Development and Validation of the Food-Craving Inventory

Objective: The primary aim of this study was to develop and validate the Food-Craving Inventory (FCI), a self-report measure of specific food cravings. Research Methods and Procedures: In a preliminary study, participants (n = 474) completed the initial version of the FCI. The results from this study were used in developing the revised FCI. Participants (n = 379) completed the revised FCI in the primary study designed to develop a self-report measure of specific food cravings. Results: Common factor analysis yielded four conceptual factors (subscales) that were interpreted as high fats, sweets, carbohydrates/starches, and fast-food fats. Confirmatory factor analysis found that the four factors could be modeled as dimensions (or first-order factors) of a higher order construct—food craving. Test–retest and internal consistency analyses indicated good reliability for the total score and each of the subscales. Subscale scores were compared with scores on the Three Factor Eating Questionnaire and a conceptual measure of food craving. We found support for the content, concurrent, construct, and discriminant validity of the FCI. Discussion: The FCI was found to be a reliable and valid measure of general and specific food cravings. The FCI can be used in research related to overeating and binge eating. Also, it may be useful in treatment studies that target obesity and/or food cravings.     

Development and Validation of the Keele Musculoskeletal Patient Reported Outcome Measure (MSK-PROM)

Objective

To develop and validate a patient report outcome measure (PROM) for clinical practice that can monitor health status of patients with a range of musculoskeletal (MSK) disorders.

Methods

Constructs for inclusion in the MSK-PROM were identified from a consensus process involving patients with musculoskeletal conditions, clinicians, purchasers of healthcare services, and primary care researchers. Psychometric properties of the brief tool, including face and construct validity, repeatability and responsiveness were assessed in a sample of patients with musculoskeletal pain consulting physiotherapy services in the United Kingdom (n=425).

Results

The consensus process identified 10 prioritised domains for monitoring musculoskeletal health status: pain intensity, quality of life, physical capacity, interference with social/leisure activities, emotional well-being, severity of most difficult thing, activities and roles, understanding independence, and overall impact. As the EuroQol (EQ-5D-5L) is a widely adopted PROMs tool and covers the first four domains listed, to reduce patient burden to a minimum the MSK-PROM was designed to capture the remaining six prioritised domains which are not measured by the EQ-5D-5L. The tool demonstrated excellent reliability, construct validity, responsiveness and acceptability to patients and clinicians for use in clinical practice.

Conclusion

We have validated a brief patient reported outcome measure (MSK-PROM) for use in clinical practice to measure musculoskeletal health status and monitor outcomes over time using domains that are meaningful to patients and sensitive to change. Further work will establish whether the MSK-PROM is useful in other musculoskeletal healthcare settings.     

Plasma Neutrophil Elastase and Elafin Imbalance Is Associated with Acute Respiratory Distress Syndrome (ARDS) Development

Background

We conducted an exploratory study of genome-wide gene expression in whole blood and found that the expression of neutrophil elastase inhibitor (PI3, elafin) was down-regulated during the early phase of ARDS. Further analyses of plasma PI3 levels revealed a rapid decrease during early ARDS development. PI3 and secretory leukocyte proteinase inhibitor (SLPI) are important low-molecular-weight proteinase inhibitors produced locally at neutrophil infiltration site in the lung. In this study, we tested the hypothesis that an imbalance between neutrophil elastase (HNE) and its inhibitors in blood is related to the development of ARDS.

