Vilmantė Pakalniškienė

Translating the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) into Lithuanian

Abstract Viliū nienė R, Evans C, Hilbig J, Pakalniškienė V, Danilevičiū tė V, Laurinaitis E, Navickas A. Translating the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) into Lithuanian. Nord J Psychiatry 2012;Early Online:1–7. Background: There are no standardized tools in Lithuanian feasible for ongoing routine use to measure the effectiveness of psychotherapeutic treatment. The CORE-OM is a widely used 34-item self-report measure for such purpose. Aims: To explore the reliability, validity and sensitivity of the Lithuanian translation of CORE-OM questionnaire. Methods: A validation study of the CORE-OM was conducted in the psychiatric clinic attached to Vilnius University. A Lithuanian translation of the English original CORE-OM was prepared by a team of translators. Then 39 psychotherapy outpatients and 187 students were asked to complete the Lithuanian version of the CORE-OM; 66 were tested twice to determine test–retest stability. Analysis included both internal and test–retest reliability, acceptability, influence of gender, principal component analysis and criteria for reliable and clinically significant change. Results: Internal and test–retest reliability were good (0.61–0.94), though somewhat lower for the risk domain (α: 0.57–0.79, Spearmans rho 0.25–0.60). Differences between scores of the clinical and non-clinical samples were large and significant (P < 0.001). Some of the Lithuanian criteria for clinically significant change were a bit lower than those of the original UK criteria (e.g. well-being) and others higher (symptoms, functioning, overall score), illustrating the need for local exploration. Conclusions: In spite of small differences in psychometric properties from the original, the Lithuanian version of the CORE-OM was reliable and sensitive in both clinical and non-clinical settings. It has the potential to become a practical, sensitive and reliable tool for psychotherapists in Lithuania. • CORE-OM; outcome measures; psychotherapy; reliability; validation.

Patients' resilience and distress over time: Is resilience a prognostic indicator of treatment?

BACKGROUND Resilience is a positive adaptation or the ability to maintain mental health despite experiencing difficulty. Many researchers are linking resilience with many aspects of life, most often with better mental health. Resilience can affect health status and symptoms, but conversely, it can also be affected by health status or symptoms. From the literature it appears that resilience can even be a predictor of psychiatric symptoms. Resilience can predict severity of symptoms, but the question is whether symptoms can also affect resilience over time when previous levels of resilience are controlled for. The aim of this study was to explore the relationship of resilience scores and the expression of distress in the context of treatment over time. METHODS Ninety-five patients diagnosed with affective and anxiety disorders from a clinical sample treated psychotherapeutically with (N=81) or without (N=14) a pharmacological treatment at a psychotherapy day center participated in the study. All the participants were assessed three times: at the beginning of the treatment, after treatment (after 6weeks), and after a follow-up interval of 6months after the end of therapy. The Resilience Scale for Adults and the Clinical Outcomes in Routine Evaluation Outcome Measure were used in the study. RESULTS All distress indicators were expressed more before the treatment compared to right after the treatment or half a year after the treatment. Distress indicators were more stable from Time 1 to Time 2, while from Time 2 to Time 3 they were less stable. In this study, resilience increased during the treatment and stayed stable after the treatment. Looking at bidirectional relationships between distress indicators and resilience over time, the results of this study suggest that levels of resilience have a prognostic value for the reduction of symptoms over the course of treatment. However, decrease in distress does not predict increase in resilience. CONCLUSIONS Levels of resilience measured by RSA scores seem to have a certain prognostic value for the reduction of symptoms over the course of treatment. Perception of self was the strongest predictor of lower levels of distress over time when distress and perception of self-stability are controlled for. Results suggest that decreased distress indicators are not directly related to increasing resilience over six weeks or over six months. Considering that resilience is rather stable over time and indicators are less stable, it is possible that resilience could be increased by personal or environmental factors, and a decrease in distress is not a contributing factor. In this study distress decreased over time, while resilience characteristics increased for the whole sample. Patients in this study underwent treatment, and decreases in global distress were a result of treatment. An increase in resilience over time supports the effectiveness of treatment. However, there were no significant differences between treatment types while evaluating models. Results suggest that treatments (psychotherapy or psychopharmacological with psychotherapy) were equally effective for the chosen patients.

