ABSTRACT
PURPOSE: The Alcohol Quality of Life Scale (AQoLS) is a new patient-reported outcome 34-item questionnaire measuring health-related quality of life (HRQOL), specific to patients with an alcohol use disorder, developed from the patients' perspective. This is the first report establishing evidence in support of measurement reliability and validity of the AQoLS. METHODS: A total of 285 randomly selected patients receiving interventions for alcohol use disorder in addiction specialised care settings in France were included in the study (response rate 80.1 %). Exploratory factor analysis was conducted to evaluate the hypothesised-during-development-stage dimensional structure of the AQoLS. Internal consistency of the total score and the dimensions subscores were assessed through Cronbach's alpha coefficients. Construct validity was tested through correlations with the Short-Form 36 Health Survey (SF-36) and EuroQol 5 dimensions (EQ-5D). RESULTS: Exploratory analysis indicated seven observed dimensions which differed slightly from the 7 dimensions defined a priori in the framework hypothesised during the scale development: activities, relationships, living conditions, negative emotions, self-esteem, control and sleep. A major common factor allows the summing of the 34 items to obtain a total score. All the 34 items were acceptable. Cronbach's alpha for the AQoLS total score was 0.96 and ranged from 0.8 to 0.9 for the dimensions subscores. Negative correlations between AQoLS and all dimensions of the SF-36, but general health and positive correlations between AQoLS and all items of the EQ-5D were shown. As expected, the correlations were mostly moderate in magnitude, low with scores referring to physical areas and the highest with the SF-36 MSC. CONCLUSION: This study provides evidence of the measure's psychometric properties in terms of construct validity and internal consistency. The "control" and "self-esteem" dimensions are of particular interest as these concepts are not captured in existing HRQOL. Further longitudinal validation of the scale is necessary to assess sensitivity to change.
Subject(s)
Alcohol-Related Disorders/psychology , Patient Reported Outcome Measures , Psychometrics/instrumentation , Quality of Life/psychology , Surveys and Questionnaires , Adult , Female , France , Health Status , Humans , Male , Middle Aged , Reproducibility of Results , Self Concept , Self-Control/psychology , Sleep , Young AdultABSTRACT
BACKGROUND: According to empirical literature, low self-esteem is highly correlated to behavioural and emotional problems in gifted children and adolescents. Since self-esteem is an indicator of social and emotional adjustment, it would be interesting to better understand the meaning of this construct, as it is evaluated explicitly with the use of self-report questionnaires. In order to explore the psychological processes underlying the explicit self-esteem, we studied the relation of a self-report questionnaire and an indirect measure of self and interpersonal perception using the Rorschach Comprehensive System (CS). METHOD: The participants were 93 children, aged between 9 and 15 years old, with an IQ≥130. They were attending regular classes (no curriculum difference). Self-esteem was evaluated using the Coopersmith Self-Esteem Inventory (SEI). We used the Rorschach CS measures of self and interpersonal perception. RESULTS: The results showed no significant correlation between self-esteem and high IQ. A negative correlation between self-esteem evaluated on the SEI and the Rorschach Vista responses was found, which reflected self-critical introspection and painful self-appraisal. Then a positive correlation was observed between self-esteem and reflection answers on the Rorschach (Fr+rF>0), which are related to narcissistic-like features of personality. We also found a positive correlation between self-esteem and the Rorschach egocentricity index (EGO), which provides an estimate of self-concern. Finally, the strongest correlation was found between self-esteem and the dominance of good over poor human representations (GHR>PHR), which reveals effective interpersonal behaviour. DISCUSSION: The psychological processes which seem to be related to low self-esteem in gifted children and adolescents are maladaptive interpersonal behaviours, painful experience of introspection focusing on perceived negative aspects of the self, absence of narcissistic-like features of the personality and low self-concern. These findings may suggest that intervention planning with gifted children and adolescents with low self-esteem should emphasize the accurate interpretation of interpersonal data, develop social skills and restructure negative self-thoughts.
