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Browsing by Subject "Confirmatory factor analysis"
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Item Coping Among Breast Cancer Survivors: A Confirmatory Factor Analysis of the Brief COPE(Springer, 2019-08-01) Rand, Kevin L.; Cohee, Andrea A.; Monahan, Patrick O.; Wagner, Lynne I.; Champion, Victoria L.; Psychology, School of ScienceBACKGROUND AND PURPOSE: Cancer survivors continue to cope with significant stressors after completing treatment. The Brief COPE (Carver, 1997) is frequently used to measure coping; however, its factor structure remains unclear. The purpose of this study was to determine the best factor conceptualization of the Brief COPE for use among breast cancer survivors. METHODS: Breast cancer survivors (N = 1,127) completed the Brief COPE. We conducted confirmatory factor analyses comparing several a priori models based on research in cancer-relevant populations. RESULTS: Of the eight models examined, the 14-factor model of the Brief COPE showed the best fit. CONCLUSIONS: Despite efforts to simplify the structure of the Brief COPE, our results suggest coping among breast cancer survivors is best assessed using Carver's (1997) original 14-factor conceptualization.Item Elucidating Dimensions of Posttraumatic Stress Symptoms and their Functional Correlates in Disaster-Exposed Adolescents(Elsevier, 2014) Sumner, Jennifer A.; Pietrzak, Robert H.; Danielson, Carla Kmett; Adams, Zachary W.; Ruggiero, Kenneth J.; Psychiatry, School of MedicineThe aim of this study was to elucidate the dimensional structure of posttraumatic stress disorder (PTSD) and potential moderators and functional correlates of this structure in disaster-affected adolescents. A population-based sample of 2000 adolescents aged 12-17 years (M = 14.5 years; 51% female) completed interviews on post-tornado PTSD symptoms, substance use, and parent-adolescent conflict between 4 and 13 months (M = 8.8, SD = 2.6) after tornado exposure. Confirmatory factor analyses revealed that all models fit well but a 5-factor dysphoric arousal model provided a statistically significantly better representation of adolescent PTSD symptoms compared to 4-factor dysphoria and emotional numbing models. There was evidence of measurement invariance of the dysphoric arousal model across gender and age, although girls and older adolescents aged 15-17 years had higher mean scores than boys and younger adolescents aged 12-14 years, respectively, on some PTSD dimensions. Differential magnitudes of association between PTSD symptom dimensions and functional correlates were observed, with emotional numbing symptoms most strongly positively associated with problematic substance use since the tornado, and dysphoric arousal symptoms most strongly positively associated with parent-adolescent conflict; both correlations were significantly larger than the corresponding correlations with anxious arousal. Taken together, these results suggest that the dimensional structure of tornado-related PTSD symptomatology in adolescents is optimally characterized by five separate clusters of re-experiencing, avoidance, numbing, dysphoric arousal, and anxious arousal symptoms, which showed unique associations with functional correlates. Findings emphasize that PTSD in disaster-exposed adolescents is not best conceptualized as a homogenous construct and highlight potential differential targets for post-disaster assessment and intervention.Item Factor structure of the autonomy preference index in people with severe mental illness(Elsevier, 2015-08-30) Bonfils, Kelsey A.; Adams, Erin L.; Mueser, Kim T.; Wright-Berryman, Jennifer L.; Salyers, Michelle P.; Department of Psychology, School of SciencePeople vary in the amount of control they want to exercise over decisions about their healthcare. Given the importance of patient-centered care, accurate measurement of these autonomy preferences is critical. This study aimed to assess the factor structure of the Autonomy Preference Index (API), used widely in general healthcare, in individuals with severe mental illness. Data came from two studies of people with severe mental illness (N=293) who were receiving mental health and/or primary care/integrated care services. Autonomy preferences were assessed with the API regarding both psychiatric and primary care services. Confirmatory factor analysis was used to evaluate fit of the hypothesized two-factor structure of the API (decision-making autonomy and information-seeking autonomy). Results indicated the hypothesized structure for the API did not adequately fit the data for either psychiatric or primary care services. Three problematic items were dropped, resulting in adequate fit for both