Pedestrian crowds can form the substrate of important socially contagious behaviors, including propagation of visual attention, violence, opinions, and emotional state. However, relating individual ...to collective behavior is often difficult, and quantitative studies have largely used laboratory experimentation. We present two studies in which we tracked the motion and head direction of 3,325 pedestrians in natural crowds to quantify the extent, influence, and context dependence of socially transmitted visual attention. In our first study, we instructed stimulus groups of confederates within a crowd to gaze up to a single point atop of a building. Analysis of passersby shows that visual attention spreads unevenly in space and that the probability of pedestrians adopting this behavior increases as a function of stimulus group size before saturating for larger groups. We develop a model that predicts that this gaze response will lead to the transfer of visual attention between crowd members, but it is not sufficiently strong to produce a tipping point or critical mass of gaze-following that has previously been predicted for crowd dynamics. A second experiment, in which passersby were presented with two stimulus confederates performing suspicious/irregular activity, supports the predictions of our model. This experiment reveals that visual interactions between pedestrians occur primarily within a 2-m range and that gaze-copying, although relatively weak, can facilitate response to relevant stimuli. Although the above aspects of gaze-following response are reproduced robustly between experimental setups, the overall tendency to respond to a stimulus is dependent on spatial features, social context, and sex of the passerby.
The U.S. Department of Veterans Affairs (VA) has placed increased emphasis on the availability and use of evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD). However, many ...individuals do not complete a full course of EBP. The current study aimed to quantify the percentage of veterans receiving adequate EBP in VA hospitals and identify factors related to treatment completion.
A national sample of 16,559 VA patients who began cognitive processing therapy (CPT) or prolonged exposure (PE) during fiscal year 2015 was obtained via administrative data. Generalized estimating equations were used to evaluate individual-level predictors of treatment adequacy, defined as eight sessions within 14 weeks. Generalized linear models were used to examine facility-level factors.
A total of 5,142 (31.1%) veterans completed eight or more sessions of psychotherapy. Older age was associated with greater odds of completing eight or more sessions (odds ratio OR=1.02, 95% confidence interval CI=1.01, 1.02, p<0.001), and comorbid bipolar or psychotic disorders were associated with reduced odds of completion (OR=0.89, 95% CI=0.80, 0.99, p=0.03). The percentage of patients who completed eight or more sessions was higher at facilities with higher percentages of EBP use among all patients with PTSD (β=6.55, SE=1.97, p=0.001) and greater numbers of EBP-certified providers (β=0.004, SE=0.002, p=0.038) and lower at facilities with a higher percentage of patients receiving a PTSD Checklist (β=-1.16, SE=0.46, p=0.011).
A minority of VA patients with PTSD complete an adequate dose of EBPs for PTSD. Individual and facility-level factors related to treatment adequacy may point to opportunities for intervention.
The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was developed to briefly measure a broad range of cognitive abilities, but it initially lacked a scale to evaluate ...executive functioning. Robert Spencer and colleagues recently created an Executive Errors scale (RBANS-EE) that quantified executive functioning (EF) errors committed during four RBANS subtests: List Learning, Semantic Fluency, Coding, and List Recall. In the present paper we cross-validated the RBANS-EE with a sample of 234 U.S. military veterans (M AGE = 67.2, SD = 11.5 years; M EDUCATION = 13.3, SD = 2.4 years) who completed the RBANS and various EF criterion measures as part of neuropsychological assessments they underwent during their clinical care. We found the RBANS-EE to be significantly correlated with most of the criterion EF measures. The RBANS-EE scale demonstrated modest ability to classify EF impairment at mild and severe levels; and, similarly, the RBANS-EE was modestly capable of accurately classifying those veteran respondents who were determined to have or to not have a neurocognitive disorder. Overall, the RBANS-EE can be quickly calculated, adds no administration time to an RBANS assessment, and yields useful scores to screen for EF dysfunction without replacing standalone EF tests.
This study aimed to assess the ability for exercise training performed before and during biweekly doxorubicin (DOX) administration to attenuate adverse effects of DOX on skeletal muscle. We ...hypothesized that DOX treatment would increase REDD1, impair mammalian target of rapamycin (mTOR) signaling, and reduce muscle fiber size, and that exercise training would attenuate these responses.
