Sample Of Noninstitutionalized Research Articles

Adult Outcomes of Children With Reactive Attachment Disorder in a Non-Institutionalized Sample.

Adult Outcomes of Children With Reactive Attachment Disorder in a Non-Institutionalized Sample.

Measuring bereavement prevalence in a complex sampling survey: the 2019 Georgia Behavioral Risk Factor Surveillance System (BRFSS)

BackgroundThe Behavioral Risk Factor Surveillance System (BRFSS) is an annual survey designed to identify trends in the public’s health. In its 2019 field survey, the U.S. state of GA tested a new 3 – item module to measure the numbers of bereaved, resident adults aged 18 years and older. Participants were eligible if they answered ‘Yes’ to the item ‘Have you experienced the death of a family member or close friend in the years 2018 or 2019?’. This analysis explores two research questions. Can estimates for bereavement prevalence be derived without large sampling errors, low precision, and small subsamples? Can multiple imputation techniques be applied to overcome non-response and missing data to support multivariate modeling?MethodsBRFSS is a non-institutionalized sample of adults aged 18 years and older living in the U.S. state of Georgia. Analyses in this study were conducted under two scenarios. Scenario 1 applies the complex sample weights created by the Centers for Disease Control and imputes values for missing responses. Scenario 2 treats the data as a panel – no weighting combined with removal of persons with missing data. Scenario 1 reflects the use of BRFSS data for public health and policy, while Scenario 2 reflects data as it is commonly used in social science research studies.ResultsThe bereavement screening item has a response rate (RR) of 69.1% (5206 of 7534 persons). Demographic subgroups and categories of health have RR of 55% or more. Under Scenario 1, the estimated prevalence of bereavement is 45.38%, meaning that 3,739,120 adults reported bereaved in 2018 or 2019. The estimated prevalence is 46.02% with Scenario 2 which removes persons with any missing data (4,289 persons). Scenario 2 overestimates the bereavement prevalence by 1.39%. An illustrative logistic model is presented to show the performance of exposure to bereavement under the two data scenarios.ConclusionsRecent bereavement can be ascertained in a surveillance survey accounting for biases in response. Estimating bereavement prevalence is needed for measuring population health. This survey is limited to one US state in a single year and excludes persons aged 17 years and younger.

Health Costs of Older Opioid Users with Pain and Comorbid Hypercholesterolemia or Hypertension in the United States.

This retrospective cross-sectional database study used 2018 Medical Expenditure Panel Survey data to quantify and assess differences in healthcare expenditures between opioid users and non-users among a non-institutionalized sample of older (≥50 years) United States adults with pain in the past four weeks and a diagnosis of comorbid hypercholesterolemia (pain–hypercholesterolemia group) or hypertension (pain–hypertension group). Hierarchical multivariable linear regression models were constructed by using logarithmically transformed positive cost data and adjusting for relevant factors to assess cost differences between groups. Percent difference between opioid users and non-users was calculated by using semi-logarithmic equations. Healthcare costs included inpatient, outpatient, office-based, emergency room, prescription medication, other, and total costs. In adjusted analyses, compared to non-users, opioid users in the pain–hypercholesterolemia and pain–hypertension groups respectively had 66% and 60% greater inpatient expenditure, 46% and 55% greater outpatient expenditure, 67% and 72% greater office-based expenditure, 50% and 60% greater prescription medication expenditure, 24% and 22% greater other healthcare expenditure, and 85% and 93% greater total healthcare expenditure. In conclusion, adjusted total healthcare expenditures were 85–93% greater among opioid users versus non-users in older United States adults with pain and comorbid hypercholesterolemia or hypertension. Future research is needed to identify opioid use predictors among these populations and reduce expenditures.

Predictive and criterion validity of the Cervantes-SF menopause quality of life questionnaire.

