Is the performance at the implicit association test sensitive to feedback presentation? A Rasch-based analysis.

The Implicit Association Test (IAT) is commonly used for the indirect assessment of psychological constructs. While the features of the IAT that might influence the performance of the respondents have been extensively investigated, the effect of informing the respondents about the correctness of their responses (i.e., feedback presentation) has been poorly addressed so far. The study addresses this issue by presenting an across-domain (implicit prejudice and food preference) Rasch-based analysis of IAT data obtained with and without feedback presentation. Results showed that speed was influenced by the interaction between feedback presentation and associative condition, whereas accuracy was influenced by the associative condition. This result varied across-domain. Results suggested that IATs administered with feedback presentation provide more accurate information on the construct of interest.

Acetylcholinesterase inhibitors and cognitive stimulation, combined and alone, in treating individuals with mild Alzheimer's disease.

BACKGROUNDS: Acetylcholinesterase inhibitors (AChEI) and cognitive stimulation (CS) are the standard pharmacological and non-pharmacological treatments for Alzheimer's disease (AD). AIMS: The aim of this study was to investigate the effects of these treatments, alone or combined, on the neuropsychological profiles of patients with AD. METHODS: Forty participants were assigned to three groups receiving either only AChEI (n = 14), AChEI + CS (n = 15), or only CS (n = 11). Cognition was evaluated at baseline and after three months. Linear mixed-effects models were used to investigate differences among the treatments in terms of changes in the patients' neuropsychological profiles. RESULTS: Results, although preliminary because of the small sample size, suggest that a general improvement was found in patients who received AChEI + CS and those who received only CS compared with those who received only AChEI. Interestingly, individuals who received only CS showed a significant improvement in immediate memory recall than those who received only AChEI. Furthermore, the group receiving AChEI + CS showed an improvement in delayed recall than the other two groups. DISCUSSION: The combination of AChEI and CS seems to have the greatest benefit for patients with mild AD. More interestingly, CS alone is more effective than AChEI alone, even in improving memory, considered to be the "lost" cognitive domain in AD.

Religious assessment in Italian older adults: psychometric properties of the Francis Scale of Attitude toward Christianity and the Behavioral Religiosity Scale.

OBJECTIVES: Studies have shown that religiosity (R) and spirituality (S) can positively impact older adults' life. Nevertheless, no validated tools for measuring these constructs in the older Italian population are currently available. This study investigates the psychometric properties of two of the most common measures of R and S in the literature: the Francis Scale of Attitude toward Christianity short form (FSACsf) and the Behavioral Religiosity Scale (BRS). METHOD: 313 older Italians completed the questionnaires anonymously. The functioning of the items and the response scales, the factor structure, age invariance and internal consistency of both scales were investigated. RESULTS: Each scale defines a substantively unidimensional variable. Moreover, items seem, on the whole, to be well formulated. The values of the Rasch-Andrich thresholds suggest that the response scale of the FSACsf was adequate for measuring spirituality. However, this was not the case for BRS, where the response categories needed to be collapsed to measure behavioral religiosity properly. Age invariance was confirmed for each scale. Cronbach's α, composite reliability and person separation reliability revealed both scales to be internally consistent. DISCUSSION: The results suggest that the scales have solid psychometric properties, and can therefore be considered valid, reliable tools for investigating religiosity and spirituality in older people.

Does discrimination beat association in the IAT? The discrimination-association model reconceived.

The discrimination-association model (DAM; Stefanutti et al. 2013) disentangles two components underlying the responses to the implicit association test (IAT), which pertain to stimuli discrimination (the strength of the association of the stimuli with their own category) and automatic association (the strength of the association between targets and attributes). The assumption of the DAM that these two components sum into a single process generates critical drawbacks. The present work provides a new formulation of the model, called DAM-4C, in which stimuli discrimination and automatic association are separate, independent, and competing processes. Results of theoretical and simulation studies suggest that the DAM-4C outperforms the DAM. The IAT effect is found to vary with the association rates of the DAM-4C and not with those of the DAM. The parameters of the DAM-4C fitted on data from a Coca-Pepsi IAT are found to account for variance in brand attractiveness, taste preference, and cola choice that is not accounted for by the D score and the diffusion model. In addition, the association rates estimated on data from a Black-White IAT are in line with expectations.

Testing the actual equivalence of automatically generated items.

