Subjective Confidence Ratings Research Articles

Confidence in Moral Decision-Making

Moral decision-making typically involves trade-offs between moral values and self-interest. While previous research on the psychological mechanisms underlying moral decision-making has primarily focused on what people choose, less is known about how an individual consciously evaluates the choices they make. This sense of having made the right decision is known as subjective confidence. We investigated how subjective confidence is constructed across two moral contexts. In Study 1 (240 U.S. participants from Amazon Mechanical Turk, 81 female), participants made hypothetical decisions between choices with monetary profits for themselves and physical harm for either themselves or another person. In Study 2 (369 U.S. participants from Prolific, 176 female), participants made incentive-compatible decisions between choices with monetary profits for themselves and monetary harm for either themselves or another person. In both studies, each choice was followed by a subjective confidence rating. We used a computational model to obtain a trial-by-trial measure of participant-specific subjective value in decision-making and related this to subjective confidence ratings. Across all types of decisions, confidence was positively associated with the absolute difference in subjective value between the two options. Specific to the moral decision-making context, choices that are typically seen as more blameworthy – i.e., causing more harm to an innocent person to benefit oneself – suppressed the effects of increasing profit on confidence, while amplifying the dampening effect of harm on confidence. These results illustrate some potential cognitive mechanisms underlying subjective confidence in moral decision-making and highlighted both shared and distinct cognitive features relative to non-moral value-based decision-making.

Beauty is in the nose of the beholder: Fragrance modulates attractiveness, confidence and femininity ratings and neural responses to faces of self and others

Previous research investigated cross-modal influence of olfactory stimuli on perception and evaluation of faces. However, little is known about the neural dynamics underpinning this multisensory perception, and no research examined perception for images of oneself, and others, in presence of fragrances. This study investigated the neural mechanisms of olfactory-visual processing using electroencephalography (EEG) and subjective evaluations of self- and other-images.22 female participants evaluated images of female actors and themselves while being exposed to the fragrance of a commercially available body wash or clean air delivered via olfactometer. Participants rated faces for attractiveness, femininity, confidence and glamorousness on visual analogue scales. EEG data was recorded and event-related potentials (ERPs) associated with onset of face stimuli were analysed to consider effects of fragrance presence on face processing, and interactions between fragrance and self-other image-type.Subjective ratings of confidence, attractiveness and femininity were increased for both image-types in pleasant fragrance relative to clean air condition. ERP components covering early-to-late stages of face processing were modulated by the presence of fragrance. Findings also revealed a cross-modal fragrance-face interaction, with pleasant fragrance particularly affecting ERPs to self-images in mid-latency ERP components.Results showed that the pleasant fragrance of the commercially available body wash impacted how participants perceived faces of self and others. Self- and other-image faces were subjectively rated as more attractive, confident and feminine in the presence of the pleasant fragrance compared to an un-fragranced control. The pleasant fragrance also modulated underlying electrophysiological activity. For the first time, an effect of pleasant fragrance on face perception was observed in the N1 component, suggesting impact within 100 ms. Pleasant fragrance also demonstrated greater impact on subsequent neural processing for self, relative to other-faces. The findings have implications for understanding multisensory integration during evaluations of oneself and others.

The misjudgment of interoceptive awareness: Systematic overrating of interoceptive awareness among individuals with lower interoceptive metacognitive skills

Knowing when perceiving inner bodily signals better and when perceiving them worse is a health relevant but understudied dimension of interoception. Therefore, the present study assessed interoceptive metacognition (IMC) as the skill to adequately monitor interoceptive accuracy in the cardiac domain. We used the Graz Ambulatory Interoception task (GRAIT), which applied two intervals of the heartbeat tracking task 12 times a day for 3 days in total to n = 66 participants. We assessed IMC as the relative correspondence between interoceptive accuracy and the subjective confidence ratings. We found that 6 % of the total IMC variance was due to person, which was assessed reliable (RKRn=0.81). Furthermore, the between-person variation of IMC was negatively associated with the MAIA (especially attention regulation and self-regulation). People who believe that they are aware of their interoceptive experiences (MAIA) showed lower IMC. This study advocates the assessment of interoception in everyday life.

