Impact of Home-Based Work during the COVID-19 Pandemic on Mental and Physical Health in a German Population-Based Sample

Background: The COVID-19 outbreak necessitated physical distancing, as part of secondary prevention, at a personal and professional level. Working from home (WFH) became increasingly important. In this study, the impact of the COVID-19 pandemic restrictions on physical and mental health is investigated, compared with pre-pandemic data, and with employees who WFH and are on-site. Methods: Data from the German Saxon longitudinal study population were used. Attitudes towards WFH as well as mental and physical health assessments during the COVID-19 pandemic were examined. Comparisons were made with corresponding pre-pandemic scores and between employees WFH and on-site in 2022. Results: In total, 319 participants with equal gender distribution were included. Of those, 86 worked from home stating better organizability of their work, more time for partnership, less stress, and greater work satisfaction. Compared to pre-pandemic data, the D-score, PHQ-4, G-Score, and PHQ-SSS-8 showed a significant increase. No difference in physical or mental health between employees WFH and on-site was observed. Conclusion: In general, COVID-19 restrictions had a negative impact on mental and physical health. Although WFH is well accepted, it did not show significant health benefits.

[Anxiety, Depression, Psychological Strain and Physical Complaints before and after the Covid-19 Pandemic in a German Longitudinal Study with Adults from Saxony]

OBJECTIVE

The objective of the study was to investigate whether psychological distress increased in a German community sample from Saxony during the course of the Corona pandemic.

METHODS

In 2017/2018 and 2022, N=289 participants (54.7% female) of the Saxon Longitudinal Study were interviewed about their psychological well-being using questionnaires (PHQ-4, SSS-8).

RESULTS

There is a significant increase in complaints (anxiety, depression, psychological distress, physical complaints) compared to 2017/2018 to 2022 with effect sizes in the small and medium range (Cohens d=0.26-0.62).

CONCLUSION

Data collection was not due to the pandemic but was routine as part of an ongoing long-term study. The Covid-19 pandemic led to an increase in psychological distress and physical complaints in a Saxonian, age-homogeneous population sample.

Variables associated with oral health-related self-efficacy - results of a cross-sectional study

BACKGROUND

Oral health-related self-efficacy (OH-SE) is pivotal for oral health and is associated with other oral-health related variables, such as dental fear and anxiety (DF/A) and dental hygiene behaviors (DHB). This study attempts to analyze associations between OH-SE and oral healthrelated variables in a German population to extend previous research by analyzing whether OH-SE can be predicted by these variables, as this might contribute to the development of treatment interventions.

METHODS

OH-SE, DF/A, oral health-related quality of life (OHRQoL), self-perceived dental condition, satisfaction with general health, DHB, and socioeconomic status were assessed as a part of the Saxon Longitudinal Study in an adult sample (n = 309, 56.3% female, all Saxon secondary school 8th graders in 1987). The associations of OH-SE with these variables were examined by means of correlation, multiple linear regression analyses, and group comparisons. Significance (p), standardized regression coefficients (β), and effect size (Cohen's d) were calculated.

RESULTS

The correlation analyses revealed increased OH-SE to be accompanied by low levels of DF/A, high levels of OHRQoL, high levels of self-perceived dental condition, increased satisfaction with general health and socioeconomic status (all r ≥ 0.142; all p ≤ 0.013). In the regression analysis, OH-SE was mainly predicted by self-perceived dental condition and satisfaction with general health (R2 = 0.157) as well as by daily frequency of toothbrushing, OHRQoL, and socioeconomic status on a trend-level basis. In the group comparisons OH-SE was lower in participants with moderate for manifest DF/A and higher in individuals with higher OHRQoL, better self-perceived dental condition, increased satisfaction with general health, increased daily frequency of toothbrushing, more dental appointments, and above-average socioeconomic status (trend level; all t ≥ 1.57; p ≤ 0.059).

CONCLUSIONS

In this cross-sectional study, high levels of OH-SE were mainly predicted by general health as well as self-perceived dental condition. It was also associated with decreased DF/A, increased DHB, higher OHRQoL, and higher socioeconomic status. Future research should analyze these associations in longitudinal designs to address whether interventions focusing on adherence to good DHB improve (dental) health and thus OH-SE. This might be a promising approach, particularly in relation to the treatment of DF/A.

Insomnia symptoms in adulthood. Prevalence and incidence over 25 years

OBJECTIVE/BACKGROUND

Despite its high prevalence, little information is available about the course of insomnia symptoms over the life span. In this study, we analyzed the self-reported insomnia symptoms of the general population over more than 20 years, covering young up to middle adulthood.

PATIENTS/METHODS

Data from waves 12 to 32 of the Saxon Longitudinal Study (1996-2021), were analyzed. Based on data from the 12th wave, n = 115 adults (48 men (41.7%), 67 women (58.3%), Mage = 23.59, SD = 0.59) completed the G-Score Item #3 in the following 18 waves, thus forming the basis for our analyses. The G-Score Item #3 reads "In the last 12 months, have you had the following complaints? Please indicate how often they occurred - Insomnia". The G-Score Item #3 was dichotomized using a cut-off score of 2, and prevalence and incidence rates were calculated by gender.

RESULTS

The minimum prevalence rate was 23.48% (Mage = 32.11, SD = 0.40), and the maximum was 47.83% (Mage = 48.43, SD = 0.64), indicating an increase in insomnia symptoms with age. In most cases, no evidence was found for gender differences in prevalence rates. The incidence rates were 10.43% for the 1st year of follow-up and 8.7% for the 5th year and 6th year of follow-up, respectively.

CONCLUSIONS

This study provides further evidence for the high prevalence rates of insomnia symptoms in the general population. As this study is the first epidemiological study of insomnia symptoms based on a single-item (screening) instrument, it should be rather seen as an extension than a replication of previous study findings.

Regional differences in the assessment of depressive symptoms in the former German Democratic Republic and Federal Republic of Germany

AIM

The present study investigated regional differences in response behaviour for the Patient Health Quetionnaire-9. We tested for measurement invariance and differential item and test functioning between formerly divided East- and West-Germany: the former German Democratic Republic and Federal Republic of Germany. Diverging socialization experiences in socialist versus capitalist and collectivist versus individualist systems may affect culturally sensitive assessments of mental health.

SUBJECT AND METHODS

To test this empirically, we used factor analytic and item-response-theoretic frameworks, differentiating between East- and West-Germans by birthplace and current residence based on several representative samples of the German general population (n = 3 802).