Methodology/Principal Findings

PI3, SLPI, and HNE were measured in plasma samples collected from 148 ARDS patients and 63 critical ill patients at risk for ARDS (controls). Compared with the controls, the ARDS patients had higher HNE, but lower PI3, at the onset of ARDS, resulting in increased HNE/PI3 ratio (mean = 14.5; 95% CI, 10.9–19.4, P<0.0001), whereas plasma SLPI was not associated with the risk of ARDS development. Although the controls had elevated plasma PI3 and HNE, their HNE/PI3 ratio (mean = 6.5; 95% CI, 4.9–8.8) was not significantly different from the healthy individuals (mean = 3.9; 95% CI, 2.7–5.9). Before the onset (7-days period prior to ARDS diagnosis), we only observed significantly elevated HNE, but the HNE-PI3 balance remained normal. With the progress from prior to the onset of ARDS, the plasma level of PI3 declined, whereas HNE was maintained at a higher level, tilting the balance toward more HNE in the circulation as characterized by an increased HNE/PI3 ratio. In contrast, three days after ICU admission, there was a significant drop of HNE/PI3 ratio in the at-risk controls.

Conclusions/Significance

Plasma profiles of PI3, HNE, and HNE/PI3 may be useful clinical biomarkers in monitoring the development of ARDS.     

Validation of an Instrument to Measure Older Adults' Expectations Regarding Movement (ERM)

Background

Many individuals with Parkinson''s disease are not diagnosed and treated. Attitudes about aging and related help-seeking may affect the timely diagnosis of Parkinson''s disease. Our objectives were to develop measures of older adults'' expectations regarding movement with aging, specifically related to parkinsonism, and their beliefs about seeking healthcare for the diagnosis and treatment of parkinsonism.

Methods

We established content and face validity from interviews with experts, review of the literature, and pre-testing with key informants. Two 9-item instruments resulted: Expectations Regarding Movement (ERM) and Healthcare Seeking Beliefs for parkinsonism (HSB). These instruments were administered to 210 older adults at senior centers to investigate internal consistency and construct validity.

Results

192 (91%) of the older adults completed more than 90% of the survey. The mean age was 76; 17 (9%) reported parkinsonism. Both scales demonstrated good internal consistency (α = 0.90). Factor analysis supported construct validity of the ERM and HSB scores. Older age, lower education, worse self-reported health and African American race each were associated with lower ERM scores, but not HSB scores.

Conclusion

The ERM, a brief measure of expectations regarding movement with aging, shows reliability and validity. This scale may be useful in identifying older adults at increased risk for under-identification of Parkinson''s disease. Further work is needed to measure healthcare seeking for parkinsonism.     

Development and Validation of a Smartphone Addiction Scale (SAS)

Objective

The aim of this study was to develop a self-diagnostic scale that could distinguish smartphone addicts based on the Korean self-diagnostic program for Internet addiction (K-scale) and the smartphone''s own features. In addition, the reliability and validity of the smartphone addiction scale (SAS) was demonstrated.

Methods

A total of 197 participants were selected from Nov. 2011 to Jan. 2012 to accomplish a set of questionnaires, including SAS, K-scale, modified Kimberly Young Internet addiction test (Y-scale), visual analogue scale (VAS), and substance dependence and abuse diagnosis of DSM-IV. There were 64 males and 133 females, with ages ranging from 18 to 53 years (M = 26.06; SD = 5.96). Factor analysis, internal-consistency test, t-test, ANOVA, and correlation analysis were conducted to verify the reliability and validity of SAS.

Results

Based on the factor analysis results, the subscale “disturbance of reality testing” was removed, and six factors were left. The internal consistency and concurrent validity of SAS were verified (Cronbach''s alpha = 0.967). SAS and its subscales were significantly correlated with K-scale and Y-scale. The VAS of each factor also showed a significant correlation with each subscale. In addition, differences were found in the job (p<0.05), education (p<0.05), and self-reported smartphone addiction scores (p<0.001) in SAS.

Conclusions

This study developed the first scale of the smartphone addiction aspect of the diagnostic manual. This scale was proven to be relatively reliable and valid.     

