity, and job demand (the latter three in joint regression analyses) as predictors of postpartum symptoms of depression, somatization, obsessive-compulsiveness, anxiety, and anger/hostility. In Model 1 we controlled for sociodemographic variables, and in Model 2 we also controlled for pre-existing symptoms of the respective mental health variable during pregnancy. Separate analyses were calculated for mothers and partners, and each mental health outcome.

RESULTS

Multiple regression analyses revealed that prepartum precarious employment and abusive supervision predicted mothers' and partners' mental health symptoms 14 months postpartum even after controlling for pre-existing symptoms. Prepartum job insecurity and job demand also predicted mental health symptoms 14 months postpartum but were no longer significant predictors in most models after controlling for pre-existing mental health symptoms. There were only minor differences regarding the considered mental health outcomes and between mothers' and partners' results.

CONCLUSIONS

Our study demonstrates that adverse working conditions are important risk factors for the adjustment of parents in the transition to parenthood, requiring more attention from research and practice. Precarious employment and abusive supervision appear to be particularly important factors affecting new parents' mental health. Future research should investigate the mechanisms behind these variables, including comparisons between mothers and their partners, and the role of stress-related biomarkers. Additionally, developing screening methods for clinical use to facilitate targeted preventive interventions is essential.

Development of a Vaccine Advocacy Scale for Childhood Vaccines and Psychometric Evaluation: A Methodological Study

AIM

This study developed the Vaccine Advocacy Scale for childhood vaccines for adults and evaluated its psychometric properties.

METHOD

This methodological study involved 211 adults. A literature review was conducted to create the item pool of the scale, and 12 items were prepared. While evaluating the scale's psychometric properties, the researchers performed content validity, explanatory factor analysis (factor loadings of the items, eigenvalues of the sub-dimensions, and explained variance rates), confirmatory factor analysis (factor loadings and common fit indices), and criterion validity (predictive validity) in the validation phase. In the predictive validity assessment, the distribution of scores on the scale was examined according to some behaviours related to vaccine advocacy. Additionally, we analysed the item-total score correlation, Cronbach's alpha coefficient, and split-half test consistency in the reliability phase.

RESULTS

The study's calculated Kaiser-Meyer-Olkin value was 0.868, and Bartlett's test of sphericity resulted in significant results (X2 = 1724.166; p < 0.001). The explanatory factor analysis revealed that the items' factor loadings were between 0.451 and 0.949 and explained 58.29% of the total variance of the structure, which consisted of 12 items and two sub-dimensions. The confirmatory factor analysis found the factor loadings of the items between 0.62 and 0.85 and identified 'common fit indices' within acceptable ranges and close to the perfect fit values (X2/df, GFI, CFI, RMSEA, RMR, NFI, TLI and IFI were 1.906, 0.950, 0.952, 0.093, 0.059, 0.906, 940 and 0.953, respectively). The Cronbach's alpha value for the scale was 0.92, and the Spearman-Brown coefficient, Guttman's split-half coefficient, and split-half correlation coefficients were 0.843, 0.842 and 0.713, respectively. The study findings indicated that individuals who had talked to other parents about vaccines, recommended vaccinations, and communicated vaccine-related issues with medical professionals had significantly higher total scale scores (p < 0.005).

CONCLUSION

Considering the study findings and evaluations, the Vaccine Advocacy Scale was a valid and reliable measurement tool to assess adults' vaccine advocacy behaviour for childhood vaccines.

Functionality appreciation in young children

In recognition of a need to better understand children's body image, this study aimed to explore how young children describe what they appreciate about their body functionality. A total of 381 British children aged four to six years old were interviewed in a brief play-based session. We looked at the absolute number of responses children gave when asked to list all the amazing things they could do with their bodies as well as the range of responses across body functionality domains using a coding rubric. We assessed whether there were differences by age and gender for both scores and then tested whether each were associated with body appreciation. On average, we found that children listed five amazing things they can do with their body across two body functionality domains. There were no significant differences by gender for either score. Older children gave significantly more functionality appreciation responses than younger children, which spanned more domains. The number of functionality appreciation domains children covered in their responses was positively associated with body appreciation while the total number included in their list was not. Insights from this preliminary work can aid the development and evaluation of positive body image interventions for young children.