RESULTS

Across all survey, we discovered slightly higher depression sum scores for East- versus West-Germans. The majority of items did not display differential item functioning-with a crucial exception in the assessment of self-harm tendencies. The scale scores were largely invariant exhibiting only small amounts of differential test functioning. Nonetheless, they made up on average about a quarter of the observed group differences in terms of effect magnitude.

CONCLUSION

We explore possible causes and discuss explanations for the item-level differences. Overall, analyses of East- and West-German depressive symptom developments in the wake of reunification are feasible and statistically grounded.

[Psychometric Evaluation of a Single-Item-Screener for Sleep Disturbances]

OBJECTIVE

Sleep disturbances are one of the most prevalent health complaints in the general population. Thus, the need for validated screening instruments and prevention measures is high. The aim of the current study is to evaluate a potential single-item screening instrument and therefore, contribute to an improved early detection.

METHODS

Data from Saxony Longitudinal Study (SLS) is being analyzed. Based on data of 32nd wave (n=321, 172 women, 149 men, M age=48.42, SD=0.64), the G-Score Item #3 ("Have you had the following complaints in the last 12 months? Please indicate how often they occurred. - sleeplessness"), a potential screening instrument, is psychometrically evaluated. A Receiver Operating Characteristic (ROC)-Analysis is calculated to assess the predictive validity of the G-Score Item #3.

RESULTS

Retestreliability for the G-Score Item #3 is 0.70 (p<0.001). Correlation with the Jenkins Sleep Scale (JSS) was r=0.79 (p<0.01). The area under the curve (AUC) is 0.92, providing evidence for a very good predictive validity.

DISCUSSION AND CONCLUSION

This study provides evidence for the use of the G-Score Item #3 as a screening instrument for sleep disturbances by showing good psychometric properties and brevity.

The association between sleep problems and general quality of life in cancer patients and in the general population

Objective

It is well-known that patients with cancer frequently experience sleep problems, and that sleep quality is associated with general quality of life (QoL). The aims of this study were to analyze the relationship between sleep problems and other components of QoL in more detail and to investigate sex and age differences in sleep quality in cancer patients in comparison with the general population.

Method

This study comprised one general population sample (n = 4,476) and eight samples with cancer patients (n between 323 and 4,020). Sleep Quality was measured using the QoL questionnaire EORTC QLQ-C30.

Results

All of the cancer patient groups reported more sleep problems than the general population. Sleep problems were associated with all facets of QoL both in cancer patients and in the general population. The highest associations were found in cancer patients for fatigue (r = 0.52) and emotional functioning (r = -0.47). The association between sleep quality and general QoL was lower in the cancer samples (r = -0.37) than in the general population (r = -0.46). Female cancer patients reported markedly more sleep problems than male patients did (d = 0.45), while this sex difference was lower in the general population (d = 0.15). In contrast to the general population, younger cancer patients had greater trouble sleeping than older patients did (d = -0.17).

Conclusion

The results underline the significance of the role mental factors play in sleep problems. Health care providers should pay special attention to female patients and younger patients concerning this issue.

Are Attitudes towards COVID-19 Pandemic Related to Subjective Physical and Mental Health?

In this paper, we investigate the relationship between a person's psychological distress, subjective physical health and their attitudes towards the COVID-19 pandemic. The evaluation was performed on the basis of data from two waves of the Saxon Longitudinal Study, carried out in 2019 (pre-pandemic) and 2021. The number of study participants in both waves was 291. We tested in autoregressive cross-lagged models the stability of the respondents' health status before and during the pandemic and reviewed their influence on attitudes towards COVID-19. Our results show that COVID-19-related concerns are controlled by subjective physical health, while pandemic denial is linked to psychological distress. In an unknown and critical situation, with limited control over the situation, the strategy of avoidance or suppression may be used by individuals for protection by psychologically downplaying the stressor and danger.

Quality of Life Domains in Breast Cancer Survivors: The Relationship Between Importance and Satisfaction Ratings

Objectives

Quality of life (QoL) has been the focus of increasing interest in oncology. QoL assessment instruments implicitly assume that each QoL domain has the same meaning for each patient. The objective of this study was to analyze the importance of and the satisfaction with QoL domains and to analyze the relationship between the two.

Methods

A sample of 308 breast cancer survivors was examined twice with a three-month time interval. The women completed the two QoL questionnaires Questions of Life Satisfaction (FLZ-M), which measures participants' satisfaction with eight QoL domains and the subjective importance of those domains to them, and the EORTC QLQ-C30. A sample of 1,143 women from the general population served as controls.

Results

Compared with the general population sample, the patients were less satisfied with their health and more satisfied with all other QoL domains. The subjective importance of health was lower in the patients' sample (Effect size: d = 0.38). Satisfaction with health and importance of health were slightly positively correlated (r between 0.05 and 0.08). The effect of QoL domain importance on general QoL was small (beta between −0.05 and 0.11), and interaction effects between domain importance and satisfaction on the prediction of global QoL were negligible.

Conclusion

In addition to satisfaction with QoL dimensions, the subjective importance of these dimensions is relevant for psychooncological research and treatment. Health is not the only relevant QoL domain in breast cancer survivors, other domains such as finances also deserve health care providers' attention.

[Psychometric Properties of a Short Alexithymia Scale (SAS-3) in the German General Population]

OBJECTIVE

The literature on alexithymia has multiplied in recent decades as the construct has important implications for mental health. The so far used inventories are of limited use in epidemiological research, primary care, and other clinical settings where time and effort are important factors in assessment. Based on items of the authorized German version of the Toronto Alexithymia Scale, the aim of this study was to develop an ultra-short questionnaire for a condensed and unidimensional assessment of alexithymia.

METHODS

Criteria for the abbreviated scale were: (a) one-dimensionality (necessary to calculate a global score), (b) one item from each of the originally postulated dimensions, and (c) no reverse-coded items (to avoid method artifacts). Data were drawn from two nationwide representative population surveys in Germany: a survey conducted in 1996 to develop the SAS-3 (N=2.047); and a survey conducted in 2013 (N=2.508) for the evaluation and calculation of SAS-3 percentiles.

RESULTS

Reasonable correlations between the SAS-3 and the PHQ-2, the GAD-2, and the GBB-8 were observed. Based on a confirmatory factor analysis, the one-dimensionality of the SAS-3 could be confirmed, achieving very good fit indices. An additional invariance analysis regarding gender and different age groups resulted in (partial) strict invariance for the different multi-group analyses. Percentile ranks for SAS-3 sum score are reported stratified by gender and by age groups.

