Meta-analysis of the relationship between self-critical perfectionism and depressive symptoms: Comparison between Asian American and Asian international college students.

A body of research has been dedicated to demonstrating the relationship of perfectionism with a range of mental health indicators. Self-critical perfectionism, a component of perfectionism, has been framed primarily in a negative light within the mental health context. Given that research informs educational and clinical practices, it is important to explore the degree to which such findings generalize across cultures and subcultures. The current meta-analytic research systemically collated studies conducted with Asian college students with a particular attention to exploring whether orientation to Asian culture and cultural values correspondingly moderates the relationship between self-critical perfectionism and depressive symptoms. The degree of upholding Asian cultural values was represented by group identity (i.e., Asian American and Asian international). Eleven studies (N = 3,239) were identified through the literature search. Findings from the random-effects meta-analysis indicated a significant relationship between self-critical perfectionism and depressive symptoms in the overall sample. The group identity significantly moderated the relationship; among Asian international college students, self-critical perfectionism appeared to have a less harmful effect on mental distress compared to Asian American college students. Self-cultivation-one of the salient and virtuous Asian cultural values that aligns with self-critical perfectionism-may have motivated continuous striving for self-improvement to fulfill the honorable duty for their family for Asian international students. Additional findings and implications of the study are further discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Diversity, Equity, and Inclusiveness in Medicine and Cardiology: Next Steps for JAHA.

We, the Editors of the Journal of the American Heart Association, sincerely regret the publication of the article "Diversity, Inclusion, and Equity: Evolution of Race and Ethnicity Considerations for the Cardiology Workforce in the United States of America From 1969 to 2019".1 We are aware that the publication of this flawed and biased article has caused a great deal of unnecessary pain and anguish to a number of parties, and reflects extremely poorly on us. We fully support the retraction of this article.

How does perfectionism affect academic achievement? Examining the mediating role of accurate self-assessment.

Perfectionism, a multidimensional disposition encompassing both positive and negative attributes, has been widely examined in a number of different fields, one of which is academics. However, results of research on the precise connection between perfectionism and academic success remain largely inconclusive. The present study, therefore, attempted to identify this underlying mechanism by examining the mediating role of accurate self-assessment in the relationship between perfectionism and academic achievement of college students. The results revealed that while perfectionistic concerns and strivings did not directly affect academic achievement, their indirect effects were statistically significant. Perfectionistic concerns negatively predicted academic achievement through inaccurate self-assessment, whereas perfectionistic strivings positively predicted academic achievement through accurate self-assessment. These findings are expected to promote a practical and balanced understanding of academic perfectionism by explaining the relationship between the sub-dimensions of perfectionism and academic achievement.

Clinical and Payer-Based Analysis of Value of Dual-Energy Computed Tomography for Workup of Incidental Abdominal Findings.

OBJECTIVE: To perform a clinical and payer-based analysis of the value of dual-energy computed tomography (DECT) for workup of incidental abdominal findings. METHODS: This was a single-center, retrospectively designed, Health Insurance Portability and Accountability Act-compliant study approved by our institutional review board. Sixty-nine examinations in 69 patients (45 men, 24 women; mean age, 57.7 years) who underwent single-phase postcontrast abdominal DECT studies between January 1, 2011, and December 31, 2017, were included. Two radiologists, blinded to study objective and design, reviewed all cases and identified incidental abdominal findings needing further imaging. All incidental findings were reviewed by 2 other investigators, who determined whether an imaging-based diagnosis could be made using DECT virtual noncontrast images and iodine maps. Additional studies and associated payer-reimbursement amounts avoided by use of DECT were estimated. All imaging costs were estimated based on the US Centers for Medicare & Medicaid Services reimbursement amounts. RESULTS: Thirty-four incidental findings (renal mass, n = 20; adrenal nodule, n = 8; pancreatic cystic lesions, n = 3; others, n = 3) were identified in 19 (27.5%) of 69 patients. Dual-energy computed tomography characterized 27 incidental findings in 15 patients and accounted for cost savings of 15 additional imaging examinations (abdominal magnetic resonance imaging, n = 11; abdominal computed tomography, n = 4). Based on Centers for Medicare & Medicaid Services reimbursement amounts, we estimated that, by abolishing the need for additional imaging use, DECT saved US $84.95 per patient. CONCLUSIONS: Dual-energy computed tomography can provide an imaging-based diagnosis of incidental abdominal findings, otherwise incompletely characterized on routine abdominal computed tomography, in approximately 21% of patients. In select patients, the monetary savings from abolishing additional imaging may reduce payer costs associated with use of DECT.

