Validity of In-Home Teleneuropsychological Testing in the Wake of COVID-19.

OBJECTIVE: Teleneuropsychology (TNP) has been shown to be a valid assessment method compared with in-person neuropsychological evaluations. Interest in delivering TNP directly to patients' homes has arisen in response to the coronavirus disease 2019 (COVID-19) pandemic. However, prior research has typically involved patients tested in clinical settings, and the validity of in-home TNP testing has not yet been established. The present study aims to explore the validity and clinical utility of in-home TNP testing in a mixed clinical sample in the wake of COVID-19. METHODS: Test profiles for 111 in-home TNP patients were retrospectively compared with 120 patients who completed in-person evaluations. The TNP test battery consisted of tests measuring attention/processing speed, verbal memory, naming, verbal fluency, and visuoconstruction. TNP scores of cognitively normal (CN) patients were compared with patients with neurocognitive disorders (NCD), and score profiles were examined among suspected diagnostic groups of Alzheimer's disease (AD), Parkinson's disease (PD), and vascular disease (VaD). RESULTS: TNP test scores did not significantly differ from in-person testing across all tests except the Hopkins Verbal Learning Test-Revised Discrimination Index. Within the TNP group, significant differences between the CN and NCD groups were found for all tests, and the memory and semantic fluency tests yielded large effect sizes (d ≥ 0.8). Score profiles among the AD, PD, and VaD groups were explored. CONCLUSIONS: These findings support the validity of in-home TNP testing compared with in-person neuropsychological testing. Practice considerations, limitations, and future directions are discussed.

Childhood obesity: survey of physician assessment and treatment practices.

BACKGROUND: This study examined physician experience with the 2007 Expert Committee Recommendations (ECR) on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity. METHODS: Pediatricians and family physicians (n = 194) practicing in the Midwest completed a survey designed to assess knowledge of, adherence to, and self-efficacy in implementing the 2007 Expert Committee recommendations. RESULTS: The majority of physicians (71%) were aware of the ECR and adhered to approximately 60% of the recommendations. Adherence was significantly higher for physicians who were aware of the ECR. Differences in awareness of and adherence to the ECR were noted among physician groups by specialty and location. Self-efficacy for assessing and treating pediatric obesity was significantly positively correlated with adherence to the ECR (Pearson r = 0.46). When asked for strategies that would facilitate improved pediatric weight management, physicians most often reported desiring to learn effective methods to increase patient motivation. CONCLUSIONS: Efforts to improve adherence to the Expert Committee recommendations should focus on improving physician awareness of and training in the use of the recommendations and on improved training and development of self-efficacy in pediatric weight assessment and patient counseling skills.

Self-report and startle-based measures of emotional reactions to body image cues as predictors of Drive for Thinness and Body Dissatisfaction in female college students.

The purpose was to compare self-report and psychophysiological assessment techniques in the measurement of emotional response to body image cues. Female college students (n=53; % Caucasian=53.6; M body mass index=26.1 kg/m²) completed the Eating Disorder Inventory (EDI-3) and viewed photos of themselves both unaltered and morphed to simulate weight gain. Response to the photos was assessed by self-report and the affect modulated startle paradigm. EDI-3 Drive for Thinness (DT) and Body Dissatisfaction (BD) scale scores were correlated with startled amplitude for the largest simulated weight gain photo. Startle eye blink amplitude predicted more variance in DT and BD subscales than self-reported response to the image. The affect modulated startle paradigm may provide unique information in the assessment of eating disorder symptomatology that cannot be captured via self-report techniques, and has potential to inform evaluation of treatment outcomes of eating and body image disorders.

Startle as an objective measure of distress related to teasing and body image.

OBJECTIVE: The startle reflex was used to assess negative emotion in response to body image cues in persons with and without body-related teasing histories. METHOD: Fifty-three female college students viewed photos of themselves both unaltered and morphed to look heavier and thinner. Participants with a teasing history were compared to participants without a teasing history on self-report measures and the affect modulated startle paradigm when viewing the photos. RESULTS: All participants, regardless of teasing history, self-reported that the photo morphed to look heaviest was more unpleasant than the neutral photo. When assessed by the affect modulated startle paradigm, a significant teasing history by photo interaction was found between the neutral and morphed to look heaviest photos and the neutral and morphed to look smallest photo. Those with a teasing history had greater startle response to the morphed images in comparison to the neutral images than did those without a teasing history. DISCUSSION: College-aged women with weight-related teasing histories may have negative emotional reactions to personally relevant body image cues, as measured by the startle reflex, even when they subjectively report no distress. Objective measures, such as the startle reflex should be considered when assessing emotional reactions to body image cues.

A motivational interviewing course for pharmacy students.

OBJECTIVE: To create, implement, and evaluate a pharmacy course on motivational interviewing. DESIGN: A 3-hour elective course was created to train doctor of pharmacy (PharmD) students in brief patient-centered motivational interviewing counseling strategies that have proven effective with the types of health issues most commonly addressed in pharmacy settings. Students were assisted in developing their skills through required readings, interactive lectures, in-class demonstrations and practice sessions, out of class skills practice, one-on-one supervision provided by doctoral level clinical health psychology students, and written reflections on each class session. ASSESSMENT: Students demonstrated significant improvement in motivational interviewing skills and a high level of motivation for and confidence in using these skills in their future practice. Students overall assessment of the course and supervision process was highly positive. CONCLUSION: This patient-centered counseling skills course was feasible and produced improvements in PharmD students' counseling skills and increased their motivation and confidence to use motivational interviewing skills in their future communications with patients.