How Much Distress Is Too Much on Deployed Operations? Validation of the Kessler Psychological Distress Scale (K10) for Application in Military Operational Settings

The aim of this study was threefold: (a) to assess the factor structure of the Kessler Psychological Distress Scale (K10) to determine whether interpreting the scale as a single dimensional measure of psychological distress is justified in military operational setting; (b) to validate the K10 for mental health surveillance in operational settings against self-reported occupational impairment; (c) to evaluate whether the K10 has better discriminatory power than de facto standards for mental health surveillance on deployment, namely the Patient Health Questionnaire and the Posttraumatic Stress Disorder Checklist, Civilian version. A convenience sample of Canadian Armed Forces personnel serving in Afghanistan (N = 1,264) completed self-report measures of psychological distress and occupational impairment. On examination of 6 competing models, the authors determined that interpreting the K10 as a measure of unspecified psychological distress is justified. Using receiver operating characteristic (ROC) curve analysis, they identified new cutoff values for dichotomous and polychotomous scoring methods. After comparing the area beneath the ROC curves for each of the 3 mental health surveillance questionnaires, the authors determined that all measures perform well as predictors of self-rated occupational impairment, with values ranging from .86 to .90. These results highlight the importance of cross-setting validation and demonstrate that validating psychological screening questionnaires against self-report measures of occupational impairment can be a useful strategy for understanding the manifestation of psychological distress on deployed military operations.     

Development of Prospective Memory: Tasks Based on the Prefrontal-Lobe Model

This study investigated the development of prospective memory using tasks based on the prefrontal-lobe model. Three groups each of 30 children, adolescents, and young adults were compared on prospective-memory performance using ongoing tasks with two levels of cognitive demand (low and high), and two levels of importance (unstressed and stressed) of remembering prospective cues. The Self-Ordered Pointing Task (SOPT), Stroop Color Word Interference Test, and Tower of London were also used to assess relationships between prospective memory and prefrontal-lobe functions. The children remembered fewer prospective cues than either the adolescents or adults, but the adolescents and adults remembered equally well. This trend increased significantly as the cognitive demand of the ongoing tasks increased. However, stressing or not stressing the importance of remembering made no difference to prospective-memory performance. Performance on the SOPT and Stroop Colour Word Interference predicted performance on the high- but not on the low-demand condition. These findings implicate the maturation of the brain's prefrontal region in the development of prospective memory.     

Race and Girls’ Self-Evaluations: How Mothering Matters

Research conducted in the United States shows that Black adolescent girls have higher self-esteem and, to a lesser extent, a higher sense of control than White girls. However, few studies conducted with representative samples of Black and White girls systematically examine why Black girls may have higher self-esteem and sense of control. Drawing on Black feminist thought, we posit that Black mothers’ socialization of their daughters may explain Black girls’ higher self-esteem and sense of control. Using survey data collected in 1994 from a nationally representative sample of U.S. Black (N?=?1,330) and White (N?=?3,797) girls and their mothers, we examine racial differences across two key components of the self-concept: self-esteem and sense of control. We ask: 1) Do Black girls have higher self-esteem and sense of control than White girls? 2) Do Black girls have more positive relationships with their mothers and receive more encouragement of academic achievement and independence from their mothers than White girls? and 3) Do more positive mother-daughter relationships and mothers’ encouragement help to explain Black girls’ higher self-esteem and sense of control in comparison to White girls? Findings indicate that Black girls have higher self-esteem and sense of control than White girls, and Black mothers’ relationship with their daughters and stronger encouragement of daughters’ independence in part explain race differences in self-evaluations.     

