Behavioral Domains Research Articles

Women with polycystic ovary syndrome are at risk of emotional and uncontrolled eating at midlife: a population-based cohort study

To investigate eating behavior domains-emotional, uncontrolled, and cognitive restraint eating-in women with polycystic ovary syndrome (PCOS) with different PCOS phenotypes and women without PCOS at midlife. A prospective cohort study. Eating behavior domains were assessed at age of 46 years. Predictors of eating behaviors were evaluated using variables collected at ages of 31 and 46 years. Not applicable. Women identified as having PCOS (n = 251) at age of 31 years using the updated Rotterdam criteria were compared with women without any PCOS criteria (n = 935). The PCOS population comprised women with the classic A+B-phenotype (hyperandrogenism and oligomenorrhea, with or without elevated antimüllerian hormone, n = 60), C-phenotype (hyperandrogenism and elevated antimüllerian hormone, n = 84), and D-phenotype (oligomenorrhea and elevated antimüllerian hormone, n = 86). Not applicable. Revised Three-Factor Eating Questionnaire-18 scores for eating behavior domains. Compared with women without PCOS, women with PCOS exhibited higher scores for emotional (33.1 ± 27.8 vs. 39.0 ± 29.9) and uncontrolled eating (26.7 ± 18.2 vs. 30.7 ± 19.4) but no difference in cognitive restraint (46.6 ± 18.6 vs. 45.9 ± 18.5) at age of 46 years. Emotional and uncontrolled eating scores were higher in the A+B-phenotype compared with women without PCOS, whereas uncontrolled eating scores in the C-phenotype were higher than in women without PCOS and the D-phenotype. At age of 46 years, the perception of overweight was an independent predictor of emotional eating among women with PCOS (B = 11.96 [95% confidence interval {CI}: 2.81-20.29]), whereas a history of weight loss attempts was a predictor of uncontrolled eating (B = 6.06 [95% CI: 1.05-10.83]). Among women with PCOS, higher psychological distress at age of 31 years was a significant risk factor for scoring in the highest quartile of emotional (adjusted odds ratio [aOR]: 2.85 [95% CI: 1.19-6.85]) and uncontrolled eating (aOR: 4.37 [95% CI: 1.77-10.80]) at age of 46 years. Women with PCOS at midlife showed a high tendency for unfavorable eating behaviors. Our findings emphasize the need for sensitivity in weight management counseling and addressing psychological distress to prevent unfavorable eating in this population.

Convergent functional effects of antidepressants in major depressive disorder: a neuroimaging meta-analysis.

Neuroimaging studies have provided valuable insights into the macroscale impacts of antidepressants on brain functions in patients with major depressive disorder. However, the findings of individual studies are inconsistent. Here, we aimed to provide a quantitative synthesis of the literature to identify convergence of the reported findings at both regional and network levels and to examine their associations with neurotransmitter systems. Through a comprehensive search in PubMed and Scopus databases, we reviewed 5,258 abstracts and identified 36 eligible functional neuroimaging studies on antidepressant effects in major depressive disorder. Activation likelihood estimation was used to investigate regional convergence of the reported foci of consistent antidepressant effects, followed by functional decoding and connectivity mapping of the convergent clusters. Additionally, utilizing group-averaged data from the Human Connectome Project, we assessed convergent resting-state functional connectivity patterns of the reported foci. Next, we compared the convergent circuit with the circuits targeted by transcranial magnetic stimulation (TMS) therapy. Last, we studied the association of regional and network-level convergence maps with selected neurotransmitter receptors/transporters maps. No regional convergence was found across foci of treatment-associated alterations in functional imaging. Subgroup analysis across the Treated > Untreated contrast revealed a convergent cluster in the left dorsolateral prefrontal cortex, which was associated with working memory and attention behavioral domains. Moreover, we found network-level convergence of the treatment-associated alterations in a circuit more prominent in the frontoparietal areas. This circuit was co-aligned with circuits targeted by "anti-subgenual" and "Beam F3" TMS therapy. We observed no significant correlations between our meta-analytic findings with the maps of neurotransmitter receptors/transporters. Our findings highlight the importance of the frontoparietal network and the left dorsolateral prefrontal cortex in the therapeutic effects of antidepressants, which may relate to their role in improving executive functions and emotional processing.

