Development, psychometric evaluation, and factor analysis of an instrument measuring quality of life in autistic preschoolers.

INTRODUCTION: Early interventions for autistic children should target their quality of life (QoL) but require adapted measures. The association of a child's temperament and parental characteristics with the QoL of autistic children remains unknown. METHODS: We constructed an autism module based on a thematic analysis, a Delphi survey with experts, and a pre-test with parents to be completed alongside the proxy version of the PedsQL 4.0. We explored compliance, responsiveness, internal consistency, convergent validity, and factor structure with 157 parents of autistic preschool children. We examined the association between child and parental characteristics with the QoL of autistic children using correlation analysis, principal component analysis, hierarchical ascending classification, and linear regression. Sociodemographic information was collected via multiple choice questions, autism severity via Autism Diagnostic Observation Schedule (ADOS) scores, and parental acceptance and child's temperament via the Acceptance and Action Questionnaire and the Emotionality, Activity, and Sociability. RESULTS: An autism module comprised of 27 items emerged. Psychometric evaluation resulted in a 24-item autism module with good internal consistency and significant convergent validity. ADOS total score was not significantly related to QoL, contrary to children's sleep issues, children's emotionality, and parental acceptance. CONCLUSIONS: The autism module is a reliable QoL proxy measure for autistic preschool children. Results suggest parental interventions targeting children's QoL.

Corrigendum: Illness perceptions of COVID-19 in Europe: predictors, impacts and temporal evolution.

[This corrects the article DOI: 10.3389/fpsyg.2021.640955.].

Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study.

BACKGROUND: Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies. METHOD: In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category). RESULTS: In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04). CONCLUSIONS: This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.

Mental Health and Adherence to COVID-19 Protective Behaviors among Cancer Patients during the COVID-19 Pandemic: An International, Multinational Cross-Sectional Study.

A population-based cross-sectional study was conducted during the first COVID-19 wave, to examine the impact of COVID-19 on mental health using an anonymous online survey, enrolling 9565 individuals in 78 countries. The current sub-study examined the impact of the pandemic and the associated lockdown measures on the mental health, and protective behaviors of cancer patients in comparison to non-cancer participants. Furthermore, 264 participants from 30 different countries reported being cancer patients. The median age was 51.5 years, 79.9% were female, and 28% had breast cancer. Cancer participants reported higher self-efficacy to follow recommended national guidelines regarding COVID-19 protective behaviors compared to non-cancer participants (p < 0.01). They were less stressed (p < 0.01), more psychologically flexible (p < 0.01), and had higher levels of positive affect compared to non-cancer participants. Amongst cancer participants, the majority (80.3%) reported COVID-19, not their cancer, as their priority during the first wave of the pandemic and females reported higher levels of stress compared to males. In conclusion, cancer participants appeared to have handled the unpredictable nature of the first wave of the pandemic efficiently, with a positive attitude towards an unknown and otherwise frightening situation. Larger, cancer population specific and longitudinal studies are warranted to ensure adequate medical and psychological care for cancer patients.

Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution.

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors. Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context. Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis.

This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001-0.021). Seeking social support was the significant mediator across subgroups (all ps range = <0.001-0.005) except from the Hong Kong sample (p = 0.06) and the North and South American sample (p = 0.53). No mediation was found for problem-solving (except from the Northern European sample, p = 0.009). Prosociality was the significant mediator in the Hong Kong sample (p = 0.016) and the Eastern European sample (p = 0.008). These findings indicate that fostering psychological flexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles of seeking social support, problem-solving and prosociality vary across regions.

To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic.

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans' social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multiple regression analyses showed that prosocial behavior was associated with better well-being consistently across regions. With regard to predictors of prosocial behavior, high levels of perceived social support were most strongly associated with prosocial behavior, followed by high levels of perceived stress, positive affect and psychological flexibility. Sociodemographic and psychosocial predictors of prosocial behavior were similar across regions.

Impact of COVID-19 pandemic on mental health: An international study.

BACKGROUND: The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. METHODS: The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. RESULTS: Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. CONCLUSIONS: These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.

Relationship between anticipatory, consummatory anhedonia and disorganization in schizotypy.

BACKGROUND: The disorganized and negative dimensions of schizotypy are characterized by cognitive disorganization and anhedonia, respectively. The aim of the study was to investigate the relationships between these two dimensions of schizotypy by taking into account ambivalence and the distinction between consummatory and anticipatory anhedonia. METHODS: Dimensional analysis and categorical analysis were performed on two different samples (N = 400 and 399) of university students. Self-reported scales were used to measure cognitive disorganization, anticipatory and consummatory anhedonia, and ambivalence. Dimensional analysis using confirmatory factorial analysis examined various models of disorganized and negative schizotypy and categorical analysis compared the scores on anticipatory, consummatory anhedonia and ambivalence scales between various groups of subjects presenting either disorganized schizotypy or negative schizotypy or free of schizotypy. RESULTS: The disorganized dimension of schizotypy was characterized by schizotypal ambivalence and anticipatory anhedonia, while the negative dimension of schizotypy was characterized by anticipatory and consummatory anhedonia. CONCLUSION: The results suggested firstly that ambivalence was not specific of disorganized schizotypy and secondly that anticipatory anhedonia was not specific of negative schizotypy.

