Psychometric assessment of the 10-item Thai version of the Experience in Close Relationship-Revised for Adolescents (ECR-R-10-AD).

The 18-item version of the Experiences in Close Relationships-revised (ECR-R-18) is a valid and reliable scale used among Thai adolescents. However, it revealed problematic items that impacted the scale's internal consistency. The study aimed to achieve two objectives: (1) develop a new, shorter scale by retaining only highly loaded items equally between attachment anxiety and attachment avoidance, and (2) evaluate the psychometric properties of the shorter ECR-R version compared to the existing 18-item scale. Objective 1 was achieved through Study 1, involving 204 youths aged 16-18 years (64% female). All participants completed the 18-item ECR-R, and exploratory factor analysis was conducted to identify suitable items for the new ECR-R-AD. Objective 2 was fulfilled in Study 2, which included a total of 443 students in grades aged 15-18 years old (88% female) from Thai boarding schools in Northern Thailand. All participants completed both the 18-item ECR-R, and confirmatory factor analysis of both the existing 18-item and the new shorter scale was performed and compared. Additional measures including the Rosenberg Self-Esteem Scale, Perceived Stress Scale-10, and Relationship Questionnaire were completed alongside the ECR-R to assess convergent, discriminant, and criterion validity. The invariance test for the new ECR-R across genders was conducted using multigroup confirmatory factor analysis. For objective 1, Study 1 developed a new scale called "ECR-R-10-AD" with 10 items, comprising 5 for attachment anxiety and 5 for attachment avoidance. The McDonald's omega values were 0.866 for avoidance and 0.823 for anxiety subscales. The corrected correlation between the ECR-R-18 and ECR-R-10-AD was significant. For objective 2, Study 2 found that the first-order two-factor solution model fit the data best for the ECR-R-10-AD. Convergent, discriminant, and criterion validity with other measurements and invariance tests based on sex were established for the ECR-R-AD. The ECR-R-10-AD provided sufficient psychometric properties among Thai adolescents. Factorial validity, convergent validity, and measurement invariance were established. As the ECR-R-10-AD is brief, it can be administered with less burden. Limitations and future research were discussed.

Social Inhibition and Depressive Symptoms among Couples with Children with Autism Spectrum Disorder: The Mediating Role of Perceived Family Support.

Background and Objectives: A limited understanding exists regarding the intricate dynamics between the levels of social inhibition exhibited by both wives and husbands concerning their perceived family support and depressive symptoms, particularly within couples who are parents of children diagnosed with autism spectrum disorder (ASD). Materials and Methods: This study used the actor-partner interdependence mediation model to analyze data collected from 397 pairs of Chinese parents with children diagnosed with ASD. Results: The findings of the study revealed significant indirect actor effects, indicating that the levels of social inhibition exhibited by both wives and husbands were associated with their own depressive symptoms through their respective perceptions of family support. In general, the study did not find significant partner effects, except for some indirect effects of wives on their husbands' depressive symptoms through the wives' perceived social support. Conclusions: In line with related studies, social inhibition was associated with depressive symptoms. At the same time, perceived family support could be a mediator of depression. Gender differences in emotional expression, influenced by cultural norms and distinct role expectations within the family context, may elucidate why only wives' perceived family support could impact husbands' depressive symptoms. These results underscore the potential importance of interventions aimed at addressing social inhibition and enhancing perceived family support to alleviate depressive symptoms in this population. Additionally, encouraging family support for both wives and husbands' involvement in collaboration may be of benefit in improved outcomes for both parents and children within families affected by ASD.

Syntactic Errors in Older Adults with Depression.

Background and Objectives: This study investigated the differences in syntactic errors in older individuals with and without major depressive disorder and cognitive function disparities between groups. We also explored the correlation between syntax scores and depression severity. Materials and Methods: Forty-four participants, assessed for dementia with the Mini-Cog, completed the 15-item Geriatric Depression Scale (TGDS-15) and specific language tests. Following a single-anonymized procedure, clinical psychologists rated the tests and syntax scores. Results: The results showed that the depressive disorders group had lower syntax scores than the non-depressed group, primarily on specific subtests. Additionally, cognitive test scores were generally lower among the depressed group. A significant relationship between depression severity and syntax scores was observed (r = -0.426, 95% CI = -0.639, -0.143). Conclusions: In conclusion, major depressive disorder is associated with reduced syntactic abilities, particularly in specific tests. However, the relatively modest sample size limited the sensitivity of this association. This study also considered the potential influence of cultural factors. Unique linguistic characteristics in the study's context were also addressed and considered as potential contributors to the observed findings.

