How do Americans perceive the stigma of leprosy?

The stigma of leprosy will have reduced effects if people cannot reliably perceive it. Two factors impact these perceptions: familiarity and entitativity. One hundred and forty-five participants tested this assertion using an online platform to complete measures of stigma about leprosy as well as measures of familiarity and entitativity. The group of 145 completed the same measures of stigma, entitativity, and familiarity 1 week later. Standard deviations of time 1 and time 2 measures of stigma were used as indices of consistent (reliable) perceptions at the individual level. Results showed partial support for familiarity being positively associated with reliable responding. Moreover, high entitativity scores were associated with greater stigma perceptions at time 1 and time 2. Ongoing research on these indicators may be important in crafting future anti-stigma programs for leprosy.

Stopping Rules for Computer Adaptive Testing When Item Banks Have Nonuniform Information.

The standard error (SE) stopping rule, which terminates a computer adaptive test (CAT) when the SE is less than a threshold, is effective when there are informative questions for all trait levels. However, in domains such as patient reported outcomes, the items in a bank might all target one end of the trait continuum (e.g., negative symptoms), and the bank may lack depth for many individuals. In such cases, the predicted standard error reduction (PSER) stopping rule will stop the CAT even if the SE threshold has not been reached, and can avoid administering excessive questions that provide little additional information. By tuning the parameters of the PSER algorithm, a practitioner can specify a desired tradeoff between accuracy and efficiency. Using simulated data for the PROMIS Anxiety and Physical Function banks, we demonstrate that these parameters can substantially impact CAT performance. When the parameters were optimally tuned, the PSER stopping rule was found to outperform the SE stopping rule overall and particularly for individuals not targeted by the bank, and presented roughly the same number of items across the trait continuum. Therefore, the PSER stopping rule provides an effective method for balancing the precision and efficiency of a CAT.

Differential effects of cognition-focused interventions for people with Alzheimer's disease: A meta-analysis.

OBJECTIVE: The efficacy of cognition-focused interventions (CFIs) for the treatment of Alzheimer's disease (AD) has been questioned recently. To date, the specific effects of cognitive rehabilitation (CR), cognitive training (CT), and cognitive stimulation [CS] have not been analyzed due to inconsistencies in the use of the comparison groups. This work aims to analyze the differential effects of CFIs by removing the influence of the comparison group from the estimates of the effects. METHOD: a literature search performed in Pubmed, Proquest, and Embase databases yielded 65 potential studies, of which 33 studies with a sample size of 1,225 individuals were meta-analyzed. Each intervention group was treated as the unit of analysis to remove the confounding effects of the comparison condition. Measures of general cognitive functioning, memory and functional outcomes were compared using the hierarchical robust variance estimator metaregression. Age, education, sex, risk of bias, sample size, duration of intervention, the proportion of drop-outs, pharmacological treatment, and severity of disease were included as covariates. RESULTS: Only CT differed from no cognition-focused interventions (NCFI) for memory outcomes in univariate analyses, but differences became nonsignificant when covariates were included in the model. CR showed a significantly higher effect in outcomes measuring functioning in targeted domains with no differences in standard cognitive tests relative to NCFI. CONCLUSIONS: This work supports previous findings questioning the efficacy of CT or CS for AD. Moving toward CFIs focused on relevant goals and including measures related to the skills, abilities or activities that are the focus of the intervention is encouraged. (PsycINFO Database Record

A meta-analysis of the relationship between individual assessments and job performance.

Though individual assessments are widely used in selection settings, very little research exists to support their criterion-related validity. A random-effects meta-analysis was conducted of 39 individual assessment validation studies. For the current research, individual assessments were defined as any employee selection procedure that involved (a) multiple assessment methods, (b) administered to an individual examinee, and (c) relying on assessor judgment to integrate the information into an overall evaluation of the candidate's suitability for a job. Assessor recommendations were found to be useful predictors of job performance, although the level of validity varied considerably across studies. Validity tended to be higher for managerial than nonmanagerial occupations and for assessments that included a cognitive ability test. Validity was not moderated by the degree of standardization of the assessment content or by use of multiple assessors for each candidate. However, higher validities were found when the same assessor was used across all candidates than when different assessors evaluated different candidates. These results should be interpreted with caution, given a small number of studies for many of the moderator subgroups as well as considerable evidence of publication bias. These limitations of the available research base highlight the need for additional empirical work to inform individual assessment practices. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Measurement equivalence of the Empowerment Scale for White and Black persons with severe mental illness.

