Quality of life and related constructs in a group of infertile Hungarian women: a validation study of the FertiQoL.

Quality-of-life measurement is a basic prerequisite for psychologically sensitive fertility care and the FertiQoL is a psychometrically sound outcome measure in this field. The aim of the present research was to investigate the reliability and validity of the Hungarian Core FertiQoL. Two independent samples of infertile women were merged (n = 320). While the model fit of the four-factor Confirmatory Factor Analysis was under the level of acceptability (χ2(246) = 626.36, p < 0.001, RMSEA = 0.070 [CI90 = 0.063-0.076], CFI = 0.878, SRMR = 0.071), the four-factor Exploratory Structural Equation Model showed much improved model fit (χ2(186) = 395.63, p < 0.001, RMSEA = 0.059 [CI90 = 0.051-0.067], CFI = 0.933, SRMR = 0.035). Good internal consistency (Cronbach's Alphas 0.77-0.92) and construct reliability (0.75-0.95) were found for both factor structures. Depression correlated negatively with fertility-specific quality of life. Almost a quarter of the sample suffered from moderate-to-severe depression. Multivariate analysis of variance indicated that Beck Depression Inventory categories (mild, moderate etc.) co-occurred with significantly distinct FertiQoL score ranges, leading to a possible, clinically meaningful threshold on the Core FertiQoL. Pearson coefficients showed secondary infertility, rural residency and pre-treatment status to be associated with better fertility quality of life.

Alcohol Use, Binge Drinking, and Drunkenness Experience in Adolescence: Complex Associations with Family, Peers, Social Context, and Risk Perceptions.

Background: A number of correlates to adolescent substance use have been shown, yet their unique predictive influence is unclear. We investigated the incremental validity of demographics, family background, school variables, risk perception, parental alcohol attitudes, age of first alcohol use, peer group influence, and behavioral variables as they concurrently predicted last month alcohol use, binge drinking, and drunkenness experience frequency. Methods: Hierarchical multiple regression analyses in a sample of N = 743 adolescents (mean age = 15.01). Results: All predictors explained 26-40% of the total variance. Alcohol use was predicted by age, gender, having two working parents, academic family background, relationship to parents, relative risk perception, parental acceptance of alcohol use, age of first use, talking about positive aspects of alcohol, normality of alcohol use among peers, time spent with friends, and going out to clubs. Binge drinking was predicted by age, working parents, school problems, relative risk perception, parental alcohol acceptance, age of first use, talking about positive aspects of alcohol, time spent with friends, and going out to clubs. Drunkenness was predicted by age, relationship to parents, school problems, relative risk perception, age of first use, talking about positive aspects of alcohol, and going out to clubs. Conclusions: Researchers need to take the complexity of adolescent substance use into account when designing studies and interventions. Relative risk perception emerged as the strongest (positive) predictor, indicating that adolescents are able to rather accurately assess their own risk and risk awareness alone does not suffice to engage in protective behavior.

Changing Me, Changing Us: Relationship Quality and Collective Efficacy as Major Outcomes in Systemic Couple Therapy.

We examine the sensitivity to change in the Evaluation of Social Systems (EVOS) scale, which assesses relationship quality and collective efficacy. In Study 1 we conducted a waitlist-control, short-term couple therapy RCT study (N = 43 couples) with five systemic therapy sessions treating communication and partnership problems; our intent was to provide high external validity. Construct validity of EVOS was assessed by comparison with additionally applied scales (Family Scales; Outcome Questionnaire, OQ-45.2). In Study 2, N = 332 individuals completed an experiment with high internal validity in order to verify sensitivity to change in three different social contexts. Results from Study 1 revealed a significant increase in relationship quality in the treatment group directly after treatment, as compared to the control group. Sensitivity to change was slightly better for EVOS than for other measures. While this positive change could not be fully sustained between posttreatment and a 4-week follow-up, EVOS score did not fall below baseline and pretreatment levels, supporting moderate-to-large sensitivity to change. Study 2 supported high sensitivity to change in EVOS for couple relations, family relations, and work-team relationships. Therefore, EVOS can be used as an outcome measure to monitor the process of systemic interventions focusing on relationship quality and collective efficacy. Due to its sensitivity to change, EVOS can provide evidence for treatment success with regard to relationship aspects.

Risk Competence in Dealing With Alcohol and Other Drugs in Adolescence.

