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Objectives:Categorical criteria are not well suited to inform personality disorder (PD) diagnoses in older adults. More promising are the ICD-11 and DSM-5 alternative models. Both conceptualize PD by level of severity and maladaptive traits. Severity is conditional for making a PD diagnosis. Trait levels portray stylistic differences in PD expression. Yet, in older adults the hierarchical trait structure is unknown. Neither is the differentiation of the severity criterion from maladaptive traits confirmed.Methods:A series of exploratory factor analyses with progressively greater numbers of factors were conducted to examine the hierarchical trait structure in 293 community dwelling older adults. The on average differentiation of a single higher order personality functioning factor from trait factors at succeeding levels of the hierarchy was estimated with Cohen q effect size.Results:Six meaningful trait levels were identified. From the fourth trait level on the general personality functioning factor shared less than 15% variance on average with the trait factors. Trait factors at the sixth level corresponded to both DSM-5 and ICD-11 pathological traits.Conclusion:A future nosology integrating DSM-5 and ICD-11 trait proposals would be applicable in older adults. Personality functioning can be differentiated from traits, so separate assessment of traits and severity is worthwhile.

Previous research indicates that the invigorating effect of stress sensitivity on gambling behavior might be moderated by individual differences. The current preregistered study tested whether gender and negative urgency (i.e. an emotion-related impulsivity trait) moderate the relationship between perceived stress and laboratory gambling following experimentally induced sadness. One hundred twenty college students were randomly assigned to a sadness versus a control condition before completing a laboratory gambling task. Although the distribution of the main study variables forced us to slightly deviate from the preregistered data analysis plan, we were able to show that heightened stress sensitivity affects gambling behavior and that this effect differs by gender (but not in terms of negative urgency) under conditions of sadness versus neutral mood. Men with high stress sensitivity gambled more money and more frequently selected the riskier betting option in the sadness condition, whereas women with heightened stress sensitivity display the same pattern in the neutral condition. Our study is relevant from a methodological standpoint and answers recent calls for endorsing open-science practices in gambling research. Findings also suggest that more research into female gambling is warranted and that emotion-regulation skills should be a central component of problem gambling prevention.

Sexual interest in children is an important factor contributing to sexual (re)offending against children. The current state of research makes it difficult to conclude if people with pedophilia are overly interested in children, or have lower interest in adults, or both. This is relevant knowledge in treatment for preventing sexual (re)offenses against children. This study aimed to systematically analyze sexual interest in both children and adults in samples of men with pedophilia and comparison groups. A total of 55 studies (N = 8465) were included in four meta-analyses and a systematic review. Most included studies considered people who had sexually offended against children (PSOC; nPSOC = 5213). Results indicated that PSOC with pedophilia did not have a clear sexual preference for either children or adults. Compared to comparison groups, they had more absolute sexual interest in children and lower sexual interest in adults. We conclude that the lack of sexual interest in adults may be a relevant factor in PSOC with pedophilia. More studies are needed to disentangle sexual interest in children from sexual interest in adults, while using carefully matched comparison groups and appropriate research designs.

Sexual interest in children is an important factor contributing to sexual (re)offending against children. The current state of research makes it difficult to conclude if people with pedophilia are overly interested in children, or have lower interest in adults, or both. This is relevant knowledge in treatment for preventing sexual (re)of-fenses against children. This study aimed to systematically analyze sexual interest in both children and adults in samples of men with pedophilia and comparison groups. A total of 55 studies (N = 8465) were included in four meta-analyses and a systematic review. Most included studies considered people who had sexually offended against children (PSOC; nPSOC = 5213). Results indicated that PSOC with pedophilia did not have a clear sexual preference for either children or adults. Compared to comparison groups, they had more absolute sexual interest in children and lower sexual interest in adults. We conclude that the lack of sexual interest in adults may be a relevant factor in PSOC with pedophilia. More studies are needed to disentangle sexual interest in children from sexual interest in adults, while using carefully matched comparison groups and appropriate research designs.

We report a systematic search and synthesis of evidence about the measurement properties of the Numeric Pain Rating Scale and the Visual Analog Scale as patient-reported outcome measures in neck pain research. CINAHL, Embase, PsychInfo and MedLine databases were searched to identify studies evaluating the psychometric properties of the Numeric Pain Rating Scale and the Visual Analog Scale used in samples of which >50% of participants were people with neck pain. Quality and consistency of findings were synthesized to arrive at recommendations. 46 manuscripts were included. High-to-moderate quality evidence of good to excellent (0.58 to 0.93) test-retest reliability over an interval of seven hours to four weeks. Moderate evidence of clinically important difference of 1.5 to 2.5 points, with minimum detectable change of 2.6 to 4.1 points. Moderate evidence of a moderate association (r=0.48 to 0.54) between the Numeric Pain Rating Scale and the Visual Analog Scale and the Neck Disability Index, with findings from other patient-reported outcome measures indicating stronger associations with physical performance than emotional status. There is limited research addressing the extent that these measures reflect important patient outcomes. It is clear Numeric Pain Rating Scale and the Visual Analog Scale ratings are feasible to implement, provide reliable scores and relate to multi-item patient-reported outcome measures. Responsiveness (meaningful change) of the scales and interpretation of change scores requires further refinement. The Numeric Pain Rating Scale can be a useful single item assessment complimenting more comprehensive multi-item patient-reported outcome measures in neck pain research and practice.

