Causal attribution in individuals with subclinical and clinical autism spectrum disorder: An fMRI study

This neuroimaging study compares brain activation during causal attribution to three different attribution loci (i.e., self, another person, and situation) across a typical population without (N = 20) or with subclinical autism spectrum symptoms (N = 18) and a clinical population with autism spectrum disorder (ASD; N = 11). While they underwent fMRI, all participants read short sentences describing positive and negative behaviors and thoughts of another person directed toward the participant (i.e., “you”). Participants were then asked to attribute these behaviors to themselves, the other person, or the situation. Behavioral measures revealed self-serving attributions (i.e., attributing positive events to the self, while attributing negative events externally from the self) in all three participant groups. Neural measures revealed a great deal of shared activation across the three attribution loci and across the three participant groups in the temporo-parietal junction, the posterior superior sulcus, and the precuneus. Comparison between groups revealed more widespread activation in both subclinical and clinical ASD participants, which may be indicative of the extraneural resources these participants invest to compensate their impairments.     

Culture,causal attributions to visual impairments,and stigma: A mediation model

BackgroundCausal attributions are central to the understanding of public reactions to disability (that is, disability-related stigma). Research shows that culture and ethnicity were found to play a significant role in both causal attributions of disability and disability-related stigma.Disability-related stigma was found to influence physical and mental health. Nevertheless, to the best of our knowledge, the relationships linking culture, causal attributions of disability and disability-related stigma, have not been previously examined.ObjectiveThe study examined whether causal attributions (natural, mystic, punitive and emotional) to a specific disability-visual impairments - mediate the relationship between culture and stigma towards individuals with visual impairments.MethodsA quota sample comprised of 305 university and college students was drawn. Data were collected via a self-reported questionnaire.ResultsThe main findings indicated that emotional and punitive causal attribution to visual impairments mediated the relationship between culture and visual impairments-stigma; Israeli Arab-Palestinians had a higher tendency to attribute higher levels of punitive and emotional causes to visual impairments compared to Israeli Jews. Higher levels of punitive and emotional attributed causes for visual impairments were correlated with higher levels of visual impairments-stigma. Israeli Arab-Palestinians have a higher tendency to attribute visual impairments to mystic causes compared to Israeli Jews. However, this type of perceived causation was unrelated to visual impairments-stigma.ConclusionsInterventions to reduce visual impairments-stigma should focus on misconceptions concerning causation. It is especially important to design culturally sensitive interventions for visual impairments stigma reduction among Israeli Arab-Palestinians, which will focus on de-psychologizing visual impairments.     

Story comprehension in pre-readers: understanding goal structure and generating inferences when a story has competing goals

ABSTRACT

The purpose of this study was to explore pre-readers’ comprehension of a story with competing character goals. Fifty-eight children in three age groups (2½–3 years; 3–4 years; and 4–5 years) were read a story in which the protagonist’s goal was unstated and conflicted with the goal of the secondary character. Understanding of explicit story content was tested through a joint story retell, during which children were prompted to supply 10 story elements. Children in the two older groups supplied more than half of the elements; those in the youngest group obtained a significantly lower score, supplying an average of two elements. Responses to questions suggested that a majority of participants in each age group had accurately inferred the protagonist’s goal. However, few children demonstrated that they had linked actions with goal, an indication that they had difficulty grasping the goal structure of a story with competing goals.     

Spontaneous and intentional trait inferences recruit a common mentalizing network to a different degree: Spontaneous inferences activate only its core areas

This fMRI study analyzes inferences on other persons' traits, whereby half of the participants were given spontaneous (“read”) instructions while the other half were given intentional (“infer the person's trait”) instructions. Several sentences described the behavior of a target person from which a strong trait could be inferred (trait diagnostic) or not (trait nondiagnostic). A direct contrast between spontaneous and intentional instructions revealed no significant differences, indicating that the same social mentalizing network was recruited. There was, however, a difference with respect to different brain areas that passed the significance threshold, suggesting that this common network was recruited to a different degree. Specifically, spontaneous inferences significantly recruited only core mentalizing areas, including the temporo-parietal junction and medial prefrontal cortex, whereas intentional inferences additionally recruited other brain areas, including the (pre)cuneus, superior temporal sulcus, temporal poles, and parts of the premotor and parietal cortex. These results suggest that intentional instructions invite observers to think more about the material they read, and consider it in many ways besides its social impact. Future research on the neurological underpinnings of trait inference might profit from the use of spontaneous instructions to get purer results that involve only the core brain areas in social judgment.     

The relationship between weight change and daytime sleepiness: the Sleep Heart Health Study

ObjectiveThrough a causal framework, we aim to assess the association between weight change and daytime sleepiness, and the role of obstructive sleep apnoea (OSA) in this relationship.MethodsFrom the Sleep Heart Health Study, we selected individuals who were: (1) 40–64 years old, with (2) body mass index (BMI) ≥18.5 kg/m², (3) no history of stroke, treatment for OSA, and tracheostomy at baseline. We used multiple linear regression to assess the relationship between five-year weight change and daytime sleepiness (assessed through Epworth Sleepiness Scale (ESS)) at five years, adjusting for daytime sleepiness, demographics, diabetes, subjective sleep duration, sleep disturbance, smoking status, weight, and use of antidepressants and benzodiazepines at baseline, in those with complete data (N = 1468). We further assessed the potential mediating role of OSA in this relationship.ResultsAt baseline, the study participants were on average 55 years old, 46% males, with mean BMI 28 kg/m²; and 25% had ESS>10. ESS at five years worsened by 0.36 units (95% confidence interval (CI) 0.12–0.61, p = 0.004) with every 10-kg weight gain. When stratified by sex, this relationship was only found in women (0.55, 95% CI 0.25–0.86, p < 0.001; p-interaction = 0.02). Approximately one-fifth of the relationship between weight change and daytime sleepiness was mediated by severity of OSA at five years.ConclusionWeight gain has a detrimental effect on daytime sleepiness, mostly through pathways other than OSA. This study provides further evidence and understanding of the relationship between obesity and excessive daytime sleepiness.     

