The present study examined the reliability and validity of a Chinese translation of the Mindful Attention Awareness Scale (MAAS). Three questionnaires, the MAAS, the Positive and Negative Affect Schedule (PANAS), and the brief version of the World Health Organization's Quality of Life (WHOQOL-BREF), were completed by 263 Chinese undergraduates (207 males, 56 females). Seventy of these students were assessed again with the MAAS after 20 days to evaluate the scale's testretest reliability. Results from confirmatory factory analysis indicated that a one-factor solution fit the MAAS data satisfactorily. Reliability coefficients, including Cronbach's alpha, Guttman split-half, item-total correlations, and testretest, were also satisfactory. Addressing validity, the MAAS was negatively correlated with PANAS negative affect and positively associated with PANAS positive affect as well as with the quality of life indexed by the WHOQOL-BREF. The Chinese version of the MAAS appears to be a reliable and valid instrument to assess levels of mindfulness in a Chinese college population.

Objective: Insomnia is evident in the majority of youth with depression, and is associated with poorer outcomes. There are limited data on the impact of insomnia in response to acute treatment, which is particularly relevant with serotonin-selective reuptake inhibitors, given their tendency to worsen sleep architecture. Methods: Three hundred nine children and adolescents (ages 7-18 years) were randomized to fluoxetine (n = 157) or placebo (n = 152) for 8-9 weeks (Emslie et al.1997. Substantial insomnia at baseline was defined as a child's depression rating scale-revised [CDRS-R] sleep item ‡ 4. Outcome measures were CDRS-R, response, and remission. Results: Insomnia was reported in 172/309 (55.7%) youth, and was associated with higher depression severity and greater fatigue, suicidal ideation, physical complaints, and decreased concentration. While response rates were similar in those with or without insomnia overall (51.7% vs. 55.7%), there is a significant difference by age group. Among adolescents, those with insomnia were less likely to respond to fluoxetine (39.2%; 20/51) than those without (65.9%; 27/41; p = 0.013), while in children on fluoxetine, those with insomnia were more likely to respond to fluoxetine (69.4%; 25/36) than those without insomnia (41.4%; 12/29; p = 0.027). Insomnia did not impact the response to placebo in either age group. Within adolescents, the overall least squares means for CDRS-R total score (across the 8 weeks of treatment) were significantly different between those who had insomnia versus those who did not within the fluoxetine group ( Conclusions: While adolescents reporting substantial insomnia were less likely to respond to antidepressant treatment than those without insomnia, children were more responsive to fluoxetine when they had insomnia. Additional intervention targeting sleep disturbance may be warranted in adolescents.

This study examined the relationship between frequency of exposure to non-suicidal self-injury (NSSI) and engagement in NSSI among adolescents. Ninety inpatient adolescents with a history of NSSI, ages 12 to 17, completed a structured interview. The majority of participants had learned about NSSI prior to initiating the behavior themselves. More frequent exposure to specific methods of NSSI was associated with greater frequency of using those same methods. Greater exposure to NSSI in the media and seeking out NSSI content were related to greater frequency of engagement in NSSI. Clinicians may help those who self-injure to become more knowledgeable and educated consumers of media to prevent NSSI behavior and contagion.

ObjectiveTo investigate the construct and criterion validity of the Euro Qol-5D (EQ-5D), which allows quality-adjusted life-years to be calculated, in patients with systemic lupus erythematosus (SLE).MethodsConsecutive SLE patients who had been followed at the Renji Hospital, School of Medicine, Shanghai Jiao Tong University were recruited. Cross-sectional correlations of the EQ-5D with equivalent domains in disease-specific health-related quality of life (HRQoL), LupusQol, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) measures, the Systemic Lupus International Collaborating Clinics Damage Index (SDI), and patient characteristics were tested. Discriminant validity to assess the ability to distinguish between patients of different disease severity was assessed. There also were evaluations of ceiling and floor effects.Results240 patients were recruited in total. The EQ-5D correlated moderately to strongly with all domains of the LupusQoL (r: 0.44–0.7) apart from intimate relationships (r = 0.25) and body image (r = 0.18). There was moderate negative correlation between EQ-5D and clinical assessment of disease, SLEDAI (r = −0.589) and SDI (r = −0.509). When compared with equivalent domains on LupusQoL, there was good construct validity in EQ-5D (r: 0.631–0.812). EQ-5D could also discriminate patients with varied disease severity (according SLEDAI and SDI). There was no floor effect in EQ-5D but the ceiling effect remains strong (34%).ConclusionOur results provide sufficient evidence that the EQ-5D displays construct and criterion validity for use in SLE patients. Disease-specific measures of HRQoL used alongside may be a better choice.

In a time of increasing economic constraints, it is crucial that health systems optimize their resource use to ensure that they generate the maximum possible health gain. Therefore, it is necessary for health interventions to be evaluated and compared across therapeutic boundaries. Undertaking such an evaluation a generic utility-based measure is required. But it remains uncertain whether the utility values obtained by direct or indirect methods are comparable and which approach is the most appropriate in Systemic Lupus Erythematosus (SLE) population. In the study, we compared the utility values obtained by an indirect method (EQ-5D) with direct utility instruments, the standard gamble (SG) and visual analog scale (VAS), in SLE patients. The correlations between VAS, EQ-5D and LupusQoL were significant; relative good intraclass correlations or kappa coefficients indicated the reliability of these instruments. A model incorporating the SLEDAI scores and LupusQoL domains of emotional health and pain was a good predictor of VAS. SLEDAI score was a good predictor in the SG regression model. These findings suggested that the VAS and EQ-5D might be valid and reliable measures to assess health related quality of life in SLE patients and represent promising outcome measures for future research in this population.