Association Between Pornography Use, Sexism, and Sexual Violence Myth Acceptance in Chinese Men: The Moderating Effect of Perceived Realism

Pornography is spreading more and more widely due to websites, applications, and social media. It has attracted the attention of a large number of researchers who are sometimes divided on the impact of pornography. However, the relationship between pornography and sexual violence myths has received little scholarly attention in China. Based on the 3AM model and previous research, the study examined hostile sexism (HS) as a mediator and perceived realism as a moderator in the links between pornography use frequency and sexual violence myths in a sample of Chinese men (N = 376). The results showed that although pornography use and sexual violence myths did not directly correlate with one another, there was an indirect correlation through HS. Further, perceived realism moderated the relationship between pornography use frequency and HS. When participants' perceived realism was high (i.e. +1 SD), the indirect effect of HS was strong; when participants' perceived realism was low (i.e. -1 SD), the indirect effect of HS was not significant. Taken together, the findings reveal the cross-cultural consistency of the 3AM theory in China, and the findings provide new insight into the potential impact of pornography on sexism. At the same time, the results suggest an increase in appropriate education and interventions to reduce the incidence of sexual violence.

Does Religious-Service Attendance Increase Mental Health? A Random-Intercept Cross-Lagged Panel Analysis Across 18 Years

The study aimed to investigate the within-person relationship between religious-service attendance and mental health using data from the British Household Panel Survey (N = 29,298), a longitudinal survey of adult British households between 1991 and 2009. The outcome variables were mental health (as measured with the General Health Questionnaire) and life satisfaction. Using random-intercept cross-lagged panel models over 10 waves of data spanning over 18 years, the associations between religious-service attendance and mental health at the within-person level were mostly nonsignificant. The few significant findings indicated that an increase in religious-service attendance is associated subsequently with either higher or lower levels of mental health, suggesting both detrimental and beneficial effects. A series of robustness analyses (including the use of marginal structural models) mainly supported these findings. The results suggest that there is a need to question the assumption that religious-service attendance provides mental health benefits.

Violence in the Family of Origin, Reflective Functioning, and the Perpetration of Isolating Behaviors in Intimate Relationships: A Mediation Model

BACKGROUND

The intergenerational transmission of violence from the family of origin to couple relationships in adulthood is well-known in the scientific literature. However, the perpetration of isolating behaviors (IBs) is still poorly explored, and additional studies are required to comprehend the mechanisms that intervene in the association between Violence in the family of origin (VFO) and isolating behaviors. Drawing from Fonagy's mentalization model, which describes reflective functioning as the capacity to conceive mental states as explanations for one's own and other people's behavior, the present study aims to examine the mediating role of reflective functioning in the link between VFO and the perpetration of isolating behaviors.

METHODS

Online self-report questionnaires were completed by 663 Italian participants (66.8% women; Mage = 28.4, SD = 8.5) who were in a couple relationship in the last 12 months. A mediation model was tested to assess the direct and indirect effects of VFO on the perpetration of isolating behaviors through certainty and uncertainty of mentalization.

RESULTS

A direct association was found between VFO and the perpetration of isolating behaviors. Furthermore, we found an indirect effect of VFO on the perpetration of the perpetration of isolating behaviors, mediated by the certainty and uncertainty of mentalization.

CONCLUSIONS

The results demonstrated the mediating role of reflective functioning in the intergenerational transmission of violence and support its implication in the perpetration of isolating behaviors in couple relationships. Although these results are preliminary, they can provide useful data at the theoretical and clinical levels.

Development and psychometric testing of the family caregiver self-efficacy scale for patients in the early post-coronary artery bypass grafting

BACKGROUND AND OBJECTIVES

Family caregiver self-efficacy plays an important role in improving the health and quality of life of patients in the early post-coronary artery bypass grafting (CABG). However, there is a lack of targeted self-efficacy assessment tool for caregivers of patients. Thus, the purpose of this study was to develop a Family Caregiver Self-Efficacy Scale for patients in the early post-CABG (FCSES-EPCABG) and to test its reliability and validity.

METHODS

Based on self-efficacy theory, the initial scale was formed by the literature review, semi-structured interviews, Delphi expert consultation, and pre-survey. Through the convenience sampling method, 133 caregivers who met the selection criteria were chosen for the questionnaire survey at Wuhan Asian Heart Hospital from January 2024 to May 2024. The aim was to test the reliability and validity of the scale.

RESULTS

The final scale contained five dimensions of wound care, medication management, cardiac rehabilitation management, social support, and self-care, with a total of 22 items. The item-level content validity index ranged from 0.889 to 1.000, the scale-level content validity index/average was 0.985, and the content validity ratio ranged from 0.778 to 1.000. The exploratory factor analysis showed that the cumulative variance contribution rate of the five dimensions was 69.433%. In the criterion-related validity analysis, the total score of the FCSES-EPCABG was positively correlated with the total score of the General Self-Efficacy Scale (r = 0.762, P<0.001). The Cronbach's alpha coefficient of the scale was 0.919, the half reliability was 0.779, and the test-retest reliability was 0.936.

