Cross-Validation of the Financial Exploitation Vulnerability Scale.

OBJECTIVES: The present study is a cross-validation of the Financial Exploitation Vulnerability Scale (FEVS), a measure of contextual risk for financial exploitation. METHODS: The sample was drawn from both the community and the SAFE program, a service for older adults who have been financially scammed. FEVS was administered within a larger assessment battery. The total score ability to differentiate exploitation groups and its correlates were examined. ROC analysis and logistic regression evaluated the clinical utility of the FEVS to detect exploitation. Results were compared to the initial validation study. RESULTS: FEVS score was significantly higher for those who were exploited and correlated with age. ROC analysis revealed adequate detection of financial exploitation. FEVS total score remained a strong predictor of exploitation when compared to demographic factors and several measures of cognitive functioning. CONCLUSIONS: Cross-validation demonstrates strong evidence that the FEVS detects financial exploitation in older adults, beyond the ability of many known risk factors. CLINICAL IMPLICATIONS: FEVS is an evidence-based tool for identifying exploitation and is accessible to many professionals working with older adults. Items query contextual factors that allow professionals to support clients with the appropriate standard of care.

Suffering in children and adolescents in paediatric palliative care in Spain: psychometric properties of the qESNA scale.

OBJECTIVE: To analyze the psychometric properties of the qESNA scale and its usefulness to assess the suffering of paediatric patients with life-limiting and/or life-threatening diseases (children with LLTC) in clinical practice. METHODS: Cross-sectional and longitudinal study in 58 patients in Spain (female, 32.8%; mean age, 15.6 [SD, 4.5]; age range, 8-23 years), with administration of the qESNA scale along with other scales to assess anxiety, depression, emotion regulation and psychosocial functioning. We performed exploratory and confirmatory factor analyses and calculated goodness-of-fit indices were calculated; we assessed reliability by means of the Cronbach alpha and temporal stability and convergent validity through the intraclass correlation coefficient with scales used to assess psychological disorders and the specificity and sensitivity through ROC curves. RESULTS: The factor analysis identified a 14-item scale with 3 factors, a comparative fit index of 0.93, a Tucker-Lewis index of 0.91 and a root mean square error of approximation of 0.07. The Cronbach alpha was 0.85 and the intraclass correlation coefficient was 0.66. The convergent validity was high for the correlation to the risk of depression (-0.69) and of anxiety (-0.60) and emotional changes (-0.59). The analysis of the ROC curves showed that a score of less than 81 would be indicative of suffering, with a sensitivity of 83.33% and a specificity of 93.48%. CONCLUSIONS: This study confirmed that the psychometric properties of the qESNA scale are good and the scale's usefulness as an instrument to detect emotional suffering in children with life-limiting or life-threatening illnesses in clinical practice.

Psychological Assessment in Anorexia Nervosa: A Single Case Study on Predictive Factors of Dropout.

Anorexia nervosa (AN) has the highest mortality rate among psychiatric disorders. Adult AN patients have a chronic history of treatment dropout due to denial of their psychological and physical disease states, which may be connected to defense mechanisms. We developed an assessment protocol to evaluate the psychological functioning of patients undergoing a psychodynamic approach for eating disorders (PAED), aimed at identifying the psychological factors associated with intervention success or dropout. We analyzed the case of an adult patient who quit treatment at the start and discussed her psychological functioning profile. We present the case of a 45-year-old woman with enduring AN, who entered the PAED program at an Italian hospital. In adult AN patients, denial and acting out may have significant impacts on clinic compliance. This hampers establishing a relationship with the clinic and the success of the psychological work aimed at promoting mental awareness and insights into the disorder. This highlights the need to consider which aspects of the initial psychological assessment are predictive of dropout in AN patients.

Evaluating Adolescent Patient Outcomes and Staff Member Injuries at a General Psychiatric Inpatient Unit.