Eight-week-old ovariectomized female Sprague-Dawley rats were randomized to one of four treatments: exercise + DOX (Ex-Dox), Ex + vehicle (Ex-Veh), sedentary + DOX (Sed-Dox), and Sed + Veh (Sed-Veh). DOX (4 mg·kg) or vehicle (saline) intraperitoneal injections were performed biweekly for a total of three injections (cumulative dose, 12 mg·kg). Ex animals performed interval exercise (4 × 4 min, 85%-90% V˙O2peak) 5 d·wk starting 1 wk before the first injection and continued throughout study duration. Animals were euthanized ~5 d after the last injection, during which the soleus muscle was dissected and prepared for immunoblot and immunohistochemical analyses.
REDD1 mRNA and protein were increased only in Sed-Dox (P < 0.05). The phosphorylation of mTOR and 4E-BP1 and MHC I and MHC IIa fiber size were lower in Sed-Dox versus Sed-Veh (P < 0.05). By contrast, REDD1 mRNA and protein, mTOR, 4E-BP1, and MHC I fiber size were not different between Ex-Dox and Ex-Veh (P > 0.05). LC3BI was higher, and the LC3BII/I ratio was lower in Sed-Dox versus Sed-Veh (P < 0.05) but not between Ex-Dox and Ex-Veh (P > 0.05).
These data suggest that DOX may inhibit mTORC1 activity and reduce MHCI and MHCIIa fiber size, potentially through elevated REDD1, and that exercise may provide a therapeutic strategy to preserve skeletal muscle size during chronic DOX treatment.
The Response Bias Scale (RBS) was developed to predict non-credible cognitive presentations among disability claimants without head injury. Developers used empirical keying, which is independent of ...apparent content, to select items from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) item pool that distinguished between individuals passing or failing performance validity tests (PVTs). No study has examined which of these items would have psychometric value when used in clinical neuropsychological evaluations. This study reexamined items comprising RBS with reference to manifest item content, internal consistency, PVTs, and a symptom validity test (SVT) in a sample of 173 predominately White male veterans (M
AGE
= 50.70, M
EDU
= 13.73) in a VA outpatient neuropsychology clinic. Participants completed the MMPI-2 Restructured Form (MMPI-2-RF), PVTs, and an SVT. The 28-item RBS appears to contain three types of items: those that manifestly address cognitive functioning, those that are supported but do not appear to address cognitive functioning, and nine items that were unrelated to cognition and not statistically supported. The 19 empirically supported items, or RBS-19, predicted PVT and SVT failures marginally better than the RBS. Both the RBS and RBS-19 had stronger relationships with SVTs relative to PVTs. Although the removal of the nine problematic items improved the diagnostic accuracy of the scale, it still did not reach the level that is generally considered to be clinically optimal. The RBS-19 offers a measure with improved internal consistency and predictive validity compared to the RBS and warrants additional research.
The performance of an optical coating stack depends on thickness and refractive index of each layer. In situ spectroscopic ellipsometry (SE) can track coating properties in real-time, but ex situ SE ...characterization is limited by the large number of unknown sample properties. We review various SE characterization strategies for multilayer structures using 37-layer alternating high-low index stacks of Ta2O5 and SiO2. A “tooling factor” for each coating material is developed to inform how the actual layer thicknesses compare to nominal specifications.
We also introduce tests for sources of error that can occur during multilayer processing. Process drift may produce a gradual change in film properties, such as a slight increase or decrease in coating thickness or optical constants. This is modeled by adding a gradient to each tooling factor. User-error is also considered, where incorrect parameter entry produces an unintentional stack design. An erroneous layer is identified by systematically testing each layer. A “blind” test was performed to determine SE sensitivity to such errors, where a single layer was intentionally altered within a 37-layer stack, and systematic testing was able to resolve the altered layer thickness and position in the stack.
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•We present ex situ spectroscopic ellipsometry characterization of a 37-layer optical coating stack.•We developed new data analysis strategies to determine how coating thickness compares to nominal design using a “tooling parameter” for each material.•We augment the tooling factor with linear scaling to show that process drift can be captured with ex situ measurements.•We show results from a “blind” test where a single altered thickness is correctly identified.
The Montreal Cognitive Assessment (MoCA) is among the most frequently administered cognitive screening tests, yet demographically diverse normative data are needed for repeated administrations.
Data ...were obtained from 18,410 participants using the National Alzheimer's Coordinating Center Uniform Data Set. We developed regression-based norms using Tobit regression to account for ceiling effects, explored test-retest reliability of total scores and by domain stratified by age and diagnosis with Cronbach's alpha, and reported the cumulative change frequencies for individuals with serial MoCA administrations to gage expected change.