If the automatic item generation is used for generating test items, the question of how the equivalence among different instances may be tested is fundamental to assure an accurate assessment. In the present research, the question was dealt by using the knowledge space theory framework. Two different ways of considering the equivalence among instances are proposed: The former is at a deterministic level and it requires that all the instances of an item template must belong to exactly the same knowledge states; the latter adds a probabilistic level to the deterministic one. The former type of equivalence can be modeled by using the BLIM with a knowledge structure assuming equally informative instances; the latter can be modeled by a constrained BLIM. This model assumes equality constraints among the error parameters of the equivalent instances. An approach is proposed for testing the equivalence among instances, which is based on a series of model comparisons. A simulation study and an empirical application show the viability of the approach.

An evaluation system for postgraduate pediatric residency programs: report of a 3-year experience.

The way a postgraduate medical training program is organized and the capacity of faculty members to function as tutors and to organize effective professional experiences are among the elements that affect the quality of training. An evaluation system designed to target these elements has been implemented within the framework of the Pediatric Residency Program of the University of Padua (Italy). The aim of this report is to describe some aspects of the experience gained in the first 3 years of implementation of the system (2013-2015). Data were collected using four validated questionnaires: the "Resident Assessment Questionnaire", the "Tutor-Assessment Questionnaire", the "Rotation-Assessment Questionnaire", and the "Resident Affairs Committee-Assessment Questionnaire". The response rate was 72% for the "Resident Assessment Questionnaires"; 78% for the "Tutor-/Rotation-Assessment Questionnaires" and 84% for the "Resident Affair Committee-Assessment Questionnaires". The scores collected were validated by psychometric tests. CONCLUSION: The high rates of completed questionnaires returned and the psychometric validation of the results collected indicate that the evaluation system reported herein can be effectively implemented. Efforts should be made to refine this system and, more importantly, to document its impact in improving the Pediatric Residency Program. What is known: • The elements that influence the quality of postgraduate training programs and the knowledge, performance, and competences of residents must be regularly assessed. • Comprehensive evaluation systems for postgraduate residency programs are not universally implemented also because quite often common guidelines and rules, well-equipped infrastructures, and financial resources are missing. What is new: • We show the feasibility of implementing an evaluation system that targets some of the key elements of a postgraduate medical training program in Italy, a European country in which the regulations governing training programs and, notably, the evaluation of residents are still being developed.

Measurement of change in health status with Rasch models.

BACKGROUND: The traditional approach to the measurement of change presents important drawbacks (no information at individual level, ordinal scores, variance of the measurement instrument across time points), which Rasch models overcome. The article aims to illustrate the features of the measurement of change with Rasch models. METHODS: To illustrate the measurement of change using Rasch models, the quantitative data of a longitudinal study of heart-surgery patients (N = 98) were used. The scale "Perception of Positive Change" was used as an example of measurement instrument. All patients underwent cardiac rehabilitation, individual psychological intervention, and educational intervention. Nineteen patients also attended progressive muscle relaxation group trainings. The scale was administered before and after the interventions. Three Rasch approaches were used. Two separate analyses were run on the data from the two time points to test the invariance of the instrument. An analysis was run on the stacked data from both time points to measure change in a common frame of reference. Results of the latter analysis were compared with those of an analysis that removed the influence of local dependency on patient measures. Statistics t, χ(2) and F were used for comparing the patient and item measures estimated in the Rasch analyses (a-priori α = .05). Infit, Outfit, R and item Strata were used for investigating Rasch model fit, reliability, and validity of the instrument. RESULTS: Data of all 98 patients were included in the analyses. The instrument was reliable, valid, and substantively unidimensional (Infit, Outfit < 2 for all items, R = .84, item Strata range = 3.93-6.07). Changes in the functioning of the instrument occurred across the two time, which prevented the use of the two separate analyses to unambiguously measure change. Local dependency had a negligible effect on patient measures (p ≥ .8674). Thirteen patients improved, whereas 3 worsened. The patients who attended the relaxation group trainings did not report greater improvement than those who did not (p = .1007). CONCLUSIONS: Rasch models represent a valid framework for the measurement of change and a useful complement to traditional approaches.

Investigating the Functioning of Rating Scales With Rasch Models.

The hypothesis implicit in the rating scale design is that the categories reflect increasing levels of the latent variable. Rasch models for ordered polytomous items include parameters, called thresholds, that allow for empirically testing this hypothesis. Failure of the thresholds to advance monotonically with the categories (a condition that is referred to as "threshold disordering") provides evidence that the rating scale is not functioning as intended. This work focuses on scales consisting of rather large numbers of categories, whose use is often recommended in the literature. Threshold disordering is observed in both an extended 8-point scale specially developed for the Patient Health Questionnaire-9 and the original 10-point scale of the Behavioral Religiosity Scale. The results of this work prompt practitioners not to take the functioning of the rating scale for granted, but to verify it empirically.

