Hierarchical factor structure of the Intolerance of Uncertainty Scale short form (IUS-12) in the Italian version

Despite widespread use, few translations are available for the Intolerance of Uncertainty Scale short form (IUS-12) as well as limited research on its psychometric properties in Italy. Moreover, recent evidence has suggested a multifaceted hierarchical structure for this scale. We compared the two-factor model to second-order and bi-factor models, in which a General IU factor was posited with two more narrow factors: Prospective IU and Inhibitory IU. Models were tested on a pooled dataset of students (N = 609) taking the IUS-12 alone or with other IUS-27 items. The bi-factor model fitted the sample data better than alternative models. The general factor accounted for 80% of the item variance. Presentation mode did not impact scalar invariance. Convergent validity with neuroticism, need for closure, and the uncertainty response scale was high for the total score. As such, scoring the IUS-12 total score is recommended in clinical research and assessmen

千葉医学雑誌 88巻3号 表紙 : 目次.千葉医学雑誌 88巻 3号

<p>Mediation analysis.</p

A correlational analysis of the relationships among intolerance of uncertainty, anxiety sensitivity, subjective sleep quality, and insomnia symptoms

In this study, we used structural equation modeling to investigate the interplay among Intolerance of Uncertainty (IU), Anxiety Sensitivity (AS), and sleep problems. Three hundred undergraduate students completed the Intolerance of Uncertainty Scale, the Intolerance of Uncertainty Inventory, the Anxiety Sensitivity Index, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Pittsburgh Sleep Quality Index and the Insomnia Severity Index. 68% and 40% of the students reported poor sleep quality or sub-threshold insomnia problems, respectively. Depression and anxiety levels were above the cut-off for about one-fourth of the participants. Structural equation modeling revealed that IU was strongly associated with AS, in turn influencing both insomnia severity and sleep quality via depression and anxiety. Significant indirect effects revealed that an anxious pathway was more strongly associated with insomnia severity, while a depression pathway was more relevant for worsening the quality of sleep. We discussed the results in the frameworks of cognitive models of insomnia. Viewing AS and IU as antecedents of sleep problems and assigning to AS a pivotal role, our study suggested indications for clinical interventions on a population at risk for sleep disorders

Miedo a caer. El taijiquan como forma de terapia de exposición gradual en vivo

Las caídas en las personas mayores pueden causar lesiones que llevan a una pérdida de independencia. La pérdida de control postural, de equilibrio, y los menores tiempos de reacción son factores importantes favorecedores de las caídas (Lajoie & Gallagher, 2004). Los programas de ejercicio tradicionales se centran en el estudio y tratamiento de estos factores (Tideiksaar, 1997); sin embargo, el miedo a la caída –otro fuerte elemento factor favorecedor– ha recibido una relativamente escasa atención en la literatura terapéutica (Maki et al., 1991). Existen indicadores de que existe una relación directa entre el miedo a caer y las caídas (Myers et al., 1996), así como una relación entre la evitación de actividades por miedo y las caídas (Delbaere et al., 2004). El taijiquan, una antigua arte marcial china convertida en método de ejercitación (Wolf et al., 2001), se ha mostrado como una práctica efectiva para mejorar el miedo a las caídas y a los antecedentes previos de caídas (Tsang et al., 2004). Como las terapias de exposición gradual, los practicantes de taijiquan logran lenta y progresivamente, en un entorno de calma, posiciones cada vez más difíciles que simulan situaciones potencialmente generadoras de miedo. En comparación con otros tratamientos mediante el ejercicio, tales como el entrenamiento del equilibrio computerizado, la educación y el ejercicio gradual, el taijiquan ha dado como resultado reducciones significativas del miedo a caer y de las caídas en sí mismas (McGibbon et al., 2005). En este trabajo se revisan las investigaciones existentes sobre el taijiquan y las caídas, defendiéndolo como una forma de terapia de exposición gradual para reducir el miedo a las caídas y las caídas en personas mayores. También se discutirán las consecuencias de estos trabajos y las futuras líneas de investigación

Exploring Item Order in Anxiety-Related Constructs: Practical Impacts of Serial Position