Traditional personality disorder (PD) taxonomies have been developed for adult populations. We aimed to identify an adolescent hierarchical tree typology of PD indicators to provide classification into broad severity classes but also more fine-grained classification within those classes. A large sample of community adolescents (N = 1,940) completed a validated dimensional measure that covers a comprehensive range of pathologically formulated personality traits, the Personality Inventory for DSM-5. Latent class tree modeling suggested three classes at the first level of the tree representing high, medium, and low PD-trait levels-thus spanning the range between normal and pathological personality. These classes were divided into subclasses lower in the hierarchy, which suggested subclinical variants of patterns that are often found in clinical samples, medium levels of externalizing and internalizing behaviors, and differential profiles of thriving in the low-risk classes. The identified classes had promising initial criterion validity based on meaningful relations with self- and peer-reported measures of friendship and social functioning with peers. Our hierarchical PD tree typology may represent groups at differential risk for developing PDs and could therefore be useful for preventive purposes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Severity Indices of Personality Problems (SIPP; Verheul et al., 2008) is a popular self-report questionnaire that measures severity of maladaptive personality functioning. Two studies demonstrated the utility of the short form (SIPP-SF) among older adults but validation in clinical settings is lacking. Therefore, we examined the psychometric properties of the SIPP-SF in a large sample of older adult Dutch outpatients (N = 124; age range = 60-85 years, M = 69.8, SD = 5.3). The SIPP-SF domains showed good to excellent internal reliability (Cronbach's α = .75-.91) and effectively discriminated between participants with and without a personality disorder, as assessed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Convergent validity of the SIPP-SF was examined with instruments for measuring personality pathology among older adults (Informant Personality questionnaire [HAP]; Gerontological Personality Disorders Scale [GPS]). The GPS generally correlated with the SIPP-SF domains in expected directions, with small to large effect sizes. For the HAP, only 1 scale correlated with all SIPP-SF domains. No associations were found between the SIPP-SF and psychiatric symptomatology as measured by the Brief Symptom Inventory (BSI). The SIPP-SF appears to be a promising instrument for assessing maladaptive personality functioning among older adult outpatients.

Objective: Numerous provocations cause aggressive behavior. However, different provocation procedures are rarely directly compared. This study examined whether two different provocations (i.e., social exclusion and insult) were equally effective in terms of producing aggressive behavior, negative affective change and threat perception. As psychopathic and narcissistic personality traits may moderate provoked aggression, the current study also explored the differential impact of psychopathic and narcissistic traits on these variables. Method: A male (N = 94) community sample was randomly allocated to receive negative social belonging feedback (i.e., social exclusion) or negative intelligence feedback (i.e., insult) by a confederate. Aggressive behavior was measured using a competitive reaction time task after provocation. Here, aggressive behavior before first provocation (i.e., noise blast) by the opponent reflected unprovoked aggression, whereas aggressive behavior after first provocation reflected provoked aggression. Negative affect was measured pre- and postprovocation, and threat perception was measured postprovocation. Results: Results showed that both provocations were equally effective in producing aggressive behavior, negative affective change, and threat perception. Explorative analysis revealed that increased threat perception suppresses initial aggressive responding under the condition of agentic threat in narcissistic people. Also, decreased negative affective change during provocation suppressed aggressive responding in people with psychopathic traits. Conclusions: The findings suggest that both provocations can interchangeably be implemented to study provoked aggression. Emotional blunting may protect against detrimental provocation effects in people with psychopathic traits. Under conditions of agentic threat narcissistic traits related to withholding aggressive responding after first provocation, lashing out when a new threat emerges.

Purpose:To assess the test-retest reliability of the Special Interest Group on Amputation Medicine Mobility Scale/Dutch Working Group on Amputations and Prosthetics, better known as SIGAM/WAP mobility scale, in persons with a lower-limb amputation. Method:Longitudinal study at the outpatient departments of a rehabilitation center and a university medical center. Persons with a lower-limb amputation, wearing a prosthesis, were assessed at the end of their multidisciplinary rehabilitation treatment twice, with a 3-week interval, by the same practitioner. Test-retest reliability was quantified using the intraclass correlation coefficient for agreement. Results:Eighty persons participated (mean age +/- SD, 61 +/- 15 years; 61% men; 76% vascular cause of amputation; 70% able to walk >50m). Fifty-one of them rated themselves to be stable with respect to their mobility and their intraclass correlation coefficient was 0.90 (95% confidence intervals 0.84-0.94). Conclusions:The Special Interest Group on Amputation Medicine Mobility Scale/Dutch Working Group on Amputations and Prosthetics had, at the outpatient departments of a rehabilitation center and a university medical center, excellent test-retest reliability in persons wearing a prosthesis after a lower-limb amputation.

Background Although there are many benefits associated with working in academia, this career path often involves structural and organisational stressors that can be detrimental to wellbeing and increase susceptibility to psychological distress and mental ill health. This exploratory study examines experiences of work-related psychosocial stressors, psychological distress, and mental health diagnoses among mental health researchers. Methods This international cross-sectional study involved 207 mental health researchers who were post-graduate students or employed in research institutes or university settings. Work-related psychosocial stressors were measured by the Copenhagen Psychosocial Questionnaire III (COPSOQ III). Psychological distress was assessed using the Depression-Anxiety-Stress Scale-21 (DASS-21). Thoughts of suicide was assessed using an adaptation of the Patient Health Questionnaire-9 (PHQ-9). History of mental health diagnoses was assessed through a custom questionnaire. Pearson’s chi-square test of independence was used to compare mental health diagnoses and suicidal ideation across career stages. The association between work-related psychosocial stressors and psychological distress was conducted using multivariate linear regression controlling for key demographic, employment-related and mental health factors. Results Differences in ‘demands at work’ and the ‘work-life balance’ domain were lowest among support staff (p = 0.01). Overall, 13.4% of respondents met the threshold for severe psychological distress, which was significantly higher in students compared to participants from other career stages (p = 0.01). Among the subgroup of participants who responded to the question on mental health diagnoses and suicidal ideation (n = 152), 54% reported a life-time mental health diagnosis and 23.7% reported suicidal ideation since their academic career commencement. After controlling for key covariates, the association between the ‘interpersonal relations and leadership’ domain and psychological distress was attenuated by the mental health covariates included in model 3 (β = −0.23, p = 0.07). The association between the remaining work-related psychosocial stressors and psychological distress remained significant. Conclusions Despite working in the same environment, research support staff report experiencing significantly less psychosocial stressors compared to postgraduate students, early-middle career researchers and senior researchers. Future research that targets key modifiable stressors associated with psychological distress including work organization and job content, and work-life balance could improve the overall mental health and wellbeing of mental health researchers.

