Rating Scale Measures Research Articles

Individual treatment expectations predict clinical outcome after lumbar injections against low back pain.

Abstract Subjective expectations are known to be associated with clinical outcomes. However, expectations exist about different aspects of recovery, and few studies have focused on expectations about specific treatments. Here, we present results from a prospective observational study of patients receiving lumbar steroid injections against low back pain (N = 252). Patients completed questionnaires directly before ( ), directly after ( ), and 2 weeks after ( ) the injection. In addition to pain intensity, we assessed expectations (and certainty therein) about treatment effects, using both numerical rating scale (NRS) and the Expectation for Treatment Scale (ETS). Regression models were used to explain (within-sample) treatment outcome (pain intensity at ) based on pain levels, expectations, and certainty at and . Using cross-validation, we examined the models' ability to predict (out-of-sample) treatment outcome. Pain intensity significantly decreased (P < 10−15) 2 weeks after injections, with a reduction of the median NRS score from 6 to 3. Numerical Rating Scale measures of pain, expectation, and certainty from jointly explained treatment outcome (P < 10−15, R 2 = 0.31). Expectations at explained outcome on its own (P < 10−10 ) and enabled out-of-sample predictions about outcome (P < 10−4), with a median error of 1.36 on a 0 to 10 NRS. Including measures from did not significantly improve models. Using the ETS as an alternative measurement of treatment expectations (sensitivity analysis) gave consistent results. Our results demonstrate that treatment expectations play an important role for clinical outcome after lumbar injections and may represent targets for concomitant cognitive interventions. Predicting outcomes based on simple questionnaires might be useful to support treatment selection.

Validation of accelerometry as a digital phenotyping measure of negative symptoms in schizophrenia

Negative symptoms are commonly assessed via clinical rating scales; however, these measures have several inherent limitations that impact validity and utility for their use in clinical trials. Objective digital phenotyping measures that overcome some of these limitations are now available. The current study evaluated the validity of accelerometry (ACL), a passive digital phenotyping method that involves collecting data on the presence, vigor, and variability of movement. Outpatients with schizophrenia (SZ: n = 50) and demographically matched healthy controls (CN: n = 70) had ACL continuously recorded from a smartphone and smartband for 6 days. Active digital phenotyping assessments, including surveys related to activity context, were also collected via 8 daily surveys throughout the 6 day period. SZ participants had lower scores on phone ACL variables reflecting vigor and variability of movement compared to CN. ACL variables demonstrated convergent validity as indicated by significant correlations with active digital phenotyping self-reports of time spent in goal-directed activities and clinical ratings of negative symptoms. The discriminant validity of ACL was demonstrated by low correlations with clinical rating scale measures of positive, disorganized, and total symptoms. Collectively, findings suggest that ACL is a valid objective measure of negative symptoms that may complement traditional approaches to assessing the construct using clinical rating scales.

Critical Illness Polyneuropathy and Functional Outcome in Subjects with Covid-19: Report on Four Patients and a Scoping Review of the Literature.