CONCLUSION

The FCSES-EPCABG has satisfactory reliability and validity, which is suitable for evaluating the self-efficacy of family caregivers of patients in the early post-CABG.

Comparing self-assessment and instructor ratings: a study on communication and interviewing skills in psychology student training

BACKGROUND

A multitude of studies have investigated, assessed, and debated the merits of self-assessment within medical education and related fields, yielding inconclusive results. This raises questions about the reliability of self-assessment as a tool for evaluating competency development. The objective of the current study was to investigate the self-assessment accuracy of psychology students regarding their performance in training for interviewing and communication skills. A novel assessment instrument was employed for this purpose. The main research questions were: (1) How accurate are students' self-assessments of their performance in comparison to instructors' ratings? (2) How well do these self-assessments align with perceived changes in skill development at both group and individual levels?

METHODS

The study was conducted in three phases to achieve the research objective. In Phase 1, 206 psychology students from the first three semesters of a 5-year master's program at Stockholm University conducted 15-minute video-recorded interviews, which were rated by instructors using an 11-item assessment instrument. Data were analyzed using Exploratory Factor Analysis (EFA). Phase 2 included 173 second semester students conducting 15-minute video interviews. These were reviewed in small groups, with both students and instructors rating the interviews using the same instrument. The process was repeated after one week. Two Confirmatory Factor Analyses (CFAs) were conducted on instructors' and students' ratings to validate the three-factor model identified in Phase 1. In Phase 3, correlation analyses and paired-samples t-tests were conducted at both group and individual levels to address the research questions.

RESULTS

The findings indicated high self-assessment accuracy, reflecting strong self-assessment abilities among the students. Comparisons between instructor ratings and students' self-assessments of skill progression demonstrated good overall alignment. The validated assessment scale developed in Phases 1 and 2 shows potential for application in various educational contexts.

CONCLUSIONS

This study demonstrates that students are capable of evaluating their own interviewing and communication skills and can take an active role in their skill development when provided with suitable tools and adequate training. The findings support the viability of self-assessment as an educational tool and suggest its integration into psychology training programs, emphasizing clear criteria and reflective practices.

A Multidimensional Exploration of the Link Between Religiosity and Mental Wellbeing for 2SLGBTQI+ Canadians

2SLGBTQI+ Canadians occupy various prejudicial cis/heteronormative systems, as illustrated by rapidly increasing homo/bi/transphobia and gender- and sexuality-based violence targeting this population. As a result, their mental wellbeing is progressively deteriorating; the identification of risk and protective factors for this population's mental wellbeing is vital. Religiosity, although protective for other populations, may be such a risk factor for the mental wellbeing of some 2SLGBTQI+ people. This study investigated and compared how five independent dimensions of religiosity-private practice, ideology, intellect, public practice, and experience-are linked to mental wellbeing for 2SLGBTQI+ Canadians who report a religious belief. Through its cross-sectional design, this study was conducted among self-identified 2SLGBTQI+ people in Canada (N = 903) by means of an online survey from November 2022 to January 2023. The sample contained representation from every Canadian province and territory, as well as diversity in terms of sexual orientations and gender identities. The results of multiple regression analyses, which further compared participants with and without a current religious affiliation, confirmed that religiosity is a complex and multidimensional phenomenon, with dimensions independently serving as protective (i.e. experience and private practice) or as risk (i.e. ideology) factors for 2SLGBTQI+ Canadians. Implications for research and praxis are discussed.

The impact of teacher support on school adaptation among Chinese urban adolescents: a moderated mediation model

BACKGROUND

The issue of school adaptation among urban adolescents has received increasing attention. Previous research has primarily focused on Chinese rural and mobile adolescents, exploring the impact of factors such as teacher support, resilience, and left-behind status on their academic achievement. However, there has been relatively limited research on urban adolescents in this regard.

METHODS

In line with the study's objectives, this study selected parent and student questionnaires from the CEPS (2013-2014) and CEPS (2014-2015) datasets for a matched analysis. This process resulted in a final sample of 2502 urban adolescents aged 13 to 15. The key variables examined included teacher academic support, teacher emotional support, teacher relationship support, resilience, school adaptation, and left-behind status. To investigate these relationships, we employed structural equation modeling to explore how resilience mediates the impact of teacher support on school adaptation among urban adolescents. Additionally, we examined whether left-behind status moderates this mediation process.

