Longitudinal validation of cognitive reserve proxy measures: a cohort study in a rural Chinese community

BACKGROUND

While evidence supports cognitive reserve (CR) in preserving cognitive function, longitudinal validation of CR proxies, including later-life factors, remains scarce. This study aims to validate CR's stability over time and its relation to cognitive function in rural Chinese older adults.

METHODS

Within the project on the health status of rural older adults (HSRO), the survey included baseline assessment (2019) and follow-up assessment (2022). 792 older adults (mean age: 70.23 years) were followed up. The confirmatory factor analysis (CFA) was constructed using cognitive reserve proxies that included years of formal education, social support, hobbies, and exercise. We examined the longitudinal validity of the CR factor using confirmatory factor analyses and measurement invariance and explored the association of CR with cognition using Spearman's correlation and Generalized Estimating Equations (GEE).

RESULTS

The results showed that CR's CFA structure was stable over time (T0, χ2/df: 3.21/2; RMSEA: 0.02, and T1, χ2/df: 7.47/2; RMSEA: 0.05) and that it accepted both configural and metric invariance (Δχ2/df = 2.28/3, P = 0.52). In addition, it was found that CR had a stable positive relationship with cognitive function across time (T0, r = 0.54; T1, r = 0.49). Furthermore, longitudinal CR were associated with MMSE (β = 2.25; 95%CI = 2.01 ~ 2.49).

CONCLUSIONS

This study provided valuable evidence on the stability and validity of cognitive reserve proxy measures in rural Chinese older adults. Our findings suggested that cognitive reserve is associated with cognitive function over time and highlighted the importance of accumulating cognitive reserve in later life.

Quantifying vocabulary learning belief and strategy - A validation study of the Vietnamese version of Gu's (2018) vocabulary learning questionnaire

Background

The field of language teaching and learning has long recognized the role of vocabulary knowledge in all aspects of language proficiency and indicated that vocabulary beliefs and learning strategies play a pivotal role in learners' vocabulary development. As a result, understanding learners' beliefs and strategies in vocabulary learning is of paramount importance to language teachers. The Vocabulary Learning Questionnaire (VLQ) developed by Peter Gu in 2018 could be considered the most recent, validated instrument for the measurement of vocabulary learning beliefs and strategies. However, the VLQ contains too many items and is only available in English. The objectives of the study, therefore, are (1) to develop and validate a Vietnamese version of the VLQ which can exclude construct-irrelevant noises related to L2 comprehension, and (2) to reduce the number of items while retaining the key factors in the instruments.

Methods

722 Vietnamese university students took part in the study. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were examined with the free software Jamovi 2.3.13. Both Cronbach's alpha and McDonald's omega were employed to evaluate the factors' internal consistency.

Results

Separate EFAs confirmed the two dimensions of vocabulary beliefs, explaining 62.6% of the total variance, and seven factors of vocabulary strategies, predicting 72.1% of the total variance. CFAs confirmed the hypothesized 9-dimensional structures of different vocabulary learning beliefs and strategies and offer cross-validation evidence for the Vietnamese VLQ. Reliability metrics demonstrated acceptable internal reliability for vocabulary belief and strategy sub-scales.

Conclusion

The Vietnamese VLQ provides a validated measure of vocabulary beliefs and strategies. The 30-item version of the Vietnamese VLQ serves as a starting point for future research in the field of vocabulary learning and teaching in Vietnam.

Self-Perceptions of Aging: Factorial Structure and Invariance by Gender

BACKGROUND AND OBJECTIVES

Self-perceptions of aging (SPA)-the appraisals people place on their own aging processes-predict well-being in later life. Researchers are increasingly hypothesizing that the overarching construct of SPA is comprised of two factors-positive SPA and negative SPA-and that SPA are gendered. The purpose of this study was to empirically test the hypothesized two-factor structure of SPA and to analyze how the two-factor structure varies between men and women.

RESEARCH DESIGN AND METHODS

Data come from the 2012 wave of the Health and Retirement Study (N = 7,029; Mage = 68.08), which includes an 8-item SPA scale. We used confirmatory factor analysis (CFA) to assess (i) the positive SPA and negative SPA two-factor solution for the 8-item scale and (ii) whether the two-factor solution had configural, strong, or weak invariance across men and women.