Psychosocial risk and protective factors for youth problem behavior are associated with food addiction in the Generation Z.

Objective: Food Addiction (FA) and other well-known risk behavior as substance misuse tend to co-occur and may share similar risk and protective factors. The aim of this study was to assess the association between the diagnosis/severity of FA and psychosocial domains typically related to risk behavior syndrome in a large, nationally representative community sample of Generation Z underage Italian students. Method: The sample consisted of 8,755 students (3,623 from middle schools, 5,132 from high schools). A short version of the Yale Food Addiction Scale 2.0 was administered to evaluate FA. Risk and protective factors related to demographic, personality, behavior, and family variables were examined. Stepwise multivariate logistic and linear regressions were conducted. Results: The prevalence of FA was 30.8%. Female gender, social anxiety and depression symptoms, social withdrawal risk, Internet gaming disorder, social media addiction, current substance use, social challenge engagement and experienced doxing boosted the chance of FA diagnosis, whereas eating fruit and vegetables, playing competitive sports and an average sleep duration of 7-8 h per night reduced these odds. FA severity was significantly and positively associated with trait impulsiveness, social anxiety and depressive symptoms, risk of social withdrawal, recent substance use, social media, and gaming addiction, doxing suffered and risky social challenges participation. Negative associations between the severity of FA and fruit and vegetable diet habits were found. Conclusion: Our findings confirm that FA is widespread among Italian adolescents. The associations between the diagnosis and severity of FA and psychosocial risk factors for health, including, addictive and deviant behaviors related to digital misuse, suggest its belonging to the risk behavior constellation. Health promotion schemes based on a multicomponent strategy of intervention should consider the inclusion of FA and its psychosocial correlates.

PsycAssist: A Web-Based Artificial Intelligence System Designed for Adaptive Neuropsychological Assessment and Training.

Assessing executive functions in individuals with disorders or clinical conditions can be challenging, as they may lack the abilities needed for conventional test formats. The use of more personalized test versions, such as adaptive assessments, might be helpful in evaluating individuals with specific needs. This paper introduces PsycAssist, a web-based artificial intelligence system designed for neuropsychological adaptive assessment and training. PsycAssist is a highly flexible and scalable system based on procedural knowledge space theory and may be used potentially with many types of tests. We present the architecture and adaptive assessment engine of PsycAssist and the two currently available tests: Adap-ToL, an adaptive version of the Tower of London-like test to assess planning skills, and MatriKS, a Raven-like test to evaluate fluid intelligence. Finally, we describe the results of an investigation of the usability of Adap-ToL and MatriKS: the evaluators perceived these tools as appropriate and well-suited for their intended purposes, and the test-takers perceived the assessment as a positive experience. To sum up, PsycAssist represents an innovative and promising tool to tailor evaluation and training to the specific characteristics of the individual, useful for clinical practice.

A discrimination-association model for decomposing component processes of the implicit association test.

A formal model is proposed that decomposes the implicit association test (IAT) effect into three process components: stimuli discrimination, automatic association, and termination criterion. Both response accuracy and reaction time are considered. Four independent and parallel Poisson processes, one for each of the four label categories of the IAT, are assumed. The model parameters are the rate at which information accrues on the counter of each process and the amount of information that is needed before a response is given. The aim of this study is to present the model and an illustrative application in which the process components of a Coca-Pepsi IAT are decomposed.

Enhancing Computerized Adaptive Testing with Batteries of Unidimensional Tests.

The article presents a new computerized adaptive testing (CAT) procedure for use with batteries of unidimensional tests. At each step of testing, the estimate of a certain ability is updated on the basis of the response to the latest administered item and the current estimates of all other abilities measured by the battery. The information deriving from these abilities is incorporated into an empirical prior that is updated each time that new estimates of the abilities are computed. In two simulation studies, the performance of the proposed procedure is compared with that of a standard procedure for CAT with batteries of unidimensional tests. The proposed procedure yields more accurate ability estimates in fixed-length CATs, and a reduction of test length in variable-length CATs. These gains in accuracy and efficiency increase with the correlation between the abilities measured by the batteries.

Machine learning-decision tree classifiers in psychiatric assessment: An application to the diagnosis of major depressive disorder.