Development and Validation of a New Method to Measure Walking Speed in Free-Living Environments Using the Actibelt? Platform

Walking speed is a fundamental indicator for human well-being. In a clinical setting, walking speed is typically measured by means of walking tests using different protocols. However, walking speed obtained in this way is unlikely to be representative of the conditions in a free-living environment. Recently, mobile accelerometry has opened up the possibility to extract walking speed from long-time observations in free-living individuals, but the validity of these measurements needs to be determined. In this investigation, we have developed algorithms for walking speed prediction based on 3D accelerometry data (actibelt®) and created a framework using a standardized data set with gold standard annotations to facilitate the validation and comparison of these algorithms. For this purpose 17 healthy subjects operated a newly developed mobile gold standard while walking/running on an indoor track. Subsequently, the validity of 12 candidate algorithms for walking speed prediction ranging from well-known simple approaches like combining step length with frequency to more sophisticated algorithms such as linear and non-linear models was assessed using statistical measures. As a result, a novel algorithm employing support vector regression was found to perform best with a concordance correlation coefficient of 0.93 (95%CI 0.92–0.94) and a coverage probability CP1 of 0.46 (95%CI 0.12–0.70) for a deviation of 0.1 m/s (CP2 0.78, CP3 0.94) when compared to the mobile gold standard while walking indoors. A smaller outdoor experiment confirmed those results with even better coverage probability. We conclude that walking speed thus obtained has the potential to help establish walking speed in free-living environments as a patient-oriented outcome measure.     

Olfactory Thresholds of the U.S. Population of Home-Dwelling Older Adults: Development and Validation of a Short,Reliable Measure

Current methods of olfactory sensitivity testing are logistically challenging and therefore infeasible for use in in-home surveys and other field settings. We developed a fast, easy and reliable method of assessing olfactory thresholds, and used it in the first study of olfactory sensitivity in a nationally representative sample of U.S. home-dwelling older adults. We validated our method via computer simulation together with a model estimated from 590 normosmics. Simulated subjects were assigned n-butanol thresholds drawn from the estimated normosmic distribution and based on these and the model, we simulated administration of both the staircase and constant stimuli methods. Our results replicate both the correlation between the two methods and their reliability as previously reported by studies using human subjects. Further simulations evaluated the reliability of different constant stimuli protocols, varying both the range of dilutions and number of stimuli (6–16). Six appropriately chosen dilutions were sufficient for good reliability (0.67) in normosmic subjects. Finally, we applied our method to design a 5-minute, in-home assessment of older adults (National Social Life, Health and Aging Project, or NSHAP), which had comparable reliability (0.56), despite many subjects having estimated thresholds above the strongest dilution. Thus, testing with a fast, 6-item constant stimuli protocol is informative, and permits olfactory testing in previously inaccessible research settings.     

Evolutionary Attitudes and Literacy Survey (EALS): Development and Validation of a Short Form

The Evolutionary Attitudes and Literacy Survey (EALS) is a multidimensional scale consisting of 16 lower- and 6 higher-order constructs developed to measure the wide array of factors that influence both an individual??s endorsement of and objection to evolutionary theory. Past research has demonstrated the validity and utility of the EALS (Hawley et al., Evol Educ Outreach 4:117?C132, 2011); however, the 104-item long-form scale may be excessive for researchers and educators. The present study sought to reduce the number of items in the EALS while maintaining the validity and structure of the long form. For the present study, and following best practices for short-form construction, we surveyed a new sample of several hundred undergraduates from multiple majors and reduced the long form by 40% while maintaining the scale structure and validity. A multiple-group confirmatory factor analysis supported strong factorial invariance across samples, and therefore verified structure and pattern between the six higher-order constructs of the long-form EALS and the EALS short form (EALS-SF). Regression analysis further demonstrated the short form??s validity (i.e., demographics and openness to experience) and replicated previous findings. In the end, the EALS-SF may be a versatile tool that may be used whole or in part for a variety of research areas, including curricular effectiveness of courses on evolution and/or biology.     