Strong ceiling effects and negative skew were observed at the total score, domain, and item levels for the cognitively normal group, and performances became more normally distributed as the degree of cognitive impairment increased. In regression models, years of education was associated with higher MoCA scores, whereas older age, male sex, Black and American Indian or Alaska Native race, and Hispanic ethnicity were associated with lower predicted scores. Temporal stability was adequate and good at the total score level for the cognitively normal and cognitive disorders groups, respectively, but fell short of reliability standards at the domain level.
MoCA total scores are adequately reproducible among those with cognitive diagnoses, but domain scores are unstable. Robust regression-based norms should be used to adjust for demographic performance differences, and the limited reliability, along with the ceiling effects and negative skew, should be considered when interpreting MoCA scores.
Objective: Psychotherapy for depression is effective for many veterans, but the relationship between number of treatment sessions and symptom outcomes is not well established. The Dose-Effect model ...predicts that greater psychotherapeutic dose (total sessions) yields greater symptom improvement with each additional session resulting in smaller session-to-session improvement. In contrast, the Good-Enough Level (GEL) model predicts that rate of symptom improvement varies by total psychotherapeutic dose with faster improvement associated with earlier termination. This study compared the dose-effect and GEL model among veterans receiving psychotherapy for depression within the Veterans Health Administration. Method: The sample included 13,647 veterans with ≥2 sessions of psychotherapy for depression with associated Patient Health Questionnaire-9 (PHQ-9) scores in primary care (n = 7,502) and specialty mental health clinics (n = 6,145) between October 2014 and September 2018. Multilevel longitudinal modeling was used to compare the Dose-Effect and GEL models within each clinic type. Results: The GEL model demonstrated greater fit for both clinic types relative to dose-effect models. In both treatment settings, veterans with fewer sessions improved faster than those with more sessions. In primary care clinics, veterans who received 4-8 total sessions achieved similar levels of symptom response. In specialty mental health clinics, increased psychotherapeutic dose was associated with greater treatment response up to 16 sessions. Veterans receiving 20 sessions demonstrated minimal treatment response. Conclusions: These findings support the GEL model and suggest a flexible approach to determining length of psychotherapy for depression may be useful for optimizing treatment response and allocation of clinical resources.
What is the public health significance of this article?
Rates of improvement and total number of psychotherapy sessions needed to achieve a good-enough depression symptom response vary substantially across individuals. Clinicians should tailor treatment duration to the rate of improvement of the individual patient. Health systems should anticipate wide variation in treatment duration when assessing mental health care quality and access.
Objectives
Recent efforts have been made to develop 10 personality disorder spectra scales using items from the Minnesota Multiphasic Personality Inventory‐2 Restructured Form (MMPI‐2‐RF). These ...scales, developed by Sellbom et al. (2018, J. Pers. Assess., 1–15), demonstrated good validity and warranted cross‐validation.
Method
In all, 97 veterans undergoing neuropsychological evaluation in a VA outpatient clinic completed the MMPI‐2‐RF and the MCMI‐III. We examined the psychometric properties of the scales and proposed additional scales based on personality constructs found in other established tests and prior versions of the Diagnostic and Statistical Manual for Mental Disorders (DSM; APA, 2013).
Results
The 10 original and three additional scales demonstrated acceptable psychometric properties. Most of the 13 scales correlated strongly with the corresponding MCMI‐III scale, however, DSM criteria coverage was variable between scales.
Conclusion
These data provide additional support for 10 personality disorder spectra scales based on MMPI‐2‐RF items and establish preliminary evidence for three additional scales. Further validation is needed in larger and diverse samples.
Little is known regarding treatment utilization among individuals meeting DSM-5 criteria for posttraumatic stress disorder (PTSD).
Data were analyzed from the third wave of the National Epidemiologic ...Survey on Alcohol and Related Conditions, a nationally representative sample using DSM-5 criteria.
Factors related to increased odds of PTSD treatment utilization for individuals meeting lifetime criteria included some college education versus less than a high school degree (odds ratio OR=3.17), having health insurance versus no insurance (OR=2.86), having a comorbid phobia disorder versus not having a phobia disorder (OR=1.36), and greater PTSD symptom count (OR=1.11). Older age (OR=.40), identifying as black or Asian versus white non-Hispanic (OR=.70 and OR=.28, respectively), and greater social functioning (OR=.98) were associated with decreased odds of PTSD treatment utilization.
Results highlight factors that may be useful in identifying population subgroups with PTSD that are at risk for underutilization of services.
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