Stephanie Braun

The Resilience Scale for Adults: Construct Validity and Measurement in a Belgian Sample

The Resilience Scale for Adults (RSA) was developed and has been extensively validated in Norwegian samples. The purpose of this study was to explore the construct validity of the Resilience Scale for Adults in a French-speaking Belgian sample and test measurement invariance between the Belgian and a Norwegian sample. A Belgian student sample (N = 363) completed the RSA, the Hopkins Symptom Checklist-25 (HSCL-25), and Sense of Coherence Scale (SOC-29). A Norwegian second sample (N = 315) was included in the analyses of invariance of the RSA. There were expected positive and negative significant correlations with SOC-29 and HSCL-25, respectively. The metric invariance was supported, with the exception of one of the six RSA factors. The findings demonstrate that the RSA may be a valid and reliable self-report measure of protective factors and further the results also indicated cross-cultural validity for the RSA in a French-speaking Belgian sample.

Depression, anxiety and loss of resilience after multiple traumas: an illustration of a mediated moderation model of sensitization in a group of children who survived the Nazi Holocaust

BACKGROUND Depressive and anxiety disorders (DAD) have become a major public health problem. Multiple trauma is known to increase the risk of DAD through a sensitization mechanism. We investigate the hypothesis that resilience is a mediator of this mechanism. METHODS Former Hidden Children (FHC), the Jewish youths who spent World War II in various hideaway shelters across Nazi-occupied Europe, were compared with a control group. In each group, we measured the presence of multiple traumas, the resilience with the Resilience Scale for Adults, which has a six factors solution, and the DAD with the Hopkins Symptoms Checklist. We test a mediated moderation model with childhood trauma as the predictor; Later trauma as the moderator; Resilience as the mediator; and DAD as the outcome variable. RESULTS Results are consistent with a sensitization model of DAD mediated by resilience: confrontation with a primary trauma during childhood followed by secondary trauma(s) after childhood damages resilience, which, in turn, results in higher level of DAD. LIMITATIONS We are unable to differentiate if the sensitization process is a consequence of the nature of the trauma endured by FHC (long-standing exposure to extreme external events) or a consequence of the fact that this first trauma occurred during childhood. CONCLUSIONS Resilience construct is multi-factorial and a limited damaging of some of the factors is sufficient to lead to DAD even if other factors remain unaltered. Resilience can be altered by multiple traumas and, therefore, needs to be bolstered in therapy sessions.

Transgenerational transmission of trauma in families of Holocaust survivors: The consequences of extreme family functioning on resilience, Sense of Coherence, anxiety and depression

BACKGROUND The psychological transmission of the noxious effects of a major trauma from one generation to the next remains unclear. The present study aims to identify possible mechanisms explaining this transmission among families of Holocaust Survivors (HS). We hypothesized that the high level of depressive and anxiety disorders (DAD) among HS impairs family systems, which results in damaging coping strategies of their children (CHS) yielding a higher level of DAD. METHODS 49 CHS completed the Resilience Scale for Adults, the Hopkins Symptom Check List-25, the 13-Item Sense of Coherence (SOC) scale, and the Family Adaptability and Cohesion Scale. We test a mediation model with Family types as the predictor; coping strategies (i.e. Resilience or SOC) as the mediator; and DAD as the outcome variable. RESULTS Results confirm that the CHS׳ family types are more often damaged than in general population. Moreover, growing in a damaged family seems to impede development of coping strategies and, therefore, enhances the occurrence of DAD. LIMITATIONS The present investigation is correlational and should be confirmed by other prospective investigations. CONCLUSIONS At a theoretical level we propose a mechanism of transmission of the noxious effects of a major trauma from one generation to the next through family structure and coping strategies. At a clinical level, our results suggest to investigate the occurrence of trauma among parents of patients consulting for DAD and to reinforce their coping strategies.

