The Performance of the PHQ-2 and the Examination of Risks Associated With Postdeployment Depression in Air Force Medical Service Personnel

This study assessed the performance of the 2-item Patient Health Questionnaire (PHQ-2) in identifying postdeployment depressive disorders in a cohort of Air Force Medical Services personnel (N = 18,398). The prevalence of depressive disorders in the cohort was 9.00% based on medical record data. The area under the receiver operating characteristic curve was 0.56, indicating very poor classification accuracy. Sensitivity was 15.53%, specificity was 95.57%, positive predictive value was 25.75%, and negative predictive value was 91.97%. The positive and negative likelihood ratios were 3.51 and 0.88, respectively. Several risk factors associated with postdeployment depressive disorders were identified that could potentially improve screening in this population.     

Examination of the PC-PTSD in previously deployed Air Force Medical Service personnel

This study assessed the performance of the PC-PTSD in diagnosing postdeployment posttraumatic stress disorder (PTSD) in a cohort of Air Force Medical Services personnel (N = 18,530). The prevalence of PTSD in the cohort was 5.18% based on medical record data. The area under the receiver operating characteristic curve was 0.69, indicating poor classification accuracy. Sensitivity was 47.55%, specificity was 90.68%, positive predictive value was 21.79%, and negative predictive value was 96.94%. The positive and negative likelihood ratios were 5.10 and 0.58, respectively. Several risk factors were found to be associated with a diagnosis of postdeployment PTSD: being a nurse, being enlisted in the medical service career field, being enlisted in the mental health service career field, those over age 30, being a member of the Active Duty service component, and having one’s first deployment be to Iraq. Being an officer was found to be a protective characteristic. These factors could potentially improve screening for PTSD among Air Force healthcare personnel.     

A practical method for screening psychiatric disorder in children with speech and language disorders

Children with speech and language disorders have been found to have a prevalence rate of psychiatric disorder of 50%. The authors sought to develop an efficient screening procedure to distinguish such children who have psychiatric disorder and those who do not. Cutoff scores for easily administered parent and teacher behavior rating questionnaires were investigated in a population of 256 children with speech and language disorders and known presence or absence of psychiatric disorder. It was learned that when the questionnaires are used together, a cutoff score of 31 or greater on either questionnaire has a positive predictive value of 74.1 % and a negative predictive value of 76.1%. This screening method shows promise in assisting speech pathologists in comprehensive evaluation and treatment planning for children with speech and language disorders.     

A randomised trial of the effect of appearance versus health-framed messages on engagement with an online brief screening and alcohol reduction intervention

Objectives: To compare the impact of appearance versus health-framed messages on engagement in a brief web-based risk screening and alcohol reduction intervention.

Design: Randomised trial delivered via Drinkaware’s website. Visitors were exposed to appearance (n?=?51,588) or health-framed messages (n?=?52,639) directing them towards an AUDIT-C risk screening questionnaire. Users completing this questionnaire were given feedback on their risk level and extended frame-congruent information.

Outcomes: The primary outcome is completion of the AUDIT-C questionnaire. The secondary outcome is whether the participant accessed any of four further resources.

Results: The appearance-framed message led to a small but significant increase in the number of users completing the AUDIT-C compared to the health-framed message (n?=?3,537, 6.86% versus n?=?3,355, 6.37%, p?<?0.01). Conversely, following subsequent risk feedback, users exposed to extended health-framed information were more likely to access further resources (n?=?1,146, 2.17% versus n?=?942, 1.83%, p?<?0.01).

Conclusions: Physical appearance-framed messages increased the likelihood of engagement with an online alcohol screening and brief intervention tool, whereas health-framed messages increased the likelihood of accessing further resources. This highlights the potential for the use of multi-level approaches in alcohol reduction interventions.     