RESULTS

The findings reveal that teacher support directly affects the school adaptation of urban adolescents and also indirectly influences it through the mediating role of resilience. Additionally, the left-behind status significantly moderates the direct effect of teacher relationship support on school adaptation among urban adolescents, but it does not similarly affect the direct impact of teacher academic support and emotional support.

CONCLUSIONS

Enhancing teacher support can effectively enhance the resilience of urban adolescents, leading to improved school adaptation. For left-behind adolescents, strengthening the quality of teacher-student relationships is particularly crucial for their school adaptation. Moreover, providing all students with consistent emotional support is essential, as it positively influences school adaptation regardless of their left-behind status.

Research on the relationship between social support and academic self-efficacy among college students: a multivariate empirical analysis

Background

The critical role of social support in college students' academic development cannot be ignored. This study aims to analyze the interrelationships and potential mechanisms between social support, sense of security, family cultural capital and academic self-efficacy.

Methods

A multivariate moderated mediation model was constructed by surveying 1,119 college students using the Social Support Scale, the Sense of Security Scale, the Academic Self-efficacy Scale, and the Family Cultural Capital Scale.

Results

(1) social support significantly increases sense of security; (2) sense of security significantly enhances academic self-efficacy; (3) social support directly contributes to academic self-efficacy; and (4) sense of security partially mediates the relationship between social support and academic self-efficacy; (5) family cultural capital plays a moderating role in the effects of social support on academic self-efficacy, especially in the first half of the direct and indirect effects.

Conclusion

These findings could provide an important theoretical basis and practical guidance for further understanding and enhancing academic self-efficacy among college students.

Social cure in the time of COVID-19: Social identity and belongingness predict greater well-being and academic motivation in university students

Social isolation during the COVID-19 pandemic increased negative affect and feelings of loneliness among university students.

OBJECTIVE

Given that identifying as a member of a social group, like a university student, serves as a protective factor against diminished well-being, we examined whether students' social identity might offer a "social cure" during COVID-related remote learning.

PARTICIPANTS

Three hundred fifty-six students from a large, public university that was fully remote in 2021.

RESULTS

Students with a stronger social identity as a member of their university reported lower loneliness and greater positive affect balance during remote learning. Social identification was also associated with greater academic motivation, whereas two well-established predictors of positive student outcomes - perceived social support and academic performance - were not. Nonetheless, academic performance, but not social identification, predicted lower general stress and COVID-related worry.

CONCLUSIONS

Social identity may be a potential social cure for university students who are learning remotely.

Development and psychometric evaluation of beliefs about the orthokeratology lens compliance scale (BOLCS): Based on the theory of planned behavior

PURPOSE

Non-adherence to standard wear, care, and follow-up procedures is a major risk factor for contact lens-related complications. The effectiveness of orthokeratology largely depends on the wearer's adherence. However, a deficiency in scales capturing adherence beliefs pertinent to orthokeratology exacerbates the lack of guidance for effective intervention strategies. The purpose of this study is to develop and evaluate the psychometric properties of a new scale based on the Theory of Planned Behavior that assesses the level of adherence among ortho-k wearers.

METHODS

This study involved three stages following the STROBE checklist: (1) developing initial scale items based on the Theory of Planned Behavior, a literature review, and a qualitative study; (2) evaluation of content and face validity; (3) psychometric testing on 296 participants. Item analysis, based on Classical Test Theory, assessed the overall consistency, reliability, and validity of the scale.

RESULTS

The final 37-item Beliefs about the Orthokeratology Lens Compliance Scale (BOLCS) comprises 11 dimensions. The Cronbach's alpha coefficients for each dimension ranged from 0.560 to 0.798. The folded half reliabilities were 0.845, and the combined reliabilities ranged from 0.676 to 0.793, indicating strong reliability. Item-level CVI (I-CVI) and scale-level CVI/average (S-CVI/Ave) values, assessed by the panel, ranged from 0.71 to 1 and 0.954, respectively. Exploratory and confirmatory factor analyses supported a factor structure consistent with the theoretical model.

CONCLUSIONS

The scale's construction adhered to a standardized process, yielding preliminary validation results with satisfactory reliability and validity.