Excessive Checking in Obsessive-Compulsive Disorder: Neurochemical Correlates Revealed by 7T Magnetic Resonance Spectroscopy

BackgroundCompulsive checking, a common symptom of obsessive-compulsive disorder (OCD), has been difficult to capture experimentally. Therefore, determination of its neural basis remains challenging despite some evidence suggesting that it is linked to dysfunction of cingulostriatal systems. This study introduces a novel experimental paradigm to measure excessive checking and its neurochemical correlates. MethodsThirty-one patients with OCD and 29 healthy volunteers performed a decision-making task requiring them to decide whether 2 perceptually similar visual representations were the same or different under a high-uncertainty condition without feedback. Both groups underwent 7T magnetic resonance spectroscopy scans on the same day. Correlations between out-of-scanner experimental measures of checking and the glutamate/GABA (gamma-aminobutyric acid) ratio in the anterior cingulate cortex, supplementary motor area, and occipital cortex were assessed. Their relationship with subjective ratings of doubt, anxiety, and confidence was also investigated. ResultsPatients with OCD exhibited excessive and dysfunctional checking, which was significantly correlated with changes in the glutamate/GABA ratio within the anterior cingulate cortex. No behavioral/neurochemical relationships were evident for either the supplementary motor area or occipital cortex. The excessive checking observed in patients was negatively correlated with their confidence levels and positively related to doubt, anxiety, and compulsivity traits. ConclusionsWe conclude that experimental measures of excessive and dysfunctional checking in OCD, which have been linked to increased doubt, anxiety, and lack of confidence, are related to an imbalance between excitatory and inhibitory neural activity within the anterior cingulate cortex. This study adds to our understanding of the role of this region in OCD by providing a laboratory model of the possible development of compulsive checking.

Increasing access to psychologically-informed care: A Cognitive Behavioural Therapy informed programme for multidisciplinary staff working in older peoples’ community mental health teams

BackgroundIncreasing psychological skills and therapies in the wider workforce is essential for psychologists working with finite resources and a growing older adult population. While much of the focus within older peoples’ multidisciplinary teams (MDT) and training initiatives in Scotland are on memory and dementia, there is a need to consider the changing demand which may come from older people who are increasingly socialised to seeking support with mood difficulties.AimsA Cognitive Behaviour Therapy (CBT) informed programme was co-developed with multidisciplinary colleagues with the aim of developing a sustainable and ongoing infrastructure that would increase the competence and confidence of attendees in delivering psychologically informed care for older people experiencing common mood difficulties (anxiety and depression).MethodA one-day teaching session with six-weekly coaching groups was delivered. Outcome measures related to engagement and ‘benefit’; measured via a vignette assessing competence in CBT-based knowledge and skills and via subjective confidence ratings on CBT-based competencies. Acceptability and feasibility was tested via a pilot in 2018; and has subsequently ran in its present form since 2019.ResultsFrom 2019 to 2022, programme attendees have almost doubled and average coaching group attendance has increased from 30 per cent to 58 per cent. Competence and confidence scores have similarly increased. Qualitative feedback reflects patient-centred benefits including an increase in goal-focused interventions, collaborative working and formulation-based (rather than diagnosis-led) discussions during MDT meetings.Conclusions & ReflectionsThe programme outcomes indicate MDT acceptability and effectiveness. A model of teaching and follow-up coaching allows for ongoing knowledge and skill development and is believed to be an effective model for facilitating application of knowledge and skills to practice. Within the local health board, the programme has contributed to an infrastructure for psychologically informed care, increased knowledge of therapies for older people and provided a governance framework which is workable for an older adult psychology service to sustain. A key reflection has been the importance of modelling the CBT approach throughout the programme.

Alpha oscillations and stimulus-evoked activity dissociate metacognitive reports of attention, visibility, and confidence in a rapid visual detection task.

