Self-report Measures Of Function Research Articles

Transdiagnostic and functional predictors of depression severity and trajectory in the Penn state psychiatry clinical assessment and rating evaluation system (PCARES) registry

BackgroundTimely, accurate diagnosis and subsequent identification of risk factors for depression that is difficult-to-treat can aid in decreasing the burden of depressive illness and reducing probability of future disability. We aimed to identify sociodemographic, clinical, and functional factors that predict depression severity over one year in a real-world, naturalistic, transdiagnostic clinical sample. A subset sample with moderate depression was examined to determine the magnitude of improvement. MethodsThe Penn State Psychiatry Clinical Assessment and Rating System (PCARES) Registry houses data from systematically-structured patient-reported outcomes and clinical data from an Electronic Medical Record (EMR) gathered during routine clinical care of patients seeking mental health care at a mid-Atlantic clinic. Self-report symptom and functional measures were obtained, and sociodemographic features and clinical diagnoses were extracted from the EMR from 1,766 patients between 2/6/2016 to 9/30/2019. The Patient Health Questionnaire 9 (PHQ-9) depression scale was obtained at each visit. Using a discrete mixture clustering model, the study population was divided into five longitudinal trajectory groups, termed depression severity groups, based on intra-individual PHQ-9 score trajectories over one year. Multinomial logistic regression models were estimated to evaluate associations between characteristics and the likelihood of depression severity group membership. To determine the magnitude of improvement, predictors of the slope of the PHQ-9 trajectory were examined for patients with moderate depression. ResultsThe strongest predictors of high depression severity over one year were poor functioning, high transdiagnostic DSM-5 Level 1 crosscutting symptom score, diagnosis of Post-Traumatic Stress Disorder (PTSD), public/self-pay insurance, female gender, and non-White race. Among the subset of patients with moderate depression, strong predictors of improvement were commercial insurance and exposure to trauma; the strongest predictors of worsening were high functional impairment, high transdiagnostic Level 1 symptom score, diagnosis of PTSD, diagnosis of bipolar disorder, and marital status of single or formerly married; depression-specific symptom measures were not predictive. LimitationsLimitations include inferring education and income status from zip code level-data, the non-random missingness of data, and the use of diagnoses collected from the electronic medical record. ConclusionFunctional impairment, transdiagnostic measures of symptom burden, and insurance status are strong predictors of depression severity and poor outcome.

Spinal Cord Injury–Functional Index/Capacity: Responsiveness to Change Over Time

ObjectiveTo establish responsiveness of 3 Spinal Cord Injury–Functional Index/Capacity (SCI-FI/C) item banks in the first year after spinal cord injury (SCI). DesignLongitudinal patient-reported outcomes assessment replicated through secondary analysis of an independent data set. SettingA total of 8 SCI Model Systems rehabilitation hospitals in the United States. ParticipantsStudy 1 participants included 184 adults with recent (≤4 months) traumatic SCI and 221 community-dwelling adults (>1 year post injury) (N=405). Study 2 participants were 418 individuals with recent SCI (≤4 months) (N=418). InterventionsIn study 1, SCI-FI/C computer adaptive tests were presented in a standardized interview format either in person or by phone call at baseline and 6-month follow-up. Responsiveness was examined by comparing 6-month changes in SCI-FI scores within and across samples (recently injured vs community-dwelling) because only the recent injury sample was expected to exhibit change over time. Effect sizes were also computed. In study 2, the study 1 results were cross-validated in a second sample with recent SCI 1 year after baseline measurement. Study 2 also compared the SCI-FI/C measures’ responsiveness to that of the Self-reported Functional Measure (SRFM) and stratified results by injury diagnosis and completeness. Main Outcome MeasuresThe SCI-FI Basic Mobility/C, Self-care/C and Fine Motor/C item banks (study 1 and study 2); Self-reported Functional Measure SRFM (study 2 only). ResultsIn study 1, changes in SCI-FI/C scores between baseline and 6-month follow-up were statistically significant (P<.01) for recently injured individuals. SCI-FI Basic Mobility/C, Self-care/C, and Fine Motor/C item banks demonstrated small to medium effect sizes in the recently injured sample. In the community-dwelling sample, all SCI-FI/C effects were negligible (ie, effect size<0.08). Study 2 results were similar to study 1. As expected, SCI-FI Basic Mobility/C and Self-care/C were responsive to change for all individuals in study 2, whereas the SCI-FI Fine Motor/C was responsive only for individuals with tetraplegia and incomplete paraplegia. The SRFM demonstrated a medium effect size for responsiveness (effect size=0.65). ConclusionsThe SCI-FI Basic Mobility/C and Self-care/C banks demonstrate adequate sensitivity to change at 6 months and 1 year for all individuals with SCI, while the SCI-FI/C Fine Motor item bank is sensitive to change in individuals with tetraplegia or incomplete paraplegia. All SCI-FI/C banks demonstrate stability in a sample not expected to change. Results provide support for the use of these measures for research or clinical use.