RESULTS

CFAs indicated a two-factor latent structure of the 8-item scale, with SPA being comprised of both a positive SPA factor and a negative SPA factor. The latent structure was the same for both men and women.

DISCUSSION AND IMPLICATIONS

Results suggest that SPA is a broader construct made up of positive and negative latent factors. Researchers should consider separating the SPA by positive and negative factors to analyze how each factor uniquely shapes health. Moreover, the two-factor solution was equivalent across men and women, possibly because of the generalized nature of the 8-item scale. Researchers can use the 8-item scale similarly for men and women and should continue to elucidate possible gender differences in SPA.

Application of the Chinese version of Zelaya's HIV-related stigma scale to undergraduates in mainland China

Background

This cross-sectional study aims to validate the Chinese version of Zelaya’s HIV-related Stigma Scale (CVZHSS) among a large undergraduate sample in mainland China, and apply it to measure the level of different dimensions of stigma and their respective determinants.

Methods

From September 10, 2018, to January 9, 2019, a total of 10,665 eligible undergraduates conveniently drawn from 30 provinces in mainland China (except for Tibet) completed the self-designed online questionnaire distributed via sojump.com voluntarily, anonymously and confidentially. Both exploratory and confirmatory factor analyses (EFA and CFA) were first performed to test its construct validity, Cronbach’s alpha was then used to assess its internal consistency, and Logistic regression analyses were finally carried out to identify predictors of various dimensions of stigma.

Results

As expected from the original model, four factors (i.e., “fear of casual transmission”, “moral judgment”, “personal stigma” and “perceived community stigma”) were extracted using principal component analysis with varimax rotation, accounting for 63.26% of the total variance. The CFA further confirmed the four-factor construct (CFI = 0.92, GFI = 0.91, RMSEA = 0.07). In addition, all the four factors demonstrated acceptable internal consistency with Cronbach’s alpha ranging from 0.83 to 0.92. Stigma as measured by “fear of casual transmission” (74.4%), “moral judgement” (61.6%), “personal stigma” (79.0%) and “perceived community stigma”(36.5%) is highly prevalent among undergraduates. Except for non-freshmen, less knowledge about HIV and unsafe sex which were consistently associated with higher levels of stigma in all four dimensions, other eight variables including gender, residential area, major, sexual orientation, having ever being tested perception of HIV risk, willingness to utilize HTC service and awareness of the national AIDS policy played differential roles in affecting different dimensions of stigma.

Conclusions

The CVZHSS is a reliable and valid measurement tool and can be used to identify undergraduates with high levels of stigma. However, the four dimensions (Fear, moral judgement, personal stigma and perceived community stigma) were respectively influenced by different determinants, and thus should be treated independently when designing, implementing and evaluating stigma reduction programs.

Conceptualizing comorbid PTSD and depression among treatment-seeking, active duty military service members

BACKGROUND

Among active duty service members and veterans with PTSD, depression is the most commonly diagnosed comorbid psychiatric condition. More research is warranted to investigate the relationship between PTSD and depression to improve treatment approaches. Byllesby et al. (2017) used confirmatory factor analyses in a sample of trauma-exposed combat veterans with PTSD and found that only the general distress factor, and not any specific symptom cluster of PTSD, predicted depression. This study seeks to replicate Byllesby et al. (2017) in a sample of treatment-seeking active duty soldiers.

METHODS

Confirmatory factor analyses, bifactor modeling, and structural equation modeling (SEM) were used with data gathered at pretreatment and posttreatment as part of a large randomized clinical trial.

RESULTS

Confirmatory factor analyses and bifactor modeling demonstrated that PTSD symptom clusters, Negative Alterations in Cognition and Mood (NACM) and Alterations in Arousal and Reactivity (AAR), as well as the general distress factor significantly predicted depression at pretreatment and posttreatment.

LIMITATIONS

The current study was predominantly male, limiting the generalizability to female service members with PTSD. Also, self-report measures were used, which may introduce response-bias.

CONCLUSIONS

The current study did not replicate Byllesby et al. (2017). Results demonstrated that the relationship between PTSD and depression among active duty service members can be explained by both transdiagnostic factors and disorder-specific symptoms.