Variability in the detection and discrimination of weak visual stimuli has been linked to oscillatory neural activity. In particular, the amplitude of activity in the alpha-band (8–12 Hz) has been shown to impact the objective likelihood of stimulus detection, as well as measures of subjective visibility, attention, and decision confidence. Here we investigate how preparatory alpha in a cued pretarget interval influences performance and phenomenology, by recording simultaneous subjective measures of attention and confidence (experiment 1) or attention and visibility (experiment 2) on a trial-by-trial basis in a visual detection task. Across both experiments, alpha amplitude was negatively and linearly correlated with the intensity of subjective attention. In contrast with this linear relationship, we observed a quadratic relationship between the strength of alpha oscillations and subjective ratings of confidence and visibility. We find that this same quadratic relationship links alpha amplitude with the strength of stimulus-evoked responses. Visibility and confidence judgments also corresponded with the strength of evoked responses, but confidence, uniquely, incorporated information about attentional state. As such, our findings reveal distinct psychological and neural correlates of metacognitive judgments of attentional state, stimulus visibility, and decision confidence when these judgments are preceded by a cued target interval.

Levels of specificity in episodic memory: Insights from response accuracy and subjective confidence ratings in older adults and in younger adults under full or divided attention.

We propose that the specificity with which associations in episodic memory can be remembered varies on a continuum. Older adults have been shown to forget highly specific information (Greene & Naveh-Benjamin, 2020b), and in Experiment 1, we provide further evidence that older adults' deficits in associative memory scale with the amount of specificity that needs to be retrieved. In Experiment 2, we address whether depleted attentional resources, simulated in young adults under divided attention at encoding, could account for older adults' associative memory specificity deficits. Participants studied face-scene pairs and later completed an associative recognition test, with test pairs that were old, highly similar or less similar to old pairs, or completely dissimilar. Participants rated their confidence in their decisions. False positive recognition responses increased with the amount of specificity needed to be retrieved. Whereas older adults' associative memory deficits scaled with how much specific information needed to be remembered, younger adults under divided attention had a more general deficit in associative memory. Confidence-accuracy analysis showed that participants were best able to calibrate their confidence when less specific information was needed to perform well. While divided attention young adults were generally prone to high-confidence errors, older adults' high-confidence errors were most apparent when highly specific information needed to be remembered. These results provide further evidence for levels of specificity in episodic memory. Access to the most specific levels is most vulnerable to forgetting, in line with a specificity principle of memory (Surprenant & Neath, 2009). Further, depleted attentional resources at encoding cannot entirely explain older adults' associative memory specificity deficits. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Supplemental Material for Levels of Specificity in Episodic Memory: Insights From Response Accuracy and Subjective Confidence Ratings in Older Adults and in Younger Adults Under Full or Divided Attention

Supplemental Material for Levels of Specificity in Episodic Memory: Insights From Response Accuracy and Subjective Confidence Ratings in Older Adults and in Younger Adults Under Full or Divided Attention

Metacognitive monitoring and metacognitive strategies of gifted and average children on dealing with deductive reasoning task.

In this paper, we inquire into possible differences between children with exceptionally high intellectual abilities and their average peers as regards metacognitive monitoring and related metacognitive strategies. The question whether gifted children surpass their typically developing peers not only in the intellectual abilities, but also in their level of metacognitive skills, has not been convincingly answered so far. We sought to examine the indicators of metacognitive behavior by means of eye-tracking technology and to compare these findings with the participants’ subjective confidence ratings. Eye-movement data of gifted and average students attending final grades of primary school (4th and 5th grades) were recorded while they dealt with a deductive reasoning task, and four metrics supposed to bear on metacognitive skills, namely the overall trial duration, mean fixation duration, number of regressions and normalized gaze transition entropy, were analyzed. No significant differences between gifted and average children were found in the normalized gaze transition entropy, in mean fixation duration, nor - after controlling for the trial duration – in number of regressions. Both groups of children differed in the time devoted to solving the task. Both groups significantly differed in the association between time devoted to the task and the participants’ subjective confidence rating, where only the gifted children tended to devote more time when they felt less confident. Several implications of these findings are discussed.