Frontal EEG alpha asymmetry predicts foreign language anxiety while speaking a foreign language

Engaging in dialog requires interlocutors to coordinate sending and receiving linguistic signals to build a discourse based upon interpretations and perceptions interconnected with a range of emotions. Conversing in a foreign language may induce emotions such as anxiety which influence the quality communication. The neural processes underpinning these interactions are crucial to understanding foreign language anxiety (FLA). Electroencephalography (EEG) studies reveal that anxiety is often displayed via hemispheric frontal alpha asymmetry (FAA). To examine the neural mechanisms underlying FLA, we collected self-reported data on the listening and speaking sections of the Second language skill specific anxiety scale (L2AS) over behavioral, cognitive, and somatic domains and recorded EEG signals during participation in word chain turn-taking activities in first (L1, Chinese) and second (L2, English) languages. Regression analysis showed FAA for the L2 condition was a significant predictor primarily of the behavioral and somatic domains on the L2AS speaking section. The results are discussed along with implications for improving communication during L2 interactions.

Horse Owners' Knowledge of Fundamental Care and their Perceptions on the Implementation of a Mandatory Certificate of Knowledge.

The aims of this study were to first determine the extent of owners' fundamental knowledge of equine care, second, gain their opinions on the implementation of a mandatory certificate of knowledge and third, to investigate the association of certification on horse owner knowledge. An online survey comprising 23 questions (18 closed, 5 open) was distributed worldwide via snowball sampling, and completed by 1847 horse owners who were all ≥18 years old from 17 different countries. Almost all (96%, n = 1781) completed surveys were usable. Just over half (52%) of participants held a current equine knowledge certification, and 59% believed a mandatory certificate of knowledge should be necessary to buy, own, or sell a horse. Horse owners with an equine certificate of knowledge were more likely to be in favor of a mandatory certificate (Pearson's Chi-squared = 50.79, df = 1, p < 0.0001). The mean correctly answered knowledge questions was 68%, indicating that approximately 1/3 of horse owners lacked fundamental horse care knowledge. Further examination indicated that participating horse owners showed the least understanding in the behavioral interactions domain (ANOVA F(4, 24) = 4.98, p < 0.01), specifically in relation to pain recognition and learning theory terminology. Arguably, this deficit in knowledge and likely correct application increases the risk of owners using misinformed or inappropriate techniques to manage horse behavior and training, predisposing the horse to experiencing a sub-optimal quality of life. Overall no significant difference was found between the total correct scores of horse owners with or without a certificate (ANOVA F(1, 56) = 0.78, p > 0.05); however, a series of Chi-squared tests revealed that for the more complex questions, horse owners with a certificate scored better than those without (all p < 0.05). Further work is needed to develop an evidence-based assessment framework if mandatory certification of horse owners is to become an effective tool for improving horse welfare and quality of life.

Preferences for Text Messaging Supports During Youth Transition to Adult Mental Health Services: Theory-Informed Modified e-Delphi Study.