Seeing is believing: How front-of-pack food imagery shapes parents' perceptions of child-oriented snack foods

Child-oriented snack foods often display front-of-pack images suggesting they are natural or wholesome, yet many of these products are ultra-processed and nutrient poor. This study investigated parent's perceptions in response to common forms of front-of-pack food imagery on child-orientated snacks. An online experiment comprising four between-subjects food image conditions (no image; food photo; food cartoon; cartoon of children gardening) and two within-subjects snack type conditions (fruit; vegetable) was conducted with N = 800 Australian adult parents/guardians of children aged 4-10 years. Participants viewed packaged snacks then rated them on visual appeal, perceived healthfulness, suitability for their child, and purchase intentions. For each outcome, 4 (between-subjects) x 2 (within-subjects) mixed ANOVAs were performed, with significant main effects explored using post-hoc pairwise t-tests with Bonferroni adjustment. The extent to which perception metrics predicted purchase intention within each condition was examined using multiple regression analyses. Participants perceived snacks displaying food photographs as healthier compared to all other conditions. When children's snacks displayed food photos, participants perceived the snack as more suitable for their child and showed stronger intentions to purchase the product than when cartoon children were displayed. Participants preferred fruit over vegetable snacks across all metrics, particularly when the picture was photorealistic. Visual appeal was the only perception metric that consistently predicted purchase intention across conditions. Findings provide clear evidence that parent's perceptions and purchase intentions towards children's snack foods are enhanced by pictures displayed on the packaging. Policy to regulate food packaging should require that foods depicted on the packaging accurately reflect product ingredients, particularly where whole foods are represented, and the actual ingredients are highly processed and no longer provide the nutrition of whole foods.

Clusters of Patient Empowerment and Mental Health Literacy Differentiate Professional Help-Seeking Attitudes in Online Mental Health Communities Users

OBJECTIVES

Grounded in the Health Empowerment Model, which posits that health literacy and patient empowerment are intertwined yet distinct constructs, this study investigates how the interplay of these factors influences attitudes toward seeking professional psychological help in members of online communities for mental health (OCMHs). This while acknowledging the multidimensionality of patient empowerment, encompassing meaningfulness, competence, self-determination, and impact.

DESIGN AND METHODS

A cluster analysis of data gathered from 269 members of Italian-speaking OCMHs on Facebook has been performed.

RESULTS

Four profiles have been identified: dangerous self-managers (11.2%), effective self-managers (21.2%), disempowered (40.5%) and ambivalent empowered (27.1%). Clusters provided meaningful variations in help-seeking attitudes, also when controlling for depression and anxiety severity, F3, 265 = 11.910, p < 0.001.

CONCLUSIONS

The findings provided further evidence of the multidimensionality of patient empowerment. Considering the results, we discussed potential interventions aimed at enhancing the quality of OCMHs, tailoring to the unique characteristics of each cluster.

PATIENT OR PUBLIC CONTRIBUTION

Administrators and moderators of mental health Facebook communities-whether expert-led by mental health professionals or peers-played a key role in this study. They provided valuable insights during the questionnaire design process to ensure the questions were both relevant and appropriate for community members. These administrators and moderators also actively facilitated participant recruitment by creating and sharing posts, either video- or text-based, on community homepages. Furthermore, after completing the questionnaire, participants were encouraged to comment on the Facebook posts where the survey link was shared, mentioning that they participated and inviting other members to take part. This approach aimed to foster a sense of involvement and further promoted the survey within the community.

Digital competency among pediatric healthcare workers and students: a questionnaire survey

BACKGROUND

Digital technologies play an important role in improving the quality of healthcare services, however, many healthcare workers and students do not recognize this and have low levels of digital competencies and skills. Therefore, this paper aims to investigate digital perceptions and competencies among medical students in pediatrics and pediatric healthcare workers in China.

METHODS

A questionnaire on digital competency was designed. The formal survey was carried out from  February to May 2024 in pediatric students and pediatricians. Data were analyzed by SPSS20.0 software.

RESULTS

The study included 518 valid questionnaires; 199 medical students in pediatrics and 319 pediatric healthcare workers. In all five themes, pediatric healthcare workers and pediatric students had a mean score higher than 3.0, and the former scored higher. There was no significant difference in the digital competency in pediatricians (3.91) compared to pediatric students (3.82) (P > 0.05). Multivariable analysis revealed that gender and education level were related with digital competency, with male medical students (3.94 vs. 3.75, P = 0.021) and those with higher levels of education (3.99 vs. 3.75, P = 0.030) having better performance. In addition, medical students in pediatric surgery scored higher than those who majored in internal pediatrics (4.11 vs. 3.76, P = 0.017).

CONCLUSIONS

Pediatric students and pediatric healthcare workers had a good perception on information of digital technology in the medical field, but had limited ability in digital use and collaboration, digital capacity development, and digital content creation. Better medical education and training strategies should be developed for potential challenges in the coming artificial intelligence era.