Communicating During COVID-19: The Effect of Transparent Masks for Speech Recognition in Noise.

The purpose of this study was to assess the speech recognition in noise when using a transparent mask that allows greater visibility of the talker's face compared to an opaque mask in persons with normal and impaired hearing via an online format. A repeated-measures design was used to evaluate the auditory-visual recognition of sentences recorded in background noise with transparent and opaque face masks, and without a mask (N = 154). In a smaller follow-up study (N = 29), the same files were presented via auditory-only presentation to determine if differences observed in the transparent and opaque mask conditions were attributable to additional visual cues or to acoustic differences between the recordings of the two mask types. Listeners completed the 40-minute online session on a computer, laptop, or tablet in a quiet room via their personal listening devices (earbuds or hearing assistive device). The adult volunteers who used English as their first language were recruited through social media links and email and categorized into three groups: normal hearing and confirmed or suspected hearing loss either with or without the use of assistive listening devices. Auditory-visual recognition of sentences recorded with the transparent mask was significantly better (M = 68.9%) than for sentences recorded with the opaque mask (M = 58.9%) for all participants. There was a trend for those who used hearing assistive technology to score lower than the other two groups who had similar performance across all conditions regardless of the mask type. Subjective ratings of confidence and concentration followed the expected pattern based on objective scores. Results of the auditory-only presentation of the sentences to listeners with normal hearing suggested that the transparent mask benefits were not attributable to an acoustic advantage but rather to the addition of the visual cues of the talker's face available through the transparent mask. In fact, performance in the auditory-only presentation was significantly lower with the transparent mask (M = 40.7%) compared to the opaque mask (M = 58.2%). Use of transparent masks can significantly facilitate speech recognition in noise even for persons with normal hearing and thus may reduce stressful communication challenges experienced in medical, employment, and educational settings during the global pandemic. To mitigate the spread of COVID-19 and facilitate communication, safety-approved transparent masks are strongly encouraged over opaque masks.

Teaching webside manner: development and initial evaluation of a video consultation skills training module for undergraduate medical students

ABSTRACT Background Video consultations are increasingly used to communicate with patients, particularly during the current COVID-19 pandemic. However, training in video consultation skills receives scant attention in the literature. We sought to introduce this important topic to our undergraduate medical school curriculum. Objective To increase final year medical students’ video consultation skills and knowledge. Methods We used Plan, Do, Study, Act (PDSA) quality improvement methodology with a pre-post study design to develop a teaching session for 5th year medical students, informed by a literature review and online clinician survey. The 2 hour session comprised an introduction and three practical stations: patient selection and ethics, technology and example videos, and simulation. Subjective pre- and post-session confidence was reported by students across seven domains using 5-point scales (1: not at all confident; 5: extremely confident). Students and facilitators completed post-session feedback forms. Results The 40 students and 3 facilitators who attended, over two separate teaching sessions, provided unanimously positive feedback. All students considered the session relevant. Subjective confidence ratings (n = 34) significantly increased from pre- to post-session (mean increase 1.78, p < 0.001). Conclusions The inaugural teaching session was well-received and subjective assessment measures showed improvement in taught skills. This pilot has informed a UK-wide multi-centre study with subjective and objective data collection.

Performance monitoring during categorization with and without prior knowledge: A comparison of confidence calibration indices with the certainty criterion.

Subjective confidence reports are used in numerous research paradigms to examine the extent to which participants are aware of their performance in a task. By examining the discrepancy between objective performance and subjective confidence ratings, inferences can be made about the conditions in which participants have greater explicit knowledge of the representations and processes used to complete a task. In the current study, we examined the effects of prior knowledge on subjective assessments of performance using a categorisation task wherein lists of features that defined exemplars shared latent feature associations on the basis of prior knowledge or had no prior associations. Using 2 methods for computing confidence, we demonstrate the strengths and limitations of these measures of subjective awareness. Whereas our findings replicated the effect of prior knowledge on learning, our results challenge the role of explicit and implicit knowledge suggested by previous research using a similar paradigm. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Eye movement analyses of strong and weak memories and goal-driven forgetting