To determine the predictive and criterion-based validity of the Cervantes-SF scale that measures the impact of menopause on Health-Related Quality of Life. We recruited a noninstitutionalized sample of peri/postmenopausal women aged 40 to 65 years, who had their last menstrual cycle 12+ months prior to inclusion in the study of the psychometric validity of the Cervantes-SF scale. Predictive validity of the scale was confirmed for various health outcome measures administered concomitantly (years of disability-free life expectancy, work productivity and impact on daily activities, economic impact arising from loss of work productivity, hours of undisturbed sleep each day, and the utilization of healthcare facilities), whilst criterion validity was determined by the likelihood of identifying a moderate-to-severe vasomotor or genital syndrome requiring specific treatment. A sample of 308 peri/postmenopausal women with a mean age of 55.7 years (SD: 5.3 y) was analyzed in this study. A score >25 points on the dimension of vasomotor problems (or menopausal health) showed values of sensitivity and specificity > 80% for identifying women with moderate-severe vasomotor syndrome requiring pharmacological treatment. Predictive validity was confirmed for menopause-related health outcomes. A change of 6.7 points in the scale score, equivalent to the value of its minimal difference, is indicative of a significant increase in the degree of disability regarding work/day-to-day activities, greater economic loss due to decreased work productivity, fewer years of life expectancy without disability, fewer hours of undisturbed sleep, and more visits to the physician per year due to menopausal symptoms. These results confirm the criterion and predictive validity of the Cervantes-SF scale in peri/postmenopausal women.

Antecedents to Secondary-Like Psychopathy in Noninstitutionalized Youth

ABSTRACT Secondary-like psychopathy in youth is often recognized in research as being the more problematic of the psychopathy variants. Little is known about the emergence of this variant in spite of early theory describing possible antecedents to the condition. The present research sought to evaluate these possible precursors among those resembling the secondary-like variant of psychopathy in a noninstitutionalized sample of youth. Findings from a probit path model examining data spanning several waves indicated that social context variables (poverty and maternal education), authoritarian parenting practices, and parent–child attachment were implicated in later downstream secondary-like psychopathy in mid-adolescence. Findings, implications and directions for future research are discussed.

A US national randomized study to guide how best to reduce stigma when describing drug-related impairment in practice and policy.

Background and AimsDrug‐related impairment is persistently stigmatized delaying and preventing treatment engagement. To reduce stigma, various medical terms (e.g. ‘chronically relapsing brain disease’, ‘disorder’) have been promoted in diagnostic systems and among national health agencies, yet some argue that over‐medicalization of drug‐related impairment lowers prognostic optimism and reduces personal agency. While intensely debated, rigorous empirical study is lacking. This study investigated whether random exposure to one of six common ways of describing drug‐related impairment induces systematically different judgments.Design, Setting and ParticipantsCross‐sectional survey, US general population, among a nationally representative non‐institutionalized sample (n = 3635; 61% response rate; December 2019–January 2020).InterventionTwelve vignettes (six terms × gender) describing someone treated for opioid‐related impairment depicted in one of six ways as a(n): ‘chronically relapsing brain disease’, ‘brain disease’, ‘disease’, ‘illness’, ‘disorder’ or ‘problem’.MeasurementsMulti‐dimensional stigma scale assessing: blame; social exclusion; prognostic optimism, continuing care, and danger (a = 0.70–0.83).FindingsUS adults [mean age = 47.81, confidence interval (CI) = 47.18–48.44; 52.4% female; 63.14% white] rated the same opioid‐impaired person differently across four of five stigma dimensions depending on which of six terms they were exposed to. ‘Chronically relapsing brain disease’ induced the lowest stigmatizing blame attributions (P < 0.05); at the same time, this term decreased prognostic optimism [mean difference (MD) = 0.18, 95% CI = 0.05, 0.30] and increased perceived need for continuing care (MD = –0.26, 95% CI = –0.43, –0.09) and danger (MD = –0.13, 95% CI = –0.25, –0.02) when compared with ‘problem’. Compared with a man, a woman was blamed more for opioid‐related impairment (MD = –0.08, 95% CI = –0.15, –0.01); men were viewed as more dangerous (MD = 0.13, 95% CI = 0.06, 0.19) and to be socially excluded (MD = 0.16, 95% CI = 0.09, 0.23).ConclusionsThere does not appear to be one single medical term for opioid‐related impairment that can meet all desirable clinical and public health goals. To reduce stigmatizing blame, biomedical ‘chronically relapsing brain disease’ terminology may be optimal; to increase prognostic optimism and decrease perceived danger/social exclusion use of non‐medical terminology (e.g. ‘opioid problem’) may be optimal.

Coverage and Access for Americans with Cardiovascular Disease or Risk Factors After the ACA: a Quasi-experimental Study.

