Development and Psychometric Evaluation of an Item Bank for Computerized Adaptive Testing of the EORTC Insomnia Dimension in Cancer Patients (EORTC CAT-SL)

To further advance assessment of patient-reported outcomes, the European Organisation of Research and Treatment of Cancer (EORTC) Quality of Life Group has developed computerized adaptive test (CAT) versions of all EORTC Quality of Life Core Questionnaire (QLQ-C30) scales/items. The aim of this study was to develop and evaluate an item bank for CAT measurement of insomnia (CAT-SL). In line with the EORTC guidelines, the developmental process comprised four phases: (I) defining the concept insomnia and literature search, (II) selection and formulation of new items, (III) pre-testing and (IV) field-testing, including psychometric analyses of the final item bank. In phase I, the literature search identified 155 items that were compatible with our conceptualisation of insomnia, including both quantity and quality of sleep. In phase II, following a multistep-approach, this number was reduced to 15 candidate items. Pre-testing of these items in cancer patients (phase III) resulted in an item list of 14 items, which were field-tested among 1094 patients in phase IV. Psychometric evaluations showed that eight items could be retained in a unidimensional model. The final item bank yielded greater measurement precision than the original QLQ-C30 insomnia item. It was estimated that administering two or more items from the insomnia item bank with CAT results in a saving in sample size between approximately 15–25%. The 8-item EORTC CAT-SL item bank facilitates precise and efficient measurement of insomnia as part of the EORTC CAT system of health-related quality life assessment in both clinical research and practice.

     

Predictors of decision-making style among cancer patients: An empirical test of theory

Abstract

Patient decision-making has been shown to be far from data-driven which results in serious consequences for physical health and psychological well-being. Cancer patients were found to have made their medical decisions in four ways: information-seeking, information-processing, advice-following, and ruminating. These four ways represent two routes of cognitive processing. The first two exemplify central route processing and the second two exemplify peripheral route processing. Medical decisions have also been shown to be highly influencable based on message presentation. This study represents the first step in applying social influence theory to medical decision-making. The elaboration likelihood model was used to determine whether the variables shown to have influenced routes of processing could predict which decisional style the cancer patients used. Specifically, the elaboration likelihood model of Petty and Cacioppo (1986) was applied as predictors of decisional processing style. Using a discriminant function analysis, the variables motivation (both cognitive and emotional), ability to process, and cognitive responding predicted whether cancer patients made their medical decisions using the four categories of decisional styles.     

Decreased susceptibility to false memories from misinformation in hormonal contraception users

Sex hormones are increasingly implicated in memory formation. Recent literature has documented a relationship between hormones and emotional memory and sex differences, which are likely related to hormones, have long been demonstrated in a variety of mnemonic domains, including false memories. Hormonal contraception (HC), which alters sex hormones, has been associated with a bias towards gist memory and away from detailed memory in women who use it during an emotional memory task. Here, we investigated whether HC was associated with changes in susceptibility to false memories, which may be related to the formation of gist memories. We tested false memory susceptibility using two well-validated false memory paradigms: the Deese–Roediger–McDermott (DRM) task, and a story-based misinformation task. We found that hormonal contraceptive users were less susceptible to false memories compared to non-users in the misinformation task, and no differences were seen between groups on the DRM task. We hypothesise that the differences in false memories from the misinformation task may be related to hormonal contraceptive users' memory bias away from details, towards gist memory.     

Genetic and environmental influences on odor identification ability in the very old

Odor identification ability and cognition were measured in a population-based cohort of 1,222 very old twins and singletons, including 91 centenarians. Heritability for identifying odors was low, in contrast to that for cognition. Common genes were found to contribute to both olfaction and cognition. In a multiple regression model, sex, age, cognitive function, and smoking, but not APOEε4 status, were significant predictors of the olfactory test scores (all ps < 0.001). This study, along with data from other studies, suggests that indices of heritability for odor identification decline with age, likely reflecting adverse environmental influences on the smell system.     

Perceived Conflict and Leader Dominance: Individual and Contextual Factors Behind Preferences for Dominant Leaders

Recent research finds that political candidates and leaders with dominant, masculine physical features are more preferred under conditions of conflict than of cooperation. Importantly, however, methodological limitations of past research have hindered the identification of whether this effect reflects that voters intuitively view (1) dominant leaders as more competent in solving problems of conflict, (2) nondominant leaders as more competent in solving problems of cooperation, or (3) both. In this article, we utilize recent advances in evolutionary psychology to form precise predictions on the nature of the underlying psychology and employ an unprecedented array of data types—including highly controlled experiments, natural experiments, and behavioral measures—to investigate the validity of these predictions. Using large approximately nationally representative surveys of 2,009 Poles and Ukrainians fielded during the Crimea crisis in 2014, we find that preferences for leader dominance are exclusively driven by the intuition that dominant leaders are better able to facilitate aggressive responses during social conflict and that these preferences are regulated by contextual conditions and individual predispositions related to such responses.     