Experiments in psychology often target hypothetical constructs to test some causal hypothesis or theory. In light of this goal, it is pertinent to use a manipulation that actually changes the focal hypothetical construct, and only that construct. In assessing whether such manipulation “success” can be assumed, researchers often include manipulation validity checks in their designs—a measure of the focal construct which should be responsive to the manipulation. One interpretation of a positive manipulation check is that it lends credence to a particular causal interpretation of a phenomenon. Scrutinizing the results of such manipulation checks supposedly enables a more stringent test of a causal hypothesis. This paper submits that manipulation checks do not improve our inferences to causal explanations, but may in practice result in weaker hypothesis tests. Rather than being useful, manipulation checks are at best uninformative, but more likely compromise the appraisal of a causal hypothesis. The second half of this paper advocates four methodological heuristics, offered as alternatives to manipulation validity checks, to more severely test causal hypotheses. The heuristics call for a burgeoning focus on (a) assessing the specificity of manipulations, (b) evaluating theoretical risk, (c) attempts to cast doubt on alternatives, and (d) appraising the relative merits of explanations. I conclude that rather than relying on manipulation checks as a ‘Band-Aid’ method to alleviate validity concerns, inferential rigor can be improved by virtue of these heuristics.

Background Holotropic breathwork (Grof ® Breathwork), was developed by Stanislav Grof and Christina Grof as a ‘non-drug’ alternative technique to evoke altered states of consciousness (ASC). Interestingly, although HBW has been anecdotally reported to evoke experiences and mental health effects corresponding to those of psychedelic substances, the scientific literature on the matter is scarce. Aims The objective of this study was to assess the (sub)acute and long-term effects of HBW on satisfaction with life, and whether these depend on the depth of the experience evoked by the HBW session. Methods A naturalistic observational design was employed in the present study. Between January 2019 and July 2020, 58 Czech-speaking participants who had an experience with HBW were assessed using three separate anonymous online-surveys created and hosted on Qualtrics. Assessments of mindfulness, satisfaction with life, depression, anxiety, and stress were made once prior to (baseline), and two times following (sub-acutely and 4-weeks) the participants’ experience with HBW. The ego dissolution inventory and the 5-dimensional altered states of consciousness scale was used to quantify the HBW experience. Results Despite low ratings of the psychedelic experience (mean range of 0–34% out of 100%), ratings of non-judgement significantly increased sub-acutely following the HBW session and persisted for 4-weeks. Stress-related symptoms significantly decreased while satisfaction with life significantly increased at 4-weeks after HBW. Conclusion An experience with HBW may be associated with improvement in non-judgement, satisfaction with life, and reductions of stress-related symptoms.

The authors would like to thank all the women that participated in the HealthyMoms trial and thereby contributed to the present study. We would also like to thank the involved midwifes at the maternity clinics for helping with the recruitment, and Eva Flinke and Ellinor Nilsson for their assistance in the data collection. The HealthyMoms trial is funded by the Swedish Research Council (2016-01147 to M.L.) and additionally supported by the Swedish Research Council for Health, Working Life and Welfare (Forte, 2017-00088 to P.H.); Bo and Vera Ax:son Johnsons' Foundation (to M.L.); the Strategic Research Area Health Care Science, Karolinska Institutet/Umea University (to P.H.); the Swedish Society of Medicine (to P.H.); Karolinska Institutet (to P.H.); and Lions Forskningsfond (to P.H.). M.H.L. was supported by a grant from Yrjo Jahnsson Foundation. The funders have no role in the design, conduct, data management, or interpretation of the analysis or in the decision to submit the manuscript for publication., Physical fitness is a strong marker of health, but objective fitness measurements are not always feasible. The International FItness Scale (IFIS) for self-reported fitness is a simple-to-use tool with demonstrated validity and reliability; however, validation in pregnancy needs to be confirmed. Also, its association with cardiometabolic health in pregnant women is unknown. Hence, we examined (1) the validity of the IFIS with objectively measured fitness, and (2) the associations of self-reported versus objectively measured cardiorespiratory fitness (CRF) and muscular strength with cardiometabolic risk factors in early pregnancy. Women (n = 303) from the HealthyMoms trial were measured at gestational week 14 for: CRF (6-min walk test); upper-body muscular strength (handgrip strength test); self-reported fitness (IFIS), body composition (air-displacement plethysmography); blood pressure and metabolic parameters (lipids, glucose, insulin). Higher self-reported fitness was associated with better measured fitness (ANOVA overall p < 0.01 for all fitness types), indicating the usefulness of the IFIS in pregnancy. Furthermore, higher self-reported overall fitness and CRF were associated with lower cardiometabolic risk scores (ANOVA p < 0.001), with similar results shown for measured CRF (ANOVA p < 0.001). The findings suggest that IFIS could be useful to stratify pregnant women in appropriate fitness levels on a population-based level where objective measurement is not possible., Swedish Research Council, European Commission 2016-01147, Swedish Research Council for Health, Working Life and Welfare (Forte) 2017-00088, Bo and Vera Ax:son Johnsons' Foundation, Strategic Research Area Health Care Science, Karolinska Institutet/Umea University, Swedish Society of Medicine, Karolinska Institutet, Lions Forskningsfond, Yrjo Jahnsson Foundation