Patients with COVID-19 may develop a range of neurological disorders. We report here 4 COVID-19 subjects with intensive care unit-acquired weakness and their functional outcome. In addition, a scoping review of COVID-19 literature was performed to investigate this issue. Of the post-COVID-19 patients admitted to our Neuro-Rehabilitation Unit, 4 (3 males, 1 female; mean age 59.2 ± 8.62 years) had intensive care unit-acquired weakness, diagnosed with electromyography. Muscle strength and functional evaluation were performed on all patients with Medical Research Council, Disability Rating Scale and Functional Independence Measure, respectively, at admission, discharge and 6-month follow-up after discharge. Electromyography revealed that 3 subjects had critical illness polyneuropathy and 1 had critical illness polyneuropathy/critical illness myopathy. At follow-up, the 3 subjects with critical illness polyneuropathy reached full recovery. The patient with critical illness polyneuropathy/critical illness myopathy showed moderate disability requiring bilateral ankle foot-orthosis and support for ambulation. The scoping review retrieved 11 studies of COVID-19 patients with intensive care unit-acquired weakness, concerning a total of 80 patients: 23 with critical illness myopathy (7 probable), 21 with critical illness polyneuropathy (8 possible), 15 with critical illness polyneuropathy and myopathy (CIPNM) and 21 with intensive care unit-acquired weakness. Of 35 patients who survived, only 3 (8.5%) reached full recovery. All 3 had critical illness myopathy, but 2 of these had a diagnosis of probable critical illness myopathy. Intensive care unit-acquired weakness commonly occurred in subjects with COVID-19. Recovery was variable and a low percentage reached full recovery. However, the heterogeneity of studies did not allow definitive conclusions to be drawn. LAY ABSTRACTPatients with COVID-19 may develop a range of neurological disorders. We report here 4 cases of COVID-19 patients with intensive care unit-acquired weakness and their functional outcome. In addition, a scoping review of the COVID-19 literature was performed to investigate the occurrence of, and recovery from, intensive care unit-acquired weakness and sub-types (critical illness polyneuropathy, critical illness myopathy and critical illness polyneuropathy/critical illness myopathy) in subjects with COVID-19. Of these 4 patients, the 3 patients with critical illness polyneuropathy reached full recovery. The patient with critical illness polyneuropathy/critical illness myopathy showed moderate disability, requiring use of a bilateral device (ankle foot-orthosis). The scoping review of studies of COVID-19 patients with intensive care unit-acquired weakness retrieved a total of 80 patients: 21 with intensive care unit-acquired weakness, 23 with critical illness myopathy, 21 with critical illness polyneuropathy, and 15 with critical illness polyneuropathy/critical illness myopathy. Intensive care unit-acquired weakness commonly occurred in COVID-19 subjects, but the outcome was variable and a low percentage reached full recovery. COVID-19 subjects can develop long-term consequences and limitations, particularly those with intensive care unitacquired weakness, who need more rehabilitation. New rehabilitative strategies and well-designed studies investigating the benefit of rehabilitation are necessary.

Contrasting two methods, attitudinal and monetary, to assess support changes toward wildlife species by urban dwellers

AbstractMonitoring the general public's support toward wildlife species is a strategy to identify whether a specific human–wildlife conflict (HWC) is escalating or de‐escalating over time. The support can change due to multiple factors, such as mass media news of HWC or providing information about ecological traits of a species. Methods such as the rating scale (RS) and the allocation of a fixed amount of money (money allocation [MA]) have been used in the human–wildlife dimension as a proxy to measure support toward wildlife species. We compared these two methods' capacity to assess the general public's support changes toward wildlife species in an experimental design setting. Face‐to‐face interviews were applied among urban dwellers (n: 359) in Valdivia, Chile. In each interview, the support toward 12 wildlife species was elicited using an RS and MA methods, on two occasions, before and after disclosing ecological traits of the species. The results indicate that the MA grouped the wildlife species based on shared ecological traits, information disclosed to the participants, while the RS did not obtain the same results. Specifically, the MA identified an increase and decrease of support toward the wildlife species, and the RS only an increment of support. These results could be partly explained due to the conceptual foundation of each method. The MA was designed to elicit preferences in a constrained choice, while the RS measures attitudes. As a constrained choice, the MA does allow maximum support to be given to one species only if all other species are left unsupported, while in the RS, it is possible to provide maximum support for all species. The mentioned characteristics of the MA make it more suitable than the RS when the objective is to identify support changes.

Psychometric properties of the Dimensional Anhedonia Rating Scale in Chinese typical, subthreshold, and clinically depressed adolescents.