Psychometric assessment of the 10-item, revised experience of close relationship (ECR-R-10) in nonclinical and clinical populations of adults and older adults in Thailand.

The experiences of close relationships-revised (ECR-R) is a widely used 36-item self-report measurement for measuring adult attachment. However, various short versions of the ECR-R have been developed and tested psychometrically. Given the cultural impact, a short version of the Thai ECR-R should be derived from the existing Thai version of the ECR-R. This study aimed to develop a 10-item version of the ECR-R that demonstrates comparable psychometric properties to the previous Thai version and the 18-item ECR-R. This study included four studies with a total of 1,322 participants. In study 1, 434 adults in a nonclinical setting were used for the development of the 10-item Thai ECR-R and tested in an independent sample. Studies 2, 3, and 4 were conducted on 312 adults in the clinical setting, 227 older adults in the nonclinical, and 123 older adults in clinical settings. The Cronbach alphas and corrected correlations between the ECR-R-18 and the ECR-R-10 in each study were calculated. Confirmatory factor analysis of the first-order two-factor solution model with fit statistics was examined with each sample. Correlations of the ECR-R-18 and the ECR-R-10 with other measurements were presented and compared. Known-group validity and measurement invariance test were also examined. The Cronbach alphas of the ECR-R-10 among all samples were acceptable, ranging between .77 and .85 for avoidance subscales and between .82 and .86 for anxiety subscales. The corrected correlation between the ECR-R-18 and ECR-R-10 was between .61 (p < .001) and .82 (p < .001). The values of the comparative fit index and Tucker-Lewis index for the model of ECR-R-10 were between .903 and .985, whereas the root-mean-square error of approximation was between .082 and .036, indicating that the model fits were acceptable. The ECR-R-10 was related to the measurements with a similar construct; however, no difference in the magnitude of correlation was observed between ECR-R-18 and ECR-R-10. Known group validity was established. Measurement invariance was successfully established across different age and gender groups, although it was only partially achieved with respect to clinical status. The ECR-R-10 provided equal or superior psychometric properties to the ECR-R-18 across age groups and settings. As it is a briefer scale, the ECR-R-10 can be practically used in general and clinical samples to reduce the burden of assessment, especially with older adults. Further investigation is needed to test the scale's temporal stability.

The Mediating Role of Precepts and Meditation on Attachment and Depressive Symptoms in Adolescents.

Research shows that Buddhist precept adherence (i.e., abstaining from killing, stealing, sexual misconduct, lying, and intoxicant use) and meditation practice influence mental health outcomes. This study investigated how Buddhist precept adherence and meditation practice influenced the relationship between insecure attachment and depressive symptoms among Thai adolescents. A total of 453 Thai boarding-school students from 10th-12th grade were recruited from five boarding schools (two purposively selected Buddhist schools and three conveniently selected secular schools). They completed these tools: Experiences in Close Relationships Questionnaire-revised-18, Outcome-Inventory-21: Depression Subscale, Precept Practice Questionnaire, and Inner-Strength-Based Inventory: Meditation. A parallel mediation model analyzed the indirect effects of attachment anxiety and attachment avoidance on depression through precept adherence and meditation practice. The participants' demographics were 16.35 ± 0.96 years, 88% female, and 89.4% Buddhist. The mean scores for attachment anxiety were 2.7 ± 1.1; attachment avoidance, 2.78 ± 1.2; overall regular precept adherence, 20.1 ± 4.4; regular but not daily meditation, 2.94 ± 1.3; and low depressive symptoms, 3.75 ± 3.4. The standardized indirect effects for attachment anxiety (ß = 0.042, 95% CI = 0.022, 0.070) and avoidance (ß = 0.024, 95% CI = 0.009, 0.046) on depressive symptoms through meditation and precept adherence were significant. Meditation practice had a significantly higher indirect effect size than precept adherence.

