Depression differentially affects patient and caregiver perceptions of neuropsychiatric symptoms in Parkinson's disease.

OBJECTIVE: The aims of this study were twofold. First, we examined the relationship between patient and caregiver ratings of neuropsychiatric symptoms in Parkinson's disease (PD). Second, we examined if the severity of depressive symptoms affects patient and caregiver perceptions of other neuropsychiatric symptoms and contributes to discrepancies between their perceptions. METHOD: We examined data from a retrospective clinical cohort of 209 patients with PD and their caregivers. We used intra-class correlation coefficients and the Bland Altman method to assess intra-respondent (retrospective versus current) and inter-respondent (patient versus caregiver) agreement between Frontal Systems Behavior Scales (FrSBe) subscale scores. We then used generalized estimating equation models to examine FrSBe subscale scores and the magnitude of the intra- and inter-respondent discrepancies in FrSBe subscale scores, as a function of Beck Depression Inventory-2nd Edition scores, with patient demographic variable adjustments. RESULTS: There was low agreement between patient and caregiver ratings on all three subscales, at both time points, and high response variability within and between raters. Patients generally reported more severe neuropsychiatric symptoms than caregivers. Depression severity predicted patients' perceptions at both time points, but was more strongly associated with current perceptions. Depression severity predicted caregivers' current perceptions only. The inter-respondent discrepancy in perceived apathy and disinhibition, but not executive dysfunction, increased as a function of depression severity. CONCLUSIONS: There are differences in how patients with PD and caregivers perceive neuropsychiatric behaviors and the extent to which depressive symptoms influence their perceptions. Shared neuropathology and negative response biases likely contribute to these relationships.

Authoritative school climate and sexual harassment: A cross-sectional multilevel analysis of student self-reports.

School sexual harassment (SH) is defined as unwelcome behavior of a sexual nature that interferes with a student's ability to learn. There is an important need for schools to assess the prevalence of SH and its relation to school climate to guide intervention efforts. This study investigated 3 research questions: (a) Is there psychometric support for a 4-item multilevel measure of SH? (b) What is the prevalence of SH in a statewide high school sample, and how does SH vary across gender, grade level, race-ethnicity, and socioeconomic status? (c) Is an authoritative school climate-characterized by strict but fair discipline and supportive teacher-student relationships-associated with lower levels of SH for students? A statewide sample of high school students (N = 62,679) completed a school climate survey that included a new 4-item measure of SH. Results of a multilevel confirmatory factor analysis indicated good fit for a single SH factor at both student and school levels. A multiway analysis of variance demonstrated the high prevalence of SH and variations across demographic groups. Multilevel hierarchical regression analyses indicated that an authoritative school climate accounted for 5.7% of the student-level variance and 38.3% of the school-level variance in SH scores. Routine assessment of SH can help school psychologists bring attention to this underrecognized problem. (PsycINFO Database Record (c) 2019 APA, all rights reserved).