OBJECTIVE: The current study examined the measurement equivalence on a measure of personal empowerment for Black and White consumers of mental health services. METHOD: Confirmatory factor analysis was used to assess measurement equivalence of the 28-item Empowerment Scale (Rogers, Chamberlin, Ellison, & Crean, 1997), using data from 1,035 White and 301 Black persons with severe mental illness. RESULTS: Metric invariance of the Empowerment Scale was supported, in that the factor structure and loadings were equivalent across groups. Scalar invariance was violated on 3 items; however, the impact of these items on scale scores was quite small. Finally, subscales of empowerment tended to be more highly intercorrelated for Black than for White respondents. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: RESULTS generally support the use of Empowerment Scale for ethnic group comparisons. However, subtle differences in the psychometric properties of this measure suggest that Black and White individuals may conceptualize the construct of empowerment in different ways. Specifically, Black respondents had a lower threshold for endorsing some items on the self-esteem and powerlessness dimensions. Further, White respondents viewed the 3 dimensions of empowerment (self-esteem, powerlessness, and activism) as more distinct, whereas these 3 traits were more strongly interrelated for Blacks.

Challenging the public stigma of mental illness: a meta-analysis of outcome studies.

OBJECTIVE: Public stigma and discrimination have pernicious effects on the lives of people with serious mental illnesses. Given a plethora of research on changing the stigma of mental illness, this article reports on a meta-analysis that examined the effects of antistigma approaches that included protest or social activism, education of the public, and contact with persons with mental illness. METHODS: The investigators heeded published guidelines for systematic literature reviews in health care. This comprehensive and systematic review included articles in languages other than English, dissertations, and population studies. The search included all articles from the inception of the databases until October 2010. Search terms fell into three categories: stigma, mental illness (such as schizophrenia and depression), and change program (including contact and education). The search yielded 72 articles and reports meeting the inclusion criteria of relevance to changing public stigma and sufficient data and statistics to complete analyses. Studies represented 38,364 research participants from 14 countries. Effect sizes were computed for all studies and for each treatment condition within studies. Comparisons between effect sizes were conducted with a weighted one-way analysis of variance. RESULTS: Overall, both education and contact had positive effects on reducing stigma for adults and adolescents with a mental illness. However, contact was better than education at reducing stigma for adults. For adolescents, the opposite pattern was found: education was more effective. Overall, face-to-face contact was more effective than contact by video. CONCLUSIONS: Future research is needed to identify moderators of the effects of both education and contact.

Predictors of Self-Stigma in Schizophrenia: New Insights Using Mobile Technologies.

OBJECTIVE: Self-stigma has significant negative impact on the recovery of individuals with severe mental illness, but its varying course is not well understood. Individual levels of self-stigma may vary over time and fluctuate in response to both external/contextual (i.e., location, activity, social company) and internal (i.e., psychiatric symptoms, mood) factors. The aim of this study was to examine the relationship between self-stigmatizing beliefs and these factors, as they occur in the daily life of individuals with schizophrenia. METHODS: Mobile technologies were used to longitudinally track momentary levels of self-stigma, psychotic symptoms, negative affect, positive affect, activity, and immediate social and physical environment in twenty-four individuals with schizophrenia, multiple times daily, over a one-week period. RESULTS: Multilevel modeling showed that participants' current activity was associated with changes in self-stigma (χ2= 10.53, p <0.05), but immediate location and social company were not. Time-lagged analyses found that increases in negative affect (ß=0.11, p<0.01) and psychotic symptom severity (ß=0.16, p<0.01) predicted increases in the intensity of self-stigmatizing beliefs. Psychotic symptoms were found to be both an antecedent and a consequence (ß=0.08, p<0.01) of increased self-stigma. CONCLUSIONS: Our findings support a framework for understanding self-stigma as an experience that changes based on alterations in internal states and external circumstances. Mobile technologies are an effective methodology to study self-stigma and have potential to be used to deliver clinical interventions.