types of treatment. These results suggest that with relatively minor modifications the API has an acceptable factor structure when asking people with severe mental illness about their preferences to be involved in decision-making. The modified API has clinical and research utility for this population in the burgeoning field of autonomy in patient-centered healthcare.Item The Structure of Mood and Anxiety Symptoms in the Perinatal Period(Elsevier, 2023) Miller, Michelle L.; O’Hara, Michael W.; Psychiatry, School of MedicineBackground: The perinatal period is increasingly recognized as a vulnerable time for the development and exacerbation of psychiatric symptoms. Research has often focused on perinatal depression, with much less information on perinatal anxiety. This study examined the psychometric structure of all internalizing (anxiety and mood disorder symptoms) in the perinatal period. Methods: Participants were primarily community adults receiving prenatal care from an academic medical center (N = 246). Participants completed a structured clinical interview using the Interview for Mood and Anxiety Symptoms (IMAS) during pregnancy (28-32 weeks gestation) and the postpartum (6-8 weeks). Clinical interviews dimensionally assessed all current anxiety, mood, and obsessive-compulsive symptoms as well as lifetime psychiatric diagnoses. Results: Confirmatory factor analyses identified three latent factors onto which psychiatric symptoms loaded: Distress (depression, generalized anxiety, irritability, and panic symptoms), Fear (social anxiety, agoraphobia, specific phobia, and obsessive-compulsive symptoms), and Bipolar (mania and obsessive-compulsive symptoms) in both pregnancy and the postpartum. The fit statistics of the models indicated adequate to good fit in both models. Limitations: The IMAS is validated against the DSM-IV-TR rather than the DSM-5 and assessments of psychiatric symptoms were focused only on the current pregnancy. Conclusions: A three-factor model consisting of Distress, Fear and Bipolar latent factors was the best-fitting model in pregnancy and the postpartum period and showed stability across time. The structure of internalizing symptoms has important implications for future perinatal research and can be utilized to guide treatment by highlighting which psychiatric symptoms may be most similar during the perinatal period.Item Translation, Adaptation, and Validation of the Modified Thai Version of Champion’s Health Belief Model Scale (MT-CHBMS)(MDPI, 2022-12-31) Suriyong, Patinya; Jiraniramai, Surin; Wongpakaran, Nahathai; Pinyopornpanish, Kanokporn; Angkurawaranon, Chaisiri; Jiraporncharoen, Wichuda; Champion, Victoria L.; Wongpakaran, Tinakon; School of NursingBackground: While breast cancer is the leading cause of cancer death among Thai women, breast self-examination (BSE), mammography, and ultrasound use are still underutilized. There is a need to assess women’s beliefs about breast cancer and screening in different cultural settings. As a result, a tool to measure the beliefs that influence breast-cancer-screening practices is needed. Champion’s Health Belief Model Scale (CHBMS) is a valid and reliable tool for assessing individuals’ attitudes toward breast cancer and screening methods, but it has not been validated in Thai women. The study aimed to translate and validate the CHBMS for breast self-examination and mammography among Thai women and to modify the original scale by adding ultrasound items for breast cancer screening. In addition, the purpose of this study was to create a modified Thai version of the CHBMS which could be used to better understand patients’ beliefs regarding breast cancer screening in Thailand, in order to develop practical and effective interventions suited to their beliefs. Methods: The CHBMS was translated into Thai, validated by a panel of experts, back-translated, modified by adding content about ultrasound for screening breast cancer, and pretested. Confirmatory factor analysis was used with a sample of 130 Thai women aged 40 to 70 years old. Result: The final MT-CHBMS consisted of 64 items determining ten subscales: susceptibility, seriousness, benefits—breast self-examination, benefits—mammogram, barriers—BSE, barriers—mammogram, confidence, health motivation, benefits—ultrasound, and barriers—ultrasound. The MT-CHBMS demonstrated excellent internal consistency. The ten-factor model was best fitted to the data. Conclusion: The MT-CHBMS was found to be a reliable and valid tool for measuring individuals’ attitudes toward breast cancer and screening methods. The scale could be easily used by healthcare providers to determine the beliefs before planning appropriate interventions to increase early detection.