Construction of Risk Prediction Model of Type 2 Diabetic Kidney Disease Based on Deep Learning.

Background: This study aimed to develop a diabetic kidney disease (DKD) prediction model using long short term memory (LSTM) neural network and evaluate its performance using accuracy, precision, recall, and area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Methods: The study identified DKD risk factors through literature review and physician focus group, and collected 7 years of data from 6,040 type 2 diabetes mellitus patients based on the risk factors. Pytorch was used to build the LSTM neural network, with 70% of the data used for training and the other 30% for testing. Three models were established to examine the impact of glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), and pulse pressure (PP) variabilities on the model's performance. Results: The developed model achieved an accuracy of 83% and an AUC of 0.83. When the risk factor of HbA1c variability, SBP variability, or PP variability was removed one by one, the accuracy of each model was significantly lower than that of the optimal model, with an accuracy of 78% (P<0.001), 79% (P<0.001), and 81% (P<0.001), respectively. The AUC of ROC was also significantly lower for each model, with values of 0.72 (P<0.001), 0.75 (P<0.001), and 0.77 (P<0.05). Conclusion: The developed DKD risk predictive model using LSTM neural networks demonstrated high accuracy and AUC value. When HbA1c, SBP, and PP variabilities were added to the model as featured characteristics, the model's performance was greatly improved.

Testing whether the relations between sex and psychopathology are accounted for by structural morphometry in ABCD.

Sex differences in psychopathology are well-established, with females demonstrating higher rates of internalizing (INT) psychopathology and males demonstrating higher rates of externalizing (EXT) psychopathology. Using two waves of data from the Adolescent Brain Cognitive Development Study (N = 6,778 at each wave), the current study tested whether the relations between sex and psychopathology might be accounted for by structural brain differences. In general, we found robust, relatively consistent relations between sex and structural morphometry across waves. Relatively few morphometric brain variables were significantly related to INT or EXT across waves, however, with very small effect sizes when present. Next, we tested the extent to which each morphometric brain variable could account for the associations of sex with INT and EXT psychopathology. We found a total of 26 brain regions that accounted for significant portions of the associations between sex and psychopathology across both waves (almost all related to EXT), although the effects present were very small. The current evidence suggests that in children aged 9-12, multiple whole-brain and regional brain variables appear to statistically account for small portions of the sex-psychopathology links, especially for externalizing. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perioperative Insulin Pump Therapy Decreases Readmission Risk and Improves Outcomes in Patients with Diabetes.

OBJECTIVE: To evaluate the impact of temporary insulin pump use during hospitalization on glycemia, postoperative complications, and cost/utilization in perioperative patients with diabetes. METHODS: Patients (n=159) with type 2 diabetes and hospitalized for elective surgery were recruited from three hospitals. Subjects were categorized into the insulin pump group and the multiple daily subcutaneous insulin injection group according to their treatment therapy. Data were collected at admission, discharge, and 3 months post-discharge. RESULTS: Subjects in the CSII group who were still on insulin therapy transitioned from CSII to MDII; however, their daily insulin dosages were lower than those in the MDII group (15.31±10.98 U/d vs. 23.48±17.02 U/d, P=0.015) after discharge. In terms of medical costs, the CSII group had significantly higher hospitalization costs than the MDII group (112.36±103.43 thousand RMB vs. 82.65±77.98 thousand RMB, P=0.043). After 3 months, the CSII group had significantly lower outpatient costs than the MDII group (3.17±0.94 thousand RMB vs. 3.98±1.76 thousand RMB, P ˂ 0.001). In the MDII group, 10 patients reported severe postoperative complications requiring re-hospitalization; there were no similar reports in the CSII group. CONCLUSION: Temporary use of insulin pump therapy for perioperative patients with diabetes results in a reduction in blood glucose and blood glucose fluctuation during hospitalization, HbA1c, and the risk of postoperative complication and readmission, thus significantly decreasing costs in this complex patient cohort. Further work is needed to better understand indications for utilizing pump therapy based on diabetes phenotype and the complexity of planned surgical intervention.

