Personal Symbolism in Language Patterns†

With increasing emphasis on understanding genetic contribution to disease, inclusion of all racial and ethnic groups in molecular genetic research is necessary to ensure parity in distribution of research benefits. Blacks are underrepresented in large-scale genetic studies of psychiatric disorders. In an effort to understand the reasons for the underrepresentation, this study explored black participants' attitudes towards genetic research of psychiatric disorders. Twenty-six adults, the majority of whom were black (n = 18) were recruited from a New York City community to participate in six 90-minute focus groups. This paper reports findings about respondents' understanding of genetics and genetic research, and opinions about psychiatric genetic research. Primary themes revealed participants' perceived lack of knowledge about genetics, concerns about potentially harmful study procedures, and confidentiality surrounding mental illness in families. Participation incentives included provision of treatment or related service, monetary compensation, and reporting of results to participants. These findings suggest that recruitment of subjects into genetic studies should directly address procedures, privacy, benefits and follow-up with results. Further, there is critical need to engage communities with education about genetics and mental illness, and provide opportunities for continued discussion about concerns related to genetic research.     

Factors associated with parent views about participation in infant MRI research provide guidance for the design of the Healthy Brain and Child Development (HBCD) study

PurposeThe National Institutes of Health announced the Healthy Brain and Child Development (HBCD) study to further understanding of infant brain development. This study examined perceptions and knowledge about research among the demographic groups to be studied in HBCD.Method1164 participants (n = 548 pregnant people and 616 mothers of infants < 12 months) completed anonymous, on-line surveys. Domains included research literacy, MRI knowledge, and attitudes about research incentives and biospecimen collection. Logistic regression was used to examine factors related to outcome variables.ResultsKnowledge of MRI safety was low and research literacy was high across participants. Likelihood of participation given various incentives differed between participants. Those with lower education were less likely to rate any items as increasing likelihood of participation. Substance use during pregnancy improved the model fit only for items about alternate visit structures (home and telephone visits) and confidentiality.ConclusionOverall results support the feasibility of infant imaging studies, such as HBCD with respondents having high research literacy and interest in learning about their baby’s development. Educating potential participants about MRI safety and providing flexible incentives for participation will improve the success of infant MRI studies.     

Consumer views of representative payee use of disability funds to leverage treatment adherence

OBJECTIVE: Although representative payee arrangements are common among people with psychiatric disabilities, only a small body of research has investigated how consumers feel about representative payees' use of disability funds to attempt to improve treatment adherence. METHODS: Consumers who were in treatment for a recently documented diagnosis of schizophrenia or a related disorder (N=104) were interviewed to assess their perceptions of the use of disability funds and other legal pressures to attempt to improve treatment adherence. RESULTS: Most consumers in the sample (65 percent) did not agree that withholding money was a useful method to improve treatment adherence. Multivariate analyses indicated that participants were more likely to agree that use of money as leverage was helpful if they also felt that other legal pressures were helpful for improving adherence and if they felt free to do as they wanted regarding their mental health treatment. On the other hand, participants were less likely to endorse the benefits of money used as leverage if they had at least a high school education and if they reported abusing substances in the past month. CONCLUSIONS: The results of this study point to factors that mediate the potentially negative effects of perceived coercion that are sometimes associated with representative payee arrangements. Leverage of disability funds will likely have an optimal effect if combined with efforts to enhance a sense of self-determination. Conversely, consumers with more education may be less open to this practice, possibly because of perceived stigma related to not being able to control their own finances.     