This work illustrates the advantages of using machine learning classifiers in psychiatric assessment. Machine learning-decision trees (ML-DTs) represent a new approach to scoring and interpreting psychodiagnostic test data that allows for increasing assessment accuracy and efficiency. The approach is outlined in an easy yet detailed way, and its application is illustrated on real psychodiagnostic test data. Specifically, cross-sectional data concerning nonclinical and clinical Japanese populations were taken from a panel registered with an internet survey company. Responses to the Patient Health Questionnaire-9 (PHQ-9) underwent receiver operating characteristic (ROC) curve, DSM algorithm, and ML-DT analyses. The results showed greater diagnostic accuracy for ML-DT (0.71-0.75) compared with the DSM algorithm (0.69) and ROC curves (0.70-0.71). Moreover, ML-DT enabled classifying participants as having or not having a diagnosis of depression using, on average, the information from 2.99 out of 9 items (SD = 1.35). The application showed that ML-DTs can provide information of high clinical value to integrate traditional psychometric methods. The resulting assessments are informative, accurate, and efficient.

Development of a scale for capturing psychological aspects of physical-digital integration: relationships with psychosocial functioning and facial emotion recognition.

The present work aims at developing a scale for the assessment of a construct that we called "physical-digital integration", which refers to the tendency of some individuals not to perceive a clear differentiation between feelings and perceptions that pertain to the physical or digital environment. The construct is articulated in four facets: identity, social relationships, time-space perception, and sensory perception. Data from a sample of 369 participants were collected to evaluate factor structure (unidimensional model, bifactor model, correlated four-factor model), internal consistency (Cronbach's α, McDonald's ω), and correlations of the physical-digital integration scale with other measures. Results showed that the scale is valid and internally consistent, and that both the total score and the scores at its four subscales are worthy of consideration. The physical-digital integration scores were found to be differently associated with digital and non-digital behaviors, individuals' ability to read emotions in the facial expressions of others, and indicators of psychosocial functioning (anxiety, depression, and satisfaction with social relationships). The paper proposes a new measure whose scores are associated with several variables that may have relevant consequences at both individual and social levels.

Assessing the local identifiability of probabilistic knowledge structures.

Given a collection Q of problems, in knowledge space theory Doignon & Falmagne, (International Journal of Man-Machine Studies 23:175-196, 1985) the knowledge state of a student is the collection K ⊆ Q of all problems that this student is capable of solving. A knowledge structure is a pair (Q, ), where is a collection of knowledge states that contains at least the empty set and Q. A probabilistic knowledge structure (PKS) is a knowledge structure (Q, , π), where π is a probability distribution on the knowledge states. The PKS that has received the most attention is the basic local independence model BLIM; Falmagne & Doignon, (British Journal of Mathematical and Statistical Psychology 41:1-23, 1988a, Journal of Mathematical Psychology 32:232-258, 1988b). To the best of our knowledge, systematic investigations in the literature concerning the identifiability of the BLIM are totally missing. Based on the theoretical work of Bamber and van Santen (Journal of Mathematical Psychology 29:443-473, 1985), the present article is aimed to present a method and a corresponding computerized procedure for assessing the local identifiability of the BLIM, which is applicable to any finite knowledge structure of moderate size.

COVID-19 emergency: the influence of implicit attitudes, information sources, and individual characteristics on psychological distress, intentions to get vaccinated, and compliance with restrictive rules.

BACKGROUND: To limit the spread of the COVID-19 emergency, a massive vaccination program was implemented and restrictive measures were imposed on the population. However, the propensity to adhere to the vaccination program has struggled to take off. Moreover, complying with the restrictive rules and maintaining social distancing have been highly distressing for many individuals. PARTICIPANTS AND PROCEDURE: Italian participants (N = 140, females = 65%, mean age = 29.50, SD = 10.80) were presented with an online survey consisting of multiple-choice questions and two single-category implicit association tests (SC-IATs). One SC-IAT evaluated the tendency of participants to automatically associate personal protective equipment (PPE) and vaccines with safety or danger; the other evaluated their tendency to automatically associate social situations with good or bad. Multiple-choice questions explored individual, social, and environmental factors that were expected to contribute to vaccine propensity, compliance with restrictive rules, and feelings of distress. RESULTS: Using scientific information sources was related to implicitly associating PPE and vaccines with safety, which in turn was associated with the propensity to get the vaccine. Moreover, being female, young, unsatisfied with social relationships, having suffered health and economic consequences due to the pandemic, and having negative implicit attitudes toward social situations contributed to increasing feelings of distress. CONCLUSIONS: Communication may contribute to individuals' behavior and preferences and it can also be associated with implicit attitudes, becoming consequently one of the main leverages to reduce vaccine hesitancy. Recovery programs should prioritize the development of interventions aimed at fostering psychological well-being through the enhancement of social contacts.

An Item Response Theory-Based Scoring of the South Oaks Gambling Screen-Revised Adolescents.

