The National Council Licensure Examination (NCLEX) program has evaluated differential item functi... more The National Council Licensure Examination (NCLEX) program has evaluated differential item functioning (DIF) using the Mantel-Haenszel (M-H) chi-square statistic. Since a Rasch model is assumed, DIF implies a difference in item difficulty between a reference group, e.g., White applicants, and a focal group, e.g., African-American applicants. The National Council of State Boards of Nursing (NCSBN) is planning to change the statistic used to evaluate DIF on the NCLEX from M-H to the separate calibration t-test (t). In actuality, M-H and t should yield identical results in large samples if the assumptions of the Rasch model hold (Linacre and Wright, 1989, also see Smith, 1996). However, as is true throughout statistics, "how large is large" is undefined, so it is quite possible that systematic differences exist in relatively smaller samples. This paper compares M-H and t in four sets of computer simulations. Three simulations used a ten-item test with nine fair items and one ...
Given the role of sleep in the development and treatment of major depressive disorder (MDD), it i... more Given the role of sleep in the development and treatment of major depressive disorder (MDD), it is becoming increasingly clear that elucidation of the biological mechanisms underlying sleep disturbances in MDD is crucial to improve treatment outcomes. Sleep disturbances are varied and can present as insomnia and/or hypersomnia. Though research has examined the biological underpinnings of insomnia in MDD, little is known about the role of biomarkers in hypersomnia associated with MDD. This paper examines biomarkers associated with changes in hypersomnia and insomnia and as predictors of improvements in sleep quality following exercise augmentation in persons with MDD. Subjects with non-remitted MDD were randomized to augmentation with one of two doses of aerobic exercise: 16 kilocalories per kilogram of body weight per week (KKW) or 4 KKW for 12 weeks. The four sleep-related items on the clinician-rated Inventory of Depressive Symptomatology (sleep onset insomnia, mid-nocturnal insom...
Journal of child and adolescent psychopharmacology, 2014
Although acute treatments have been shown to be effective in treating early-onset depression, onl... more Although acute treatments have been shown to be effective in treating early-onset depression, only one-third or thereabouts reach a remission within 3 months. Unfortunately, delayed time to remission in early-onset depression leads to poorer therapeutic outcomes. Clearly, there is a need to identify, diagnose, and provide effective treatment of a depressed patient quickly. A sophisticated understanding of depression subscales and their change over time with treatment could enhance pathways to individualized treatment approaches for childhood depression. Previous studies have found that the clinician-measured instrument, Children's Depression Rating Scale-Revised (CDRS-R) measures multiple subscales (or components) of depression. The aim of this study was to see how these subscales may change over the course of a 12-week study. This knowledge will help determine if dimensions/subscales of childhood depression (paralleling the adult literature) using the subscales derived from fac...
Journal of Child and Adolescent Psychopharmacology, 2010
Objective: The aim of this study was to present the reliability and validity of the Children's De... more Objective: The aim of this study was to present the reliability and validity of the Children's Depression Rating Scale-Revised (CDRS-R) in the adolescent age group. Method: Adolescents with symptoms of depression were assessed using the CDRS-R and global severity and functioning scales at screening, baseline, and after 12 weeks of fluoxetine treatment. Global improvement was also assessed at week 12 (or exit). Reliability and validity were analyzed using Classical Test Theory (item-total correlations and internal consistency) and correlations between the CDRS-R and other outcomes. Results: Adolescents (n ¼ 145) were evaluated at screening; 113 (77.9%) met criteria for major depressive disorder, 8 (5.5%) had subthreshold depressive symptoms, and 24 (16.6%) had minimal depressive symptoms. Ninety-four adolescents had a baseline visit after 1 week, and 88 were treated with fluoxetine. Internal consistency for the CDRS-R was good at all three visits (screening: 0.79; baseline: 0.74; exit: 0.92), and total score was highly correlated with global severity (r ¼ 0.87, 0.80, and 0.93; p < 0.01). Only exit CDRS-R score was significantly correlated with global functioning (Children's Global Assessment Scale; r ¼ À0.77; p < 0.01). Reductions on the CDRS-R total score were highly correlated with improvement scores at exit (Clinical Global Impressions-Improvement; r ¼ À0.83; p < 0.01). Conclusions: The results demonstrate good reliability and validity in adolescents with depression.