Criterion validity of the cognitive slippage and schizotypal ambivalence scales.

This study explored the criterion-validity of the Cognitive Slippage Scale (CSS) and the Schizotypal Ambivalence Scale (SAS). 27 first-degree relatives of individuals with schizophrenia (9 males, 18 females; M age=45.3 yr., SD=13) were compared with 30 first-degree relatives of non-psychotic patients (15 males, 15 females; M age = 44.6 yr., SD = 11.6) on the French versions of the CSS and SAS. The former group, who is at high risk for schizophrenia, had significantly higher scores than the latter group on both scales.

[Acceptance and commitment therapy in the treatment of chronic pain]. / Mieux vivre avec la douleur chronique grâce à la thérapie d'acceptation et d'engagement.

OBJECTIVES: The purpose of this article is to present the characteristics of the Acceptance and Commitment Therapy (ACT) for the treatment of chronic pain. The historical context of the development of cognitive and behavioural therapy (CBT) for chronic pain will be described and the theoretical aspects of ACT will be introduced. The components of an acceptance and mindfulness based treatment will also be presented by exploring various processes of the psychological flexibility model. Finally, the article will summarize the scientific evidence supporting ACT based on experimental, correlational and clinical studies in the field of chronic pain. METHOD: The theoretical aspects underlying ACT, as well as its clinical components in the specific domain of chronic pain were described based on major books in this area, such as McCracken (2005) and Dahl et al. (2005). A descriptive literature review was undertaken to explore the data on the efficacy of ACT for the treatment of chronic pain. Psycinfo and Medline, as well as the Association for Contextual Science website were analyzed for relevant articles. The key search terms were: "Acceptance and Commitment Therapy" or "ACT" or "acceptance" or "mindfulness" or "defusion" and "chronic pain" or "pain." The reference lists of the articles retrieved were also analyzed. The articles that were not in English or French were excluded as well as those that were not specific to ACT and chronic pain. RESULTS: Results show that ACT is a relevant and empirically supported approach that may be used as a complement to CBT strategies in the treatment of chronic pain. There is growing evidence stemming from experimental and correlational studies that support the majority of the ACT processes. Clinical studies undertaken in the field of chronic pain from different backgrounds support the efficacy of ACT for the management of this condition. CONCLUSION: ACT is a promising and evidence-based approach for the treatment of chronic pain. More research is needed to further validate its theoretical model and further refine our understanding of how ACT could be effective for the management of chronic pain and enhance quality of life for people who suffer from this health condition. For now, ACT is considered to be as effective as traditional cognitive and behavioral therapy for chronic pain.

Subjective experiences in first-degree relatives of schizophrenic subjects.

First-degree relatives of patients with schizophrenia may score higher on the Frankfurt Complaint Questionnaire (FCQ) than controls. The present study was designed to provide evidence of validity for the French version of the 24-item subscale of the Frankfurt Complaint Questionnaire (FCQ-24). In 27 first-degree relatives of patients with schizophrenia (high-risk group) and 30 controls, the high-risk group scored significantly higher on the FCQ, as expected.

Test-retest reliability of the Frankfurt Complaint Questionnaire.

Long-term reliability of the Frankfurt Complaint Questionnaire (FCQ) was investigated in two follow-up studies of participants with psychosis using a test-retest method. In the first study (N = 56), the duration of the follow-up ranged from 6 months to 2 years; Spearman rho was .62 for the abridged (18 items) Spanish version of the questionnaire. In Study 2 (N = 21), in participants with stable schizophrenia, the follow-up ranged from 8 to 11 years; test-retest Spearman rho was .83 for the French version of the questionnaire. Subjective experiences could constitute, in psychosis-prone people, traits or markers of psychotic vulnerability.

Adopting the perspective of another in belief attribution: contribution of Relational Frame Theory to the understanding of impairments in schizophrenia.

Impaired ability of identifying mental states is a characteristic of schizophrenia spectrum disorders. In particular, people suffering from this illness tend to fail at attributing a belief to another, which has been linked to difficulties in changing interpersonal perspective. Following the view of Relational Frame Theory on perspective-taking skills, the current study aimed at examining the involvement of social anhedonia, one of the frequent features of schizophrenia, in the development of deficits in reversing the I-YOU relation (i.e., adopting the perspective of another). A task consisting of attributing a belief to another or to the self was employed with 30 non-clinical participants with a high level of social anhedonia and with 15 patients diagnosed with schizophrenia. In comparison to two control groups, both experimental groups showed significant poorer performance when adopting the perspective of another. These results constitute important indications to target specific relational repertoires when attempting to remediate impairments in mental states attribution linked to schizophrenia.

