An Evidence-Based,Community-Engaged Approach to Develop an Interactive Deliberation Tool for Pediatric Neuromuscular Trials

Duchenne/Becker muscular dystrophy (DBMD) and spinal muscular atrophy (SMA) are rare neuromuscular disorders that present challenges to therapeutic and clinical trial decision making. We developed an interactive, evidence-based online tool designed to encourage thoughtful deliberation of the pros and cons of trial participation and to inform meaningful discussions with healthcare providers. Prior research demonstrates the importance of tool availability at the time each family is considering trial participation, which may be prior to the informed consent process. The tool is intended to be easily modified to other pediatric disease communities. Tool development was informed by prior qualitative research, literature reviews, and stakeholder input. Specific items were derived based on an online exploratory questionnaire of parents whose children participated in a trial for DBMD or SMA to understand motivations for participation. Parent participants in the exploratory survey reported strong impact of altruistic and individual benefit motivations and placed much greater emphasis on anticipated trial benefits than on harms when making participation decisions. We used this data to develop the evidence-based deliberation tool using a community-engaged approach. We initially targeted the tool for DBMD while using SMA survey data to evaluate ease of transition to that population. We conducted two iterative sets of activities to inform development and refinement of the tool: (1) community engagement of key stakeholders and (2) user experience testing. These activities suggest that the tool may increase deliberation and the weighing of benefits and harms. Ongoing evaluation will determine the acceptability and efficacy of this online intervention.     

The Protective Effects of Religious Beliefs on Behavioral Health Factors Among Low Income African American Adolescents in Chicago

Religious involvement has long been argued to have protective effects for negative behavioral health outcomes for vulnerable youth. This study builds on the existing resilience literature and need for more studies that examine protective factors associated with behavioral health. A sample of 638 low-income African American adolescents in Chicago to examine within group variations of the influence of religious involvement on delinquency, school engagement, substance use and sexual risk behaviors, and whether such relationships differ by gender, sexual orientation, and socioeconomic status. Logistic regression findings documented that greater religious involvement was protective with regards to lower rates of delinquency, drug use, risky sexual behaviors and higher rates of school engagement, and that gender, sexual orientation and socioeconomic status varied for several of these relationships. Overall findings are discussed with regards to future research.     

Action‐semantic and syntactic deficits in subjects at risk for Huntington's disease

Frontostriatal networks play critical roles in grounding action semantics and syntactic skills. Indeed, their atrophy distinctively disrupts both domains, as observed in patients with Huntington's disease (HD) and Parkinson's disease, even during early disease stages. However, frontostriatal degeneration in these conditions may begin up to 15 years before the onset of clinical symptoms, opening avenues for pre‐clinical detection via sensitive tasks. Such a mission is particularly critical in HD, given that patients’ children have 50% chances of inheriting the disease. Against this background, we assessed whether deficits in the above‐mentioned domains emerge in subjects at risk to develop HD. We administered tasks tapping action semantics, object semantics, and two forms of syntactic processing to 18 patients with HD, 19 asymptomatic first‐degree relatives, and sociodemographically matched controls for each group. The patients evinced significant deficits in all tasks, but only those in the two target domains were independent of overall cognitive state. More crucially, relative to controls, the asymptomatic relatives were selectively impaired in action semantics and in the more complex syntactic task, with both patterns emerging irrespective of the subjects’ overall cognitive state. Our findings highlight the relevance of these dysfunctions as potential prodromal biomarkers of HD. Moreover, they offer theoretical insights into the differential contributions of frontostriatal hubs to both domains while paving the way for innovations in diagnostic procedures.     

Two Puzzles Concerning Spinoza's Conception of Belief

Spinoza's account of belief entails that if A has two ideas, p and q, with incompatible content, A believes that p (and not that q) if the idea of p is stronger than the idea of q. This seems to leave little space for dominant non‐beliefs, or cases in which there is discord between one's beliefs and one's affective‐behavioral responses. And yet Spinoza does allow for two classes of dominant non‐beliefs: efficacious fictions [fictiones] and ideas that conduce to akrasia. I show how Spinoza can account for dominant non‐beliefs within his model of cognition by distinguishing between the doxastic and the affective powers of ideas and by suggesting that doxastic power is best understood diachronically. While other scholars have stressed the elegance of Spinoza's account of ideas, this paper highlights the sophistication and flexibility of his account.     