Atherosclerotic cardiovascular disease (CVD) is the leading cause of death in the USA. Many with CVD or cardiovascular risk factors (CVRFs) lacked insurance coverage and access to care before enactment of the Affordable Care Act (ACA). To assess the effect of the ACA on insurance coverage, access to care, and racial/ethnic disparities among non-elderly adults with CVD or CVRFs. Quasi-experimental policy intervention. Nationally representative, non-institutionalized sample of 1,014,450 adults aged 18 to 64years with CVD or at least 2 established CVRFs in the pre-ACA (2012-2013) and post-ACA (2015-2016) periods. Implementation of ACA provisions on 1 January 2014. Insurance coverage, having a check-up, having a personal physician, and not having to forgo a needed physician visit because of cost. Following ACA implementation, insurance coverage increased by 6.9 percentage points (95% CI, 6.6 to 7.2), not having to forgo a physician visit increased by 3.6 percentage points (CI, 3.3 to 3.9), having a check-up increased by 2.1 percentage points (CI, 1.8 to 2.6), and having a personal physician increased by 1 percentage point (0.6 to 1.3); changes were approximately doubled for those with lower incomes (< $35,000/year). Changes in coverage varied substantially by state and all outcomes improved more in Medicaid expansion states. Although racial/ethnic minorities had greater improvements in some outcomes, approximately 13% black and 29% Hispanic adults continued to lack coverage and access to care post-ACA. The ACA increased coverage and access for adults with CVD or multiple CVRFs; substantial gaps remain, particularly for minorities and those in Medicaid non-expansion states.

The network structure of psychopathic personality traits in a non-institutionalized sample

Central and peripheral traits of psychopathy remain highly debated and the contribution of positive adjustments in the psychopathy network is unclear. Indeed, the structure of psychopathic personality traits could vary across populations and settings. Using network analysis, we estimated a model based on the 18 Elemental Psychopathy Assessment facets in a large college student sample (N = 2291). We then examined the accuracy and stability of the network, and finally performed bootstrapped difference tests to determine central and peripheral traits involved in our model. Centrality indices were highly stable and emphasized the major contribution of Callousness, Dominance and Unconcern facets in the psychopathy network. Conversely, Thrill-seeking, Impersistence and Distrust facets were more peripheral in the network. Our results support that callousness is a reliable indicator of psychopathy regardless of the sample characteristics, and that some positive adjustments (i.e., boldness) could be useful to index psychopathy in non-incarcerated samples. Future research should investigate the network structure of psychopathic traits across different settings.

Factor Structure and Construct Validity of the Levenson Self-Report Psychopathy Scale (LSRP): A Replication and Extension in Dutch Nonclinical Participants

The Levenson Self-Report Psychopathy (LSRP) scale is widely used to assess psychopathic traits in noninstitutionalized samples. Recent studies suggest that a three-factor structure measuring Egocentricity, Callousness, and Antisocial factors outperformed the original two-factor structure of the LSRP. This study replicated and extended these findings by examining the factor structure and construct validity of a Dutch version of the LSRP in a community sample (N = 856, subsamples ranging between 140 and 572 participants). Confirmatory factor analysis results corroborated the superiority of the three-factor model of the LSRP, using 19 of the 26 LSRP items. Limitations included the need to specify correlated residuals for some indicators, although these were largely in line with prior studies. Across three subsamples, we found evidence for construct validity of the LSRP subscales. Egocentricity and Antisocial showed a pattern of differential associations with external correlates in accordance with theoretical expectations. Callousness shared some correlates with Egocentricity, others with Antisocial, and uniquely predicted low morality and high physical aggression. Few exceptions to the hypothesized associations were observed, mostly concerning Callousness. Overall, the LSRP three-factor model received further support in a Dutch sample, and is thus recommended in future research, possibly adding items to improve the performance of the Callousness factor.

Is psychopathy associated with deficits in bonding in an adult noninstitutionalized sample? The association between intimate social network size, attachment behavior, and psychopathy

The diminished capacity to form bonds is an attribute that has been widely ascribed to psychopathy, particularly the affective domain of the construct. The purpose of the current study was to inves...

Psychopathic Personality Traits in the Military: An Examination of the Levenson Self-Report Psychopathy Scales in a Novel Sample.

The Levenson Self-Report Psychopathy Scale is a short, self-report measure initially developed to assess psychopathic traits in noninstitutionalized samples. The present study aimed to explore factor structure and convergent and discriminant validity of the Levenson Self-Report Psychopathy Scale in a large U.S. military sample (90.7% Army National Guard). Factor analytic data, regression, and correlational analyses point to the superiority of Brinkley, Diamond, Magaletta, and Heigel's three-factor model in this sample. Implications for theory and the study of psychopathic personality traits in a military sample are discussed.