The present study was designed to test for item order effects by measuring four distinct constructs that contribute substantively to anxiety-related psychopathology (i.e., anxiety sensitivity, fear of negative evaluation, injury/illness sensitivity, and intolerance of uncertainty). Participants (n = 999; 71% women) were randomly assigned to complete measures for each construct presented in one of two modalities: (a) items presented cohesively as measures or (b) items presented randomly interspersed with one another. The results suggested that item order had a relatively small impact on item endorsement, response patterns, and reliabilities. The small impact was such that item order appears unlikely to influence clinical decisions related to these measures. These findings not only have implications for these and other similar measures, but further inform a long-standing debate about whether item grouping is a substantial concern in measurement. Accessed 6,950 times on https://pareonline.net from April 21, 2012 to December 31, 2019. For downloads from January 1, 2020 forward, please click on the PlumX Metrics link to the right

A longitudinal examination of the interpersonal fear avoidance model of pain:the role of intolerance of uncertainty

Youth with chronic pain and their parents face uncertainty regarding their diagnosis, treatment, and prognosis. Given the uncertain nature of chronic pain and high comorbidity of anxiety among youth, intolerance of uncertainty (IU) may be critical to the experience of pediatric chronic pain. This study longitudinally examined major tenets of the Interpersonal Fear Avoidance Model of Pain and included parent and youth IU as key factors in the model. Participants included 152 youth with chronic pain (Mage = 14.23 years; 72% female) and their parents (93% female). At baseline, parents and youth reported on their IU and catastrophic thinking about youth pain; youth reported on their fear of pain, pain intensity, and pain interference; and parents reported on their protective responses to child pain. Youth reported on their pain interference 3 months later. Cross-lagged panel models, controlling for baseline pain interference, showed that greater parent IU predicted greater parent pain catastrophizing, which, in turn, predicted greater parent protectiveness, greater youth fear of pain, and subsequently greater youth 3-month pain interference. Youth IU had a significant indirect effect on 3-month pain interference through youth pain catastrophizing and fear of pain. The results suggest that parent and youth IU contribute to increases in youth pain interference over time through increased pain catastrophizing, parent protectiveness, and youth fear of pain. Thus, parent and youth IU play important roles as risk factors in the maintenance of pediatric chronic pain over time and may be important targets for intervention.</p

Physical and psychological challenges faced by military, medical and public safety personnel relief workers supporting natural disaster operations: a systematic review

Natural disasters, including floods, earthquakes, and hurricanes, result in devastating consequences at the individual and community levels. To date, much of the research reflecting the consequences of natural disasters focuses heavily on victims, with little attention paid to the personnel responding to such disasters. We conducted a systematic review of the challenges faced by military, medical and public safety personnel supporting natural disaster relief operations. Specifically, we report on the current evidence reflecting challenges faced, as well as positive outcomes experienced by military, medical and public safety personnel following deployment to natural disasters. The review included 382 studies. A large proportion of the studies documented experiences of medical workers, followed by volunteers from humanitarian organizations and military personnel. The most frequently reported challenges across the studies were structural (i.e., interactions with the infrastructure or structural institutions), followed by resource limitations, psychological, physical, and social challenges. Over 60% of the articles reviewed documented positive or transformative outcomes following engagement in relief work (e.g., the provision of additional resources, support, and training), as well as self-growth and fulfillment. The current results emphasize the importance of pre-deployment training to better prepare relief workers to manage expected challenges, as well as post-deployment supportive services to mitigate adverse outcomes and support relief workers’ well-being

Do trauma cue exposure and/or PTSD symptom severity intensify selective approach bias toward cannabis cues in regular cannabis users with trauma histories?

Trauma cue-elicited activation of automatic cannabis-related cognitive biases are theorized to contribute to comorbid posttraumatic stress disorder and cannabis use disorder. This phenomenon can be studied experimentally by combining the trauma cue reactivity paradigm (CRP) with cannabis-related cognitive processing tasks. In this study, we used a computerized cannabis approach-avoidance task (AAT) to assess automatic cannabis (vs. neutral) approach bias following personalized trauma (vs. neutral) CRP exposure. We hypothesized that selective cannabis (vs. neutral) approach biases on the AAT would be larger among participants with higher PTSD symptom severity, particularly following trauma (vs. neutral) cue exposure. We used a within-subjects experimental design with a continuous between-subjects moderator (PTSD symptom severity). Participants were exposed to both a trauma and neutral CRP in random order, completing a cannabis AAT (cannabis vs. neutral stimuli) following each cue exposure. Current cannabis users with histories of psychological trauma (n = 50; 34% male; mean age = 37.8 years) described their most traumatic lifetime event, and a similarly-detailed neutral event, according to an established interview protocol that served as the CRP. As hypothesized, an AAT stimulus type x PTSD symptom severity interaction emerged (p = .042) with approach bias greater to cannabis than neutral stimuli for participants with higher (p = .006), but not lower (p = .36), PTSD symptom severity. Contrasting expectations, the stimulus type x PTSD symptoms effect was not intensified by trauma cue exposure (p = .19). Selective cannabis approach bias may be chronically activated in cannabis users with higher PTSD symptom severity and may serve as an automatic cognitive mechanism to help explain PTSD-CUD co-morbidity.</p