Background-The ability to convert total scores from one scale to another facilitates the interpre... more Background-The ability to convert total scores from one scale to another facilitates the interpretation of research findings and facilitates the use of systematic measurement in clinical practice. Methods-Item Response Theory methods were used to convert total scores between the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR 16) and the Montgomery Asberg Depression Rating Scale (MADRS) total scores. Data were obtained from a sample of 233 outpatients with highly treatment-resistant, nonpsychotic major depressive episodes participating in a one-year open label study of vagus nerve stimulation to augment psychotropic medication treatment. Results-MADRS total scores averaged 31.9 (SD=6.7) at baseline and 21.9 (SD=11.0) at one year. QIDS-SR 16 total scores averaged 17.6 (SD=3.6) at baseline and 12.5 (SD=5.8) at one year. Based on one-year data (or exit if the patient did not complete one year), corresponding QIDS-SR 16 and MADRS total scores were presented for each possible QIDS-SR 16 and MADRS total score. A QIDS-SR 16 total score of 5 was comparable to a MADRS total score of 7 or 8 (7.5). Limitation-The degree to which these results generalize to less treatment-resistant samples is unknown. Conclusion-The conversion of QIDS-SR 16 and MADRS total scores provides a basis for clinicians who wish to use the QIDS-SR 16 to understand what MADRS total scores reported in clinical trials approximate QIDS-SR 16 total scores obtained with their patients.
International Journal of Methods in Psychiatric Research, 2011
Both the 17-item Hamilton Rating Scale for Depression (HRSD 17) and 30-item Inventory of Depressi... more Both the 17-item Hamilton Rating Scale for Depression (HRSD 17) and 30-item Inventory of Depressive Symptomatology-Clinician-rated (IDS-C 30) contain a subscale that assesses anxious symptoms. We used classical test theory and item response theory methods to assess and compare the psychometric properties of the two anxiety subscales (HRSD ANX and IDS-C ANX) in a large sample (N = 3453) of outpatients with non-psychotic major depressive disorder in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Approximately 48% of evaluable participants had at least one concurrent anxiety disorder by the self-report Psychiatric Diagnostic Screening Questionnaire (PDSQ). The HRSD ANX and IDS-C ANX were highly correlated (r = 0.75) and both had moderate internal consistency given their limited number of items (HRSD ANX Cronbach's alpha = 0.48; IDS-C ANX Cronbach's alpha = 0.58). The optimal threshold for ascribing the presence/absence of anxious features was found at a total score of eight or nine for the HRSD ANX and seven or eight for the IDS-C ANX. It would seem beneficial to delete item 17 (loss of insight) from the HRSD ANX as it negatively correlated with the scale's total score. Both the HRSD ANX and IDS-C ANX subscales have acceptable psychometric properties and can be used to identify anxious features for clinical or research purposes.