Exploring Risk and Protective Factors for Suicidality and Physical Self-Harm: A Cross-Sectional Analysis in Nordic Adolescents

While the connection between risk factors and suicidality (suicide attempts and ideation) and physical self-harm is well established, the preventive roles of social bonding and dietary patterns remain underexplored. This study, based on the 2021 National Ungdata Surveys in Norway among middle and high school students (N = 15,430), can provide novel and context-specific insights into comparable environments. The results indicated a 5% suicide attempt rate, 18.3% prevalence of physical self-harm, and 26.7% suicidal ideation in the sample. The prevalence was higher among girls, students with low socioeconomic status, middle schoolers, and non-religious individuals. Logistic regression models for suicide attempts showed that substance use and victimization (sexual harassment and bullying) were significant predictors of suicide attempts. Elevated depressive symptoms and the use of pain relievers increased the risk. For suicidal ideation, victimization and depressive symptoms were significant predictors. Concerning physical self-harming behavior, substance use and risky behaviors increased odds, whereas binge drinking had varying effects. Victimization variables and health measures were also significant predictors. Dietary patterns, social bonding measures, and self-motivation were found to be protective factors, as they decreased the likelihood of suicidal and self-harming behaviors, highlighting the critical role of strong social connections, healthy dietary habits, and well-being.

Validation of a brief food parenting measure for fathers: A test of factorial validity, measurement invariance, internal reliability, and concurrent validity

Fathers are underrepresented in food parenting research partly due to the lack of succinct, theory-informed, and father-mother equivalent food parenting measurement tools. To address this, we 1) tested the factorial validity of a brief food parenting measure utilizing a subset of items from the Comprehensive Feeding Practices Questionnaire (CFPQ) to represent coercive control, structure, and autonomy support, 2) assessed the extent to which the brief tool works similarly in fathers and mothers (i.e., measurement invariance), and 3) evaluated its internal reliability and concurrent validity. Participants included 1071 fathers of children aged 2-6 years and 487 of their co-parents (mothers) from the Fathers & Families study. Fathers and mothers responded to 16 CFPQ items, and fathers reported on children's diets. Confirmatory factor analysis (CFA) was used to test factorial validity. Multi-group CFA was used to examine measurement invariance across fathers and mothers. Internal reliability was examined using Cronbach's alpha and the Spearman-Brown coefficient. Concurrent validity was assessed utilizing multiple logistic regressions to examine associations between the three food parenting factors and children's intakes of fruit, vegetables, sugar-sweetened beverages (SSBs), and fast food. CFA confirmed a three-factor model with 11 items, including coercive control (four items), structure (five items), and autonomy support (two items). Multi-group CFA indicated measurement invariance across fathers and mothers. Internal reliability was established. Concurrent validity was strong for structure, but weaker for coercive control and autonomy support. Further refinements are encouraged to enhance items' utility in characterizing fathers' food parenting practices, including in different social and cultural contexts.

Development and validation of the Women Autonomy Scale for measuring psychosocial freedom from conventional gender roles

BACKGROUND

The concepts of masculinity and femininity have historically shaped gender roles, leading to inequality and gender-based discrimination. Women's autonomy, defined as the ability to make independent choices across various life domains, remains inadequately measured by existing scales. This study addresses this gap by developing and validating the Women Autonomy Scale (WAS).

METHODS

The development and validation of the WAS involved four phases with a total of 2,252 adult women from Rawalpindi and Islamabad, Pakistan. These phases included exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and assessments of convergent and discriminant validity by using the Psychosocial Life Satisfaction Scale and the Dependent Personality Disorder sub-scale of the Personality Disorders Questionnaire.

RESULTS

The WAS demonstrated high reliability across the four phases (α = 0.810 to 0.857). Test-retest reliability was 0.788 after two weeks of initial administration. EFA revealed a four-factor structure consisting of 18 items: personal freedom, freedom from conventional femininity, freedom from conventional masculinity, and freedom from shame. CFA confirmed this structure, showing good fit indices (CFI = 0.951, RMSEA = 0.052). The scale's convergent validity was established through a significant positive correlation with the Psychosocial Life Satisfaction Scale (r = 0.394, p < 0.01), and discriminant validity was confirmed via a significant inverse correlation with the Dependent Personality Disorder sub-scale (r = -0.255, p < 0.01).

CONCLUSION

The WAS is a reliable and valid instrument for comprehensively assessing women's autonomy. It addresses limitations of previous measures and provides a robust tool for research and policymaking aimed at promoting gender equality and women's empowerment.