Short-term pediatric psychiatric hospitalization is used to manage acute-crisis behaviors. Few studies have detailed their clinical model and key metrics such as patient behavioral health outcomes and staff experience. This study describes a model which emphasizes group therapy based on dialectical behavior therapy during brief inpatient stays (average length of stay of 8 days). The study variables assessed included patient symptoms of depression, anxiety, and anger at discharge, patient satisfaction, and staff safety. The program produced significant improvements in adolescent depression, anxiety, and anger, and patients reported high satisfaction with the services received. However, there was a high rate of staff injuries, correlated with staffing ratios and the time of day. The key findings from this study demonstrate the effectiveness of brief inpatient programs and highlight variables that may impact staff experiences on these units, which could serve as further discussion points to improve clinical care.

A questionnaire on the current situation of resignation intention of nurses in intensive care units in China - A descriptive quantitative study.

AIM: This study analysed and summarized the correlation between various indicators of ICU nurses' personal lives, hospital work situation, social opinion, psychological assessment, and their intention to resign. DESIGN: A descriptive quantitative study. METHODS: This study was a multicentre questionnaire on factors influencing intensive care unit (ICU) nurses' intention to resign. This study was completed through the Critical Care E Institute (CCEI) and China Calm Therapy Research Group Academic Organization (CNCSG) by contacting ICU nurses in three hospitals in 34 provinces in China. The questionnaire was in the form of a cell phone WeChat scan code. The survey included 22 indicators, including basic information about nurses (marital and child status, personal income, etc.), hospital work (weekly working hours, night shift, hospital environment, etc.), and psychological symptoms. RESULTS: A total of 1904 nurses were included in this study. Among them, 1060 (55.67%) had the intention to resign. In this study, among the 22 indicators involved, 16 factors, including hospital work hours, job title, satisfaction with current income, having children, and evaluation of the hospital, significantly impact nurses' intentions to resign (all p < 0.05). Logistic regression analysis showed that six indicators influenced nurses' choice of resignation intention (all p < 0.05), including hospital work time, professional title, income satisfaction, hospital work pride, satisfaction of nurses with the compassion and care given to them by their hospitals, and career vision score. The ROC curve showed that all six indicators were <0.70, but the model receiver operating characteristic (ROC) curve constructed for the indicators was 0.756. In China, increasing the income of ICU nurses, fostering pride in hospital work, reducing working hours, ensuring smooth promotion processes, and enhancing career prospects can all decrease their likelihood of choosing to resign. Absorbing practical nursing management and work experience from other countries will help decrease the intention to resign within this group. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Using the multidimensional nominal response model to model faking in questionnaire data: The importance of item desirability characteristics.

Faking in self-report personality questionnaires describes a deliberate response distortion aimed at presenting oneself in an overly favorable manner. Unless the influence of faking on item responses is taken into account, faking can harm multiple psychometric properties of a test. In the present article, we account for faking using an extension of the multidimensional nominal response model (MNRM), which is an item response theory (IRT) model that offers a flexible framework for modeling different kinds of response biases. Particularly, we investigated under which circumstances the MNRM can adequately adjust substantive trait scores and latent correlations for the influence of faking and examined the role of variation in the way item content is related to social desirability (i.e., item desirability characteristics) in facilitating the modeling of faking and counteracting its detrimental effects. Using a simulation, we found that the inclusion of a faking dimension in the model can overall improve the recovery of substantive trait person parameters and latent correlations between substantive traits, especially when the impact of faking in the data is high. Item desirability characteristics moderated the effect of modeling faking and were themselves associated with different levels of parameter recovery. In an empirical demonstration with N = 1070 test-takers, we also showed that the faking modeling approach in combination with different item desirability characteristics can prove successful in empirical questionnaire data. We end the article with a discussion of implications for psychological assessment.

Psychometric validation of the Italian Self-Report Symptoms inventory (SRSI): Factor structure, construct validity, and diagnostic accuracy.