Journal of the American Academy of Child & Adolescent Psychiatry, 2007
Objective-This study compared the psychometric properties of the Children's Depression Rating Sca... more Objective-This study compared the psychometric properties of the Children's Depression Rating Scale-Revised (CDRS-R) and the Montgomery-Asberg Depression Rating Scale (MADRS) in children with major depressive disorder (MDD). Method-Children (n=96) (8-11 years inclusive) with nonpsychotic MDD were enrolled. Participants were part of a multisite, outpatient, randomized, placebo-controlled, 9-week trial of fluoxetine (10 mg/day for the first week and 20 mg/day thereafter). The CDRS-R and MADRS were completed based on clinician interviews with both parents and children. Classical Test Theory and Item Response Theory analyses were conducted. Results-The MADRS and CDRS-R total scores were correlated at baseline (r=0.51) and at study exit (0.85). The Cronbach's alpha was 0.86 (CDRS-R) and 0.82 (MADRS) at exit. The effect sizes for change from baseline to exit between the fluoxetine and placebo groups were 0.78 (CDRS-R) and 0.61 (MADRS). Agreement between the CDRS-R and MADRS in the declaration of treatment response (50% improvement from baseline to exit) occurred in 84.2% of children. Test information function favored the CDRS-R. Conclusion-The CDRS-R showed greater effect size for differentiating drug and placebo and better test information than the MADRS in this study of depressed children.
Journal of the American Academy of Dermatology, 2014
Determining a disease&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp... more Determining a disease&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s impact on life quality is important in clinical decision making, research, and resource allocation. Determinants of quality of life (QOL) in morphea are poorly understood. We sought to ascertain demographic and clinical variables correlated with negative impact on self-reported QOL in morphea. We conducted a cross-sectional survey of the Morphea in Adults and Children cohort. Symptoms (pruritus and pain) and functional impairment were correlated with decreased QOL in children and adults. This was true in both sexes and was independent of subtype and age. Patient-reported QOL correlated with physician-based measures of disease severity in adults, but not in children. Patients with linear and generalized morphea had the greatest impact on QOL. Small sample size is a limitation. Symptoms and functional impairment were determinants of impaired life quality in both children and adults independent of morphea subtype. These results suggest that clinicians should consider suppressing the accumulation of new lesions (when rapidly accumulating) and symptoms (pain and pruritus) in the treatment of patients with morphea.
Objective: To evaluate psychometric properties and comparability ability of the Montgomery-Å sber... more Objective: To evaluate psychometric properties and comparability ability of the Montgomery-Å sberg Depression Rating Scale (MADRS) vs. the Quick Inventory of Depressive Symptomatology-Clinicianrated (QIDS-C 16) and Self-report (QIDS-SR 16) scales to detect a current major depressive episode in the elderly. Method: Community and clinic subjects (age ‡60 years) were administered the Mini-International Neuropsychiatric Interview (MINI) for DSM-IV and three depression scales randomly. Statistics included classical test and Samejima item response theories, factor analyzes, and receiver operating characteristic methods. Results: In 229 elderly patients (mean age = 73 years, 39% male, 54% current depression), all three scales were unidimensional and with nearly equal Cronbach a reliability (0.85-0.89). Each scale discriminated persons with major depression from the non-depressed, but the QIDS-C 16 was slightly more accurate. Conclusion: All three tests are valid for detecting geriatric major depression with the QIDS-C 16 being slightly better. Self-rated QIDS-SR 16 is recommended as a screening tool as it is least expensive and least time consuming.
Purpose: Job satisfaction plays a large role in enhancing retention and minimizing loss of physic... more Purpose: Job satisfaction plays a large role in enhancing retention and minimizing loss of physicians from careers in academic medicine. The authors explored the effect of learning communities (LCs) on the faculty members' job satisfaction. Methods: Between October 2011 and May 2012, the authors surveyed 150 academic clinical faculty members serving as LC mentors for students at five US medical schools. Factor analysis was used to explore satisfaction themes and relationships between these themes and other characteristics. Results: Factor analysis revealed two major sources of this satisfaction: a Campus Engagement factor (e.g., feeling happier, improved sense of community, better communication skills, and feeling more productive) and a skills factor (e.g., improved clinical skills, being a better doctor). Higher Campus Engagement factor satisfaction was associated with less desire to leave the learning community (p ¼ 0.01) and more FTE support for role in LC (p ¼ 0.01). Higher skills factor satisfaction was associated with the school that provided more structured faculty development (p ¼ 0.0001). Conclusion: Academic clinical faculty members reported serving as a mentor in an LC was a strong source of job satisfaction. LC may be a tool for retaining clinical faculty members in academic careers.