The Dimensional Anhedonia Rating Scale measures state anhedonia in multiple domains, such as hobbies, food and drink, social activities, and sensory experience, and it has good reliability and validity in adult samples. However, no study has examined the psychometrical properties of this scale in adolescents. The present study examined its reliability and validity in adolescents with and without depression. In Study 1, 988 high-school students completed the Dimensional Anhedonia Rating Scale; 915 completed the second-round survey 3months later. Confirmatory factor analysis was used to determine the factor structure. Additionally, internal consistency and test-retest reliability, and concurrent, convergent, and divergent validity were assessed in typical adolescents. In Study 2, the Dimensional Anhedonia Rating Scale was administrated to 108 patients with major depressive disorder, 108 adolescents with subthreshold depression, and 108 healthy controls. Factor structure and convergent validity were assessed in the clinical and subclinical groups. Finally, a one-way analysis of variance (ANOVA) was applied to examine the effect of depression severity on the scale scores. The results of Study 1 indicated that a four-factor model (i.e., hobbies, food and drink, social activities, and sensory experience) best fit the data. Meanwhile, the scale also yielded good concurrent, convergent, and divergent validity, as well as high internal consistency and test-retest reliability, in typical adolescents. In Study 2, goodness-of-fit statistics also suggested a good fit for the four-factor model in the two depressed groups. The one-way ANOVA revealed significant group differences in the total and factor scores, whereby the major depressive disorder group had lower scores than the subthreshold depression group, whose scores were lower than the healthy controls, indicating excellent eligibility of the scale in depressed adolescents. The Chinese version of the Dimensional Anhedonia Rating Scale is a reliable and valid instrument to comprehensively measure state anhedonia in Chinese typical and depressed adolescents.

State Anhedonia in Young Healthy Adults: Psychometric Properties of the German Dimensional Anhedonia Rating Scale (DARS) and Effects of the COVID-19 Pandemic.

Healthy reward processing is a complex interplay of several components. Recent self-report measures of anhedonia, the decrease or loss of hedonic capacity, take this complexity into account. The Dimensional Anhedonia Rating Scale (DARS) measures interest, motivation, effort and consummatory pleasure across four domains: hobbies, food/drink, social activities and sensory experiences. In the present cross-sectional survey study, we validated the German version of the DARS in a sample of 557 young healthy adults. Factor structure as well as convergent and divergent validity were assessed. As a secondary aim, we examined the effects of the COVID-19 pandemic on state anhedonia and depression severity. Our results suggest good convergent and divergent validity and high internal consistency of the German DARS. The original differentiation of four factors mapping onto the four domains was confirmed and measurement invariance before and during the COVID-19 pandemic was established. We conclude that the DARS is a valid instrument to comprehensively assess state anhedonia in healthy German samples. Future studies should further assess the utility of the German DARS in clinical contexts. In line with many previous studies, participants during the pandemic reported significantly higher levels of depressive symptoms compared to participants in the months before. We found no indication that the COVID-19 pandemic affected state hedonic capacity.

Do side effects of antidepressants impact efficacy estimates based on the Hamilton Depression Rating Scale? A pooled patient-level analysis

The Hamilton Depression Rating Scale (HDRS-17) measures symptoms that may overlap with common antidepressant side effects (e.g., sexual dysfunction), thus making it possible that side effects of antidepressant treatment are erroneously rated as symptoms of depression, and vice versa. This study uses patient-level data from previously conducted antidepressant treatment trials to assess whether side effect ratings co-vary with HDRS-17 ratings. Data from all HDRS-17-rated, industry-sponsored pre- and post-marketing trials (n = 4647) comparing the serotonin and noradrenaline reuptake inhibitor, duloxetine, to placebo and/or to a selective serotonin reuptake inhibitor were pooled; three studies, which utilised sub-therapeutic doses, did not have symptom-level ratings available and could not be included. Severity was assessed for side effects related to sleep, somatic anxiety, gastrointestinal function, and sexual dysfunction. Analysis of covariance was used to assess the relation between these side effects and ratings of relevant HDRS-17-derived outcome parameters. Side effects related to sleep, somatic anxiety and sexual dysfunction significantly and exclusively associated with higher scores on HDRS-17 items measuring the corresponding domains. Side effects related to gastrointestinal function associated with higher HDRS-17 item scores on all assessed domains. Treatment outcome was significantly related to side effect severity when assessed using HDRS-17-sum (beta 0.32 (0.074), p < 0.001), but not when the HDRS-6-sum-score (beta 0.035 (0.043), p = 0.415) or the depressed mood item (beta 0.007 (0.012), p = .527) were used as effect parameters. That some HDRS-17 items co-vary with common antidepressant side effects suggests some of these adverse events are counted twice, potentially leading to an underestimation of antidepressant efficacy.