The Dental Subscale of the Children's Fear Survey Schedule: Predictive Value and Clinical Usefulness

This study reports on the predictive value and clinical usefulness of the Dutch parental version of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Parents of 718 children (4–12 years) completed this CFSS-DS version before or during the child's visit. The dentist rated the child's dental fear during treatment on a 5-point Likert-type Scale from 1 (not afraid at all) to 5 (very afraid). Reliability analysis was performed, and correlation coefficients between the two measures were calculated. The reliability of the scale proved to be high (Cronbach's = .93) and significant correlation coefficients were found (r = .58 and r = .68, p < .01). The negative predictive value of the CFSS-DS was high (.96), whereas its positive predictive value was relatively low (0.41). It was concluded that the CFSS-DS might be of clinical value as a screening device of dental fear, whereas its predictive value of fearful behavior should not be overestimated.     

Concurrent Validity of the Strengths and Difficulties Questionnaire in an Indigenous Pre-School Population

The strengths and difficulties questionnaire (SDQ) is a frequently used tool for universal screening of pre-schoolers’ behavioural and emotional problems. However, evidence for its concurrent validity is equivocal and has not been tested in a Māori population. We aimed to evaluate the concurrent validity of the strengths and difficulties questionnaire (SDQ) in Māori pre-schoolers (tamariki), aged 4 and 5. We carried out a prospective study of 225 tamariki (46% female) for whom a recent SDQ was available from the New Zealand Ministry of Health’s Before School Check database. A trained nurse carried out a standardised wellbeing and behavioural assessment for these children. Sensitivity, specificity, positive predictive and negative predictive values were calculated, using optimal total difficulty scale threshold values published for the SDQ (parent version SDQ-P; teacher version SDQ-T). Primary outcome: an assessment-based child referral to Child and Adolescent Mental Health Services or to a Paediatric outpatient service. Secondary outcomes: assessment-based parental referral to a parenting programme and combined referral. The optimal thresholds for child referral were low for the SDQ-P (13) and SDQ-T (7). Child referral SDQ-P: sensitivity 62%, specificity 83%, positive predictive value 0.35, negative predictive value 0.94. Child referral SDQ-T: sensitivity 77%, specificity 78%, positive predictive value 0.31, negative predictive value 0.96. The findings demonstrate optimal threshold values for referral for Māori on the SDQ-P and SDQ-T are much lower when compared to published thresholds (17 vs. 16). Sensitivity values were also low. A surveillance approach for the assessment of psychosocial problems is recommended for pre-schoolers.     

Clinical cutoffs for the beck Depression inventory and the Geriatric Depression scale with older adult psychiatric outpatients

The present study developed new clinical cutoffs for the Beck Depression Inventory (BDI) and the Geriatric Depression Scale (GDS) with 59 older adult psychiatric outpatients. Maximum discrimination of a current major depressive episode resulted, with cutoff scores of 22 for the BDI and 16 for the GDS. Specifically, the following validity scores emerged for the BDI: sensitivity, 64%; specificity, 73%; positive predictive power, 75%; negative predictive power, 61%; and hit rate 68%. For the GDS the validity scores were as follows: sensitivity, 79%; specificity, 69%; positive predictive power, 77%; negative predictive power, 72%; and hit rate, 75%. Combined BDI and GDS scores did not result in improved prediction of a current major depressive episode as compared to the GDS alone. These results support the notion that the BDI and GDS are valid quick screening instruments in discriminating a current major depressive episode for older adult psychiatric outpatients.     

The Effects of Alcohol Intoxication on Accuracy and the Confidence–Accuracy Relationship in Photographic Simultaneous Line‐ups

Acute alcohol intoxication during encoding can impair subsequent identification accuracy, but results across studies have been inconsistent, with studies often finding no effect. Little is also known about how alcohol intoxication affects the identification confidence–accuracy relationship. We randomly assigned women (N = 153) to consume alcohol (dosed to achieve a 0.08% blood alcohol content) or tonic water, controlling for alcohol expectancy. Women then participated in an interactive hypothetical sexual assault scenario and, 24 hours or 7 days later, attempted to identify the assailant from a perpetrator present or a perpetrator absent simultaneous line‐up and reported their decision confidence. Overall, levels of identification accuracy were similar across the alcohol and tonic water groups. However, women who had consumed tonic water as opposed to alcohol identified the assailant with higher confidence on average. Further, calibration analyses suggested that confidence is predictive of accuracy regardless of alcohol consumption. The theoretical and applied implications of our results are discussed.© 2017 The Authors Applied Cognitive Psychology Published by John Wiley & Sons Ltd.     