For many young people, the transition from child to adult mental health services is a vulnerable time associated with treatment disengagement and illness progression. Providing service information and options to youth, appealing to them, and tailoring to their needs during this period could help overcome systematic barriers to a successful transition. We know little about how SMS text message-based interventions might be leveraged to support the motivational, informational, and behavioral needs of youth during this time. Ascertaining youth preferences for the content and functionality of an SMS text message service could inform prototype development. This study investigated consensus preferences among youth on important content, technology features, and engagement supports to inform a transition-focused SMS text message service. A modified e-Delphi survey design was used to collect demographics, current levels of technology use, importance ratings on message content, preferred technical features, and barriers and enablers to engagement for youth in Canada aged 16-26 years who have accessed mental health services within the past 5 years. Survey items on content were categorized according to the information-motivation-behavioral skills (IMB) model. Survey items on technical features were categorized according to the persuasive system design (PSD) model. A predefined consensus rating matrix and descriptive statistics were used to characterize the sample. The high consensus threshold was 70%. A total of 100 participants, predominantly non-White (n=47, 47%), aged 20-26 years (n=59, 59%), and who had first accessed mental health services between the ages of 13 and 19 years (n=60, 60%), were selected. The majority (n=90, 90%) identified as daily SMS text message users. A high level of consensus on importance ratings was reported in 45% (9/20) of content items based on the IMB model. There were higher levels of consensus on importance ratings related to behavior domain items (3/3, 100%) than information domain items (4/9, 44%) or motivation domain items (2/8, 25%). A high level of consensus on importance ratings was reported in only 19% (4/21) of feature and functionality items based on the PSD model. Among PSD model categories, there was a high level of consensus on importance ratings in 8% (1/12) of the primary task support domain items and 100% (3/3) of the system credibility support domain items. None of the dialogue-support and social-support domain items met the high level of consensus thresholds. In total, 27% (27/100) of youth indicated that the most significant enabler for engaging with a transition-focused SMS text message intervention was the personalization of text messages. Scientists developing next-generation SMS text messaging interventions for this population need to consider how levels of consensus on different features may impact feasibility and personalization efforts. Youth can (and should) play an integral role in the development of these interventions.

The Content Validity of an Instrument That Measures Health-Seeking Behavior for Tuberculosis among People Living with HIV in India.

Determinants of health-seeking behavior among people living with HIV (PLHIV) are important. This study aims to develop and assess the content validity of an instrument that measures health-seeking behavior for tuberculosis among PLHIV in India. An instrument was developed using deductive methods and the Modified Andersen's Behavioral Model of Health Services (BMHS). We identified three domains using the BMHS. Ten subject experts validated the tool between June 2022 and August 2022. Lawshe's Content Validity Ratios (CVRs) and Scale Content Validity Indices (CVIs) were computed. The items with CVR and CVI values ≥0.62 were considered for the final tool. The health-seeking behavior among PLHIV, based on the BMHS, identified knowledge regarding TB (domain 1), healthcare accessibility and factors leading to delay in treatment-seeking behavior (domain 2), and client satisfaction regarding diagnostic and treatment-seeking behavior (domain 3). Content Validity Ratios (CVRs) of all the items related to domains 1 and 2 were ≥0.62. The Scale Content Validity Indices (for relevance), i.e., S-CVI (average) and S-CVI (proportional relevance), were ≥0.62 for all domains. The items with CVR and CVI values ≥0.62 in the domains were accepted in the final tool, which contained 69 items.

Positive psychology and employee adaptive performance: systematic literature review.

Adaptive performance will increasingly be confronted with new insights as society today changes constantly. This raises questions as to what factors will impact employee's adaptive performance and what is their inner psychological mechanism. The terms of positive psychology and adaptive performance are important concepts in the domain of organizational behavior and human resource development areas. The literature, however, lacks a systematic review of it. Our research seeks to explore the inherence of employee adaptive performance via the prism of positive psychology, including Psychological Capital and PERMA (Positive Emotions, Engagement, Relationships, Meaning and Accomplishment). We selected 27 papers out of 382, which were generated from Web of Science and Scopus databases associated the keywords of the two concepts, and used the 2020 PRISMA flow program for the paper screening. By analyzing the underpin theories, the causation, and the measurement, we discovered that there is a complex and nuanced relationship between positive psychology and adaptive performance, and most of the research to date suggests that positive psychology components improve employee adaptive performance. This study maps the current knowledge at the nexus of positive psychology and adaptive performance to identify existing gaps and potential for further investigation.