Recovery of Consciousness and Functional Outcome in Moderate and Severe Traumatic Brain Injury

Traumatic brain injury (TBI) leads to 2.9 million visits to US emergency departments annually and frequently involves a disorder of consciousness (DOC). Early treatment, including withdrawal of life-sustaining therapies and rehabilitation, is often predicated on the assumed worse outcome of disrupted consciousness. To quantify the loss of consciousness, factors associated with recovery, and return to functional independence in a 31-year sample of patients with moderate or severe brain trauma. This cohort study analyzed patients with TBI who were enrolled in the Traumatic Brain Injury Model Systems National Database, a prospective, multiyear, longitudinal database. Patients were survivors of moderate or severe TBI who were discharged from acute hospitalization and admitted to inpatient rehabilitation from January 4, 1989, to June 19, 2019, at 1 of 23 inpatient rehabilitation centers that participated in the Traumatic Brain Injury Model Systems program. Follow-up for the study was through completion of inpatient rehabilitation. Traumatic brain injury. Outcome measures were Glasgow Coma Scale in the emergency department, Disability Rating Scale, posttraumatic amnesia, and Functional Independence Measure. Patient-related data included demographic characteristics, injury cause, and brain computed tomography findings. The 17 470 patients with TBI analyzed in this study had a median (interquartile range [IQR]) age at injury of 39 (25-56) years and included 12 854 male individuals (74%). Of these patients, 7547 (57%) experienced initial loss of consciousness, which persisted to rehabilitation in 2058 patients (12%). Those with persisting DOC were younger; had more high-velocity injuries; had intracranial mass effect, intraventricular hemorrhage, and subcortical contusion; and had longer acute care than patients without DOC. Eighty-two percent (n = 1674) of comatose patients recovered consciousness during inpatient rehabilitation. In a multivariable analysis, the factors associated with consciousness recovery were absence of intraventricular hemorrhage (adjusted odds ratio [OR], 0.678; 95% CI, 0.532-0.863; P = .002) and intracranial mass effect (adjusted OR, 0.759; 95% CI, 0.595-0.968; P = .03). Functional improvement (change in total functional independence score from admission to discharge) was +43 for patients with DOC and +37 for those without DOC (P = .002), and 803 of 2013 patients with DOC (40%) became partially or fully independent. Younger age, male sex, and absence of intraventricular hemorrhage, intracranial mass effect, and subcortical contusion were associated with better functional outcome. Findings were consistent across the 3 decades of the database. This study found that DOC occurred initially in most patients with TBI and persisted in some patients after rehabilitation, but most patients with persisting DOC recovered consciousness during rehabilitation. This recovery trajectory may inform acute and rehabilitation treatment decisions and suggests caution is warranted in consideration of withdrawing or withholding care in patients with TBI and DOC.

Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial.

Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared. A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups (P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group. Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection. Level II.

Developing an Index of Medical Conditions Associated with Outcomes after Moderate-to-Severe Traumatic Brain Injury.

Medical conditions co-occurring with traumatic brain injury (TBI) are associated with outcomes, and comorbidity indices such as Charlson and Elixhauser are used in TBI research, but they are not TBI specific. The purpose of this research was to develop an index or indices of medical conditions, identified in acute care after moderate to severe TBI, that are associated with outcomes at rehabilitation discharge. Using the TBI Model Systems National Database, the International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) codes of 8988 participants were converted to Healthcare Cost and Utilization Project (HCUP) diagnostic categories. Poisson regression models were built predicting Disability Rating Scale and Functional Independence Measure Cognitive and Motor subscale scores from HCUP categories after controlling for demographic and injury characteristics. Unweighted, weighted, and anchored indices based on the outcome models predicted 7.5-14.3% of the variance in the observed outcomes. When the indices were applied to a new validation sample of 1613 cases, however, only 2.6-6.6% of the observed outcomes were predicted. Therefore, no models or indices were recommended for future use, but several study findings are highlighted suggesting the importance and the potential for future research in this area.