Brief pitch-priming facilitates infants’ discrimination of pitch-evoking noise: Evidence from event-related potentials

Pitch is derived by the auditory system through complex spectrotemporal processing. Pitch extraction is thought to depend on both spectral cues arising from lower harmonics that are resolved by cochlear filters in the inner ear, and on temporal cues arising from the pattern of action potentials contained in the cochlear output. Adults are capable of extracting pitch in the absence of robust spectral cues, taking advantage of the temporal cues that remain. However, recent behavioral evidence suggests that infants have difficulty discriminating between stimuli with different pitches when resolvable spectral cues are absent. In the current experiments, we used the mismatch negativity (MMN) component of the event related potential derived from electroencephalographic (EEG) recordings to examine a cortical representation of pitch discrimination for iterated rippled noise (IRN) stimuli in 4- and 8-month-old infants. IRN stimuli are pitch-evoking sounds generated by repeatedly adding a segment of white noise to itself at a constant delay. We created IRN stimuli (delays of 5 and 6 ms creating pitch percepts of 200 and 167 Hz) and high-pass filtered them to remove all resolvable spectral pitch cues. In experiment 1, we did not find EEG evidence that infants could detect the change in the pitch of these IRN stimuli. However, in Experiment 2, after a brief period of pitch-priming during which we added a sine wave component to the IRN stimulus at its perceived pitch, infants did show significant MMN in response to pitch changes in the IRN stimuli with sine waves removed. This suggests that (1) infants can use temporal cues to process pitch, although such processing is not mature and (2) that a short amount of pitch-priming experience can alter pitch representations in auditory cortex during infancy.     

Women's views about intimate examinations and sexually inappropriate practices by their general practitioners

Abstract

The aim of this survey of 472 adult women was to assess women patients' feelings about intimate examinations and their perceptions and experiences of sexually inappropriate medical practice. Two-thirds of women preferred a women doctor for intimate examinations. Slightly more than two-thirds found intimate examinations embarrassing and stressful, and strongly expressed the need for information and on-task, health-related comments during these examinations. General personal comments or non-medical touching were not particularly welcomed, even for the purpose of comforting the patient. There was a range of views about patients' personal relationships with doctors, with the lines between acceptable and unacceptable behaviour somewhat ambiguous. A small but significant number of women perceived that they had been sexually harassed (5%) or abused (3%) by a doctor, with this experience more common for non-English speaking women. Results were discussed in terms of implications for improved doctor practice, particularly during intimate examinations and with vulnerable patients.     

Predicting short and long-term exercise intentions and behaviour in patients with coronary artery disease: A test of protection motivation theory

The purpose of this study was to examine the utility of protection motivation theory (PMT) in the prediction of exercise intentions and behaviour in the year following hospitalisation for coronary artery disease (CAD). Patients with documented CAD (n?=?787), recruited at hospital discharge, completed questionnaires measuring PMT's threat (i.e. perceived severity and vulnerability) and coping (i.e. self-efficacy, response efficacy) appraisal constructs at baseline, 2 and 6 months, and exercise behaviour at baseline, 6 and 12 months post-hospitalisation. Structural equation modelling showed that the PMT model of exercise at 6 months had a good fit with the empirical data. Self-efficacy, response efficacy, and perceived severity predicted exercise intentions, which, in turn predicted exercise behaviour. Overall, the PMT variables accounted for a moderate amount of variance in exercise intentions (23%) and behaviour (20%). In contrast, the PMT model was not reliable for predicting exercise behaviour at 12 months post-hospitalisation. The data provided support for PMT applied to short-term, but not long-term, exercise behaviour among patients with CAD. Health education should concentrate on providing positive coping messages to enhance patients’ confidence regarding exercise and their belief that exercise provides health benefits, as well as realistic information about disease severity.     

The Contribution of Executive Skills to Reading Comprehension

Although word recognition deficits (WRD) are a known cause of reading comprehension deficits (RCD), other contributions to RCD, including executive function (EF), have not been fully explored. We examined the contribution of EF (working memory and planning), along with attention, decoding, fluency, and vocabulary to reading comprehension in 60 children (including 16 WRD and 10 RCD), ages 9–15 years. After controlling for commonly accepted contributors to reading comprehension (i.e., attention, decoding skills, fluency, and vocabulary), EF continued to make a significant contribution to reading comprehension but not to word recognition skills. These findings highlight the need for consideration of the role of EF in RCD.     

Anxiety Sensitivity and Interoceptive Exposure: A Transdiagnostic Construct and Change Strategy

Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants (N = 54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS.