Problematic Internet use in British adolescents: An exploration of the addictive symptomatology

Research into online addictions has increased substantially over the last decade, particularly amongst youth. This study adapted the Problematic Internet Entertainment Use Scale for Adolescents [PIEUSA] for use with a British population. The adapted scale was used to (i) validate the instrument for English-speaking adolescent samples, (ii) estimate the prevalence of adolescent online problem users and describe their profile, and (iii) assess the accuracy of the scale"s classification of symptomatology. A survey was administered to 1097 adolescents aged between 11 and 18 years. The results indicated that (i) reliability of the adapted scale was excellent; factor validity showed unidimensionality, and construct validity was adequate. The findings also indicated that (ii) prevalence of online problem users was 5.2% and that they were more likely to younger males that engaged in online gaming for more than two hours most days. The majority of online problem users displayed negative addictive symptoms, especially"loss of control" and"conflict". The adapted scale showed (iii) very good sensitivity, specificity, and classification accuracy, and was able to clearly differentiate between problem and non-problem users. The results suggest certain differences between adolescent and adult online problem users based in the predominance of slightly different psychological components.

Prevalence of Problematic Mobile Phone Use in British Adolescents

The problematic use of mobile phones among adolescents has not been widely studied. There are very few instruments for assessing potential technological addiction to mobile phones, or for categorizing different types of users or uses. The most widely used scale is the Mobile Phone Problem Use Scale (MPPUS), which is used to study adult populations, and has been applied in various forms in international contexts. The aims of this study were to adapt the Spanish version of this scale (MPPUSA) to British adolescents, and then to estimate the prevalence of possible problematic users. A questionnaire was administered to a sample of 1,529 secondary school pupils aged between 11 and 18 years, with 1,026 completed questionnaires being collected. The analysis showed that the factor and construct validity and reliability were comparable to those obtained in previous studies. The prevalence of problematic users among the students was 10%, and the typical problematic user tended to be an adolescent between 11 and 14 years old, studying in a public school, who considered themselves to be an expert user of this technology, who made extensive use of his/her mobile phone, and who attributed the same problem of use among their peers. These users presented notable scores in all the symptoms covered by the scale used to assess problematic use. In conclusion, the adaptation of the MPPUSA as a screening scale for British adolescents presents good sensitivity and specificity for detecting the main addictive symptoms proposed in this validated version.

Clinical usefulness of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) scale in patients with type I bipolar disorder

Background: The relevance of persistent cognitive deficits to the pathogenesis and prognosis of bipolar disorders (BD) is understudied, and its translation into clinical practice has been limited by the absence of brief methods assessing cognitive status in Psychiatry. This investigation assessed the psychometric properties of the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) for the detection of cognitive impairment in BD. Methods: After short training, psychiatrists at 40 outpatient clinics administered the SCIP three times over two weeks to a total of 76 consecutive type I BD admissions. Experienced psychologists also administered a comprehensive battery of standard neuropsychological instruments to clinical sample and 45 healthy control subjects. Results: Feasibility was supported by a brief administration time (approximately 15 minutes) and minimal scoring errors. The reliability of the SCIP was confirmed by good equivalence of forms, acceptable stability (ICC range 0.59 to 0.87) and adequate internal consistency (Chronbach's alpha of 0.74). Construct validity was granted by extraction of a single factor (accounting 52% of the variance), acceptable correlations with conventional neuropsychological instruments, and a clear differentiation between bipolar I and normal samples. Efficiency was also provided by the adequate sensitivity and specificity. Limitations: The sample size is not very large. The SCIP and the neurocognitive battery do not cover all potentially relevant cognitive domains. Also, sensitivity to change remains unexplored. Conclusion: With minimal training, physicians obtained a reliable and valid estimate of cognitive impairment in approximately 15 minutes from an application of the SCIP to type I BD patients.

Clinical usefulness of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) scale in patients with type I bipolar disorder

