Response sets in self-report data and their associations with personality traits

Objective: With a strong reliance on the use of self-report questionnaires in psychiatric research, appropriate attention should he given to the existence and correlates of response sets. We studied the presence of response tendencies by using an old research paradigm from psychology. Methods: We administered response options without questions to a sample of 91 second-year medical students, together with two personality questionnaires. Results: The scores of the respondents demonstrated the willingness of respondents to fill in a content-free questionnaire and revealed the presence of a general tendency towards positive responses. In psychometric theory, this would be referred to,as a 'constant error'. More importantly, positive answers were significantly related to low neuroticism, high extraversion and high well-being. In psychometric theory, this would imply,response bias' in which the self-reports are confounded by personality features. Conclusions: In the development and evaluation of questionnaires, researchers should be aware of the potential for this bias, particularly when asking questions about subjective health status

The effectiveness of a bibliotherapy in increasing the self-management ability of slightly to moderately frail older people

Objective: Self-management ability (SMA) is the ability to obtain those resources necessary for the production of well-being. With age, SMA becomes increasingly important, if one has a large variety of resources, physical and psychosocial losses due to the aging process can be substituted or compensated for. This study examined whether an increase in SMA would ensure sustainable levels of positive well-being among slightly to moderately frail older people. Methods: A bibliotherapy was developed to increase the SMA of slightly to moderaterly frail older people, and to help these persons to sustain a certain level of well-being. The effectiveness of this bibliotherapy was examined by comparing the SMA, mastery, and subjective well-being of 97 older people participating in the bibliotherapy to those of 96 older people in a delayed-treatment control condition. Results: The bibliotherapy resulted in a significant increase in SMA and mastery compared to the delayed-treatment control condition, and for SMA, this effect still existed 6 months after the intervention. The increase in SMA among older people who received the bibliotherapy prevented a decline in well-being as expected, but only in the short-term. Conclusion: The current findings show that it is possible to counteract an age-related decline in well-being, even with only slight to moderate levels of frailty. Practice implications: Cheap and easily accessible interventions, like the self-management bibliotherapy described in this article, may provide a useful addition to more traditional gerontological interventions. (c) 2005 Elsevier Ireland Ltd. All rights reserved

Is glycogen storage disease 1a associated with atherosclerosis?

Deficiency of microsomal glucose-6-phosphatase in liver and kidney leads to glycogen storage disease type 1a (GSD 1a). Notwithstanding intensive dietary therapy, moderate to severe dyslipidaemia and microalbuminuria, both known atherosclerotic risk factors, remain present. Although more patients reach adult age, no information is still available about accelerated atherosclerosis. The aim of our study was to investigate whether GSD 1a was associated with premature atherosclerosis. In nine adolescent patients (mean age 22.7 +/- 3.4 years) and nine matched healthy control subjects, lipid profile, blood pressure, ankle-brachial indices, aortic distensibility and intima-media thickness (IMT) of the carotid and femoral arteries were determined. As expected, lipid profiles were significantly unfavourable in the patient group compared with the control group. No differences were found in blood pressure, ankle-brachial indices and aortic distensibility between both groups. IMT segments were comparable in both groups, with even thinner segments in the patient group. In different multivariate models, GSD 1a remained an independent predictor for a thinner IMT (R-2 = 0.90; beta =-0.69; P = 0.018). Conclusion: glycogen storage disease type la is not associated with premature atherosclerosis, despite the existence of longstanding dyslipidaemia and microalbuminuria

INTERMED - A clinical instrument for biopsychosocial assessment

Using the INTERMED, a system for classifying case complexity, the authors evaluated patients admitted to a general internal medicine ward on length of stay (LOS), number of medicines prescribed during the hospital stay, and whether they, had received specialist medical consults. Using the patients' INTERMED scores, the authors divided the patients into three clusters of patients: standard (n = 41), chronic (n = 26), and complex (n = 18). A comparison of the three clusters indicated that patients who had scored within the complex cluster were at risk of requiring complex care and an increased LOS. The findings suggest that the INTERMED detects complex patients at admission and may, therefore, be used for early integral case management