Autism likelihood in infants born to mothers with asthma is associated with blood inflammatory gene biomarkers in pregnancy

Mothers with asthma or atopy have a higher likelihood of having autistic children, with maternal immune activation in pregnancy implicated as a mechanism. This study aimed to determine, in a prospective cohort of mothers with asthma and their infants, whether inflammatory gene expression in pregnancy is associated with likelihood of future autism.Mothers with asthma were recruited to the Breathing for Life Trial. RNA was extracted from blood samples collected at mid-pregnancy. 300 ng total RNA was hybridized with the nCounter Human Inflammation gene expression panel (Nanostring Technologies, 249 inflammation-related genes). Parents completed the First Year Inventory (FYI) at 12-month follow-up, which assessed an infant's likelihood for autism across 2 behavioural domains: social communication and sensory regulation. A total score ≥19.2 indicated increased likelihood for future autism.Inflammatory gene expression was profiled from 24 mothers: four infants scored in the high autism likelihood range; 20 scored in the low autism likelihood range. Six inflammatory genes were differentially expressed and significantly up-regulated in the high autism likelihood group: CYSLTR2, NOX1, C1QA, CXCL10, C8A, IL23R. mRNA count significantly correlated with social communication FYI score for CYSLTR2 (Pearson r = 0.46, p = 0.024) and CXCL10 (r = 0.43, p = 0.036) and with sensory regulation score for ALOX5 (r = −0.43, p = 0.038) and MAFK (r = −0.46, p = 0.022).In this proof-of-concept study, inflammatory gene expression during pregnancy in mothers with asthma was associated with an infant's likelihood of future autism as well as scores relating to social communication and sensory regulation.

The Effects of Teacher's Competencies in the Application of Online Teaching and Learning on Students' Academic Stress, Learning Motivation, and Academic Achievement in Statistics Subject

Online learning may lead to several problems, causing academic stress that lowers student motivation. Thus, great instructor skills are needed to overcome challenges and automatically build a successful and efficient online learning process. The study examines how teacher competencies in four dimensions – Teacher’s technological pedagogical content knowledge (TPACK), teacher’s belief (TB), teacher’s self-efficacy (TSE), and teacher’s enthusiasm (TE) – affect students’ academic stress in the cognitive (CD), behavioral (BD), affective (AD), and physiological domains (PD), as well as learning motivation (SLM) and academic achievement (AA). The study uses multivariate regression analysis, the ordinal logistic regression, and the Structural Equation Model (SEM). Multivariate regression analysis is utilized to examine the effects partially and simultaneously of dependent and independent variables. The ordinal logistic regression is used for the same purpose but on the data with an ordinal scale; the final grade shows the AA variable. Whereas, SEM is used to investigate the relationship between complex variables. The sample retrieval technique is conducted using non-probabilistic sampling by the method of accidental sampling with 219 college students. Results show that TPACK, which is one dimension of a teacher’s competencies, negatively affects students’ academic stress, which is BD, AD, and PD. However, TPACK does not significantly affect CD. Adverse effects suggest increasing teacher’s competencies in integrating technology and pedagogies in the development of educational content, especially in online learning, and reducing or minimizing students’ academic stress. Besides that, TPACK also has a positive effect on SLM, and SLM in turn positively affects AA. On the other hand, the variable component of teachers’ competencies, such as TSE and TE, has a positive effect on CD. Likewise, CD positively affects AA, so indirectly, TSE and TE positively affect AA. Of every effect and relationship between independent and dependent variables studied, the variable to contribute most effectively to online learning is the TPACK variable. Keywords: online teaching, teacher’s competencies, student’s academic stress, student’s learning motivation, academic achievement, TPACK, SEM, multivariate regression, logistic ordinal regression