Validation and Reliability of a Classification Method to Measure the Time Spent Performing Different Activities

The aim of this study was to validate the performance and reliability of results obtained from a classification model that measures time spent performing activities in confined (CE) and unrestricted (UE) environments. In CE, participants wore a pair of biaxial and/or triaxial accelerometers while performing pre-determined training activities classified as variants of lying down, dynamic standing, sitting, walking and running on two separate days. A classification model trained with activities performed in a specific order during the first day was developed to validate the activities performed in a random order on the second day (CE) and over 24 hours on a separate day (UE). The performance of the classification model was validated against triaxial accelerometers using six (x, y and step counts for arm and thigh) or eight (same as six features plus z axis) features. The reliability of the classification model was tested in both environments using six features. Results revealed an overall accuracy of 94% in CE and 90% in UE. The sensitivity in CE and UE was 94% and 95% for lying down, 88% and 80% for dynamic standing, 97% and 89% for sitting, 96% and 78% for walking and 90% and 64% for running, respectively. No significant differences were noted between performances obtained with six or eight features. Results were highly reproducible in both environments. The results obtained from the classification model were accurate and reproducible, and highlight the potential use of this approach in research to quantify the time spent performing different activities.     

Advances in the Conceptualization and Measurement of Health Care Empowerment: Development and Validation of the Health Care Empowerment Inventory

The Health Care Empowerment Model offers direction for the investigation of patient-controlled engagement and involvement in health care. At the core of the model is the construct of Health Care Empowerment (HCE), for which there exist no validated measures. A set of 27 candidate self-report survey items was constructed to capture five hypothesized inter-related facets of HCE (informed, engaged, committed, collaborative, and tolerant of uncertainty). The full item set was administered to 644 HIV-infected persons enrolled in three ongoing research studies. Exploratory and confirmatory factor analyses resulted in a two factor solution comprising four items each on two subscales: (1) HCE: Informed, Committed, Collaborative, and Engaged HCE ICCE) and (2) HCE Tolerance of Uncertainty (HCE TU). Subscale scores were evaluated for relationships with relevant constructs measured in the three studies, including depression, provider relationships, medication adherence, and HIV-1 viral load. Findings suggest the utility of this 8-item Health Care Empowerment Inventory (HCEI) in efforts to measure, understand, and track changes in the ways in which individuals engage in health care.     

Emergency Room Validation of the Revised Suicide Trigger Scale (STS-3): A Measure of a Hypothesized Suicide Trigger State

Background

The Suicide Trigger Scale (STS) was designed to measure the construct of an affective ‘suicide trigger state.’ This study aims to extend the inpatient setting validation study of the original Suicide Trigger Scale version 2 to the revised Suicide Trigger Scale version 3 (STS-3) in an acute psychiatric emergency room setting.

Methods

The 42-item STS-3 and a brief psychological test battery were administered to 183 adult psychiatric patients with suicidal ideation or attempt in the psychiatric emergency room, and re-administered to subjects at 1 year follow up. Factor analysis, linear and logistic regressions were used to examine construct structure, divergent and convergent validity, and construct validity, respectively.

Results

The STS-3 demonstrated strong internal consistency (Cronbach’s alpha 0.94). Factor analysis yielded a three-factor solution, which explained 43.4% of the variance. Principal axis factor analysis was used to identify three reliable subscales: Frantic Hopelessness, Ruminative Flooding, and Near-Psychotic Somatization (Cronbach’s alphas 0.90, 0.80, and 0.76, respectively). Significant positive associations were observed between Frantic Hopelessness and BSI depression and anxiety subscales, between Ruminative Flooding and BSI anxiety and paranoia subscales, and Near Psychotic Somatization and BSI somatization subscales. Suicidal subjects with suicide attempt history had mean scores 7 points higher than those without history of suicide attempts. Frantic hopelessness was a significant predictor of current suicide attempt when only attempts requiring at least some medical attention were considered.

Conclusion

The STS-3 measures a distinct clinical entity, provisionally termed the ‘suicide trigger state.’ Scores on the STS-3 or select subscales appear to relate to degree of suicidality in terms of severity of ideation, history of attempt, and presence of substantive current attempts. Further study is required to confirm the factor structure and better understand the nature of these relations.     