Background General practitioners (GPs) play a crucial role in the fight against the COVID-19 pandemic as the first point of contact for possibly infected patients and are responsible for short and long-term follow-up care of the majority of COVID-19 patients. Nonetheless, they experience many barriers to fulfilling this role. The PRICOV-19 study investigates how GP practices in 38 countries are organized during the COVID-19 pandemic to guarantee safe, effective, patient-centered, and equitable care. Also, the shift in roles and tasks and the wellbeing of staff members is researched. Finally, PRICOV-19 aims to study the association with practice- and health care system characteristics. It is expected that both characteristics of the GP practice and health care system features are associated with how GP practices can cope with these challenges. This paper describes the protocol of the study. Methods Using a cross-sectional design, data are collected through an online questionnaire sent to GP practices in 37 European countries and Israel. The questionnaire is developed in multiple phases, including a pilot study in Belgium. The final version includes 53 items divided into six sections: patient flow (including appointments, triage, and management for routine care); infection prevention; information processing; communication; collaboration and self-care; and practice and participant characteristics. In the countries where data collection is already finished, between 13 and 636 GP practices per country participated in the study. Questionnaire data are linked with OECD and HSMR data regarding national policy responses to the pandemic and analyzed using multilevel models considering the system- and practice-level. Discussion To the best of our knowledge, the PRICOV-19 study is the largest and most comprehensive study that examines how GP practices function during the COVID-19 pandemic. Its results can significantly contribute to better preparedness of primary health care systems across Europe for future major outbreaks of infectious diseases.

In this study, the levels of mathematical literacy and visual math literacy self-efficacy perceptions of middle school students and the relationship between them were investigated. For this aim, the study was desgined as a correlational research model. The study group was determined according to convenience sampling. 328 middle school students (5th, 6th, 7th, and 8th graders) participated in this study with this sampling. In order to collect data, first, “Mathematical Literacy Scale” was developed. It was seen that the scale has just one dimension according to the exploratory factor analysis. It was found that the ratio χ2/df of the scale was found as 2.16 according to confirmatory factor analysis. This value showed that the scale indicates perfect fit. Besides, “A Visual Math Literacy Self-Efficacy Perception Scale” was used in order to measure the visual math literacy self-efficacy perceptions of middle school students. As a result, it was determined that middle school students’ mathematical literacy levels and their visual math literacy self-efficacy perceptions’ level are high. It was found that there is a high positive significant relationship between middle school students’ mathematical literacy and their visual math literacy self-efficacy perceptions.

Objective:Cognitive reserve (CR) capacity can be viewed as the maximum processing potential of neural systems that support adaptive cognitive performance in age-related cognitive decline. CR is a complex construct that can only be measured indirectly. Proxy measures (e.g., psychosocial/lifestyle variables) are traditionally used to reflect CR. However, strong relationships have been observed between these measures and cognitive functions (e.g., executive function [EF], processing resources [PR], fluid/crystallized abilities); therefore, the organizational structure of indicators implicated in CR remains unclear. The objective of this study was to test a hypothetical, theoretical model of CR capacity that includes both traditional CR proxy indicators and measures of cognitive function [Satz et al. (2011).Journal of Clinical and Experimental Neuropsychology,33(1), 121–130], which remain, as yet, untested.Method:Construct validity of the model was investigated in healthy older adults through exploratory and confirmatory factor analysis (EFA and CFA) using data from the Maastricht Ageing Study (MAAS). A secondary CFA was conducted to validate the model using data from the Irish Longitudinal Study on Ageing (TILDA).Results:EFA and CFA in MAAS established a two-factor model comprising EF/PR and cumulative cognitive enrichment (CCE), which was further validated in a secondary analysis in TILDA. Convergent and discriminant validity was supported in MAAS (range ofR2= .228–.635; factor correlation confidence interval (CI) = .622, .740) and TILDA (range ofR2= .172–.899; factor correlation CI = .559, .624).Conclusions:A dual model of CR elucidated the relationships between hypothesized indicators of CR capacity and revealed a two-factor structure suggesting that both control (EF/PR) and representational processes (CCE) are involved in CR capacity.

Author(s): Gawronski, B; De Houwer, J; Sherman, JW | Abstract: The year 2020 marks the 25th anniversary of two seminal publications that have set the foundation for an exponentially growing body of research using implicit measures: Fazio, Jackson, Dunton, and Williams's (1995) work using evaluative priming to measure racial attitudes, and Greenwald and Banaji's (1995) review of implicit social cognition research that served as the basis for the development of the Implicit Association Test (IAT). The current article provides an overview of (1) two conceptual roots that continue to shape interpretations of implicit measures; (2) conflicting interpretations of the term implicit; (3) different kinds of dissociations between implicit and explicit measures; (4) theoretical developments inspired by these dissociations; and (5) research that used implicit measures to address domain-specific and applied questions. We conclude with a discussion of challenges and open questions that remain to be addressed, offering guidance for the next generation of research using implicit measures.

Purpose of Review The aim of the paper is reviewing recent literature on the epidemiology, assessment, and treatment of personality disorders (PDs) among older adults (≥ 60 years). Recent Findings Since 2015, 12 primary empirical studies have been published addressing PDs in older adults; 3 addressing epidemiological aspects, 6 on assessment, 2 exploring both epidemiology and assessment, and 1 examining treatment. PD research in older adults is steadily growing and is predominantly focused on assessment. The studies showed that PDs were rather prevalent ranging from 10.6–14.5% in community-dwelling older adults, to 57.8% in nursing home–residing older adults. The Severity Indices of Personality Problems-Short Form, Gerontological Personality disorders Scale, and Assessment of DSM-IV Personality Disorders turned out to be promising instruments for assessing PDs in later life. Furthermore, schema therapy seems to be a feasible and effective intervention. Summary Despite promising findings, there is an urgent need for studies addressing PDs in older adults, especially studies investigating epidemiological aspects and treatment options. Furthermore, new areas of interest arise such as PDs in other settings, and behavioral counseling.