以问题为基础教学法对提高脑血管病方向研究生科研能力的作用

目的 探讨以问题为基础教学法（problem-based learning，PBL）的教学模式在传统教学模式基础上对脑血管病专业硕士研究生科研设计能力提高的作用。      

Clinical research participation among aging adults enrolled in an Alzheimer's Disease Center research registry

In light of our limited understanding of what motivates older adults to participate in clinical studies of Alzheimer's disease (AD), the current study examines incentives and barriers to participating in AD clinical research among older adults. 235 participants enrolled in the Boston University Alzheimer's Disease Center research registry (75 ± 8 years, range 58-99 years, 60% female), a longitudinal registry from which individuals are recruited into other clinical studies, completed a survey assessing registry participation satisfaction, religiousness, trust in healthcare institutions, and medical research attitudes. Most participants reported initially enrolling in the registry for societal benefit. Insufficient time was a commonly endorsed barrier to enrolling in other Center-approved studies, particularly among younger participants. Driving and a lack of transportation to the medical facility were also barriers, particularly for older participants. Transportation was the most popular incentive, followed by home-based visits (particularly for older participants and participants with less formal education) and compensation (particularly among respondents from racial/ethnic minority groups). Participation interest in other studies was associated with favorable medical research attitudes (r = 0.34, p = 0.00003) but not religiousness (r = -0.09, p = 0.21), or trust in healthcare institutions (r = 0.09, p = 0.17). Among older adults, societal benefit is a motivating factor for registry enrollment; however, participation in additional studies is hindered by insufficient time among younger participants and transportation barriers among older participants. Providing transportation, home-based visits, and modest compensation may improve participation rates. Furthermore, favorable attitudes toward medical research are strongly associated with interest in enrolling in additional studies and may serve as a beneficial outreach triage technique.     

Fostering hand washing before lunch by students attending a special needs young adult program

A multiple baseline across groups design was used to investigate the effects of a treatment package on hand washing before lunch by five students with disabilities who attended a young adult educational program. To evaluate hand washing, a lotion called Glo Germ was applied to participants’ hands. Glo Germ is visible under a black light, which allowed the quality of hand washing to be assessed by comparing the amount visible before and after hand washing using a 3-point scale. Following a baseline period in which hand washing was assessed, participants were exposed to a hand washing training procedure, which improved one participant's hand washing. Next, a lottery system was imposed in which the number of lottery tickets earned each day depended on the quality of hand washing, specifically, on the rating assigned (0, 1, or 2). This condition was associated with improved hand washing by the other four participants. Finally, a condition adding feedback to the lottery system resulted in further improvements in the quality of hand washing for all participants. Follow up data indicated modest maintenance of hand washing after lunch. These results suggest that treatment packages similar to that used in the present study merit further investigation and that Glo Germ is of value in ascertaining the quality of hand washing.     

The role of monetary incentives in feedback processing: why we should pay our participants

Performance monitoring has been associated with two event-related potentials. The feedback-related negativity reflects a reinforcement-learning signal leading to remedial action, whereas the P3 reflects the motivational significance of feedback outcomes. Till date, research has focused on how these components are influenced by different outcomes within a range of the same, usually monetary, feedback type. This study examined how different feedback types (monetary vs. nonmonetary) influence these two components. Participants performed a time-estimation task under a monetary and a nonmonetary condition. Larger feedback-related negativities, better overall performance, and smaller behavioral adjustments were found under the monetary condition. Larger P3 amplitudes were present under the monetary condition and in response to positive outcomes. Condition order influenced only the P3. Addition of financial incentives increased the P3 amplitude, whereas removal of financial incentives did not alter the P3 amplitude. The results suggest that individuals were more reluctant to commit errors under the monetary condition as evidenced by more pronounced reinforcement-learning signals and better overall performance. Positive outcomes under this condition were most salient as indicated by larger P3s.     

Fostering hand washing before lunch by students attending a special needs young adult program

A multiple baseline across groups design was used to investigate the effects of a treatment package on hand washing before lunch by five students with disabilities who attended a young adult educational program. To evaluate hand washing, a lotion called Glo Germ was applied to participants' hands. Glo Germ is visible under a black light, which allowed the quality of hand washing to be assessed by comparing the amount visible before and after hand washing using a 3-point scale. Following a baseline period in which hand washing was assessed, participants were exposed to a hand washing training procedure, which improved one participant's hand washing. Next, a lottery system was imposed in which the number of lottery tickets earned each day depended on the quality of hand washing, specifically, on the rating assigned (0, 1, or 2). This condition was associated with improved hand washing by the other four participants. Finally, a condition adding feedback to the lottery system resulted in further improvements in the quality of hand washing for all participants. Follow up data indicated modest maintenance of hand washing after lunch. These results suggest that treatment packages similar to that used in the present study merit further investigation and that Glo Germ is of value in ascertaining the quality of hand washing.     