Development and Validation of a Biomarker for Diarrhea-Predominant Irritable Bowel Syndrome in Human Subjects

Diarrhea-predominant irritable bowel syndrome (IBS) is diagnosed through clinical criteria after excluding “organic” conditions, and can be precipitated by acute gastroenteritis. Cytolethal distending toxin B (CdtB) is produced by bacteria that cause acute gastroenteritis, and a post-infectious animal model demonstrates that host antibodies to CdtB cross-react with vinculin in the host gut, producing an IBS-like phenotype. Therefore, we assessed circulating anti-CdtB and anti-vinculin antibodies as biomarkers for D-IBS in human subjects. Subjects with D-IBS based on Rome criteria (n=2375) were recruited from a large-scale multicenter clinical trial for D-IBS (TARGET 3). Subjects with inflammatory bowel disease (IBD) (n=142), subjects with celiac disease (n=121), and healthy controls (n=43) were obtained for comparison. Subjects with IBD and celiac disease were recruited based on the presence of intestinal complaints and histologic confirmation of chronic inflammatory changes in the colon or small intestine. Subjects with celiac disease were also required to have an elevated tTG and biopsy. All subjects were aged between 18 and 65 years. Plasma levels of anti-CdtB and anti-vinculin antibodies were determined by ELISA, and compared between groups. Anti-CdtB titers were significantly higher in D-IBS subjects compared to IBD, healthy controls and celiac disease (P<0.001). Anti-vinculin titers were also significantly higher in IBS (P<0.001) compared to the other groups. The area-under-the-receiver operating curves (AUCs) were 0.81 and 0.62 for diagnosis of D-IBS against IBD for anti-CdtB and anti-vinculin, respectively. Both tests were less specific in differentiating IBS from celiac disease. Optimization demonstrated that for anti-CdtB (optical density≥2.80) the specificity, sensitivity and likelihood ratio were 91.6%, 43.7 and 5.2, respectively, and for anti-vinculin (OD≥1.68) were 83.8%, 32.6 and 2.0, respectively. These results confirm that anti-CdtB and anti-vinculin antibodies are elevated in D-IBS compared to non-IBS subjects. These biomarkers may be especially helpful in distinguishing D-IBS from IBD in the workup of chronic diarrhea.     

The Development and Validation of the Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia

ObjectivesTo develop and validate Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia.MethodsThe OPAAT was modified from the Malaysian Osteoporosis Knowledge Tool and developed from an exploratory study on patients. Face and content validity was established by an expert panel. The OPAAT consists of 30 items, categorized into three domains. A higher score indicates higher knowledge level. English speaking non-osteoporotic postmenopausal women ≥50 years of age and pharmacists were included in the study.ResultsA total of 203 patients and 31 pharmacists were recruited. Factor analysis extracted three domains. Flesch reading ease was 59.2. The mean±SD accuracy rate was 0.60±0.22 (range: 0.26-0.94). The Cronbach’s α for each domain ranged from 0.286-0.748. All items were highly correlated (Spearman’s rho: 0.761-0.990, p<0.05), with no significant change in the overall test-retest scores, indicating that OPAAT has achieved stable reliability. Pharmacists had higher knowledge score than patients (80.9±8.7vs63.6±17.4, p<0.001), indicating that the OPAAT was able to discriminate between the knowledge levels of pharmacists and patients.ConclusionThe OPAAT was found to be a valid and reliable instrument for assessing patient’s knowledge about osteoporosis and its prevention in Malaysia. The OPAAT can be used to identify individuals in need of osteoporosis educational intervention.     

Development and Validation of the Single Item Narcissism Scale (SINS)

Main Objectives

The narcissistic personality is characterized by grandiosity, entitlement, and low empathy. This paper describes the development and validation of the Single Item Narcissism Scale (SINS). Although the use of longer instruments is superior in most circumstances, we recommend the SINS in some circumstances (e.g. under serious time constraints, online studies).

Methods

In 11 independent studies (total N = 2,250), we demonstrate the SINS'' psychometric properties.