Direct serotonin release in humans shapes aversive learning and inhibition

The role of serotonin in human behaviour is informed by approaches which allow in vivo modification of synaptic serotonin. However, characterising the effects of increased serotonin signalling in human models of behaviour is challenging given the limitations of available experimental probes, notably selective serotonin reuptake inhibitors. Here we use a now-accessible approach to directly increase synaptic serotonin in humans (a selective serotonin releasing agent) and examine its influence on domains of behaviour historically considered core functions of serotonin. Computational techniques, including reinforcement learning and drift diffusion modelling, explain participant behaviour at baseline and after week-long intervention. Reinforcement learning models reveal that increasing synaptic serotonin reduces sensitivity for outcomes in aversive contexts. Furthermore, increasing synaptic serotonin enhances behavioural inhibition, and shifts bias towards impulse control during exposure to aversive emotional probes. These effects are seen in the context of overall improvements in memory for neutral verbal information. Our findings highlight the direct effects of increasing synaptic serotonin on human behaviour, underlining its role in guiding decision-making within aversive and more neutral contexts, and offering implications for longstanding theories of central serotonin function.

Transition between face-to-face education to virtuality: understanding students’ selves.

This qualitative research study aimed to describe the transition from face-to-face to virtual education, in order to understand, as teachers, the personal and academic life of students before and during the pandemic. This descriptive study was conducted on a group of students from different majors at a public institution in Tunja, Boyacá, Colombia. Four relevant aspects were taken into consideration to categorize the data: behavioral, motivational, affective-emotional and cognitive domains. Data were gathered through a questionnaire and notes taken by the researchers. The interpretation of the findings led to a profound reflection in order to orient a change, if necessary, in current teaching practices.

Utilization of Telemedicine to Supervise Medical Students in the Post-Acute/Long-Term Care Setting

ObjectivesTelemedicine has become a widely accepted alternative to face-to-face patient encounters. Although there have been several peer-reviewed journal articles on incorporating telemedicine into the medical school curriculum, particularly during the COVID-19 pandemic, assessments of the effectiveness of remote supervision of medical students have not been reported. This prospective cohort study of student subjects using observational survey data evaluated the efficacy of telemedicine as an educational resource by comparing learning outcomes between osteopathic medical students receiving direct (physically present) supervision with a group who received remote (telemedicine) supervision by clinical faculty within a post-acute/long-term care (PA/LTC) setting. Learning outcomes in the domains of patient rapport, attitudes, knowledge, and behavior were measured using standardized survey instruments. DesignProspective cohort study of student subjects using observational survey data. Setting and ParticipantsA total of 167 fourth-year osteopathic medical students at a teaching nursing home (TNH). MethodsA total of 167 fourth-year osteopathic medical students (OMS-4s) were randomly assigned face-to-face PA/LTC patient encounters at the TNH. The encounters were follow-up visits to residents of the TNH that were supervised by faculty geriatricians. Half were accompanied by the physician and the other half were supervised by the physician through telemedicine. Evaluation using validated survey instruments measured patient rapport, verbal communication, and physical examination skills as well as attitudes, knowledge, and behaviors of the student/subjects. ResultsA nonparametric statistical analysis of 4 dependent variables measuring patient rapport, attitudes, knowledge and behavior showed no significant difference between the 2 teaching modalities. Conclusions and ImplicationsThe results of this prospective cohort study indicate that telemedicine supervision is comparable (noninferior) to direct supervision of medical student trainees in a PA/LTC setting.

“Attentive to their drawing”: A pilot study of the implications of a single session mindfulness-based art therapy intervention on early childhood assistants

Early childhood assistants (ECA) often cope with job-related stressors and experience burnout. This study examined the implications for ECAs of a single session mindfulness-based art therapy (SSMBAT) intervention that combined mindfulness with drawing and photography in a group setting. In this qualitative study, a convenience sample of 16 ECA volunteers were recruited after they had taken part in the SSMBAT as part of an ECA training program. Semi-structured interviews were conducted to explore their experiences during the SSMBAT. The questions focused on mindfulness, understanding and practice, and its possible contribution to personal or professional life. The thematic analysis revealed that mindfulness practices in the workshop elicited an impact in the sensory, emotional, cognitive and metacognitive, and behavioral domains. Components of the workshop, such as mindfulness sitting and walking meditations, artmaking and group sharing were seen as contributing to professional and self-development, working with children, teamwork with peers, and communication with the children’s parents. The results underscore the theoretical as well as the practical value of SSMBAT. They contribute to the scant literature on the wellbeing of ECA and efforts to support them.