Http Dx Doi Org 10 1207 S15327906mbr1701_7, Jun 10, 2010
... n = 120) of police recruits were stable when applied to large police, security guard, and ...... more ... n = 120) of police recruits were stable when applied to large police, security guard, and ... To the extent these are the dimensions most relevant to the criteria, little true predictive ... and Raymond M. Co~stello Component I appears to represent a general pathology or elevation factor. ...
Http Dx Doi Org 10 1207 S15327752jpa4404_7, Jun 10, 2010
Absrract: A national security guard company administered the MMPI to all its guards following hir... more Absrract: A national security guard company administered the MMPI to all its guards following hiring. This paper presents the normative data derived from all guards hired during the 12 months of 1978 (n = 4534). The validity of I profile in 5 was questionable. However, I in 8 was ...
ABSTRACT Objective: To evaluate the psychometric properties and relations among the Quick Invento... more ABSTRACT Objective: To evaluate the psychometric properties and relations among the Quick Inventory of Depressive Symptomatology (QIDS-C16), clinical version, the Quick Inventory of Depressive Symptomatology, self-report version (QIDS-SR16), and the 17-item version of the Hamilton Rating Scale for Depression (HAM-D17) in a Turkish student sample Materials and methods: Slightly modified versions of the three scales were administered to 114 outpatients at the Uludağ University campus-based family health center. SAS, MPlus, Multilog, and SS-IRT were used to provide descriptive statistics, classical psychometric analyses, including factor analysis, test informations, and equatings of the three scale scores. Results: The internal consistencies (Cronbach’s a) values of the QIDS-C16, QIDS-SR16, and HAMD 17 were 0.81, 0.80, and 0.89. Both versions of the QIDS were unidimensional, but the HAM-D17 required two dimensions according to a parallel analysis criterion. The pattern of item-total correlations for the two versions of the QIDS was similar. The correlation between the QIDS-C16 and QIDS-SR16 was 0.70. Similarly, the correlation between the QIDS-C16 and HAM-D17 was 0.79, and the correlation between the QIDS-SR16 and the HAM-D17 was 0.59. These respective correlations increased to 0.87, 0.94 and 0.70 when disattenuated (corrected for unreliability). Scores on the three measures were also equated. Discussion: All three measures have good psychometric properties and convergent validity. In particular, this extends the utility of the QIDSSR 16, the object of a previous study. One important limitation in the present case is the small sample size (N = 114) Use of the QIDS-SR16 is recommended when a self-reported instrument is appropriate even though this measure has slightly less in common with the QIDS-C16 and HAM-D17 when clinical judgment is possible.
ABSTBACT Personality moderating vanables act to qualify the relationship between a personahty tra... more ABSTBACT Personality moderating vanables act to qualify the relationship between a personahty trait measure and a relevant behavioral cntenon Two data analytic techniques that can be used to test for significant moderating effects are the "median split" (MS) approach and the "moderated multiple regression" (MMR) approach The goals of the present research were (a) to apply the MS approach to computer-simulated data in which the moderator and trait extremity are confounded, to determine the extent of artifact, and ib) to compare the performance (Type I and Type II error rates) of the two approaches when applied to confounded and nonconfounded data It was found that when the MS approach was apphed to confounded data in which no real moderating effect existed, this approach produced an alarming rate of apparent, but spunous, moderating effects When the MMR approach was applied to the same data, the rate of spunous effects was reduced to that expected by chance When both approaches were apphed to simulated data which contamed genuine moderatmg effects, the MMR approach consistently resulted m more correct detections of these effects than the MS approach We conclude tiiat researchers should always employ the MMR rather than the MS approach when testmg for personality moderator vanable effects The authors would like to thank David Kenny and two ad hoc reviewers for their comments on previous versicnis of this article Repnnt requests and other correspondence should be sent to
The National Council Licensure Examination (NCLEX) program has evaluated differential item functi... more The National Council Licensure Examination (NCLEX) program has evaluated differential item functioning (DIF) using the Mantel-Haenszel (M-H) chi-square statistic. Since a Rasch model is assumed, DIF implies a difference in item difficulty between a reference group, e.g., White applicants, and a focal group, e.g., African-American applicants. The National Council of State Boards of Nursing (NCSBN) is planning to change the statistic used to evaluate DIF on the NCLEX from M-H to the separate calibration t-test (t). In actuality, M-H and t should yield identical results in large samples if the assumptions of the Rasch model hold (Linacre and Wright, 1989, also see Smith, 1996). However, as is true throughout statistics, "how large is large" is undefined, so it is quite possible that systematic differences exist in relatively smaller samples. This paper compares M-H and t in four sets of computer simulations. Three simulations used a ten-item test with nine fair items and one ...
