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Background: Qualitative evidence points to the importance of both mental health-related barriers and benefits to exercise in chronic pain, yet this bidirectional relationship has not been established quantitatively. Methods: 89 adults with chronic pain (75 female, Age: M = 34.7, SD=13.2), and 89 demographically-matched individuals without chronic pain (73 female, Age: M = 32.0, SD=13.3) self-reported demographic and health information, mental health-related barriers and benefits to exercise, and leisure-time exercise activity. Results: Adults with chronic pain had significantly higher scores on mental health-related barriers to exercise, and lower leisure-time exercise participation than adults without chronic pain. The groups did not differ on mental health-related benefits of exercise scores. Benefits scores positively predicted exercise, yet there was a significant negative interaction between pain and benefit scores, indicating a weaker positive relationship between benefits and exercise for adults with chronic pain than for those without chronic pain. Barrier scores significantly negatively predicted exercise engagement, but did not interact significantly with chronic pain. Conclusion: Mental health-related barriers and benefits to exercise are important considerations when prescribing exercise for adults with chronic pain. Adults with chronic pain may require individualised support to address mental health-related barriers to leisure-time exercise.
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OBJECTIVE: To replicate a seven-factor model previously reported for the Delis-Kaplan Executive Function System (D-KEFS). METHOD: This study used the D-KEFS standardization sample including 1,750 non-clinical participants. Several seven-factor models previously reported for the D-KEFS were re-evaluated using confirmatory factor analysis (CFA). Previously published bi-factor models were also tested. These models were compared with a three-factor a priori model based on Cattell-Horn-Carroll (CHC) theory. Measurement invariance was examined across three age cohorts. RESULTS: All previously reported models failed to converge when tested with CFA. None of the bi-factor models converged after large numbers of iterations, suggesting that bi-factor models are ill-suited to represent the D-KEFS scores as reported in the test manual. Although poor fit was initially observed for the three-factor CHC model, inspection of modification indices showed potential for improvement by including method effects via correlated residuals for scores derived from similar tests. The final CHC model showed good to excellent fit and strong metric measurement invariance across the three age cohorts with minor exceptions for a subset of Fluency parameters. CONCLUSIONS: CHC theory extends to the D-KEFS, supporting findings from previous studies that executive functions can be integrated into CHC theory.
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Executive Function , Humans , Factor Analysis, Statistical , Neuropsychological TestsABSTRACT
BACKGROUND: Physical exercise has been shown to reduce anxiety and depression symptoms, the most common mental health disorders globally. Despite the benefits of exercise in anxiety and depression, the symptoms of these disorders may directly contribute to a lack of engagement with exercise. However, mental health-related barriers and benefits to exercise engagement have not been addressed in quantitative research. We introduce the development and psychometric validation of the Mental health-related barriers and benefits to EXercise (MEX) scale. METHODS: Three samples were collected online prospectively (sample 1 n = 492; sample 2 n = 302; sample 3 n = 303) for scale refinement and validation with exploratory and confirmatory factor analysis. All participants were generally healthy adults, aged 18-45, and had no history of severe mental illness requiring hospitalization and no physical disability impacting over 50% of daily function. RESULTS: We identified a 30-item, two-factor model comprising 15 barrier and 15 benefit items. Overall model fit was excellent for an item-level scale across the three samples (Comparative Fit Index = 0.935-0.951; Root-Mean-Square Error of Approximation = 0.037-0.039). Internal consistency was also excellent across the three samples (α = 0.900-0.951). The barriers subscale was positively correlated with symptoms of anxiety, depression and stress, and negatively correlated with measures of physical activity and exercise engagement. The benefits subscale was negatively correlated with symptoms of anxiety, depression and stress, and positively correlated with measures of physical activity and exercise engagement. CONCLUSION: The MEX is a novel, psychometrically robust scale, which is appropriate for research and for clinical use to ascertain individual and/or group level mental health-related barriers and benefits to exercise.
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OBJECTIVES: To establish a theoretically justified factor structure for the Addenbrooke's Cognitive Examination-Revised (ACE-R). METHODS: Our sample comprised 288 patients with Parkinson's disease (179 men and 109 women). The mean age of participants was 66.66 (SD = 8.93). Confirmatory factor analysis (CFA) was used to evaluate the test developers' five-factor model of the ACE-R, and alternative models as guided by the Cattell-Horn-Carroll (CHC) theory. Exploratory structural equation modeling (ESEM) was also employed to examine alternative factor structures to ensure that a good candidate model was not overlooked. RESULTS: A three-factor CHC-guided CFA and a similar three-factor ESEM model both showed acceptable overall fit, and interpretable factor structures. The three-factor CFA model showed two factors of pure CHC constructs: acquired knowledge (Gc), and visuospatial ability (Gv), and one combined factor, namely, long-term memory retrieval, fluency, and working memory (Glr-Gsm). The three-factor ESEM model showed three factors essentially in line with the CFA results. CONCLUSION: The three-factor CHC-guided CFA model was selected as the best model to guide clinical interpretation of cognitive variables underlying ACE-R scores.
