Relationships of Positive and Negative Affect to Coping and Functional Outcomes in Systemic Sclerosis

A modern network approach to revisiting the Positive and Negative Affective Schedule (PANAS) construct validity

Introduction

The factor structure of the Positive and Negative Affective Schedule (PANAS) is still a topic of debate. There are several reasons why using Exploratory Graph Analysis (EGA) for scale validation is advantageous and can help understand and resolve conflicting results in the factor analytic literature.

Objective

The main objective of the present study was to advance the knowledge regarding the factor structure underlying the PANAS scores by utilizing the different functionalities of the EGA method. EGA was used to (1) estimate the dimensionality of the PANAS scores, (2) establish the stability of the dimensionality estimate and of the item assignments into the dimensions, and (3) assess the impact of potential redundancies across item pairs on the dimensionality and structure of the PANAS scores.

Method

This assessment was carried out across two studies that included two large samples of participants.

Results and Conclusion

In sum, the results are consistent with a two‐factor oblique structure.

Coping profiles and health outcomes among individuals with systemic sclerosis: A latent profile analysis approach

Background:

Systemic sclerosis has negative implications for quality of life, and coping is a mechanism by which individuals can adapt more successfully to illness. This study (1) identified coping profiles in patients with systemic sclerosis and (2) examined distress and disability correlates of the profiles.

Methods:

A sample of 93 patients with confirmed diagnoses of systemic sclerosis received clinical examinations and reported on coping, psychological distress, and health-related disability. Latent profile analysis was used to identify coping-based profile groups. The profile groups were then compared on psychological distress and health-related disability, controlling for disease severity.

Results:

A two-profile solution was supported: Active Copers emphasized problem-focused, social support, counting blessings, and religious approaches to coping with systemic sclerosis. Passive Copers emphasized blaming self and others, avoidance, and wishful thinking approaches to coping. Active Copers reported significantly less psychological distress than Passive Copers, but no significant differences were found for health-related disability.

Discussion:

The findings identify multidimensional patterns of coping that are differentially related to psychological distress in systemic sclerosis patients. These findings can inform coping-based interventions for patients with systemic sclerosis.

Examining the role of positive and negative affect in recovery from spine surgery

Consistent evidence supports a significant association between lower positive affect and higher negative affect and increased pain and disability in adults with chronic pain. However, examining this relation in surgical populations has received little empirical consideration. The primary purpose of this study was to determine whether preoperative and postoperative positive and negative affect predict pain, disability, and functional status after spine surgery. A secondary objective was to assess the relation of depression to postoperative outcomes compared with positive and negative affect. Participants were 141 patients treated by spine surgery for lumbar or cervical degeneration. Data collection occurred at baseline and 6 weeks and 3 months postoperatively. Affect was measured with the Positive and Negative Affect Schedule. Multivariable mixed-model linear regression analyses found that preoperative variables were not predictive of postoperative pain, disability and functional status. However, multivariable postoperative analysis found that 6-week positive affect predicted functional status, and 6-week negative affect predicted pain interference and pain-related disability at 3 months following surgery. Postoperative depression demonstrated statistically significant and stronger associations with pain intensity, pain interference, and pain-related disability at 3-month follow-up, as compared with negative affect. Results suggest that positive affect and depression are important variables to target when seeking to improve postoperative outcomes in a spine surgery population. Recommendations include postoperative screening for positive affect and depression, and treating depression as well as focusing on rehabilitation strategies to bolster positive affect so as to improve functional outcomes after spine surgery.

Reliability Generalization

The assessment of positive affect (PA) and negative affect (NA) by means of the Positive Affect and Negative Affect Schedule has received a remarkable popularity in the social sciences. Using a meta-analytic tool—namely, reliability generalization (RG)—population reliability scores of both scales have been investigated on the basis of a random effects model in 147 studies. Correcting for measurement errors, the results demonstrate moderate to high internal consistency coefficients and variations of the PA and NA reliability scores with regard to time frame instructions, language of items, and sample characteristics. The percentage of PA and NA true score variance differs in subpopulations up to 11%. RG analysis of test–retest coefficients illustrates state-like fluctuations and trait-like stability of both scales. Calculations of the fail-safe number point at the robustness of the results. Applications of RG coefficients compared to single-study coefficients highlight the relevance of population coefficients for research and assessment situations.

From devastation to integration: Adjusting to and growing from medical trauma

Recent trauma research has begun to investigate the possibility of posttraumatic growth. However, most studies have investigated posttraumatic growth using quantitative methods and thus have neglected people's subjective experience and have left unexamined post-traumatic growth in persons with visible impairment. To fill some of these gaps, the authors examined the process of recovery and posttraumatic growth using a qualitative method. They interviewed 10 participants with visible impairment from chronic illness or serious injury using a semistructured interview. Using a grounded theory data analysis procedure, the authors developed a stage model of trauma and recovery from the interviews. The stages that emerged are thematically entitled Apprehension, Diagnosis and Devastation, Choosing to Go On, Building a Way to Live, and Integration of the Trauma and Expansion of the Self. The authors discuss limitations of the study and clinical implications for psychological counseling with this population.