Mental Health Monitoring: Design Concept of a Smartphone Application.

Mental health (MH) has become a global issue. Digital phenotyping in mental healthcare provides a highly effective, scaled, cost-effective approach to handling global MH problems. We propose an MH monitoring application. The application monitors overall MH based on mood, stress, behavior, and personality. Further, it proposes objective MH assessment from smartphone data and subjective screening of MH via periodic, short, self-report standardized questionnaires.

Focusing on what matters: Restructuring the presentation of Bayesian reasoning problems.

We propose that a mismatch in problem presentation and question structures may promote errors on Bayesian reasoning problems. In this task, people determine the likelihood that a positive test actually indicates the presence of a condition. Research has shown that people routinely fail to correctly identify this positive predictive value (PPV). We point out that the typical problem structure is likely to confuse reasoners by focusing on the incorrect reference class for answering this diagnostic question; instead, providing the anchor needed to address the diagnostic question about sensitivity (SEN). Results of two experiments are described in which participants answer diagnostic questions using problems presented with congruent or incongruent reference classes. Aligning reference classes eases both representational and computational difficulties, increasing the proportion who were consistently accurate to an unprecedented 93% on PPV questions, and 69% on SEN questions. Analysis of response components from incongruent problems indicated that many errors reflect difficulties in identifying and applying appropriate values from the problem, which are prerequisite processes that contribute to computational errors. We conclude with a discussion of the need, especially in applied settings and on initial exposure, to adopt problem presentations to guide, rather than confuse, the organization and use of diagnostic information. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Improving Understanding of Diagnostic Test Outcomes.

BACKGROUND: Understanding diagnostic test outcomes requires determining the positive predictive value (PPV) of the test, which most laypeople and medical professionals struggle to do. Despite advances found with frequency formats and visual aids, less than 40% of people can typically identify this value. This study tests the impact of using congruent reference classes in problem-question pairings, evaluates the role of numeracy, and assesses how diagnostic value estimates affect the reported likelihood to use the test. METHOD: A 3 × 2, Pairing (congruent test-focus, congruent condition-focus, incongruent) × Response Format (frequency, percentage) mixed design experiment was conducted, in which participants answered diagnostic questions about 7 medical problems presented in a format focusing either on the reference class of those who test positive or those who have the condition. Answer accuracy, numeracy, and ratings of likelihood to use estimates were assessed. RESULTS: Focusing on the congruent test reference class allowed 87% of participants to consistently identify the PPV, and focusing on the congruent condition reference class led 63% of participants to consistently identify the sensitivity (SEN). Aligning reference classes was especially beneficial for those with lower numeracy, increasing accuracy on problems from 21% for incongruent pairings to 66% for congruent pairings. Ratings of likelihood to use the test were closely tied to participants' estimates of diagnostic values, regardless of the accuracy of those estimates. CONCLUSIONS: Although often overlooked, a straightforward mapping of reference classes from the relevant diagnostic information to the question of interest reduces confusion and substantially increases accuracy in estimates of diagnostic values. These findings can be used to strengthen training in the assessment of uncertainties associated with medical test results.

Effect of propranolol on naming in chronic Broca's aphasia with anomia.

Previous research suggests that the noradrenergic system modulates flexibility of access to the lexical-semantic network, with propranolol benefiting normal subjects in lexical-semantic problem solving tasks. Patients with Broca's aphasia with anomia have impaired ability to access appropriate verbal output for a given visual stimulus in a naming task. Therefore, we tested naming in a pilot study of chronic Broca's aphasia patients with anomia after propranolol and after placebo in a double-blinded crossover manner. Naming was better after propranolol than after placebo, suggesting a potential benefit from propranolol in chronic Broca's aphasia with anomia. Larger follow-up studies are necessary to further investigate this effect.

Mapping child molester treatment progress with the FoSOD: denial and explanations of accountability.