CONCLUSIONS

The SAS-3 appears to be suitable in epidemiological research and other instances requiring an economical assessment of alexithymia.

Measuring physical, cognitive, and emotional aspects of exhaustion with the BOSS II-short version - results from a representative population-based study in Germany

Background

The aim of the present study was the construction and psychometric evaluation of a shortened version of the Burnout Screening Scales II (BOSS II), a measure for exhaustion and burnout.

Methods

To this end, among a representative sample of the German general population (N = 2429, 52.9% women), we shortened the scale from 30 to 15 items applying ant-colony-optimization, and calculated item statistics of the short version (BOSS II-short). To estimate its reliability, we used McDonald’s Omega (ω). To demonstrate validity, we compared the correlation between the BOSS II-short and the BOSS II, as well as their associations with depression, anxiety, and quality of life. Furthermore, we evaluated model fit and measurement invariance across respondent age and gender in confirmatory factor analyses (CFA). Finally, we present adapted norm values.

Results

The CFA showed an excellent model fit (χ² = 223.037, df = 87, p < .001; CFI = .975; TLI = .970; RMSEA [90%CI] = .036 [.031;.040]) of the BOSS II-short, and good to very good reliability of the three subscales: ‘physical’ (ω = .76), ‘cognitive’ (ω = .89), and ‘emotional’ (ω = .88) symptoms. There was strict measurement invariance for male and female participants and partial strict invariance across age groups. Each subscale was negatively related to quality of life (‘physical’: r = −.62; ‘cognitive’: r = −.50; ‘emotional’: r = −.50), and positively associated with depression (‘physical’: r = .57; ‘cognitive’: r = .67; ‘emotional’: r = .73) and anxiety (‘physical’: r = .50; ‘cognitive’: r = .63; ‘emotional’: r = .71).

Conclusions

Overall, the BOSS II-short proved to be a valid and reliable instrument in the German general population allowing a brief assessment of different symptoms of exhaustion. Norm values can be used for early detection of exhaustion.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12961-z.

Psychometric properties and validation of the English version Giessen Subjective Complaints List (GBB-8)

Background

The present study investigated the psychometric properties of the newly developed English version of the Giessen Subjective Complaint List-8 (GBB-8), a questionnaire assessing psychosomatic symptoms with regard to exhaustion, gastrointestinal, musculoskeletal and cardiovascular.

Methods

A U.S. sample of 638 participants (47.6% female) was recruited by MTurk to participate in this cross-sectional online survey. Validation instruments included the Patient Health Questionnaire-4, Perceived Stress Scale, short version of the Trier Inventory for Chronic Stress.

Results

Reliability was high with ω’s between .80 and .86 for all subscales. Confirmatory factor analyses yielded comparable good model fit for a four-dimensional model as well as a higher order model. Multi-group confirmatory factor analyses confirmed measurement invariance of the GBB-8 across sex and age. Regarding convergent validity, correlations with other instruments were highly significant and of large magnitude as expected.

Conclusion

The English version of the GBB-8 has shown excellent psychometric properties. Therefore, it can be recommended for the assessment of psychosomatic complaints in contexts where short screening instruments are necessary.

[Internal Migration and Mental Health - Relevant Factors 20 and 30 years after Unification: Results of a Longitudinal Study in German]

Aim The aim of the present study was to determine the relevant factors in the mental health of people who experienced internal migration in comparison with people who did not. Methods Data from a longitudinal study in Saxony were used to compare the psychological distress of individuals who migrated internally with that of those who did not in 2010 and 2020. Bootstrapping-based mediation analysis was applied to examine possible mediators between internal migration and mental health.Results Individuals who experienced internal migration reported less mental distress compared to those who did not in 2010, but not in 2020, but these effects disappeared after including covariates and mediators. Important mediators in 2010 were life situation, political solidarity with FRG, winner of German Unification and job security; in 2020, these were threat of old-age poverty and experiences with system.Discussion Internal migration influences mental distress through different factors. Especially the current life circumstances play a crucial role.

Weight Stigma and Disease and Disability Concepts of Obesity: A Survey of the German Population

INTRODUCTION

Recent years have witnessed a medicalization of obesity, promoting a classification as a disease or disability in order to reduce or protect against weight stigma and discrimination. This study sought to investigate the public understanding of the disability and disease concepts in obesity, their acceptance, and association with weight stigma.

METHODS

In a representative German population sample (n = 2,524), public views of obesity as a disease or disability were assessed via a self-report questionnaire. For the assessment of weight stigma, the Weight Control/Blame subscale from the Antifat Attitudes Test was used.

RESULTS

A significantly greater acceptance of the disease than the disability concept was found (37.1 vs. 15.4%). Both disease and disability were mainly viewed as physical conditions, although one-third also viewed obesity as a mental disease. While agreement with the disease concept - especially of physical and genetic disease - significantly predicted lower weight stigma; agreement with the disability concept - especially of mental or intellectual disability - predicted higher weight stigma.

CONCLUSIONS

These results suggest a careful use of the disease and disability terms and precise definitions. The disability concept in particular carries notions that are publicly devalued.

Psychological and Socio-Economical Determinants of Health: The Case of Inner German Migration

A substantial body of research has shown worse health conditions for East- vs. West-Germany in the wake of reunification. In the present study, we investigate how these differences between the two formerly divided regions developed and what maintains them. Specifically, we consider the associations between health status, income satisfaction, and health-related locus of control. In a quasi-experimental and longitudinal study design, we are particularly interested in the differences between individuals who stayed in East-Germany and those who were born in the East but migrated to West-Germany. To this end, we examined data from seven waves of the Saxony Longitudinal Study (2003-2009). Specifically, we tested a cross-lagged panel model with random effects, which evinced very good model fit. Most parameters and processes were equivalent between individuals who stayed in East-Germany vs. moved to West-Germany. Crucially, there was the expected pattern of positive correlations between health, income, and locus of control. In addition, we found substantially lower values for all three of these variables for the individuals who stayed in East-Germany (vs. moved to West-Germany). A possible explanation is the increase in socio-economic status that the internal migrants experienced. These findings present an important contribution of research in order to foster a better understanding on the social dynamics in Germany related to internal/domestic migrants and implications in the context of health outcomes (e.g., significantly more unemployment in East vs. West-Germany), especially since almost 20-25% of East-German citizens migrated to West-Germany. Until now, there are no similar studies to the Saxony longitudinal project, since the data collection started in 1987 and almost every year an identical panel has been surveyed; which can be particularly useful for health authorities. The study mainly focuses on social science research and deals with the phenomenon of reunification, approaching several subjects such as mental and physical health, quality of life and the evaluation of the political system. Yet even though many people have experienced such a migration process, there has been little research on the subjects we approach. With our research we deepen the understanding of the health consequences of internal migration.