Examining the structure of personality dysfunction.

Personality impairment is a core feature of personality disorders in both current (i.e., Diagnostic and Statistical Manual of Mental Disorders, fifth edition [DSM-5] personality disorders, International Classification of Diseases,11th revision personality disorders) and emerging (i.e., DSM-5's alternative model of personality disorders) models of psychopathology. Yet, despite its importance within clinical nosology, attempts to identify its optimal lower-order structure have yielded inconsistent findings. Given its presence in diagnostic models, it is important to better understand its empirical structure across a variety of instantiations. To the degree that impairment is multifaceted, various factors may have different nomological networks and varied implications for assessment, diagnosis, and treatment. Therefore, participants were recruited from two large public universities in the present preregistered study (N = 574) to explore the construct's structure with exploratory "bass-ackward" factor analyses at the item level. Participants completed over 250 items from six commonly used measures of personality dysfunction. Criterion variables in its nomological network were also collected (e.g., general and pathological personality traits, internalizing/externalizing behavior, and personality disorders) using both self- and informant-reports. These factor analyses identified four lower-order facets of impairment (i.e., negative self-regard, disagreeableness, intimacy problems, and lack of direction), all of which showed moderate to strong overlap with traits from both general and pathological models of personality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Exploring the structure of fearlessness using self-report measures.

OBJECTIVE: The present study examined the hierarchical structure of self-reported fearlessness and compared this structure to external criterion measures. BACKGROUND: Fearlessness is often discussed in relation to clinical and personality research. However, there is a paucity of research focusing on its empirical structure, in particular with self-report measures. METHOD: Using a preregistered analytical approach, we employed Goldberg's 2006 "bass-ackward" factor analysis on self-reported trait fear and fearlessness items to uncover the hierarchical structure of the construct. The final sample consisted of 619 participants and 562 informants. RESULTS: By assessing fit statistics and interpretability of the factors, we found a six-factor model fit the data best. The six-factor solution emerged as comprehensive and included components labeled Assertiveness, Low Anxiety, Sociability, Recklessness, Openness to Action, and Adventurousness. Criterion variables measuring boldness, fear, anxiety, psychopathy, basic personality traits, and impulsivity, were correlated with the factor scores at each factor level of the model. Conclusions The findings from this study elucidate how trait fearlessness unfolds at varying levels and how these factors relate to and diverge from various outcomes.

Comparing Brief Measures of Narcissism-Internal Consistency, Validity, and Coverage.

Many measures, varying in breadth and length, have been constructed to measure narcissism. In recent years, super-short forms have become popular in research settings. Although brief measures hold some advantages, their brevity can come at psychometric costs. Participants recruited from Amazon's Mechanical Turk (N = 473) completed long and brief narcissism measures and criterion measures in a randomized order. Short forms were examined and compared to long forms in terms of their completion times and psychometric properties. Generally, the short forms demonstrated adequate internal consistency, variable convergence with each other, mostly moderate to strong convergence with long forms, and appropriate convergence with external criteria. These findings suggest that some short forms may be used when efficiency of survey administration is particularly important without significant psychometric cost. We discuss the advantages and disadvantages of the brief measures and make recommendations for which to use depending on the priorities of a given study.

Momentary assessment of the relations between narcissistic traits, interpersonal behaviors, and aggression.

INTRODUCTION: This study explores the associations among narcissistic traits, interpersonal behaviors, and aggression using repeated, situation-based measurement. We examine narcissism's relations with aggression across three levels of its theorized hierarchy (level 1: narcissism; level 2: grandiose vs. vulnerable narcissism; level 3: antagonism, agentic extraversion, and narcissistic neuroticism). METHODS: Using an experience-sampling approach, the current study examined the effects of narcissism and its finer-grained components on daily affective experiences and aggressive behaviors in the context of interpersonal interactions. Data were collected from 477 undergraduate students who were instructed to complete four prompts a day for ten consecutive days. RESULTS: Narcissism at the global construct level positively predicted multiple indices of episodic aggression (i.e., aggressive temper, aggressive urge, verbal aggression). At the dual-dimension level, grandiose narcissism specifically predicted aggression, and then at the trifurcated level, interpersonal antagonism predicted aggression by itself and in interaction with event-level negative affect. Negative affect consistently exhibited both within- and between-person effects on aggression. CONCLUSION: In real-life social interactions, narcissism dimensions differentially affect the way individuals experience social interactions and process negative affect, and thus in both research and clinical practice, narcissism is best assessed as a heterogeneous, multidimensional construct.

