This study evaluates the effect of a short-term group intervention titled Writing for Recovery in Gaza. Adolescents (N ¼ 139) aged 12-17 were randomly assigned to an intervention or to a waiting list group. Levels of distress were assessed at baseline and at posttest. A follow-up assessment was conducted 5 months after both groups had received the intervention. Results at posttest showed a reduction in posttraumatic stress symptoms in both groups, an increase in depression in the intervention group, and no change in anxiety symptoms. At follow-up, a significant decline in depression scores was evident. Overall, no evidence for improvements due to the intervention was found.
Abilities of the Short-Form McGill Pain Questionnaire to assess change have scarcely been addressed in previous studies. The aim of the present study was to examine test-retest reliability, sensitivity to change and responsiveness to clinically important change using a Norwegian version (NSF-MPQ) in different groups of patients. ICC(1,1) values for test-retest reliability (relative reliability) assessed 1-3 days apart for total, sensory and affective scores were, respectively, 0.75, 0.76 and 0.62 in patients with musculoskeletal pain (n=58), and 0.93, 0.95 and 0.79 in patients with rheumatic pain (n=25). Variability in total scores (absolute reliability) was less in patients with rheumatic pain (within-subject standard deviation, S(w)=2.70) than in patients with musculoskeletal pain (S(w)=4.28). Sensitivity to change by standardized response mean (SRM) was mostly large (>0.80) for three patient groups reporting improvement after treatment. More sensitivity to change was demonstrated by the total and sensory scores than by the affective score, and sensitivity of the total score was similarly good to capture improvement as the Visual Analogue Scale (VAS). Indication was provided that mean improvement of groups in NSF-MPQ total scores should be >5 on the 0-45 scale to demonstrate a clinically important change. Responsiveness to clinically important change by receiver operating characteristic curve analysis was modest, as area under the curve indicating ability to discriminate improved and not improved patients with musculoskeletal pain, was only 0.61. The study indicates mostly satisfactory test-retest reliability and responsiveness values of the NSF-MPQ, but shows that the measurement properties vary between groups of patients with pain.
The aim of this study was to validate the Kleinknecht's Dental Fear Scale and the Getz's Dental Belief Survey in a Norwegian sample by 1) testing their ability to discriminate between fearful (n = 151) and regular (n = 160) patients, and 2) correlating them. Both instruments were highly reliable (Cronbach's alpha > 0.90). Between 81% and 95% of the fearful and regular patients were correctly assigned to their appropriate groups with both instruments. It may thus be concluded that both instruments are valid. Also, the correlation between the instruments was 0.68, indicating that they to a large extent seem to measure the same concept. The most important predictor items for both instruments were related to avoidance of dental treatment.
The present study examined among adolescents in Gaza the relationship between exposure to war stressors and psychological distress as well as the effects of age, gender, and socioeconomic status. Data were collected from a sample of 139 adolescents 12 to 17 years old. Results showed that adolescents reported elevated levels of intrusion, avoidance, and depression compared to levels in communities not affected by war in the recent past. The proportion scoring within the clinical range of posttraumatic stress disorder (PTSD) was 56.8% compared to 6.3% in peacetime populations, reflecting a Hedges's g of 1.29 (p < .001). Significant risk factors for PTSD were exposure (β = .377, p < .001), female gender (β = -.257, p < .001), older age (β = .280, p < .01), and an unemployed father (β = -.280, p < .01). Risk factors for anxiety were exposure (β = .304, p < .001), female gender (β = -.125, p < .01), and older age (β = 272, p < .01), whereas female gender (β = <.238, p < .001) was the only significant risk factor for depression. The present study suggests large individual differences in how adolescents are affected by war stressors.
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