Anita Hubley

No abstract available.

Anxiety and depressive disorders are commonly experienced after a traumatic brain injury (TBI). Hence, it is necessary to have screening tools for these disorders that allow test users to make inferences from test scores that are reliable and valid. One screening tool, the Hospital Anxiety and Depression Scale (HADS), has limited and inconsistent reliability and validity evidence for use with individuals with TBIs. Therefore, the purpose of this study was to explore response processes validity evidence of the HADS anxiety subscale (HADS-A) and depression subscale (HADS-D) for use with individuals with TBIs. Participants included 22 individuals who ranged in age from 22 to 63 years old and who had sustained one or more TBIs in adulthood. A cognitive interview was conducted in order to collect data on the response processes used during the completion of the HADS. Descriptive results revealed that the HADS-A showed ‘adequate’ and the HADS-D showed ‘poor’ response processes validity evidence (78.0% and 64.3%, respectively, of item scores coded as valid). Results from the thematic analysis revealed problematic interpretations of particular items, such as 72.7% of participants expressing that Item #8D: “I feel as if I am slowed down” was asking about TBI symptoms, rather than a symptom of depression. The response processes validity evidence findings from this study is discussed within the context of the extant validity evidence of the HADS for use with individuals with TBIs presented in the literature, and it is not recommended that HADS-A and HADS-D scores are used to make inferences about anxiety and depressive symptomatology among individuals with TBIs, as it is currently written. Therefore, the findings from this study were used to make specific recommendations about modifications to the instructions and items on the HADS for use with individuals with TBIs. The results of this study should be relayed to various professionals (e.g., counsellors, psychologists, and healthcare professionals) in order to inform the extent to which it is appropriate to interpret scores from the HADS to infer anxiety and depressive symptomatology for persons with TBIs.

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No abstract available.

Although the Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1989) is the most widely used measure of self-esteem, the evidential basis to support the interpretation and use of the RSES scores with community adults is significantly lacking. Rosenberg (1965) defined self-esteem as the self-appraisal of worthiness of an individual’s socialized identity. In order to support this interpretation of the RSES for use with community adults within a research context, the dimensionality of the RSES scores was examined and the expected relationships with theoretically more related (convergent) and less related (discriminant) constructs were provided as validity evidence in a sample of 1,083 community adults. Utilizing confirmatory factor analysis (CFA), a series of models were tested based on the following emergent themes from the literature: (1) unidimensional, (2) bidimensional with distinct latent variables, representing both positive and negative self-esteem, or (3) unidimensional with method effects due to negatively worded (i.e., reverse-coded) items, positively worded items, or both. Results suggest that once method effects are taken into account, due to negatively worded (i.e., reverse-coded) items, a unidimensional model fit the data best. Convergent and discriminant evidence was examined along a theoretically and empirically expected continuum of constructs from highest to lowest expected absolute magnitude of validity coefficients: self-liking, global self-esteem, self- competence, depression, optimism, mental health functioning, physical health functioning, and narcissism. The obtained convergent and discriminant validity coefficients generally fit with the theoretically and empirically expected continuum and support more of a self-worth interpretation of RSES scores. However, the higher-than-expected correlations with optimism and mental health functioning raise some validity concerns. The results from this study equip researchers with additional evidence to evaluate the degree to which the scores derived from the RSES are indicative of global self-esteem in community adults for use within a research context.

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Depression is ranked as one of the most burdensome health conditions and is more prevalent in university students compared to the general population. Effective screening measures are an important aspect of detection and progress monitoring, as well as being key in depression research. However, current widely used measures, such as the Beck Depression Inventory-II (BDI-II) and the Center of Epidemiological Studies Depression Scale (CES-D), can be lengthy. For research participants who have to complete a battery of questionnaires and especially for depressed clients who are low on energy, it can be daunting to complete lengthy measures. Additionally, the BDI-II can be costly for research, counselling centers, and university clinics. Therefore, there is a need for a short, effective depression screen for both clinical and research purposes. The Patient Health Questionnaire-9 (PHQ-9) is an ideal candidate. It is only nine items, freely accessible, well established, and reflects the current diagnostic criteria. While there is an abundance of validity evidence for the PHQ-9 in primary and secondary care, there is a gap in validity evidence related to its use in the university population. To date, validity evidence for the inferences made from the PHQ-9 in the university population is limited to China, Japan and Nigeria, as well as a single secondary analysis in the U.S. The present study assessed internal structure, internal consistency reliability, and convergent and discriminant evidence to support the inferences made from the English version of the PHQ-9 as a depression screen for university students in Canada. A total of 204 university students completed an online survey. Results supported a unidimensional structure and high internal consistency of the PHQ-9 scores. The PHQ-9 also demonstrated the expected pattern of convergent and discriminant validity coefficients with scores on depression, anxiety, mental health functioning, and physical health functioning measures. Based on the psychometric results from this study, the PHQ-9 is tentatively recommended for use with university students.