Background: The relevance of persistent cognitive deficits to the pathogenesis and prognosis of bipolar disorders (BD) is understudied, and its translation into clinical practice has been limited by the absence of brief methods assessing cognitive status in Psychiatry. This investigation assessed the psychometric properties of the Spanish version of the Screen for Cognitive Impairment in Psychiatry (SCIP-S) for the detection of cognitive impairment in BD. Methods: After short training, psychiatrists at 40 outpatient clinics administered the SCIP three times over two weeks to a total of 76 consecutive type I BD admissions. Experienced psychologists also administered a comprehensive battery of standard neuropsychological instruments to clinical sample and 45 healthy control subjects. Results: Feasibility was supported by a brief administration time (approximately 15 minutes) and minimal scoring errors. The reliability of the SCIP was confirmed by good equivalence of forms, acceptable stability (ICC range 0.59 to 0.87) and adequate internal consistency (Chronbach's alpha of 0.74). Construct validity was granted by extraction of a single factor (accounting 52% of the variance), acceptable correlations with conventional neuropsychological instruments, and a clear differentiation between bipolar I and normal samples. Efficiency was also provided by the adequate sensitivity and specificity. Limitations: The sample size is not very large. The SCIP and the neurocognitive battery do not cover all potentially relevant cognitive domains. Also, sensitivity to change remains unexplored. Conclusion: With minimal training, physicians obtained a reliable and valid estimate of cognitive impairment in approximately 15 minutes from an application of the SCIP to type I BD patients.

Identifying first graders at risk of reading and writing difficulties : creating a group-based screening tool in kiswahili in Tanzania

Early identification of beginning readers at risk of developing reading and writing difficulties plays an important role in the prevention and provision of appropriate intervention. In Tanzania, as in other countries, there are children in schools who are at risk of developing reading and writing difficulties. Many of these children complete school without being identified and without proper and relevant support. The main language in Tanzania is Kiswahili, a transparent language. Contextually relevant, reliable and valid instruments of identification are needed in Tanzanian schools. This study aimed at the construction and validation of a group-based screening instrument in the Kiswahili language for identifying beginning readers at risk of reading and writing difficulties. In studying the function of the test there was special interest in analyzing the explanatory power of certain contextual factors related to the home and school. Halfway through grade one, 337 children from four purposively selected primary schools in Morogoro municipality were screened with a group test consisting of 7 subscales measuring phonological awareness, word and letter knowledge and spelling. A questionnaire about background factors and the home and school environments related to literacy was also used. The schools were chosen based on performance status (i.e. high, good, average and low performing schools) in order to include variation. For validation, 64 children were chosen from the original sample to take an individual test measuring nonsense word reading, word reading, actual text reading, one-minute reading and writing. School marks from grade one and a follow-up test half way through grade two were also used for validation. The correlations between the results from the group test and the three measures used for validation were very high (.83-.95). Content validity of the group test was established by using items drawn from authorized text books for reading in grade one. Construct validity was analyzed through item analysis and principal component analysis. The difficulty level of most items in both the group test and the follow-up test was good. The items also discriminated well. Principal component analysis revealed one powerful latent dimension (initial literacy factor), accounting for 93% of the variance. This implies that it could be possible to use any set of the subtests of the group test for screening and prediction. The K-Means cluster analysis revealed four clusters: at-risk children, strugglers, readers and good readers. The main concern in this study was with the groups of at-risk children (24%) and strugglers (22%), who need the most assistance. The predictive validity of the group test was analyzed by correlating the measures from the two school years and by cross tabulating grade one and grade two clusters. All the correlations were positive and very high, and 94% of the at-risk children in grade two were already identified in the group test in grade one. The explanatory power of some of the home and school factors was very strong. The number of books at home accounted for 38% of the variance in reading and writing ability measured by the group test. Parents´ reading ability and the support children received at home for schoolwork were also influential factors. Among the studied school factors school attendance had the strongest explanatory power, accounting for 21% of the variance in reading and writing ability. Having been in nursery school was also of importance. Based on the findings in the study a short version of the group test was created. It is suggested for use in the screening processes in grade one aiming at identifying children at risk of reading and writing difficulties in the Tanzanian context. Suggestions for further research as well as for actions for improving the literacy skills of Tanzanian children are presented.

Translation, adaptation and validation of the Roland-Morris questionnaire - Brazil Roland-Morris

The purpose of the present study was to translate the Roland-Morris (RM) questionnaire into Brazilian-Portuguese and adapt and validate it. First 3 English teachers independently translated the original questionnaire into Brazilian-Portuguese and a consensus version was generated. Later, 3 other translators, blind to the original questionnaire, performed a back translation. This version was then compared with the original English questionnaire. Discrepancies were discussed and solved by a panel of 3 rheumatologists and the final Brazilian version was established (Brazil-RM). This version was then pretested on 30 chronic low back pain patients consecutively selected from the spine disorders outpatient clinic. In addition to the traditional clinical outcome measures, the Brazil-RM, a 6-point pain scale (from no pain to unbearable pain), and its numerical pain rating scale (PS) (0 to 5) and a visual analog scale (VAS) (0 to 10) were administered twice by one interviewer (1 week apart) and once by one independent interviewer. Spearman's correlation coefficient (SCC) and intraclass correlation coefficient (ICC) were computed to assess test-retest and interobserver reliability. Cross-sectional construct validity was evaluated using the SCC. In the pretesting session, all questions were well understood by the patients. The mean time of questionnaire administration was 4 min and 53 s. The SCC and ICC were 0.88 (P<0.01) and 0.94, respectively, for the test-retest reliability and 0.86 (P<0.01) and 0.95, respectively, for interobserver reliability. The correlation coefficient was 0.80 (P<0.01) between the PS and Brazil-RM score and 0.79 (P<0.01) between the VAS and Brazil-RM score. We conclude that the Brazil-RM was successfully translated and adapted for application to Brazilian patients, with satisfactory reliability and cross-sectional construct validity.

