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The second edition of this series has been expanded to include a workbook for extra vocabulary and grammar practice and a teacher's resource with Cambridge Elevate, offering flexible support to German B teachers. Deutsch im Einsatz Coursebook. Deutsch im Einsatz Workbook.

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Add to cart. The households and members of these households were selected via random-route procedure. The sample was representative for the German population regarding age, gender, and education as proved by comparisons with the Federal Statistical Office. In the end, a total of persons could be included in the sample. The representative sample contains individuals A total of seven nearly equidistant age groups were set up: ages 14—24 Employment: The remainder of the sample was unemployed 8.

Educational background: Demographic information, the BSI, and further psychological assessments were collected in the survey. To investigate validity evidence based on external criteria, the 4-item version of the Patient Health Questionnaire was used to screen for depression and anxiety PHQ-4; [ 32 — 34 ]. At last, a total of 0. Descriptive statistics, reliability as well as discriminant and convergent correlations were estimated. Construct validity was tested by using the confirmatory factor analysis CFA. The corrected discriminatory power was only below.

Furthermore, the elimination of item no. Mean values and standard deviations for scale sums and the GSI are presented for gender, age and their interaction. The confirmatory factor analysis was used to prove the theoretical and empirical structure of the BSI Up to now, the BSI has not been used widely in Germany. The psychometric properties and benefits of the instrument were investigated in three samples [ 25 , 26 , 49 ].

For the present representative sample, the questions concerning reliability and model fit could be answered. The internal consistency of the scale Depression could be increased by eliminating item 17 thoughts of ending your life. This result is similar to that of other samples, but due to the clinical relevance the item should be retained.

The results by Spitzer et al. Regarding clinical data [ 25 , 26 ], it could be concluded that the BSI is more suitable to psychologically distressed than non-distressed populations. Congruent with international [ 27 , 40 , 42 , 50 ] and German clinical studies [ 25 , 26 ] the three scales of the BSI showed the best model fits by reproducing the scale structure using the confirmatory factor analysis. Besides the strength of a large sample size as a limitation, it is not possible to draw general conclusions based on the data from a representative sample since a large sample size could easily lead to significant effects.

In turn, the BSI should be applied to different clinical samples to further replicate or reprobate the factorial structure. In future research it would be productive to test the stability of the distress construct test-retest reliability and to explore connections to other distress questionnaires convergent validity or external ratings criterion validity [ 44 ]. A design with repeated measurements would allow for the comparison of factor structures across time and the determination of possible cohort effects.


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The available version of the used software to measure the factor analysis with categorical indicators was applied. This should be seen as a limitation of this study and advice for future research. The BSI is a very short, reliable instrument for the assessment of psychological distress. The factorial structure of the instrument is very good when using confirmatory factor analyses as well as the psychometric criteria.

Therefore, it is an instrument that can be used to reliably assess psychological distress in clinical samples as well as in the general population. In addition, it can be used in psychotherapy research as well as in quality assurance for psychotherapeutic long-term effects.

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Taking into account the good internal consistency reliability estimates and the encouraging convergent validity estimates, this preliminary validation is a good step forward in validation studies which are iterative in nature. SJ did the calculations under the supervision of GHF. GHF and KP wrote the manuscript.

EB did the conception and design, financed and implemented the study. HG and CB gave advice how to construct and implement the study as well as for the calculations. All authors revised the publication critically for important intellectual content and gave final approval of the version to be published. All authors agree with this publication. The consents will send by the corresponding author if accepted for publication. All participants volunteered and received a data protection declaration in agreement with the Helsinki Declaration.

Verbal informed consent was obtained from all participants. If minors or children were enrolled verbal informed consent was obtained from the next of kin, caretaker, or guardian.

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The comprehensive written information of the study participants about the exact use of the collected data through a privacy sheet and an accompanying written study information is sufficient for the legislator in this case of research. In this study, all selected participants were first informed orally about the research background of the study and its voluntary nature and the right of subsequent cancellation of own participation.

Since this was a face-to-face survey, the random selection of the target person Kish-Selection in the household was always carried out with an adult contact person. Therefore, the contents of the study were first discussed with the guardian if the target person was a minor.

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In addition to an accompanying official letter of authority for research projects all interested participants was also handed over a written privacy policy, which assured the strict confidentiality of all information given in the questionnaire and informed about the precise handling of personal-identifying data. After completion of the study the relation of these data to the collected contents was irrevocably separated.

National Center for Biotechnology Information , U. Published online Jan Author information Article notes Copyright and License information Disclaimer. Gabriele Helga Franke, Email: ed. Corresponding author. Received Jul 29; Accepted Dec This article has been cited by other articles in PMC.


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Conclusions Therefore, it is a very short, reliable instrument for the assessment of psychological distress. Open in a separate window. Materials Sample description The representative sample contains individuals Psychological assessments Demographic information, the BSI, and further psychological assessments were collected in the survey. Factorial validity The confirmatory factor analysis was used to prove the theoretical and empirical structure of the BSI Conclusion The BSI is a very short, reliable instrument for the assessment of psychological distress.

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Acknowledgements We would like to thank Liz Orrison for the native speaker proof reading. Funding The study was conducted without any kind of funding. Competing interests The authors declare that they have no competing interests. Consent for publication All authors agree with this publication. Ethics approval and consent to participate All participants volunteered and received a data protection declaration in agreement with the Helsinki Declaration. References 1. Am J Drug Alcohol Abuse.

Psychometric properties of the Brief Symptoms Inventory Bsi in a Spanish sample of outpatients with psychiatric disorders. A cross-cultural analysis of the Brief Symptom Inventory Cultur Divers Ethnic Minor Psychol.

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Existential anxiety in adolescents: prevalence, structure, association with psychological symptoms and identity development. J Youth Adolesc. Mental health service use 1-year after the World Trade Center disaster: implications for mental health care. Gen Hosp Psychiatry.

J Public Health Manag Pract. High levels of untreated distress and fatigue in cancer patients. Br J Cancer. Predictors of paternal involvement for resident and nonresident low-income fathers. Dev Psychol.

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