Multilevel confirmatory factor analysis of the Effective Behavior Support Self-Assessment Survey.

One evaluation measure available through the Positive Behavioral Interventions and Supports framework is the Effective Behavior Support Self-Assessment Survey (SAS). Evaluations of the SAS have supported its factor structure. However, the SAS is designed to be completed by school personnel who are nested within other levels of analysis (e.g., schools, grade level, district). There have been no studies examining the SAS from a multilevel perspective. The current study addressed this gap by evaluating the SAS using data from 1,726 respondents across 36 public schools in 3 school districts. Another purpose of this study was to evaluate whether the SAS can be shortened yet remain psychometrically sound to encourage completion of the survey by busy school staff members. Intraclass correlation coefficients indicated substantial dependence in item responses. Factor correlations were substantial across all models tested. Compared with a 2nd-order, hierarchical model and the basic 4-factor model based on the original hypothesized structure of the SAS, the best combination of fit and parsimony was obtained from a reduced set of 24 of the original 46 items organized within a multilevel bifactor structure (e.g., comparative fit index = .979, root-mean-square error of approximation = .019), suggesting that the SAS may be shortened. The bifactor model partitioned item variances to a general implementation fidelity factor and to 1 of the 4 hypothesized factors. These results suggest that the SAS items aim to describe dimensions for measuring implementation status that may be as relevant at the school level as they are at the individual level. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Perfectionism moderates stereotype threat effects on STEM majors' academic performance.

Using a randomized, between-subjects experimental design, we tested hypotheses that self-critical perfectionism would moderate the effects of subtle stereotype threat (ST) for women and students in underrepresented racial/ethnic groups who are pursuing traditional degrees in science, technology, engineering, or math (STEM). A diverse sample of freshmen students (N = 294) was recruited from 2 major universities. Students were blocked by gender and race/ethnicity and randomly assigned to experience subtle ST or no ST. Participants in the subtle ST condition were primed to consider their gender, race, and ethnicity prior to completing measures of science self-efficacy. Those in the control condition completed the measures without such priming. Controlling for prior academic performance and university context, ST priming significantly interacted (a) with self-critical perfectionism to predict coping self-efficacy scores and (b) with race/ethnicity to predict end-of-semester STEM grades. A 3-way interaction of ST priming, sex, and self-critical perfectionism also predicted students' grades in courses wherein women and men were more proportionally represented. The Sex × Self-Critical Perfectionism interaction was not significant for those in the ST group but was for those in the control group. Men in the control group had higher grade-point averages (GPAs) at low levels of self-critical perfectionism than they had at higher levels of perfectionism. In contrast, women had lower GPAs when self-critical perfectionism was low, but their GPAs were higher when self-critical perfectionism was high. The findings are discussed in terms of their implications for self-efficacy and performance in the pursuit of a STEM major.

The youth form of the Motivators of and Barriers to Health-Smart Behaviors Inventory.

OBJECTIVE: To develop a youth form of the Motivators of and Barriers to Health-Smart Behaviors Inventory (MB-HSBI-Youth) for use in identifying self-reported motivators of and barriers to the following health-promoting behaviors (called health-smart behaviors): eating a healthy breakfast, eating healthy foods and snacks, drinking healthy drinks, and engaging in physical activity. DESIGN: The MB-HSBI-Youth was developed through several research phases as part of a larger, multisite, and multicomponent study on modifying and preventing obesity in families. A critical aspect of the larger study was to identify the motivators of and barriers to the above-identified health-smart behaviors among African American, Asian American, Hispanic/Latino American, and non-Hispanic White American adults and youth. After preliminary research involving content validity, item analyses, and pilot testing, a pilot version of the MB-HSBI-Youth was administered to a national sample of 567 culturally diverse youth ranging from 9 to 17 years old. RESULTS: Factor analyses and internal consistency results revealed the existence of multiple subscales measuring motivators of and barriers to each of the above-specified health-smart behaviors. Scores on the MB-HSBI-Youth correlated in expected directions with health self-efficacy scores and with ratings of the importance of health-related behavioral goals. CONCLUSION: The MB-HSBI-Youth may be a useful and novel tool for developing assessment-based, culturally sensitive health promotion programs customized to be responsive to the motivators of and barriers to health-smart behaviors identified in target communities, particularly those communities whose members are mostly racial/ethnic minorities.

Patient-centered culturally sensitive health care: model testing and refinement.

