Determinants of personal recovery: a mediation analysis 173 This mediation analysis was conducted in the context of an RCT on IMR. This study was conducted in accordance with the Declaration of Helsinki. The study protocol of our RCT on IMR was approved by the accredited medical ethics trial committee at Erasmus University Medical Center Rotterdam (27/8/2012, METC nr NL38605.078.12) (11). Due to an administrative oversight, the prospective trial registration was initially overlooked; however, this omission was noticed halfway through the data collection period and the trial was registered with the Netherlands Trial Register (NL4931, NTR5033). Measures Illness (self-) management Illness (self-) management (IM) was assessed with the IMR scale client version. The IMR scale client version is a composite measure of various components of illness self-management. The 15 items rated on a scale of 1–5 comprise key IM elements, which are also trained in the IMR program, and include progress towards goals, knowledge regarding mental illness, relapse-prevention planning, involvement with significant others, coping with symptoms, medication adherence, substance abuse, and symptom distress (4, 21, 29-31). For the IMR scale, three subscales were found: ‘Coping with Illness Outcome,’ ‘Knowledge and Goals,’ and ‘Effective Medication Use/Reduced Alcohol and Drug Abuse’ (32). Personal recovery Personal recovery (PR) was assessed with the Mental-Health Recovery Measure (MHRM). The MHRM, whose 30 items are self-rated on a scale of 0–4, is a composite personal recovery scale that measures self-empowerment, learning and new potentials, and spirituality (33, 34). Clinical recovery Clinical recovery (CR) was assessed with the Brief Symptom Inventory (BSI). The BSI is self-rated and has 53 items rated on a scale of 0–4. It measures nine symptomatology dimensions: Psychoticism, Depression, Somatization, Phobic Anxiety, Obsessive Compulsive, Interpersonal Sensitivity, Anxiety, Hostility, and Paranoid Ideation (35). Functional recovery Functional recovery (FR) was assessed with the Social Functioning Scale (SF-scale). The SF-scale is a self-administered questionnaire that measures social and role functioning with 76 items with varying response formats on the following seven dimensions: social withdrawal, relationships, social activities, recreational activities,
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