Roger Booth

Higher resting heart rate variability predicts skill in expressing some emotions

Vagally mediated heart rate variability (vmHRV) is a measure of cardiac vagal tone, and is widely viewed as a physiological index of the capacity to regulate emotions. However, studies have not directly tested whether vmHRV is associated with the ability to facially express emotions. In extending prior work, the current report tested links between resting vmHRV and the objectively assessed ability to facially express emotions, hypothesizing that higher vmHRV would predict greater expressive skill. Eighty healthy women completed self-reported measures, before attending a laboratory session in which vmHRV and the ability to express six emotions in the face were assessed. A repeated measures analysis of variance revealed a marginal main effect for vmHRV on skill overall; individuals with higher resting vmHRV were only better able to deliberately facially express anger and interest. Findings suggest that differences in resting vmHRV are associated with the objectively assessed ability to facially express some, but not all, emotions, with potential implications for health and well-being.

Rasch analysis of the Perceived Stress Scale: Transformation from an ordinal to a linear measure:

Rasch analysis was conducted to enhance the precision of the widely used 10-item Perceived Stress Scale using two datasets (nu2009=u2009450 each) randomly selected from samples of the New Zealand general population (nu2009=u20091102), New Zealand university students (nu2009=u2009479) and US university students (nu2009=u2009396). The best Rasch model fit (χ2(27)u2009=u200929.92, pu2009=u2009.36), good person separation reliability (.80) and coverage (98%) of the sample by the scale items were achieved when locally dependent items were combined into subtests. These findings support reliability and internal structural validity of the 10-item Perceived Stress Scale. The instrument precision can be further improved using the ordinal-to-linear conversion tables published here.

Randomized clinical trial of expressive writing on wound healing following bariatric surgery.

Objective: Writing emotionally about upsetting life events (expressive writing) has been shown to speed healing of punch-biopsy wounds compared to writing objectively about daily activities. We aimed to investigate whether a presurgical expressive writing intervention could improve surgical wound healing. Method: Seventy-six patients undergoing elective laparoscopic bariatric surgery were randomized either to write emotionally about traumatic life events (expressive writing) or to write objectively about how they spent their time (daily activities writing) for 20 min a day for 3 consecutive days beginning 2 weeks prior to surgery. A wound drain was inserted into a laparoscopic port site and wound fluid analyzed for proinflammatory cytokines collected over 24 hr postoperatively. Expanded polytetrafluoroethylene tubes were inserted into separate laparoscopic port sites during surgery and removed after 14 days. Tubes were analyzed for hydroxyproline deposition (the primary outcome), a major component of collagen and marker of healing. Fifty-four patients completed the study. Results: Patients who wrote about daily activities had significantly more hydroxyproline than did expressive writing patients, t(34) = −2.43, p = .020, 95% confidence interval [−4.61, −0.41], and higher tumor necrosis factor–alpha, t(29) = −2.42, p = .022, 95% confidence interval [−0.42, −0.04]. Perceived stress significantly reduced in both groups after surgery. Conclusions: Expressive writing prior to bariatric surgery was not effective at increasing hydroxyproline at the wound site 14 days after surgery. However, writing about daily activities did predict such an increase. Future research needs to replicate these findings and investigate generalizability to other surgical groups.

Progress Testing for Medical Students at The University of Auckland: Results from The First Year of Assessments

Background Progress testing is a method of assessing longitudinal progress of students using a single best answer format pitched at the standard of a newly graduated doctor. Aim To evaluate the results of the first year of summative progress testing at the University of Auckland for Years 2 and 4 in 2013. SUBJECTS: Two cohorts of medical students from Years 2 and 4 of the Medical Program. Methods A survey was administered to all involved students. Open text feedback was also sought. Psychometric data were collected on test performance, and indices of reliability and validity were calculated. Results The three tests showed increased mean scores over time. Reliability of the assessments was uniformly high. There was good concurrent validity. Students believe that progress testing assists in integrating science with clinical knowledge and improve learning. Year 4 students reported improved knowledge retention and deeper understanding. Conclusion Progress testing has been successfully introduced into the Faculty for two separate year cohorts and results have met expectations. Other year cohorts will be added incrementally. Recommendation Key success factors for introducing progress testing are partnership with an experienced university, multiple and iterative briefings with staff and students as well as demonstrating the usefulness of progress testing by providing students with detailed feedback on performance.