Examining the Relationships Between the Triarchic Psychopathy Constructs and Behavioral Deviance in a Community Sample.

Few studies have examined the extent to which psychopathic traits relate to the commission of mild to moderate acts of deviance, such as vandalism and minor traffic violations. Given that psychopathy is now studied in community populations, the relationship between psychopathic traits and less severe deviant behaviors, which are more normative among noninstitutionalized samples, warrants investigation. The current study examined the relationships between the triarchic model of psychopathy (Patrick, Fowles & Krueger, 2009) and seven forms of deviant behavior (drug use, alcohol use, theft, vandalism, school misconduct, assault, and general deviance) in a nationally representative sample. Triarchic disinhibition positively predicted each form of normative deviance. Boldness positively predicted drug and alcohol use as well as general deviance, while meanness negatively predicted school misconduct. Boldness and disinhibition also positively predicted overall lifetime engagement in deviant behavior. Implications are discussed, including support of the role of boldness within the psychopathy construct.

Special Issue on Social and Emotional Competences

Special Issue on Social and Emotional Competences

Callous-Unemotional Traits and Differently Motivated Aggression

Emerging psychopathy in youth is often identified by the presence of callous-unemotional traits, while variants of psychopathy are recognized to exist in either primary or secondary form. These variants have been differentially associated with aggressive behavior, as well as dissimilarly motivated (instrumental, reactionary). The present research evaluates those resembling the variants and the qualities of aggression associated with them in a noninstitutionalized sample of youth. Findings suggest that youth resembling the secondary variant demonstrate higher expression of instrumental and reactive aggression compared to the primary-like variants and non-variants. This finding held when scrutinized against other covariates in the noninstitutionalized sample. Further distinctions based on variant type are discussed.

Using the Risk and Resilience Approach to Predict Psychopathy in an Emerging Adult Sample

Psychopathy has been shown to be a risk factor for antisocial behavior, aggression, violence, and criminal offending. Elucidating the variables that predict the likelihood of psychopathy, therefore, is important. The current study used the risk and resiliency approach to test the possible risk and protective factors of primary psychopathy using a noninstitutionalized college-aged sample. Of particular interest, we tested the individual and cumulative risk of several defining features of emerging adulthood (assessed using the Inventory of the Dimensions of Emerging Adulthood measure), sex of participant, and trait mindfulness. Participants ( N = 822) from various colleges and universities in the United States completed questionnaires used to assess the pertinent variables using a correlational design. Results showed that sex (i.e., male), low mindfulness, low identity exploration, and low other-focused orientation were risk factors for primary psychopathy. Results are discussed in terms of the importance of emerging adulthood development.

PHS102 - Utilization Trends Of Cancer Preventive Care Services In The United States: A Longitudinal Study Of Medical Expenditure Panel Survey Data For Years 1996 To 2010

To explore the utilization trends of cancer preventive care services in the United States (U.S.) from year 1996 to 2010. Longitudinal, retrospective study was conducted on a representative, non-institutionalized sample of the U.S. population using the Household Component of the Medical Expenditure Panel Survey data from year 1996 to 2010. Weighted data were used to examine the total number of U.S. adults who reported the use of cancer preventive care services: for women (Pap smear test), for men (Prostate specific antigen [PSA] test), and for both genders (Sigmoidoscopy, Colonoscopy and Blood stool test). For each preventive care service, response categories were combined according to the standard screening guidelines and graphs were plotted for each service. For Pap smear test, a consistent upward trend was observed for those who had the test ‘within past 3 years’ from year 2000 to 2010. For PSA test, generally, upward trend was observed for those who had the test ‘within past 1 year’ and downward trend for those who ‘never’ had the test. For Sigmoidoscopy and/or Colonoscopy, a consistent increase was observed from 1999 to 2007 for those who had the test ‘within past 5 years’. Moreover, from 2008 to 2010, use of Sigmoidocopy decreased while use of Colonoscopy increased. Lastly, for blood stool test, downward trend was observed for those who had the test ‘within past 1 year’ from 2002 to 2010. In general, use of Pap smear, PSA, and Colonoscopy tests increased while use of Sigmoidoscopy and blood stool tests decreased over the years. Success rate of cancer treatment can be greatly increased with early screening and detection of cancer. Findings of this study may be useful in developing consumer awareness campaigns to promote early screening for cancer.