BACKGROUND: Adolescence is a critical phase for the development substance use patterns. We propose that individual competence in dealing with psychoactive substances is crucial for the development of healthy substance use behavior and prevention of substance misuse or addiction. OBJECTIVES: We present a new concept of health related skills in dealing with alcohol and other drugs in adolescence, its operationalization and validation. Our conception of risk competence (RICO) consists of the four major factors being Reflective, Informed, Self-Controlled and Life-Oriented, and their sub-facets. METHODS: Based on a sample of N = 753 adolescents we used classical test theory as well as item response theory to create a new measure of RICO. Validity was investigated in a new sample of N = 229 with regard to substance use, risk perception, and measures of personality (Big Five, sense of coherence, general self-efficacy). RESULTS: RICO contains 7 scales with 28 items that measure independent aspects of risk competence. Cross-sectional criterion validity for most of the scales could be shown. Conclusions/Importance: The new RICO scales are a valid measure of different aspects of risk competence in dealing with psychoactive substances. The questionnaire can be used in general research settings, but may also be applied to assess the effects of interventions.

Measuring Cross-Cultural Supernatural Beliefs with Self- and Peer-Reports.

Despite claims about the universality of religious belief, whether religiosity scales have the same meaning when administered inter-subjectively-or translated and applied cross-culturally-is currently unknown. Using the recent "Supernatural Belief Scale" (SBS), we present a primer on how to verify the strong assumptions of measurement invariance required in research on religion. A comparison of two independent samples, Croatians and New Zealanders, showed that, despite a sophisticated psychometric model, measurement invariance could be demonstrated for the SBS except for two noninvariant intercepts. We present a new approach for inspecting measurement invariance across self- and peer-reports as two dependent samples. Although supernatural beliefs may be hard to observe in others, the measurement model was fully invariant for Croatians and their nominated peers. The results not only establish, for the first time, a valid measure of religious supernatural belief across two groups of different language and culture, but also demonstrate a general invariance test for distinguishable dyad members nested within the same targets. More effort needs to be made to design and validate cross-culturally applicable measures of religiosity.

Incremental validity of sense of coherence, neuroticism, extraversion, and general self-efficacy: longitudinal prediction of substance use frequency and mental health.

BACKGROUND: Several studies have demonstrated the importance of sense of coherence (SOC), neuroticism (N), extraversion (E), and general self-efficacy (GSE) for health, yet the unique utility of these overlapping constructs remains uncertain. The present research aims at exploring incremental validity when predicting (1) substance use specifically and (2) mental health generally among adolescents. METHODS: A prospective and longitudinal design was used to predict (1) initial substance use nine years into the future and (2) mental health one year and four years into the future. Participants were 318 adolescents (age 14 to 15 at the beginning of the study). RESULTS: Structural equation modeling revealed (1) that SOC had long-term incremental validity over N, E, and GSE for tobacco use and alcohol use, whereas cannabis use was predicted by E and GSE; and (2) that long-term mental health after four years was only predicted by SOC. CONCLUSIONS: Two studies provide further evidence for the importance of considering salutogenic factors when forecasting mental health and health-related behavior beyond classical constructs such as N, E, and GSE. Differences in criterion validity reveal that SOC cannot be equated with reversed neuroticism.

Assessing Drug Consumption Behavior With the Heidelberger Drogenbogen (Heidelberg Drug Scales): Reliabilities, Validities, and Cut-Off Criteria.

BACKGROUND: The Heidelberger Drogenbogen (HDB) is a German language assessment of substance-specific knowledge and consumption patterns of the illicit psychoactive substances cannabis, MDMA (ecstasy), amphetamines, cocaine, and hallucinogens. The behavior modules for each of these five drugs/drug groups allow for a diagnostic evaluation of the extent of harmful consumption behavior. Each of the five modules represents a single standardized test. OBJECTIVES: This paper outlines several statistical parameters, Cronbach's alpha, retest reliabilities, as well as numerous validity and cut-off-criteria of the behavioral modules. METHODS: Participants (N = 4,794) were recruited at schools, universities, in subcultural contexts, and in institutions of substance abuse treatment. RESULTS: Internal consistencies range from = .68 to .79 while test-retest reliabilities between .87 and .94 were found. The behavior modules of the HDB can discriminate between populations with and without clinical levels of substance use. Furthermore, this measure has incremental validity and higher diagnostic accuracy over competing measures. CONCLUSIONS: The behavior modules of the HDB are reliable and valid measures of substance use and misuse.

Measuring Social Relationships in Different Social Systems: The Construction and Validation of the Evaluation of Social Systems (EVOS) Scale.