New trends in gender and mathematics performance: a meta-analysis

In this article, we use meta-analysis to analyze gender differences in recent studies of mathematics performance. First, we meta-analyzed data from 242 studies published between 1990 and 2007, representing the testing of 1,286,350 people. Overall, d = 0.05, indicating no gender difference, and variance ratio = 1.08, indicating nearly equal male and female variances. Second, we analyzed data from large data sets based on probability sampling of U.S. adolescents over the past 20 years: the National Longitudinal Surveys of Youth, the National Education Longitudinal Study of 1988, the Longitudinal Study of American Youth, and the National Assessment of Educational Progress. Effect sizes for the gender difference ranged between -0.15 and +0.22. Variance ratios ranged from 0.88 to 1.34. Taken together, these findings support the view that males and females perform similarly in mathematics.     

Prejudice and Enforcement of Workforce Homogeneity as Explanations for Employment Discrimination1

We examined the effects of subtle and blatant prejudice and the enforcement of workforce homogeneity on employment discrimination in an experimental simulation. German participants who were advised to maintain a homogeneous (i.e., German) workforce, as hypothesized, selected fewer foreign applicants for a job interview than did participants who did not receive this advice. An interaction qualified this main effect, such that subtly prejudiced participants reacted to the advice to maintain a homogeneous workforce, but blatantly prejudiced and nonprejudiced individuals did not. The implications of these findings for research and practice are discussed.     

Die Bindungstheorie als Basis psychotherapeutischer Interventionen in der Terminalphase

Recent attachment research has shown that every person develops, already in early childhood, special attachment strategies activated in cases whenever the person cannot cope on his own with dangers. These strategies are classified into four categories: “secure”, “insecure-avoidant”, “insecure-ambivalent/enmasked” and “disoriented/disorganized” attachment patterns. The death of a next person represents a situation of a unique and final separation causing psychical disturbances for the patient himself and his relatives. It is, therefore, an especially effective trigger for the activation of the attachment system. This article aims on relating attachment theory to an attachment-oriented therapy, that would open, particularly in the field of palliative medicine, possibilities of application which have been neglected. Case studies illustrate how these insights may be applied during the psychotheraputic care for patients and their relatives. As dying patients generally are brought by their family to the clinic, physicians have a particularly favourable situation to observe the attachment patterns in the family and integrate these informations into their treatment strategy: for example in case of “avoidant” attachment patterns, to bring cautiously the denied emotions into the communication and to support hopes for the fulfilment of needs for affection and protection; or in case of so-called “ambivalent/entangled” attachment patterns to help to disentangle too close relationships; or in case of “disorganized” attachment patterns to support emotional regulation and help to clear the relationships. It is obvious that this approach based on attachment theory and offering alleviations during the process of dying, is not only on a palliative board relevant, but may be applied with success in the medical care of dying patients and their relatives.     

An Intensive Outpatient Program for Veterans With Posttraumatic Stress Disorder and Traumatic Brain Injury

Post-9/11 service members may return from military service with a complicated set of symptoms and conditions, such as posttraumatic stress disorder (PTSD), depression, substance misuse, and traumatic brain injury (TBI), that interfere with reintegration and impair functioning. Although evidence-based treatments that facilitate recovery exist, their successful delivery at a sufficient dose is limited. Barriers to accessing treatment combined with challenges compiling a comprehensive treatment team further delay delivery of effective evidence-based care for PTSD, TBI, and co-occurring mental health conditions. This paper describes the development of a comprehensive, multidisciplinary, 2-week intensive day program for post-9/11 veterans with complex mental health concerns. The treatment program combines skill building groups, family education, and integrative health approaches with evidence-based individual PTSD or TBI care. Initial results from the first 132 participants were notable for a 97% completion rate, as well as statistically significant and clinically meaningful reductions in PTSD, neurobehavioral, and depression symptom severity for the 107 veterans who completed the PTSD track and the 21 who completed the TBI track. These data suggest the intensive program approach is an effective, well-tolerated model of treatment for post-9/11 veterans with PTSD and/or TBI. Future controlled studies should examine the effectiveness of this intensive model compared to standard evidence-based therapy delivery, as well as longitudinal outcomes.     

An examination of the psychometric properties of scores on the Family Strain Index (FSI) in a general community sample

Given the potentially harmful effects of parenting stress on parents, children, and their relationship, it is critical to have a reliable and valid measure of parenting stress in clinical and community samples. The Family Strain Index (FSI) is a brief questionnaire designed to measure stress and demand on parents of children with ADHD. The present study is the first to evaluate the psychometric properties of scores on the FSI in a general community sample. Parents (89% mothers) of 550 preschool children (aged 2–5 years; 50% boys) sampled through 17 kindergartens located in Danish cities and villages completed the FSI, the ADHD Rating Scale (RS)‐IV Preschool Version, and a background questionnaire. FSI scores were characterized by restricted range and floor effects. The scale's construct validity was not supported and the measurement repeatability after 1 month was low. The scale did have convergent validity as levels of parenting stress were associated with perceived ADHD behavior in off‐spring, but overall, results did not encourage the use of the FSI as a measure of parenting stress in the general population. Measures that include more normative events may be more appropriate when attempting to capture parenting stress in general community samples.