Disentangling Sense of Coherence and Resilience in case of multiple traumas

BACKGROUND Depressive and anxiety disorders (DAD) are a major public health problem. Trauma endured during childhood is known to increase the risk of DAD in adulthood. We investigate the hypothesis that Sense of Coherence (SOC) is a mediator between childhood trauma and depressive and anxious symptoms (DAD) in adulthood. We also explore the nature (personality trait or aptitude) of SOC and attempt to disentangle the concepts of resilience and SOC. METHOD Former hidden children (FHC), the Jewish youths who spent World War II in various hideaway shelters across Nazi-occupied Europe, were compared with a control group. In each group we measured the presence of multiple traumas, the resilience with the Resilience Scale for Adults, the DAD with the Hopkins Symptoms Checklist and the SOC with the SOC-13 self-report questionnaire. We tested a mediated moderation model with childhood Trauma as the predictor; Adulthood trauma as the moderator; SOC as the mediator; and DAD as the outcome variable. RESULTS Results were consistent with a sensitization model of DAD partially mediated by SOC. A first component of SOC was similar to an aptitude and another part of SOC was more similar to a personality trait. LIMITATIONS We are unable to differentiate if the sensitization process is a consequence of the nature of the trauma endured by FHC (long-standing exposure to extreme external events) or a consequence of the fact that this first trauma occurred during childhood. CONCLUSION Our results could account for the controversial debate regarding the life time stability of SOC.

Beware of multiple traumas in PTSD assessment: the role of reactivation mechanism in intrusive and hyper-arousal symptoms

Objectives: Post-traumatic stress disorder (PTSD) is a major public health problem defined by three symptom clusters: intrusion thoughts, avoidance mechanisms and hyper-arousal. Several authors have emphasized, that some or all of these symptoms related to a past traumatic experience could be reactivated, even after long asymptomatic periods. This study investigates the role of an additional trauma in the reactivation of a childhood trauma among a group of former hidden children (n = 65), the Jewish youths who spent World War II in various hideaway shelters in Nazi-occupied Europe. They were compared with a control group. Method: The presence or absence of an additional trauma in adulthood was assessed and PTSD symptoms were measured by using the Impact of Event Scale-Revised. Results: An additional trauma reactivates PTSD symptoms of intrusion thoughts and, marginally, symptoms of hyper-arousal. At the opposite, symptoms of avoidance were not reactivated. Conclusion: Our results confirm the role of an additional trauma in the reactivation of traumatic memories, related to an earlier trauma, in later life. Clinical and theoretical implications are discussed and perspectives are proposed.

The measurement of alexithymia in children and adolescents: Psychometric properties of the Alexithymia Questionnaire for Children and the twenty-item Toronto Alexithymia Scale in different non-clinical and clinical samples of children and adolescents

This study had two aims. Firstly, the psychometric properties of the 20-item Toronto Alexithymia Scale (TAS-20) and the Alexithymia Questionnaire for Children (AQC) that measure the three dimensions of alexithymia (DIF, difficulty identifying feelings; DDF, difficulty describing feelings; EOT, externally-oriented thinking) were explored in various samples of children, adolescents or young adults to detect the best factor-structure and to examine if the Externally-Oriented Thinking (EOT) factor must be deleted or not. Secondly, the capacity for adolescents to distinguish between alexithymia and depression was studied using factorial analyses of items of self-report of alexithymia and depression scales. Four groups were examined (80 healthy children, 105 adolescents with various psychiatric disorders, 333 healthy older adolescents and 505 young adults recruited from universities). The first two groups filled out the AQC and the latter two the TAS-20. Confirmatory factorial analyses (CFA) showed that the two-factor model (DIF, DDF) provided acceptable fits and had significant advantages over the three-factor model (DIF, DDF, EOT). Low alpha coefficients for the EOT subscale were reported (range from 0.18–0.61). Except for the children sample, exploratory factorial analyses (EFA) were performed on the items of the TAS-20 or AQC without the EOT items and the Beck depression inventory-II (BDI-II) or the Zung Self-Rating Depression Scale (SDS). The items of the AQC and BDI-II or items of the TAS-20 and SDS loaded on separate factors with only a minor overlap suggesting that adolescents were able to differentiate alexithymia and depression when self-assessments were used. Alexithymia can be reliably assessed in adolescents using the TAS-20 or AQC without the eight items rating the EOT dimension.