The Self-Report Symptom Inventory (SRSI) is a novel tool designed to detect symptom overreporting and other forms of noncredible responding. Unlike existing scales, the SRSI includes genuine and pseudosymptoms scales covering cognitive, affective, motor, pain, and post-traumatic stress disorder domains. The present study aims to investigate the psychometric properties of the Italian Version of the SRSI (SRSI-It), in particular, its factor structure, reliability, convergent and discriminant validity, and diagnostic accuracy. Data from 1180 healthy participants showed a hierarchical structure with higher-order constructs for genuine symptoms and pseudosymptoms, each comprising five subscales. The SRSI-It showed a strong convergent validity with the Structured Inventory of Malingered Symptomatology and discriminant validity through low correlations with the Psychopathic Personality Inventory-Revised. Receiver operating characteristic analysis determined cut scores of 6 (95% specificity) and 9 (98% specificity) for pseudosymptoms, with a Ratio Index score of 0.289 (82% specificity). In summary, the SRSI-It appears to be a promising tool for identifying symptom exaggeration in clinical and forensic contexts, ultimately enhancing the quality and reliability of evaluations in these contexts.

PTSD and mood disorders in implantable cardioverter defibrillator patients: is more psychological assessment needed?

INTRODUCTION: The aim of this review is to identify common mood concerns in ICD patients and suggest brief psychological screeners essential for early detection and monitoring in patient care. AREAS COVERED: Reliable and valid psychological assessment tools are reviewed, including those specifically designed for ICD patient populations. EXPERT OPINION: Psychological assessment, in combination with cardiologic standard of care, can help overcome many barriers associated with poor implantable cardioverter-defibrillator (ICD) management and related cardiovascular outcomes. Earlier identification and treatment of mood concerns in ICD patients has been shown to improve quality of life (QOL) and patient outcomes. At this time, however, logistical challenges and time restraints, in addition to knowledge of appropriate treatment plans or referral options, remain central barriers to providing integrated, patient-centered care. Ultimately, all cardiology clinics would benefit from a collaborative care team that includes a mental health consultant or in-house psychologists who can provide consultations or referral services. Additionally, all patients that come to the clinics should complete proactive screening measures as routine component of care to assess the presence of mood concerns to improve patient outcomes and aid in treatment planning.

Assessment of psychological status by a comprehensive approach in thyroid cancer patients undergoing radionuclide therapy: A feasibility study.

This feasibility study evaluated the psychological status of patients with differentiated thyroid cancer (DTC) before, during, and 40 days after administration of I-131 radionuclide therapy (RAI). We investigated the appropriateness of providing patient a comprehensive psychological assessment in an isolation ward. Thirty consecutive patients (Study Group; SG) who received RAI were enrolled. The tools used were the Hospital Anxiety and Depression Scale (HADS) at three different moments, and the Coping Responses Inventory (CRI) at baseline for each patient. A supportive approach was also implemented. Data were collected at the first specialist visit, at the day of admission, and at 40 days follow-up visit. A matched cohort of patients (Control Group; CG), who did not receive psycho-oncological counseling, was retrospectively studied only about their medical needs and requests. Staff exposure to radiation was also compared during SG and CG hospitalization, to assess a possible reduction of radiological risk for them. A significant difference between the basal, intermediate, and final psychological status was observed (p < 0.0001), which was found to be irrespective of the induced hypothyroidism. Patients showed a significant worsening of their status in terms of anxiety and depression after the consent, but it improved 40 days after treatment. Repeated measures analysis showed a similar trend in patients' psychological status over this period. At hospital discharge, patients showed indirect signs of increased well-being. CG required more nursing and medical interventions. Staff exposure was significantly lower during hospitalization of SG as compared to CG. This study demonstrates that timed psychological evaluation and appropriate support may help to reduce anxiety and depression of patients receiving a diagnosis of cancer and undergoing RAI. Moreover, an improvement of workplace safety was recorded.

Psychological assessment in school contexts: ethical issues and practical guidelines.