Revised Short Screening Version of the Profile of Mood States (POMS) From the German General Population

The present study was conducted with the aim of constructing and validating a short form of the Profile of Mood States (POMS). The POMS is a widely-applied measure for the assessment of an individual's mood. Thus, it is of great relevance for many research questions in clinical and social psychology. To develop the short scale, we first examined psychometric properties and found the optimal 16-item solution among all valid combinations of the full POMS in an exploratory subsample (n = 1,029) of our complete representative sample of the German general population. We then validated this model in a confirmatory subsample (n = 977). Additionally, we examined its invariance across age groups and sex, as well as its reliability. Our results indicate that the POMS-16 is a valid and reliable measure of mood states with minimal losses compared to the 35-item version. Particularly where brevity and an economical assessment is desired, the POMS-16 should be considered.

Do patients suffering from chronic diseases retrospectively overestimate how healthy they were before they fell ill?

Background/Objective: To examine the impact of a disease on a person's subjective health state, patients are often asked to assess their current health state and to retrospectively assess how healthy they were before they fell ill. The objective of this study was to test whether patients generally overestimated the quality of their pre-disease health. Method: Six samples of patients with chronic diseases (cancer patients, cardiovascular patients, and patients diagnosed with sarcoidosis, N between 197 and 1,197) were analyzed. The patients assessed their current health states and their health states at the time before diagnosis. The retrospective scores were compared with matched data from general population studies. Results: In three of the six studies, the retrospective health ratings of the patients were significantly higher than the general population norms (effect sizes between 0.24 and 0.46), two studies yielded nonsignificant effects, and in one study there was an opposite trend. The general overestimation of pre-disease health was more pronounced in older patients as compared with younger ones, and it was more pronounced when global health/quality of life was to be assessed. Conclusions: Retrospective assessments of pre-disease health states are not appropriate for assessing disease-related changes in a person's health state.

Psychometric evaluations of the Life Orientation Test-Revised (LOT-R), based on nine samples

OBJECTIVE

The aim of this study was to examine psychometric properties of the Life Orientation Test-Revised (LOT-R).

DESIGN AND MAIN OUTCOME MEASURES

The LOT-R was administered in five clinical samples, three samples of the adult general population, and one sample of adolescents. Seven of the studies were performed in Germany and two in Colombia. All of the sample sizes were above 300.

RESULTS

Cronbach's alpha coefficients were between .57 and .75 for the eight adult samples, the correlations between the scales optimism and pessimism ranged from -.05 to -.37, and the coefficients of temporal stability (test-retest correlations) of the scales ranged from .43 to .69. There were no systematic age and gender effects observed in the nine studies. While the one-factor model of confirmatory factor analyses showed clearly insufficient fit indices among all of the samples, the two-factor model fit was markedly better.

CONCLUSIONS

The LOT-R proved to be a suitable instrument for measuring dispositional optimism in patients and in the general population, though the sum score should be viewed with caution. Studies comparing the LOT-R mean scores of different samples need not take age and gender distributions into account.

Psychometric Properties of the German Version of the Self-Regulation of Eating Behavior Questionnaire

Background: The Self-Regulation of Eating Behavior Questionnaire (SREBQ) is an economical way of assessing an individual's self-regulatory abilities regarding eating behavior. Such scales are needed in the German population; therefore, the purpose of the present study was the translation and validation of a German version of the SREBQ.

Method: First, we conducted a pilot study (Study 1; N = 371) after the translation procedure. Second, we assessed the final scale in a representative sample of the German population (Sample 2; N = 2,483) and its underlying factor structure. Further, we tested for measurement invariance and evaluated the SREBQ's associations with related scales to explore convergent and discriminant validity. Finally, we considered differences in SREBQ based on sociodemographic variables and provided derived reference scores (norm values).

Results: Factor analysis revealed deficiencies in the original model. Thus, we shortened the scale based on statistical considerations and the adapted version showed improved fit in Confirmatory Factor Analysis and reliability. We also found evidence for partial strict invariance, which means the measure is equivalent for the tested groups of age and gender. Item and scale psychometric properties of the shortened version were satisfactory. In terms of diagnostic validity, it was shown that individuals with higher body mass index (kg/m²) have worse self-regulation of eating behavior than those with lower.

Conclusion: In sum, the SREBQ evidenced good validity and reliability and is suitable for application in medical, psychological, and nutritional research.

Temporal stability of quality of life assessments in cancer patients

Quality of life (QoL) is an important outcome criterion in cancer research and practice. Multiple studies have been performed to test the short-term temporal stability (1 day–2 weeks) of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire EORTC QLQ-C30, but its stability over longer periods of time is largely unknown. The EORTC QLQ-C30 was administered at two time points between 3 and 12 months apart in six samples of cancer patients with varying characteristics (N between 298 and 923). Averaged across the six samples, the coefficients of temporal stability (intra-class correlation coefficients ICC) were between 0.31 and 0.59 for the single scales. The 2-item global health/QoL scale showed a mean coefficient of 0.44. When the stability coefficients were calculated separately for males and females and for younger vs. older patients, no systematic gender or age differences were found in the temporal stability of the QoL scales, though the stability was slightly higher in males (vs. females) and in older subgroups (vs. younger subgroups). It is nearly impossible to predict the course a cancer patients’ QoL will take over a several month period. Repeated measurements are necessary to track QoL developments.

From Bi-Dimensionality to Uni-Dimensionality in Self-Report Questionnaires

Abstract. The common factor model – by far the most widely used model for factor analysis – assumes equal item intercepts across respondents. Due to idiosyncratic ways of understanding and answering items of a questionnaire, this assumption is often violated, leading to an underestimation of model fit. Maydeu-Olivares and Coffman (2006) suggested the introduction of a random intercept into the model to address this concern. The present study applies this method to six established instruments (measuring depression, procrastination, optimism, self-esteem, core self-evaluations, and self-regulation) with ambiguous factor structures, using data from representative general population samples. In testing and comparing three alternative factor models (one-factor model, two-factor model, and one-factor model with a random intercept) and analyzing differential correlational patterns with an external criterion, we empirically demonstrate the random intercept model’s merit, and clarify the factor structure for the above-mentioned questionnaires. In sum, we recommend the random intercept model for cases in which acquiescence is suspected to affect response behavior.