OBJECTIVES: This article presents the results of an empirical test of a literature-based Patient-Centered Culturally Sensitive Health Care Model. The model was developed to explain and improve health care for ethnically diverse patients seen in community-based primary care clinics. DESIGN: Samples of predominantly low-income African American (n = 110) and non-Hispanic White American (n = 119) patients were recruited to complete questionnaires about their perceived health care provider cultural sensitivity and adherence to their provider's treatment regimen recommendations. MAIN OUTCOME MEASURES: Patients completed written measures of their perceived provider cultural sensitivity, trust in provider, interpersonal control, satisfaction with their health care provider, physical stress, and adherence to provider-recommended treatment regimen variables (i.e., engagement in a health promoting lifestyle, and dietary and medication adherence). RESULTS: Two-group path analyses revealed significant links between patient-perceived provider cultural sensitivity and adherence to provider treatment regimen recommendations, with some differences in associations emerging by race/ethnicity. CONCLUSION: The findings provide empirical support for the potential usefulness of the Patient-Centered Culturally Sensitive Health Care Model for explaining the linkage between the provision of patient-centered, culturally sensitive health care, and the health behaviors and outcomes of patients who experience such care.

Bayesian mixture modeling using a hybrid sampler with application to protein subfamily identification.

Predicting protein function is essential to advancing our knowledge of biological processes. This article is focused on discovering the functional diversification within a protein family. A Bayesian mixture approach is proposed to model a protein family as a mixture of profile hidden Markov models. For a given mixture size, a hybrid Markov chain Monte Carlo sampler comprising both Gibbs sampling steps and hierarchical clustering-based split/merge proposals is used to obtain posterior inference. Inference for mixture size concentrates on comparing the integrated likelihoods. The choice of priors is critical with respect to the performance of the procedure. Through simulation studies, we show that 2 priors that are based on independent data sets allow correct identification of the mixture size, both when the data are homogeneous and when the data are generated from a mixture. We illustrate our method using 2 sets of real protein sequences.

Motivating factors for physician ordering of factor V Leiden genetic tests.

BACKGROUND: The factor V Leiden (FVL) genetic test is used by many physicians despite its uncertain clinical utility. METHODS: We investigate whether self-reported motivations and behaviors concerning FVL genetic testing differ between 2 groups of primary care physicians defined by frequency of previous FVL test use. In January 2007, 112 physicians (60 frequent and 52 infrequent FVL test users) at Group Health, a large health care delivery system, were surveyed. Survey content areas included primary reasons and motivating factors for ordering the FVL test, the likelihood of ordering the FVL test for hypothetical patients, potential barriers to genetic testing, and practices and skills regarding FVL test ordering. RESULTS: Responses between groups agreed concerning most clinical- and patient-related factors. Frequent-FVL physicians were more likely than infrequent-FVL physicians to report ordering the FVL test for hypothetical patients with mesenteric venous thrombosis (adjusted odds ratio, 4.57; 95% confidence interval, 1.55-13.53) or venous thrombosis after hospital discharge (adjusted odds ratio, 3.42; 95% confidence interval, 1.30-8.95). Frequent-FVL physicians were also less likely to identify several items on the survey as barriers to genetic testing and were more likely to report high confidence in interpreting and explaining FVL test results. CONCLUSIONS: Generally, both physician groups reported similar motivating factors for ordering FVL tests, and reported behaviors were consistent with existing guidelines. More striking differences were observed for measures such as barriers to and confidence in using genetic tests. Although additional research is necessary to evaluate the impact of these results, they inform several knowledge-to-practice translation issues that are important for the successful integration of genetic testing into primary care.

Misclassification in a matched case-control study with variable matching ratio: application to a study of c-erbB-2 overexpression and breast cancer.

We provide a simple analytic correction for risk factor misclassification in a matched case-control study with variable numbers of controls per case. The method is an extension of existing methodology, and involves estimating the corrected proportions of controls and cases in risk factor categories within each matched set. These estimates are then used to calculate the Mantel-Haenszel odds ratio estimate corrected for misclassification. A simulation-based interval estimate is developed. An example is given from a study of risk factors for progression of benign breast disease to breast cancer, in which the risk factor is a biological marker measured with poor sensitivity.

Perfectionism and ethnicity: implications for depressive symptoms and self-reported academic achievement.

Ethnic differences in perfectionism were examined among Asian American, African American, and Caucasian American college students. Analyses revealed that Asian American students scored significantly higher than the other groups on 3 of 6 perfectionism subscales. Minority students reported significantly higher parental expectations than Caucasian students. Significant correlations emerged for all 3 groups between depressive symptoms and concerns about making mistakes, perceived criticism from parents, and self-doubt. In regression analyses, perfectionism explained significant variance in depressive symptoms for Asian Americans and Caucasians and explained significant variance in cumulative grade point average for Asian Americans and African Americans. Self-doubt emerged as a robust individual predictor in these analyses.