Improving Measurement of Trait Competitiveness: A Rasch Analysis of the Revised Competitiveness Index With Samples From New Zealand and US University Students

Measuring competitiveness is necessary to fully understand variables affecting student learning. The 14-item Revised Competitiveness Index has become a widely used measure to assess trait competitiveness. The current study reports on a Rasch analysis to investigate the psychometric properties of the Revised Competitiveness Index and to improve its precision for international comparisons. Students were recruited from medical studies at a university in New Zealand, undergraduate health sciences courses at another New Zealand university, and a psychology undergraduate class at a university in the United States. Rasch model estimate parameters were affected by local dependency and item misfit. Best fit to the Rasch model (χ2(20)u2009=u200915.86, pu2009=u2009.73, person separation indexu2009=u2009.95) was obtained for the Enjoyment of Competition subscale after combining locally dependent items into a subtest and discarding the highly misfitting Item 9. The only modifications required to obtain a suitable fit (χ2(25)u2009=u200925.81, pu2009=u2009.42, person separation indexu2009=u2009.77) for the Contentiousness subscale were a subtest to combine two locally dependent items and splitting this subtest by country to deal with differential item functioning. The results support reliability and internal construct validity of the modified Revised Competitiveness Index. Precision of the measure may be enhanced using the ordinal-to-interval conversion algorithms presented here, allowing the use of parametric statistics without breaking fundamental statistical assumptions.

Using the Objective Borderline Method (OBM) to support Board of Examiners’ decisions in a medical programme

Abstract Decisions about progress through an academic programme are made by Boards of Examiners, on the basis of students’ course assessments. For most students such pass/fail grading decisions are straightforward. However, for those students whose results are borderline (either at a pass/fail boundary or boundaries between grades) the exercise of some discretion by university staff is required. In the interests of the transparency of the exercise of this discretion and to increase the chances that the ‘right’ decision is made, we tested the validity of the second version of the Objective Borderline Method (OBM2) decision-making tool in a medical programme. Our results suggest that application of OBM2 provides valid data to help university staff make robust decisions about a student’s progression through a programme, and with which to defend these decisions if that should be required.

A take-home placebo treatment can reduce stress, anxiety and symptoms of depression in a non-patient population

Background: With a healthcare system burdened by symptomatic and mental-health related conditions, the placebo effect may represent a useful clinical tool. First, however, there is a need to broaden research attention and investigate placebo effects outside laboratories and beyond experimental pain. This study investigated the effectiveness of a take-home placebo treatment in the short-term alleviation of stress, anxiety and symptoms of depression in a non-patient population. Method: A sample of 77 participants was randomized to either the ‘oxytocin’ treatment group (nu2009=u200922), the ‘serotonin’ treatment group (nu2009=u200922) or the wait-list control group (nu2009=u200933). The two treatment groups were given an ‘anti-stress treatment spray’ (placebo) to self-administer for 3 days, and completed online measures of perceived stress (Perceived Stress Scale-10), anxiety (Cognitive Somatic Anxiety Questionnaire) and symptoms of depression (Centre for Epidemiological Studies – Depression) before and after the 3-day protocol. Results: Both the ‘serotonin’ and ‘oxytocin’ treatment sprays were effective in reducing symptoms of depression; however, only those in the ‘oxytocin’ group reported less stress and anxiety as compared with controls. Overall, the ‘oxytocin’ was perceived as more effective. Conclusion: Placebo effects can be translated to a real-life setting in the short-term reduction of stress, anxiety and symptoms of depression in a non-patient population. In treating psychological distress, placebos may be useful addition to the treatment repertoire. The information given with treatment may also be an important consideration for practitioners.