Using Lancaster's mid-P correction to the Fisher's exact test for adverse impact analyses.

Adverse impact is often assessed by evaluating whether the success rates for 2 groups on a selection procedure are significantly different. Although various statistical methods have been used to analyze adverse impact data, Fisher's exact test (FET) has been widely adopted, especially when sample sizes are small. In recent years, however, the statistical field has expressed concern regarding the default use of the FET and has proposed several alternative tests. This article reviews Lancaster's mid-P (LMP) test (Lancaster, 1961), an adjustment to the FET that tends to have increased power while maintaining a Type I error rate close to the nominal level. On the basis of Monte Carlo simulation results, the LMP test was found to outperform the FET across a wide range of conditions typical of adverse impact analyses. The LMP test was also found to provide better control over Type I errors than the large-sample Z-test when sample size was very small, but it tended to have slightly lower power than the Z-test under some conditions.

Accents in the workplace: their effects during a job interview.

As the workplace becomes increasingly global, organizations are more likely to employ persons from other countries whose accents clearly identify them as different from the local workforce. Understanding the impact of accents in the workplace is important because accents can be salient in the same way as ethnicity, age, gender, and skin color and may be a source of employment discrimination. The present study looked at the influence of accents on the evaluation of job applicants during an interview for a human resource manager position. Participants from the US were asked to evaluate an applicant with one of three accents (Midwestern US, French, Colombian) by listening to an audiofile. The results showed that the applicant with the Midwestern US accent was evaluated more positively than the applicant with the French accent; however, the applicant with the Colombian accent did not receive an evaluation that differed significantly from those given to the applicants with either the French or the Midwestern US accent. Analyses of process variables indicated that the bias against the French-accented applicant was mediated by perceived lower similarity. These results are consistent with the similarity-attraction hypothesis, which states that demographic variables will impact judgments to the extent to which they make the decision-maker view the applicant as similar or dissimilar. The ability of accent to trigger bias highlights the importance of considering the full array of characteristics that can lead to discrimination in employment settings. Research on employment discrimination has traditionally focused on visual cues such as gender and ethnicity, but in an interview situation, the way the applicant speaks is also important.

Testing for adverse impact when sample size is small.

Adverse impact evaluations often call for evidence that the disparity between groups in selection rates is statistically significant, and practitioners must choose which test statistic to apply in this situation. To identify the most effective testing procedure, the authors compared several alternate test statistics in terms of Type I error rates and power, focusing on situations with small samples. Significance testing was found to be of limited value because of low power for all tests. Among the alternate test statistics, the widely-used Z-test on the difference between two proportions performed reasonably well, except when sample size was extremely small. A test suggested by G. J. G. Upton (1982) provided slightly better control of Type I error under some conditions but generally produced results similar to the Z-test. Use of the Fisher Exact Test and Yates's continuity-corrected chi-square test are not recommended because of overly conservative Type I error rates and substantially lower power than the Z-test.

Patient satisfaction with nursing care: a multilevel analysis.

Although prior research has suggested that satisfaction with nursing care is affected by multilevel factors (e.g., patient characteristics, episode-of-care, the institution providing care), these studies typically focused only on a single level of analysis. The present study examines three levels of influence simultaneously to assess the relative effect each has on satisfaction. Results suggest that satisfaction is determined primarily by the patient and the episode of care; organization-level factors explained almost no additional variance.

Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs.

When a meta-analysis on results from experimental studies is conducted, differences in the study design must be taken into consideration. A method for combining results across independent-groups and repeated measures designs is described, and the conditions under which such an analysis is appropriate are discussed. Combining results across designs requires that (a) all effect sizes be transformed into a common metric, (b) effect sizes from each design estimate the same treatment effect, and (c) meta-analysis procedures use design-specific estimates of sampling variance to reflect the precision of the effect size estimates.