Higher Incidence of Thrombotic Complications in Thoracic Spine Surgery.

Background: Past studies have examined individual complication rates for cervical, lumbar, and thoracic spine surgery but have typically focused on just 1 region of the spine, making comparisons across spine regions difficult. The purpose of the present study was to analyze the incidence of 5 thrombotic complications, including pulmonary embolism, deep vein thrombosis, myocardial infarction, cardiac arrest, and stroke/cerebrovascular accident, across surgical procedures that target different regions of the spine, including cervical, thoracic, and lumbar.

Methods: We conducted a cross-sectional clinical analysis of these 5 thrombotic complications in a relatively large sample.

An examination of younger and older adults' age preferences.

Research suggests that how people feel about aging can contribute to their later physical, cognitive, and mental health. In two studies, we examined younger (ages 18-30) and older adults' (ages 61-70) views about aging by asking them to rate the extent to which they would find it desirable to be various ages between 0 and 120. Participants also indicated both their ideal age (the age at which they would most like to be) and their subjective age (how old they generally feel).

Data-driven characterization of traumatic brain injury severity from clinical, neuroimaging, and blood-based indicators.

The conventional clinical approach to characterizing traumatic brain injuries (TBIs) as mild, moderate, or severe using the Glasgow Coma Scale (GCS) total score has well-known limitations, prompting calls for more sophisticated strategies to characterize TBI. Here, we use item response theory (IRT) to develop a novel method for quantifying TBI severity that incorporates neuroimaging and blood-based biomarkers along with clinical measures. Within the multicenter Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study sample (N = 2545), we show that a set of 23 clinical, head computed tomography (CT), and blood-based biomarker variables familiar to clinicians and researchers index a common latent continuum of TBI severity.

Low-Performing Students Confidently Overpredict Their Grade Performance throughout the Semester.

When asked to predict how they will perform on an upcoming exam, students are often poorly calibrated, typically in the direction of overpredicting their performance. Research shows that low-performing students' calibration tends to remain poor across multiple tests over the course of a semester. We tested whether these students remain confident in these erroneously high grade predictions across the semester or whether their confidence wanes, suggesting some degree of metacognitive awareness.

Reducing Surgical Complications in Spine Patients Through a Medication Management Support Program.

Study Design: A hospital-wide medication management program was implemented to ensure that high-risk patients would systematically pause antiplatelet and anticoagulant medications. We analyzed complications before and during the implementation of this program.

Objective: The goal of the study was to determine if a medication management support program was effective for reducing perioperative complications, including hemorrhage, myocardial infarction, stroke, pulmonary embolism, and deep vein thrombosis.

Linking Rivermead Post Concussion Symptoms Questionnaire (RPQ) and Sport Concussion Assessment Tool (SCAT) scores with item response theory.

Objective: Despite the public health burden of traumatic brain injury (TBI) across broader society, most TBI studies have been isolated to a distinct subpopulation. The TBI research literature is fragmented further because often studies of distinct populations have used different assessment procedures and instruments. Addressing calls to harmonize the literature will require tools to link data collected from different instruments that measure the same construct, such as civilian mild traumatic brain injury (mTBI) and sports concussion symptom inventories.

Improving the Precision of the Glasgow Outcome Scale-Extended Using Item Response Theory: A TRACK-TBI Study.

The Glasgow Outcome Scale-Extended (GOSE) is a functional outcome measure intended to place individuals with traumatic brain injury (TBI) into one of eight broad levels of injury-related disability. This simplicity is not always optimal, particularly when more granular assessment of individuals' injury recovery is desired. The GOSE, however, is customarily assessed using a multi-question interview that contains richer information than is reflected in the GOSE score.

Functional Status Examination Yields Higher Measurement Precision than the Glasgow Outcome Scale-Extended after Moderate-to-Severe Traumatic Brain Injury.

