Implicit versus explicit measures of self-concept of self-control and their differential predictive power for spontaneous trait-relevant behaviors

Background and objectives

Low trait self-control constitutes a core criterion in various psychiatric disorders. Personality traits such as low self-control are mostly indexed by self-report measures. However, several theorists emphasized the importance of differentiating between explicit and implicit indices of personality traits, Therefore, the present study examined the unique predictive validity of an implicit measure of trait self-control for spontaneous dysfunctional behavior.

Methods

As a measure of implicit trait self-control, we used an irrelevant feature task: a speeded reaction time task comprising a task-relevant stimulus feature (i.e., capital vs. lower case letter type) and a task-irrelevant feature (high vs. low self-control word type). The irrelevant feature had to be ignored, while participants (n = 34) responded to the relevant stimulus feature. However, their response was either congruent or incongruent with the irrelevant stimulus feature, resulting in facilitated or deteriorated task performance. As indicators of trait-related spontaneous dysfunctional behavior, we included indices of frustration tolerance and the preference for short-term reward over meeting long-term goals. We also included two explicit measures of trait self-control: a self-report questionnaire and an explicit self-relevance rating of the implicit task stimuli.

Results

Specifically the implicit measure of trait self-control showed predictive validity for the target self-control behaviors.

Limitations

The predictive validity of implicit measures of personality traits requires further study in larger, non-student samples.

Conclusions

As predicted, the implicit measure of trait self-control showed superior predictive power for spontaneous trait-related behavior. This finding points to the relevance of complementing the routinely used self-report measures with implicit measures of trait self-control.     

Rasch analysis of clinical outcome measures in spinal muscular atrophy

Introduction: Trial design for SMA depends on meaningful rating scales to assess outcomes. In this study Rasch methodology was applied to 9 motor scales in spinal muscular atrophy (SMA). Methods: Data from all 3 SMA types were provided by research groups for 9 commonly used scales. Rasch methodology assessed the ordering of response option thresholds, tests of fit, spread of item locations, residual correlations, and person separation index. Results: Each scale had good reliability. However, several issues impacting scale validity were identified, including the extent that items defined clinically meaningful constructs and how well each scale measured performance across the SMA spectrum. Conclusions: The sensitivity and potential utility of each SMA scale as outcome measures for trials could be improved by establishing clear definitions of what is measured, reconsidering items that misfit and items whose response categories have reversed thresholds, and adding new items at the extremes of scale ranges. Muscle Nerve 49 :422–430, 2014     

Categorical or Dimensional: How Do Attachment Measures Inform Clinicians in Couple Therapy?

Self-report measures of adult romantic attachment have been widely used in research but their application in clinical practice has not been adequately examined. One important issue is the selection of a practical and reliable attachment measure that therapists can rely on in couple therapy. In the present study, the three-category Attachment Style Prototype (Hazan & Shaver, 1987) representing the original classic conceptualization of attachment, and the Experiences in Close Relationships (Brennan, Clark, & Shaver, 1998), a more recent scale with two dimensions representing a new conceptualization, were compared. Experiences in Close Relationships data were also used to establish four clusters based on the scores of the two dimensions. The Experiences in Close Relationships and Attachment Style Prototype categories were related in meaningful ways; however, Attachment Style Prototype was less effective in detecting a group of insecurely attached individuals who tended to self-identify as securely attached. Experiences in Close Relationships clearly shows an advantage over Attachment Style Prototype in clinical application, and therefore was recommended. Examples of the clinical utilization of Experiences in Close Relationships in couple therapy were provided using Experiences in Close Relationships scores from couples seeking therapy.     

Primary care physician PSA screening practices before and after the final U.S. Preventive Services Task Force recommendation

ObjectivesIn May 2012, United States Preventive Services Task Force (USPSTF) finalized its recommendation against prostate-specific antigen (PSA) screening in all men. We aimed to assess trends in PSA screening frequency amongst primary care physicians (PCPs) surrounding the May 2012 USPSTF recommendation.Methods and materialsThe electronic data warehouse was used to identify men aged between 40 and 79 years with no history of prostate cancer or urology visit who were evaluated by an internal medicine or family practice physician between 2007 and 2012. Analyses were directed toward PSA testing within 6-month time period from June to November, with particular focus on the 2011 (pre-USPSTF recommendation) and 2012 (post-USPSTF recommendation) cohorts. The primary outcome measure was proportion of men with at least 1 PSA test during the 6-month pre- and post-USPSTF recommendation periods.ResultsA total of 112,221 men met inclusion criteria. There was a significant decrease in screening frequency between the 2011 and 2012 cohorts (8.6% vs. 7.6%, P = 0.0001; adjusted odds ratio 0.89, 95% confidence interval 0.83–0.95). This decrease was most evident amongst patients aged 40 to 49 years (5.6% vs. 4.6%, P = 0.004) and 70 to 79 years (7.9% vs. 6.2%, P = 0.01). A significant decrease was also observed in patients with highest previous PSA value<1.0 (P<0.0001) and 1.0 to 2.49 ng/ml (P = 0.0074).ConclusionsSince the USPSTF recommendation was finalized, there is evidence of continuing decreases in PSA testing by PCPs. PCPs may be shifting toward more selective screening practices, as decreases in screening are most pronounced in the youngest and oldest patients and in those with history of PSA values<2.5 ng/ml.     