Do Noncontingent Incentives Increase Survey Response Rates among Mental Health Providers? A Randomized Trial Comparison

Surveys can be a useful tool for mental health services research. Unfortunately, clinicians typically show low response rates to surveys. To determine whether noncontingent incentives would increase responses among clinicians, we compared no incentive versus four incentives (mood magnet, $1, $2, $5) on response to a 7-page self-report survey of mental health assessment and treatment practices in a sample of 500 clinicians from the 5 largest professional guilds. Noncontingent monetary incentives significantly increased response rate compared to no incentive across all disciplines. Noncontingent monetary incentives are discussed as a cost-effective method for increasing survey response rate among mental health clinicians.     

Reward circuitry function in autism spectrum disorders

Social interaction deficits and restricted repetitive behaviors and interests that characterize autism spectrum disorders (ASDs) may both reflect aberrant functioning of brain reward circuits. However, no neuroimaging study to date has investigated the integrity of reward circuits using an incentive delay paradigm in individuals with ASDs. In the present study, we used functional magnetic resonance imaging to assess blood-oxygen level-dependent activation during reward anticipation and outcomes in 15 participants with an ASD and 16 matched control participants. Brain activation was assessed during anticipation of and in response to monetary incentives and object image incentives previously shown to be visually salient for individuals with ASDs (e.g. trains, electronics). Participants with ASDs showed decreased nucleus accumbens activation during monetary anticipation and outcomes, but not during object anticipation or outcomes. Group × reward-type-interaction tests revealed robust interaction effects in bilateral nucleus accumbens during reward anticipation and in ventromedial prefrontal cortex during reward outcomes, indicating differential responses contingent on reward type in these regions. Results suggest that ASDs are characterized by reward-circuitry hypoactivation in response to monetary incentives but not in response to autism-relevant object images. The clinical implications of the double dissociation of reward type and temporal phase in reward circuitry function in ASD are discussed.     

Voucher-based incentives for naltrexone treatment attendance in schizophrenia and alcohol use disorders

OBJECTIVE: This study assessed the feasibility of voucher-based incentives for attendance for directly observed naltrexone treatment in a controlled trial for alcohol use disorders in schizophrenia. METHODS: Cash-value voucher-based incentives were contingent on attendance at three research visits per week over 12 weeks for 61 participants. Vouchers increased in value based on consecutive attendance. Missed visits resulted in reduction of voucher value. RESULTS: Participants attended 82% of all research visits. Average value of vouchers earned was $330 (78% of the maximum possible). Psychotic symptom severity at baseline did not affect the utilization of vouchers, and 94% of participants perceived the incentive system as helpful. CONCLUSIONS: The incentive system was well accepted and used despite psychosis severity, and the attendance rate was high, although causality between incentives and attendance could not be examined. A voucher-based incentive system for attendance can be successfully applied in a clinical trial for alcohol dependence treatment in schizophrenia.     

Incentive contracting in mental health: State and local relations

One of the problems of mental health care in the 1970s and 1980s is dollars not following patients. One factor contributing to this alleged mismatch in funds is that many states have provided public mental hospital services to localities as a free good. In an effort to reduce the use of state mental hospitals, a number of states have recently introduced payment incentives. This paper presents a framework for considering the likely effects of these incentives.This research was supported in part by Grant No. 1 R29 MH45841-01 from the National Institute of Mental Health.     