A limited evidence base supports the Functional Status Examination (FSE) as superior to the more commonly used Glasgow Outcome Scale-Extended (GOSE) for precisely characterizing injury-related functional limitations. The aim of this study was to use modern psychometric tools to test the hypothesis that the FSE is more precise than the GOSE in characterizing individual differences in functional limitations after moderate-to-severe traumatic brain injury (TBI). Secondarily, we sought to confirm that the type of interviewee (patient, significant other) does not affect the test performance of the FSE.

Functional Status Examination Yields Higher Measurement Precision of Functional Limitations after Traumatic Injury than the Glasgow Outcome Scale-Extended: A Preliminary Study.

The Glasgow Outcome Scale-Extended (GOSE) is one of the most widely used measures of functional limitations after traumatic brain injury (TBI), and is the primary outcome measure used in clinical trials of acute TBI treatment. However, the GOSE appears insensitive to the full spectrum of TBI-related functional limitations, which may limit its potential to capture treatment effects or correlate with other variables that impact outcome. The Functional Status Examination (FSE) was designed to improve on the assessment of injury-related functional limitations using a standardized assessment and wider possible score range.

Hallucinations and Delusions Signal Alzheimer's Associated Cognitive Dysfunction More Strongly Compared to Other Neuropsychiatric Symptoms.

Objectives: Neuropsychiatric symptoms (NPS) are common among individuals with dementia of the Alzheimer's type (DAT). We sought to characterize which NPS more purely relate to cognitive dysfunction in DAT, relative to other NPS.

Method: Demographic, neurocognitive, neuroimaging, and NPS data were mined from the Alzheimer's Disease Neuroimaging Initiative database (n = 906).

Statistical Model of Dynamic Markers of the Alzheimer's Pathological Cascade.

Objectives: Alzheimer's disease (AD) is a progressive disease reflected in markers across assessment modalities, including neuroimaging, cognitive testing, and evaluation of adaptive function. Identifying a single continuum of decline across assessment modalities in a single sample is statistically challenging because of the multivariate nature of the data. To address this challenge, we implemented advanced statistical analyses designed specifically to model complex data across a single continuum.

Contextual consideration of the emergence of alexithymia: A case study highlighting cross-cultural client factors and limited English proficiency.

Alexithymia, characterized by deficits in recognition or expression of emotional experiences, has been demonstrated to be associated with depressive symptoms. In psychotherapy, alexithymia can partly manifest as stunted, disfluent speech when an individual attempts to describe his or her subjective experiences. However, similarly stunted, disfluent speech can be observed in individuals with limited English proficiency who are not diagnosed with a depressive disorder.

Alzheimer's Disease Assessment: A Review and Illustrations Focusing on Item Response Theory Techniques.

Alzheimer's disease (AD) affects neurological, cognitive, and behavioral processes. Thus, to accurately assess this disease, researchers and clinicians need to combine and incorporate data across these domains. This presents not only distinct methodological and statistical challenges but also unique opportunities for the development and advancement of psychometric techniques.

Item response theory applications in personality disorder research.

This article describes how item response theory (IRT) has begun to address several of the measurement limitations inherent in the personality disorder (PD) literature. In particular, we describe how IRT can be used to improve PD measurement precision, develop PD instruments, and inform PD theory. In closing, we address a key assumption of unidimensional IRT models, and address the need to move beyond these models to include multidimensional models.

Self and informant report across the borderline personality disorder spectrum.

Individuals with borderline personality disorder (BPD) features may be unaware of or unwilling to report their own personality or maladaptive behaviors, which complicates the assessment of BPD. Informants who know the individuals with BPD features may be uniquely suited to aid in the personality assessment of these individuals. The present study analyzed the comparative ability of individuals (targets) and informants to report BPD features across the continuum of BPD severity.

Factor structure of the Montreal Cognitive Assessment items in a sample with early Parkinson's disease.