Psychometric evaluation of the Eating Disorders in Youth-Questionnaire when used in adults: Prevalence estimates for symptoms of avoidant/restrictive food intake disorder and population norms

OBJECTIVE

Restrictive eating behaviors occur across ages, but little is known about symptoms of avoidant/restrictive food intake disorder (ARFID), especially in adults. This study sought to examine the prevalence of symptoms of ARFID in the adult population, providing a psychometric evaluation of the Eating Disorders in Youth-Questionnaire (EDY-Q) and population norms.

METHOD

In a representative survey of the German population, N = 2,424 adults (1,297 women, 1,127 men; age 49.5 ± 17.5 years) were assessed with the EDY-Q and measures of eating disorder and general psychopathology for divergent validation.

RESULTS

The point prevalence of self-reported symptoms of ARFID amounted to 0.8% (20/2,424), with 0.8% of women (10/1,297) and 0.9% of men (10/1,127) being affected. Adults with symptoms of ARFID were significantly more likely to have underweight or normal weight, were more likely to report restrictive behaviors and lower levels of eating disorder psychopathology and binge eating than noneating-disordered controls and adults with symptoms of an eating disorder, but did not significantly differ in levels of compensatory behaviors, or depression and anxiety. The EDY-Q revealed favorable item statistics, heterogeneity, and satisfactory construct validity, including factorial, discriminant, and divergent validity. Weight-status specific norms were provided.

DISCUSSION

Both women and men from the population reported symptoms of ARFID with an anthropometric and psychopathological profile similar to that seen in youth with symptoms of ARFID, however, with lower prevalence estimates, and distinctive from that in other eating disorders. Interview-based assessment of this symptomatology is required to confirm the prevalence of ARFID diagnosis.

The Narcissistic Personality Inventory 8: Validation of a Brief Measure of Narcissistic Personality

The present study was conducted with the aim of constructing and validating a short form of the Narcissistic Personality Inventory (NPI). The NPI is the most widely-applied measure for the assessment of narcissistic personality traits and, therefore, it is of great relevance for many research questions in personality and social psychology. To develop the short scale, we first found the optimal eight-item solution among all valid combinations of the NPI-15 items in an exploratory subsample (n = 1, 165) of our complete representative sample of the German general population. We then validated this model in a confirmatory subsample (n = 1, 126). Additionally, we examined its invariance across age groups and sex, as well as its reliability, as well as construct and predictive validity -comparing it to the NPI-15. Our results indicate that the NPI-8 is a valid and reliable measure of narcissistic personality with minimal losses compared to the 15-item version. Particularly where brevity and an economical assessment are desired, the NPI-8 should be considered.

A Brief Assessment of Body Image Perception: Norm Values and Factorial Structure of the Short Version of the FKB-20

The Body Image Questionnaire-20 (FKB-20) is one of the most applied self-report measures in the context of body image assessment in German-speaking regions. A version of the FKB-20 capturing an ideal concept of body image is also available. A special property of the scale is its high sensitivity for individuals suffering from anorexia nervosa. The present research provided a short version of this scale (for both variants) and examined its validity in a representative sample (N = 2,347) of the German population. We utilized factor analysis methods to identify the optimal short scale of the measure, finding excellent model fit and reliability for a two-factor model (FKB-6) for both real and ideal body image. Both versions of the FKB-6 can be considered invariant across sex and age groups. Good reliability indices were shown for both versions of the FKB-6. The reliability indices were similar to those mentioned in previous studies. Our study also revealed, that large discrepancies between the real and an ideal body image are correlated with somatic and body dysmorphic symptoms. Finally, we provided norm values for comparisons of individual scores with the general population. The FKB-6 is a valid and a reliable measure that economizes assessments by clinicians and researchers.

Detecting Authoritarianism Efficiently: Psychometric Properties of the Screening Instrument Authoritarianism - Ultra Short (A-US) in a German Representative Sample

With right-wing-extremist and -populist parties and movements on the rise throughout the world, the concept of authoritarianism has proven to be particularly valuable to explain the psychological underpinnings of these tendencies. Even though many scales to measure the different dimensions of authoritarianism exist, no short screening instrument has been tested and validated on a large scale so far. The present study examines the psychometric properties of the screening instrument Authoritarianism - Ultrashort (A-US) in three representative German samples (n = 2,524, n = 2,478, and n = 2,495). Using exploratory and confirmatory factor analysis, the A-US demonstrated acceptable internal consistency. Model fit was good and correlations with related constructs indicated convergent validity in both samples. Construct validity was demonstrated using the original version of the scale. The instrument proved to be invariant across sex, employment status, and education, but not across different age groups. Finally, the analyses showed that differences in the A-US are associated with sociodemographic variables. Potential causes and effects of these findings are discussed. Based on these results, the A-US proved to be a valuable and highly efficient tool to screen for authoritarian tendencies.

The long-lasting impact of unemployment on life satisfaction: results of a longitudinal study over 20 years in East Germany

BACKGROUND

Economic disruption in East Germany at the time of reunification (1990) resulted in a noticeable increase in unemployment. The present study provides data from a German cohort for over 20 years. The aim was to examine how the frequency of experiencing unemployment affects life satisfaction and whether their relationship changes over time.

METHODS

In the Saxon Longitudinal Study, an age-homogeneous sample was surveyed annually from 1987 to 2016. Since 1996, 355 people (54% female) have been examined for issues related to unemployment. Life satisfaction was measured with both the Global Satisfaction with Life Scale and the Questions on Life SatisfactionModules questionnaire.

RESULTS

In 1996, the participants were 23 years old and 50% of the sample was affected by unemployment. At all 16 different measuring points, participants who were never unemployed indicated higher life satisfaction than those who were once unemployed. The repeatedly unemployed consistently reported the lowest values of life satisfaction. In each year, there were significant differences with small to medium effect sizes.