Associations between food insecurity and child and parental physical, nutritional, psychosocial and economic well-being globally during the first 1000 days: A scoping review.

Food insecurity affects billions of individuals annually and contributes to myriad poor health outcomes. Experiences of food insecurity may be particularly harmful during the first 1000 days, but literature on the topic has not been synthesized. We therefore aimed to characterize all available studies examining associations between food insecurity and nutritional, psychosocial, physical and economic well-being among parents and children during this period. We implemented a standardized search strategy across 11 databases. Four researchers screened 10,257 articles, 120 of which met the inclusion criteria. Most studies were conducted in Sub-Saharan Africa (43.3%), followed by North America (20.8%). Studies were primarily quantitative (95.8%), cross-sectional (70.0%) and focused on women (pregnant or post-partum, 48.3%) or women and children (15.8%). Physical health outcomes were the most investigated (n = 87 studies), followed by nutritional (n = 69), psychosocial (n = 35) and economic well-being (n = 2). The most studied associations were between food insecurity and stunting (n = 15), maternal depression (n = 12), child dietary diversity (n = 7) and maternal body mass index (n = 6). The strength of evidence for the observed associations varied across populations as well as within and between examined outcomes. We recommend that future studies recruit more diverse study populations, consider temporality of relationships, use instruments that facilitate cross-site comparisons, measure individual-level food insecurity and outcomes most likely to be impacted by food insecurity, evaluate contextual factors that may modify the effects of food insecurity and employ analytic techniques that permit assessment of causal pathways.

The structure of aggressive personality.

OBJECTIVE: We sought to factor analyze a broad array of aggression measures to identify a comprehensive, coherent factor structure for this construct. BACKGROUND: Measures and models of trait aggression have multiplied to the point of incoherence. METHOD: In Study 1, a diverse sample of 922 undergraduates completed a battery of items acquired from 42 self-report aggression questionnaires. In Study 2, we administered a curated item pool to another diverse sample of 1447 undergraduates, alongside criterion measures. RESULTS: We curated an initial item pool of 734 items down to 289 items that exhibited sufficient variability, were not redundant with other items, and possessed strong loadings onto a central 'trait aggression' factor. These remaining items were best characterized by a six-factor structure, which captured relational, angry, violent, retaliatory, intimate partner, and alcohol forms of aggression. We estimated their hierarchical structure, correlations with their original aggression scales, Five Factor Model trait dimensions, impulsivity facets, and found them to be robust to gender composition and the inclusion of alcohol-naive and intimate-partner-naive participants. CONCLUSIONS: This factor structure mostly supported widely-accepted models of aggressive personality that focus on its overt and relational forms and reactive functions, though proactive aggression only loosely emerged as a distinct entity. We retained the final items as the Comprehensive Aggression Scale (CAS).

Is Personality Pathology Ego-Syntonic? Self- and Meta-Perception of Maladaptive Personality Traits.

Research has challenged the assumption that personality pathology is "ego-syntonic" or perceived favorably and consistent with one's self-image. The present study employed a community sample (n = 401) to examine relations between self-rated maladaptive personality and liking of maladaptive traits in self and others as well as meta-perception of personality pathology (i.e., how likable participants believe others find maladaptive traits). In general, individuals with higher self-rated maladaptive traits provided higher ratings of the likability of these traits in themselves and others. However, as hypothesized, comparison of liking ratings for high scorers and the rest of the sample revealed that individuals who score high on most pathological personality traits do not "like" these traits (or rate others as "liking" them) but simply dislike them less. Results support a dimensional view of ego-syntonicity.