Measuring Navigational Health Literacy in Russia: Validation of the HLS19-NAV-RU

Structures and regulations of healthcare systems in many countries have become increasingly complex and difficult for patients and users to navigate. Thus, more than ever before, navigational health literacy (NAV-HL) is needed by patients. There are no data on NAV-HL in Russia due to the lack of suitable concepts and measuring tools. Therefore, the study aimed to validate the HLS19 navigational health literacy assessment tool (HLS19-NAV) for the Russian-speaking population. This study provides a comprehensive overview of the validation process, including a comprehensibility check and psychometric analysis. Overall, the results of the HLS19-NAV-RU validation demonstrate the partial validity of the NAV-HL tool in the Russian language. Nevertheless, the instrument can be recommended for further research and use in health literacy studies in Russia.

On the Perception of Moral Standing to Blame

Is everyone equally justified in blaming another's moral transgression? Across five studies (four pre-registered; total N = 1,316 American participants), we investigated the perception of moral standing to blame-the appropriateness and legitimacy for someone to blame a moral wrongdoing. We propose and provide evidence for a moral commitment hypothesis-a blamer is perceived to have low moral standing to blame a moral transgressor if the blamer demonstrates weak commitment to that moral rule. As hypothesized, we found that when blamers did not have the chance or relevant experience to demonstrate good commitment to a moral rule, participants generally believed that they had high moral standing to blame. However, when a blamer demonstrated bad commitment to a moral rule in their past behaviors, participants consistently granted the blamer low moral standing to blame. Low moral standing to blame was generally associated with perceiving the blame to be less effective and less likely to be accepted. Moreover, indirectly demonstrating moral commitment, such as acknowledging one's past wrongdoing and feeling/expressing guilt, modestly restored moral standing to blame. Our studies demonstrate moral commitment as a key mechanism for determining moral standing to blame and emphasize the importance of considering a blamer's moral standing as a crucial factor in fully understanding the psychology of blame.

Engagement in a web-based intervention for individuals who committed sexual offenses against children: observational study

Web-based interventions have been shown to be effective for various health and mental health problems. However, the effectiveness of interventions is often limited by the fact that individuals do not start or complete them. Using data from an intermediate analysis of the randomized placebo-controlled clinical trial to evaluate the effectiveness of @myTabu, the current study investigated engagement with a web-based intervention for 113 individuals convicted of child sexual abuse and/or for child sexual exploitation material. @myTabu is a human-supported, web-based intervention for individuals who have been convicted for sexual abuse of children or the use of child sexual exploitation material with the goal of reducing the risk factors for recidivism and actual recidivism. The results of the present study indicate that (a) 81% of the participants logged into the web-based intervention within 8 weeks after login credentials were sent; (b) there was a trend toward lower treatment readiness and lower belief in their own technical prerequisites in individuals who did not login; (c) 15% of the participants completed all requested sessions within the first 5 weeks of participation, and the average participant logged in on 6 different days and completed two sessions; (d) the number of login days and completed sessions could be predicted by treatment readiness. We discuss these findings and their implications for the development and implementation of further web-based interventions in the forensic context. Trial registration: German Clinical Trial Register (DRKS00021256). Prospectively registered 24.04.2020.

Understanding the independent samples t test in nursing research

Critical thinking is required for successful nursing outcomes. For evidence-based practice, there is a need to understand and apply quantitative methods of research and statistical analysis in order to obtain evidence. However, the literature shows that the use of quantitative methods among nurse researchers can be problematic. This article aims to enhance understanding and implementation of one of the most frequently used statistical tests, the independent samples t-test, with the use of a nursing practice example. Guidance for the most used statistical software for social sciences (SPSS) and graphical representations are provided.

Empathy is associated with older adults' social behaviors and verbal emotional expressions throughout the day

Empathy plays a crucial role in promoting older adults' interpersonal experiences, but it remains unclear how these benefits of empathy occur. To address this gap, we examined associations between empathy and how older adults behave and express emotions during their daily interpersonal encounters. Participants included 268 adults aged 65+ (46% men, n = 124) from the Daily Experiences and Well-being Study. They reported background characteristics and empathy in baseline interviews and indicated interpersonal encounters every 3 hours across 5 to 6 days. Participants wore electronically activated recorders (EAR), an app that captured 30-second snippets of ambient sounds every 7 minutes. Verbatim transcripts were coded for positive and negative social behaviors (e.g., praise, complain) and text was analyzed via Linguistic Inquiry and Word Count (LIWC) software for verbal expressions of positive and negative emotions (e.g., happy, hope, hate, hurt). Multilevel models showed that greater empathy was associated with greater variety in positive social behaviors throughout the day. More empathic older adults expressed more positive emotions while engaging in positive behaviors and less negative emotions when engaging in negative behaviors. This study innovatively draws on naturalistic data to delineate how more empathic older adults may have more positive and less negative social experiences than their less empathic counterparts. Findings may inform interventions that can incorporate empathy training to target those at higher risk of poor interpersonal experiences and outcomes (e.g., social isolation).