Dimensionality of the premenstrual syndrome: confirmatory factor analysis of premenstrual dysphoric symptoms among college students

Premenstrual syndrome and premenstrual dysphoric disorder (PMDD) seem to form a severity continuum with no clear-cut boundary. However, since the American Psychiatric Association proposed the research criteria for PMDD in 1994, there has been no agreement about the symptomatic constellation that constitutes this syndrome. The objective of the present study was to establish the core latent structure of PMDD symptoms in a non-clinical sample. Data concerning PMDD symptoms were obtained from 632 regularly menstruating college students (mean age 24.4 years, SD 5.9, range 17 to 49). For the first random half (N = 316), we performed principal component analysis (PCA) and for the remaining half (N = 316), we tested three theory-derived competing models of PMDD by confirmatory factor analysis. PCA allowed us to extract two correlated factors, i.e., dysphoric-somatic and behavioral-impairment factors. The two-dimensional latent model derived from PCA showed the best overall fit among three models tested by confirmatory factor analysis (c²53 = 64.39, P = 0.13; goodness-of-fit indices = 0.96; adjusted goodness-of-fit indices = 0.95; root mean square residual = 0.05; root mean square error of approximation = 0.03; 90%CI = 0.00 to 0.05; Akaike's information criterion = -41.61). The items "out of control" and "physical symptoms" loaded conspicuously on the first factor and "interpersonal impairment" loaded higher on the second factor. The construct validity for PMDD was accounted for by two highly correlated dimensions. These results support the argument for focusing on the core psychopathological dimension of PMDD in future studies.

Severity score system for progressive myelopathy: development and validation of a new clinical scale

Progressive myelopathies can be secondary to inborn errors of metabolism (IEM) such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA) score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM), covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS), the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001) and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001) were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.

Early detection and intervention for infants at risk of autism spectrum disorders

Autism is a developmental disorder that is characterized by abnonnal social interactions and communications as well as repetitive and restricted activities and interests. There is evidence of a genetic component, as 5% of younger siblings are diagnosed if their older sibling has been diagnosed. Autism is generally not diagnosed until age 3 at the earliest, yet it has been shown that early intervention for children with autism can greatly increase their functioning. Because of this, it is important that symptoms of autism are identified as early as possible so that diagnosis can occur as soon as possible to allow these children the earliest intervention. This thesis was divided into two parts. The first looked at the psychometrics of two proposed measures, the Parent Observation Checklist (POC), administered monthly, and the Infant Behavior Summary Evaluation (mSE), administered bimonthly, to see if they can be used with the infant population to identify autistic symptoms in infants who are at high risk for autism or related problems because they have an older sibling with autism. Study 1 reported acceptable psychometric properties of both the POC and IBSE in terms of test-retest reliability, internal consistency, construct validity and predictive validity. These results provide preliminary evidence that parent report measures can help to detect early symptoms of ASD in infants. The POC was shown to differentiate infants who were diagnosed from a matched group that was not diagnosed by 3 years of age. The second part of this thesis involved a telephone interview of parents who reported developmental and/or behavior problems in their high-risk infants that may be early signs of Autism Spectrum Disorder (ASD). During the interview, a service questionnaire was administered to see what interventions (including strategies recommended by the researchers) their at risk infants and affected older siblings were receiving, how satisfied the parents were with them and how effective they felt the interventions were. 3 Study 2 also yielded promising results. Parents utilized a variety of services for at risk infants and children with ASD. The interventions included empirically validated early intervention (e.g., ABA) to non-empirically validated treatments (e.g., diet therapy). The large number of nonempirically validated treatments parents used was surprising, yet parents reported being involved and satisfied, and thought that the services were effective. Parents' perceptions of their stress levels went down slightly and feelings of competence rose when they accessed services for their infants. Overall, the results of this thesis provide new evidence that parent-report methods hold promise as early detection instruments for ASD in at-risk infants. More research is needed to further validate these instruments as well as to understand the variables related to the parents' choice of early intervention for their at risk and affected children.