Stability and relationships between trait or state anhedonia and schizophrenic symptoms in schizophrenia: a 13-year follow-up study.

The aim of the present study was to explore the stability of anhedonia and its relationships with schizophrenic symptoms across a 13-year study period. We tested the hypothesis that trait anhedonia, rated by the Physical Anhedonia Scale (PAS), was stable and independent of schizophrenic symptoms across this period, while measures of state anhedonia were not. Sixty schizophrenic subjects were evaluated at two time points, at hospital admission or during an ambulatory psychiatric consultation and 13 years later. Trait anhedonia was assessed using the Chapman Physical Anhedonia Scale, while state anhedonia was assessed with a subscale extracted from the Beck Depression Inventory. The Positive and Negative Syndrome Scale (PANSS) was used to rate schizophrenic symptomatology. Unlike trait anhedonia, state anhedonia decreased significantly over time. Based on results from multiple regressions, negative and depressive dimensions were significant predictors of state anhedonia. Trait anhedonia was not associated with negative symptoms, but was associated with severity of disorganization symptoms at baseline and with our state measure of anhedonia at follow-up. In the current study, state and trait anhedonia were correlated, but depressive symptoms in general were not associated with physical anhedonia. The results indicated that trait anhedonia, in contrast to state anhedonia, had absolute stability, was independent of the negative dimension, as measured by the PANSS, of schizophrenic symptomatology and correlated with specific aspects of depressive anhedonia.

Relationships between schizotypy and subjective experiences in a sample of 399 university students.

The high-risk approach based on the definition of schizotypy by Meehl (The American Psychologist 1962;17:827-38) and the basic symptom approach proposed by Huber (Fortschritte für Neurologie und Psychiatrie 1957;25:491-520) share many points in common. In particular, several studies have shown that high scores on psychosis proneness or subjective experiences (SE) scales were associated with the onset of psychotic disorders in nonpsychiatric or nonpsychotic subjects. However, the relationships between the 2 concepts have never been studied experimentally. The present study was therefore designed to investigate the relationships between the scores of the SE scale and several psychosis proneness scales evaluating the negative and positive components of schizotypy in a sample of 399 university students. Data were analyzed using multiple regression and principal components analyses. The results show that SE, as assessed by the Frankfurt Complaint Questionnaire, were significantly associated with the positive component of schizotypy but not with the negative component. Subjective experiences could constitute vulnerability traits for psychosis and the Frankfurt Complaint Questionnaire could be use instead of the positive psychosis proneness scales.

Attentional capture in schizophrenia and schizotypy: effect of attentional load.

INTRODUCTION: We examined the effect of attentional load on attentional capture in schizophrenia. On the basis of the ''resource limitations hypothesis'' in schizophrenia, we propose that attentional capture by an irrelevant distractor will be differentially affected by the attentional load for patients and healthy controls. METHOD: 70 patients with schizophrenia, 15 schizotypals, and 54 controls were asked to attend to a central task while a lateral distractor moved. Participants were instructed either (i) to localise a black square (low-load condition), or (ii) to locate the larger number between two 1-digit numbers (medium-load condition), or (iii) to locate the larger number between two several-digit numbers (high-load condition). In the baseline condition, no distractor moved. RESULTS: All groups showed attentional capture in the low-load condition. Patients and schizotypals resisted interference from the distractor in the medium and highload conditions. Controls resisted interference in the high-load condition. CONCLUSION: The results suggest that attentional modulation is impaired in schizophrenia and in the schizophrenia spectrum.

Dimensional structure of the Frankfurt Complaint Questionnaire in a sample of French students.

BACKGROUND: The Frankfurt Complaint Questionnaire (FCQ) is a questionnaire designed to evaluate the subjective symptoms of schizophrenics. In schizophrenic samples, several validation studies of the FCQ using principal components analyses (PCA) have shown a one-factor solution. AIM: The aim of the present study was firstly to examine the factor structure and the psychometric properties of the FCQ in a sample of 399 students and secondly to explore the reliability of the FCQ-24, a 24-item subscale extracted from the FCQ. METHOD: PCA was done using several guidelines to select the number of factors. RESULTS: PCA yielded one factor, and the values of the Cronbach alpha were 0.95 and 0.87 for FCQ and FCQ-24, respectively. CONCLUSIONS: These results firstly suggested an unidimensionality underlying FCQ items in nonpsychiatric samples and secondly confirmed the satisfactory reliability and validity of the FCQ and its subscale. Psychometric properties of the rating scales must be confirmed in other nonpsychiatric samples. CLINICAL RELEVANCE: As subjective symptoms allow to detect subjects prone to schizophrenia, it is important to use well-validated rating scales.