Righteous or self‐righteous anger? Justice sensitivity moderates defensive outrage at a third‐party harm‐doer

While bystanders' outrage over moral transgressions may represent a genuine desire to restore justice, such expressions can also be self‐serving—alleviating guilt and bolstering one's moral status. Four studies examined whether individual differences in observer justice sensitivity (JS_O) moderate the degree to which outrage at third‐party harm‐doing reflects concerns about one's own moral identity rather than justice per se. Among participants low (vs. high) in JS_O, feelings of guilt predicted greater outrage and desire to punish a corporation's sweatshop labor practices (Studies 1 & 2). Furthermore, affirming one's personal moral identity reduced outrage and support for punishing a corporate harm‐doer among those low, but not high in JS_O (Studies 3 & 4). Similar moderation was absent for other forms of justice sensitivity and just world beliefs. Effects were not explained by negative affect, empathy, personal harm, or political orientation. Results suggest that JS_O uniquely differentiates defensive and justice‐driven moral outrage (150/150).     

Intergroup anxiety and political loss: The buffering effects of believing in the open marketplace of ideas and openness to diverse political discussions

The polarized divide in current U.S. politics continues to separate citizens and impede political decision‐making. Ameliorating this polarization may require addressing intergroup anxiety. The current work examines the buffering effect of endorsing the open marketplace of ideas and openness to engaging in political conversations with people who hold opposing political views on partisans' intergroup anxiety. In Study 1 (N = 319), openness to diverse political discussions negatively predicted postelection intergroup anxiety among Obama supporters in the 2012 U.S. election. Among Romney supporters, endorsement of the open marketplace and openness to diverse political discussions negatively predicted intergroup anxiety. Study 2 (N = 349 Democrats and Republicans), employed an experimental design and produced results consistent with Study 1. For Democrats and Republicans, openness to participating in political discussions characterized by multiple political perspectives was associated with reduced intergroup anxiety. Regardless of the threat of their candidate losing the 2016 election, Republicans (compared to Democrats) expressed reduced intergroup anxiety when endorsing the open marketplace of ideas and being open to engaging in diverse political discussions. Results are discussed in terms of contact theory within the context of the American political system.     

The Effectiveness of Collaborative/Therapeutic Assessment for Psychotherapy Consultation: A Pragmatic Replicated Single-Case Study

This pragmatic study evaluated the effectiveness of a collaborative assessment intervention as an approach to midtherapy consultation, which has yet to be empirically tested. Ten adult participants in ongoing psychotherapy with a variety of presenting concerns, primarily consisting of general mood and adjustment issues, received a brief assessment-based intervention based on Finn's (2007) Therapeutic Assessment model. Following the collection of assessment questions and the administration of a multimethod assessment battery, clients and therapists participated in a joint feedback session with the assessor. Clients were then followed as their psychotherapy continued. The results of idiographic and aggregate analytic approaches revealed significant reductions in client-reported symptomatic distress, as evidenced by a medium effect size (d = –.50) and a significant change in the trajectory of distress. Client reports of the process of psychotherapy revealed a significant increase in the clients’ ratings of the working alliance. The findings suggest that a midtherapy consultation using collaborative/therapeutic assessment methods is beneficial but that further rigorous investigation is needed.     

Augmenting Visual Search Performance With Transcranial Direct Current Stimulation (tDCS)

Military personnel endure rigorous and demanding man-hours designated to monitoring and locating targets in tasks such as cyber defense and Unmanned Aerial Vehicle (UAV) operators. These tasks are monotonous and repetitive, which can result in vigilance decrement. The objective of the study was to implement a form of noninvasive brain stimulation known as transcranial DC stimulation (tDCS) over the left frontal eye field (LFEF) region of the scalp to improve cognitive performance. The participants received anodal and cathodal stimulation of 2 mA for 30 min as well as placebo stimulation on 3 separate days while performing the task. The findings suggest that anodal and cathodal stimulation significantly improves detection accuracy. Also, a correlation was detected between percent of eye closure (PERCLOS) and blinking frequency in relation to stimulation condition. Our data suggest that tDCS over the LFEF would be a beneficial countermeasure to mitigate the vigilance decrement and improve visual search performance.