Aims To assess whether parental substance use disorder (SUD) is associated with lower cognitive ability in offspring, and whether the association is independent of shared genetic factors. Design A population family-based cohort study utilizing national Swedish registries. Linear regression with increased adjustment of covariates was performed in the full population. In addition, the mechanism of the association was investigated with children-of-sibling analyses using fixed-effects regression with three types of sibling parents with increasing genetic relatedness (half-siblings, full siblings and monozygotic twins). Setting and participants A total of 3 004 401 people born in Sweden between 1951 and 1998. Measurements The exposure variable was parental SUD, operationalized as having a parent with life-time SUD diagnosis or substance-related criminal conviction in the National Patient Register or Crime Register, respectively. Outcomes were cognitive test score at military conscription and final school grades when graduating from compulsory school. Covariates included in the analyses were sex, birth year, parental education, parental migration status and parental psychiatric comorbid diagnoses. Findings In the full population, parental SUD was associated with decreased cognitive test stanine scores at conscription [4.56, 95% confidence interval (CI) = 4.55-4.57] and lower Z-standardized school grades (-0.43, 95% CI = -0.43 to -0.42) compared to people with no parental SUD (cognitive test: 5.17, 95% CI = 5.17-5.18; grades: 0.09, 95% CI = 0.08-0.09). There was evidence of a dose-response relationship, in that having two parents with SUD (cognitive test: 4.17, 95% CI = 4.15-4.20; grades: -0.83, 95% CI = -0.84 to -0.82) was associated with even lower cognitive ability than having one parent with SUD (cognitive test: 4.60, 95% CI = 4.59-4.60; grades: -0.38, 95% CI = -0.39 to -0.380). In the children-of-siblings analyses when accounting for genetic relatedness, these negative associations were attenuated, suggestive of shared underlying genetic factors. Conclusions There appear to be shared genetic factors between parental substance use disorder (SUD) and offspring cognitive function, suggesting that cognitive deficits may constitute a genetically transmitted risk factor in SUD.

Contains fulltext : 227135.pdf (Publisher’s version ) (Closed access) In the last few years scholars have postulated that non-institutionalized psychopathic individuals may be overrepresented in leadership positions. In this paper we juxtapose theory and research on the profile of those high in psychopathy in leadership positions with the traditional profile of those high in psychopathy in prisons and institutions. We hypothesize that the psychopathic leader has a unique combination of traits that enables and drives such a leader to be 'successful' in a position of power. We propose that the differentiating trait in the profile of the psychopathic leader may be the trait high self-control. This is in contrast with the traditional profile of institutionalized psychopathic individuals in which levels of self-control are typically low. Furthermore, we hypothesize that although the traits of high self-control and impulsivity are apparently contradictory, the conjunction of high self-control with one specific domain of impulsivity could further amplify the 'success' of the psychopathic leader. 17 p.

Background Empowerment helps persons with a chronic disease to self-manage their condition and increase their autonomy and participation. MSmonitor (Curavista bv) is an interactive Web-based program for self-management and multidisciplinary care in multiple sclerosis (MS). It includes, among others, short questionnaires on fatigue (Modified Fatigue Impact Scale-5 [MFIS-5]) and health-related quality of life (HRQoL, Leeds Multiple Sclerosis Quality of Life [LMSQoL]); long questionnaires on disabilities, perception of disabilities (Multiple Sclerosis Impact Profile), and HRQoL (Multiple Sclerosis Quality of Life-54); a Medication and Adherence Inventory and an Activity Diary. The combination MFIS-5, LMSQoL, and Medication and Adherence Inventory constitutes the Quick Scan. Objective This study aimed to investigate the short-term effects of MSmonitor on empowerment in patients with MS. Methods We conducted a quasi-experimental study in a general hospital. Of the 180 patients with MS, 125 were eligible, 30 used MSmonitor, and 21 participated in the study (mean age 45.4 years, SD 10.2 years). A total of 24 eligible patients who did not use MSmonitor constituted the control group (mean age 49.3 years, SD 11.4 years). At baseline and at 4 months, we assessed self-efficacy (Multiple Sclerosis Self-Efficacy Scale [MSSES]), participation and autonomy (Impact on Participation and Autonomy [IPA] questionnaire), and self-management (Partners In Health [PIH] questionnaire). Differences between time points and groups were tested with paired t tests and χ² tests. Results In the MSmonitor group, follow-up values remained unchanged for MSSES control (P=.19), MSSES function (P=.62), IPA limitations (P=.26), IPA problems (P=.40), PIH recognition and management of symptoms (P=.52), PIH adherence to treatment (P=.80), and PIH coping (P=.73), whereas the PIH knowledge score had improved (mean 27.8, SD 1.7 vs mean 28.7, SD 2.0; P=.02). The overall utilization rate of the program components was 83% and that of the Quick Scan was 95%. In the control group, all outcomes had remained unchanged. Conclusions The results suggest that for first-time users of the MSmonitor program and their health care providers, it may not be justified to expect a short-term improvement in empowerment in terms of self-efficacy, self-management, autonomy, or participation. Furthermore, a lack of effect on empowerment is not because of nonusage of the program components.

