Pilot programs in newborn screening

The term "pilot study" has been used over the years to describe the evaluation of the many elements involved in deciding whether a proposed condition should be added to a newborn screening (NBS) panel, and until recently, was unilaterally used to describe the evaluation of the assay to be used before the condition was officially adopted by a state for its newborn screening panel. Since Guthrie's introduction of screening for PKU, each time a new condition was added to the panel, the screening assay itself was validated through a population-based trial, in which the test was performed with de-identified samples to avoid association between the test result and the infant. This is considered by the laboratory as the "pilot phase" of adding a new condition. To advance the science of NBS, especially to accommodate new technologies that may provide new types of information (genetic versus physiological) for each new condition, pilot programs are essential. Involvement of the clinical community serves to improve these evaluations and provides the needed clinical validation of decisions made as a result of it. This paper describes the historical context of pilot programs in population-based NBS that utilize laboratory-based markers as indicators of concern; specifically, three applications that demonstrate different approaches to the use of pilots in adding conditions to a NBS panel are described.     

The relation of lifetime cognitive activity and lifetime access to resources to late-life cognitive function in older African Americans

Research in older Caucasians has demonstrated that cognitive activity is related to cognitive function in late adulthood. Knowledge of this association is limited in older minority populations. We examined the relation of cognitive activity and access to cognitive resources, with cognitive function in a group of 108 older African Americans. We constructed two scales to measure the frequency of cognitive activity and the presence of resources that promote cognitive activity during early and late life. Both measures had high internal consistency and the cognitive activity scale had adequate temporal stability over a 4-week interval. In analyses that controlled for age and education, more frequent lifetime cognitive activity was related to current cognitive function, but lifetime cognitive resources only approached significance. The results suggest that both measures are psychometrically sound in a minority population and that lifetime cognitive activity may contribute to current cognitive function in African Americans.     

Gender, socioeconomic status, age, and jealousy: emotional responses to infidelity in a national sample

The authors used a representative national sample (N = 777) to test the evolutionary hypothesis that men would be more bothered by sexual infidelity and women by emotional infidelity, the Jealousy as a Specific Innate Module (JSIM) effect. Our alternative conceptualization of jealousy suggests that there are distinct emotional components of jealousy that did not evolve differently by gender. The authors looked for effects of age, socioeconomic status (SES), and type of measure (continuous or dichotomous) on jealousy. The authors did not find age or SES effects. Forced-choice items provided support for our alternative view; both genders showed more anger and blame over sexual infidelity but more hurt feelings over emotional infidelity. Continuous measures indicated more emotional response to sexual than emotional infidelity among both genders.     

Does anhedonia in schizophrenia reflect faulty memory for subjectively experienced emotions?

The authors evaluated whether self-reported trait anhedonia in schizophrenia reflects faulty memory, such that patients are capable of experiencing pleasure while engaged in enjoyable activities but underestimate their pleasure in recalling these experiences. Thirty schizophrenia patients and 31 nonpatient control participants rated their emotional responses to pleasant and neutral foods and film clips and completed a surprise recall task for their emotions after a 4-hr delay. Despite reporting elevated trait anhedonia, patients did not significantly differ from control participants in immediate pleasant emotional responses to the stimuli or in delayed recall for these experiences. In-the-moment pleasure and short-term retention for emotional experiences thus appear to be relatively intact in schizophrenia. Alternative explanations for the hedonic deficit in this disorder are discussed.     

Anxiety and sensitivity to eye gaze in emotional faces

This paper reports three studies in which stronger orienting to perceived eye gaze direction was revealed when observers viewed faces showing fearful or angry, compared with happy or neutral, emotional expressions. Gaze-related spatial cueing effects to laterally presented fearful faces and centrally presented angry faces were also modulated by the anxiety level of participants, with high- but not low-state anxious individuals revealing enhanced shifts of attention. In contrast, both high- and low-state anxious individuals demonstrated enhanced orienting to averted gaze when viewing laterally presented angry faces. These results provide novel evidence for the rapid integration of facial expression and gaze direction information, and for the regulation of gaze-cued attention by both the emotion conveyed in the perceived face and the degree of anxiety experienced by the observer.     

Is there a trade-off between cognitive and motor recovery after traumatic brain injury due to competition for limited neural resources?

The status of neurorehabilitation for traumatic brain injury (TBI) is under active debate because of a dearth of research findings demonstrating effectiveness. This may be due, in part, to limitations in our understanding of basic mechanisms of cognitive and motor recovery,including those that might impede recovery. In this regard, we examined whether overall recovery following TBI might be undermined by competition between cognitive and motor functions for finite neural resources during recovery. In this preliminary study, 21 moderately and severely impaired patients were administered cognitive and motor assessments at 1, 4, and 12 months post-TBI, and recovery of cognitive and motor functions was measured using regression residuals. Negative correlations between recovery of cognitive versus motor functions were used as the index of competition. We found suggestive evidence that there may indeed be a trade-off between the recovery of cognitive and motor functions after TBI. Implications for rehabilitation are discussed.     

Taxometric Investigation of PTSD: data from two nationally representative samples

Current psychiatric nosology depicts posttraumatic stress disorder (PTSD) as a discrete diagnostic category. However, only one study has examined the latent structure of PTSD, and this study suggested that PTSD may be more accurately conceptualized as an extreme reaction to traumatic life events rather than a discrete clinical syndrome. To build on the existing literature base, the present research examined the latent structure of posttraumatic stress reactions by applying three taxometric procedures (MAXEIG, MAMBAC, and L-Mode) to data collected from large nationally representative samples of women (ns = 2684 and 3033) and adolescents (n = 3775). Results consistently provided evidence for a dimensional PTSD solution across samples and statistical procedures. These findings have important implications for the theory, assessment, and investigation of posttraumatic stress reactions.     

Episodic processes in emotional labor: perceptions of affective delivery and regulation strategies

This study examined emotional labor processes from a within-person, episodic framework. The authors hypothesized that the influence of negative emotions on affective delivery would be lessened by regulation strategies for supervisor perceptions but not self-perceptions. In addition, difficulty maintaining display rules was hypothesized to mediate the relation between negative emotions and self-perceptions of affective delivery. Finally, the influence of surface acting strategies on these processes as well as correlations with individual differences was investigated. Hypotheses were tested using ecological momentary assessment of a sample of cheerleading instructors. Results suggest that surface actors can regulate emotions effectively on an episode-to-episode basis but find the episode more difficult. In addition, surface actors exhibit more general tendencies to devalue themselves and experience fewer positive emotions.