Evaluating the Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) Scores Using Principal Components Analysis.

Introduction TheVerbal Behavior Milestones Assessment and Placement Program (VB-MAPP)is an extensive tool used to assess children with autism and other developmental disabilities who have language delays. Applied behavior analysis (ABA) professionals frequently use the VB-MAPP to create personalized intervention programs catering to each child's needs. The lack of studies examining the VB-MAPPat the pretest, posttest, and differential scores using principal components analysis (PCA) suggests an opportunity to conduct PCAs on these different VB-MAPP scores. In doing so, researchers could better understand the VB-MAPP's dimensionality and factor structure at these levels. This, in turn, could inform the development of more effective assessment strategies and intervention plans for individuals with language and social communication challenges. Materials and methods From January 2018 to July 2021, The Oxford Centerin Brighton and Troy, Michigan, treated autistic children using ABAtherapy. A convenience sample of 13 children was retrospectively analyzed using VB-MAPP, which evaluates various behavioral milestones using a pretest-posttest design. Descriptive data analysis and internal consistency reliability estimates (using Cronbach's alpha) were calculated for pretest, posttest, and difference scores. A Wilcoxen signed-rank test was conducted to determine the statistical significance between thepretest and posttest. Correlation matrices were inspected for relevant relationships between VB-MAPP scales, and a PCAwith orthogonal rotation was alsoperformed on this pretest, posttest, and difference scores. Results The mean age for the children was 4.083 years ± 1.083 years, (95%CI 3.64, 4.36). Around 66.6% of the children had an autism severity level of three, 33.3% had a severity level of two, and none were at level one. Cronbach's alpha for internal consistency reliability of the pretest, posttest, and difference scores, indicating excellent reliability with values of 0.948 for the pretest and 0.937 for theposttest, respectively. The difference scores had a lower but acceptable reliability coefficient of 0.752. PCAon the pretest scores identified three factors that explain85.584% of the total variation, indicating that these components capture most of the data's structure. The posttest PCA also identified three factors, accounting for 84.293% of the variance, suggesting a similar complexity and good model fit as the pretest. PCA revealed four factors explaining 82.317% of the variation for the difference scores. The increase in factors suggests that changes between pretest and posttest scores are complex, likely due to the ABA treatment, and require an additional component to represent the data adequately. There is a good model fit; the underlying structure is more complex than the pretest or posttest alone. Conclusions Robust coefficient alphas combined with the shift to a more detailed factor structure post-ABA treatment highlight ABA therapy's diverse and multi-faceted impact on children. The increase from three to four principal components indicates a richer and more nuanced pattern of improvements across different domains of verbal and social behavior. This detailed factor structure is a testament to the comprehensive and individualized nature of ABA treatment, reflecting the therapy's effectiveness in addressing specific needs and fostering broad developmental gains in children.

An alpha 5-GABAA receptor positive allosteric modulator attenuates social and cognitive deficits without changing dopamine system hyperactivity in rats exposed to valproic acid in utero.