CONCLUSION

Our results support the notion that the adverse effects of unemployment on life satisfaction increase with the time spent unemployed. In 2016, only 2% of the cohort were currently unemployed, but differences between people with and without unemployment experience still exist. This indicates that the negative effect of the unemployment experience will last for a very long time. To the best of our knowledge, this is the first study that demonstrates the effect so persistently at so many measurement points for over 20 years.

A reanalysis of the center for epidemiological studies depression scale (CES-D) using non-parametric item response theory

The "Center for Epidemiological Studies Depression Scale" (CES-D; Radloff, 1977) is a questionnaire used world-wide to measure depressive symptoms. Although the original four-factor-structure has been widely accepted and replicated, some studies point to other factor-structures like a one- and two-factor-structure. The goal of the current study was to evaluate the factor structure of the CES-D (one-, two- and four-factor-structure), which was found using classical test theory (CTT), with two non-parametric item-response-theory-models (Mokken-Scaling; Monotone-homogeneity-model; MHM and Double-monotonicity-model; DMM). To this end, a representative German sample was analyzed (N = 2,507). Regarding the one-factor-model, neither the MHM nor the DMM were supported; the two-factor-model and the four-factor-model, however, satisfied the assumptions of the MHM but not of the stricter DMM. Sum scores therefore constitute ordinal scales for the two-factor and four-factor-structure. This justifies, for example, the use of percentile ranks or medians and associated statistical techniques. Especially the use of the 16 negative formulated items seems appealing. Further studies should explore, whether the use of these 16 instead of the original 20 items is of advantage regarding the practical validity of the CES-D (e.g. higher sensitivity and specificity in screening applications and better temporal stability).

Correction: Revised short screening version of the attachment questionnaire for couples from the German general population

[This corrects the article DOI: 10.1371/journal.pone.0230864.].

Validation of the German version of the Bodily Distress Syndrome 25 checklist in a representative German population sample

OBJECTIVE

The Bodily Distress Syndrome 25 (BDS 25) checklist is a self-report instrument that can be used for case finding of a BDS in both clinical practice and research. We assessed the reliability and the internal and external validity of the German version of the BDS 25 in a sample of the general German population.

METHODS

The psychometric properties of the BDS 25 German were examined in a representative cross-sectional German population survey which included 2386 persons aged ≥14 years. Validation instruments included the Somatic Symptom Scale 8, the Giessen Subjective Complaints List 8 and the Patient Health Questionnaire 4. Participants were asked if they had been diagnosed with fibromyalgia or irritable bowel syndrome by a physician in the past.

RESULTS

The acceptance was high. Only 81 (2.3%) single items were not answered. Internal consistency was sufficiently high for all four subscales and the total score (α > 0.800). Exploratory and confirmatory factor analysis revealed clear evidence for a four-factorial structure with cardiopulmonary, gastrointestinal, musculoskeletal and general symptoms. Moderate to high correlations with other measures of somatic and psychological symptom burden were found. In latent class analysis, the model featuring three classes with no, moderate and severe BDS symptoms evinced the best model fit. Participants with self-reported fibromyalgia and irritable bowel syndrome were mainly found in the moderate and severe BDS group.

CONCLUSIONS

The BDS 25 German has excellent psychometric properties to screen for BDS in the general population.

Pharmaceutical industry interactions of psychiatric trainees from 20 European countries

Background:

Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees.

Methods:

One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire.

Results:

The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean) = 0.92, SD = 1.44, range = 0–12) and most in Portugal (M = 19.06, SD = 17.44, range = 0–100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M = 3.30, SD = 1.26 vs. M = 2.39, SD = 1.06 on a 5-point Likert scale: 1 “completely disagree” to 5 “completely agree”). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio) = 1.21, 95%CI = 1.12–1.30 and OR = 1.18, 95%CI = 1.02–1.37).

Conclusions:

There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.

Revised short screening version of the attachment questionnaire for couples from the German general population

In order to ensure the concentration, compliance and motivation of the participants, a short version of 12 items was extracted from the “Experiences in Close Relationships Questionnaire (ECR)”. Even though this short English version shows equally good validity and reliability as the long version, there have been no representative norm values and psychometric characteristics available for the short version in German. Therefore, the German 12-item ECR was implemented in a representative sample of 1,127 males and 1,237 females (mean age M = 49.93; SD = 12.31) from the general public (N = 2,364). The reliability values of the German 12-item ECR in the representative sample are not as good as the long version with the 36- items version (Alpha = .54–72), and the 12-item ECR factorial structure failed to show the factorial validity. Since the EFA revealed that only half the items loaded on the expected factors, an even shorter form with six items was construed and tested psychometrically. Even though the item numbers were reduced, the reliability values of the German 6-item ECR improved and were as good as the long version with 36 items (Alpha = .73–90). Furthermore, factorial validity could be shown by CFA (CFI = .981, SRMR = .038, RMSEA = .079, TLI = .964) with scalar invariance across gender and age. In sum, the 6-item ECR is a reliable and factorial scalar attachment questionnaire. Due to its shortness, it is applicable to different research fields. However, reference data from a clinical sample are still missing.

Norm values and psychometric properties for the German health regulatory focus scale - results of a representative survey

BACKGROUND

The health regulatory focus is an application of Higgins' regulatory focus theory to a health-specific context. It explains individual differences in health motivation, strategies, and behavior. Previous research found the Health Regulatory Focus Scale (HRFS) to be a reliable and valid measure for the construct. However, an evaluation of the HRFS in a representative sample has not been performed as of yet. Neither are there any normative values available.

METHODS

We collected a representative sample from the German general population to perform a confirmatory factor analysis, an analysis of measurement invariance, and to calculate norm values.

RESULTS

A two-factor model evinced good model fit with a good reliability for the two subscales. We found evidence for strict invariance across gender groups and partial strict invariance across age groups. In addition, we are presenting normative values for the general population.

CONCLUSIONS

The findings of the present study are in line with previous research in confirming the HRFS as a valid and reliable tool suitable for the assessment of the health regulatory focus. The reported normative values allow for comparisons of individuals with their respective sociodemographic group.

Measurement invariance, validation and normative data of the Jenkins Sleep Scale-4 (JSS-4) in the German general population across the life span

OBJECTIVE

As sleep disorders have become a major concern in public health, there is strong need for a brief and sound measure for sleep problems. The purposes of the study were to 1) evaluate factor structure and measurement invariance, 2) validate the scale based on sociodemographic data and distress, and 3) provide norm values for the general population.

