Differences in social support, emotion invalidation, psychological needs, cognitive emotion regulation in maritally adjusted and maladjusted women in Pakistan: A matched pairs design.

The present study aimed to find out differences of social support, perceived emotion invalidation, psychological needs, and use of adaptive and maladaptive cognitive emotion regulation strategies in maritally adjusted and maladjusted after controlling for age, education, employment status, and depressive symptomatology. The cross-sectional study uses a matched pairs design. The sample was divided into two groups; maritally adjusted and maladjusted women (n = 40 pairs) on basis of scores obtained on revised-dyadic adjustment scale. Forty maritally adjusted women were matched with 40 maritally maladjusted women according to age, education, and employment status. Social support questionnaire, perceived invalidation of emotion scale, basic psychological need satisfaction frustration scale, cognitive emotion regulation questionnaire, and center for epidemiologic studies depression scale were administered. One-way ANCOVA revealed that maritally maladjusted women had lower level of social support [mean difference; -5.65(-9.97, -1.33), p < 0.05, partial η2 = 0.08] and more emotional invalidation [mean difference; 15.36(13.08, 17.65), p < 0.001, partial η2 = 0.71] compared to maritally adjusted women after controlling for the effect of depressive symptomatology. Maritally maladjusted women had more need frustration [mean difference; 10.75(7.59, 13.92), p < 0.001, partial η2 = 0.38] compared to maritally adjusted women. However, maritally adjusted women had more need satisfaction [mean difference; 13.36(9.67, 17.05), p < 0.001, partial η2 = 0.41] compared to maritally maladjusted women. Maritally adjusted women used more adaptive CER strategies (acceptance, refocus on planning and putting into perspective) [mean difference; 4.66(2.36, 6.95), p < 0.001, partial η2 = 0.18] compared to maritally maladjusted women whereas, maritally maladjusted women used more maladaptive strategies (self-blame, catastrophizing and blaming others) [mean difference; 4.66(2.77, 6.54), p < 0.001, partial η2 = 0.25] compared to maritally adjusted women. Maladjusted women had less social support and more emotional invalidation of emotions and psychological needs frustration. They used more maladaptive strategies to manage their negative emotions in comparison to maritally adjusted women. Identification of these cognitive emotion regulation strategies will help clinicians and counselors to devise psychological intervention targeting the use of adaptive strategies to minimize the negative mental health consequences.

Confidence intervals of the difference between areas under two ROC curves in matched-pair experiments.

In a matched-pair study, when outcomes of two diagnostic tests are ordinal/continuous, the difference between two correlated areas under ROC curves (AUCs) is usually used to compare the overall discriminatory ability of two diagnostic tests. This article considers confidence interval (CI) construction problems of difference between two correlated AUCs in a matched-pair experiment, and proposes 13 hybrid CIs based on variance estimates recovery with the maximum likelihood estimation, Delong's statistic, Wilson score statistic (WS) and WS with continuity correction, the modified Wald statistic (MW) and MW with continuity correction and Agresti-Coull statistic, and three Bootstrap-resampling-based CIs. For comparison, we present traditional parametric and nonparametric CIs. Simulation studies are conducted to assess the performance of the proposed CIs in terms of empirical coverage probabilities, empirical interval widths, and ratios of the mesial noncoverage probabilities to the noncoverage probabilities. Two examples from clinical studies are illustrated by the proposed methodologies. Empirical results evidence that the hybrid Agresti-Coull CI with the empirical estimation (EAC) behaved most satisfactorily because its coverage probability was quite close to the prespecified confidence level with short interval width. Hence, we recommend the usage of the EAC CI in applications.

Drive aware training: A computerized training program for older drivers' detection of road hazards.

OBJECTIVE: Cognitive training for reducing crash rate can be delivered to older drivers via in-person on-road sessions, a driving simulator, or using computer-based cognitive methods. Despite established effectiveness, in-person on-road assessment and rehabilitation are expensive, and limited professional service may not be readily accessible; simulator-based training may not fit every driver due to simulator sickness. In comparison, computerized training is easier to implement and could be delivered with little cost to older drivers with computer access. Based on the Drive Aware Task, a validated measure of attentional processes in hazard detection, we developed a computerized cognitive training method with a focus on hazard detection. In this study, we examined the effectiveness of this newly-developed interactive training program in improving older drivers' detection of road hazards. METHODS: Using a matched-pair design, nine triads of three older drivers (aged 65 or above) with matched pretest performance and gender were formed. For each triad, each participant was randomly allocated to one of the three groups: 1) active training group to receive the two training sessions (1.5-2.5h per session); 2) passive training group to receive two video-watching sessions (i.e., watch the video of training session performance from the corresponding paired participant); 3) no-contact control group. Older drivers' performances on hazard detection and simulated driving were measured before and after training. RESULTS: The active training group showed significant training effects on the computerized hazard detection task and simulated driving performance, while there were only marginal effects in the passive training group and no effects in the no-contact control group. A post-training survey suggested older drivers were receptive to the Drive Aware training program. CONCLUSIONS: The computerized Drive Aware training program has the potential to be used as a prevention and intervention tool to improve older drivers' hazard detection performance. Future studies should examine the effectiveness of this tool in more diverse samples and in long-term outcomes.

A comparative study of matched pair designs with two binary endpoints.

We study matched pair designs with two binary endpoints under three different approaches. Power approximation and sample size calculation are derived under these situations and facilitated by R programs. An adaptive design with sample size re-estimation is also presented. Through extensive simulations, we provide general guidelines for practitioners to choose the best approach according to the ranges of the interested parameters in the sense of feasibility and robustness. Application to a cancer chemotherapy trial is illustrated.