High prevalence of vitamin D insufficiency in community-dwelling postmenopausal Polish women.

IntroductionInadequate vitamin D level is associated with altered bone turnover and bone loss, which increases the fracture risk.AimTo assess the seasonal prevalence of inadequate (insufficient or deficient) serum vitamin D levels in community-dwelling postmenopausal Polish women screened for osteoporosis.Material and methodsA cross-sectional observational study based on the regional urban non-institutionalized sample (n = 107) of postmenopausal Caucasian women in the age range of 51-83 years, not taking any medication and free from any condition likely to affect vitamin D status or calcium/bone metabolism. The outcome measures were the mean 25-OH vitamin D level across all the seasons and the percentage of vitamin D deficiency and insufficiency and defined as < 20 ng/dl (50 nmol/l) and 20-30 ng/dl (50-75 nmol/l), respectively.ResultsNo statistically significant difference has been found in the mean vitamin D level, regardless of the season (p = 0.4). The prevalence of vitamin D deficiency and insufficiency were in spring 54% and 32%, in summer 46% and 46%, in autumn 67% and 27%, and in winter 61% and 22%, respectively.ConclusionsVitamin D inadequacy is common in a sample of Polish community-dwelling postmenopausal women regardless of the season.

Psychopathic personality and utilitarian moral judgment in college students

PurposeAlthough psychopathy is characterized by amoral behavior, literature on the association between psychopathy and moral judgment pattern is mixed. Recent evidence suggests that this may be due to the moderation effect of anxiety (Koenigs, Kruepke, Zeier, & Newman, 2011). The current study aims to examine the psychopathy-utilitarian judgment association in college students. MethodIn this study, a group of 302 college students completed a moral judgment test involving hypothetical dilemmas. Their psychopathic traits were assessed by the Psychopathic Personality Inventory – Short Form (PPI-SF) (Lilienfeld & Andrews, 1996). ResultsIndividuals with higher psychopathic traits were more likely to make utilitarian responses to moral dilemmas. Furthermore, the association between utilitarian responses and psychopathy was more salient for the behavioral factor of psychopathy (PPI-II), and this association was mediated by self-reported aggression. However, the moderating effect of anxiety was not found. ConclusionsThese results build upon work on utilitarian moral judgment in psychopathic individuals in a non-incarcerated, non-institutionalized sample, and have important implications for the behavioral correction system.

Does psychopathy manifest divergent relations with components of its nomological network depending on gender?

Despite a great deal of empirical research on psychopathy there are fewer data on psychopathy in female samples, especially non-institutionalized samples, and it is unclear whether psychopathy manifests in similar ways across gender. In a large undergraduate sample, we explored psychopathy in relation to gender in a two-fold manner. First, we examined whether there were significant gender differences in self-report psychopathy scores; there were (men scored higher). Second, we tested whether psychopathy’s relations with important constructs from its nomological network differ depending on gender. Psychopathy largely manifested a pattern of relations that did not vary across gender, with a few important exceptions (e.g., traits related to impulsivity and Openness). Ultimately, these results suggest that, despite mean-level differences between men and women, psychopathy operates in a relatively consistent manner across gender.

Self-Criticism, Maladaptive Perfectionism, and Depression Symptoms in a Community Sample: A Longitudinal Test of the Mediating Effects of Person-Dependent Stressful Life Events

Both self-criticism and maladaptive dimensions of perfectionism have been associated with depression symptoms, based on cross-sectional and some longitudinal research with selective clinical and student samples. The present study evaluated a mediation model involving self-criticism, maladaptive dimensions of perfectionism, and depression-related symptoms at baseline (Time 1), and person-dependent stressful life events and depression-related symptoms 12 months later (Time 2), in a more representative noninstitutionalized sample. Participants included 723 community-based adults in an urban area. A proposed mediation model based on recent theoretical writings was evaluated, whereby the effects of self-criticism and maladaptive perfectionism on subsequent depression symptoms were hypothesized to be mediated by person-dependent stressful life events. In female respondents, the relationship between self-criticism and Time 2 depression was not mediated by person-dependent stressful life events and the relationship between socially prescribed perfectionism and Time 2 depression was fully mediated by person-dependent life events. In male respondents, self-criticism showed evidence of partial mediation while doubts about actions and socially prescribed perfectionism did not have significant main effects on Time 2 depression. Clinical and research implications of this important cognitive diathesis domain in association with person-dependent stressful life events and subsequent depression are discussed.