BackgroundDutch teachers in secondary vocational schools suffer from stress and burnout complaints that can cause considerable problems at work. This paper presents a study design that can be used to evaluate the short-term and long-term effectiveness of mindfulness-based stress reduction (MBSR), a person-focused intervention, both within and outside of the context of an additional organisational health intervention.MethodsThe proposed study comprises a cluster randomised controlled trial that will be conducted in at least three secondary vocational schools, to which teachers will be recruited from three types of courses: Care, Technology, and Economy. The allocation of the intervention programme to the participating schools will be randomised. The teachers from each school will be assigned to intervention group 1 (IG 1), intervention group 2 (IG 2), or the waiting list group (WG). IG 1 will receive MBSR training and IG 2 will receive MBSR training combined with an additional organisational health intervention. WG, that is the control group, will receive MBSR training one year later. The primary outcome variable of the proposed study is mindfulness, which will be measured using the Dutch version of the Five Facet Mindfulness Questionnaire (FFMQ-NL). In the conceptual model, the effects of teachers’ mindfulness resulting from the intervention programmes (MBSR training and MBSR training combined with an additional organisational health intervention) will be related to salient (secondary outcome) variables: mental health outcomes (e.g., burnout, work engagement), work performance, work-related perceptions (job demands and job resources), and personal competencies (e.g., occupational self-efficacy). Data will be collected before (T0) and immediately after the MBSR training (T1), and 3 (T2) and 9 months (T3) after the training. The power analysis revealed a required sample size of 66 teachers (22 in each group).DiscussionThe proposed study aims to provide insight into (1) the short-term and long-term effects of MBSR on teachers’ mental health, (2) the possible enhancing effects of the additional organisational health intervention, and (3) the teachers’ experiences with the interventions (working mechanisms, steps in the mindfulness change process). Strengths of this study design are the use of both positive and negative outcomes, the wide range of outcomes, both outcome and process measures, longitudinal data, mixed methods, and an integral approach. Although the proposed study protocol may not address all weaknesses of current studies (e.g., self-selection bias, self-reporting of data, the Hawthorne effect), it is innovative in many ways and can be expected to make important contributions to both the scientific and practical debate on how to beat work-related stress and occupational burnout, and on how to enhance work engagement and work performance.Trial registrationDutch Trial Register (www.trialregister.nl):NL5581. Registered on 6 July 2016.

Background/Objective: Social anxiety is a common issue arising in adolescence that can cause significant impairment and have detrimental consequences for development in the absence of treatment. In this study we examined the factor structure and the psychometric properties of a 12-item short form of the Portuguese-Language Social Anxiety Scale for Adolescents (SAS-A-SF). Method: A community adolescent sample (N = 835) and a young offender sample (N = 244) completed the SAS-A, the Basic Empathy Scale and the Reactive-Proactive Aggression Questionnaire. Confirmatory factor analysis, internal consistency, cross gender and cross sample invariance, convergent and discriminant validity of the SAS-A-SF were analyzed. Results: The confirmatory factor analysis revealed that the 3-factor second-order model obtained the best fit.The results provided evidence that the SAS-A-SF is a psychometrically sound instrument that shows measurement invariance across genders and across samples, good reliability and positive correlations with empathy. Conclusions: The Portuguese version of SAS-A-SF is a useful, time-efficient tool for both researchers and practitioners who need to assess social anxiety, a relevant construct in adolescent psychopathology., This work was supported by the Portuguese Foundation for Science and Technology (FCT; Grant SFRH/BPD/86666/2012) with co-financing of the European Social Fund (POPH/FSE), the Portuguese Ministry of Education and Science (MEC), and FEDER (PT2020 Partnership Agreement; UID/PSI/01662/2013).

Objective: To describe the prevalence of comorbidity and its relationship with demographic and clinical characteristics in persons wearing a prosthesis after lower-limb amputation.Design: Cross-sectional study.Subjects/patients: Persons wearing a prosthesis after lower-limb amputation (n = 171; mean age 65 years (standard deviation 12); 72% men) at the end of outpatient rehabilitation treatment.Methods: Comorbidity was assessed with the Functional Comorbidity Index: a list of 18 items addressing the presence of specific comorbid conditions impacting on functional status. Comorbidities in medical records were assessed independently by 2 assessors. Associations with demographic and clinical characteristics were analysed using linear or logistic regression.Results: The median (interquartile range) number of comorbidities was 3 (2; 4). Three or more comorbidities were present in 103 of 171 (60%) participants. Diabetes was present in 71 (41%), cardiac disease in 60 (35%), and lumbago/degenerative disc disease in 39 (23%) participants. The prevalence of comorbidities was higher in women and those with vascular cause of amputation.Conclusion: There is a high prevalence of comorbidity at the end of outpatient rehabilitation treatment in persons wearing a prosthesis after a lower-limb amputation, especially in women and those with vascular cause of amputation.

Background Despite a large body of research on planning performance in adult schizophrenia patients, results of individual studies are equivocal, suggesting either no, moderate or severe planning deficits. This meta-analysis therefore aimed to quantify planning deficits in schizophrenia and to examine potential sources of the heterogeneity seen in the literature.Method The meta-analysis comprised outcomes of planning accuracy of 1377 schizophrenia patients and 1477 healthy controls from 31 different studies which assessed planning performance using tower tasks such as the Tower of London, the Tower of Hanoi and the Stockings of Cambridge. A meta-regression analysis was applied to assess the influence of potential moderator variables (i.e. sociodemographic and clinical variables as well as task difficulty).Results The findings indeed demonstrated a planning deficit in schizophrenia patients (mean effect size: ; 95% confidence interval 0.56-0.78) that was moderated by task difficulty in terms of the minimum number of moves required for a solution. The results did not reveal any significant relationship between the extent of planning deficits and sociodemographic or clinical variables.Conclusions The current results provide first meta-analytic evidence for the commonly assumed impairments of planning performance in schizophrenia. Deficits are more likely to become manifest in problem items with higher demands on planning ahead, which may at least partly explain the heterogeneity of previous findings. As only a small fraction of studies reported coherent information on sample characteristics, future meta-analyses would benefit from more systematic reports on those variables.