Measuring the "Dark" Triad: Comparing the Five-Factor Model Antagonistic Triad Measure to Other Commonly Used Self-Report Instruments.

The "Dark" Triad (DT) refers to three personality constructs with ties to socially aversive behaviors: psychopathy, narcissism, and Machiavellianism. These constructs are commonly assessed via omnibus self-report inventories such as the Short Dark Triad (SD3) or the Dirty Dozen. Alternatively, researchers wishing to measure "dark" traits can compile stand-alone measures of each construct. Recently, the Five Factor Model Antagonistic Triad Measure (FFM ATM) was developed, which measures the DT from the perspective of the widely used Five Factor Model of personality. Initial validation studies indicated that the FFM ATM addresses common concerns with other omnibus inventories (e.g., allows for multifaceted examination of DT constructs). The current study tested the FFM ATM in relation to these other methods of measuring the DT (i.e., omnibus inventories and combinations of single-construct measures). Across three tests of validity (i.e., nomological network analysis, intraclass correlations, and incremental validity analyses), the FFM ATM showed favorable results and outperformed other measures of the DT.

Interpersonal and personality disorders: Commentary on Wright et al. (2022).

Wright et al. (2022) propose to replace personality disorders with a new classification of interpersonal disorders. We suggest that the trait model addresses well the limitations of the personality disorder categorical syndromes and accommodates the dynamics asserted as strengths of the interpersonal model. We identify weaknesses of the interpersonal model that explain why it has never been officially adopted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A comprehensive item-level examination of Conscientiousness' underlying structure across three large samples.

OBJECTIVE: The present study examined the hierarchical structure of Conscientiousness across three large samples using item-level analyses. BACKGROUND: Conscientiousness is among the strongest predictors of individual differences in major life outcomes. Yet decades of work understanding the optimal lower-order structure of Conscientiousness has not rectified the differences that remain among existing models and measures. To precisely measure its relations to major life outcomes, it is necessary to work toward a comprehensive, replicable conceptualization of the construct's structure. METHODS: The present pre-registered study used three samples (Ns = 446, 406, & 424) to explore the domain's latent structure with item-level "bass-ackward" factor analyses and evaluate the resulting structure's interpretability, parsimony, and replicability. Participants completed self-report measures of Conscientiousness and criteria in its nomological network (e.g., FFM traits, externalizing behavior, disinhibitory traits; informant reports were collected as well). RESULTS: The factor analyses identified five interpretable and replicable factors (i.e., deliberation, order, industriousness, self-discipline, and dependability) using predominant measures of general personality. An additional factor (i.e., traditionalism) was introduced in the six-factor solution when the item pool was expanded to include less widely used measures of general personality. CONCLUSION: The authors discuss the item composition of each factor, their relation to existing models and measures of the domain's structure, their association with relevant criteria, and the general implications of conceptualizing Conscientiousness using flexible, item-level factor analysis.

Test-retest reliability of the neuroanatomical correlates of impulsive personality traits in the adolescent brain cognitive development study.

While the neuroanatomical correlates of impulsivity in youths have been examined, there is little research on whether those correlates are consistent across childhood/adolescence. The current study uses data from the age 11/12 (N = 7,083) visit of the Adolescent Brain Cognitive Development Study to investigate the replicability of previous work (Owens et al., 2020) the neuroanatomical correlates of impulsive personality traits identified at age 9/10. Neuroanatomy was measured using structural and diffusion magnetic resonance imaging, and impulsive personality was measured using the UPPS-P Impulsive Behavior Scale. Replicability was quantified using three Open Science Collaboration replication criteria, intraclass correlations, and elastic net regression modeling to make predictions across timepoints. Replicability was highly variable among traits: The neuroanatomical correlates of positive urgency showed substantial similarity between ages 9/10 and 11/12, negative urgency and sensation seeking showed moderate similarity across ages, and (lack of) premeditation and perseverance showed substantial dissimilarity across ages. In all cases, effect sizes between impulsive traits and brain variables were small. These findings suggest that, even for studies with large sample sizes and the same participant pool, the replicability of brain-behavior correlations across a 2-year period cannot be assumed. This may be due to developmental changes across the two timepoints or false-positive/false-negative results at one or both timepoints. These results also highlight an array of neuroanatomical structures that may be important to impulsive personality traits across development from childhood into adolescence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development of a measure of aggressive behavior expectancies in adults: The Aggression Expectancy Questionnaire.