Autism spectrum disorders (ASDs) are characterized by core behavioral symptoms in the domains of sociability, language/communication, and repetitive or stereotyped behaviors. Deficits in the prefrontal and hippocampal excitatory/inhibitory balance due to a functional loss of GABAergic interneurons are proposed to underlie these symptoms. Increasing the postsynaptic effects of GABA with compounds that selectively modulate GABAergic receptors could be a potential target for treating ASD symptoms. In addition, deficits in GABAergic interneurons have been linked to dopamine (DA) system dysregulation, and, despite conflicting evidence, abnormalities in the DA system activity may underly some ASD symptoms. Here, we investigated whether the positive allosteric modulator of α5-containing GABAA receptors (α5-GABAARs) SH-053-2'F-R-CH3 (10 mg/kg) attenuates behavioral abnormalities in rats exposed to valproic acid (VPA) in utero, an established risk factor for autism. We also evaluated if animals exposed to VPA in utero present changes in the ventral tegmental area (VTA) DA system activity using in vivo electrophysiology and if SH-053-2'F-R-CH3 could attenuate these changes. SH-053-2'F-R-CH3 was administered intraperitoneally 30 min before each behavioral test and electrophysiology. In utero VPA exposure caused male and female rats to present increased repetitive behavior (self-grooming) in early adolescence and deficits in social interaction in adulthood. Male, but not female VPA rats, also presented deficits in recognition memory as adults. SH-053-2'F-R-CH3 attenuated the impairments in sociability and cognitive function in male VPA-exposed rats without attenuating the decreased social interaction in females. Adult male and female VPA-exposed rats also showed an increased VTA DA neuron population activity, which was not changed by SH-053-2'F-R-CH3. Despite sex differences, our findings indicate that α5-GABAARs positive allosteric modulators may effectively attenuate some core ASD symptoms.

Social Risk and Clinical Outcomes Among Adults With Type 2 Diabetes

No clear process exists for categorizing social risks in a way that informs effective social risk screening and intervention development. To investigate social risk profiles and associations of those profiles with clinical outcomes in adults with diabetes using latent profile analysis. For this cross-sectional study, a latent profile analysis was conducted using data for adults with type 2 diabetes collected at 2 primary care clinics in the Southeastern US from 2013 to 2014. Data were analyzed from November to December 2023. Participants completed validated questionnaires for 26 social risk factors within 5 domains of social determinants of health: socioeconomic, neighborhood, education, food, and social and community context. In addition, participants completed questions that assessed psychological risk and behavioral risk. A 3-step latent profile analysis was used to identify different subgroups within the sample. Profiles were then regressed on outcomes of hemoglobin A1c (HbA1c), blood pressure, and quality of life. A total of 615 participants (mean [SD] age, 61.3 [10.9] years; 379 men [61.6%]) were included. Five latent class profiles were identified. The lowest risk group had significantly higher mental health-related quality of life compared with a group with higher neighborhood risk (β, 1.11; 95% CI, 0.67 to 1.55). The second group had low economic risk but high neighborhood risk and served as the reference group. The third group had high economic and neighborhood risk and had significantly higher blood pressure (β, 8.08; 95% CI, 2.16 to 14.01) compared with the reference. The fourth group had high psychological and behavioral risks but low socioeconomic and neighborhood risks. This group had significantly higher HbA1c (β, 0.47; 95% CI, 0.01 to 0.92) and lower mental health-related quality of life (β, -1.83; 95% CI, -2.41 to -1.24) compared with the reference. The highest risk group indicated high risk in all domains, had significantly higher HbA1c (β, 1.07; 95% CI, 0.50 to 1.63), and had lower mental health-related quality of life (β, -2.15; 95% CI, -2.87 to -1.42) compared with the reference. These findings suggest that social risk profiles can be identified according to social, psychological, and behavioral risk domains and the health outcome of concern among adults with diabetes. Future work should consider the use of social risk profiles in intervention development and testing.

Clinical and financial significance of insomnia within a large payor-provider health system.