BACKGROUND: Psychological assessment in school settings involves a range of complexities and ethical dilemmas that practitioners must navigate carefully. This paper provides a comprehensive review of common issues faced by school psychologists during assessments, discussing best practices and ethical guidelines based on codes from various professional organizations. METHODS: We examine the entire assessment process, from pre-assessment considerations like informed consent and instrument selection to post-assessment practices involving results communication and confidentiality. Key ethical concerns addressed include fairness in assessment, cultural and linguistic appropriateness of testing materials, and issues surrounding informed consent. RESULTS: Specific challenges discussed include selecting appropriate assessment instruments that reflect the diverse needs and backgrounds of students, ensuring fairness and removing bias in testing, and effectively communicating results to various stakeholders while maintaining confidentiality. We emphasize the importance of multi-source, multi-method assessment approaches and the critical role of ongoing professional development in ethical practice. CONCLUSION: By adhering to established ethical standards and best practices, school psychologists can effectively support the educational and developmental needs of students. This paper outlines actionable recommendations and ethical considerations to help practitioners enhance the accuracy, fairness, and impact of their assessments in educational settings.

Clinical Signs and Symptoms of Anxiety Due to Adverse Childhood Experiences: A Cross-Sectional Trial in Adolescents.

BACKGROUND: Adverse Childhood Experiences (ACEs) are linked to the development of anxiety in adolescence. According to recent studies, the COVID-19 pandemic represents a novel ACE that is associated with anxiety among adolescents. This study investigates the relationship between ACEs, COVID-19, and anxiety in adolescents. METHODS: A cross-sectional study was conducted using a community sample of 248 boys and girls ages 12 to 15 years (mean = 13.50 years) from five high schools in Eastern Attica. A total of four questionnaires were used: (1) Demographic Questionnaire, (2) State-Trait Anxiety Inventory for Children-STAIC, (3) Adverse Childhood Experiences Scale, and (4) COVID-19 Impact Scale. RESULTS: The results demonstrated a moderate association between the total number of ACEs and anxiety (trait and state) in adolescence (trait anxiety: ρ = 0.37, p < 0.001; state anxiety: ρ = 0.29, p < 0.001). Girls scored significantly higher than boys on both trait anxiety (U = 4353, p < 0.001; mean difference = 5.5) and state anxiety (U = 5822.5, p = 0.014; mean difference = 2). The number of ACEs was found to be significantly related to the impact of COVID-19 (ß = 0.025, p < 0.001). CONCLUSIONS: This study highlights the significant link between ACEs and increased anxiety in adolescents, which is further exacerbated by the COVID-19 pandemic. The findings indicate that girls are more affected than boys. These results emphasize the need for targeted mental health interventions to enhance coping mechanisms, reduce stress, and address anxiety in adolescents, particularly during global crises like the pandemic. Developing such programs is essential for supporting the mental well-being of youth facing multiple stressors.

PERMA-Profiler for adolescents: validity evidence based on internal structure and related constructs.

Introduction: The PERMA model of well-being has gained prominence in the study of well-being by the Positive Psychology movement. However, the model has been little studied regarding its applicability in different populations, such as adolescents. This study sought to evaluate the psychometric properties of the PERMA-Profiler instrument for Brazilian adolescents, as well as the measurement invariance for different age groups and gender, and investigate the relation with external variables. Methods: Confirmatory Factor Analysis and Multigroup Confirmatory Factor Analysis were used to test the internal structure and invariance of the PERMA-Profiler. Reliability was determined with McDonald's Omega and composite reliability. A total of 1,197 adolescents between 11 and 19 years old from different regions of Brazil participated. Results: The results of the confirmatory factor analysis indicated that the five correlated factors model was the most appropriate, presenting good factor loadings and adequate reliability. The scale proved to be invariant for adolescents of different age groups and gender. Correlations with associated variables were significant and moderate to strong, showing positive relations between positive emotions and well-being, and negative relations with negative affects and depressive and anxiety symptoms. Discussion: These results contribute to the understanding of well-being in adolescence and highlight the importance of promoting different components of well-being for adolescents' mental health.

Individuals with Cleft Lip and/or Palate Demonstrated Improved Self-Reported Psychosocial Functioning Following the Onset of the COVID-19 Pandemic.