Subject(s)
Child, Gifted/psychology , Rorschach Test/statistics & numerical data , Self Concept , Adaptation, Psychological , Adolescent , Awareness , Child , Female , Humans , Intelligence , Interpersonal Relations , Male , Narcissism , Paris , Risk Factors , Social Adjustment , Statistics as Topic , Surveys and QuestionnairesABSTRACT
BACKGROUND: There is an ongoing debate of how giftedness affects social-emotional adjustment. Self-esteem may be an indicator of social-emotional adjustment but insufficient in its explanatory capacity, especially high self-esteem which tends to produce opposite responses in regards to adjustment. A distinction between defensive and genuine high self-esteem could account for these results. In order to understand how self-esteem operates on social-emotional adjustment, it should be associated with other measurements relating to self-concern. In the Rorschach comprehensive system (CS), egocentricity index measures self-centeredness, which can be defined as the balance between self-concern and concern for others. High self-concern is associated with a neglect of the others. Operationalized here, as the interaction of high self-esteem and excessive self-concern, defensive high self-esteem should predict maladaptive outcomes. METHOD: Participants were aged from 9 to 15 years old, with an IQ greater or equal to 130 on the WISC-III. They were attending regular classes and were not in counseling or psychotherapy. Children and adolescents were administrated the Rorschach CS and the Coopersmith self-esteem inventory. Parents completed the child behaviour checklist (CBCL) which assesses general psychopathology. RESULTS: Seventy-eight subjects' data satisfy the conditions of validity of the instruments used. Gifted boys present more behavior and emotional problems than gifted girls in this study. Self-esteem predicts social-emotional adjustment. There is an interaction between self-esteem and self-concern on psychopathology only for high values of self-esteem. Gifted with high self-esteem associated with high self-concern are more vulnerable to maladjustment than high self-esteem associated with low self-concern. Gifted children and adolescents with low self-esteem experience more problems anyhow. CONCLUSION: These findings reinforce the view that the gifted are a diverse group in terms of social-emotional adjustment and self-esteem. Self-esteem operates as a valuable resource for the social-emotional adjustment of gifted children and adolescents but only under some conditions. Low self-esteem gifted seem to be at more risk of maladjustment, but that does not mean any causal relationship. Gifted children and adolescents with high self-esteem can be considered as a heterogeneous category. High self-esteem associated to excessive self-concern has less beneficial effects on adjustment than high self-esteem associated to low self-concern.
Subject(s)
Character , Child, Gifted/psychology , Defense Mechanisms , Emotions , Self Concept , Social Adjustment , Adolescent , Child , Child Behavior Disorders/diagnosis , Child Behavior Disorders/psychology , Female , Humans , Individuality , Internal-External Control , Interpersonal Relations , Male , Rorschach TestABSTRACT
BACKGROUND: The Fear of Negative Evaluation scale (FNE: Watson and Friend, 1969) is the measure most commonly used to determine the degree to which people experience apprehension at the prospect of being negatively evaluated. Although the development of the FNE preceded the inclusion of social anxiety disorder (or social phobia) in the diagnostic classification system, it is widely used as a measure of cognitive symptoms because the feature tapped by this measure is at the core of recent cognitive models of social-anxiety. According to these models, socially anxious individuals divide their attention between the internal representations of their social self (negative images and "felt sense") and external cues that could be taken as a sign of negative evaluation by others. The FNE was validated in a student and patient population in English speaking countries. The English version demonstrates adequate empirical validity. It shows excellent internal consistency and one-factor structure. Test retest reliability is satisfying. It is proved to be sensible to change after treatment. It is well correlated with other measures of social anxiety demonstrating good convergent validity. However, divergent and discriminate validity have been a subject of controversy. The aim of the present study was to assess the psychometric properties of the French version of the FNE in order to obtain a valid instrument measuring the cognitive component of social anxiety. METHOD: The social anxiety group consisted of 88 patients referred to our clinic for cognitive-behavioural group therapy. All met ICD-10 criteria for social phobia (generalized subtype) as determined by the Composite International Diagnostic Interview (social phobia section). Additional axis-I diagnostic information was obtained using the Mini International Neuropsychiatric Interview (MINI: Lecrubier et al., 1997) for ICD-10. The non-patient control group consisted of 80 participants who didn't respond to social anxiety CIDI criteria. All participants were rated by the assessor on the Liebowitz Social Anxiety Scale (LSAS) and completed the following self-report questionnaires: the Fear of Negative Evaluation questionnaire (FNE), the State-Trait-Anxiety Inventory (STAI A-B), and the Beck Depression Inventory (BDI 13). RESULTS: The internal consistency is very good with Kuder-Richardson 20 coefficient of 0,94 corresponding to coefficients found in the validity studies of the original version of the FNE. One factor Anova tests showed that our two groups of subjects differed significantly on the FNE [F (1.166)=282.26, p<0.001]. Patients had a mean score of 25.6 with a standard deviation of 4.1 and the non patient control subjects had a mean score of 12.1 with a standard deviation of 6.1. This result confirms the empirical validity of the instrument. In the patient sample, the FNE was significantly correlated with the LSAS total score (r=0.55; p<0.001). This result indicates good convergent validity. However, the FNE was also significantly correlated with the BDI-13 (r=0.48; p<0.001) and the STAI B (r=0.47; p<0.001). However because high levels of general anxiety and depression are common among patients with social anxiety disorder, substantial correlations between measures of social anxiety and measures of general anxiety and depression should be probably expected. A multiple regression analysis shows a significant association of the FNE with the LSAS (Beta=0.39, p<0.001) and the STAIB (Beta=0.28, p<0.01) We explored the unidimensionality of the scale by using a principal component analysis of tetrachoric correlation suitable for dichotomic items. One sole factor with an eigenvalue superior to 1 emerged. We deduce therefore that our results are in favour of the unidimensionality of the French version of the FNE. CONCLUSION: The present study shows that the French version of the FNE has good psychometric properties and differentiates social phobic patients from the non-clinical control subjects. Given the importance that models of social anxiety attribute to cognitive processes and the importance of cognitive techniques in its treatment, we consider that the French version of the FNE is an adequate and valid questionnaire to be used in research and therapy.