Marital Satisfaction and Perceived Family Support in Families of Children with Autistic Spectrum Disorder: Dyadic Analysis.

BACKGROUND: Raising children with autism spectrum disorder (ASD) causes tremendous stress for parents that may lead to marital conflict and relationship dissatisfaction. Many factors are associated with parent relationships including severity of autistic behaviors and social support. This study aimed to investigate whether severity of autistic behaviors, perceived family support, and complementarity of interpersonal styles between husbands and wives predicted couple satisfaction among the parents of children with ASD. METHOD: Seven hundred ninety-seven parent dyads of children aged 7-14 years old with ASD participated in the study. Measurements used included couple satisfaction index, perceived family support using the Multidimensional Scale of Perceived Social Support, inter-personal style using the inventory of interpersonal problems, the ABC autism checklists as well as sociodemographic and related factors. The Actor Partner Interdependence Model estimated by multilevel modeling was used for analysis. RESULTS: Perceived family support was relevant in married couples regarding their marital relationship, but the effects on husbands and wives differed. Husbands' relationship satisfaction was predicted by how they perceived being supported by family. The severity of autistic behaviors predicted relationship satisfaction but only actor effect. Negative prediction of interpersonal complementarity on couple satisfaction was observed. In addition, time spent on raising children had a negative impact on the quality of the relationship. Partner effect of time spent was observed among women. CONCLUSION: Dyadic analysis using an actor-partner independence model confirmed perception of family support predicts relationship satisfaction among parents of children with ASD in addition to the severity of autistic behaviors and time spent caring for children. Complementarity of individual interpersonal style had no effect on couple satisfaction. This research suggests implications for interventions regarding building skills that elicit support from family members.

Fear of COVID-19 and Perceived Stress: The Mediating Roles of Neuroticism and Perceived Social Support.

Background: Fear of COVID-19 leads to stress and may result in various kinds of mental health problems. Many factors are associated with an individual's perception of stress, including neuroticism and perceived social support. This study aimed to examine the role of neuroticism and perceived social support as mediators of fear of COVID-19 on perceived stress. Methods: Data from 3299 participants aged ≥18 years from the HOME-COVID-19 survey in 2020 were used for analysis. Measurements used included the Fear of COVID-19 and Impact on Quality of Life Scale, the Perceived Stress Scale-10, the Neuroticism inventory and the Multidimensional Scale of Perceived Social Support-12. A parallel mediation model within a structural equation modeling framework with 5000 bootstrapping sampling was used to test the mediating effect. Results: Fear of COVID-19 had a direct effect on perceived stress (B = 0.100, 95% CI = 0.080−0.121, p < 0.001), whereas neuroticism, but not perceived social support, partially mediated the relationship between fear of COVID-19 and perceived stress (B = 0.018, 95% CI = 0.000−0.036). Among all types of social support, only perceived support from friends was a significant mediator (B = 0.016, 95% CI = 0.006−0.025). Conclusions: Neuroticism and perceived support from friends are critical factors in the relationship between fear of COVID-19 and perceived stress.

Meditation and Five Precepts Mediate the Relationship between Attachment and Resilience.

Secure attachment is fundamental to the development of resilience among adolescents. The present study investigated whether meditation and precept practices influence the relationship between attachment and resilience. This study recruited 453 10th−12th-grade boarding school students who completed the Experience of Close Relationship Questionnaire (revised), Resilience Inventory, Inner Strength-Based Inventory, and Precept Practice to assess attachment, resilience, meditation practice, and precepts adherence. The participants' mean age was 16.35 ± 0.96 years; 87.9% were females, and 89.2% were Buddhists. A parallel mediation model within the structural equation framework was used for an analysis of the indirect effect of attachment on resilience through meditation and precept practices. The indirect effects of attachment anxiety and avoidance on resilience were ß = −0.086, 95% CI = −0.125, −0.054, p < 0.001, and ß = −0.050, 95% CI = −0.088, −0.021, p = 0.006, respectively. The indirect effect size resulting from meditation was significantly higher than that resulting from observance of the precepts. The parallel mediation model explained the 33% variance of the resilience scores, compared with 23% from the direct effect of attachment anxiety and avoidance only. This work provides evidence that meditation and precepts significantly affect the relationship between attachment and resilience.

