Proper characterization of each individual's unique pattern of strengths and weaknesses requires good measures of diverse abilities. Here, we advocate combining our growing understanding of neural and cognitive mechanisms with modern psychometric methods in a renewed effort to capture human individuality through a consideration of specific abilities. We articulate five criteria for the isolation and measurement of specific abilities, then apply these criteria to face recognition. We cleanly dissociate face recognition from more general visual and verbal recognition. This dissociation stretches across ability as well as disability, suggesting that specific developmental face recognition deficits are a special case of a broader specificity that spans the entire spectrum of human face recognition performance. Item-by-item results from 1,471 web-tested participants, included as supplementary information, fuel item analyses, validation, norming, and item response theory (IRT) analyses of our three tests: (a) the widely used Cambridge Face Memory Test (CFMT); (b) an Abstract Art Memory Test (AAMT), and (c) a Verbal Paired-Associates Memory Test (VPMT). The availability of this data set provides a solid foundation for interpreting future scores on these tests. We argue that the allied fields of experimental psychology, cognitive neuroscience, and vision science could fuel the discovery of additional specific abilities to add to face recognition, thereby providing new perspectives on human individuality.
Five studies develop and validate the Self- and Other-Interest Inventory, an individual-difference measure of the motivation to act in one's own interest and the motivation to act in another's interest that measures these motivations at the level of self-beliefs. Study 1 demonstrates that self- and other-interest can be measured reliably and validly, as independent constructs, with a self-report measure. Study 2 develops a version of the Self- and Other-Interest Inventory for use with a general population and demonstrates systematic changes in the relation between self- and other-interest scores with age. Study 3 shows that self- and other-interest scores vary independently, as a function of the accessibility of related values. Study 4 provides evidence that self-interest scores predict behaviors that benefit the self and that other-interest scores predict behaviors that benefit another person. Finally, Study 5 demonstrates that in situations that involve a trade-off between the pursuit of self-interest and the pursuit of other-interest, such as the prisoner's dilemma, self- and other-interest scores contribute independently to behavioral prediction.
BackgroundMaintenance of mean arterial pressure (MAP) at levels sufficient to avoid tissue hypoperfusion is a key tenet in the management of distributive shock. We hypothesized that patients with distributive shock sometimes have a MAP below that typically recommended and that such hypotension is associated with increased mortality.MethodsIn this retrospective analysis of the Medical Information Mart for Intensive Care (MIMIC-III) database from Beth Israel Deaconess Medical Center, Boston, USA, we included all intensive care unit (ICU) admissions between 2001 and 2012 with distributive shock, defined as continuous vasopressor support for ≥ 6 h and no evidence of low cardiac output shock. Hypotension was evaluated using five MAP thresholds: 80, 75, 65, 60 and 55 mmHg. We evaluated the longest continuous episode below each threshold during vasopressor therapy. The primary outcome was ICU mortality.ResultsOf 5347 patients with distributive shock, 95.7%, 91.0%, 62.0%, 36.0% and 17.2%, respectively, had MAP < 80, < 75, < 65, < 60 and < 55 mmHg for more than two consecutive hours. On average, ICU mortality increased by 1.3, 1.8, 5.1, 7.9 and 14.4 percentage points for each additional 2 h with MAP < 80, < 75, < 65, < 60 and < 55 mmHg, respectively. Multivariable logistic modeling showed that, compared to patients in whom MAP was never < 65 mmHg, ICU mortality increased as duration of hypotension < 65 mmHg increased [for > 0 to < 2 h, odds ratio (OR) 1.76, p = 0.005; ≥ 6 to < 8 h, OR 2.90, p < 0.0001; ≥ 20 h, OR 7.10, p < 0.0001]. When hypotension was defined as MAP < 60 or < 55 mmHg, the associations between duration and mortality were generally stronger than when hypotension was defined as MAP < 65 mmHg. There was no association between hypotension and mortality when hypotension was defined as MAP < 80 mmHg.ConclusionsWithin the limitations due to the nature of the study, most patients with distributive shock experienced at least one episode with MAP < 65 mmHg lasting > 2 h. Episodes of prolonged hypotension were associated with higher mortality.Electronic supplementary materialThe online version of this article (10.1186/s13613-018-0448-9) contains supplementary material, which is available to authorized users.