Recruitment for genetic studies of epilepsy

Virtually nothing has been published about recruitment of adults with sporadic temporal lobe epilepsy (TLE) for genetic studies. We examined eligibility, recruitment, participation rates, and reasons for exclusion in a genetic study of TLE. Participants with non-acquired TLE with onset ≤35 were recruited through review of records and screening of incoming patients at Columbia University Medical Center (CUMC). Eligible patients were asked to participate in an interview about seizures and give a blood sample for DNA extraction. Medical records were sought for each participant. Of 2974 patients screened 252 (8.5%) were eligible, and 40 (15.9% of eligible) participated. Leading reasons for ineligibility included an antecedent cause of epilepsy, syndrome other than TLE, and seizure onset after age 35. Those declining participation cited concerns about confidentiality, lack of compensation, and fear of phlebotomy. Although TLE is common and patients were recruited from a major surgical epilepsy center, a small proportion of potential participants participated. Large numbers need to be screened to reach the target sample size. Obtaining permission from treating physicians to contact their patients directly can improve recruitment. Saliva DNA collection, monetary incentives and patient education can improve participation. This information can facilitate study design in epilepsy genetics.     

Immediate effects of group-based wellness drumming on affective states in university students

Researchers have found recreational music making to have positive impacts and that active music-making may have benefits that extend beyond passive music listening or receptive music-based interventions. The purpose of this study was to determine the immediate effects of a single 45-min group-based wellness drumming session on the affective states of university students. Participants (N = 50) were undergraduate and graduate university students from a variety of majors. Students in beginning classical guitar classes served as control participants. Experimental participants received a 45-min group-based wellness drumming protocol. The researchers utilized the Quick Mood Scale at pre- and posttest to assess a number of state affective components and collected qualitative data in the form of post-session comments to determine participants’ perceptions of the wellness drumming intervention. Results indicated statistically significant between-group posttest differences for wide awake/drowsy, relaxed/anxious, cheerful/depressed, friendly/aggressive, and clear-headed/confused. In all affective variables, the experimental condition had higher posttest means than the control condition. General results of this controlled effectiveness study tended to support the use of group wellness drumming based on the specific wellness drumming protocol for university students. Implications for on-campus wellness programs, limitations of the study, and suggestions for future research are included.     

Predictors of Psychology Graduate Student Interest in the Field of Developmental Disabilities

This study examined predictors of interest in the future provision of clinical services to people with developmental disabilities by Canadian graduate students in psychology. Utilizing a cross-sectional survey, 458 psychology students from clinical, clinical neuropsychology, and counseling psychology programs from across Canada provided information on their interest in working with the population, their formal training experiences within the university, and their experiences outside the university. Formal training in school and informal experiences in the community were significant predictors of students' intention to work with clients with a developmental disability. The implications of these findings for training programs are discussed.     

The influence of emotion regulation on decision-making under risk

Cognitive strategies typically involved in regulating negative emotions have recently been shown to also be effective with positive emotions associated with monetary rewards. However, it is less clear how these strategies influence behavior, such as preferences expressed during decision-making under risk, and the underlying neural circuitry. That is, can the effective use of emotion regulation strategies during presentation of a reward-conditioned stimulus influence decision-making under risk and neural structures involved in reward processing such as the striatum? To investigate this question, we asked participants to engage in imagery-focused regulation strategies during the presentation of a cue that preceded a financial decision-making phase. During the decision phase, participants then made a choice between a risky and a safe monetary lottery. Participants who successfully used cognitive regulation, as assessed by subjective ratings about perceived success and facility in implementation of strategies, made fewer risky choices in comparison with trials where decisions were made in the absence of cognitive regulation. Additionally, BOLD responses in the striatum were attenuated during decision-making as a function of successful emotion regulation. These findings suggest that exerting cognitive control over emotional responses can modulate neural responses associated with reward processing (e.g., striatum) and promote more goal-directed decision-making (e.g., less risky choices), illustrating the potential importance of cognitive strategies in curbing risk-seeking behaviors before they become maladaptive (e.g., substance abuse).     