Likelihood-Based Clustering of Meta-Analytic SROC Curves

Meta-analysis of diagnostic studies experience the common problem that different studies might not be comparable since they have been using a different cut-off value for the continuous or ordered categorical diagnostic test value defining different regions for which the diagnostic test is defined to be positive. Hence specificities and sensitivities arising from different studies might vary just because the underlying cut-off value had been different. To cope with the cut-off value problem interest is usually directed towards the receiver operating characteristic (ROC) curve which consists of pairs of sensitivities and false-positive rates (1-specificity). In the context of meta-analysis one pair represents one study and the associated diagram is called an SROC curve where the S stands for “summary”. In meta-analysis of diagnostic studies emphasis has traditionally been placed on modelling this SROC curve with the intention of providing a summary measure of the diagnostic accuracy by means of an estimate of the summary ROC curve. Here, we focus instead on finding sub-groups or components in the data representing different diagnostic accuracies. The paper will consider modelling SROC curves with the Lehmann family which is characterised by one parameter only. Each single study can be represented by a specific value of that parameter. Hence we focus on the distribution of these parameter estimates and suggest modelling a potential heterogeneous or cluster structure by a mixture of specifically parameterised normal densities. We point out that this mixture is completely nonparametric and the associated mixture likelihood is well-defined and globally bounded. We use the theory and algorithms of nonparametric mixture likelihood estimation to identify a potential cluster structure in the diagnostic accuracies of the collection of studies to be analysed. Several meta-analytic applications on diagnostic studies, including AUDIT and AUDIT-C for detection of unhealthy alcohol use, the mini-mental state examination for cognitive disorders, as well as diagnostic accuracy inspection data on metal fatigue of aircraft spare parts, are discussed to illustrate the methodology.     

‘It's not that we hate you’: Understanding children's gender attitudes and expectancies about peer relationships

Widespread gender segregation, evident throughout elementary school, seems to imply that girls and boys have negative feelings and thoughts about one another, and classic theories of inter‐group processes support this idea. However, research has generally overlooked children's feelings and perceptions about gender‐related interpersonal interactions. This paper investigates the nature of children's attitudes about same‐ and other‐gender peers, and explores how those attitudes relate to the expectancies and beliefs children hold about same‐ and other‐gender peer interactions. Children (N= 98 fifth graders) completed questionnaires assessing their global liking of own‐ and other‐gender peers ( Yee & Brown, 1994 ), positive and negative attitudes about own‐ and other‐gender peers, and outcome expectancies related to interacting with own‐ and other‐gender peers. Results indicated that rather than being characterized by out‐group negativity, children's inter‐group gender attitudes are best characterized by an in‐group positivity bias. Children's positive and negative affective attitudes were also significantly associated with outcome expectancies. In contrast, global liking of own‐ and other‐gender peers was less predictive of outcome expectancies. Thus, the greater specificity of the affective attitude measures appeared to be a more predictive and potentially fruitful gauge of children's feelings about own‐ and other‐gender peers. Results are discussed in terms of the need for finer grained and more extensive studies of children's gender‐related feelings and cognitions about own‐ and other‐gender peers.     

初中生饮酒期望及其与饮酒行为关系的研究

本研究通过对 1 73 4名初中生的问卷测查 ,考察了当前初中生饮酒期望的性别和年级差异 ,并进一步探讨了饮酒期望与饮酒行为之间的关系。结果表明 :( 1 )初中男生的饮酒积极期望和女生相比没有明显差异 ,但饮酒的消极期望显著低于女生 ;( 2 )随着年级的升高 ,初中生的饮酒积极期望和消极期望都呈降低的趋势 ;( 3 )性别、年级、饮酒积极期望和饮酒消极期望对于饮酒行为都有显著的作用 ,饮酒消极期望对于饮酒行为的解释率要高于饮酒积极期望 ;( 4)饮酒消极期望对于饮酒积极期望和饮酒行为的关系有重要的调节作用。     

A concise review of the correspondence between the traditional functional analysis and alternative assessment formats

The functional assessment of challenging behavior (e.g., self-injurious behavior) has evolved over many years of research and practice. This concise review summarizes the positive predictive value, negative predictive value, accuracy, sensitivity, and specificity of common procedural adaptations reported to improve functional assessment safety and efficiency. We conclude with suggestions for clinicians and researchers.     