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The adverse conditions associated with living with no fixed address give rise to many physical and mental health issues. There is a rich history of research on homelessness that focuses on related health deficits. Emerging positive psychological literature has illuminated the importance of identifying the personal strengths and potentialities of individuals who are homeless. Self-esteem is a strength that has been extensively researched in positive psychology and has been characterized as a causal force underlying many of the psychological challenges facing people who are homeless. Indeed, self-esteem has been identified as a predictor or mediator/moderator in relationships with other psychological concepts critical to adults who are marginalized. That said, few studies have examined how subjective quality of life (QoL), depression, and health conditions act as predictors of self-esteem in populations that are homeless. Secondary data from the Quality of Life for Homeless and Hard-to-House Individuals (QoLHHI) study (N = 239) was analyzed using multiple regression in SPSS to determine if, and to what degree, subjective QoL, depression, and health conditions predict self-esteem in individuals who are homeless or unstably housed. Participants were recruited from shelters, single room occupancy (SRO) hotels, and other services in three Canadian cities – Vancouver, Calgary, and Ottawa. Findings reveal that the two psychological variables – subjective QoL and depression – were the only statistically significant predictors of self-esteem in the model, with Pratt’s index showing that depression was the most important variable. Possible implications for improving the lives of adults who are homeless, from a positive psychological perspective, may be helpful to a variety of professions, such as policy makers, researchers, and clinicians.

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Substance Use Disorders (SUDs) are a significant and growing problem for Canadians; low rates of SUD treatment entry and retention suggest that our SUD treatment system requires improvement. Fear of being stigmatized by healthcare professionals is a barrier for treatment-seeking and, despite recent changes in societal attitudes towards substance use, individuals with SUDs continue to be stigmatized. Most counsellors are likely to see clients with SUDs during their careers and their attitudes towards these clients will strongly influence the therapeutic value of these encounters, which can range from helpful to harmful. Little is known about counsellors’ attitudes towards working with clients with SUDs and even less is known about the factors that contribute to them, thus providing a rationale for the current study. Counsellors were recruited from an online Canadian directory (n = 263) and data were collected using an online survey. To measure attitudes, the Medical Condition Regard Scale, modified for use with counsellors, was completed twice: once for clients with SUDs and once for clients with Major Depressive Disorder (MDD). Attitudes were mostly positive towards clients with SUDs, although 11 participants reported negative attitudes. A one-way repeated measures ANOVA found that overall scores were significantly more positive for the MCRS-MDD. However, the items of the MCRS-MDD that yielded more positive responses were all related to the difficulty of treating the disorder. We used one-way between-groups ANOVAs as well as bivariate correlation coefficients to determine which factors had significant bivariate relationships with MCRS-SUD scores. A standard ordinary least squares multiple regression was run to determine which of these variables still had an effect in the presence of the other statistically significant variables. Frequency of contact with clients with SUDs, workplace situational constraints, feelings of anger towards people with SUDs, and age remained as significant variables. The implications of these findings for research and counselling training and practice are discussed.

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Although the benefits of antiretroviral therapy (ART) on the quality of life of people living with HIV/AIDS (PLWHA) who use illicit drugs have been well-described, sub-optimal adherence to ART remains an ongoing health concern. Positive health outcomes associated with adherence self-efficacy have been well-documented but there is a paucity of research exploring the antecedents of this construct. This study sought to identify possible determinants of adherence self-efficacy among a cohort of PLWHA who use illicit drugs. From December 2005 to June 2014, data were collected from the AIDS Care Cohort to evaluate Exposure to Survival Services (ACCESS), a prospective cohort of adult PLWHA who use illicit drugs in Vancouver, Canada. We used multivariate linear regression to identify factors independently associated with higher ART adherence self-efficacy. Among 520 participants, older age and Caucasian ethnicity significantly and independently predicted higher levels of ART adherence efficacy expectations and self-regulatory efficacy, being employed predicted only higher levels of ART adherence efficacy expectations, whereas daily cocaine injection and being homeless significantly and independently predicted lower levels of ART adherence self-regulatory efficacy. Although this study highlights the potential importance that some demographic and contextual factors play in shaping adherence self-efficacy within the context of HIV and illicit drug use, efforts should be made to address methodological inconsistencies when investigating self-efficacy across different populations, including PLWHA. Future findings in this area introduce the notion of implementing screening measures for those at-risk for low ART adherence self-efficacy, as well as tailoring psychotherapy among PLWHA to increase aspects of adherence self-efficacy.

