British Journal of Clinical Psychology

Mục tiêu. Kiểm tra tính giá trị cấu trúc của phiên bản rút gọn của thang đánh giá trầm cảm, lo âu và căng thẳng (DASS-21), đặc biệt đánh giá xem căng thẳng theo chỉ số này có đồng nghĩa với tính cảm xúc tiêu cực (NA) hay không hay nó đại diện cho một cấu trúc liên quan nhưng khác biệt. Cung cấp dữ liệu chuẩn hóa cho dân số trưởng thành nói chung.

Thiết kế. Phân tích cắt ngang, tương quan và phân tích yếu tố xác nhận (CFA).

Phương pháp. DASS-21 được áp dụng cho một mẫu không có bệnh lý, đại diện rộng cho dân số trưởng thành tại Vương quốc Anh (N=1,794). Các mô hình cạnh tranh về cấu trúc tiềm ẩn của DASS-21 đã được đánh giá sử dụng CFA.

Kết quả. Mô hình có sự phù hợp tối ưu (RCFI = 0.94) có cấu trúc tứ phương, bao gồm một yếu tố chung của rối loạn tâm lý cộng với các yếu tố cụ thể vuông góc của trầm cảm, lo âu, và căng thẳng. Mô hình này có sự phù hợp tốt hơn đáng kể so với mô hình cạnh tranh kiểm tra khả năng rằng thang đo Stress chỉ đơn giản đo NA.

Kết luận. Các thang đo phụ DASS-21 có thể được sử dụng hợp lệ để đo lường các khía cạnh của trầm cảm, lo âu và căng thẳng. Tuy nhiên, mỗi thang đo phụ này cũng chạm đến một khía cạnh chung hơn của rối loạn tâm lý hoặc NA. Sự tiện ích của thang đo được nâng cao nhờ có dữ liệu chuẩn hóa dựa trên một mẫu lớn.

Two studies are reported describing the development of a short‐form of the state scale of the Spielberger State–Trait Anxiety Inventory (STAI) for use in circumstances where the full‐form is inappropriate. Using item–remainder correlations, the most highly correlated anxiety‐present and anxiety‐absent items were combined, and correlated with scores obtained using the full‐form of the STAI. Correlation coefficients greater than .90 were obtained using four and six items from the STAI. Acceptable reliability and validity were obtained using six items. The use of this six‐item short‐form produced scores similar to those obtained using the full‐form. This was so for several groups of subjects manifesting a range of anxiety levels. This short‐form of the STAI is therefore sensitive to fluctuations in state anxiety. When compared with the full‐form of the STAI, the six‐item version offers a briefer and just as acceptable scale for subjects while maintaining results that are comparable to those obtained using the full‐form of the STAI.

This paper describes a questionnaire measure of self‐reported failures in perception, memory, and motor function. Responses to all questions tend to be positively correlated, and the whole questionnaire correlates with other recent measures of self‐reported deficit in memory, absent‐mindedness, or slips of action. The questionnaire is however only weakly correlated with indices of social desirability set or of neuroticism. It is significantly correlated with ratings of the respondent by his or her spouse, and accordingly does have some external significance rather than purely private opinion of the self. The score is reasonably stable over long periods, to about the same extent as traditional measures of trait rather than state. Furthermore, it has not thus far been found to change in persons exposed to life‐stresses. However, it does frequently correlate with the number of current psychiatric symptoms reported by the same person on the MHQ; and in one study it has been found that CFQ predicts subsequent MHQ in persons who work at a stressful job in the interval. It does not do so in those who work in a less stressful environment. The most plausible view is that cognitive failure makes a person vulnerable to showing bad effects of stress, rather than itself resulting from stress.

Mục tiêu: Cung cấp dữ liệu chuẩn cho Vương quốc Anh về Thang đo Trầm cảm, Lo âu, và Căng thẳng (DASS) và kiểm tra giá trị hội tụ, phân biệt, và giá trị cấu trúc của thang đo này.

Thiết kế: Phân tích cắt ngang, tương quan, và phân tích yếu tố khẳng định (CFA).

Phương pháp: DASS được áp dụng đối với mẫu không lâm sàng, đại diện rộng rãi cho dân số người lớn tại Vương quốc Anh (N = 1,771) về các biến nhân khẩu học. Các mô hình cạnh tranh của cấu trúc tiềm ẩn DASS được rút ra từ các nguồn lý thuyết và thực nghiệm, và được đánh giá bằng phân tích yếu tố khẳng định. Phân tích tương quan được sử dụng để xác định ảnh hưởng của các biến nhân khẩu học lên điểm số DASS. Giá trị hội tụ và phân biệt của thang đo được kiểm tra thông qua tương quan giữa thang đo này với hai thang đo khác về trầm cảm và lo âu (HADS và sAD), và một thang đo về khả năng xúc cảm tích cực và tiêu cực (PANAS).

Kết quả: Mô hình tốt nhất (CFI = .93) của cấu trúc tiềm ẩn DASS bao gồm ba yếu tố có mối tương quan tương ứng với các thang đo trầm cảm, lo âu và căng thẳng, với lỗi liên kết được phép giữa các mục cấu thành phụ thang DASS. Các biến nhân khẩu học chỉ có ảnh hưởng rất nhỏ đối với điểm số DASS. Độ tin cậy của DASS là xuất sắc, và thang đo sở hữu giá trị hội tụ và phân biệt đầy đủ.

Kết luận: DASS là một thang đo đáng tin cậy và có giá trị trong việc đánh giá các cấu trúc mà nó được thiết kế để phản ánh. Tính hữu dụng của thang đo này đối với các bác sĩ tại Vương quốc Anh được nâng cao nhờ việc cung cấp dữ liệu chuẩn từ các mẫu lớn.