Adaptive neural reward processing during anticipation and receipt of monetary rewards in mindfulness meditators

Reward seeking is ubiquitous and adaptive in humans. But excessive reward seeking behavior, such as chasing monetary rewards, may lead to diminished subjective well-being. This study examined whether individuals trained in mindfulness meditation show neural evidence of lower susceptibility to monetary rewards. Seventy-eight participants (34 meditators, 44 matched controls) completed the monetary incentive delay task while undergoing functional magnetic resonance imaging. The groups performed equally on the task, but meditators showed lower neural activations in the caudate nucleus during reward anticipation, and elevated bilateral posterior insula activation during reward anticipation. Meditators also evidenced reduced activations in the ventromedial prefrontal cortex during reward receipt compared with controls. Connectivity parameters between the right caudate and bilateral anterior insula were attenuated in meditators during incentive anticipation. In summary, brain regions involved in reward processing—both during reward anticipation and receipt of reward—responded differently in mindfulness meditators than in nonmeditators, indicating that the former are less susceptible to monetary incentives.     

Descriptive Characteristics and Initial Psychometric Properties of the Non-Suicidal Self-Injury Disorder Scale

Non-suicidal self-injury (NSSI) is highly prevalent and associated with tissue damage, emotional distress, and psychiatric disorders. While often discussed in the context of Borderline Personality Disorder and suicide, research demonstrates that NSSI is distinct from these constructs and should be viewed as an independent diagnostic category. Recently, Non-Suicidal Self-Injury Disorder (NSSID) was included in the revised Diagnostic and Statistical Manual of Mental Disorders as a condition for further study. In this article, we describe the properties of a self-report measure designed to assess proposed criteria for NSSID. Undergraduate students at 2 large, public universities completed the NSSID Scale (NSSIDS) along with other measures of NSSI characteristics and psychopathology. Among participants with a history of NSSI, approximately half (54.55%) met diagnostic criteria for NSSID. Participants were most frequently excluded from an NSSID diagnosis on the basis of criterion A (frequency of NSSI) and criterion E (distress or impairment related to NSSI), while participants were least likely to be excluded from diagnosis on the basis of criterion D (NSSI method exclusions) and criterion F (diagnostic “rule-outs”). Consistent with previous literature, the most commonly reported precipitants to NSSI were negative feelings or thoughts (criterion C2). Participants who met criteria for NSSID reported more severe depression, anxiety, and NSSI than participants who engaged in NSSI but did not meet criteria for NSSID. These results support the use of the NSSIDS as a reliable and valid self-report measure of NSSID symptoms.     

Institutional affiliations of authors publishing research in Australian developmental disabilities journals

Research can contribute significantly to the improvement of services for persons with developmental disabilities. Therefore, it is important to document trends in the field of developmental disability research. Affiliations of authors publishing in Australian journals over several years were recorded to document the most productive centres of developmental disabilities research. Research on developmental disabilities emanated from a variety of centres in several countries. The 19 most productive centres were primarily universities in Australia, New Zealand, and the United States of America. This initial attempt to document trends in Australian developmental disability research may prove useful to granting agencies, service providers, and prospective graduate students.     

Stigmatization of People with Schizophrenia: Perspectives of Graduate Students in Various Healthcare Fields

Healthcare professionals exhibit stigmatization toward people with schizophrenia, which is an internationally recognized problem. This can negatively impact healthcare of people with schizophrenia. Research has shown that nursing and medical students also have stigmatizing attitudes toward individuals with schizophrenia. However, there has been little research examining graduate students in other healthcare professions. These students are important to assess because they are likely to encounter individuals with schizophrenia in their work. This study examined 113 graduate students in psychology, physical therapy, and occupational therapy programs. Students completed the Depression Anxiety Stress Scale, General Self-Efficacy Scale, and Satisfaction with Life Scale, both about themselves and what they believed a person in a narrative with schizophrenia might experience. Students from all programs engaged in stereotyping behavior. Students studying psychology, however, exhibited lower stigmatization compared to other students. This may be due to psychology students’ increased education and experience with people with schizophrenia.