According to sociocognitive theories, aggression is learned and elicited through a series of cognitive processes, such as expectancies, or the various consequences that an individual considers more or less likely following aggressive behavior. The current manuscript describes a measurement development project that ultimately yielded a 16-item measure of positive and negative aggression expectancies suitable for use in adult populations. Across two content generation surveys, two preliminary item refinement studies, and three full studies, we took an iterative approach and administered large item pools to several samples and refined item content through a combination of empirical (i.e., factor loadings, model fit) and conceptual (i.e., content breadth, non-redundancy) considerations. The Aggression Expectancy Questionnaire displays a four-factor structure, as well as evidence of convergent and divergent validity with self-reported aggression and relevant basic (e.g., antagonism, anger) and complex (e.g., psychopathy) personality variables. It is posited that this type of cognitive mechanism may serve as an intermediary link between distal characterological predictors of aggression and its proximal manifestation, which is in line with several prominent theories of personality and may ultimately hold clinical utility by providing a framework for aggression interventions.

Age and gender differences in narcissism: A comprehensive study across eight measures and over 250,000 participants.

Age and gender differences in narcissism have been studied often. However, considering the rich history of narcissism research accompanied by its diverging conceptualizations, little is known about age and gender differences across various narcissism measures. The present study investigated age and gender differences and their interactions across eight widely used narcissism instruments (i.e., Narcissistic Personality Inventory, Hypersensitive Narcissism Scale, Dirty Dozen, Psychological Entitlement Scale, Narcissistic Personality Disorder Symptoms from the Diagnostic and Statistical Manual of Mental Disorders, Version IV, Narcissistic Admiration and Rivalry Questionnaire-Short Form, Single-Item Narcissism Scale, and brief version of the Pathological Narcissism Inventory). The findings of Study 1 (N = 5,736) revealed heterogeneity in how strongly the measures are correlated. Some instruments loaded clearly on one of the three factors proposed by previous research (i.e., Neuroticism, Extraversion, Antagonism), while others cross-loaded across factors and in distinct ways. Cross-sectional analyses using each measure and meta-analytic results across all measures (Study 2) with a total sample of 270,029 participants suggest consistent linear age effects (random effects meta-analytic effect of r = -.104), with narcissism being highest in young adulthood. Consistent gender differences also emerged (random effects meta-analytic effect was -.079), such that men scored higher in narcissism than women. Quadratic age effects and Age × Gender effects were generally very small and inconsistent. We conclude that despite the various conceptualizations of narcissism, age and gender differences are generalizable across the eight measures used in the present study. However, their size varied based on the instrument used. We discuss the sources of this heterogeneity and the potential mechanisms for age and gender differences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining the Therapeutic Effect of Ceremonial Ayahuasca on Narcissistic Personality and Antagonistic Externalizing in Adults.

Changes in narcissistic traits (e.g., entitlement) following the ceremonial use of ayahuasca were examined across three timepoints (baseline, postretreat, 3-month follow-up) in a sample of 314 adults using self- and informant-report (N = 110) measures. Following ceremonial use of ayahuasca, self-reported changes in narcissism were observed (i.e., decreases in Narcissistic Personality Inventory [NPI] Entitlement-Exploitativeness, increases in NPI Leadership Authority, decreases in a proxy measure of narcissistic personality disorder [NPD]). However, effect size changes were small, results were somewhat mixed across convergent measures, and no significant changes were observed by informants. The present study provides modest and qualified support for adaptive change in narcissistic antagonism up to 3 months following ceremony experiences, suggesting some potential for treatment efficacy. However, meaningful changes in narcissism were not observed. More research would be needed to adequately evaluate the relevance of psychedelic-assisted therapy for narcissistic traits, particularly studies examining individuals with higher antagonism and involving antagonism-focused therapeutic approaches.

