15 research outputs found

    The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization

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    BACKGROUND: The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization. The purpose of this paper is to evaluate its criterion and construct validity. METHODS: Data from 10 different primary care studies have been used. Criterion validity was assessed by comparing the 4DSQ scores with clinical diagnoses, the GPs' diagnosis of any psychosocial problem for Distress, standardised psychiatric diagnoses for Depression and Anxiety, and GPs' suspicion of somatization for Somatization. ROC analyses and logistic regression analyses were used to examine the associations. Construct validity was evaluated by investigating the inter-correlations between the scales, the factorial structure, the associations with other symptom questionnaires, and the associations with stress, personality and social functioning. The factorial structure of the 4DSQ was assessed through confirmatory factor analysis (CFA). The associations with other questionnaires were assessed with Pearson correlations and regression analyses. RESULTS: Regarding criterion validity, the Distress scale was associated with any psychosocial diagnosis (area under the ROC curve [AUC] 0.79), the Depression scale was associated with major depression (AUC = 0.83), the Anxiety scale was associated with anxiety disorder (AUC = 0.66), and the Somatization scale was associated with the GPs' suspicion of somatization (AUC = 0.65). Regarding the construct validity, the 4DSQ scales appeared to have considerable inter-correlations (r = 0.35-0.71). However, 30–40% of the variance of each scale was unique for that scale. CFA confirmed the 4-factor structure with a comparative fit index (CFI) of 0.92. The 4DSQ scales correlated with most other questionnaires measuring corresponding constructs. However, the 4DSQ Distress scale appeared to correlate with some other depression scales more than the 4DSQ Depression scale. Measures of stress (i.e. life events, psychosocial problems, and work stress) were mainly associated with Distress, while Distress, in turn, was mainly associated with psychosocial dysfunctioning, including sick leave. CONCLUSION: The 4DSQ seems to be a valid self-report questionnaire to measure distress, depression, anxiety and somatization in primary care patients. The 4DSQ Distress scale appears to measure the most general, most common, expression of psychological problems

    Regional Competitiveness and the Productivity Performance of Gazelles in Cultural Tourism

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    Part of the Smart Innovation, Systems and Technologies book series (SIST, volume 209).The extant literature reports evidence that the economic performance of regions is driven not by the stagnant majority but by a minority of high-growth firms (HGFs), the so-called gazelles. Regional competitiveness depends on firms’ long-term competitiveness, which depends on labor productivity. Cultural tourism plays a crucial role in national and regional policies because it allows to engage local communities in its activities and provides them a source of income. This paper identifies HGFs operating in cultural tourism in 2014–2018 and analyses their labor productivity across Portuguese regions, relating them with the regional competitiveness. The regional distribution of gazelles in Portugal is uneven, with the Lisbon region concentrating 48%; the Northern region is the location of 26%; while the Centre and Alentejo regions capture 13% of gazelles. Results on Pearson correlations between labor productivity and changes on the Regional Competitiveness Index uncover significant negative links between HGFs average labor productivity and changes in regional competitiveness. However, the results suggest that gazelles have significantly contributed to regional competitiveness through productivity, in 2014–2015. Finally, some suggestions on strategies for promoting cultural tourism are presented.info:eu-repo/semantics/publishedVersio
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