A continuing challenge in the treatment of sexual offenders involves the identification of measurement instruments that can be used to monitor treatment progress. This paper provides evidence that the Facets of Sexual Offender Denial (FoSOD; pronounced "façade") Scale maps critical aspects of treatment progress, yet avoids problems typically associated with self-report measures. Fifty-three child molesters completed the FoSOD twice with an 18-month interval between administrations. The Time 1 and Time 2 FoSOD scores were analyzed as a function of advancement through a court-sanctioned sexual offender treatment program. Results demonstrated not only that advancement in treatment corresponded with predictable changes in FoSOD scores, but also that FoSOD component scores, representing denial associated with refutation, minimization and depersonalization of the offense, revealed critical patterns indicative of the issues with which offenders contend at various points within treatment. These results are discussed within a conceptual framework that recognizes the relationships between denial in its various forms and the explanations that offenders develop to limit their accountability for alleged offenses, associated thoughts or behaviors, and deviant predispositions.

Understanding denial in sexual offenders: a review of cognitive and motivational processes to avoid responsibility.

Treatment of sexual offenders is routinely complicated by the presence of denial. This article examines how denial is related to the willingness to take responsibility for offense-related thoughts and actions and how conceptualizations of denial have developed and changed over time. Multiple facets of denial are described in detail, along with an assessment of how different forms of denial undermine acceptance of responsibility throughout treatment. Evidence is presented to show that resistance and denial often hinge on cognitive and motivational processes that are commonly accepted as fundamental treatment targets rather than treatment obstacles. The authors propose that denial may be best understood as the acceptance of explanations that reduce accountability and are reinforced by distorted beliefs and self-deceptive thinking processes. The article concludes with a discussion of the rich clinical information embedded in different expressions of denial and the benefits of treatment strategies designed to assess and work through them.

Verb production in agrammatic aphasia: The influence of semantic class and argument structure properties on generalisation.

BACKGROUND: Some individuals with agrammatic aphasia have difficulty producing verbs when naming and generating sentences (Miceli, Silveri, Villa, & Caramazza, 1984; Saffran, Schwartz, & Marin, 1980; Zingeser & Berndt, 1990). And when verbs are produced there is an over-reliance on verbs requiring simple argument structure arrangements (Thompson, Lange, Schneider, & Shapiro, 1997; Thompson, Shapiro, Schneider, & Tait, 1994). Verbs, as argument-taking elements, show especially complex semantic and argument structure properties. This study investigated the role these properties have on verb production in individuals with agrammatic aphasia. AIM: This treatment study examined the extent to which semantic class and argument structure properties of verbs influenced the ability of seven individuals with agrammatic Broca's aphasia to retrieve verbs and then use them in correct sentence production. Verbs from two semantic classes and two argument structure categories were trained using either a semantic or an argument structure verb retrieval treatment. Specifically, acquisition and generalisation to trained and untrained verbs within and across semantic and argument structure categories was examined. In addition, the influence of verb production on each participant's sentence production was also examined. METHODS #ENTITYSTARTX00026; PROCEDURES: Utilising a single-subject crossover design in combination with a multiple baseline design across subjects and behaviours, seven individuals with agrammatic aphasia were trained to retrieve verbs with specific argument structures from two semantic classes under two treatment conditions-semantic verb retrieval treatment and verb argument structure retrieval treatment. Treatment was provided on two-place and three-place motion or change of state verbs, counterbalanced across subjects and behaviours. A total of 102 verbs, depicted in black and white drawings, were utilised in the study, divided equally into motion and change of state verbs (semantic classes) and one-place, two-place, and three-place verbs (argument structure arrangements). Verbs were controlled for syllable length, picturability, phonological complexity, and frequency. These same stimulus items were used to elicit the sentence production probe. OUTCOMES #ENTITYSTARTX00026; RESULTS: Both treatments revealed significant effects in facilitating acquisition of verb retrieval in all participants. Minimal within and across verb category generalisation occurred. However, it was found that as retrieval of verbs improved, grammatical sentence production improved. This occurred without direct treatment on sentence production. CONCLUSIONS: The results of this study lend support for treatment focused on verb production with individuals with agrammatic aphasia and support the use of linguistic-based treatment strategies.