Objective: To evaluate the impact of the COVID-19 pandemic on the psychosocial functioning of individuals with cleft lip and/or palate (CL/P). Methods: Patients with CL/P ≥ 6 years old were prospectively recruited from the Cleft and Craniofacial Clinic of a tertiary children's hospital. From July-October 2021, eligible patients (or their parent/guardian) were sent a survey regarding their psychosocial functioning before and after the start of the pandemic. Main Outcome Measure: The difference between prepandemic and intrapandemic patient-reported outcome scores. Results: Thirty-six patients (20 female, age: 15.9 ± 9.8 years) responded. Most had cleft lip and palate (77.8%), responded online (69.4%), interacted remotely via both voice- and video-conferencing (62.9%), and wore masks routinely (77.1%). Similar numbers of patients responded independently (27.8%), responded with the help of a parent/guardian (36.1%), or had a parent/guardian respond on their behalf (36.1%). General social-emotional well-being (p = 0.004, r rb = 0.659) and satisfaction with facial appearance (p = 0.044, r rb = 0.610) significantly improved after the start of the pandemic. Compared to their general intrapandemic social-emotional well-being scores, patients reported higher scores while wearing a mask (r rb = 0.827) and lower scores while interacting remotely (r rb = 0.605), although all were still significantly improved compared to their prepandemic scores (p ≤ 0.010). Patients also reported significant improvement in social functioning while wearing a mask (p = 0.036, r rb = 0.519), whereas they did not when considering their general intrapandemic feelings/experiences (p = 0.269, r rb = 0.211). Conclusion: Patients with CL/P demonstrated significant improvement in overall social-emotional well-being, satisfaction with facial appearance, and social functioning after the start of the COVID-19 pandemic, particularly when wearing a mask.

Convergence of real-time and retrospective assessments: A systematic investigation of naturally occurring and experimentally induced intrusions.

BACKGROUND AND OBJECTIVES: Ecological momentary assessment is a popular method for monitoring symptoms in real-time. Especially for fleeting experiences, such as intrusions, real-time assessments may be more accurate than retrospective estimates. However, there are concerns regarding reactivity effects associated with real-time assessments and, conversely, the reliance on bias-prone retrospective assessments in clinical science and practice. In this study we used a between-groups design to examine whether real-time intrusion assessments influence retrospective reports (aim 1). Then, we investigated whether real-time and retrospective assessments systematically differed within individuals (aim 2). METHODS: Over two weeks, 150 non-clinical individuals provided weekly retrospective intrusion assessments, while the majority (n = 102) additionally reported their intrusions in real-time, via smartphones. We examined both naturally occurring intrusions, which individuals experience in their everyday lives, and intrusions related to a standardized stressor (i.e., Trier Social Stress Test), taking place halfway. RESULTS: Using Bayesian statistics, we found that assessing intrusions in real-time did not convincingly affect retrospective reports, and there was no strong evidence that real-time and retrospective intrusion assessments differed. However, the evidence of absence was inconclusive for some measures. Real-time and retrospectively reported intrusion frequencies and distress were strongly associated with one another. LIMITATIONS: Future research is advised to replicate these findings with larger samples, for other types of stressors, in clinical populations, and over extended assessment periods. CONCLUSIONS: The general agreement between real-time and retrospective assessments of intrusions is encouraging, tentatively suggesting that researchers and clinicians can flexibly select the assessment method that best suits their objectives.

Revisiting Rorschach test and Minnesota Multiphasic Personality Inventory-II patterns in Kraepelinian vs. DSM-wise Schizophrenia: How They Differ and What It Means for Diagnosis.