Role of Equanimity on the Mediation Model of Neuroticism, Perceived Stress and Depressive Symptoms.

Background: Equanimity is widely and commonly practiced, but few have investigated the concept in clinical research. While the mediation model of neuroticism, perceived stress and depression have been demonstrated, it remains unclear whether equanimity mediates the relationship of these variables in parallel, serial or moderated mediation models. This study aimed to investigate the role of equanimity among those models. Methods: In all, 644 general participants (74.2% female, mean age = 28.28 (SD = 10.6)) provided data on the 10-item Perceived Stress Scale (PSS), the Neuroticism Inventory (NI), depression subscale of the Core Symptom Index, and the equanimity subscale of the inner Strength-based Inventory. Mediation and moderation analyses with the 5000 bootstrapping method were applied. Results: Equanimity was shown to moderate the relationship between NI/PSS and depressive symptom. Statistical evaluation supported all parallel, serial and moderated mediation models. Equanimity as a moderator provided a higher amount of percent variance explained by depressive symptoms than parallel and serial mediation models. Conclusions: Results suggest that the effect of perceived stress and neuroticism on depression can be mitigated by increasing levels of equanimity. The results demonstrated one potential benefit from practicing equanimity; enabling its extension to mental health problems could constitute an interesting focus for future research.

Reviewers on Reviewing for Psychological, Health and Medical Journals.

Being a reviewer is an honor and it continues to be a very rewarding experience throughout a career. Reviewers get the opportunity to maintain scientific standards and assist in growing the scientific psychological literature. Being a reviewer enhances and integrates scientific values and clinical skills following the scientist-practitioner model. However, for the inexperienced reviewer, the experience can be very scary and intimidating. Everyone's experience with reviewing is highly personal and at the same time, the activity is both common and universal for academic psychologists. In this interview article, three seasoned reviewers respond to questions about their experience as journal reviewers reflecting in their answers their collective wisdom and knowledge in this area.

Mental Strength and Challenges among Thai Medical Students in Their Clinical Years-Study Protocol.

(1) Background: Mental well-being and mental health problems are both important, especially among medical students who will be future doctors. The proposed study aimed to explore both positive and negative mental health experiences, especially mistreatment, occurring among medical students in their clinical years. (2) Methods/design: The study will conduct a cross-sectional survey between January 2021 and December 2021, among medical students studying in their clinical years across 23 medical schools throughout Thailand. Measurements regarding character strengths related to medical professionalism as well as other positive mental health strengths and negative mental health problems, e.g., anxiety, depression and experience of mistreatment will be completed. Both medical students and faculty members will be invited to participate in the study. (3) Discussion: this survey will provide an overall picture of medical students' mental well-being, positive and negative aspects of mental health and the magnitude of mistreatment and perspectives they experience. The limitations of the survey will be discussed.

Changes in character strengths after watching movies: when to use rasch analysis.

OBJECTIVE: Professionalism is a critical part of a medical education, and various activities have been proposed to enhance professionalism among medical students. Watching films is an activity to promote character related to professionalism. Limitation of such is a single group pre-posttest design raising concerns about the errors of measurement. The study aimed to demonstrate a method to deal with this design using Rasch analysis. RESULTS: This study used a pre-posttest design with 40 first year medical students. All participated in a 3-day activity that involved watching four selected movies: Twilight, Gandhi, The Shawshank Redemption and Amélie. These films offer compelling illustrations of the themes of self-regulation, humility, prudence and gratitude, respectively. All participants completed a 10-item composite scale (PHuSeG) addressing these themes before and after watching the movies. When determining who benefitted from the intervention, paired t-tests on the results of a Rasch analysis were used to evaluate changes between pre- and posttest. Using Rasch analyses, we could document the stability of the items from pre- to posttest, and significant changes at both the individual and group levels, which is a useful and practical approach for pre- and posttest design. Moreover, it helps validate the psychometric property of the instrument used.