Evaluating the before operational stress program: comparing in-person and virtual delivery

IntroductionPublic safety personnel (PSP) are at increased risk for posttraumatic stress injuries (PTSI). Before Operational Stress (BOS) is a mental health program for PSP with preliminary support mitigating PTSI. The current study compared the effectiveness of delivering BOS in-person by a registered clinician (i.e., Intensive) to virtually delivery by a trained clinician (i.e., Classroom).MethodsCanadian PSP completed the Intensive (n = 118; 61.9% male) or Classroom (n = 149; 50.3% male) program, with self-report surveys at pre-, post-, 1 month, and 4 months follow-ups.ResultsMultilevel modelling evidenced comparable reductions in anxiety (p &lt; 0.05, ES = 0.21) and emotional regulation difficulties (ps &lt; 0.05, ESs = 0.20, 0.25) over time with no significant difference between modalities. Participants discussed benefits of the delivery modality they received.DiscussionThe results support virtual delivery of the BOS program (Classroom) as an accessible mental health training option for PSP, producing effects comparable to in-person delivery by clinicians

Trouble with the curve: the 90–9-1 rule to measure volitional participation inequalities among Royal Canadian Mounted Police cadets during training

ObjectiveThe Royal Canadian Mounted Police (RCMP) Study includes longitudinal multimodal assessments of RCMP cadets from pre-training (i.e., starting the Cadet Training Program [CTP]) to post-deployment and for five years thereafter. The data allow for investigating the multidimensionality of volitional participation in digital health data collection frameworks within serial data collection platforms and the impact of participation inequalities by classifying cadets using the 90–9-1 rule. By classifying cadets as Lurkers, Contributors, and Superusers formally described by the 90–9-1 rule, where 90% of actors do not participate, 9% seldom contribute, and 1% contribute substantially allows for the assessing of relationships between participation inequalities in self-monitoring behaviors as well as whether mental health disorder symptoms at pre-training (i.e., starting the CTP) were associated with subsequent participation.MethodsParticipants were asked to complete a Full Assessment prior to their training at CTP, as well as short daily surveys throughout their training. Participation frequency was described using a process where participants were rank ordered by the number of daily surveys completed and classified into one of three categories. Full assessment surveys completed prior to their training at CTP included screening tools for generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and panic disorder (PD). The Kruskal-Wallis H test was used to assess differences in participation rates between mental health disorder symptom screening groups for each measure at pre-training, and Spearman’s Rho was used to test for associations amongst self-reported Full Assessment screening tool responses and the number of daily surveys completed during CTP.ResultsThere were 18557 daily survey records collected from 772 participants. The rank-ordering of cadets by the number of daily surveys completed produced three categories in line with the 90–9-1 rule: Superusers who were the top 1% of cadets (n=8) and produced 6.4% of all recordings; Contributors who were the next 9% of cadets (n=68) and produced 49.2% of the recordings; and Lurkers who were the next 90% of cadets (n=695) and produced 44.4% of daily survey recordings. Lurkers had the largest proportion of positive screens for self-reported mental health disorders at pre-training.ConclusionThe creation of highly individualized, population-based mental health injury programs has been limited by an incomplete understanding of the causal relationships between protective factors and mental health. Disproportionate rates of disengagement from persons who screen positive for mental health disorders further compounds the difficulty in understanding the relationships between training programs and mental health. The current results suggest persons with mental health challenges may be less likely to engage in some forms of proactive mental health training. The current results also provide useful information about participation, adherence, and engagement that can be used to inform evidence-based paradigm shifts in health-related data collection in occupational populations