Uncovering the roles of automatic attitudes and controlled processes in the regulation of physical activity behavior in children

Despite substantial research efforts to increase engagement in physical activity (PA), children are not sufficiently active. Dual-process theories suggest that PA behavior regulation occurs through both controlled (i.e., reflective, conscious) and automatic (i.e., non-reflective, less conscious) processes. Automatic processes depend on affective valuations and attitudes towards PA and have been shown to predict PA behavior. However, their role in PA behavior regulation in children remains unclear. Therefore, the current study investigated the unique association of automatic attitudes towards PA on self-reported seven-day PA recall, after accounting for the effects of known controlled precursors of PA (i.e., explicit attitudes, PA self-efficacy, and PA intentions). In a cross-sectional design, 69 children (age = 10.8 ± 0.6 years) completed the Single-Category Implicit Association Task (SC-IAT) and self-reported measures of PA and controlled precursors of PA. In a hierarchical regression analysis, controlled processes accounted for 28.3 % of the variance in PA behavior. Although the bivariate association between automatic attitudes and PA was not significant, the association between them became significant but negative in the fully adjusted model (b = -1.70; p = 0.025). The fully adjusted model accounted for 35.0 % of the variance in PA. In summary, the findings indicated that both controlled and automatic processes predicted PA in children, although the association with automatic attitudes was not in the expected direction in the adjusted model. Future studies are warranted to further understand the role of automatic processes in the regulation of PA behavior in children.

Coparenting Quality During COVID-19: Exploring Gender Differences Using a Mixed Methods Approach

The aim of this study was to examine potential differences in coparenting quality during the COVID-19 pandemic among mothers and fathers using an embedded mixed methods approach. The objectives were to compare mothers' and fathers' scores on the Coparenting Relationship Scale among 150 mother-father dyads, and to examine mothers' and fathers' perceptions of how COVID-19 influenced their coparenting quality using thematic analysis of 159 mothers' and 75 fathers' responses to an open-ended coparenting survey question. While total coparenting quality scores did not differ among mothers and fathers, fathers had significantly higher scores on the division of labour and endorsement subscales, and mothers had significantly higher scores on the undermining subscale. The qualitative thematic analysis identified five key themes: gendered changes to division of labour, increased hostility, increased teamwork, less alone time, and increased stress. Efforts to mitigate adverse pandemic outcomes on families should address coparenting quality.

The measurement of "high-impact chronic pain": Limitations and alternative methods

OBJECTIVE

Chronic pain is known to be an important construct in clinical practice and a particular form of chronic pain, high-impact chronic pain (HICP), has gained recent interest and attention by pain clinicians, epidemiologists, and clinical researchers. The purpose of our Topical Review is to describe the historical development of measures of HICP and to explore the psychometric properties of HICP as well as to present alternative measurement methods.

METHODS

We identified strengths and weaknesses of the psychometric characteristics of HICP measures. Limitations of existing HICP measures were discussed and summarized and alternatives to current methods were proposed.

RESULTS

HICP operational definitions show variability across studies. All definitions cannot be correct, but which ones are incorrect cannot be determined as there is no gold standard. Random measurement error and recall bias are among the other limitations of current HICP measures. Model-based definitions of HICP, the discrete (for epidemiologic applications) and continuous (for clinical applications) latent variable models are discussed as likely superior alternatives to current methods.

CONCLUSIONS

Limitations of existing HICP methods are discussed and alternative development approaches to HICP measures are presented. The use of either discrete or continuous latent variable models would improve upon the psychometric characteristics of current HICP evidence. Examples are used to illustrate the benefits of latent variable models over traditional observed variable conceptualizations as the measurement of HICP continues to develop.

SIGNIFICANCE STATEMENT

This work takes the position that current methods of measuring high impact chronic pain (HICP) likely contain substantial error. We have endorsed an alternative approach for several psychometrically grounded reasons. We recommend that future work consider the discrete latent variable framework for dichotomous measures of HICP and the continuous latent variable framework for continuous measures of HICP. The paper provides illustrative examples of these methods for a different patient reported measure that is lacking a gold standard, much like HICP measures.