The examination of predictors of success in two programmes requiring self-direction /

The new Physiotherapy and Occupational Therapy programmes, based in the Faculty of Health Sciences, McMaster University (Hamilton, Ontario) are unique. The teaching and learning philosophies utilized are based on learner-centred and selfdirected learning theories. The 1991 admissions process of these programmes attempted to select individuals who would make highly qualified professionals and who would have the necessary skills to complete such unique programmes. In order to: 1 . learn more about the concept of self-directed learning and its related characteristics in health care professionals; 2. examine the relationship between various student characteristics - personal, learner and those assessed during the admissions process - and final course grades, and 3. determine which, if any, smdent characteristics could be considered predictors for success in learner-centred programmes requiring self-directed learning skills, a correlational research design was developed and carried out. Thirty Occupational Therapy and thirty Physiotherapy smdents were asked to complete 2 instruments - a questionnaire developed by the author and the Oddi Continuing Learning Inventory (Oddi, 1986). Course grades and ratings of students during the admissions process were also obtained. Both questionnaires were examined for reliability, and factor analyses were conducted to determine construct validity. Data obtained from the questionnaires, course grades and student ratings (from the admissions process) were analyzed and compared using the Contingency Co-efficient, the Pearson's product-moment correlation co-efficient, and the multiple regression analysis model. The research findings demonstrated a positive relationship (as identified by Contingency Coefficient or Pearson r values) between various course grades and the following personal and learner characteristics: field of smdy of highest level of education achieved, level of education achieved, sex, marital stams, motivation for completing the programmes, reasons for eru-oling in the programmes, decision to enrol in the programmes, employment history, preferred learning style, strong selfconcept and the identification of various components of the concept of self-directed learning. In most cases, the relationships were significant to the 0.01 or 0.(X)1 levels. Results of the multiple regression analyses demonstrated that several learner and admissions characteristic variables had R^ values that accounted for the largest proportion of the variance in several dependent variables. Thus, these variables could be considered predictors for success. The learner characteristics included: level of education and strong self-concept. The admissions characteristics included: ability to evaluate strengths, ability to give feedback, curiosity and creativity, and communication skills. It is recommended that research continue to be conducted to substantiate the relationships found between course grades and characteristic variables in more diverse populations. "Success in self-directed programmes" from the learner's perspective should also be investigated. The Oddi Continuing Learning Inventory should continue to be researched. Further research may lead to refinement or further development of the instrument, and may provide further insight into self-directed learner attributes. The concept of self-directed learning continues to be incorporated into educational programmes, and thus should continue to be explored.

Assessing the psychometric properties of dream content questionnaires

The present study was the first of its kind to systematically explore the psychometric properties of dream content questionnaires as measures of dream experience. One hundred and six University students filled out the Dream Content Questionnaire (DCQ) and kept a 14-day dream diary on two separate occasions, in addition to filling out the NEO-PI-R and Multidimensional Personality Questionnaire and measures of spatial ability and imaginativeness. The DCQ's reliability was acceptable, as was its discriminant and construct validity. Six of eight predicted relationships between trait personality and DCQ reported dream content were significant. In contrast, dream diaries showed instability over time and were unrelated to personality traits. The DCQ's concurrent validity could not be adequately appraised due to the inconsistency in dream diary content over time. The results suggest that questionnaires may be used to measure dream experience; however, the precise utility of dream questionnaires remains unclear. The findings raise important questions concerning measures of dream experience.

SAVOURING ABILITIES SCALE (SAS): THE DEVELOPMENT OF A STRENGTHS - BASED ASSESSMENT FOR THERAPEUTIC RECREATION PROFESSIONALS

The purpose of this study was to develop and evaluate an assessment that measured savouring leisure. The assessment items developed were reviewed for content validity by eight international therapeutic recreation (TR) educators and administrators as well as eleven TR practitioners. An exploratory factor analysis was conducted to determine the most suitable items for the assessment. The results suggest that the original three subscale design needed to be modified to five. The reliability of the total assessment is α=.84. Statistical analysis for construct validity reveal 58.52% of the variance explained, and a moderate correlation was found between this study and other savouring assessments. The implications of the shift in conceptualization are reviewed through discussing factor analysis issues, the lived experience of savouring leisure, and the impact of the content validity process. This study contributes to the ongoing dialog of savouring leisure. Recommendations for future research are discussed.

Autonomy and Relatedness in Mainland Chinese Adolescents: Social or Personal? Accommodation or Distinctiveness?