Research indicates that eye movements can reveal expressions of memory for previously studied relationships. Specifically, eye movements are disproportionately drawn to test items that were originally studied with the test scene, compared to other equally familiar items in the test display – an effect known as preferential viewing (e.g., Hannula, Ryan, Tranel, & Cohen, 2007). Across four studies we assessed how strength-based differences in memory are reflected in preferential viewing. Participants studied objects superimposed on background scenes and were tested with three-object displays superimposed on the scenes viewed previously. Eye movements were monitored at test. In Experiment 1 we employed an item-method directed forgetting (DF) procedure to manipulate memory strength. In Experiment 2, viewing patterns were examined across differences in memory strength assessed through subjective confidence ratings. In Experiment 3, we used spaced repetitions to objectively strengthen items, and Experiment 4 involved a list-method DF manipulation. Across all experiments, eye movements consistently differentiated the effect of DF from other strength-based differences in memory, producing different viewing patterns. They also differentiated between incidental and successful intentional forgetting. Finally, despite a null effect in recognition accuracy in list-method DF, viewing patterns revealed both common as well as critical differences between list-method DF and item-method DF. We discuss the eye movement findings from the perspective of theoretical accounts of DF and other strength-based differences in memory.

Review and developments in level 2 psychological support skills training for oncology clinical nurse specialists

Background/Aims The need for holistic support to address the psychosocial impact of cancer has featured in NHS recommendations since 2004. This article describes the review, rewrite and evaluation of the North Central and North East London region ‘level 2’ psychological support skills training for oncology clinical nurse specialists. Methods The review was conducted in 2016–18; the new training package was then rolled out and evaluated in 2018–19. The re-written training includes models of individualised assessment based on psychological theory, including adjustment and adaptation. It also includes self-care exercises, providing experiential learning for the dual purpose of self-care and as potential material to teach to patients as level 2 interventions. The new training model requires follow-up attendance in clinical discussion groups to consolidate knowledge and skills development. In total, 135 clinical nurse specialists attended over an 18-month period. The evaluation involved pre- and post-training questionnaires. Results Evaluation suggests the new training is valued by clinical nurse specialists, is pitched at the right level and increases clinical nurse specialists' subjective ratings of confidence and identification of psychological need, onward referral and self-care. Conclusions The new package provides a useful development of the level 2 training model. Future plans are discussed.

Relevance of metacognition and brain activity to decision-making tasks related to self-reflection

Daily life requires many decisions. People with high metacognition may effectively and quickly make decisions. We used functional magnetic resonance imaging (fMRI) to examine the neural basis of the relationship between metacognition and self-related decision-making. Tokyo Metropolitan University Research Ethics Committee (No. 14072) approved this study. Participants included 13 young, healthy, right-handed people (mean age ± standard deviation: 21.38 ± 1.12 years, range 20–24 years). Before fMRI scanning, explicit self-esteem and metacognition were assessed using the Rosenberg Self-esteem Scale (RSES) and Metacognitive Awareness Inventory (MAI), respectively. Using a computer mouse, subjects answered decision-making task questions, which were randomly presented during scanning. Condition 1 (self-related decision-making) asked, “If given these 2 types of work, which would you do first?” Condition 2 (word decision-making) asked, “Which of the 2 words is longer?” The 2 presented words were randomized and the same for each condition. We analyzed differences between these conditions using SPM12 implemented in MATLAB R2017a. We also analyzed the correlation between the MAI scores (Factor 1: monitoring; Factor 2: control; Factor 3: metacognitive knowledge) and RSES scores and the averaged parameter estimates in the spherical region of interest. The left orbitofrontal cortex, left superior frontal gyrus, left inferior frontal gyrus, left angular gyrus, left temporal pole, bilateral middle temporal gyrus (MTG), and left hippocampus were activated in self-related compared with word decision-making. MAI Factor 1 and 3 scores were negatively correlated with the MTG ( r = −0.84 and r = −0.71, respectively; P < 0.05). MAI Factor 2 was not significantly correlated with any activity. The negative correlation between MAI Factor 1 and 3 scores and MTG activity disagrees with previous reports that MTG is involved in higher subjective confidence ratings. Moreover, metacognitive control may be regulated by other brain areas.