Resilience in a reborn nation: Validation of the Lithuanian Resilience Scale for Adults (RSA).

BACKGROUND Resilience, as an ability to withstand or rebound from crisis or adversity, is becoming an increasingly significant concept in health promotion and well-being. Individuals exhibiting resilience use skills or resources flexibly to solve situational demands. The Resilience Scale for Adults (RSA) may be used to assess protective resources, and the aim of the present study was to validate the Lithuanian translation. METHODS The translated RSA was administered to a clinical (n=125) and a non clinical sample (n=499) to examine the discriminant validity of the RSA items with a confirmatory factor analysis, the internal consistency as well as construct validity by correlating it with the Quick Psycho-Affective Symptoms Scan (QPASS). RESULTS The internal consistency, the test-retest stability and the factor structure were replicated as adequate, thus indicating good psychometric properties and support of discriminant validity. Females reported more resilience resources for the domains of social competence, family cohesion and social resources compared to men. The RSA subscales correlated negatively with the QPASS scores, and patients reported significantly less resilience resources than non-patients, thus indicating construct validity. CONCLUSIONS Valid psychometric tools for research purposes and routine every-day use are urgently needed in Lithuania, a young nation still under numerous challenges due to social, economic and political transitions. The RSA represents a reliable and valid tool for assessing protective factors. Assessing resilience factors may extend the understanding of factors relevant for mental health problems as well as treatment prognosis beyond the capabilities of mere symptom oriented approaches.

Adolescent Influence on Parental Purchase Decisions: Typology of Innovative Products

Purpose – There is common agreement that children’s influence on parents to purchase products depends on the product category (products for a child vs. products for the family; minor everyday purchases vs. shopping goods). However, purchasing an innovative product in the presence of an adolescent, compared to the purchase of traditional products, creates a special context in which an adolescent might be considered a substantial source of expertise with diverse levels of impact on parents. The current research aims to demonstrate the magnitude of adolescents’ impact on parents when purchasing innovative products, and to cluster the products based on the size of the impact and the level of the perceived innovativeness. Specific characteristics of clusters and the implications for marketers are discussed. Design/Methodology/Approach – An Internet panel was used to survey parents and adolescents from Lithuania on their assessment of the level of innovativeness and the level of children’s influence on the purchasing 14 product groups. Within each group, an innovative product preselected on the basis of qualitative interviews was paired with the usual product in the category. Later, the products were clustered by the level of innovativeness and the adolescents’ impact on parents. Findings and implications – The products were clustered to demonstrate important implications for marketers, namely, where the influence of adolescents on parental purchase decisions is stronger and where it is weaker. Limitations – An examination of selected products shows the interrelationships between their perceived innovativeness and the impact of adolescents on their parents’ purchase; however, the findings could be tested on a larger range of products. The innovativeness of the particular product is time and place bound. Originality – To our knowledge, this is the first attempt to cluster the products based on their innovativeness and the adolescents’ impact on parents in the purchasing process.

Balanced Time Perspective: Many Questions and Some Answers

Balanced time perspective is one of the areas in time perspective research that attracts the most attention. This implies that it might be one of the mechanisms underlying well-being. Moreover, conducted analysis allows for the conclusion that there are at least two reliable ways to recognize the balanced time perspective: the method of profiles and the method of deviation from balanced time perspective. In addition, there are indications that other time perspective profiles exist, with the best investigated among them being negative time perspective profile. Despite considerable interest in this field, many issues regarding the balanced time perspective remain unaddressed. Further investigation should focus on examining the dynamic nature of the balanced time perspective, as well as the nature and significance of other suggested time perspective profiles.