METHODS

In a representative survey of the German population N = 2515 participants (14 to 95 years) filled in the 4-item Jenkins Sleep Scale (JSS-4), sociodemographic questions and the Brief Symptom Inventory-18 (anxiety, depression, somatic symptom load). The JSS-4 was analyzed by principal component analysis, confirmatory and multi-group confirmatory factor analyses. A multiple-indicator-multiple-cause model was tested to investigate the relationship of the JSS-4 to distress and sociodemographic variables.

RESULTS

The one-factor structure of JSS-4 was confirmed. Given the heterogeneity of facets of sleep problems captured in the four items, internal consistency of the JSS-4 was remarkably high. The JSS-4 was strictly invariant across both sexes, and partially strictly invariant across income groups and individuals living with or without a partner. With regard to the full age range, it showed partial scalar invariance.

CONCLUSION

Female sex, higher age, living without a partner, lower education, lower income and increased distress were associated with more sleep problems. Calculated normative data of sleep problems allow comparisons of JSS-4 scores stratified by sex and age.

Psychometric Properties of the Multidimensional Fatigue Inventory (MFI-20), Derived From Seven Samples

CONTEXT

Fatigue is a frequent symptom in patients suffering from chronic diseases. The Multidimensional Fatigue Inventory (MFI-20) is often used to measure fatigue. The aim of this article was to test the scale structure of the questionnaire.

METHODS

The MFI-20 data were obtained from seven samples, including general population samples and samples of patients with different diseases (N between 122 and 1993). Five confirmatory factor analysis (CFA) models were tested for each sample.

RESULTS

The scale structure postulated by the original test authors could not be confirmed by the CFAs. The inclusion of a method factor which considers the positive versus the negative orientation of the items yielded a better model fit. Cronbach's alpha was acceptable for most of the samples and scales: the total score of the MFI-20 reached alpha coefficients above 0.89. A short form of the MFI-20 which is restricted to the 10 positively oriented items (MFI-10) showed relatively good CFA indices.

CONCLUSION

The factorial validity of the MFI-20 is insufficient, an issue which is due, at least in part, to the inclusion of positively and negatively oriented items. Nevertheless, we recommend maintaining the scale structure of the MFI-20 and not searching for alternative structures.

[Psychometric Properties of the Shortend Version of the Scale "Transpersonal Trust" in a Representative Sample of the German Population]

INTRODUCTION

The aim of the present study was to show the development of the revised and shortened German version (6 items) of the scale "Transpersonales Vertrauen" (TPV-6R; 2017) as well as to examine its psychometric properties.

METHODS

In a representative German sample the questionnaire has been given to 2513 subjects. Collected data from 2464 subjects could be analysed. Exploratory and confirmatory factor analysis has been made to prove the original one-factor model (Belschner, 2000) as well as the 2-factorial structure found by Albani et al. (2003). Measurement invariance was tested using multigroup analysis. Correlations were used to determine convergent and discriminant validity towards other items.

RESULTS

After excluding 2 items due to their unsatisfactory scale fit, the 4 item model showed good item and scale characteristics as well as excellent model fit. The one factorial structure of the original work of Belschner and colleagues (2000) could be replicated. Metric invariance could be shown for gender and age, partial scalar invariance could be only generated for gender. No metric or scalar invariance could be shown for federal state and denomination.

DISCUSSION

Due to the good psychometric properties of the TPV-4R questionnaire it should be further analyzed in future research with other validated instruments that are measuring spiritual or religious attitudes.

CONCLUSIONS

The new German short version, the TPV-4R, is an economic, reliable and valid questionnaire to measure spiritual attitudes.

Assessing Procrastination

Abstract. The short form of the General Procrastination Scale (GPS-K; Klingsieck & Fries, 2012 ; Lay, 1986 ) is a reliable self-report scale measuring general procrastination. The presumed one-dimensional factor structure of the scale, however, has never been examined. Thus, the purposes of this representative study were to examine its dimensionality and factorial invariance across age and sex, and to provide norm values of the German general population. The GPS-K was administered to a representative community sample ( N = 2,527; age range 14–95 years). A confirmatory factor analysis (CFA) was conducted. To explore convergent validity, standardized scales of distress and life satisfaction were used. Measurement invariance across sex and age was tested. The CFA revealed an unsatisfactory model fit of the presumed unidimensional factor structure of the GPS-K. Therefore, a 5-item one-dimensional version of the scale was suggested (General Procrastination Scale – Screening; GPS-S). Correlations between GPS-S, distress and reduced life satisfaction provide evidence on its convergent validity. The one-dimensional GPS-S can be assumed to be scalar invariant across sex and for participants older than 29 years. The scale can be administered in only a few minutes providing an economic screening for research and practice.

[Psychometric Evaluation and Norm Values of an Ultra-Short Version of the Sense of Coherence Scale "SOC-3"]

Sense of coherence is a psychological resource which contributes substantially to an individual's ability to cope well with stressful situations. In the present study we investigate an ultra-short form of the Sense of Coherence Scale (SOC-3) in a representative sample of the German general population (N=2.018). The 3-item model evinced excellent model fit qualities and acceptable reliability. We present evidence for partial strict invariance across sex and age groups. In terms of construct validity, our analyses demonstrate strong overlap between the SOC-3 and two longer versions (-9 and -29). In addition, correlations to related constructs such as attachment styles, physical and mental health, as well as quality of life were similar between the SOC versions. For the first time, normative values for the German population are presented to allow for the classification of individual scores. We recommend the SOC-3 as a screener for applied sciences and for large-scale surveys in particular.

Psychometric Properties of Two Brief Versions of the Hopkins Symptom Checklist: HSCL-5 and HSCL-10

The Hopkins Symptom Checklist-25 (HSCL-25) is a widely applied measure of depression and anxiety. The present study examines two of its short forms-the HSCL-5 and HSCL-10, which have been proposed by previous research-in a representative sample of the German general population. To this end, we conducted exploratory and confirmatory analysis on two subsamples (n = 1,246 and n = 1,216). Our results suggest that, compared with the HSCL-25, both short forms represent economical ways of assessing depression and anxiety. Model fit was good and correlations with established measures demonstrate convergent validity. Both HSCL short forms are strongly invariant across sex, and we found evidence for partial strong invariance across age groups. Further analyses showed that differences in HSCL can be partially explained by sociodemographic variables. Finally, we report normative values for usage by researchers and clinicians. We recommend the HSCL-5 and HSCL-10 for clinical and research-oriented application.