Body Composition Trajectories During the First 23 Months of Life Differ by HIV Exposure Among Infants in Western Kenya: A Prospective Study.

BACKGROUND: Infants who are HIV-exposed and uninfected have suboptimal growth patterns compared to those who are HIV-unexposed and uninfected. However, little is known about how these patterns persist beyond 1 year of life. OBJECTIVES: This study aimed to examine whether infant body composition and growth trajectories differed by HIV exposure during the first 2 years of life among Kenyan infants using advanced growth modeling. METHODS: Repeated infant body composition and growth measurements (mean: 6; range: 2-7) were obtained from 6 weeks to 23 months in the Pith Moromo cohort in Western Kenya (n = 295, 50% HIV-exposed and uninfected, 50% male). Body composition trajectory groups were fitted using latent class mixed modeling (LCMM) and associations between HIV exposure and growth trajectories were examined using logistic regression analysis. RESULTS: All infants exhibited poor growth. However, HIV-exposed infants generally grew suboptimally than unexposed infants. Across all body composition models except for the sum of skinfolds, HIV-exposed infants had a higher likelihood of belonging to the suboptimal growth groups identified by LCMM than the HIV-unexposed infants. Notably, HIV-exposed infants were 3.3 times more likely (95% CI: 1.5-7.4) to belong to the length-for-age z-score growth class that remained at a z-score of < -2, indicating stunted growth. HIV-exposed infants were also 2.6 times more likely (95% CI: 1.2-5.4) to belong to the weight-for-length-for-age z-score growth class that remained between 0 and -1, and were 4.2 times more likely (95% CI: 1.9-9.3) to belong to the weight-for-age z-score growth class that indicated poor weight gain besides stunted linear growth. CONCLUSIONS: In a cohort of Kenyan infants, HIV-exposed infants grew suboptimally compared to HIV-unexposed infants beyond 1 year of age. These growth patterns and longer-term effects should be further investigated to support the ongoing efforts to reduce early-life HIV exposure-related health disparities.

Methodological and quantitative issues in the study of personality pathology.

This special issue presents 12 invited articles on quantitative and methodological issues of particular importance in the study of personality disorders (PDs). The special issue includes manuscripts on issues related to open science (i.e., registration continuum), sampling practices, concerns with the application of PD research and diagnoses to minoritized populations, best practices for addressing comorbidity and heterogeneity, aligning experimental, behavioral tasks used in PD work with Research Domain Criteria constructs, studying PDs using ecological momentary assessment, as well as other longitudinal approaches. Additional manuscripts cover the need to think carefully about response validity in data collection, recommendations for the ongoing use of factor analysis, concerns and recommendations for the search for elusive and typically underpowered moderators, and a review of the clinical trial literature as it relates to PDs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Questionable Practice of Partialing to Refine Scores on and Inferences About Measures of Psychological Constructs.

Partialing is a statistical approach researchers use with the goal of removing extraneous variance from a variable before examining its association with other variables. Controlling for confounds through analysis of covariance or multiple regression analysis and residualizing variables for use in subsequent analyses are common approaches to partialing in clinical research. Despite its intuitive appeal, partialing is fraught with undesirable consequences when predictors are correlated. After describing effects of partialing on variables, we review analytic approaches commonly used in clinical research to make inferences about the nature and effects of partialed variables. We then use two simulations to show how partialing can distort variables and their relations with other variables. Having concluded that, with rare exception, partialing is ill-advised, we offer recommendations for reducing or eliminating problematic uses of partialing. We conclude that the best alternative to partialing is to define and measure constructs so that it is not needed.