Does MMPI assessed at medical school admission predict psychological problems in later years?

OBJECTIVE: Psychological distress among medical students is related to personality. The Minnesota Multiphasic Personality Inventory (MMPI) is a common instrument used to assess personality and psychological problems during the medical school admission process in Thailand. The purpose of this study was to examine how the MMPI can predict medical students' psychological problems including perceived stress, anxiety, depression, interpersonal difficulties as well as self-esteem in later years. RESULTS: Anxiety and depressive symptoms were predicted by the psychopathic deviation, psychasthenia, and schizophrenia scales of the MMPI, while perceived stress was predicted by schizophrenia scale of MMPI. Social introversion predicted interpersonal difficulties. No MMPI scale was found to predict self-esteem.

Predictive factors for suicidal attempts: A case-control study.

PURPOSE: To identify predictors for 12-month suicide attempt from general psychiatric outpatients. DESIGN AND METHODS: A case-control study compared 55 cases of suicide attempt within the previous 12 months matched for age and sex with 55 nonsuicidal cases. All were interviewed for psychiatric and personality disorder (PD) diagnoses using a DSM-IV-TR diagnostic interview. FINDINGS: Factors associated with suicide attempt included depressive disorders (odds ratio [OR] = 4.62) and borderline PD (OR = 8.99). PRACTICAL IMPLICATIONS: More attention should be paid to identifying PD especially borderline PD in suicidal attempters, and further study of modifiable factors associated with depression and borderline PD is encouraged.

Factors associated with motivation in medical education: a path analysis.

BACKGROUND: This study identified and investigated the relationship between demographics, mental health problems, positive personality traits and perceived social support and motivation in medical education (MME) among first year medical students. METHODS: One hundred-thirty eight first year medical students completed the Academic Motivation Scale, Outcome Inventory, Strength Based Inventory, and Multidimensional Scale for Perceived Social Support. Path analysis was conducted to identify relationships between the variables of interest and each type of motivation, including intrinsic and extrinsic motivation and amotivation. RESULTS: The mean age of the sample was 18.86 ± 0.74 and 60% of the subjects were female. Path analysis showed that extrinsic motivation was positively associated with being female, personal choice for studying medicine, and grade point average at high school. Intrinsic motivation was correlated with perceived family support, personal choice for studying medicine and the positive attribute of determination. Amotivation was related to being male, personal choice, and depression. While both extrinsic and intrinsic motivation were correlated, they were uncorrelated with amotivation. All variables accounted for 18, 13, and 45% of variance of intrinsic motivation, extrinsic motivation and amotivation, respectively. CONCLUSION: Each type of motivation has different but related predictors. Extrinsic and intrinsic motivation can be promoted, whereas amotivation represents an exclusive issue, one related more to depression, that needs to be reduced to not interfere with academic achievement and quality of life of medical students.

Public education and media relations in psychology.

This article reviews psychology's attempts to influence public attitudes about both the science and the profession of psychology. The early history of the profession is reviewed, and the efforts of the American Psychological Association (APA) to shape the public's perception of psychology are discussed. The rise of social media is reviewed, and important social media outlets relevant to psychology are identified. The activities of the Society for Media Psychology and Technology (APA Division 46) are illustrated, and the presidents of the Division are identified. The work of those psychologists who are noted public intellectuals or who have received Nobel prizes or National Medal of Science awards for their research is briefly reviewed, and the public notoriety of 4 prominent media celebrities (Joy Browne, Joyce Brothers, Laura Schlessinger, and Phil McGraw) is discussed. Several controversies in the field of psychology that have influenced the public and their attitudes about psychology are also briefly reviewed. (PsycINFO Database Record

A comparison of Cohen's Kappa and Gwet's AC1 when calculating inter-rater reliability coefficients: a study conducted with personality disorder samples.