Given the role of sleep in the development and treatment of major depressive disorder (MDD), it i... more Given the role of sleep in the development and treatment of major depressive disorder (MDD), it is becoming increasingly clear that elucidation of the biological mechanisms underlying sleep disturbances in MDD is crucial to improve treatment outcomes. Sleep disturbances are varied and can present as insomnia and/or hypersomnia. Though research has examined the biological underpinnings of insomnia in MDD, little is known about the role of biomarkers in hypersomnia associated with MDD. This paper examines biomarkers associated with changes in hypersomnia and insomnia and as predictors of improvements in sleep quality following exercise augmentation in persons with MDD. Subjects with non-remitted MDD were randomized to augmentation with one of two doses of aerobic exercise: 16 kilocalories per kilogram of body weight per week (KKW) or 4 KKW for 12 weeks. The four sleep-related items on the clinician-rated Inventory of Depressive Symptomatology (sleep onset insomnia, mid-nocturnal insom...
Journal of child and adolescent psychopharmacology, 2014
Although acute treatments have been shown to be effective in treating early-onset depression, onl... more Although acute treatments have been shown to be effective in treating early-onset depression, only one-third or thereabouts reach a remission within 3 months. Unfortunately, delayed time to remission in early-onset depression leads to poorer therapeutic outcomes. Clearly, there is a need to identify, diagnose, and provide effective treatment of a depressed patient quickly. A sophisticated understanding of depression subscales and their change over time with treatment could enhance pathways to individualized treatment approaches for childhood depression. Previous studies have found that the clinician-measured instrument, Children's Depression Rating Scale-Revised (CDRS-R) measures multiple subscales (or components) of depression. The aim of this study was to see how these subscales may change over the course of a 12-week study. This knowledge will help determine if dimensions/subscales of childhood depression (paralleling the adult literature) using the subscales derived from fac...
Journal of Child and Adolescent Psychopharmacology, 2010
Objective: The aim of this study was to present the reliability and validity of the Children's De... more Objective: The aim of this study was to present the reliability and validity of the Children's Depression Rating Scale-Revised (CDRS-R) in the adolescent age group. Method: Adolescents with symptoms of depression were assessed using the CDRS-R and global severity and functioning scales at screening, baseline, and after 12 weeks of fluoxetine treatment. Global improvement was also assessed at week 12 (or exit). Reliability and validity were analyzed using Classical Test Theory (item-total correlations and internal consistency) and correlations between the CDRS-R and other outcomes. Results: Adolescents (n ¼ 145) were evaluated at screening; 113 (77.9%) met criteria for major depressive disorder, 8 (5.5%) had subthreshold depressive symptoms, and 24 (16.6%) had minimal depressive symptoms. Ninety-four adolescents had a baseline visit after 1 week, and 88 were treated with fluoxetine. Internal consistency for the CDRS-R was good at all three visits (screening: 0.79; baseline: 0.74; exit: 0.92), and total score was highly correlated with global severity (r ¼ 0.87, 0.80, and 0.93; p < 0.01). Only exit CDRS-R score was significantly correlated with global functioning (Children's Global Assessment Scale; r ¼ À0.77; p < 0.01). Reductions on the CDRS-R total score were highly correlated with improvement scores at exit (Clinical Global Impressions-Improvement; r ¼ À0.83; p < 0.01). Conclusions: The results demonstrate good reliability and validity in adolescents with depression.