Higher clinical performance during a surgical clerkship is independently associated with matriculation of medical students into general surgery

Background

The purpose of our study was to determine the predictive impact of individual academic measures for the matriculation of senior medical students into a general surgery residency.

Methods

Academic records were evaluated for third-year medical students (n = 781) at a single institution between 2004 and 2011. Cohorts were defined by student matriculation into either a general surgery residency program (n = 58) or a non–general surgery residency program (n = 723). Multivariate logistic regression was performed to evaluate independently significant academic measures.

Results

Clinical evaluation raw scores were predictive of general surgery matriculation (P = .014). In addition, multivariate modeling showed lower United States Medical Licensing Examination Step 1 scores to be independently associated with matriculation into general surgery (P = .007).

Conclusions

Superior clinical aptitude is independently associated with general surgical matriculation. This is in contrast to the negative correlation United States Medical Licensing Examination Step 1 scores have on general surgery matriculation. Recognizing this, surgical clerkship directors can offer opportunities for continued surgical education to students showing high clinical aptitude, increasing their likelihood of surgical matriculation.     

Psychometrics evaluation of Charcot‐Marie‐Tooth Neuropathy Score (CMTNSv2) second version,using Rasch analysis

Charcot‐Marie‐Tooth Neuropathy Score second version (CMTNSv2) is a validated clinical outcome measure developed for use in clinical trials to monitor disease impairment and progression in affected CMT patients. Currently, all items of CMTNSv2 have identical contribution to the total score. We used Rasch analysis to further explore psychometric properties of CMTNSv2, and in particular, category response functioning, and their weight on the overall disease progression. Weighted category responses represent a more accurate estimate of actual values measuring disease severity and therefore could potentially be used in improving the current version. Copyright © 2014 John Wiley & Sons, Ltd.     

持续改进护理在预防恶性肿瘤患者化疗期间外周置入中心静脉导管感染的效果观察

目的观察持续改进护理在预防恶性肿瘤患者化疗期间外周置入中心静脉导管（PICC）感染的疗效。方法采用回顾性对照研究,选择2012年1月至2012年12月123例PICC置管化疗的恶性肿瘤患者作为对照组,选取2013年1月至2013年12月129例PICC置管化疗的恶性肿瘤患者为观察组,比较持续改进护理前后护理人员PICC相关知识及处理能力改进情况,同时比较两组患者PICC置管期间感染发生率。结果持续改进护理实施后,本院肿瘤科护士PICC理论知识及感染处理能力均有显著提高,实施后与实施前比较差异具有统计学意义（P均〈0．05）。对照组PICC感染发生率为13．82％,观察组PICC感染发牛率为3．83％,两组比较差异具有统计学意义（x^2=4．100,P〈0．05）。结论应用持续改进护理循环管理模式,有利于减少和消除护理不当导致的PICC相关感染,具有较好的防控作用,为恶性肿瘤患者化疗的顺利完成创造了必要的条件。     

甲状腺手术喉返神经损伤原因分析及防治对策

目的:探讨甲状腺手术所致喉返神经(RLN)损伤的原因及预防措施。方法:回顾分析2000年—2005年420例甲状腺手术资料,对甲状腺病变的位置及手术方法与RLN损伤的关系进行比较分析。结果:发生不同程度声带麻痹21例,位于甲状腺背侧的病变RLN损伤率为14.29%,甲状腺腺叶切除RLN损伤率为12.5%,甲状腺次全切除RLN损伤率为2.27%。结论:甲状腺手术时喉返神经损伤与病变位置和手术方法明显相关;肿块位于甲状腺背侧和行甲状腺腺叶切除时,手术应常规显露RLN。甲状腺手术中喉返神经损伤与肿瘤位置和手术方式有关。