Relationships between social withdrawal and facial emotion recognition in neuropsychiatric disorders

BackgroundEmotion recognition constitutes a pivotal process of social cognition. It involves decoding social cues (e.g., facial expressions) to maximise social adjustment. Current theoretical models posit the relationship between social withdrawal factors (social disengagement, lack of social interactions and loneliness) and emotion decoding. ObjectiveTo investigate the role of social withdrawal in patients with schizophrenia (SZ) or probable Alzheimer's disease (AD), neuropsychiatric conditions associated with social dysfunction. MethodsA sample of 156 participants was recruited: schizophrenia patients (SZ; n = 53), Alzheimer's disease patients (AD; n = 46), and two age-matched control groups (SZc, n = 29; ADc, n = 28). All participants provided self-report measures of loneliness and social functioning, and completed a facial emotion detection task. ResultsNeuropsychiatric patients (both groups) showed poorer performance in detecting both positive and negative emotions compared with their healthy counterparts (p < .01). Social withdrawal was associated with higher accuracy in negative emotion detection, across all groups. Additionally, neuropsychiatric patients with higher social withdrawal showed lower positive emotion misclassification. ConclusionsOur findings help to detail the similarities and differences in social function and facial emotion recognition in two disorders rarely studied in parallel, AD and SZ. Transdiagnostic patterns in these results suggest that social withdrawal is associated with heightened sensitivity to negative emotion expressions, potentially reflecting hypervigilance to social threat. Across the neuropsychiatric groups specifically, this hypervigilance associated with social withdrawal extended to positive emotion expressions, an emotional-cognitive bias that may impact social functioning in people with severe mental illness.

Common and distinct characteristics associated with self-reported functional status in older patients with cancer receiving chemotherapy.

To evaluate for inter-individual differences in two subjective measures of functional status in older patients (n = 112), as well as to determine which demographic, clinical, and symptom characteristics, and levels of cognitive function, were associated with initial levels and with the trajectory of the two measures. Functional status was assessed using self-report measures of physical function (PF) and role function (RF) from the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess inter-individual differences in and characteristics associated with initial levels and changes in PF and RF. Characteristics associated with decreases in PF at the initiation of chemotherapy were higher numbers of comorbidities and higher depression, pain, and dyspnea scores. For initial levels of poorer RF, lower Karnofsky Performance Status scores and higher pain and fatigue scores were the associated characteristics. Characteristic associated with worse trajectories of PF was not having had surgery. For RF, worse trajectories were associated with lower cognitive function and higher RF at enrollment. Characteristic associated with both lower initial levels and improved trajectories of PF was having lower performance status at enrollment. Older patients undergoing chemotherapy experience reduced functional performance. Characteristics associated with decrements in PF and RF need to be assessed and interventions implemented to maintain and increase functional status in older oncology patients.

Impact of whey protein supplementation in a weight-loss intervention in rural dwelling adults: A feasibility study

