Panning for the gold in health research: Incorporating studies’ methodological quality in meta-analysis

Background: Systematic reviews now routinely assess methodological quality to gauge the validity of the included studies and of the synthesis as a whole. Although trends from higher quality studies should be clearer, it is uncertain how often meta-analyses incorporate methodological quality in models of study results either as predictors, or, more interestingly, in interactions with theoretical moderators.

Objective and methods: We survey 200 meta-analyses in three health promotion domains to examine when and how meta-analyses incorporate methodological quality.

Results: Although methodological quality assessments commonly appear in contemporary meta-analyses (usually as scales), they are rarely incorporated in analyses, and still more rarely analysed in interaction with theoretical determinants of the success of health promotions. The few meta-analyses (2.5%) that did include such an interaction analysis showed that moderator results remained significant in higher quality studies or were present only among higher quality studies. We describe how to model quality interactively with theoretically derived moderators and discuss strengths and weaknesses of this approach and in relation to current meta-analytic practice.

Conclusions: In large literatures exhibiting heterogeneous effects, meta-analyses can incorporate methodological quality and generate conclusions that enable greater confidence not only about the substantive phenomenon but also about the role that methodological quality itself plays.     

Associative activation of stimulus representations restores lost salience: implications for perceptual learning

In 3 experiments, rats received preexposure to presentations of a compound flavor BX. The effective salience of B was then tested by assessing its ability to interfere with the aversion controlled by another flavor or the tendency to drink a saline solution after the induction of a salt need. It was found that the effective salience of B was maintained when during preexposure, presentations of BX alternated with presentations of X alone. This was true both when BX was presented as a simultaneous compound (Experiment 1) and as a serial compound (X-->B; Experiments 2 and 3); salience was not maintained when the serial compound took the form B-->X (Experiments 2 and 3a). It was argued that the salience of B declines during preexposure but is restored when presentations of X are able to activate the representation of B by way of the associative X-B link.     

What the voice reveals: within- and between-category stereotyping on the basis of voice

The authors report research that attempts to shift the traditional focus of visual cues to auditory cues as a basis for stereotyping. Moreover, their approach examines whether gender-signaling vocal cues lead not only to between-category but also to within-category gender stereotyping. Study 1 showed that both men and women vary within category in how feminine their voices sound and that perceptions of vocal femininity are highly consensual. Furthermore, the measured acoustic characteristics that differed between gender were also related to perceptions of within-gender femininity. Subsequent studies demonstrated that variability in vocal femininity affects gender stereotyping when the targets are all of the same gender (Study 2) and when the targets are of different genders (Study 3). In the latter case, evidence of both category-based and feature-based stereotyping was found. Mediation analyses showed that the relationship between acoustics and stereotyping was in part due to femininity.     

Concreteness and item-to-list context associations in the free recall of items differing in context variability

Context variability can be defined as the number of preexperimental contexts in which a given concept appears. Following M. Steyvers and K. J. Malmberg's (2003) work, the authors have shown that concepts that are experienced in fewer preexperimental contexts generally are better remembered in episodic memory tasks than concepts that are experienced in a greater number of preexperimental contexts. The purpose of this article is to demonstrate that low context variability confers its memorial advantage because of stronger item-to-list context associations as compared with high context variability. Three experiments that use environmental context changes from study to test demonstrate that the low context variability advantage is eliminated when item-to-list context associations are not available because of environmental changes at test. In addition, the low context variability advantage is eliminated when inward processing at study prevents the formation of item-to-list context associations.     

Challenges using motivational interviewing as an adjunct to exposure therapy for obsessive-compulsive disorder

Exposure and response prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD). However, patients often do not adhere fully to EX/RP procedures. Motivational interviewing (MI) has been shown to improve treatment adherence in other disorders. This pilot study used a randomized controlled design to examine whether MI can be successfully added to EX/RP and whether this intervention (EX/RP + MI) could improve patient adherence to between-session EX/RP procedures relative to EX/RP alone. Thirty adults with OCD were randomized to 18 sessions of EX/RP or EX/RP + MI. Therapists rated patient adherence at each exposure session. Independent evaluators assessed change in OCD and depressive symptoms, and patients completed self-report measures of readiness for change and quality of life. The two treatment conditions differed in degree of congruence with MI but not in conduct of EX/RP procedures. Both groups experienced clinically significant improvement in OCD symptoms, without significant group differences in patient adherence. There are several possible reasons why EX/RP + MI had no effect on patient adherence compared to standard EX/RP, each of which has important implications for the design of future MI studies in OCD. We recommend that MI be further evaluated in OCD by exploring alternative modes of delivery and by focusing on patients less ready for change than the current sample.     