Background-The ability to convert total scores from one scale to another facilitates the interpre... more Background-The ability to convert total scores from one scale to another facilitates the interpretation of research findings and facilitates the use of systematic measurement in clinical practice. Methods-Item Response Theory methods were used to convert total scores between the 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR 16) and the Montgomery Asberg Depression Rating Scale (MADRS) total scores. Data were obtained from a sample of 233 outpatients with highly treatment-resistant, nonpsychotic major depressive episodes participating in a one-year open label study of vagus nerve stimulation to augment psychotropic medication treatment. Results-MADRS total scores averaged 31.9 (SD=6.7) at baseline and 21.9 (SD=11.0) at one year. QIDS-SR 16 total scores averaged 17.6 (SD=3.6) at baseline and 12.5 (SD=5.8) at one year. Based on one-year data (or exit if the patient did not complete one year), corresponding QIDS-SR 16 and MADRS total scores were presented for each possible QIDS-SR 16 and MADRS total score. A QIDS-SR 16 total score of 5 was comparable to a MADRS total score of 7 or 8 (7.5). Limitation-The degree to which these results generalize to less treatment-resistant samples is unknown. Conclusion-The conversion of QIDS-SR 16 and MADRS total scores provides a basis for clinicians who wish to use the QIDS-SR 16 to understand what MADRS total scores reported in clinical trials approximate QIDS-SR 16 total scores obtained with their patients.
International Journal of Methods in Psychiatric Research, 2011
Both the 17-item Hamilton Rating Scale for Depression (HRSD 17) and 30-item Inventory of Depressi... more Both the 17-item Hamilton Rating Scale for Depression (HRSD 17) and 30-item Inventory of Depressive Symptomatology-Clinician-rated (IDS-C 30) contain a subscale that assesses anxious symptoms. We used classical test theory and item response theory methods to assess and compare the psychometric properties of the two anxiety subscales (HRSD ANX and IDS-C ANX) in a large sample (N = 3453) of outpatients with non-psychotic major depressive disorder in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Approximately 48% of evaluable participants had at least one concurrent anxiety disorder by the self-report Psychiatric Diagnostic Screening Questionnaire (PDSQ). The HRSD ANX and IDS-C ANX were highly correlated (r = 0.75) and both had moderate internal consistency given their limited number of items (HRSD ANX Cronbach's alpha = 0.48; IDS-C ANX Cronbach's alpha = 0.58). The optimal threshold for ascribing the presence/absence of anxious features was found at a total score of eight or nine for the HRSD ANX and seven or eight for the IDS-C ANX. It would seem beneficial to delete item 17 (loss of insight) from the HRSD ANX as it negatively correlated with the scale's total score. Both the HRSD ANX and IDS-C ANX subscales have acceptable psychometric properties and can be used to identify anxious features for clinical or research purposes.
