Delineating and diagnosing depression and anxiety in the presence of a medical condition, such as diabetes, is complicated by the presence of overlapping symptoms that, therefore, are etiologically ambiguous. These overlapping symptoms include feelings of fatigue, concentration difficulties, restlessness, changes in appetite, irritability and autonomic arousal. The difficulty in understanding these overlapping symptoms has been proposed to lead to an underdiagnosis of depression and anxiety disorders among adults with diabetes, which is problematic given that such disorders are associated with poorer health outcomes. The goal of the current study is to test whether or not these overlapping symptoms are affected by the presence of diabetes by comparing structural models of these symptoms in adults with diabetes versus those free of major medical conditions. Participants include 226 adults with diabetes and 379 adults free of diabetes who completed a series of questionnaires assessing symptoms of depression, anxiety and health status. In addition, for adults with diabetes, the most recent hemoglobin A1c lab result was collected from patient medical records. Results indicate that overlapping symptoms were strongly related to mood for adults with and without diabetes. In conclusion, it is recommended that when these overlapping symptoms are present in adults with diabetes, depression and anxiety should be considered as possible contributors to their presence.

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This study responds to the globally increasing rate of caesarean section, and specifically to the very high rate of elective caesarean section among Taiwanese mothers as evidence suggests that such elective caesareans pose potential health risks for mothers and babies. The purpose of this study was to develop and evaluate a multi-component instrument based on the theory of planned behavior (TPB) to better understand Taiwanese pregnant women's decisions regarding their childbirth delivery options (spontaneous vaginal delivery or elective caesarean section). The study was a four-phased mixed method design. First, the TPB guided item development and instrument drafting. Second, pretesting and instrument refinement used cognitive interviewing with a small sample of Taiwanese pregnant women. Third, the instrument was administered to 310 such women to examine psychometric properties of the component scales. Fourth, the phase 3 instrument was re-administered to 30 women to estimate item stability. Confirmatory factor analyses (CFA) were used to assess construct validity of the multi-item, multi-component measurement model with LISREL 9.1. Based on the TPB, the 52-item self-administered Childbirth Delivery Options Questionnaire (CDOQ) was developed to measure three components: intention regarding delivery options, attitudes toward delivery options, and perceptions of significant others' (partner, mother, and mother-in-law) feelings about delivery options. Respondents from phase two thought that the items on the CDOQ were easy to read and comprehend; they reported favorably on the wording and formatting. Preliminary item analysis revealed that the items referring to dangerousness of delivery options did not function as intended and were dropped because they did not differentiate between the two delivery options, leaving 36 items. Test-retest reliability indicated that responses to each item were positively correlated and those referring to spontaneous vaginal delivery were more stable than those referring to elective caesarean section. Corrected item-to-total correlations and expected change in Cronbach's alpha if item deleted revealed that four items might form a measure of general social norms associated with the Taiwanese culture. The Cronbach's alphas for the components of the CDOQ ranged from .55 to .89. The measurement model incorporating the design features of the CDOQ fitted the data well using the CFA. Because serious problems with multicollinearity and suppression were revealed, Beckstead's (2012) criterion-irrelevant-variance-omitted (CIVO) regression method was used to untangle the suppressor effects when predicting intention from the other components of the CDOQ. The results indicated that attitude and partner's feelings were significant and explained the bulk of the variance in intentions. The TPB-based instrument developed here will be of considerable use to maternal-child health researchers. The findings of this study suggest that decisions regarding delivery options may be modified by interventions geared toward pregnant women's attitudes within family- and cultural-centered prenatal programs.

Contexte. Les infractions à caractère sexuel ont fortement augmenté dans les dernières années et les personnes mineures en sont les principales victimes. Un grand intérêt est accordé aux distorsions cognitives dans le champ de la recherche en délinquance sexuelle. Cependant, très peu d’études se sont intéressées aux dimensions mesurées par l’un des instruments les plus utilisés : l’échelle de cognitions Molest (ÉCM ; Bumby, 1996). Peu d’études se sont également intéressées au lien entre les distorsions cognitives et la carrière criminelle des auteurs d’infractions à caractère sexuel sur personnes mineures (AICSM). Objectif. L’objectif du présent mémoire est d’explorer les dimensions mesurées par l’ÉCM et les comparer aux résultats d’études précédentes. Il est aussi question d’étudier le lien entre les distorsions cognitives mesurées par l’ÉCM et la carrière criminelle des AICSM. Méthodes. L’échantillon est composé de 1232 hommes adultes AICSM étant suivis au Centre d’intervention en délinquance sexuelle (CIDS) de Laval. Les participants ont tous complété l’ÉCM lors de leur suivi au centre. Résultats. Les résultats indiquent que quatre dimensions émergent de l’ÉCM et que certaines distorsions cognitives telles que mesurées par cet instrument sont liées aux différents paramètres de carrière criminelle des individus composant l’échantillon, incluant la récidive violente et sexuelle. / Background. Sexual offenses have increased sharply in recent years and minors are the main victims. There is considerable interest in cognitive distortions in the field of sexual offending research. However, very few studies have focused on the dimensions measured by one of the most widely used instruments: the MOLEST Cognitions Scale (Bumby, 1996). Few studies have also looked at the link between cognitive distortions and the criminal careers of people who have sexually offended against a minor (PSOM). Objective. The objective of the present study is to explore the dimensions measured by the MOLEST scale and compare them with the results of previous studies. It also investigates the relationship between cognitive distortions measured by the MOLEST scale and PSOMs’ criminal careers. Methods. The sample consisted of 1,232 adult men who sexually offended on a minor and were being treated at the Intervention centre in sexual delinquency (ICSD) in Quebec (Canada). All participants completed the MOLEST cognition scale during their treatment at the ICSD. Results. Findings indicate that four dimensions emerge from the MOLEST scale, and that certain cognitive distortions as measured by this instrument are related to the different criminal career parameters of sample, including violent and sexual recidivism.