Relations between PTSD and depression symptom clusters in samples differentiated by PTSD diagnostic status

Co-occurring posttraumatic stress disorder (PTSD) and depression following traumatic experiences are cumulatively associated with functional impairment. To examine mechanisms for the PTSD-depression comorbidity, we investigated their cluster-level associations. Using data obtained from Amazon's Mechanical Turk platform, 368 trauma-exposed participants were split into two subsamples: those with (n = 163) and without (n = 185) probable PTSD. In both subsamples, confirmatory factor analyses indicated an optimal seven-factor PTSD Hybrid Model. Results of Wald tests of parameter constraints indicated that, in both subsamples, PTSD's dysphoric arousal cluster strongly related to somatic depression compared to all/most other PTSD Hybrid Model clusters. Additionally, in both subsamples, PTSD's negative affect, externalizing behaviors, and anhedonia clusters each strongly related to non-somatic depression compared to PTSD's anxious arousal cluster. Our results indicated that PTSD's dysphoric arousal symptoms mainly accounted for PTSD's shared variance with somatic depression, while the negative alterations in cognitions and mood (NACM)/dysphoria and arousal symptoms (primarily externalizing behaviours) mainly accounted for PTSD's shared variance with non-somatic depression. Our findings have implications for the discussion on PTSD's specific/non-specific clusters tied to diagnostic modifications, for understanding mechanisms underlying PTSD-depression comorbidity, and for the use of transdiagnostic and multi-component treatment protocols for PTSD-depression symptoms.

The Work Role Functioning Questionnaire v2.0 Showed Consistent Factor Structure Across Six Working Samples

Objective The Work Role Functioning Questionnaire v2.0 (WRFQ) is an outcome measure linking a persons' health to the ability to meet work demands in the twenty-first century. We aimed to examine the construct validity of the WRFQ in a heterogeneous set of working samples in the Netherlands with mixed clinical conditions and job types to evaluate the comparability of the scale structure. Methods Confirmatory factor and multi-group analyses were conducted in six cross-sectional working samples (total N = 2433) to evaluate and compare a five-factor model structure of the WRFQ (work scheduling demands, output demands, physical demands, mental and social demands, and flexibility demands). Model fit indices were calculated based on RMSEA ≤ 0.08 and CFI ≥ 0.95. After fitting the five-factor model, the multidimensional structure of the instrument was evaluated across samples using a second order factor model. Results The factor structure was robust across samples and a multi-group model had adequate fit (RMSEA = 0.63, CFI = 0.972). In sample specific analyses, minor modifications were necessary in three samples (final RMSEA 0.055-0.080, final CFI between 0.955 and 0.989). Applying the previous first order specifications, a second order factor model had adequate fit in all samples. Conclusion A five-factor model of the WRFQ showed consistent structural validity across samples. A second order factor model showed adequate fit, but the second order factor loadings varied across samples. Therefore subscale scores are recommended to compare across different clinical and working samples.

Factor analyses for the Örebro Musculoskeletal Pain Questionnaire for working and nonworking patients with chronic low back pain

BACKGROUND CONTEXT

The Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) has good psychometric properties to predict return to work in patients with acute low back pain. Although it is used in patients with chronic back pain and nonworkers, there is no evidence on the factor structure of the ÖMPQ in these populations. This is deemed an important prerequisite for future prediction studies.

PURPOSE

This study aimed to analyze the factor structure of the ÖMPQ in working and nonworking patients with chronic back pain.

STUDY DESIGN/SETTING

This is a cross-sectional study in a university-based spine center.

PATIENT SAMPLE

The patient sample consists two cohorts of working and nonworking adult patients (>18 years) with specific and nonspecific chronic back pain.

OUTCOME MEASURES

The Örebro Musculoskeletal Pain Questionnaire.

METHODS

Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed in working (N=557) and nonworking (N=266) patients for three, four, five, and six factors identified in literature. A goodness of fit index was calculated by a chi-square. Root mean square error of approximation (RMSEA) was calculated, and the number of factors identified was based on RMSEA values <.05. A Tucker-Lewis index (TLI) and a normed fit index (NFI) >0.90 are considered to indicate acceptable fit.

RESULTS

In working patients, a five-factor solution had the best fit (RMSEA<0.05; NFI and TLI >0.90), but substantial adaptations should be made to get proper fit (removal of the work-related items). In nonworking patients, a four-factor analysis had the best fit (RMSEA<0.05). For both samples, items related to duration could not fit in the overall model.

CONCLUSIONS

Factor structure of the ÖMPQ was not confirmed in working and nonworking patients with chronic back pain. Substantial adaptations should be made to obtain a factor structure with acceptable fit.