Journal of the American Academy of Child & Adolescent Psychiatry, 2007
Objective-This study compared the psychometric properties of the Children's Depression Rating Sca... more Objective-This study compared the psychometric properties of the Children's Depression Rating Scale-Revised (CDRS-R) and the Montgomery-Asberg Depression Rating Scale (MADRS) in children with major depressive disorder (MDD). Method-Children (n=96) (8-11 years inclusive) with nonpsychotic MDD were enrolled. Participants were part of a multisite, outpatient, randomized, placebo-controlled, 9-week trial of fluoxetine (10 mg/day for the first week and 20 mg/day thereafter). The CDRS-R and MADRS were completed based on clinician interviews with both parents and children. Classical Test Theory and Item Response Theory analyses were conducted. Results-The MADRS and CDRS-R total scores were correlated at baseline (r=0.51) and at study exit (0.85). The Cronbach's alpha was 0.86 (CDRS-R) and 0.82 (MADRS) at exit. The effect sizes for change from baseline to exit between the fluoxetine and placebo groups were 0.78 (CDRS-R) and 0.61 (MADRS). Agreement between the CDRS-R and MADRS in the declaration of treatment response (50% improvement from baseline to exit) occurred in 84.2% of children. Test information function favored the CDRS-R. Conclusion-The CDRS-R showed greater effect size for differentiating drug and placebo and better test information than the MADRS in this study of depressed children.
Journal of the American Academy of Dermatology, 2014
Determining a disease&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp... more Determining a disease&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s impact on life quality is important in clinical decision making, research, and resource allocation. Determinants of quality of life (QOL) in morphea are poorly understood. We sought to ascertain demographic and clinical variables correlated with negative impact on self-reported QOL in morphea. We conducted a cross-sectional survey of the Morphea in Adults and Children cohort. Symptoms (pruritus and pain) and functional impairment were correlated with decreased QOL in children and adults. This was true in both sexes and was independent of subtype and age. Patient-reported QOL correlated with physician-based measures of disease severity in adults, but not in children. Patients with linear and generalized morphea had the greatest impact on QOL. Small sample size is a limitation. Symptoms and functional impairment were determinants of impaired life quality in both children and adults independent of morphea subtype. These results suggest that clinicians should consider suppressing the accumulation of new lesions (when rapidly accumulating) and symptoms (pain and pruritus) in the treatment of patients with morphea.
Objective: To evaluate psychometric properties and comparability ability of the Montgomery-Å sber... more Objective: To evaluate psychometric properties and comparability ability of the Montgomery-Å sberg Depression Rating Scale (MADRS) vs. the Quick Inventory of Depressive Symptomatology-Clinicianrated (QIDS-C 16) and Self-report (QIDS-SR 16) scales to detect a current major depressive episode in the elderly. Method: Community and clinic subjects (age ‡60 years) were administered the Mini-International Neuropsychiatric Interview (MINI) for DSM-IV and three depression scales randomly. Statistics included classical test and Samejima item response theories, factor analyzes, and receiver operating characteristic methods. Results: In 229 elderly patients (mean age = 73 years, 39% male, 54% current depression), all three scales were unidimensional and with nearly equal Cronbach a reliability (0.85-0.89). Each scale discriminated persons with major depression from the non-depressed, but the QIDS-C 16 was slightly more accurate. Conclusion: All three tests are valid for detecting geriatric major depression with the QIDS-C 16 being slightly better. Self-rated QIDS-SR 16 is recommended as a screening tool as it is least expensive and least time consuming.
Purpose: Job satisfaction plays a large role in enhancing retention and minimizing loss of physic... more Purpose: Job satisfaction plays a large role in enhancing retention and minimizing loss of physicians from careers in academic medicine. The authors explored the effect of learning communities (LCs) on the faculty members' job satisfaction. Methods: Between October 2011 and May 2012, the authors surveyed 150 academic clinical faculty members serving as LC mentors for students at five US medical schools. Factor analysis was used to explore satisfaction themes and relationships between these themes and other characteristics. Results: Factor analysis revealed two major sources of this satisfaction: a Campus Engagement factor (e.g., feeling happier, improved sense of community, better communication skills, and feeling more productive) and a skills factor (e.g., improved clinical skills, being a better doctor). Higher Campus Engagement factor satisfaction was associated with less desire to leave the learning community (p ¼ 0.01) and more FTE support for role in LC (p ¼ 0.01). Higher skills factor satisfaction was associated with the school that provided more structured faculty development (p ¼ 0.0001). Conclusion: Academic clinical faculty members reported serving as a mentor in an LC was a strong source of job satisfaction. LC may be a tool for retaining clinical faculty members in academic careers.