Weight loss in older adults enhances physical function, but may lead to sarcopenia and osteoporosis. Whey protein is a low cost rich source of essential amino acids, may improve physical function. We evaluated the feasibility and acceptability of consuming whey protein in the context of a weight-loss intervention in older adults with obesity. A 12-week pilot feasibility, non-randomized weight loss study of 28 older adults was conducted, consisting of individualized, weekly dietitian visits with twice weekly physical therapist-led group strengthening classes. Half consumed whey protein, three times weekly, following exercise. Preliminary efficacy measures of body composition, sit-to-stand, 6-min walk and grip strength and subjective measures of self-reported health and function were also evaluated. Of the 37 enrolled, 28 completed the study (50% in the protein group). Attendance rates for protein vs. non-protein groups were 89.9±11.1% vs. 95.6±3.4% (p=0.08). Protein consumption was high in those attending classes (90.3%) as was compliance at home (82.6%). Whey was pleasant (67.3±22.1, range 30-100, above average), had little aftertaste, and was neither salty or sticky. All were compliant (0.64±0.84, range 0-5, low=higher compliance). Both groups lost significant weight (protein vs. no protein,-3.45±2.86 vs.-5.79±3.08, p=0.47); Sit-to-stand, 6-min walk, and gait speed were no different, grip strength was improved in the protein compared to the non-protein group (-2.63kg vs. 4.29kg; p<0.001). Our results suggest that whey protein is a low-cost and readily available nutritional supplement that can be integrated into a weight loss intervention.

48. A PHENOTYPIC SPECTRUM OF AUTISM IS ATTRIBUTABLE TO THE COMBINED EFFECTS OF RARE VARIANTS, POLYGENIC RISK AND SEX

Timely, accurate diagnosis and subsequent identification of risk factors for depression that is difficult-to-treat can aid in decreasing the burden of depressive illness and reducing probability of future disability. We aimed to identify sociodemographic, clinical, and functional factors that predict depression severity over one year in a real-world, naturalistic, transdiagnostic clinical sample. A subset sample with moderate depression was examined to determine the magnitude of improvement.The Penn State Psychiatry Clinical Assessment and Rating System (PCARES) Registry houses data from systematically-structured patient-reported outcomes and clinical data from an Electronic Medical Record (EMR) gathered during routine clinical care of patients seeking mental health care at a mid-Atlantic clinic. Self-report symptom and functional measures were obtained, and sociodemographic features and clinical diagnoses were extracted from the EMR from 1,766 patients between 2/6/2016 to 9/30/2019. The Patient Health Questionnaire 9 (PHQ-9) depression scale was obtained at each visit. Using a discrete mixture clustering model, the study population was divided into five longitudinal trajectory groups, termed depression severity groups, based on intra-individual PHQ-9 score trajectories over one year. Multinomial logistic regression models were estimated to evaluate associations between characteristics and the likelihood of depression severity group membership. To determine the magnitude of improvement, predictors of the slope of the PHQ-9 trajectory were examined for patients with moderate depression.The strongest predictors of high depression severity over one year were poor functioning, high transdiagnostic DSM-5 Level 1 crosscutting symptom score, diagnosis of Post-Traumatic Stress Disorder (PTSD), public/self-pay insurance, female gender, and non-White race. Among the subset of patients with moderate depression, strong predictors of improvement were commercial insurance and exposure to trauma; the strongest predictors of worsening were high functional impairment, high transdiagnostic Level 1 symptom score, diagnosis of PTSD, diagnosis of bipolar disorder, and marital status of single or formerly married; depression-specific symptom measures were not predictive.Limitations include inferring education and income status from zip code level-data, the non-random missingness of data, and the use of diagnoses collected from the electronic medical record.Functional impairment, transdiagnostic measures of symptom burden, and insurance status are strong predictors of depression severity and poor outcome.

The Association of Physical Function Measures With Frailty, Falls History, and Metabolic Syndrome in a Population With Complex Obesity.