Psychological and Socio-Demographic Data Contributing to the Resilience of Holocaust Survivors

ABSTRACT The authors provide a within-group study of 65 Former Hidden Children (FHC; i.e., Jewish youths who spent World War II in various hideaway shelters across Nazi-occupied Europe) evaluated by the Hopkins Symptom Check List (HSCL), the Sense of Coherence Scale (SOCS), the Resilience Scale for Adults (RSA), and a socio-demographic questionnaire. The aim of the present article is to address the sensitization model of resilience (consisting in a reduction of resistance to additional stress due to previous exposure to trauma) and to identify the family, psychological, and socio-demographic characteristics that predict resilience among a group of FHC. The RSA score is negatively correlated with the number of post-war traumas and positively correlated with the SOCS score. FHC who have children present a higher RSA score than FHC who have no children. RSA global score negatively and significantly predicts HSCL score. In a global multivariate model, and in accordance with the sensitization model, the number of post-war traumas negatively predicts the RSA score. Moreover, the SOCS score and the number of children positively predict it. Therapeutic implications are discussed, limitations are considered, and further investigations are proposed.

Head-to-head comparison of Microflex LT and Vitek MS systems for routine identification of microorganisms by MALDI-TOF mass spectrometry in Chile

Background Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry (MS) is a new and revolutionary identification method for microorganisms and has recently been introduced into clinical microbiology in many industrialized countries in Europe and North America. Objectives Our study aimed to compare the performance and practicality of two commercial MALDI-TOF MS platforms in a head-to head manner at a routine laboratory in Chile. Methods During a five-month period in 2012–13, the diagnostic efficiency (correct identification rate) and agreement between Microflex LT (Bruker Daltonics) and Vitek MS (bioMérieux) was compared in a parallel manner to conventional identification including genotypic analysis for difficult-to-identify strains. The study included 804 microbial isolates: 252 Enterobacteriaceae, 126 non-fermenters, 36 other gram-negative rods, 279 gram-positive cocci, 32 gram-positive rods, 32 anaerobes, and 47 yeasts. Other relevant factors of the two devices such as user friendliness and connectivity were also evaluated and compared. Results Both systems correctly identified the vast majority (98%) of the isolates to the genus level. Vitek MS reached higher rates of identification to species and species complex level than Microflex LT (81% vs. 85% and 87% vs. 93%, respectively), which was mainly based on the higher performance among coagulase negative staphylococci and Candida isolates. The evaluation of user friendliness and other technical aspects showed only marginal differences, which slightly favored Vitek MS, mainly due to its ready-to-use supplies, easier connectivity and workflow integration, and availability of local technical support. Conclusions Both MALDI-TOF MS systems permitted fast and accurate identification of most microbial strains and showed a high level of user-friendliness. The observed differences were marginal and slightly favored Vitek MS, mainly due to practicality and connectivity issues within our setting.

SELF-REPORT OF EMPATHY: A SHORTENED FRENCH ADAPTATION OF THE INTERPERSONAL REACTIVITY INDEX (IRI) USING TWO LARGE BELGIAN SAMPLES.

For more than 30 years, the Interpersonal Reactivity Index (IRI) has been used to measure the multidimensional aspects of empathy. But the 28-item, 4-factor model of Davis (1980) is currently contested because of methodological issues and for theoretical reasons. Confirmatory (CFA) and exploratory factor analyses (EFA) were applied in two French-speaking Belgian student samples (1,244 participants in the first and 729 in the second study) to test this model and to propose a shortened version. A non-optimal fit was found with respect to the CFI value (Study 1). By splitting the student group into two random subsamples, EFA and then CFA were used to propose a 15-item, 4-factor model with good fit indices. A CFA on the second student group (Study 2) replicated this model. Results are discussed considering the influence of social desirability response bias, an absence of strong invariance across sex and the usefulness of self-report scales to measure empathy.

French adaptation of the Narcissistic personality inventory in a Belgian French-speaking sample

The Narcissistic Personality Inventory (NPI) is the most widely used self-report scale to assess the construct of narcissism, especially in its grandiosity expression. Over the years, several factor models have been proposed in order to improve the understanding of the multidimensional aspect of this construct. The available data are heterogeneous, suggesting one to at least seven factors. In this study, we propose a French adaptation of the NPI submitted to a sample of Belgian French-speaking students (n = 942). We performed a principal component analysis on a tetrachoric correlation matrix to explore its factor structure. Unlike previous studies, our study shows that a first factor explains the largest part of the variance. Internal consistency is excellent and we reproduced the sex differences reported when using the original scale. Correlations with social desirability are taken into account in the interpretation of our results. Altogether, the results of this study support a unidimensional structure for the NPI using the total score as a self-report measure of the Narcissistic Personality Disorder in its grandiose form. Future studies including confirmatory factor analysis and gender invariance measurement are also discussed.