The South Oaks Gambling Screen-Revised Adolescent (SOGS-RA) is one of the most widely used screening tools for problem gambling among adolescents. In this study, item response theory was used for computing measures of problem gambling severity that took into account how much information the endorsed items provided about the presence of problem gambling. A zero-inflated mixture two-parameter logistic model was estimated on the responses of 4,404 adolescents to the South Oaks Gambling Screen-Revised Adolescent to compute the difficulty and discrimination of each item, and the problem gambling severity level (θ score) of each respondent. Receiver operating characteristic curve analysis was used to identify the cutoff on the θ scores that best distinguished daily and nondaily gamblers. This cutoff outperformed the common cutoff defined on the sum scores in identifying daily gamblers but fell behind it in identifying nondaily gamblers. When screening adolescents to be subjected to further investigations, the cutoff on the θ scores must be preferred to that on the sum scores.

Italian Diagnostic Adaptive Behavior Scale: Reliability and diagnostic accuracy compared with the Vineland-II.

BACKGROUND: The Diagnostic Adaptive Behavior Scale (DABS) is a short scale with excellent properties to assess the conceptual, social, and practical adaptive behavior domains for the diagnosis of intellectual disability (ID) in individuals aged 4-21 years. AIMS: Investigate the test-retest and inter-respondent reliability of the Italian adaptation of the DABS, verify its diagnostic accuracy in identifying individuals with ID and excluding individuals with typical development (TD), and compare its psychometric properties to those of the Vineland-II. METHODS: Test-retest reliability: The same respondent completed the Italian DABS for the same assessed person at two separate times (n = 71). Inter-respondent reliability: Two respondents for the same assessed person completed the Italian DABS independently (n = 57). Diagnostic accuracy: The same respondent completed the Italian DABS and Vineland-II for the same assessed person (n = 378; 50 % ID, 50 % TD). RESULTS: Italian DABS test-retest and inter-respondent correlation coefficients were excellent. Italian DABS sensitivity was 86 % and specificity was 99 %, Italian DABS Areas Under the ROC Curves were excellent (or good, practical skill domain), and comparable to the results reported for the Vineland-II. CONCLUSIONS: The Italian DABS is an excellent measure to evaluate the adaptive behavior for ID diagnosis; it is comparable to the Vineland-II but being shorter, the Italian DABS requires less time to administer.

Assessing learning processes with the gain-loss model.

Within the framework of knowledge space theory, a probabilistic skill multimap model for assessing learning processes is proposed. The learning process of a student is modeled as a function of the interaction between his competence state and the effect of a learning object on specific skills. Model parameters are initial probabilities of the skills, effects of learning objects on gaining and losing the skills, careless error, and lucky guess probabilities of the problems. A simulation study assessed model identifiability and goodness-of-recovery under several conditions. Practical implications of using the model are discussed, and the MATLAB code for simulating, estimating and testing it is available in the Psychonomic Society supplemental archive.

Perception of stress and cognitive efficiency in older adults with mild and moderate dementia during the COVID-19-related lockdown.

AIM: Many studies have been carried out with the aim of understanding the manifold effects of the novel coronavirus (Covid-19) on individuals' clinical and psychological states. This paper deals with perceived stress (PS) and cognitive efficiency (CE) in older adults with dementia during the first wave of the pandemic. The study also investigated the potential effects of PS and CE on participants' cognitive functioning. The modulating effect of cognitive reserve (CR) on these variables was also considered, given its well-known role in the onset and evolution of neurodegenerative diseases. METHOD: Thirty-eight older adults with mild/moderate dementia (mean age: 81.47 ± 5.05; mean MMSE pre-lockdown: 24.03 ± 3.14) were recruited for this study from March to May [4]. Two questionnaires, the Perceived Stress Scale (PSS) and the FLEI Mental Ability Questionnaire (FLEI), were administered to all participants by telephone every two weeks during lockdown (T1: early April, T2: mid-April, T3: early May). After lockdown, their neuropsychological and psychological profiles were assessed. Linear mixed-effects models were used to investigate changes over time. RESULTS: The level of PS increased at both Time 2 and Time 3 (f2 = 0.10). Cognitive functioning worsened during lockdown, resulting in lower scores at the post-lockdown evaluation (f2s = 0.09 and 0.06 for MMSE and ENB-2, respectively). The decrease in these scores was not associated with either PS or CE. Although the size of these effects was rather small, their clinical relevance is not negligible. CONCLUSION: Individuals with dementia seem to have experienced stress (S) during the first-wave of lockdown related to Covid-19. Cognition worsened during the pandemic, in accordance with the neurodegenerative nature of the disease, but it was unrelated to PS and CE.