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Background: Quality of Life (QoL) and functional outcomes appear to be markers of mental health but little is known about their trajectory in the early stages of Bipolar Disorder Type I (BD I). Early phase depression appears to have a significant influence on such outcomes. This study observed the trajectory of QoL and functional outcomes and examined if (a) number of prodromal depressive episodes (prior to the first episode of mania) (b) the total number of episodes of depression experienced by 3 years, and (c) severity of ongoing depressive symptomatology, impacted QoL and functioning, across the first 3 years following the first episode of mania in a cohort of individuals with BD I. Methods: 40 individuals diagnosed with BD I and recovering from their first episode of mania were recruited from an overarching clinical program based in a hospital setting. Participants completed assessments for QoL (the Quality of Life Enjoyment and Satisfaction Questionnaire), functionality (the Multidimensional Scale of Independent Functioning), and depressive symptomology (Hamilton Depression Rating Scale) annually from baseline to year 3. Any history of prodromal and recurrent depressive episodes was also recorded. Results: QoL and functionality were observed to improve between baseline and year 1, and then stabilize up to year 3. OLS regression was utilized to assess the predictors of QoL and functional outcomes. Higher severity of depressive symptomology at baseline and year 3 were found to be predictive of lower QoL at 3 years following the onset of illness. No depression variables were significantly related to QoL or functionality difference scores between year 3 and baseline.Conclusion: This is the first longitudinal study to (a) examine the trajectory of QoL and functionality in the first 3 years of illness in a First Episode Mania (FEM) sample of individuals with BD I and (b) examine the relationship of multiple depression variables to QoL at year 3 as well as change in QoL and functionality from baseline to year 3. The findings support the need for treatment to focus on the management of depressive symptomology in the early stages of BD I, which in turn may enhance QoL.

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The Rosenberg Self-Esteem scale (RSES) is a commonly used measure, cited over 3,000 times in the past five years. The aim of this study was to produce a synthesis of the available sources of reliability and validity evidence for the RSES as classified by the Standards for Educational and Psychological Testing (AERA, APA & NCME, 2014). Despite the popularity of the RSES, only 27 articles have examined reliability and validity evidence for the scale. This study showed that the most prevalent source of reliability is based on internal consistency and the most prevalent validity evidence is based on internal structure, followed by relations to other variables. The latter source of evidence primarily consisted of convergent validity evidence. Evidence based on response processes is seldom examined and no studies examined validity evidence based on content or consequences of testing. When examining reliability, internal structure, and relations to other variables, studies tended to overlook the implications of the order in which these factors are studied. There is also a need for researchers to clearly state assumptions and criteria to interpret findings as well as more clarity in the reporting of results. The implications of these findings for researchers interested in the use of the RSES and for measurement experts will be discussed.

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This thesis had two primary goals. The first was to examine methods and procedures that researchers use in the process of validating the Satisfaction With Life Scale (SWLS) (Diener, Emmons, Larsen & Griffen, 1985). The second was to suggest a framework to organize and examine validation procedures presented in support of measures found across disciplines and journals. A literature search using the PsycINFO database from 1985 through July 2012 was conducted to capture all published validation studies of the SWLS. Each article was coded for reliability and validity evidence (i.e., test content, response processes, internal structure, relations to other variables, and consequences of testing) as described in the Standards for Educational and Psychological Testing (AERA, APA, & NCME, 1999). Each area was further broken down into elements specific to each area to account for the rationale for theoretical decisions made, procedures used, and the completeness of the reporting of validation procedures presented. Results indicate that validation studies for the SWLS focused on internal structure and relations to other variables. Relations to other variables evidence consisted mainly of convergent evidence. Where statistical analyses were conducted, criterion values for interpretation of results were rarely provided. A greater understanding is needed of what constitutes evidence of relations to other variables; how to conceptualize this evidence and provide a rationale for constructs, measures and variables used; and how to describe expected relationships and subsequently evaluate the evidence.

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