Secreted Peptides for Diagnostic Trajectory Assessments in Brain Injury Rehabilitation

Background Rehabilitation following traumatic brain injury (TBI) significantly improves outcomes; yet TBI heterogeneity raises the need for molecular evidence of brain recovery processes to better track patient progress, evaluate therapeutic efficacy, and provide prognostication. Objective Here, we assessed whether the trajectory of TBI-responsive peptides secreted into urine can produce a predictive model of functional recovery during TBI rehabilitation. Methods The multivariate urinary peptidome of 12 individuals with TBI was examined using quantitative peptidomics. Measures were assessed upon admission and discharge from inpatient rehabilitation. A combination of Pavlidis template matching and partial least-squares discriminant analysis was used to build models on Disability Rating Scale (DRS) and Functional Independence Measure (FIM) scores, with participants bifurcated into more or less functional improvement groups. Results The produced models exhibited high sensitivity and specificity with the area under the receiver operator curve being 0.99 for DRS- and 0.95 for FIM-based models using the top 20 discriminant peptides. Predictive ability for each model was assessed using robust leave-one-out cross-validation with Q2 statistics of 0.64 (P = .00012) and 0.62 (P = .011) for DRS- and FIM-based models, respectively, both with a high predictive accuracy of 0.875. Identified peptides that discriminated improved functional recovery reflected heightened neuroplasticity and synaptic refinement and diminished cell death and neuroinflammation, consistent with postacute TBI pathobiology. Conclusions Produced models of urine-based peptide measures reflective of ongoing recovery pathobiology can inform on rehabilitation progress after TBI, warranting further study to assess refined stratification across a larger population and efficacy in assessing therapeutic interventions.

Lurasidone in the Long-Term Treatment of Bipolar I Depression: A 28-week Open Label Extension Study

Lurasidone has demonstrated efficacy for short-term treatment of bipolar depression in a diverse ethnic population including Japanese. This study evaluated the long-term safety and effectiveness of open-label lurasidone treatment in these patients. Patients for this 28-week extension study were recruited from those who completed a 6-week double-blind study of lurasidone, 20-60 mg/day, lurasidone 80-120 mg/day, and placebo. In the extension study, lurasidone was flexibly dosed (20 to 120 mg/day). Safety was evaluated in terms of change from extension-phase baseline to endpoint including adverse events, vital signs, body weight, ECG, laboratory tests, and measures of suicidality and extrapyramidal symptoms. Effectiveness was determined by Montgomery Åsberg Depression Rating Scale (MADRS) and other measures. 303 of 413 (73.3%) subjects completed the extension study. Discontinuation due to a treatment-emergent adverse event occurred for 11.4% of those who received placebo, and 8.9% of those who received lurasidone, in the prior 6-week trial. The most common treatment-emergent adverse event was akathisia. Minimal changes were evident on body weight and metabolic parameters. Long-term treatment with lurasidone further reduced mean MADRS total scores from long-term baseline to week 28 (or endpoint) for both those who had received prior placebo (-11.3), and those who had receive prior lurasidone (-8.9), in the 6-week double-blind trial. There was no placebo control and treatment was not double-blind. Long-term treatment with lurasidone (20-120 mg/day) was well-tolerated with no new safety concerns and associated with continued improvement in depressive symptoms in this international sample of patients with bipolar depression. JapicCTI-132319, clinicaltrials.gov - NCT01986114.

Illuminating the complexities of conflict with evolution: validation of the scales of evolutionary conflict measure (SECM)

BackgroundAlthough personal, familial, and community conflict with evolution have been documented in the literature, these scales require conceptualization as a construct and operationalization as a measure. The Scales of Conflict with Evolution Measure (SECM) instrument was developed in response to these needs. Using a construct validity framework, the content, internal structure, convergent, and substantive validity of the SECM were evaluated using Rasch analysis, Structural Equation Modeling (SEM), and follow up questioning. The conceptual utility of the instrument was explored by examining whether it added explanatory insights into evolution acceptance above and beyond religiosity, evolution knowledge, and background variables.ResultsA literature review and expert consultation indicated that construct of evolutionary conflict perception should (i) encompass the hierarchical nature of human social structures (personal, family, community) and (ii) probe conflict as it relates to human values, cultures, and beliefs. A three-dimensional construct was operationalized as a nine-item rating scale measure. Using Rasch analyses of SECM responses from a diverse sample of > 1000 students studying evolution, the instrument met criteria of robust measurement, including: fit to model expectations; three-dimensional structure; high reliability; good rating scale function; measurement invariance with time; and convergence with a similar construct. SEM showed that: (i) family and community conflict had unique causal contributions to personal conflict, with family showing a stronger and modest impact, and (ii) personal conflict had a significant and modest causal impact on evolution acceptance above and beyond the contributions of religiosity, evolution knowledge, and background variables.ConclusionThe SECM is an easy-to-administer instrument to measure conflict with evolution and is supported by several forms of validity evidence. The SECM has potential for facilitating measurement of evolutionary conflict in educational settings, thereby raising instructor awareness of conflict levels in students, promoting rigorous evaluations of educational interventions designed to reduce conflict, and fostering conceptual advances in the field of evolution education. Future work is needed to gather additional forms of validity evidence and to test current validity claims in additional participant samples. SECM measures should also be incorporated into more complex SEM models that treat evolution knowledge and religiosity as part of the structural paths to evolution acceptance. Such models could provide insights into the most worthwhile targets for the development of educational interventions to mitigate conflict at multiple scales.