There is currently a lack of understanding of the structure of personality disorder (PD) trait facets. The network approach may be useful in providing additional insights, uncovering the unique association of each PD trait facet with every other facet. A unique feature of network analysis is centrality, which indicates the importance of the role a trait facet plays in the context of other trait facets. Using data from 1,940 community Dutch adolescents, we applied network analysis to the 25 trait facets from the 100-item Personality Inventory for DSM-5 Short-Form (PID-5-SF) to explore their associations. We found that some trait facets only seem to be core indicators of their pre-ordained domains, whereas we observed that other trait facets were strongly associated with trait facets outside of their hypothesized domains. Importantly, anxiousness and callousness were identified as highly central facets, being uniquely associated with many other trait facets. Future longitudinal network studies could therefore further examine the possibility of anxiousness and callousness as risk marker trait facets among other PD trait facets.

Interpersonal problems are key transdiagnostic constructs in psychopathology. In the past, investigators have neglected the importance of operationalizing interpersonal problems according to their latent structure by using divergent representations of the construct: (a) computing scores for severity, agency, and communion (“dimensional approach”), (b) classifying persons into subgroups with respect to their interpersonal profile (“categorical approach”). This hinders cumulative research on interpersonal problems, because findings cannot be integrated both from a conceptual and a statistical point of view. We provide a comprehensive evaluation of interpersonal problems by enlisting several large samples (Ns = 5,400, 491, 656, and 712) to estimate a set of latent variable candidate models, covering the spectrum of purely dimensional (i.e., confirmatory factor analysis using Gaussian and nonnormal latent t-distributions), hybrid (i.e., semiparametric factor analysis), and purely categorical approaches (latent class analysis). Statistical models were compared with regard to their structural validity, as evaluated by model fit (corrected Akaike’s information criterion and the Bayesian information criterion), and their concurrent validity, as defined by the models’ ability to predict relevant external variables. Across samples, the fully dimensional model performed best in terms of model fit, prediction, robustness, and parsimony. We found scant evidence that categorical and hybrid models provide incremental value for understanding interpersonal problems. Our results indicate that the latent structure of interpersonal problems is best represented by continuous dimensions, especially when one allows for nonnormal latent distributions., General Scientific Summary This study suggests that interpersonal problems are best characterized by continuous differences in severity and interpersonal style (i.e., agency and communion), and not by “types” of people.

BACKGROUND: Follow-up of stroke survivors is important to objectify activity limitations and/or participations restrictions. Responsive measurement tools are needed with a low burden for professional and patient.AIM: To examine the concurrent validity, floor and ceiling effects and responsiveness of both domains of the Late-Life Function and Disability Index Computerized Adaptive Test (LLFDI-CAT) in first-ever stroke survivors discharged to their home setting.DESIGN: Longitudinal study.SETTING: Community.POPULATION: First ever stroke survivors.METHODS: Participants were visited within three weeks after discharge and six months later. Stroke Impact Scale (SIS 3.0) and Five-Meter Walk Test (5MWT) outcomes were used to investigate concurrent validity of both domains, activity limitations, and participation restriction, of the LLFDI-CAT. Scores at three weeks and six months were used to examine floor and ceiling effects and change scores were used for responsiveness. Responsiveness was assessed using predefined hypotheses. Hypotheses regarding the correlations with change scores of related measures, unrelated measures, and differences between groups were formulated.RESULTS: The study included 105 participants. Concurrent validity (R) of the LLFDI-CAT activity limitations domain compared with the physical function domain of the SIS 3.0 and with the 5MWT was 0.79 and -0.46 respectively. R of the LLFDI-CAT participation restriction domain compared with the participation domain of the S1S 3.0 and with the 5MWT was 0.79 and -0.41 respectively. A ceiling effect (15%) for the participation restriction domain was found at six months. Both domains, activity limitations and participation restrictions, of the LLFDI-CAT, scored well on responsiveness: 100% (12/12) and 91% ( I 2/11) respectively of the predefined hypotheses were confirmed.CONCLUSIONS: The LLFDI-CAT seems to be a valid instrument and both domains are able to detect change over time. Therefore, the LLFD-CAT is a promising tool to use both in practice and in research.CLINICAL REHABILITATION IMPACT: The LLFDI-CAT can be used in research and clinical practice.

Objective: Studies have shown preliminary support for mindfulness-based interventions benefitting people with dementia and their caregivers. However, most studies focus on these two groups separately. This study examined whether it would be possible and beneficial for people with dementia and their caregiver to jointly undergo an adjusted Mindfulness-Based Stress Reduction (MBSR) training, named TANDEM.Methods: The 8-week MBSR training was adjusted based on a literature review and interviews with experts (clinicians and mindfulness trainers). Seven couples (a person with early-stage dementia and their caregiver) participated together in the 8-week TANDEM program. Semi-structured qualitative interviews were conducted after completion. Questionnaires (administered before and after the intervention) assessed the primary outcomes of quality of life and psychological distress (stress, anxiety and depressive symptoms). Secondary outcomes were mindfulness, self-compassion, positive mental health, worrying, and perceived burden (for caregivers).Results: All participants completed the program and reported beneficial effects (relaxation, awareness, acceptance, and resilience). Most managed to integrate exercises into their daily lives and planned to continue their practice. Participating in a group was considered valuable and supportive. Furthermore, it was appreciated that participants could follow the training together (as a couple). The quantitative results showed a small effect on increased quality of life for caregivers. No substantial decrease in psychological distress was apparent. Caregivers displayed a large increase in mindfulness.Conclusion: The results of this mixed-methods study suggest that an adjusted mindfulness program is feasible and well-received among couples of persons with early-stage dementia and their caregiver, warranting further research in this area.