Three studies comprised the current research program, in which the major goals were to propose and validate empirically the proposed two-level (universal and culture-specific) model of both autonomy and relatedness, as well as to develop reliable and valid measures for these two constructs. In Study 1, 143 mainland Chinese adolescents were asked open-ended questions about their understanding of autonomy and relatedness in three social contexts (peer, family, school). Chinese youth’s responses captured universal and culturally distinctive forms of autonomy (personal vs. social) and relatedness (accommodation vs. distinctiveness), according to a priori criteria based on the theoretical frameworks. Also, scenarios designed to reflect culture-specific forms of autonomy and relatedness suggested their relevance to Chinese adolescents. With a second sample of 201 mainland Chinese youth, in Study 2, the obtained autonomy and relatedness descriptors were formulated into scale items. Those items were subject to refinement analyses to examine their psychometric properties and centrality to Chinese youth. The findings of Study 1 scenarios were replicated in Study 2. The primary goal of Study 3 was to test empirically the proposed two-level (universal and culture-specific) models of both autonomy and relatedness, using the measures derived from Studies 1 and 2. A third sample of 465 mainland Chinese youth completed a questionnaire booklet consisting of autonomy and relatedness scales and scenarios and achievement motivation orientations measures. A series of confirmatory factor analysis (CFA) autonomy and relatedness measurement models (first-order and second-order), as well as structural models linking culture-specific forms of autonomy and relatedness and achievement motivation orientations, were conducted. The first-order measurement models based on scale and scenario scores consistently confirmed the distinction between personal autonomy and social autonomy, and that of accommodation and distinctiveness. Although the construct validity of the two culture-specific forms of autonomy gained additional support from the structural models, the associations between the two culture-specific forms of relatedness and achievement motivation orientations were relatively weak. In general, the two-level models of autonomy and relatedness were supported in two ways: conceptual analysis of scale items and second-order measurement models. In addition, across the three studies, I explored potential contextual and sex differences in Chinese youth’s endorsement of the diverse forms of autonomy and relatedness. Overall, no substantial contextual variability or sex differences were found. The current research makes an important theoretical contribution to the field of developmental psychology in general, and autonomy and relatedness in particular, by proposing and testing empirically both universal and culture-specific parts of autonomy and relatedness. The current findings have implications for the measurement of autonomy and relatedness across social contexts, as well as for socialization and education practice.

Development of a Chinese version WHO Self-Assessment Tool for Evaluating Health Promotion in Hospital

[Support Institutions:] Department of Administration of Health, University of Montreal, Canada Public Health School of Fudan University, Shanghai, China

Du bien-être psychologique au travail : fondements théoriques, conceptualisation et instrumentation du construit

Malgré la préoccupation croissante des chercheurs et praticiens pour la santé psychologique au travail, le concept de bien-être vécu au travail est encore mal compris de la communauté scientifique. En effet, peu d’efforts ont été consacrés à ce jour pour développer des connaissances sur le bien-être psychologique au travail arrimées à la réalité des employés. Cette thèse a donc pour objectif de développer une conceptualisation du bien-être psychologique au travail et une instrumentation psychométriquement fiable lui étant rattachée. Pour ce faire, deux études ont été réalisées. La première, de nature qualitative et exploratoire, fut menée auprès de 20 travailleurs canadiens francophones afin de répertorier, à partir d’incidents critiques vécus par ceux-ci, des manifestations de bien-être psychologique au travail. Celles-ci ont pu être classifiées selon un modèle en 2 axes, soit la sphère de référence dans laquelle le bien-être psychologique au travail se vit et la directionnalité selon laquelle il se développe. Ce modèle a ensuite été comparé aux conceptualisations génériques du bien-être psychologique existantes, et cette analyse a permis d’étayer la validité convergente et divergente du modèle. Dans un deuxième temps, l’Indice de bien-être psychologique au travail (IBEPT) a été créé sur la base des manifestations relevées lors de l’étude qualitative, afin d’en assurer la validité de contenu. Une version expérimentale de l’instrument a ensuite été soumise à une expérimentation auprès de 1080 travailleurs québécois. Les analyses factorielles exploratoires révèlent une structure interne en 25 items reflétant 5 dimensions, représentant elles-mêmes un construit de second ordre. La validité de construit de cette conceptualisation a ensuite été étudiée par l’analyse des intercorrélations avec une série de mesures du bien-être et de la détresse psychologique génériques. Les résultats appuient la validité convergente de l’instrument, et démontrent également sa validité divergente. Enfin, l’instrument affiche une cohérence interne satisfaisante. Au terme de cette recherche doctorale, les résultats des deux études sont interprétés en fonction de l’état actuel des connaissances sur le bien-être psychologique, les limites des études sont énoncées, et des pistes de recherche future sont avancées.