OBJECTIVE: This retrospective chart review study aimed to investigate the differences in the Rorschach test and Minnesota Multiphasic Personality Inventory (MMPI)-II profiles among patients with Kraepelinian schizophrenia, those with DSM-wise schizophrenia, and controls. Kraepelinian schizophrenia is characterised by a chronic, deteriorative disease course and a predominance of negative symptoms. METHODS: Patients with Kraepelinian schizophrenia were selected based on medical record reviews. We then compared their Rorschach test and MMPI-II results with those of the DSM-wise schizophrenia group and the control group. RESULTS: The Rorschach test revealed a significant increase in DV2 score and a decrease in D score in patients with Kraepelinian schizophrenia compared to those with DSM-wise schizophrenia. In the MMPI-II profiles, patients with Kraepelinian schizophrenia exhibited an elevated L relative to those with DSM-wise schizophrenia. CONCLUSION: Our results suggested the value of revisiting psychological tests in clinically delineated subgroups, such as Kraepelinian schizophrenia. Although patients fall under the same diagnostic category of schizophrenia, considering different phenotypes is important when interpreting psychological test outcomes. Additionally, our study indicated that both schizophrenia groups did not show as many abnormalities as expected compared to controls. This highlights the potential value of revisiting established profiles of certain psychological tests and calls for further research on other psychological tests.

[Driving competence in older age: psychological assessment and interventions]. / Fahrkompetenz im Alter: Psychologische Diagnostik und Interventionen.

The article introduces the issue of psychological assessment and training for driving safety, driving competence, and the mobility of older drivers. The psychological methods for assessing driving competence and the training approaches for maintaining mobility in old age are outlined and illustrated with examples. Preserving driving ability in old age remains a task for which development needs and research gaps must be specified. Although periodic mandatory examinations based on age do not yield any relevant improvement in enhancing traffic safety, they do not cause harm and are widely accepted. It is desirable to move away from a theory focusing on deficits of older age and instead develop an assessment of the comprehensive functions, abilities, and resources of elderly drivers to help preserve the mobility and participation of that specific demographic in traffic.

Risk Factors and Interventions for Suicide in Huntington's Disease-A Systematic Review.

Background/Objectives: Huntington's disease (HD) is an autosomal dominant genetic disorder causing progressive neurodegeneration which, aside from symptomatic therapies for controlling psychological and motor problems, currently has no effective treatment. People who receive this diagnosis often feel disoriented and lost without guidance. Furthermore, HD patients are estimated to have a two to seven times greater risk of suicide death compared to the general population. The current review investigates the complex relationship between HD and suicide, seeking to identify key risk factors influencing suicidal ideation and behaviour in affected individuals. Methods: We conducted a systematic review following the PRISMA guidelines. Studies were searched for on the PubMed, Cochrane, and Web of Science databases, and 17 articles met the inclusion criteria. Results: The findings reveal that emotional strain, neuropsychiatric symptoms, and the absence of a cure contribute to heightened suicidal tendencies in HD patients. Critical periods for suicide risk coincide with early symptomatic stages of disease or the successive phase, with the loss of independence impacting on daily functioning. Risk factors associated with HD include a depressive mood, cognitive impairments, and a history of suicide attempts. Conclusions: From a prevention perspective, a comprehensive multidisciplinary and multidimensional approach could enhance the overall well-being of people with HD. In particular, screening for suicidal thoughts in people with HD could mitigate suicide risk.

Assessment of psychological personality traits in transgender groups using the Minnesota multiphasic personality inventory.

Objective: To explore the psychological personality characteristics of transgender groups and to determine whether these characteristics differ according to sociodemographic factors. Methods: This cross-sectional study was conducted between January 2021 and April 2023 at a psychosexual outpatient clinic in a psychiatric hospital in Beijing, China. In total, 481 individuals were included in this study, and demographic information was collected using a self-administered general questionnaire. Psychological personality traits were assessed using the Minnesota Multiphasic Personality Inventory (MMPI). Results: The mean scores of the assigned male at birth (AMAB) group were significantly higher than those of the male controls for all 10 clinical factors of the MMPI (p < 0.01 or p < 0.001). The scores for both the Masculinity-femininity (Mf) and Depression (D) factors in the AMABs group exceeded the clinical threshold (T > 60) and were the highest and second-highest scores on the entire scale, respectively. Individuals assigned female at birth (AFAB) had significantly higher scores than female controls for Hysteria (Hy), Psychopathic Deviate (Pd), and Hypomania (Ma) (p < 0.05, p < 0.01, and p < 0.001, respectively). There were significant differences in the rates of abnormal values for the various factors of the MMPI (T > 60) according to gender, age, and education (p < 0.05, p < 0.01, and p < 0.001, respectively). Compared to AFABs, AMABs had higher rates of abnormal scores (T > 60) on the Hypochondriasis (Hs), D, Hy, Mf, Paranoia (Pa), Psychasthenia (Pt), Schizophrenia (Sc), and Social Introversion (Si) scales (p < 0.05, p < 0.01, and p < 0.001, respectively). Second, the transgender group aged ≤25 years had higher rates of abnormal scores (T > 60) on the Hs, D, Hy, Pd, Pa, Pt, Sc, and Ma scales (p < 0.05, p < 0.01, and p < 0.001, respectively). Finally, outliers (T > 60) for the Hs, D, Hy, Pd, Pa, Pt, Ma, and Si factors were more prevalent among those with a primary to high school level of education (p < 0.05, p < 0.01, and p < 0.001, respectively). Conclusion: Assigned male at births may have a variety of psychological vulnerabilities, and there is a need to focus especially on those with a primary to high school level of education, those aged ≤25 years, and transgender females.