Kurzversion des Bielefelder Fragebogens zu Partnerschaftserwartungen (BFPE-12)

Zusammenfassung. Die Kurzfassung des Bielefelder Fragebogens zu Partnerschaftserwartungen (BFPE-12) ist ein Selbstrating zur Messung partnerschaftsbezogener Bindungsaspekte. Neben der Messung der Dimensionen Akzeptanzprobleme, Öffnungsbereitschaft und Zuwendungsbedürfnis können Personen Bindungsmustern zugewiesen werden. Die vorliegende Studie evaluiert Faktorenstruktur und psychometrische Eigenschaften des Instruments anhand einer aktuellen bevölkerungsrepräsentativen Stichprobe. Die Stichprobe umfasst N = 1574 Personen. Es wurden soziodemographische Variablen, der BFPE-12, die Kurzform des Depressive Experiences Questionnaire Self-Criticism sowie der Patient Health Questionnaire-4 erhoben. Es wurden explorative und konfirmatorische Faktorenanalysen durchgeführt und interne Konsistenz, Itemstatistiken und Korrelationen mit Außenkriterien bestimmt. Explorative und konfirmatorische Faktorenanalyse bestätigten die angenommene Faktorenstruktur (RMSEA < .08). Die interne Konsistenz der drei Skalen war akzeptabel (α > .7). Starke Akzeptanzprobleme und geringe Öffnungsbereitschaft korrelierten hypothesenkonform mit Selbstkritik, Ängstlichkeit und Depressivität. z-Werte, t-Werte und Prozentränge werden berichtet. Insgesamt kann für den BFPE-12 konstatiert werden, dass er eine mehrfach evaluierte Faktorenstruktur und akzeptable psychometrische Eigenschaften aufweist.

[Psychometric Properties of the Shortend Version of the "Systems of Belief Inventory" in a Representative Sample of the German Population]

INTRODUCTION

The aim of the present study was to show the development of the revised and shortened German version (6 items) of the "Systems of Belief Inventory" (SBI-6R-D) as well as to examine its psychometric properties.

METHODS

In a representative German sample the questionnaire has been given to 2513 subjects. A confirmatory factor analysis has been made to prove the original American factor structure. Measurement invariance was tested using multigroup analysis. Correlations were used to determine convergent and discriminant validity towards other items.

RESULTS

The SBI-6R-D showed good item and scale characteristics as well as good model fit. In difference to the work of Albani et al. (SBI-15R-D), the 2 factorial structure of the original American questionnaire could be replicated. Scalar invariance could be shown for gender and age, metric invariance for denomination and federal state.

DISCUSSION

Due to the good psychometric properties of the questionnaire it should be further analyzed in future research with other validated religious instruments.

CONCLUSIONS

The new German short version, the SBI-6R-D, is an economic, reliable and valid questionnaire to measure spiritual and religious attitudes.

Measuring Illness Behavior in One Minute

Abstract. The present study addresses shortcomings in previous psychometric research into the Scale for the Assessment of Illness Behavior (SAIB) and develops a short form, the SAIB-10. We used ant-colony optimization to construct a subset of items in an exploratory sample ( n = 1,187) and affirmed it in factor analysis in a confirmatory sample ( n = 1,208). We find excellent model fit and evidence for strict invariance across sex and age. As expected, there were associations with distressed personality, perceived social support, and mental health. Finally, we report normative values for usage by researchers and clinicians. In sum, the SAIB-10 is an economical measure of illness behavior and recommended as a screening tool or for large-scale surveys.

Response shift effects in the assessment of urologic cancer patients' quality of life

OBJECTIVE

Urologic cancer patients often assess their quality of life (QoL) as being relatively good. Response shift (change in internal standards) may be one reason for that effect. The aim of this study was to test such response shift effects.

METHODS

A sample of 197 male urologic cancer patients was tested while hospitalised (t1) and three months later (t2). The participants had to assess their current health state and the health state of two anchoring vignettes. They also completed the EORTC QLQ-C30 and PHQ-4 questionnaires, including a retrospective thentest. The control sample was comprised of members of the general population.

RESULTS

The patients rated their general health as being worse than people from the general population did (effect size: d = 0.73, p < 0.001). Moreover, the patients assessed the vignette presenting physical problems as being significantly healthier than people from the general population did (d = 0.42, p < 0.001). Under the retrospective thentest condition, the patients rated their QoL and their mental burden as being significantly worse than in the pre-test condition. Both methods showed response shift effects.

CONCLUSION

Urologic cancer patients' assessments of their QoL should be handled with caution because of possible shifts in their internal standards of judgement.

Response shift effects of quality of life assessments in breast cancer survivors

Measurements of quality of life (QoL) can be distorted by respondents adapting to new situations between measurement points and consequently having a changed frame of reference. To investigate this bias in breast cancer survivors, we compare their QoL with that of the general population and use two complementary methods for detecting this bias. Breast cancer survivors (n = 308, response rate: 91%) were tested with the QoL questionnaire European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. Response shift was examined with the thentest (retrospective judgements) and with the structural equation modelling (SEM) approach. Compared with the general population, breast cancer survivors showed impaired QoL in all functioning scales (Hedges' g: -0.56 to -0.93) and symptom scales (Hedges' g: 0.28-0.74).The thentest method indicated recalibration effects in several dimensions including social functioning. The SEM method detected a non-uniform recalibration effect for social functioning from pretest to posttest and from pretest to thentest, but no effect between thentest and posttest. Breast cancer survivors' QoL is clearly diminished. Comparing the two approaches for detecting response shift showed that it is also useful to apply SEM to retrospective judgements and that this can reveal response shift effects that would otherwise be overlooked.

Social support in the general population: standardization of the Oslo social support scale (OSSS-3)

BACKGROUND

The objectives of the study were to generate normative data for the Oslo Social Support Scale (OSSS-3) for different age groups for men and women and to further investigate the factor structure in the general population.

METHODS

Nationally representative face-to face household surveys were conducted in Germany in 2008 (n = 2524).

RESULTS

Normative data for the Oslo Social Support Scale were generated for men and women (52.3% female) and different age levels (mean age (SD) of 48.9 (18.3) years). Men had mean scores comparable to women (10.1 [SD = 2.3] vs. 10.2 [SD = 2.2]). The EFA resulted in a clear one-factor solution for the OSSS-3.

CONCLUSIONS

The normative data provide a framework for the interpretation and comparisons of social support with other populations.