A multifactorial model of the formation and maintenance of persecutory delusions is presented. Persecutory delusions are conceptualized as threat beliefs. The beliefs are hypothesized to arise from a search for meaning for internal or external experiences that are unusual, anomalous, or emotionally significant for the individual. The persecutory explanations formed reflect an interaction between psychotic processes, pre‐existing beliefs and personality (particularly emotion), and the environment. It is proposed that the delusions are maintained by processes that lead to the receipt of confirmatory evidence and processes that prevent the processing of disconfirmatory evidence. Novel features of the model include the (non‐defended) direct roles given to emotion in delusion formation, the detailed consideration of both the content and form of delusions, and the hypotheses concerning the associated emotional distress. The clinical and research implications of the model are outlined.

Objective. To provide normative data for the Hospital Anxiety Depression Scale (HADS).

Design. Repeated measures and correlational.

Methods. The HADS was administered to a non‐clinical sample, broadly representative of the general adult UK population (N = 1792) in terms of the distributions of age, gender and occupational status. Correlational analysis was used to determine the influence of demographic variables on HADS scores.

Results. Demographic variables had only very modest influences on HADS scores. The reliability of the HADS is acceptable; the Anxiety and Depression scales are moderately correlated (.53). Tables to convert raw scores to percentiles are presented for females and males.

Conclusions. The present normative data allow clinicians to assess the rarity of a given HADS score, and thus provide a useful supplement to existing cut‐off scores.

Purpose. To review critically the evidence for three contemporary theories of delusions.

Methods. The theoretical approaches to delusions proposed by Frith and colleagues (‘theory of mind’ deficits), Garety and colleagues (multi‐factorial, but involving probabilistic reasoning biases) and Bentall and colleagues (attributional style and self‐discrepancies) are summarised. The findings of empirical papers directly relevant to these proposals are critically reviewed. These papers were identified by computerised literature searches (for the years 1987‐1997) and a hand search.

Results. The evidence does not unequivocally support any of the approaches as proposed. However, strong evidence is found to support modifications of Garety and colleagues and Bentall and colleagues theories. Studies have replicated a ‘jumping to conclusions’ data‐gathering bias and an externalising attributional bias in people with delusions. There is preliminary evidence for a ‘theory of mind’ deficit, as proposed by Frith, although possibly related to a more general reasoning bias. Evidence for an underlying discrepancy between ideal and actual self‐representations is weaker.

Conclusions. A multi‐factorial model of delusion formation and maintenance incorporating a data‐gathering bias and attributional style, together with other factors (e.g. perceptual processing, meta‐representation) is consistent with the current evidence. It is recommended that these findings be incorporated into cognitive therapy approaches. However, there are limitations to existing research. Future studies should incorporate longitudinal designs and first episode studies, and should not neglect the co‐morbidity of delusions, including affective processes, or the multi‐dimensional nature of delusions.

Objectives: Self‐critical people, compared with those who self‐reassure, are at increased risk of psychopathology. However, there has been little work on the different forms and functions of these self‐experiences. This study developed two self‐report scales to measure forms and functions of self‐criticism and self‐reassurance and explore their relationship to depression.

Methods: A self‐report scale measuring forms of self‐criticism and self‐reassuring, and a scale measuring possible functions of self‐criticism, together with a measure of depression and another self‐criticism scale (LOSC), were given to 246 female students.

Results: Self‐criticizing vs. self‐reassuring separated into two components. Forms of self‐criticizing separated into two components related to: being self‐critical, dwelling on mistakes and sense of inadequacy; and a second component of wanting to hurt the self and feeling self‐disgust/hate. The reasons/functions for self‐criticism separated into two components. One was related to desires to try to self‐improve (called self‐improving/correction), and the other to take revenge on, harm or hurt the self for failures (called self‐harming/persecuting). Mediation analysis suggested that wanting to harm the self may be particularly pathogenic and is positively mediated by the effects of hating the self and negatively mediated by being able to self‐reassure and focus on one's positives.

Conclusions: Self‐criticism is not a single process but has different forms, functions, and underpinning emotions. This indicates a need for more detailed research into the variations of self‐criticism and the mechanisms for developing self‐reassurance.

Means and standard deviations are reported for the State‐Trait Anxiety Inventory and the Zung Self‐Rating Depression scale, collected during the course of a general health survey. Data for different age samples and for both sexes are presented for use in the evaluation of the significance of anxiety and depression levels in patients presenting with these symptoms. High estimates of reliability based on internal consistency statistics were found for all scales. Females scored more highly on both the measures and scores were inversely correlated with age, indicating the importance of specific and appropriate norms in assessing affective states.

Purpose. The purpose of this review was to present an in‐depth analysis of literature identifying the extent of dropout from Internet‐based treatment programmes for psychological disorders, and literature exploring the variables associated with dropout from such programmes.

Methods. A comprehensive literature search was conducted on PSYCHINFO and PUBMED with the keywords: dropouts, drop out, dropout, dropping out, attrition, premature termination, termination, non‐compliance, treatment, intervention, and program, each in combination with the key words Internet and web. A total of 19 studies published between 1990 and April 2009 and focusing on dropout from Internet‐based treatment programmes involving minimal therapist contact were identified and included in the review.

Results. Dropout ranged from 2 to 83% and a weighted average of 31% of the participants dropped out of treatment. A range of variables have been examined for their association with dropout from Internet‐based treatment programmes for psychological disorders. Despite the numerous variables explored, evidence on any specific variables that may make an individual more likely to drop out of Internet‐based treatment is currently limited.

Conclusions. This review highlights the need for more rigorous and theoretically guided research exploring the variables associated with dropping out of Internet‐based treatment for psychological disorders.