We distinguish three senses of the concept of measurement (measurement as the selection of observable indicators of theoretical concepts, measurement as the collection of data from respondents, and measurement as the formulation of measurement models linking observable indicators to latent factors representing the theoretical concepts), and we review important issues related to measurement in each of these senses. With regard to measurement in the first sense, we distinguish the steps of construct definition and item generation, and we review scale development efforts reported in three major marketing journals since 2000 to illustrate these steps and derive practical guidelines. With regard to measurement in the second sense, we look at the survey process from the respondent's perspective and discuss the goals that may guide participants' behavior during a survey, the cognitive resources that respondents devote to answering survey questions, and the problems that may occur at the various steps of the survey process. Finally, with regard to measurement in the third sense, we cover both reflective and formative measurement models, and we explain how researchers can assess the quality of measurement in both types of measurement models and how they can ascertain the comparability of measurements across different populations of respondents or conditions of measurement. We also provide a detailed empirical example of measurement analysis for reflective measurement models.

Objective: To identify the frequency, nature and profile of complaints for trauma patients with and without mild traumatic brain injury (mTBI), and to assess their relation to anxiety and depression.Methods: A prospective cohort study in a level-one trauma centre was conducted. Mild traumatic brain injury patients and trauma controls were approached for participation. Two weeks after injury, The Head Injury Symptom Checklist (HISC) and the Hospital Anxiety and Depression Scale (HADS) were administered.Results: Two-hundred seventy two patients with mTBI and 125 TC patients completed the questionnaires. Differences were demonstrated between the two trauma populations on frequency and nature of reported complaints. Ordinal common factor analysis on the mTBI scores yielded three factors: mental distress, physical discomfort, and sensory disbalance, which were all significantly correlated to anxiety and depression scores. Discriminant analyses identified a subset of complaints which could allocate almost 80% of patients to the correct group.Conclusions: Patients with mTBI showed a different pattern of complaints than orthopaedic control patients. A mental distress factor consisting of both somatic and cognitive complaints proved to be most discriminating and showed high correlations with anxiety and depression. (C) 2016 Elsevier Ltd. All rights reserved.

HowNutsAreTheDutch (Dutch: HoeGekIsNL) is a national crowdsourcing study designed to investigate multiple continuous mental health dimensions in a sample from the general population (n=12,503). Its main objective is to create an empirically based representation of mental strengths and vulnerabilities, accounting for (i) dimensionality and heterogeneity, (ii) interactivity between symptoms and strengths, and (iii) intra-individual variability. To do so, HowNutsAreTheDutch (HND) makes use of an internet platform that allows participants to (a) compare themselves to other participants via cross-sectional questionnaires and (b) to monitor themselves three times a day for 30days with an intensive longitudinal diary study via their smartphone. These data enable for personalized feedback to participants, a study of profiles of mental strengths and weaknesses, and zooming into the fine-grained level of dynamic relationships between variables over time. Measuring both psychiatric symptomatology and mental strengths and resources enables for an investigation of their interactions, which may underlie the wide variety of observed mental states in the population. The present paper describes the applied methods and technology, and presents the sample characteristics. Copyright (c) 2015 John Wiley & Sons, Ltd.

Patients hospitalised with severe mental illness (SMI) have poor physical health. Recently, a multidisciplinary lifestyle enhancing treatment for inpatients with SMI (MULTI) was implemented after which improvements of physical health were observed in the longer term. As part of a comprehensive evaluation of MULTI, we aimed to additionally analyse changes in perceived psychosocial functioning and quality of life after 18 months of MULTI compared to treatment as usual (TAU). Furthermore, we explored whether increased physical activity mediated significant changes. In this observational study, we collected data on psychosocial functioning (HoNOS) and quality of life (EQ-5D and WHOQoL-Bref) within our cohort of inpatients with SMI. This was supplemented by repeated physical activity measurement (ActiGraph GT3X+). Data were analysed using linear multilevel regression, adjusting for baseline values of outcome and differences between groups. Patients receiving MULTI (n = 65) showed significantly improved functioning on sum score and subscales for impairment and social functioning compared to TAU (n = 47). Quality of life improved within MULTI but did not differ significantly from TAU. Changes in total activity did not mediate improvements in psychosocial functioning, suggesting that multiple components of MULTI contribute to these improvements. In addition to previously observed improvement of physical health, MULTI showed to be a feasible treatment to sustainably improve psychosocial functioning compared to TAU and increase the quality of life in inpatients with SMI.

This study presents a French translation and validation of the Durand Adaptive Psychopathic Traits Questionnaire (DAPTQ; Durand, 2017), an instrument for assessing adaptive traits known to correlate with the psychopathic personality. The first sample, which included individuals from France and Canada (N = 135, 52% in France, M-age = 26.98, SD = 9.24), completed the DAPTQ in French, alongside measures of empathy, positive and negative affects, satisfaction with life, and self-esteem. The second sample included bilingual (French and English) individuals from France and Canada (N= 141, 52% in France, M-age = 29.73, SD = 9.09) who completed both versions of the DAPTQ (French and English), alongside measurements of perceived stress, trait anxiety, and creativity. The results support the DAPTQ-French version good internal consistency (alpha = .89/.87), convergent validity, and concurrent validity. Correlation between the DAPTQ total and subscales across versions (French-English) showed strong associations (r = .84 to .96). These findings support the cross-cultural equivalence of the DAPTQ and its effectiveness as a valid assessment method of adaptive traits in the field of psychopathy.