Jee-Seon Kim

Comparison of 5 Health-Related Quality-of-Life Indexes Using Item Response Theory Analysis:

Background. Five health-related quality-of-life (HRQoL) indexes—EQ-5D, HUI2, HUI3, QWB-SA, and SF-6D—are each used to assign community-based utility scores to health states, although these scores differ. Objective. The authors transform these indexes to a common scale to understand their interrelationships. Methods. Data were from the National Health Measurement Study, a telephone survey of 3844 US adults. The 5 indexes were analyzed using item response theory analysis to estimate scores on an underlying construct of summary health, θ. Unidimensionality was evaluated using nonlinear principal components analysis. Index scores were plotted against the estimated scores on the common underlying construct. In addition, scores on the Health and Activities Limitation Index (HALex), the Centers for Disease Control and Prevention Healthy Days questions, and self-rated health on a 5-category scale ranging from excellent to poor were plotted. Results. SF-6D and QWB-SA are nearly linear across the range of θ but with a shallow slope; EQ-5D, HUI2, and HUI3 are linear with a steep slope from low θ (poor health) into midrange of θ, then approximately linear with a less steep slope for higher θ (health just below to well above average), although the inflection points differ by index. Conclusion. Simple linear functions may serve as crosswalks among these indexes only for lower health states, albeit with low precision. Ceiling effects make crosswalks among most of the indexes ill specified above a certain level of health. Although each index measures generic health on a utility scale, these indexes are not identical but are relatively simply, if imprecisely, related.

Autism spectrum disorder in children and adolescents with fragile X syndrome: within-syndrome differences and age-related changes.

The Autism Diagnostic Interview-Revised (ADI-R) was used to examine diagnostic profiles and age-related changes in autism symptoms for a group of verbal children and adolescents who had fragile X syndrome, with and without autism. After controlling for nonverbal IQ, we found statistically significant between-group differences for lifetime and current autism symptoms for the Communication and Restricted Interests/Repetitive Behaviors domains, but not the Reciprocal Social Interaction domain. Effect sizes for differences in Reciprocal Social Interaction also were smaller than effect sizes for the other domains, with one exception. Overall, severity of autism symptoms improved with age for all participants, with the least improvement noted for Restricted Interests and Repetitive Behaviors. FMRP did not account for unique variance in autism symptoms over and above nonverbal IQ.

Collaboration in referential communication : Comparison of youth with down syndrome or fragile X syndrome

Referential communication was examined in youth with Down syndrome or fragile X syndrome in comparison to each other and to MA-matched typically developing children. A non-face-to-face task was used in which the participant repeatedly described novel shapes to listeners. Several dimensions of referential communication were especially challenging for the syndrome groups (i.e., they displayed below-MA performance), although there were differences in the dimensions that each syndrome group found to be most challenging. Independently assessed expressive language ability contributed to variations in referential performance, especially for participants with Down syndrome.

Does exercise induce hypoalgesia through conditioned pain modulation

Pain sensitivity decreases with exercise. The mechanisms that underlie this exercise-induced hypoalgesia (EIH) are unclear. Our purpose was to investigate conditioned pain modulation (CPM) as a potential mechanism of EIH. Sixteen women completed pain testing during three sessions: painful exercise, nonpainful exercise, and quiet rest. Intensity and unpleasantness ratings to noxious heat stimuli were assessed at baseline and during and following each session. Results showed that pain sensitivity decreased significantly during both exercise sessions (p < .05), but not during quiet rest. Effect size calculations showed that the size of the hypoalgesic response was greater following painful exercise than nonpainful exercise. Our results suggest that exercise-induced muscle pain may contribute to the magnitude of EIH. However, as pain sensitivity also decreased following nonpainful exercise, CPM is not likely the primary mechanism of EIH.

Signaling Noncomprehension of Language: A Comparison of Fragile X Syndrome and Down Syndrome

Signaling noncomprehension of the spoken messages of others was examined for youth with fragile X or Down syndrome in comparison with each other and nonverbal MA-matched typically developing children. A direction-following task was used in which some of the directions were inadequate. Both syndrome groups signaled noncomprehension less often than did the typically developing children. The ability to signal noncomprehension appropriately was related to a measure of receptive vocabulary and syntax. Preliminary analyses indicated that males with fragile X syndrome signaled noncomprehension less often than did their female peers, even after controlling for differences in nonverbal MA.

The Effects of Accommodations on Adolescents' Self-Efficacy and Test Performance

This study examined the effects of testing accommodations on eighth-grade students’ performance on large-scale achievement tests and also on their attitudes and reactions to the tests. Findings revealed significant differences in the ways students with and without disabilities experienced testing and how testing accommodations affected students’ attitudes toward and beliefs about the tests. Results suggested that (a) students with disabilities had significantly lower test-related self-efficacy than students without disabilities, (b) self-efficacy was positively correlated with test performance for all students, and (c) accommodations improved the test performance of all students and exerted a differential boost for students with disabilities on test-related self-efficacy and motivation. These findings suggest that testing accommodations may have a positive effect on students’ test performance by improving test-related self-efficacy and motivation, especially for students with learning disabilities. The implications of these findings for future research and practice concerning psychological aspects of testing are discussed.

