Ften try to preserve mental resources when filling out different questionnaires, compromising the quality for more arbitrarily chosen answers [80]. In relation to the individuals in the media group this may not have been an issue, but for the patients in the treatment group the instrument developed for the current study was one of seven outcome measures to be completed. Thus, for future studies, the problem of cognitive load needs to be considered. The NEQ now consists of 32 items and should avoid some of this problem, but the administration of the instrument on a separate MLN9708 site occasion is nonetheless recommended. Fifth, albeit the current study has provided some evidence of negative effects of psychological treatments, the association between its occurrence and implications for outcome is still unclear. Adverse and unwanted events that arise during treatment might be a transient phenomenon related to either the natural fluctuations in psychiatric disorders or treatment interventions that are negatively experienced by the patient, but helpful in the AZD1722 biological activity long-run. Alternatively, such negative effects may have an impact that prevents the patient from benefitting from treatment, resulting in deterioration, hopelessness, and a sense of failure. To investigate this issue, the NEQ therefore needs to be accompanied by other outcome measures. By collecting data from several time points throughout treatment and relating it to more objective results, both at post treatment assessment and follow-up, it should be possible to determine what type of impact adverse and unwanted events actually have for the patient. Sixth, even though there exist several methods for validating a factor solution from an EFA, the findings are still to some extent a result of making subjective choices [53]. Relying solely on the Kaiser criterion or scree test provide a relatively clear criterion for obtaining the factor solution, such as, using eigenvalues greater than one as a cutoff, but risk missing factors that are theoretically relevant for the underlying construct(s) [54]. Likewise, such methods often lead to over- or underfactoring and is thus not regarded as the only mean for determining the number of factors to retain [57]. In the current study, a six-factor solution seemed most reasonable, particularly as it fits well with prior theoretical assumptions and empirical findings, which is one way of validating the results [62]. A parallel analysis and a stability analysis also provided some support for the findings, but such methods also have a number of limitations [53]. Most notably, factors that are randomly generated still have to be compared to a factor solution that is subjectively chosen, and the selection of a random number of cases to retest the factors are still derived from the same sample. Thus, it should be noted that replications are needed to fully ascertain if the obtained factor solution is truly valid and stable across samples. This would, however, warrant recruiting patients and individuals from additional settings, and to implement alternative statistical methods, such as Rasch-analysis, which has some benefits in investigating data where the level of measurement can be assumed to be quasi-interval [81]. Lastly, using EFA to determine theoretically interesting latent constructs does not imply that the items that were not retained are inapt, only that they did not fit the uni- or multidimensionality of the final factor solution. Hence, some of the items th.Ften try to preserve mental resources when filling out different questionnaires, compromising the quality for more arbitrarily chosen answers [80]. In relation to the individuals in the media group this may not have been an issue, but for the patients in the treatment group the instrument developed for the current study was one of seven outcome measures to be completed. Thus, for future studies, the problem of cognitive load needs to be considered. The NEQ now consists of 32 items and should avoid some of this problem, but the administration of the instrument on a separate occasion is nonetheless recommended. Fifth, albeit the current study has provided some evidence of negative effects of psychological treatments, the association between its occurrence and implications for outcome is still unclear. Adverse and unwanted events that arise during treatment might be a transient phenomenon related to either the natural fluctuations in psychiatric disorders or treatment interventions that are negatively experienced by the patient, but helpful in the long-run. Alternatively, such negative effects may have an impact that prevents the patient from benefitting from treatment, resulting in deterioration, hopelessness, and a sense of failure. To investigate this issue, the NEQ therefore needs to be accompanied by other outcome measures. By collecting data from several time points throughout treatment and relating it to more objective results, both at post treatment assessment and follow-up, it should be possible to determine what type of impact adverse and unwanted events actually have for the patient. Sixth, even though there exist several methods for validating a factor solution from an EFA, the findings are still to some extent a result of making subjective choices [53]. Relying solely on the Kaiser criterion or scree test provide a relatively clear criterion for obtaining the factor solution, such as, using eigenvalues greater than one as a cutoff, but risk missing factors that are theoretically relevant for the underlying construct(s) [54]. Likewise, such methods often lead to over- or underfactoring and is thus not regarded as the only mean for determining the number of factors to retain [57]. In the current study, a six-factor solution seemed most reasonable, particularly as it fits well with prior theoretical assumptions and empirical findings, which is one way of validating the results [62]. A parallel analysis and a stability analysis also provided some support for the findings, but such methods also have a number of limitations [53]. Most notably, factors that are randomly generated still have to be compared to a factor solution that is subjectively chosen, and the selection of a random number of cases to retest the factors are still derived from the same sample. Thus, it should be noted that replications are needed to fully ascertain if the obtained factor solution is truly valid and stable across samples. This would, however, warrant recruiting patients and individuals from additional settings, and to implement alternative statistical methods, such as Rasch-analysis, which has some benefits in investigating data where the level of measurement can be assumed to be quasi-interval [81]. Lastly, using EFA to determine theoretically interesting latent constructs does not imply that the items that were not retained are inapt, only that they did not fit the uni- or multidimensionality of the final factor solution. Hence, some of the items th.