Results

The SINS is significantly correlated with longer narcissism scales, but uncorrelated with self-esteem. It also has high test-retest reliability. We validate the SINS in a variety of samples (e.g., undergraduates, nationally representative adults), intrapersonal correlates (e.g., positive affect, depression), and interpersonal correlates (e.g., aggression, relationship quality, prosocial behavior). The SINS taps into the more fragile and less desirable components of narcissism.

Significance

The SINS can be a useful tool for researchers, especially when it is important to measure narcissism with constraints preventing the use of longer measures.     

Development and Validation of a Social Capital Questionnaire for Adolescent Students (SCQ-AS)

Objectives

Social capital has been studied due to its contextual influence on health. However, no specific assessment tool has been developed and validated for the measurement of social capital among 12-year-old adolescent students. The aim of the present study was to develop and validate a quick, simple assessment tool to measure social capital among adolescent students.

Methods

A questionnaire was developed based on a review of relevant literature. For such, searches were made of the Scientific Electronic Library Online, Latin American and Caribbean Health Sciences, The Cochrane Library, ISI Web of Knowledge, International Database for Medical Literature and PubMed Central bibliographical databases from September 2011 to January 2014 for papers addressing assessment tools for the evaluation of social capital. Focus groups were also formed by adolescent students as well as health, educational and social professionals. The final assessment tool was administered to a convenience sample from two public schools (79 students) and one private school (22 students), comprising a final sample of 101 students. Reliability and internal consistency were evaluated using the Kappa coefficient and Cronbach''s alpha coefficient, respectively. Content validity was determined by expert consensus as well as exploratory and confirmatory factor analysis.

Results

The final version of the questionnaire was made up of 12 items. The total scale demonstrated very good internal consistency (Cronbach''s alpha: 0.71). Reproducibility was also very good, as the Kappa coefficient was higher than 0.72 for the majority of items (range: 0.63 to 0.97). Factor analysis grouped the 12 items into four subscales: School Social Cohesion, School Friendships, Neighborhood Social Cohesion and Trust (school and neighborhood).

Conclusions

The present findings indicate the validity and reliability of the Social Capital Questionnaire for Adolescent Students.     

Health Literacy Measure for Adolescents (HELMA): Development and Psychometric Properties

Background

Health literacy refers to personal competencies for the access to, understanding of, appraisal of and application of health information in order to make sound decisions in everyday life. The aim of this study was to develop and evaluate the psychometric properties of an instrument for the measurement of health literacy among adolescents (the Health Literacy Measure for Adolescents-HELMA).

Methods

This study was made up of two phases, qualitative and quantitative, which were carried out in 2012–2014 in Tehran, Iran. In the qualitative part of the study, in-depth interviews with 67 adolescents aged 15–18 were carried out in 4 high schools to generate the initial item pool for the survey. The content validity of the items was then assessed by an expert panel review (n = 13) and face validity was assessed by interviewing adolescents (n = 16). In the quantitative part of the study, in order to describe the psychometric properties of the scale, validity, reliability (internal consistency and test-retest) and factor analysis were assessed.

Results

An item pool made up of 104 items was generated at the qualitative stage. After content validity was considered, this decreased to 47 items. In the quantitative stage, 582 adolescents aged 15–18 participated in the study with a mean age of 16.2 years. 51.2% of participants were females. In principal component factor analysis, 8 factors were loaded, which accounted for 53.37% of the variance observed. Reliability has been approved by α = 0.93 and the test-retest of the scale at two-week intervals indicated an appropriate stability for the scale (ICC = 0.93). The final questionnaire was approved with 44 items split into eight sections. The sections were titled: gain access to, reading, understanding, appraise, use, communication, self-efficacy and numeracy.

Conclusion

The Health Literacy Measure for Adolescents (HELMA) is a valid and reliable tool for the measurement of the health literacy of adolescents aged 15–18 and can be used to evaluate different levels of functional, interactive, and critical health literacy in adolescents.     