BACKGROUND: Rater agreement is important in clinical research, and Cohen's Kappa is a widely used method for assessing inter-rater reliability; however, there are well documented statistical problems associated with the measure. In order to assess its utility, we evaluated it against Gwet's AC1 and compared the results. METHODS: This study was carried out across 67 patients (56% males) aged 18 to 67, with a mean SD of 44.13 ± 12.68 years. Nine raters (7 psychiatrists, a psychiatry resident and a social worker) participated as interviewers, either for the first or the second interviews, which were held 4 to 6 weeks apart. The interviews were held in order to establish a personality disorder (PD) diagnosis using DSM-IV criteria. Cohen's Kappa and Gwet's AC1 were used and the level of agreement between raters was assessed in terms of a simple categorical diagnosis (i.e., the presence or absence of a disorder). Data were also compared with a previous analysis in order to evaluate the effects of trait prevalence. RESULTS: Gwet's AC1 was shown to have higher inter-rater reliability coefficients for all the PD criteria, ranging from .752 to 1.000, whereas Cohen's Kappa ranged from 0 to 1.00. Cohen's Kappa values were high and close to the percentage of agreement when the prevalence was high, whereas Gwet's AC1 values appeared not to change much with a change in prevalence, but remained close to the percentage of agreement. For example a Schizoid sample revealed a mean Cohen's Kappa of .726 and a Gwet's AC1of .853 , which fell within the different level of agreement according to criteria developed by Landis and Koch, and Altman and Fleiss. CONCLUSIONS: Based on the different formulae used to calculate the level of chance-corrected agreement, Gwet's AC1 was shown to provide a more stable inter-rater reliability coefficient than Cohen's Kappa. It was also found to be less affected by prevalence and marginal probability than that of Cohen's Kappa, and therefore should be considered for use with inter-rater reliability analysis.

Psychological profile of sasang typology: a systematic review.

A systematic review of studies related to the psychological characteristics of Sasang types was conducted with the goal of delineating generalizable psychological profiles based on Sasang typology, a traditional Korean medical typology with medical herbs and acupuncture that is characterized as personalized medicine. Journal articles pertaining to Sasang typology were collected using five electronic database systems in Korea and in the USA. As a result, 64 potentially relevant studies were identified and 21 peer-reviewed research articles that employed psychometric inventories were included. Beginning with the use of the Minnesota Multiphasic Personality Inventory in 1992, Myers-Briggs Type Indicator, NEO-Personality Inventory, Temperament and Character Inventory and other personality assessment tools were employed in the identified studies. Because data synthesis could not be carried out due to the heterogeneity of the studies, the present review article sought to delineate the mutual relevance of the studies based on research results pertaining to the correlation between the aforementioned psychological assessment instruments. Results of the review indicate that two super-factors, Extraversion and Neuroticism, serve as the foundation in regards to delineating personality constructs, such that the So-Yang type scored high on the Extraversion dimension and low on the Neuroticism dimension, while the So-Eum type scored low on the Extraversion dimension and high on the Neuroticism dimension. The present systematic review indicates that Sasang typology shares similarities with the Western psychological tradition.

Innovative methods for making behavioral science relevant to medical education.

Thousands of psychologists teach in U.S. medical schools, and these psychologists are responsible for ensuring that the medical students they train are aware of the ways in which research findings from the behavioral and social sciences can enhance the practice of medicine. In addition, it is imperative that physicians appreciate the limits of their own ability to treat psychological and psychiatric problems and know when to refer to mental health professionals. This brief article is based on a talk given by the author at the 2007 American Psychological Association (APA) convention after receiving the Association of Psychologists in Academic Health Centers (APAHC) Ivan Mensh Award for Distinguished Achievement in Teaching. The paper draws on the personal experiences of the author after three decades spent teaching behavioral science to medical students, and it introduces readers to the reasoning behind many of the decisions made in planning and developing each of the author's four editions of the medical school text Behavior and Medicine.

An international perspective on psychotherapy.

This commentary reviews the contributions made in each of the other articles in this issue in the context of the author's international experience. I discuss the tremendous diversity in education, training, experience, and legal status of psychologists around with world, using examples from Argentina, Australia, Brunei, Iran, Japan, Mexico, South Africa, and Spain--the eight countries represented in this issue of Journal of Clinical Psychology: In Session.