Background: Frailty, falls and metabolic syndrome are known to be associated with poorer physical function. This study builds on available research by further investigating the relationship between physical function measures, including those comprising frailty, with metabolic syndrome (MetS) and falls, in the context of complex obesity.Methods: Participants were recruited from the national Level 3 weight management service in Ireland. A retrospective audit of data gathered at initial assessment was performed. Data included past medical history, blood tests, blood pressure measurement, anthropometrics, falls history, self-reported physical activity levels (PALs) and physical function measures, including hand grip strength (HGS), “timed up and go” (TUG), functional reach (FR), sit to stand (STS) and gait speed. A modified version of the Fried Frailty Index was employed.Results: Of the 713 participants, 65.1% (n = 464) were female and 34.9% (n = 249) were male with a mean age of 44.2 (±11.7) years and body mass index (BMI) of 50.6 kg/m2 (±8.2). Frailty was identified in 3.4% (n = 24), falls in 28.8% (n = 205) and MetS in 55.1% (n = 393). Frailty was associated with older age (53.8 ± 14.3 vs. 43.9 ± 11.5 years), poorer PALs (27.29 ± 46.3 vs. 101.1 ± 147.4 min/wk), reduced grip strength (17.7 ± 4.6 vs. 34.2 ± 11.0 Kg) longer STS (21.7 ± 6.6 vs. 13.7 ± 5.7 s), shorter functional reach (29.7 ± 7.9 vs. 37.9 ± 8.2 cm) and slower gait speed (0.6 ± 0.2 vs. 1.1 ± 0.5 m/s). Those reporting a falls history had a reduced FR (35.8 ± 8.9 vs. 38.3 ± 7.8 cm) and slower STS (15.4 ± 8.0 vs. 13.3 ± 4.7 s). Participants with MetS had lower PALs (83.2 ± 128.2 vs. 119.2 ± 157.6) and gait speed (1.1 ± 0.3 vs. 1.2 ± 0.7 m/s). There was no difference in BMI between fallers and non-fallers (51.34 ± 8.44 vs. 50.33 ± 8.13 Kg/m2, p = 0.138), nor between those with or without MetS. Significant associations were found between BMI and all physical function measures except the TUAG.Conclusion: The associations between frailty, falls and MetS and their combined impact on physical function in people living with obesity demonstrates the need for appropriate screening. Utilising grip strength and gait speed to identify frailty in those with obesity and metabolic syndrome could help target therapies aimed at improving strength, physical function and ultimately quality of life.

Prenatal mother-father cortisol linkage predicts infant executive functions at 24 months.

The present study investigated associations between prenatal mother-father cortisol linkage and infant executive functions. Data come from an international sample (N = 358) of predominantly white and middle- to upper-class first-time parents. During late pregnancy, parents collected diurnal salivary cortisol samples and reported on levels of psychological stress. At 24 months, children completed a battery of executive function tasks. Parent cortisol linkage was operationalized as the time-dependent, within-dyad association between maternal and paternal diurnal cortisol. Results indicated that prenatal linkage was positively related to infant executive functions, suggesting that stronger mother-father cortisol linkage was associated with higher executive function scores. Additionally, this relation was moderated by paternal average cortisol levels such that executive function scores were lower when fathers had higher average cortisol levels and linkage was weak. This association suggests that elevated paternal cortisol amplifies the negative relation between lower cortisol linkage and lower infant executive function scores. Importantly, these findings were observed while controlling for observational measures of caregiving and self-report measures of psychosocial functioning and infant social-emotional behavior. These results suggest that prenatal linkage of mother's and father's stress physiology plays a potentially important part in programming and regulating infant neurocognitive development.

A pilot study of a brief inpatient social-skills training for young adults with psychosis.

Objective: Psychotic disorders are serious illnesses that are most amenable to early intervention. Though inpatient units are typically the first care setting for young people with psychosis, almost all early intervention work has been limited to outpatient settings. Social difficulties are a core feature of psychotic illnesses, and despite need for empirically supported social-skills treatments there are few interventions intended specifically for the developmental phase during which psychosis manifests (i.e., late teenage to early adult years). Method: Our group implemented an adapted social-skills training intervention (SST) designed for young adults on a psychiatric inpatient unit. Nineteen young adult inpatients (aged 18-35) with psychosis participated. Psychiatric symptoms and aspects of social functioning, including reported social self-efficacy and performance on social skills role-plays, were assessed before and after SST participation. Results: Preliminary data demonstrate improvements in both self-report and performance-based measures of social functioning after SST participation. Conclusions and Implications for Practice: These findings, though preliminary, support additional, larger-scale investigations of this SST among young adults with psychosis. Further, multidisciplinary collaborations are valuable in providing specialized care for young adults with psychosis who are receiving inpatient psychiatric care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Understanding Patients’ Perceived Health After Critical Illness: Analysis of Two Prospective, Longitudinal Studies of ARDS Survivors