Http Dx Doi Org 10 1207 S15327906mbr1701_7, Jun 10, 2010
... n = 120) of police recruits were stable when applied to large police, security guard, and ...... more ... n = 120) of police recruits were stable when applied to large police, security guard, and ... To the extent these are the dimensions most relevant to the criteria, little true predictive ... and Raymond M. Co~stello Component I appears to represent a general pathology or elevation factor. ...
Http Dx Doi Org 10 1207 S15327752jpa4404_7, Jun 10, 2010
Absrract: A national security guard company administered the MMPI to all its guards following hir... more Absrract: A national security guard company administered the MMPI to all its guards following hiring. This paper presents the normative data derived from all guards hired during the 12 months of 1978 (n = 4534). The validity of I profile in 5 was questionable. However, I in 8 was ...
ABSTRACT Objective: To evaluate the psychometric properties and relations among the Quick Invento... more ABSTRACT Objective: To evaluate the psychometric properties and relations among the Quick Inventory of Depressive Symptomatology (QIDS-C16), clinical version, the Quick Inventory of Depressive Symptomatology, self-report version (QIDS-SR16), and the 17-item version of the Hamilton Rating Scale for Depression (HAM-D17) in a Turkish student sample Materials and methods: Slightly modified versions of the three scales were administered to 114 outpatients at the Uludağ University campus-based family health center. SAS, MPlus, Multilog, and SS-IRT were used to provide descriptive statistics, classical psychometric analyses, including factor analysis, test informations, and equatings of the three scale scores. Results: The internal consistencies (Cronbach’s a) values of the QIDS-C16, QIDS-SR16, and HAMD 17 were 0.81, 0.80, and 0.89. Both versions of the QIDS were unidimensional, but the HAM-D17 required two dimensions according to a parallel analysis criterion. The pattern of item-total correlations for the two versions of the QIDS was similar. The correlation between the QIDS-C16 and QIDS-SR16 was 0.70. Similarly, the correlation between the QIDS-C16 and HAM-D17 was 0.79, and the correlation between the QIDS-SR16 and the HAM-D17 was 0.59. These respective correlations increased to 0.87, 0.94 and 0.70 when disattenuated (corrected for unreliability). Scores on the three measures were also equated. Discussion: All three measures have good psychometric properties and convergent validity. In particular, this extends the utility of the QIDSSR 16, the object of a previous study. One important limitation in the present case is the small sample size (N = 114) Use of the QIDS-SR16 is recommended when a self-reported instrument is appropriate even though this measure has slightly less in common with the QIDS-C16 and HAM-D17 when clinical judgment is possible.
ABSTBACT Personality moderating vanables act to qualify the relationship between a personahty tra... more ABSTBACT Personality moderating vanables act to qualify the relationship between a personahty trait measure and a relevant behavioral cntenon Two data analytic techniques that can be used to test for significant moderating effects are the "median split" (MS) approach and the "moderated multiple regression" (MMR) approach The goals of the present research were (a) to apply the MS approach to computer-simulated data in which the moderator and trait extremity are confounded, to determine the extent of artifact, and ib) to compare the performance (Type I and Type II error rates) of the two approaches when applied to confounded and nonconfounded data It was found that when the MS approach was apphed to confounded data in which no real moderating effect existed, this approach produced an alarming rate of apparent, but spunous, moderating effects When the MMR approach was applied to the same data, the rate of spunous effects was reduced to that expected by chance When both approaches were apphed to simulated data which contamed genuine moderatmg effects, the MMR approach consistently resulted m more correct detections of these effects than the MS approach We conclude tiiat researchers should always employ the MMR rather than the MS approach when testmg for personality moderator vanable effects The authors would like to thank David Kenny and two ad hoc reviewers for their comments on previous versicnis of this article Repnnt requests and other correspondence should be sent to
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