BackgroundEngagement and training of educators in student mental health holds promise for promoting access to care as a task sharing strategy but has not been well-studied in low-income regions.MethodsWe used a prospective and convergent mixed methods design to evaluate a customized school mental health 2½ day training for teachers in rural Haiti (n = 22) as the initial component of formative research developing a school-based intervention to promote student mental health. Training prepared teachers to respond to student mental health needs by providing psychoeducational and practical support to facilitate access to care. We examined level of participation and evaluated feasibility, acceptability, and perceived effectiveness by calculating mean scores on self-report Likert-style items eliciting participant experience. We examined effectiveness of the training on improving mental health knowledge and attitudes by comparing mean scores on an assessment administered pre- and post-training. Finally, we examined self-report written open-ended responses and focus group discussion (FGD) interview data bearing on perceived feasibility, acceptability, and effectiveness to contextualize participant ratings of training and to identify recommendations for enhancing the utility of mental health training locally for educators.ResultsMean scores of knowledge and attitudes significantly improved between the pre-test and post-tests; e.g., knowledge improved from 58% correct at baseline to 68% correct on the second post-test (p = 0.039). Mean ratings of the training were favorable across all categories and FGD data demonstrated widespread participant endorsement of training acceptability and effectiveness; participants recommended extending the duration and number of training sessions.ConclusionsFindings support feasibility, acceptability, and a limited scope of effectiveness of brief mental health training for secondary school teachers in Haiti. Further development of approaches to engage teachers in promoting school mental health through training is warranted.
Background The mental health treatment gap for youth in low- and middle-income countries (LMICs) is substantial; strategies for redress are urgently needed to mitigate the serious health and social consequences of untreated mental illness in youth. Aims To estimate the burden of major depressive episode (MDE) and posttraumatic stress disorder (PTSD) as well as utilization of care among Haitian youth in order to describe the mental health treatment gap in a LMIC setting. Methods We estimated the point prevalence of MDE, PTSD, and subthreshold variants in a school-based sample of youth (n=120, ages 18–22) using a modified SCID-based interview and examined treatment utilization among those receiving one of these diagnoses. We assessed additional psychopathology with self-report measures to examine validity of study diagnostic assignments. Results The combined prevalence of full-syndrome or subthreshold MDE or PTSD was high (36.7%). A large majority of affected individuals (88.6%) had accessed no mental health services in the health sector and 36.4% had accessed no care of any kind in either the health or folk sectors in the past year. Conclusions Findings demonstrate a high mental health burden among Haiti’s youth and that many youth with MDE and PTSD are not accessing mental health care.
This study investigates the separate and joint effects of the inclusion of experts and collaborative planning on the performance of analytic teams. Teams either did or did not include members with expert-level task-relevant cognitive abilities, and either did or did not receive an intervention that fostered collaborative planning. Results support the authors' hypothesis that analytic performance requires both task-appropriate expertise and collaborative planning to identify strategies for optimally using that expertise. Indeed, high expertise in the absence of collaborative planning actually decreased team performance. Teams engaging in collaborative planning were more likely to effectively integrate their information on key aspects of the analytic problem, which significantly enhanced their analytic performance. Furthermore, information integration mediated the effects of the interaction of expertise and collaboration on performance. The implications of the findings for the optimal use of team member skills and the development of team performance strategies are discussed.
BACKGROUND: Brexanolone injection (BRX) was approved by the FDA in 2019 for the treatment of adult patients with postpartum depression (PPD), but its cost-effectiveness has not yet been evaluated. OBJECTIVE: To estimate the cost-effectiveness of BRX compared with treatment with selective serotonin reuptake inhibitors (SSRIs) for PPD. METHODS: We projected costs (2018 U.S. dollars) and health (qualityadjusted life-years [QALYs]) for mothers treated with BRX or SSRIs and their children. A health state transition model projected clinical and economic outcomes for mothers based on the Edinburgh Postnatal Depression Scale, from a U.S. payer perspective. The modeled population consisted of adult patients with moderate to severe PPD, similar to BRX clinical trial patients. Short-term efficacy for BRX and SSRIs came from an indirect treatment comparison. Long-term efficacy outcomes over 4 weeks, 11 years (base case), and 18 years were based on results from an 18-year longitudinal study. Maternal health utility values came from analysis of trial-based short-form 6D responses. Other inputs were derived from the literature.RESULTS: The incremental cost-effectiveness ratio for BRX versus SSRIs was $106,662 per QALY gained over an 11-year time horizon.
People tend not to recognize bias in their judgments. Such "bias blindness" persists, we show, even when people acknowledge that the judgmental strategies preceding their judgments are biased. In Experiment 1, participants took a test, received failure feedback, and then were led to assess the test's quality via an explicitly biased strategy (focusing on the test's weaknesses), an explicitly objective strategy, or a strategy of their choice. In Experiments 2 and 3, participants rated paintings using an explicitly biased or explicitly objective strategy. Across the three experiments, participants who used a biased strategy rated it as relatively biased, provided biased judgments, and then claimed to be relatively objective. Participants in Experiment 3 also assessed how biased they expected to be by their strategy, prior to using it. These pre-ratings revealed that not only did participants' sense of personal objectivity survive using a biased strategy, it grew stronger.
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