Gender label and perceived infant emotionality: a partial replication of a classic study

In a study often referred to as "classic," Condry and Condry (1976) showed a videotaped infant to participants, telling half of them the infant was a boy and half it was a girl. Participants who thought they were viewing a boy rated the infant's reaction to a jack-in-the-box as anger; those who thought they were viewing a girl rated the reaction as fear. Participants in the present partial replication of the Condrys' study did not rate the infant differently based on the infant's gender label, although there was evidence that participants' own sex affects their perception of an infant's emotionality. Results were discussed in light of inconsistent results among other gender-labeling studies and relevant methodological, historical, and theoretical issues.     

Recognition of Emotion in Facial Expressions and Vocal Tones in Children With Psychopathic Tendencies

The authors investigated the ability of children with emotional and behavioral difficulties, divided according to their Psychopathy Screening Device scores (P. J. Frick & R. D. Hare, in press), to recognize emotional facial expressions and vocal tones. The Psychopathy Screening Device indexes a behavioral syndrome with two dimensions: affective disturbance and impulsive and conduct problems. Nine children with psychopathic tendencies and 9 comparison children were presented with 2 facial expression and 2 vocal tone subtests from the Diagnostic Analysis of Nonverbal Accuracy (S. Nowicki & M. P. Duke, 1994). These subtests measure the ability to name sad, fearful, happy, and angry facial expressions and vocal affects. The children with psychopathic tendencies showed selective impairments in the recognition of both sad and fearful facial expressions and sad vocal tone. In contrast, the two groups did not differ in their recognition of happy or angry facial expressions or fearful, happy, and angry vocal tones. The results are interpreted with reference to the suggestion that the development of psychopathic tendencies may reflect early amygdala dysfunction (R. J. R. Blair, J. S. Morris, C. D. Frith, D. I. Perrett, & R. Dolan, 1999).     

Attentional interference by threat and post-traumatic stress disorder: The role of thought control strategies

Attentional interference by threat is associated with PTSD, but the mechanisms of this relationship remain unclear. Attentional interference might be related to increased use of maladaptive thought control strategies, such as suppressing unwanted thoughts (thought suppression) or replacing threatening thoughts with everyday concerns (worry), which increase PTSD risk. Conversely, attentional interference might be associated with reduced use of adaptive strategies, such as talking about threatening thoughts (social control), which decrease PTSD risk. This study tested if thought control strategies mediate the relationship between attentional interference and PTSD. Sixty-one male Vietnam-era veterans completed measures of PTSD symptoms and thought control strategies. Participants also completed a Visual Search Task measuring attentional interference, which required participants to identify a target letter string among a group of threat or neutral words. Attentional interference by threat was related to PTSD symptoms, and mediation analyses revealed significant indirect effects of attentional interference through thought suppression and worry. Attentional interference was related to re-experiencing and avoidance, but not hyperarousal, symptom clusters. Thought suppression was a unique mediator for re-experiencing, whereas thought suppression and worry both mediated the relationship with avoidance. These results offer evidence for maladaptive thought control strategies as a mechanism linking attentional biases for threat to PTSD.     

Managing Salesperson Motivation in a Territory Realignment

Although typically undertaken to improve aggregate sales force performance, the realignment of sales territories can be quite de-motivational to individual salespersons. Findings of two studies reported here demonstrate that salesperson motivation and performance can be positively influenced by the managerial actions taken during the implementation phase of a territory realignment. Actions based on expectancy theory were found to be more effective for salespeople whose territory realignment increased sales potential, and justice-based actions were more effective for salespersons experiencing a reduction in territory potential.     

Concurrent and 2-Year Longitudinal Relations Between Executive Function and the Behavior of 1st and 2nd Grade Children

Concurrent and 2-year longitudinal relations were investigated between two indicators of children’s (n =60; mean age = years 11 months) executive function, inhibitory control and sequencing ability, and behavior problem symptomatology. Dependent measures were parent and teacher reported internalizing and externalizing behavior. Hierarchical multiple regression analyses demonstrated few significant concurrent associations between either inhibitory control or sequencing ability, and behavior problem symptoms. In contrast, baseline inhibitory control predicted decreased teacher reported externalizing, and parent reported externalizing and internalizing behavior problems over a 2-year period. Baseline sequencing ability also predicted decreased teacher reported externalizing and parent reported internalizing behavior over this same time period. Results suggest that some aspects of executive function in early elementary grade-school children may be more strongly associated with change in behavior over time than concurrent behavior. Implications of these findings for the prevention of behavior problems are discussed.