Mood Management Effects of a Brief Behavioral Activation Internet Intervention

This randomized controlled trial investigated the effect of a brief unsupported behavioral activation Internet intervention (BAII) designed to improve mood. A total of 671 participants were recruited through Amazon’s Mechanical Turk (AMT) (M age = 35.71 years; SD = 12.34, 32.3% male) and 187 (27.9%) individuals completed the 1-week follow-up survey. Participants were randomly assigned to a behavioral activation “Activities” condition or a waitlist control (WLC) and assessed for depression (PHQ-9), anxiety (GAD-7), self-reported mood, and confidence and motivation to make behavioral changes. Repeated measure ANOVAs showed that individuals in the Activities condition significantly improved their motivation and confidence from baseline to immediate-post intervention. Mixed-effect modeling was used to determine the within-subject effect (time) and between-subject effect (WL vs. Activities condition). Significant main effects for time (but not condition) were found for PHQ-9 depression scores (F (1, 393) = 13.24, p < 0.001), GAD-7 anxiety scores (F 1, 393) = 8.36, p < 0.01), and for subjective ratings of confidence (F (1, 387) = 4.94, p < 0.05), such that depression and anxiety scores were lower and confidence was higher at the second time-point, regardless of condition. Furthermore, a significant time by condition interaction was found for self-reported mood (F (1, 387) = 4.24, p < 0.05), where individuals who received the intervention had a more positive rating of subjective mood at the 1-week follow-up. Individuals in the WL condition did not report significant improvements in subjective mood at follow-up (p = 0.056). After a brief online behavioral activation intervention, participants who endorsed mild to moderate depression symptoms at baseline experienced an immediate improvement in confidence and motivation. They also exhibited significant improvements in self-reported mood at 1 week. However, there was no change observed in depression, anxiety, motivation, or confidence at 1-week follow-up. Overall, this study provides partial support for the utilization of a brief online activities-focused intervention and highlights the need to develop more powerful versions of such interventions.

Affective blindsight in the absence of input from face processing regions in occipital-temporal cortex

Previous research suggests that the implicit recognition of emotional expressions may be carried out by pathways that bypass primary visual cortex (V1) and project to the amygdala. Some of the strongest evidence supporting this claim comes from case studies of “affective blindsight” in which patients with V1 damage can correctly guess whether an unseen face was depicting a fearful or happy expression. In the current study, we report a new case of affective blindsight in patient MC who is cortically blind following extensive bilateral lesions to V1, as well as face and object processing regions in her ventral visual stream. Despite her large lesions, MC has preserved motion perception which is related to sparing of the motion sensitive region MT+ in both hemispheres.To examine affective blindsight in MC we asked her to perform gender and emotion discrimination tasks in which she had to guess, using a two-alternative forced-choice procedure, whether the face presented was male or female, happy or fearful, or happy or angry. In addition, we also tested MC in a four-alternative forced-choice target localization task. Results indicated that MC was not able to determine the gender of the faces (53% accuracy), or localize targets in a forced-choice task. However, she was able to determine, at above chance levels, whether the face presented was depicting a happy or fearful (67%, p = .006), or a happy or angry (64%, p = .025) expression. Interestingly, although MC was better than chance at discriminating between emotions in faces when asked to make rapid judgments, her performance fell to chance when she was asked to provide subjective confidence ratings about her performance. These data lend further support to the idea that there is a non-conscious visual pathway that bypasses V1 which is capable of processing affective signals from facial expressions without input from higher-order face and object processing regions in the ventral visual stream.

Are you early or late?: Temporal error monitoring.