Similarity to prototypical heavy drinkers and non-drinkers predicts AUDIT-C and risky drinking in young adults: prospective study

Objective: The aim of the present study was to explore whether constructs within the Prototype Willingness Model (PWM) predicted risky drinking as measured by AUDIT-C, drinking harms and unplanned drunkenness in a sample of UK young adults. Previous studies exploring the PWM often do not use validated measures of alcohol consumption, and the outcomes of risky drinking are underexplored. Design: An online prospective study design with 4 week follow-up was employed and 385 young adults completed the study (M age?=?21.76, SD?=?3.39, 69.6% female; 85.2% students). Main outcome measures: Intentions to get drunk, AUDIT-C, drinking harms experienced in the last 4 weeks, and unplanned drunkenness in the last 4 weeks. Results: Heavy and non-drinker prototype similarity predicted AUDIT-C, drinking harms and unplanned drunkenness when controlling for past behaviour and reasoned action pathway constructs. Intentions and willingness both mediated the relationship between prototype perceptions and AUDIT-C. Conclusion: This study supports the use of the PWM in the prediction of AUDIT-C, drinking harms and unplanned drinking in a UK sample. Prototype perceptions influenced behaviour via both reasoned and reactive cognitions. Targeting similarity to heavy and non-drinker prototypes should be the focus of future interventions in this population.     

Validation of eating disorder examination questionnaire (EDE-Q)--Spanish version--for screening eating disorders

This research examines the internal consistency, convergent validity, and sensitivity, specificity, and positive and negative predictive value of the Spanish version of the Eating Disorder Examination-Self-Report Questionnaire (S-EDE-Q), as a screening questionnaire for eating disorders (ED) in a community sample. Participants were 1543 male and female Spanish-speaking students (age range: 12-21 years), who volunteered to complete the S-EDE-Q and the EAT-40. The Spanish version of the Eating Disorders Examination (S-EDE) interview, 12th edition, was administered to 602 of the students. Acceptable internal consistency for the four subscales of the S-EDE-Q was obtained (alpha > or = .74). Corrected point-biserial correlation performed with the 22 items included in the S-EDE-Q subscales showed acceptable values for all the items. The EAT-40 Dieting subscale correlated highly and positively with the four S-EDE-Q subscales (r > or = .70). Acceptable results in sensitivity, specificity, and positive and negative predictive value when compared with the EDE were found. Correlation between S-EDE and S-EDE-Q diagnoses was positive and significant. Overall, results support the psychometric adequacy of the S-EDE-Q as a screening questionnaire for ED in community samples.     

妊娠早产预测的策略分析

应用宫颈分泌物中高磷酸化胰岛素样生长因子结合蛋白-1(phosphorylated insulin-like growth factor-bindingprotein-1,phIGFBP-1)及宫颈长度对高危早产孕妇预测早产进行评价分析。腹部超声宫颈长度≤4.0cm结合phIG-FBP-1预测早产的阳性预测值58.33%、阴性预测值91.6%;阴道超声宫颈长度≤2.5cm结合phIGFBP-1预测早产的阳性预测值80%、阴性预测值80%。三者联合预测早产取得满意效果。这一预测策略体现了哲学的光辉。     

Depression,Positive and Negative Affect,Optimism and Health-Related Quality of Life in Recently Diagnosed Multiple Sclerosis Patients: The Role of Identity,Sense of Coherence,and Self-efficacy