Social interactions have gained increasing importance, both as an outcome and as a possible mediator in psychotherapy research. Still, there is a lack of adequate measures capturing relational aspects in multi-person settings. We present a new measure to assess relevant dimensions of quality of relationships and collective efficacy regarding interpersonal interactions in diverse personal and professional social systems including couple partnerships, families, and working teams: the EVOS. Theoretical dimensions were derived from theories of systemic family therapy and organizational psychology. The study was divided in three parts: In Study 1 (N = 537), a short 9-item scale with two interrelated factors was constructed on the basis of exploratory factor analysis. Quality of relationship and collective efficacy emerged as the most relevant dimensions for the quality of social systems. Study 2 (N = 558) confirmed the measurement model using confirmatory factor analysis and established validity with measures of family functioning, life satisfaction, and working team efficacy. Measurement invariance was assessed to ensure that EVOS captures the same latent construct in all social contexts. In Study 3 (N = 317), an English language adaptation was developed, which again confirmed the original measurement model. The EVOS is a theory-based, economic, reliable, and valid measure that covers important aspects of social relationships, applicable for different social systems. It is the first instrument of its kind and an important addition to existing measures of social relationships and related outcome measures in therapeutic and other counseling settings involving multiple persons.

Development of risk perception and substance use of tobacco, alcohol and cannabis among adolescents and emerging adults: evidence of directional influences.

BACKGROUND: While several studies have investigated the relationship between risk perception and substance use, surprisingly little is known about mutual influences between both variables over time. OBJECTIVES: The present study aimed to explore two different hypotheses separately for tobacco, alcohol and cannabis: influences from risk perception on behavior (motivational hypothesis) and influences from behavior on risk perception (risk reappraisal hypothesis). METHODS: A prospective and longitudinal cross-lagged panel design was used with substance use and risk perception measured five times over the course of 10 years. Participants were 318 German youths aged 14-15 at the beginning of the study. Risk perception and substance use frequency were measured using self-reports. RESULTS: Structural equation modeling indicated significant influences of risk perception on substance use behavior for all substances, which supports the motivational hypothesis. Changes in risk perception predict changes in future substance use of tobacco, alcohol and cannabis. Specifically for cannabis, influences of substance use on risk perception can also be shown, thus, supporting the risk reappraisal hypothesis. CONCLUSIONS: While there is support for the rationale behind adequate risk perception as a goal of preventive interventions, the possibility of risk reappraisal should not be neglected, especially regarding illicit substances.

Two patterns of cannabis use among adolescents: results of a 10-year prospective study using a growth mixture model.

BACKGROUND: The present study aimed to distinguish cannabis consumption patterns among adolescents and to relate these to life satisfaction, academic achievement, and the use of other psychoactive substances. METHODS: This study used a prospective design. Cannabis use was measured 14 times over the course of 10 years. Participants were 318 adolescents aged 14 to 15 at the beginning of the study. RESULTS: Growth mixture modeling identified 2 latent classes. Class 1 was defined by phases of high-frequency cannabis use, and Class 2 was defined by low-frequency use or nonuse. Class 1 reported decreased satisfaction with life and one's own academic and professional achievement at the age of 24 as well as higher use of tobacco and illicit substances. CONCLUSIONS: High-frequency use of cannabis predicts a decreased satisfaction with life and one's own academic and professional achievement as well as an increased use of other substances.

Development of salutogenetic factors in mental health - Antonovsky's sense of coherence and Bandura's self-efficacy related to Derogatis' symptom check list (SCL-90-R).

BACKGROUND: The paper analyses how resilience factors and mental health problems interrelate in a 3-year-longitudinal study with 16-19 year olds. METHODS: Resilience was measured with a 13-item short version of the Life-Orientation-Scale by Antonovsky (sense-of-coherence, SOC) and a 10-item self-efficacy-scale (SWE) by Jerusalem and Schwarzer. Mental health problems were measured with Derogatis Symptom Check list (SCL-90-R). The data set included 155 participants and was analyzed using Structural Equation Modeling (SEM) designed to examine mutual influence in longitudinal data with Mplus software. RESULTS: The descriptive data analysis indicates (1) negative correlations between SOC and SCL-90-R at both age 16 and 19 in all subscales but somatization and likewise (2) between self-efficacy and SCL-90-R. (3) SOC correlates positively with SWE at age 16 and 19. Results of SEM analysis were based on the assumption of two latent variables at two points in time: resilience as measured with mean SOC and mean self-efficacy scores and health problems measured with sub scale scores of SCL-90-R - both at ages 16 and 19. The first SEM model included all possible paths between the two latent variables across time. We found (4) that resilience influences mental health problems cross-sectionally at age 16 and at age 19 but not across time. (5) Both resilience and mental health problems influenced their own development over time. A respecified SEM model included only significant paths. (6) Resilience at age 16 significantly influences health problems at age 16 as well as resilience at age 19. Health problems at age 16 influence those at age 19 and resilience at age 19 influences health problems at age 19. CONCLUSION: (a) SOC and self-efficacy instruments measure similar phenomena. (b) Since an influence of resilience on mental health problems and vice versa over time could not be shown there must be additional factors important to development. (c) SOC and self-efficacy are both very stable at 16 and 19 years. This refutes Antonovsky's assumption that SOC achieves stability first around the age of 30. SOC and self-efficacy are protective factors but they seem to form in (early) childhood.