Perceived health is one of the strongest determinants of subjective well-being, but it has received little attention among survivors of ARDS. How well do self-reported measures of physical, emotional, and social functioning predict perceived overall health (measured using the EQ-5D visual analog scale [EQ-5D-VAS]) among adult survivors of ARDS? Are demographic features, comorbidity, or severity of illness correlated with perceived health after controlling for self-reported functioning? We analyzed the ARDSNet Long Term Outcomes Study (ALTOS) and Improving Care of Acute Lung Injury Patients (ICAP) Study, two longitudinal cohorts with a total of 823 survivors from 44 US hospitals, which prospectively assessed survivors at 6 and 12months after ARDS. Perceived health, evaluated using the EQ-5D-VAS, was predicted using ridge regression and self-reported measures of physical, emotional, and social functioning. The difference between observed and predicted perceived health was termed perspective deviation (PD). Correlations between PD and demographics, comorbidities, and severity of illness were explored. The correlation between observed and predicted EQ-5D-VAS scores ranged from 0.68 to 0.73 across the two cohorts and time points. PD ranged from -80 to+34 and was more than the minimum clinically important difference for 52%to 55%of survivors. Neither demographic features, comorbidity, nor severity of illness were correlated strongly with PD, with |r|< 0.25 for all continuous variables in both cohorts and time points. The correlation between PD at 6- and 12-month assessments was weak (ALTOS: r= 0.22, P< .001; ICAP: r= 0.20, P= .02). About half of survivors of ARDS showed clinically important differences in actual perceived health vspredicted perceived health based on self-reported measures of functioning. Survivors of ARDS demographic features, comorbidities, and severity of illness were correlated only weakly with perceived health after controlling for measures of perceived functioning, highlighting the challenge of predicting how individual patients will respond psychologically to new impairments after critical illness.

95. Effect of spinal cord stimulation on balance and gait in failed back surgery syndrome patients

<h3>BACKGROUND CONTEXT</h3> While spine surgery can produce good outcomes in many patients, there are patients who do not benefit from the intervention and have conditions not thought not to be addressable by surgical intervention. These failed back surgery syndrome (FBSS) patients may be candidates for spinal cord stimulation (SCS) for pain management. While multiple studies have reported benefits of SCS related to pain reduction, improved quality of life, and reduced pain medication intake, there has been little investigation into measurable physical functional improvement in this population. <h3>PURPOSE</h3> The purpose of this study was to evaluate the effect of SCS on traditional self-reported pain and functional measures, the psychological parameter of kinesiphobia, as well as functional measures of balance and gait, in FBSS patients. <h3>STUDY DESIGN/SETTING</h3> Prospective repeated-measures design. <h3>PATIENT SAMPLE</h3> A total of 15 symptomatic FBSS patients eligible for SCS. <h3>OUTCOME MEASURES</h3> Outcome assessment was based on visual analog scales (VAS) for back and leg pain, Oswestry Disability index (ODI), Tampa Scale for Kinesiophobia (TSK) and functional testing components including balance, sway and gait. <h3>METHODS</h3> Patients completed patients reported outcomes and functional evaluations prior to the SCS trial procedure (Pre) and at 6 (Post6) and 12 (Post12) weeks after SCS implantation. Gait and balance were evaluated using 3D human motion capture and dynamic surface EMG. Balance effort and Cone of Economy (CoE) dimensions were as measured by total sway and range of sway (RoS), respectively. Repeated measurements and one-way analysis of variance (ANOVA) were used to analyze data. <h3>RESULTS</h3> SCS implant significantly improved gait and balance in FBSS patients. The following gait parameters showerd significant improvement: Walking speed (Pre: 0.75, Post6: 0.86, Post12: 0.92 m/s, p<0.011), cadence (Pre: 85.42, Post6: 94.1, Post12: 95.94 steps/m, p<0.032), stride length (Pre: 0.98, Post6: 1.05, Post12: 1.07 m, p<0.049), and gait deviation index (GDI; Pre: 74.0, Post6: 83.2, Post12: 90.8, p<0.012). Additionally, significant improvements were seen in balance effort (head sway, Pre: 80.2, Post6: 52.2, Post12: 50.0 cm, p<0.049) sway dimensions as seen by reduced sagittal (p<0.047) and coronal (p<0.042) sway. For patient-reported outcomes, significant improvements were noted for VAS low back (Pre: 6.5, Post6: 3.6, Post12: 3.9, p<0.036), ODI (Pre: 57.6, Post6: 39.7, Post12: 38.3, p<0.006). Scores on the and TSK also improved significantly (p<0.044). <h3>CONCLUSIONS</h3> The results of this study support prior literature reporting significant improvement in pain and self-reported function reflected in VAS and ODI scores. Additionally, significant improvements were found post-SCS in gait and balance. The results suggest that SCS is associated not only with significant improvement in patient self-reported outcome measures, but also with physical functional testing. The patients included in this study showed more efficient gait patterns and improves balanced. This may be reflective of an overall improvement in activities of daily living following SCS implantation. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Motivationally-relevant domains of positive affectivity are differentially related to social anxiety symptoms