The study aimed to describe the levels of depression, positive and negative affect, optimism and health-related quality of life (HRQOL) in a group of recently diagnosed multiple sclerosis (MS) patients (up to 3 years since the diagnosis), taking into account gender, age, and disease duration differences, and to investigate the possible role of identity, sense of coherence (SOC), and self-efficacy in MS (SEMS) on patients’ depression, positive and negative affect, optimism, and HRQOL. The cross-sectional study involved 90 MS patients (61% women; age: M = 37, SD = 12) with an Expanded Disability Status Scale score between 1 and 4 (mild to moderate disability). Patients completed measures of depression (CESD-10), positive and negative affect (PANAS), optimism (LOT-R), HRQOL (SF-12), identity motives, SOC, and SEMS. Depression scores were near the cut-off level for clinically significant depressive symptoms, and negative affect was higher and HRQOL was lower than those in the general population. Women and younger patients reported better adjustment as time passes since the diagnosis. Results of multiple regressions indicated that higher SOC was related to higher mental health, lower negative affect and lower depression. Higher SEMS was predictive of greater positive affect and lower negative affect, whereas higher identity satisfaction was predictive of higher positive affect and optimism and lower depression. The results suggest the usefulness of addressing identity redefinition, SOC and self-efficacy in psychological interventions aimed at promoting patients’ adjustment to MS.     

Robustness of expected utility model in predicting individual choices

In this paper we show how utility, lottery dependent utility, and weighted utility models can be calibrated using algebraic and statistical techniques. The models are empirically compared in laboratory (student subjects) and real settings (sales force personnel of the Los Angeles Times). In our empirical comparison we evaluate two aspects: the extent to which observed preferences are consistent with each model, and predictive accuracy of the models on a holdout sample. The results indicate that only about 20% of the observed choice patterns in our experimental design are consistent with the expected utility model, 50% with the weighted utility model, and 90% with the general lottery dependent utility model. On individual level predictions to the holdout sample, however, the expected utility model does as well as the other two models. This latter finding is robust across different measurement and estimation methods and student and non-student subjects.     

Stress and alcohol use: moderating effects of gender, coping, and alcohol expectancies.

A stressor vulnerability model of stress-induced drinking was tested in a stratified random sample of 1,316 Black and White adult drinkers. Stressors were highly predictive of both alcohol use and drinking problems among men who relied on avoidant forms of emotion coping or held strong positive expectancies for alcohol's effects and accounted for more than 35% of the variance in alcohol use among the subgroup of men who were high in both vulnerability factors. In contrast, stressors were negatively related among men who were low in both and were unrelated among women regardless of their coping or expectancies. These findings suggest that tension reduction theories of alcohol use are overly broad and that individual characteristics must be considered to account for stress-related effects on alcohol use and abuse.     

Posttraumatic Growth Among HIV/AIDS Patients1

Correlates (n= 835 at Time 1) and predictors (n= 434 at Time 2) of posttraumatic growth (PTG; perceiving positive life changes stemming from diagnosis) over 1.6 years were examined among a diverse sample of HIV/AIDS patients. PTG was common–59% of participants reported to have experienced at least moderate positive changes since diagnosis. At Time 1, PTG had significant negative associations with age, alcohol use, depression, and pessimism; and positive associations with African American ethnicity (vs. White), female gender, eating a healthy diet, and optimism. At Time 2, religiosity was positively associated with PTG. The process of experiencing PTG over time was associated with lower levels of depression over time. Although the underlying process of PTG remains unclear, these results suggest that PTG is worthy of intervention focus.     

Understanding the Relationship of Trauma,Substance Use,and Resilience Among Religiously Affiliated University Students

This study examined patterns of association between experiencing 12 traumatic life events, resilience, and substance use at a conservative church-affiliated university. The authors used data (N?=?278) from a Health Risk and Protective Factors Study that was conducted during the 2012 spring semester. Initial bivariate analysis indicated several significant positive and negative associations between three of the traumatic life event variables and alcohol, marijuana, and tobacco use within the past year and between two of the traumatic life event variables and alcohol use within the past 30 days. Preliminarily, resilience was only inversely associated with amphetamine use within the past year for men. When examined further using partial correlations to clarify these relationships while controlling for resilience, strong significant positive associations were found specifically between experiencing a disaster-type event and alcohol use within the past year and within the past 30 days for men only. Overall significant moderate positive associations were found between experiencing parental divorce and alcohol use within the past year, and between experiencing a disaster-type event and alcohol use within the past year and within the past 30 days. Use of two-way between-groups ANOVA found no significant interaction among these variables. Results may suggest that experiencing certain traumatic life events and male gender are more likely connected to alcohol use behaviors, whereas resilience may have multiple pathways for adaptive coping.