Development and Validation of an Index to Measure the Quality of Facility-Based Labor and Delivery Care Processes in Sub-Saharan Africa

Background

High quality care is crucial in ensuring that women and newborns receive interventions that may prevent and treat birth-related complications. As facility deliveries increase in developing countries, there are concerns about service quality. Observation is the gold standard for clinical quality assessment, but existing observation-based measures of obstetric quality of care are lengthy and difficult to administer. There is a lack of consensus on quality indicators for routine intrapartum and immediate postpartum care, including essential newborn care. This study identified key dimensions of the quality of the process of intrapartum and immediate postpartum care (QoPIIPC) in facility deliveries and developed a quality assessment measure representing these dimensions.

Methods and Findings

Global maternal and neonatal care experts identified key dimensions of QoPIIPC through a modified Delphi process. Experts also rated indicators of these dimensions from a comprehensive delivery observation checklist used in quality surveys in sub-Saharan African countries. Potential QoPIIPC indices were developed from combinations of highly-rated indicators. Face, content, and criterion validation of these indices was conducted using data from observations of 1,145 deliveries in Kenya, Madagascar, and Tanzania (including Zanzibar). A best-performing index was selected, composed of 20 indicators of intrapartum/immediate postpartum care, including essential newborn care. This index represented most dimensions of QoPIIPC and effectively discriminated between poorly and well-performed deliveries.

Conclusions

As facility deliveries increase and the global community pays greater attention to the role of care quality in achieving further maternal and newborn mortality reduction, the QoPIIPC index may be a valuable measure. This index complements and addresses gaps in currently used quality assessment tools. Further evaluation of index usability and reliability is needed. The availability of a streamlined, comprehensive, and validated index may enable ongoing and efficient observation-based assessment of care quality during labor and delivery in sub-Saharan Africa, facilitating targeted quality improvement.     

Validation of the FEEL-KJ: An Instrument to Measure Emotion Regulation Strategies in Children and Adolescents

Although the field of emotion regulation in children and adolescents is growing, there is need for age-adjusted measures that assess a large variety of strategies. An interesting instrument in this respect is the FEEL-KJ because it measures 7 adaptive and 5 maladaptive emotion regulation strategies in response to three different emotions. However, the FEEL-KJ has not yet been validated extensively. Therefore, the current study aims to test the internal structure and validity of the FEEL-KJ in a large sample of Dutch-speaking Belgian children and adolescents (N = 1102, 8–18 years old). The investigation of the internal structure confirms earlier reports of a two-factor structure with Adaptive and Maladaptive Emotion Regulation as overarching categories. However, it also suggests that the two-factor model is more complex than what was previously assumed. The evaluation of the FEEL-KJ validity furthermore provides evidence for its construct and external validity. In sum, the current study confirms that the FEEL-KJ is a valuable and reliable measure of emotion regulation strategies in children and adolescents.     

The Hypersomnic Syndrome: (Classification,Clinical Aspects,Pathogenesis, Treatment)

In neurological practice one often encounters various forms of disturbances of the waking state. Sometimes somnolence is one of the manifestations of a pathological process, and in others it is the major and dominant symptom bringing the patient to the doctor. Our experience in the study of hypersomnia (we have observed 120 patients in recent years) demonstrates that physicians have inadequate familiarity with this problem. Sometimes somnolence is regarded not as the result of pathology, but as a manifestation of excessive fatigue. There is inadequate differentiation of the forms of hypersomnic disorders. One of the causes of these errors is the absence of a logical classification. The most thorough classification is that of A. Epshtein, (1) etiological in nature: 1) random sleep disorders; 2) secondary sleep disorders; 3) constitutional neuropathic; 4) reactive; 5) symptomatic; 6) essential disorders; and 7) sleep disorders associated with psychosis. It has become obsolete, and does not cover the clinical forms of hypersomnia. We have deemed it desirable to make a classification based on clinical principles, with due consideration for etiology.