This study investigated the extent to which specific facets of positive affectivity (PA) demonstrate differential relationships with social anxiety symptomatology as well as social functioning. Following the conceptual framework of the Broaden and Build theory, as well as prior work demonstrating reward-based linkages to specific PA subdomains, we hypothesized that motivationally-valenced PA facets would show distinct associations with social anxiety and social functioning measures. Two samples (N = 446 and N = 375) completed self-report measures of PA, social anxiety, internalizing symptoms, and social functioning. Correlational, multiple and logistic regression, and contrast analyses of correlated correlation coefficients were used to identify the presence and magnitude of relationships between PA facets and symptom measures. Relationships between social anxiety and specific subdomains of PA appeared to depend on the motivational relevance of each facet. Specifically, self-assurance was associated with social anxiety symptoms above and beyond other PA facets and negative affect. Additionally, contrast analyses indicated that motivationally-valenced (versus non-motivationally-valenced) PA facets were stronger negative predictors of social anxiety symptoms. These results demonstrate a statistically significant divergence between motivationally-valenced subdomains of PA and non-motivationally-valenced subdomains of PA, as they relate to social anxiety symptom severity.

Terminal decline in objective and self-reported measures of motor function before death: 10 year follow-up of Whitehall II cohort study

ObjectivesTo examine multiple objective and self-reported measures of motor function for their associations with mortality.DesignProspective cohort study.SettingUK based Whitehall II cohort study, which recruited participants aged 35-55 years in 1985-88;...

Development and Validation of a Measure to Assess Early Adolescents’ Perceptions of Caring Student-Teacher Relationships

There is accruing evidence documenting the importance of caring student-teacher relationships in fostering students’ social and emotional competence (SEC), well-being, and school success, particularly during early adolescence. However, few studies have investigated dimensions of caring student-teacher relationships from the perspective of early adolescents. This study describes the development and validation of the Caring Student-Teacher Relationship (CSTR) scale. Participants included 222 sixth and seventh grade middle school students who completed the CSTR and self-report measures of classroom supportiveness, prosociality, well-being, and school functioning. Students also assessed their teachers’ SEC. Classroom teachers (n = 14) completed self-report measures of mindfulness in teaching and burnout, reported on closeness and conflict in their relationships with students, and rated students’ SECs and academic success. Results from an Exploratory Factory Analysis (EFA) indicated high internal consistency of the CSTR and a two-factor solution: Teacher Support and Attunement and Caring Teacher Qualities. Further analyses revealed that the two factors of the CSTR were related in expected directions to measures of teacher support (e.g., academic and personal) and SEC, and to students’ reports of classroom supportiveness, prosociality, well-being, and school functioning. Positive associations of the two CSTR factors to teacher reports of students’ SEC and academic success were also found. The two factors of the CSTR were positively associated with teachers’ reports of mindfulness in teaching and negatively associated with teachers’ burnout. These findings have implications for understanding the role that students’ perceptions of student-teacher relationships may play in promoting their positive adaptation and success in school.

Advancing the Measurement of Executive Functioning in Pediatric Chronic Pain.

Youth with chronic pain often report executive functioning difficulties, many of which have been linked to poor treatment adherence and health-related quality of life in adults with chronic pain, as well as in other pediatric chronic health populations. Despite the extensive implications for functional impairment, executive functioning remains understudied in pediatric chronic pain. Measurement approaches have lacked clear theoretical guidance, resulting in only some domains of executive functioning being investigated. To date, the methods used to measure executive functioning have been inconsistent, ranging from self-report measures of everyday executive functioning in home and school contexts to standardized neuropsychological tests. We argue for enhanced measure validation efforts and increased clarity in the approaches chosen to measure executive functioning in pediatric chronic pain to better guide research efforts in this area, thus yielding clearer clinical implications.