Introduction: The Montreal Cognitive Assessment (MoCA) is a frequently utilized cognitive screening tool that has attractive clinical attributes when utilized in individuals with Parkinson's disease. However, the construct validity of this instrument has not been well-characterized in Parkinson's samples. The purpose of this study is to explore the underlying factor structure of the MoCA in individuals with early stage Parkinson's disease.

A Statistical Consideration Regarding the Threshold of the Psychopathy Checklist-Revised.

The Psychopathy Checklist-Revised (PCL-R; Hare, 2003 ) is one of the most commonly used measures of psychopathy. Scores range from 0 to 40, and legal and mental health professionals sometimes rely on a cut score or threshold to classify individuals as psychopaths. This practice, among other things, assumes that all items contribute equally to the overall raw score.

Methodological issues in the use of individual brain measures to index trait liabilities: The example of noise-probe P3.

Recent research initiatives have called for an increased use of biological concepts and measures in defining and studying mental health problems, but important measurement-related challenges confront efforts in this direction. This article highlights some of these challenges with reference to an intriguing measure of neural reactivity: the probe P3 response, a mid-latency brain potential evoked by an intense, unexpected acoustic-probe stimulus. Using data for a large adult sample (N=418), we report evidence that amplitude of probe P3 response to unwarned noise bursts occurring in a picture-viewing task exhibits robust, independent associations with two distinct trait constructs: weak inhibitory control (or disinhibition; DIS) and threat sensitivity (THT).

Informant Perceptions of the Cause of Activities of Daily Living Difficulties in Parkinson's Disease.

Objective: Individuals with Parkinson's disease (PD) can have difficulties with activities of daily living (ADL) that stem from cognitive, motor, or affective manifestations of the disease. Accurately attributing ADL difficulty specifically to cognitive decline is critical when conducting a neuropsychological evaluation of a person with PD. Informant description of ADL performance is frequently used for this purpose, but there has been little work assessing informants' ability to attribute ADL dysfunction to a specific symptom source in PD.

How Do Scores on the ADAS-Cog, MMSE, and CDR-SOB Correspond?

Objective: Clinicians and researchers who measure cognitive dysfunction often use the Alzheimer's Disease Assessment Scale--Cognitive Subscale (ADAS-Cog), the Mini-Mental State Examination (MMSE), or the Clinical Dementia Rating scale (CDR-SOB). But, the use of different measures can make it difficult to compare data across patients or studies. What is needed is a simple chart that shows how scores on these three important measures correspond to each other.

Gender Differences in Borderline Personality Disorder Features in an Epidemiological Sample of Adults Age 55-64: Self Versus Informant Report.

The literature on the prevalence of borderline personality disorder (BPD) across gender reveals multiple trends. A number of studies indicate that women have a higher prevalence. Others indicate no difference, and a few even reveal that men have a higher prevalence.

Examining DSM criteria for trichotillomania in a dimensional framework: implications for DSM-5 and diagnostic practice.

Background: Diagnosis of trichotillomania (TTM) requires meeting several criteria that aim to embody the core pathology of the disorder. These criteria are traditionally interpreted monothetically, in that they are all equally necessary for diagnosis. Alternatively, a dimensional conceptualization of psychopathology allows for examination of the relatedness of each criterion to the TTM latent continuum.

Adding delayed recall to the ADAS-cog improves measurement precision in mild Alzheimer's disease: Implications for predicting instrumental activities of daily living.

As research increasingly focuses on preclinical stages of Alzheimer's disease (AD), instruments must be retooled to identify early cognitive markers of AD. A supplemental delayed recall subtest for the Alzheimer's Disease Assessment Scale-cognitive (ADAS-cog; Mohs, Rosen, & Davis, 1983; Rosen, Mohs, & Davis, 1984) is commonly implemented, but it is not known precisely where along the spectrum of cognitive dysfunction this subtest yields incremental information beyond what is gained from the standard ADAS-cog, or whether it can improve prediction of functional outcomes. An item response theory approach can analyze this in a psychometrically rigorous way.