A Natural Language Processing Approach to Social License Management

Dealing with the social and political impacts of large complex projects requires monitoring and responding to concerns from an ever-evolving network of stakeholders. This paper describes the use of text analysis algorithms to identify stakeholders’ concerns across the project life cycle. The social license (SL) concept has been used to monitor the level of social acceptance of a project. That acceptance can be assessed from the texts produced by stakeholders on sources ranging from social media to personal interviews. The same texts also contain information on the substance of stakeholders’ concerns. Until recently, extracting that information necessitated manual coding by humans, which is a method that takes too long to be useful in time-sensitive projects. Using natural language processing algorithms, we designed a program that assesses the SL level and identifies stakeholders’ concerns in a few hours. To validate the program, we compared it to human coding of interview texts from a Bolivian mining project from 2009 to 2018. The program’s estimation of the annual average SL was significantly correlated with rating scale measures. The topics of concern identified by the program matched the most mentioned categories defined by human coders and identified the same temporal trends.

Preliminary Outcomes of an Older Peer and Clinician co-Facilitated Pain Rehabilitation Intervention among Adults Aged 50Years and Older with Comorbid Chronic Pain and Mental Health Conditions.

The present study aimed to examine the acceptability, feasibility, and preliminary effectiveness of an older peer and clinician co-facilitated Behavioral Activation for Pain Rehabilitation (BA-PR) intervention among adults aged 50years and older with comorbid chronic pain and mental health conditions. This was a mixed-methods research design with eight participants aged 55 to 62years old with mental health conditions including schizophrenia spectrum disorder, bipolar disorder, major depressive disorder, personality disorder, and adjustment disorder. The quantitative data were assessed from observational methods, a pain rating scale and related measures. We used semi-structured interviews for qualitative feedback on experiences with the BA-PR intervention after participation. Overall, the participants had positive experiences following receipt of the BA-PR intervention. The recruitment and adherence rates for participants were 72.7% and 100%, respectively. Approximately 75% of the participants remained enrolled in the study. Findings from a paired t-test showed the BA-PR intervention was linked to significantly reduced prescription opioid misuse risk, t (7) = 2.42, p < 0.05. There were also non-significant reductions in pain intensity and depression severity, in addition to improvements in active and passive pain coping strategies and behavioral activation.The BA-PR intervention is the first pain rehabilitation intervention specifically designed for middle-aged and older adults with comorbid chronic pain and mental health conditions. Our findings indicate promise for the BA-PR intervention to potentially reduce prescription opioid misuse risk, pain, and depressive symptoms. However, a quasi-experimental study is needed before rigorous effectiveness testing.

Global executive dysfunction, not core executive skills, mediate the relationship between adversity exposure and later health in undergraduate students

Executive function (EF) represents a set of higher-order cognitive skills that permit engagement in goal-oriented behavior. EF deficits are associated with wide-ranging negative health-related consequences, including psychopathology and engagement in risky health-related behaviors. Because neural substrates supporting EF develop over a protracted period of time, an extended window of vulnerability exists whereby environmental stressors can interrupt development, culminating in lifelong EF deficits. We capitalized on this understanding of the vulnerability of EF-relevant neural structures to elucidate the link between adverse childhood experiences (ACEs) and early mortality. ACEs are highly prevalent in the general population and exert negative downstream implications for many health-related behaviors, ultimately hastening mortality. However, underlying mechanisms linking ACEs with poor health remain less understood. To address this gap in the literature, we assessed ACE history and health factors, including psychopathology and risky alcohol use behaviors in undergraduates. We further assessed EF using performance-based and rating scale measures. Results revealed that some measures of EF mediated the relationship between ACEs and current mental health, but EF did not mediate the association between ACEs and engagement in risky health-related behaviors. These results partially support a neurodevelopmental model of ACE exposure vis-à-vis future health, focusing on the role of EF.