Impairments in grip and pinch force accuracy and steadiness in people with osteoarthritis of the hand: A case-control comparison

BackgroundSymptomatic hand osteoarthritis (OA) is severely disabling condition. Limited evidence has focused on force control measures in this population. ObjectivesIt was the aim of the present study to determine whether force matching accuracy and steadiness are impaired in people with hand OA. In addition, the relationship between force control measures (accuracy and steadiness) and measures of hand function and pain in people with symptomatic hand OA was explored. DesignCase-control study. MethodSixty-two participants with symptomatic hand OA and 26 healthy pain-free controls undertook an isometric grip and pinch force matching task at 50 % of their maximum voluntary contraction. Average pain hand pain was recorded. In addition, the Disability of the Arm Shoulder and Hand Questionnaire (DASH), and the Functional Index of Hand Osteoarthritis were collected. ResultsGrip force-matching accuracy and steadiness were significantly impaired in the hand OA group compared to controls (P < 0.05). Pinch force-matching error was greater in people with hand OA (P < 0.05), however, pinch force steadiness was not different between groups. There was a learning effect in people with hand OA, with resolution of force matching impairments with task repetition. A small positive correlation was identified between grip force control and the DASH. No association was found between other measures of force control and self-reported measures of function or pain. ConclusionsPeople with hand OA presented with greater impairments in measures of submaximal force control. These were correlated with self-reported hand function but not pain. Future studies may wish to examine whether objective measures of functional performance are related to force-matching error and steadiness.

A Greek Validation Study of the Multiple Sclerosis Work Difficulties Questionnaire-23.

The Multiple Sclerosis Work Difficulties Questionnaire-23 (MSWDQ-23) is a self-report instrument developed to assess barriers faced by People with Multiple Sclerosis (PwMS) in the workplace. The aim of this study was to explore the psychometric properties of the Greek version of the MSWDQ-23. The study sample consisted of 196 PwMS, all currently working in part- or full-time jobs. Participants underwent clinical examination and cognitive screening with the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and completed self-report measures of fatigue, psychological functioning, and quality of life, along with the MSWDQ-23 questionnaire. Confirmatory Factor Analysis (CFA) was performed, and goodness-of-fit measures were used to evaluate construct validity. Convergent validity was checked by correlating MSWDQ-23 scores with study measures. Cronbach’s alpha value was produced to assess internal consistency. CFA yielded a model with a fair fit confirming the three-factor structure of the instrument. Higher work difficulties were associated with higher Expanded Disability Status Scale (EDSS) scores, poorer cognitive function, more fatigue, stress, anxiety, and depression, and poorer health status, supporting the convergent validity of MSWDQ-23. Internal consistency (Cronbach’s alpha = 0.94) and test–retest reliability (ICC = 0.996, 95%, CI = 0.990–0.998) were excellent. The Greek MSWDQ-23 can be considered a valid patient-reported outcome measure and can be used in interventions aiming to improve the vocational status of PwMS.

Similar Benefits Seen After Radial Extracorporeal Shockwave Therapy or Autologous Blood Injection in Patients With Chronic Plantar Fasciitis-A Retrospective Cohort Study.