Measurement and control of response styles using anchoring vignettes: a model-based approach.

Response styles are frequently of concern when rating scales are used in psychological survey instruments. While latent trait models provide an attractive way of controlling for response style effects (Morren, Gelissen, & Vermunt, 2011), the analyses are generally limited to accommodating only a small number of response style types. The use of anchoring vignettes provides an opportunity to overcome this limitation. In this article, a new latent trait model is introduced that uses vignette responses to measure and control for any form of response style. An illustration is provided with data from a cross-national study of self-reported conscientiousness by Mõttus, Allik, Realo, Pullman, et al. (2012).

Influence of exercise intensity for improving depressed mood in depression: a dose-response study

INTRODUCTION Exercise effectively improves mood in major depressive disorder (MDD), but the optimal exercise stimulus to improve depressed mood is unknown. PURPOSE To determine the dose-response relationship of acute exercise intensity with depressed mood responses to exercise in MDD. We hypothesized that the acute response to exercise would differ between light, moderate, and hard intensity exercise with higher intensities yielding more beneficial responses. METHODS Once weekly, 24 women (age: 38.6±14.0) diagnosed with MDD underwent a 30-minute session at one of three steady-state exercise intensities (light, moderate, hard; rating of perceived exertion 11, 13 or 15) or quiet rest on a stationary bicycle. Depressed mood was evaluated with the Profile of Mood States before, 10 and 30 minutes post-exercise. RESULTS Exercise reduced depressed mood 10 and 30 minutes following exercise, but this effect was not influenced by exercise intensity. Participants not currently taking antidepressants (n=10) had higher baseline depression scores, but did not demonstrate a different antidepressant response to exercise compared to those taking antidepressants. CONCLUSIONS To acutely improve depressed mood, exercise of any intensity significantly improved feelings of depression with no differential effect following light, moderate, or hard exercise. Pharmacological antidepressant usage did not limit the mood-enhancing effect of acute exercise. Acute exercise should be used as a symptom management tool to improve mood in depression, with even light exercise an effective recommendation. These results need to be replicated and extended to other components of exercise prescription (e.g., duration, frequency, mode) to optimize exercise guidelines for improving depression.

Psychobiological Responses to Preferred and Prescribed Intensity Exercise in Major Depressive Disorder.

Exercise acutely improves mood in major depressive disorder (MDD). However, it is unknown whether benefits differ depending on whether exercise intensity is self-selected or prescribed. PURPOSE This study aimed to compare psychological and biological responses to preferred and prescribed steady-state exercise intensities to a patient-selected preferred intensity. METHOD Female adults (N = 24, age = 38.6 ± 14.0 yr) diagnosed with MDD completed four 30-min sessions of cycling exercise at three prescribed intensities (RPE of 11, 13, and 15) and one session with a self-selected intensity (preferred). Order was randomized and counterbalanced. Depressed mood (DM) was evaluated before, 10 min, and 30 min postexercise using the Profile of Mood States. Serum brain-derived neurotrophic factor (BDNF) was measured before and within 10 min postexercise. Changes in BDNF and DM for the preferred session were compared with the following prescribed sessions: 1) performed at the most similar intensity (matched on RPE; closest) and 2) with the greatest improvement in DM (greatest). RESULTS Compared with the preferred session, improvement in DM was significantly larger after the greatest session (30 min postexercise: -11.8 ± 7.4 vs -3.4 ± 4.8), and the BDNF response was significantly greater after the closest session (5.4 ± 6.9 vs -1.4 ± 9.8 ng·mL). CONCLUSIONS Permitting patients to select their own exercise intensity did not maximize improvements in mood. Further, preferred intensity exercise was also associated with a smaller BDNF response. Overall, the results suggest that exercise undertaken to improve mood should be prescribed on an individual basis in MDD and not necessarily based on the patients preferred intensity. Clinicians, psychologists, and other practitioners should consider providing clear exercise intensity recommendations for symptom management in depression rather than allowing patients to self-select their intensity.

Investigating Stage-Sequential Growth Mixture Models with Multiphase Longitudinal Data

This article investigates three types of stage-sequential growth mixture models in the structural equation modeling framework for the analysis of multiple-phase longitudinal data. These models can be important tools for situations in which a single-phase growth mixture model produces distorted results and can allow researchers to better understand population heterogeneity and growth over multiple phases. Through theoretical and empirical comparisons of the models, the authors discuss strategies with respect to model selection and interpreting outcomes. The unique attributes of each approach are illustrated using ecological momentary assessment data from a tobacco cessation study. Transitional discrepancy between phases as well as growth factors are examined to see whether they can give us useful information related to a distal outcome, abstinence at 6 months postquit. It is argued that these statistical models are powerful and flexible tools for the analysis of complex and detailed longitudinal data.