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      Measuring stress in clinical and nonclinical subjects using a German adaptation of the Perceived Stress Scale Translated title: Evaluación del estrés en muestra clínica y no clínica mediante la adaptación alemana de la Perceived Stress Scale

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          Abstract

          Background/Objective: Stress is perceived differently across individuals, which might be particularly true for nonclinical and clinical subjects. For this reason, we tested a German adaption of the 10-item Perceived Stress Scale (PSS-10) for model fit and measurement invariance in a big nonclinical and clinical sample. Method: We (1) conducted multiple confirmatory factor analysis (CFA) in 1,248 nonclinical subjects and 575 outpatients, (2) measurement invariance with multigroup CFA, (3) assessed correlations with relevant constructs and (4) calculated internal consistencies for overall stress and the subscales Helplessness and Self-efficacy. Results: In both samples, CFA revealed a robust two-factorial structure with an excellent model fit. Group comparisons revealed strict measurement invariance. Correlations with associated measures support validity. Internal consistencies were good to very good. Conclusions: We show highly satisfactory psychometric properties of the German PSS-10 for nonclinical and clinical individuals. Measurement invariance analyses demonstrated that varying stress levels of people with a different mental health status are due to true interindividual differences.

          Resumen

          Antecedentes/Objetivo: El estrés se percibe de manera diferente entre los individuos, lo que podría ser particularmente cierto para los sujetos no clínicos y clínicos. Por esta razón, probamos una adaptación alemana de la Perceived Stress Scale de 10 ítems (PSS-10) para el ajuste del modelo y la invarianza de la medición en una gran muestra clínica y no clínica. Método: Realizamos (1) un análisis factorial confirmatorio múltiple (CFA) en 1.248 sujetos no clínicos y 575 pacientes ambulatorios, (2) invarianza de medición con CFA multigrupo, (3) correlaciones con constructos relevantes y (4) cálculos de la consistencia interna para la escala general y las subescalas Desvalidez y Autoeficacia. Resultados: En ambas muestras, el CFA reveló una estructura robusta de dos factores con un excelente ajuste del modelo. Las comparaciones grupales indicaron invarianza estricta. Las correlaciones con las medidas asociadas respaldan la validez. Los coeficientes de consistencia interna fueron buenos a muy buenos. Conclusión: Mostramos propiedades psicométricas altamente satisfactorias de la version alemana de la PSS-10 para individuos no clínicos y clínicos. Los análisis de invarianza de medición demostraron que los niveles variables de estrés de las personas con un estado de salud mental diferente se deben a diferencias interindividuales verdaderas.

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          Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five well-being scale

          The health status questionnaire Short‐Form 36 (SF‐36) includes subscales measuring both physical health and mental health. Psychometrically, the mental health subscale contains a mixture of mental symptoms and psychological well‐being items, among other things, to prevent a ceiling effect when used in general population studies. Three of the mental health well‐being items are also included in the WHO‐Five well‐being scale. In a Danish general population study, the mental health subscale was compared psychometrically with the WHO‐Five in order to evaluate the ceiling effect. Tests for unidimensionality were used in the psychometric analyses, and the sensitivity of the scales in differentiating between changes in self‐reported health over the past year has been tested. The results of the study on 9,542 respondents showed that, although the WHO‐Five and the mental health subscale were found to be unidimensional, the WHO‐Five had a significantly lower ceiling effect than the mental health subscale. The analysis identified the three depression symptoms in the mental health subscale as responsible for the ceiling effect. The WHO‐Five was also found to be significantly superior to the mental health subscale in terms of its sensitivity in differentiating between those persons whose health had deteriorated over the past year and those whose health had not. In conclusion, the WHO‐Five, which measures psychological well‐being, reflects aspects other than just the absence of depressive symptoms. Copyright © 2003 Whurr Publishers Ltd.
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            Trajectories of resilience and dysfunction following potential trauma: A review and statistical evaluation

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              Cortisol stress reactivity across psychiatric disorders: A systematic review and meta-analysis.

              The hypothalamus-pituitary-adrenal (HPA) axis and its end product cortisol are essential for an adequate response to stress. Considering the role of stress as a risk factor for psychiatric disorders, it is not surprising that cortisol stress reactivity has frequently been investigated in patients versus healthy individuals. However, the large heterogeneity in measures of the cortisol stress response has hampered a systematic evaluation of the evidence. We here report of a systematic literature review and meta-analysis on cortisol reactivity to psychosocial stress across psychiatric disorders. Original data from authors were obtained to construct standardized cortisol outcomes (the areas under the curve with respect to increase (AUCi) and ground (AUCg)) and to examine the influence of sex and symptomatic state on cortisol stress reactivity. Fourteen studies on major depressive disorder (MDD) (n=1129), 9 on anxiety disorders (n=732, including social anxiety disorder (SAD), posttraumatic stress disorder, panic disorder and mixed samples of anxiety disorders) and 4 on schizophrenia (n=180) were included that used the Trier Social Stress Test or an equivalent psychosocial stress task. Sex-dependent changes in stress reactivity were apparent in MDD and anxiety disorders. Specifically, women with current MDD or an anxiety disorder exhibited a blunted cortisol stress response, whereas men with current MDD or SAD showed an increased cortisol response to psychosocial stress. In individuals with remitted MDD, altered cortisol stress reactivity was less pronounced in women and absent in men. For schizophrenia, cortisol stress reactivity was blunted in both men and women, but the number of studies was limited and showed evidence for publication bias. These findings illustrate that sharing individual data to disentangle the effects of sex, symptom levels and other factors is essential for further understanding of the alterations in cortisol stress reactivity across psychiatric disorders.
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                Author and article information

                Contributors
                Journal
                Int J Clin Health Psychol
                Int J Clin Health Psychol
                International Journal of Clinical and Health Psychology : IJCHP
                Asociacion Espanola de Psicologia Conductual
                1697-2600
                2174-0852
                22 May 2020
                May-Aug 2020
                22 May 2020
                : 20
                : 2
                : 173-181
                Affiliations
                [a ]Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University Mainz, Germany
                [b ]Leibniz Institute for Resilience Research, Mainz, Germany
                Author notes
                [* ]Corresponding author at: Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Wallstrasse 3, 55122 Mainz, Germany wessa@ 123456uni-mainz.de
                Article
                S1697-2600(20)30017-X
                10.1016/j.ijchp.2020.03.004
                7296237
                32550857
                980a975a-b0c2-452a-b148-0918e9454451
                © 2020 Published by Elsevier España, S.L.U. on behalf of Asociación Española de Psicología Conductual.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 29 August 2019
                : 20 February 2020
                : 19 March 2020
                Categories
                Original article

                perceived stress scale,clinical subjects,factor analyses,invariance,instrumental study.,pacientes,análisis factorial,invarianza,estudio instrumental.

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