Insomnia has profound negative effects on behavioral health, physical health, and functional domains. Leveraging claims data from one of the nation's largest payor-provider systems, the current study examined the real-world prevalence of insomnia, comorbidity of insomnia with behavioral health and other sleep disorders, and the impact of insomnia on total health care costs. Prevalence and costs associated with insomnia were assessed by examining claims data on approximately 3 million insured members during the year 2022. Using propensity score matching, total health care expenditures were calculated and compared for members with insomnia relative to matched cohorts without insomnia. Generalized linear modeling tested for differences between the cohorts. Nine percent of members were identified as having insomnia; 64% of those also had depression, anxiety, and/or substance use disorder. Median total health care costs among individuals with insomnia were 4-6 times greater than among those without insomnia. A disproportionate amount (21.1%) of total claims spend came from members with insomnia. Findings demonstrate a high degree of clinical need and behavioral health comorbidity associated with insomnia within a large insured cohort. Beyond the clinical significance, the current results demonstrate substantial financial need and opportunity for adequately treating insomnia. This is especially the case for the high proportion of members with insomnia and cooccurring depression, anxiety, and/or substance use disorders. Overall, the findings point to the important role payors and providers may have in promoting greater attention to sleep and insomnia.

Examining the Criterion and Incremental Validity of the MMPI-3 Impulsivity Scale.

The Minnesota Multiphasic Personality Inventory-3 (MMPI-3) includes a new Impulsivity (IMP) scale designed to assess for poor impulse-control and non-planful behavior, which was added to broaden the utility of the instrument. The current study aimed to examine the criterion and incremental validity of the IMP scale. A university student sample (n = 1,440) and a community sample oversampled for externalizing tendencies (n = 231) were used for this purpose, and IMP scores were compared to scores on various well-validated criterion measures of impulsivity and externalizing psychopathology. To examine the scale's incremental validity, hierarchical multiple regression analyses were conducted to determine whether IMP adds to other MMPI-3 Specific Problem (SP) scales in the prediction of relevant criteria. The IMP scale primarily showed meaningful correlations with the Negative Urgency and Positive Urgency on the UPPS-P. Significant correlations were also observed with the cognitive, behavioral, disinhibition, and lifestyle domains of various psychopathy measures, as well as measures of antisocial personality disorder and substance use. The IMP scale scores accounted for incremental variance in most of the directly relevant criterion measures above and beyond scores of other MMPI-3 SP scales. Several important caveats, limitations, and future directions are discussed.

Representation of Social Determinants of Health terminology in medical subject headings: impact of added terms.

To enhance and evaluate the quality of PubMed search results for Social Determinants of Health (SDoH) through the addition of new SDoH terms to Medical Subject Headings (MeSH). High priority SDoH terms and definitions were collated from authoritative sources, curated based on publication frequencies, and refined by subject matter experts. Descriptive analyses were used to investigate how PubMed search details and best match results were affected by the addition of SDoH concepts to MeSH. Three information retrieval metrics (Precision, Recall, and F measure) were used to quantitatively assess the accuracy of PubMed search results. Pre- and post-update documents were clustered into topic areas using a Natural Language Processing pipeline, and SDoH relevancy assessed. Addition of 35 SDoH terms to MeSH resulted in more accurate algorithmic translations of search terms and more reliable best match results. The Precision, Recall, and F measures of post-update results were significantly higher than those of pre-update results. The percentage of retrieved publications belonging to SDoH clusters was significantly greater in the post- than pre-update searches. This evaluation confirms that inclusion of new SDoH terms in MeSH can lead to qualitative and quantitative enhancements in PubMed search retrievals. It demonstrates the methodology for and impact of suggesting new terms for MeSH indexing. It provides a foundation for future efforts across behavioral and social science research (BSSR) domains. Improving the representation of BSSR terminology in MeSH can improve PubMed search results, thereby enhancing the ability of investigators and clinicians to build and utilize a cumulative BSSR knowledge base.

Mobile App Intervention to Reduce Substance Use, Gambling, and Digital Media Use in Vocational School Students: Exploratory Analysis of the Intervention Arm of a Randomized Controlled Trial.

During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and youth outside this system are not reached. A mobile app ("Meine Zeit ohne") has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness. The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants' characteristics, and (3) to study how variations in app use were related to participants' baseline characteristics. Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection ("congruent use": eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models. The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high. The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and users' characteristics. German Clinical Trials Register DRKS00023788; https://tinyurl.com/4pzpjkmj. RR2-10.1186/s13063-022-06231-x.