Effects in Adherent Subjects

Dropouts confound the treatment effect when the outcome and the dropout process both depend on subject characteristics. If dropout is unrelated to treatment, there is an unconfounded effect, but it is the effect in a principal stratum, rather than a de jure effect. There are at least two different definitions of the effect if all subjects adhered, giving effects different numerically from each other and from the effect in the adherent principal stratum. Estimation of either of these two effects requires an assumption (MAR) different from but sometimes confused with the assumption that dropout is unrelated to treatment.     

Primer of statistics in dental research: Part II

The Part I of Primer of Statistics in Dental Research covered five topics that are often mentioned in statistical check list of many peer-review journals [1], [2], [3] including (1) statistical graph, (2) how to deal with outliers, (3) p-value and confidence interval, (4) testing equivalence, and (5) multiplicity Adjustment [4]. The Part II of the series covers another set of important topics in dental statistics including (1) selecting the proper statistical tests, (2) repeated measures analysis, (3) epidemiological consideration for causal association, and (4) analysis of agreement. First, a guide in selecting the proper statistical tests based on the research question will be laid out in text and with a table so that researchers choose the univariable statistical test by answering five simple questions. Second, the importance of utilizing repeated measures analysis will be illustrated. This is a key component of data analysis as in many dental studies, observations are considered repeated in a single patient (several teeth are measured in a single patient). Third, concepts of confounding and the use of regression analysis are explained by going over a famous observational cohort study. Lastly, the use of proper agreement analysis vs. correlation for study of agreement will be discussed to avoid a common pitfall in dental research.     

The Risk-Benefit Paradigm vs the Causal Exposure Paradigm: LDL as a primary cause of vascular disease

All current guidelines use the 10-year risk of a cardiovascular event to select subjects for statin primary preventive therapy. Benefit from therapy is stated to be determined by risk with the result that statin primary preventive therapy is initiated only when the risk of a cardiovascular event over the next decade exceeds a specified level. Thus all current guidelines are based primarily on the Risk-Benefit paradigm of primary prevention. The recent American Heart Association/American College of Cardiology guidelines differ from others in basing selection for statin therapy virtually exclusively on risk except for those few subjects with markedly elevated levels of low-density lipoprotein cholesterol (LDL-C). The Causal Exposure paradigm differs from the Risk-Benefit paradigm in that the objective of therapy is to prevent the anatomic disease within arterial walls that produces cardiovascular risk. Moreover, the anatomic disease and, therefore, the cardiovascular risk, is a function of the injurious action of the causal factors of vascular disease, such as blood pressure and LDL, on the arterial wall over long periods. In this article, we explain the strengths and weaknesses of both paradigms to provide a more secure framework to compare the strengths and weaknesses in the different cholesterol guidelines with particular emphasis on the evidence that the cardiovascular risk and the benefit from statin therapy is related to the level of LDL.     

隐性高血压病人中心动脉压及增强指数

目的探讨“隐性高血压”与中心动脉压及动脉硬化的关系。方法采用脉搏波分析仪记录89例临床诊断为血压正常(偶测血压<140/90 mm Hg)及75例高血压(偶测血压≥140/90 mm Hg或正在服用降压药物者)患者的桡动脉脉搏波,经计算机自动转换为相应的中心动脉脉搏波,并分析中心动脉压力及反映全身动脉硬化的增强指数(AIx)。结果小样本人群中,隐性高血压的患病率为15.7%。与血压正常(偶测血压<140/90 mm Hg及白昼动态血压<135/85 mm Hg)组相比,隐性高血压组的血浆总胆固醇及低密度脂蛋白胆固醇浓度、饮酒的比例显著增高;中心动脉收缩压、舒张压、收缩末期压及中心动脉增强压分别增加14.8 mm Hg(CI5.6~24.0 mm Hg)、9.1 mm Hg(CI3.1~15.1 mm Hg)、14.0mm Hg(CI5.8~22.2)及4.2(CI0.6~7.8 mm Hg),增强指数增加11.9%(CI2.8%~20.9%)。虽然隐性高血压组的偶测血压显著低于高血压组,经年龄、性别及身高调整后,两组的白昼动态血压、中心动脉收缩压、舒张压、增强压及增强指数均无显著差异。结论隐性高血压患者的中心动脉压力及增强指数升高,提示动脉顺应性下降,动脉硬化。这些血液动力学的改变可能增加心血管病危险,对其进行评价有助于偶测血压正常者的危险分层。     

检验分析前质量问题原因分析及对策

目的通过对检验分析前的质量问题存在的原因分析,降低不合格标本的发生率,提高护士对标本采集知识的掌握。方法护理部与检验科、信息科合作,完善条形码信息、制订《检验手册》全院护士共享、检验科专家讲课。结果经过护理部干预,护士采集不合格标本的发生率显著下降,护士对标本的采集知识的掌握显著提高。结论护理部通过对检验分析前的质量控制干预,可显著降低护士采集不合格标本的发生率,显著提高护士对标本采集知识的掌握。