P.619 The Hamilton depression rating scale measures side effects and therefore underestimates the antidepressant effect of SSRIs and SNRIs

P.619 The Hamilton depression rating scale measures side effects and therefore underestimates the antidepressant effect of SSRIs and SNRIs

“Being Stuck between Two Worlds” – Identity Configurations of Occupational and Family Identities

ABSTRACTMost research on identity has focused on either identity processes or identity content, neglecting how individuals structure their identities. We investigated how individuals negotiated their sometimes conflicting multiple identifications of work and family into different types of workable identity configurations. We also examined differences across configurations in the gender distribution, degree of conflict, and life satisfaction. Through a mixed methods approach, a community sample of 124 young Swedish adults (50% women, Mage 33.29 years) were interviewed about work and family priorities and completed a rating scale measure of life satisfaction. The qualitative analyses showed six different types of identity configurations, the most common being Family first, followed by Everything is important, Struggling to prioritize, Now family comes first, Inability to prioritize, and Work first. The quantitative analyses showed few gender differences across configurations, but there were differences in conflict and life satisfaction between configurations. The findings from this study reflect the complex and dynamic ways identity is structured within a cultural context.

Associations among behavioral inhibition and owner-rated attention, hyperactivity/impulsivity, and personality in the domestic dog (Canis familiaris).

In humans, behavioral disinhibition is associated with attention-deficit/hyperactivity disorder (ADHD). Limitations to rodent models of ADHD-like behaviors/symptoms may be augmented by complementary ones, such as the domestic dog. We examined associations between family dogs' (N = 29; of 14 breeds and 12 mongrels) performance on a self-developed touchscreen behavioral Go/No-Go paradigm and their owner-rated inattention and hyperactivity/impulsivity, accounting for relevant covariates. A greater proportion of commission errors was associated with greater hyperactivity/impulsivity. Regardless of accuracy, relative to dogs with no previous training, those with basic training had shorter response latencies. Also, regardless of accuracy, greater confidence and extraversion were associated with shorter latencies, and greater openness was associated with longer latencies. Shorter latency to commission errors was associated with greater inattention. Findings support the dog as a model of the association between behavioral disinhibition and ADHD-like behaviors/symptoms and are early evidence of convergent validity between the behavioral paradigm and the rating scale measure in dogs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Altered large-scale functional brain networks in neurological Wilson's disease.

Wilson's disease patients with neurological symptoms have motor symptoms and cognitive deficits, including frontal executive, visuospatial processing, and memory impairments. Although the brain structural abnormalities associated with Wilson's disease have been documented, it remains largely unknown how Wilson's disease affects large-scale functional brain networks. In this study, we investigated functional brain networks in Wilson's disease. Particularly, we analyzed resting state functional magnetic resonance images of 30 Wilson's disease patients and 26 healthy controls. First, functional brain networks for each participant were extracted using an independent component analysis method. Then, a computationally efficient pattern classification method was developed to identify discriminative brain functional networks associated with Wilson's disease. Experimental results indicated that Wilson's disease patients, compared with healthy controls, had altered large-scale functional brain networks, including the dorsal anterior cingulate cortex and basal ganglia network, the middle frontal gyrus, the dorsal striatum, the inferior parietal lobule, the precuneus, the temporal pole, and the posterior lobe of cerebellum. Classification models built upon these networks distinguished between neurological WD patients and HCs with accuracy up to 86.9% (specificity: 86.7%, sensitivity: 89.7%). The classification scores were correlated with the United Wilson's Disease Rating Scale measures and durations of disease of the patients. These results suggest that Wilson's disease patients have multiple aberrant brain functional networks, and classification scores derived from these networks are associated with severity of clinical symptoms.