When insurance is not a barrier: psychological factors predicting whether bariatric candidates undergo surgery.

BACKGROUND: Despite the effectiveness of bariatric surgery, utilization rates have increased only marginally over the last 2 decades; candidates who are eligible for bariatric surgery regularly fail to undergo surgery. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) has previously been used to assist in identification of those who will not move forward with surgery after being identified as eligible. However, medical insurance has been identified as a significant barrier to surgery; research in those who have universal healthcare may yield different results. OBJECTIVES: Determine if MMPI-RF scales are associated with failure to undergo bariatric surgery in patients eligible to have the procedure. SETTING: Large military hospital in the Northwestern U.S. METHODS: This study used archival data for 279 patients psychologically screened for eligibility for bariatric surgery. All assessments took place between January 2017 and December 2019. T-tests and chi-square tests were used to compare groups of patients who did and did not have surgery on relevant medical and demographic variables. Profile analyses of patient MMPI-2-RF scores were conducted to examine scale associations with undergoing surgery. RESULTS: A total of 86 bariatric surgery candidates (30.8%) did not undergo surgery. Results showed that sex, age, employment status, and arthritis were different between groups. Additionally, MMPI-2-RF scales were different between groups, including somatic complaints, neurological complaints, cynicism, and helplessness/hopelessness. CONCLUSIONS: MMPI-2-RF scales were associated with not having bariatric surgery, although not all scales exceeded clinical cut-offs. Findings indicate psychological and psychosocial differences, rather than psychopathology per se, may play a role in who undergoes bariatric surgery.

Long term follow-up on young adults that underwent hypospadias repair through urethral advancement in childhood.

Assess the long-term outcome on cosmetic appearance, voiding, sexual function, and psychological impact of young adults operated by urethral advance (UA) technique in childhood. Patients over 14 years old, who underwent UA hypospadias repair in our centre (2000-2010) were evaluated. All patients presented mid-distal hypospadias with subcoronal or penile meatus and curvature lower than 20°. The cosmetic appearance, urinary and sexual function, body perception and overall satisfaction were assessed through 5 questionnaires. From 2000 to 2010, 143 children underwent UA hypospadias repair. 36 patients between 14 and 27 years were evaluated. The Hypospadias Objective Penile Evaluation (HOPE) showed an average of 8.75 (+/- 0.97), which indicates a good aesthetic result. Voiding dysfunction symptoms were assessed through the American Urological Association Symptom Index (AUASI) where 80.6% had none or mild symptoms and 19.4% had moderate symptoms. Only 11/36 patients were sexually active, according to the International Index of Erectile Function (IIEF-15) scale, none had erectile dysfunction, and their relationships were satisfactory. Assessment of the body perception through the Genital Perception Scale (GPS) was positive or very positive in 88.9% of the patients. However, the perception of their genitals was positive or very positive in 77.8%, there is a negative correlation between the perception of their body and genitals in 13.9% of the patients. Our results indicate that UA technique for hypospadias repair might be a valid option for the correction of mid-distal hypospadias when indicated.