Assessing rumination response style among undergraduate nursing students: A construct validation study

BACKGROUND

Rumination is one of the risk factors for mental health problems among nursing students. Rumination refers to repetitive thoughts focusing on negative emotions. There is a need to use an appropriate instrument to detect rumination to prevent the development of emotional problems. The ruminative response scale (RRS) is an instrument widely used to assess rumination levels in adult populations. It is inconclusive if the scale can be used for younger people like nursing students.

OBJECTIVES

This study aimed to examine the psychometric properties of the 10-item ruminative response scale (RRS-10) in undergraduate nursing students.

DESIGN

A cross-sectional research design was used.

SETTINGS

This study was undertaken at one of the universities in Thailand.

PARTICIPANTS

A sample of 747 undergraduate nursing students was recruited.

METHOD

Data were collected through a self-administered questionnaire, containing the 10-item RRS and Thoughts, Feelings and Experiences Questionnaire, and personal information. Exploratory/confirmatory factor analyses and correlational analyses were performed to test the construct and concurrent validity of the RRS respectively. Cronbach's alphas were used as parameters for the internal consistency reliability.

RESULTS

The RRS-10 had two distinct factors: brooding (moody pondering) and reflection (analysing depression-relating situations). Adequate model fit indices were obtained and significant factor loadings were observed, indicating acceptable construct validity. These two factors had significant correlations with emotional distress, depression, anxiety, and hopelessness, supporting concurrent validity of the scale. Cronbach's alphas were 0.71 and 0.73 for the brooding and reflection factors respectively, suggesting good reliability.

CONCLUSION AND RECOMMENDATION

The RRS-10 demonstrated satisfactory psychometric properties. Therefore, it can be used to assess rumination response style among undergraduate nursing students in Thailand. Future research can test the scale on nursing students or youths in other countries.

Comparing four competing models of depressive symptomatology: a confirmatory factor analytic study of 986,647 U.S. veterans

BACKGROUND

Few rigorous studies have examined the factor structure of major depression symptoms as assessed by current diagnostic systems. This study evaluated four competing models of depressive symptomatology among a large, heterogeneous sample of U.S. veterans.

METHODS

To determine the best fitting model of major depressive symptoms among four competing models, this study conducted a series of confirmatory factor analyses on a national sample of 986,647 U.S. veterans.

RESULTS

A two-factor model first reported by Krause, Reed, and McArdle (2010) provided superior fit to symptom-level data compared to three other models. The optimal model consists of a somatic factor including anhedonia, sleep difficulties, fatigue, appetite changes, concentration difficulties, and psychomotor agitation; and a non-somatic factor including depressed mood, feelings of worthlessness, and thoughts of death. Factorial invariance testing found this model to be invariant by gender and major depression diagnosis.

LIMITATIONS

A widely used self-report measure of depression was used and the sample consisted solely of veterans so further study is needed with clinician-administered measures and non-veteran samples.

CONCLUSIONS

Together, these findings support separating symptoms of major depression into somatic and non-somatic factors which may have clinical relevance, and help clarify debates about the factor structure of depressive symptoms.

DSM-5 PTSD's symptom dimensions and relations with major depression's symptom dimensions in a primary care sample

Existing literature indicates significant comorbidity between posttraumatic stress disorder (PTSD) and major depression. We examined whether PTSD's dysphoria and mood/cognitions factors, conceptualized by the empirically supported four-factor DSM-5 PTSD models, account for PTSD's inherent relationship with depression. We hypothesized that depression's somatic and non-somatic factors would be more related to PTSD's dysphoria and mood/cognitions factors than other PTSD model factors. Further, we hypothesized that PTSD's arousal would significantly mediate relations between PTSD's dysphoria and somatic/non-somatic depression. Using 181 trauma-exposed primary care patients, confirmatory factor analyses (CFA) indicated a well-fitting DSM-5 PTSD dysphoria model, DSM-5 numbing model and two-factor depression model. Both somatic and non-somatic depression factors were more related to PTSD's dysphoria and mood/cognitions factors than to re-experiencing and avoidance factors; non-somatic depression was more related to PTSD's dysphoria than PTSD's arousal factor. PTSD's arousal did not mediate the relationship between PTSD's dysphoria and somatic/non-somatic depression. Implications are discussed.