Temporal judgments regarding a target interval typically produce a nearly normally distributed reproduction times centered on the target with substantial variance. This phenomenon indicates that the majority of our temporal judgments are deviations from the target times, which are assumed to originate from the underlying timing uncertainty. Although humans were found to adapt their decisions in response to timing uncertainty, we do not know if they can accurately judge the direction and degree of their temporal errors. In this study, we asked participants to reproduce durations as accurately as possible. After each reproduction, participants were asked to retrospectively rate their confidence in their temporal estimates and to judge if their response time was earlier or later than the target interval. The results revealed that human participants are aware of both the direction and magnitude of their timing errors, pointing at an informationally rich temporal error monitoring ability. We further show that a sequential diffusion process can account for the detection of direction of errors as well as the qualitative features of the relationship of objective temporal errors with subjective confidence ratings and associated response times. (PsycINFO Database Record

Linear units improve articulation between social and physical constructs: An example from caregiver parameterization for children supported by complex medical technologies

Despite broad sweeping pronouncements by international research organizations that social sciences are being integrated into global research programs, little attention has been directed toward obstacles blocking productive collaborations. In particular, social sciences routinely implement nonlinear, ordinal measures, which fundamentally inhibit integration with overarching scientific paradigms. The widely promoted general linear model in contemporary social science methods is largely based on untransformed scores and ratings, which are neither objective nor linear. This issue has historically separated physical and social sciences, which this report now asserts is unnecessary. In this research, nonlinear, subjective caregiver ratings of confidence to care for children supported by complex, medical technologies were transformed to an objective scale defined by logits (N=70). Transparent linear units from this transformation provided foundational insights into measurement properties of a social- humanistic caregiving construct, which clarified physical and social caregiver implications. Parameterized items and ratings were also subjected to multivariate hierarchical analysis, then decomposed to demonstrate theoretical coherence (R2 >.50), which provided further support for convergence of mathematical parameterization, physical expectations, and a social-humanistic construct. These results present substantial support for improving integration of social sciences with contemporary scientific research programs by emphasizing construction of common variables with objective, linear units.

Intra-individual comparison of CAIPIRINHA VIBE technique with conventional VIBE sequences in contrast-enhanced MRI of focal liver lesions

PurposeTo evaluate the impact of controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) volume interpolated breath-hold examination (VIBE) magnetic resonance imaging (MRI) technique on image quality, reader confidence, and inter-observer agreement for the assessment of focal liver lesions in comparison with the standard VIBE approach. Material and methodsIn this IRB-approved intra-individual comparison study, abdominal arterial and portal-venous contrast-enhanced MRI studies were retrospectively analyzed in 38 patients with malignant liver lesions. Each patient underwent both CAIPIRINHA and conventional VIBE 3T MRI within 3 months, showing stable disease. Images were evaluated using 5-point rating scales by two blinded radiologists with more than 20 and 5 years of experience in MRI, respectively. Readers scored dignity of liver lesions and assessed which liver segments were affected by malignancy (ranging from 1=definitely benign/not affected to 5=definitely malignant/affected by malignancy). Readers also rated overall image quality, sharpness of intrahepatic veins, and diagnostic confidence (ranging from 1=poor to 5=excellent). ResultsReviewers achieved a higher inter-observer reliability using CAIPIRINHA when they reported which liver segments were affected by malignancy compared to traditional VIBE series (κ=0.62 and 0.54, respectively, p<0.05). Similarly, CAIPIRINHA showed a slightly higher inter-rater agreement for the dignity of focal liver lesions versus the standard VIBE images (κ=0.50 and 0.49, respectively, p<0.05). CAIPIRINHA series also scored higher in comparison to standard VIBE sequences (mean scores: image quality, 4.2 and 3.5; sharpness of intrahepatic vessels, 3.8 and 3.2, respectively, p<0.05) for both reviewers and allowed for higher subjective diagnostic confidence (ratings, 3.8 and 3.2, respectively, p<0.05). ConclusionCompared to the standard VIBE approach, CAIPIRINHA VIBE technique provides improved image quality and sharpness of intrahepatic veins, as well as higher diagnostic confidence. Additionally, this technique allows for higher inter-observer agreement when reporting focal liver lesions for both dignity and allocation.