To compare the outcomes for patients with chronic plantar fasciitis after extracorporeal shockwave therapy (ESWT) or autologous blood injection (ABI). Cohort study-retrospective analysis of prospectively collected data. Hospital-based Sports Medicine Outpatient Clinic. One hundred two consecutive patients with chronic plantar fasciitis, treated with either radial-ESWT (rESWT) (n = 54) or ABI (n = 48), with minimum 3-month follow-up and 96% (98/102) having 6-month follow-up. Mean age 49.5 years and mean duration of symptoms 37.5 months before treatment. Patients received either 3 sessions of radial ESWT (one session per week for 3 weeks), or a single ultrasound-guided dry needling and ABI (3 mL whole autologous blood). All patients received standardized after-care, including progressive structured home exercise program of flexibility, strengthening, and proprioception exercises. 0 to 10 numerical rating scale (NRS) for self-reported "average pain" and "average stiffness" values. Secondary outcome measures included assessments of local foot function [including Manchester-Oxford Foot Questionnaire (MOXFQ), revised-Foot Function Index] as well as markers of mental health functioning (HAD), global health (EQ-5D-5L), and physical activity (International Physical Activity Questionnaire). This study demonstrated statistically significant improvements in self-reported measures of pain and local foot function after either procedure at 6 weeks, 3 months, and 6 months, but no statistically significant differences were seen between groups at any time-period studied. At 6 months, the average pain using a 0 to 10 NRS was improved from 6.8 ± 1.8 to 4.0 ± 2.7 (P < 0.001) after ESWT and from 7.1 ± 1.6 to 3.8 ± 2.7 (P < 0.001) after ABI. At 6 months, significant improvements were seen following either group using a number of different validated patient-rated outcome measures assessing local foot pain and function, eg, the total score for MOXFQ improved from 56.1 ± 12.8 to 42.5 ± 16.6 (P < 0.001) after ESWT and from 58.8 ± 13.2 to 44.2 ± 19.2 (P < 0.001) after ABI. However, measures of physical activity or wider aspects of patient functioning did not consistently improve from baseline values to follow-up periods. Patients with chronic plantar fasciitis improved to statistically significant extent after either rESWT or ABI procedures, with no significant differences seen between groups. The lack of randomization in this pragmatic study is noted, which may have influenced the outcome seen. Potentially larger and more robust studies are required to investigate this treatment comparison further.

Adolescent Emotionality and Emotion Regulation in the Context of Parent Emotion Socialization Among Adolescents with Neurodevelopmental Disorders: A Call to Action with Pilot Data.

To date, only three studies have examined the role of emotion socialization in the emotional functioning of youth with neurodevelopmental disorders. As such, this review article with pilot data sought to provide a call to action and first step in addressing this limited research body. Pilot data was collected with 18 adolescents (Mage = 13.5, SD = 1.6; 70% male) with a neurodevelopmental disorder and their primary caregiver. All adolescents were diagnosed with attention-deficit/hyperactivity disorder and displayed a range of comorbid disorders: autism spectrum disorder (27.8%), anxiety (66.7%), depression (44.4%), and disruptive behavior disorders (50%). Adolescents and caregivers completed a conflict discussion task while physiological, observational, and self-report measures of emotion socialization and emotional functioning were measured. Observed supportive parent emotion socialization behaviors were significantly associated with more observed adaptive emotion regulation strategies, and decreased observed and adolescent-reported negative affect, whereas non-supportive emotion socialization behaviors were associated with more observed negative affect and less observed adaptive emotion regulation strategies. Our pilot findings support growing research suggesting that adaptive parent emotion socialization practices can help foster less negative emotionality and better emotion regulation in youth with neurodevelopment disorders. We make a call to action for more emotion socialization research focused on youth with neurodevelopmental disorders, and propose four important directions for future research: 1) Research examining emotion socialization behaviors during daily life, 2) Understanding the nuanced role of emotion socialization practices, 3) Considering diversity in emotion socialization practices with clinical populations, and 4) Longitudinal and intervention research studies.

Autism spectrum disorder: An examination of sex differences in neuropsychological and self-report measures of executive and non-executive cognitive function.

Research comparing females and males with a diagnosis of autism suggests that there are sex differences in some characteristics such as behaviour regulation. One area not studied in detail is whether females and males with autism perform differently in tests of cognitive ability. The results of previous research are quite mixed. One explanation may be that some research comparing females and males with autism did not include a neurotypical control group for comparison. As a result, it is not clear whether the sex differences in cognitive ability observed in people with autism are similar to differences between neurotypical males and females. To better understand whether there are unique differences between males and females with autism, it is important to also compare them with neurotypical males and females. In our research, we included a neurotypical group and compared males and females with and without a diagnosis of autism. We found that the sex differences in autism are similar to what we observe in males and females without autism. Our study showed that compared with males, females (with and without autism) do better in assessments of processing speed, cognitive flexibility, verbal learning and memory and semantic fluency. Our results suggest that although females show different cognitive performance to males, these sex differences were not specific to the group with a diagnosis of autism.