The Shame and Guilt Scales of the Test of Self-Conscious Affect-Adolescent (TOSCA-A): Factor Structure, Concurrent and Discriminant Validity, and Measurement and Structural Invariance Across Ratings of Males and Females

This study examined various psychometric properties of the items comprising the shame and guilt scales of the Test of Self-Conscious Affect-Adolescent. A total of 563 adolescents (321 females and 242 males) completed these scales, and also measures of depression and empathy. Confirmatory factor analysis provided support for an oblique two-factor model, with the originally proposed shame and guilt items comprising shame and guilt factors, respectively. Also, shame correlated with depression positively and had no relation with empathy. Guilt correlated with depression negatively and with empathy positively. Thus, there was support for the convergent and discriminant validity of the shame and guilt factors. Multiple-group confirmatory factor analysis comparing females and males, based on the chi-square difference test, supported full metric invariance, the intercept invariance of 26 of the 30 shame and guilt items, and higher latent mean scores among females for both shame and guilt. Comparisons based on the difference in root mean squared error of approximation values supported full measurement invariance and no gender difference for latent mean scores. The psychometric and practical implications of the findings are discussed.

Does pegvisomant treatment expertise improve control of resistant acromegaly? The Italian ACROSTUDY experience

OBJECTIVE

GH receptor antagonist pegvisomant is indicated for treatment of patients with resistant acromegaly. We compared safety and treatment outcomes of pegvisomant therapy in patients managed by Italian centers enrolling less or more than 15 cases in ACROSTUDY, a safety surveillance study of long-term pegvisomant treatment of patients with acromegaly. A noninterventional safety surveillance study in which safety and treatment outcomes of pegvisomant were evaluated on the basis of data collected during a 7-year period.

METHODS

A total of 204 acromegaly patients treated by seven centers enrolling 16-49 patients each (group A) and 137 subjects by 18 centers following 3-14 cases ( group B).

RESULTS

Patients of group A and B were treated for 4.4 ± 2.7 and 4.2 ± 2.2 years, respectively. IGF-1 ULN normalized in 64.4 % (n = 56) and 54.4 % (n = 31) in group A and B, respectively, after 1-year treatment, and in 57.3 % (n = 106) and 72.5 % (n = 87) at last visit. Starting doses were significantly higher in group A. They were progressively increased during treatment in both groups, but were higher in uncontrolled patients than in controlled ones only in group A. Reported adverse events were more frequent, and the prevalence of patients with adverse events was higher in group B.

CONCLUSIONS

On the basis of this original study approach, we could speculate that in the centers in which more patients are treated with pegvisomant, less adverse events are reported, but the long-term effectiveness is lower than in centers with less cases, perhaps because of an inadequate patient's selection.

Latent profile analysis of working memory performance in a sample of children with ADHD

The current study used latent profile analysis (LPA) to ascertain distinct groups of children with ADHD (N = 701) in terms of performance on working memory (WM) tasks that tapped visuospatial sketchpad, spatial central executive, and verbal central executive functions. It compared the WM performances of these classes with a clinical comparison group (N = 59). The participants' age ranged from 7 to 16 years (586 males, 71 females). The results of the LPA supported three classes. For all three WM tasks, class 1 (N = 196) had more difficulties than classes 2 (N = 394) and 3 (N = 111), and the clinical comparison group. Class 2 had more difficulties than class 3 and the clinical comparison group, and there was no difference between class 3 and the clinical comparison group. Class 1 had lower IQ and academic abilities, and relatively more individuals with depressive disorders. The implications of the findings for understanding ADHD and its treatment are discussed.

Duration-dependent effects of the BDNF Val66Met polymorphism on anodal tDCS induced motor cortex plasticity in older adults: a group and individual perspective

The brain derived neurotrophic factor (BDNF) Val66Met polymorphism and stimulation duration are thought to play an important role in modulating motor cortex plasticity induced by non-invasive brain stimulation (NBS). In the present study we sought to determine whether these factors interact or exert independent effects in older adults. Fifty-four healthy older adults (mean age = 66.85 years) underwent two counterbalanced sessions of 1.5 mA anodal transcranial direct current stimulation (atDCS), applied over left M1 for either 10 or 20 min. Single pulse transcranial magnetic stimulation (TMS) was used to assess corticospinal excitability (CSE) before and every 5 min for 30 min following atDCS. On a group level, there was an interaction between stimulation duration and BDNF genotype, with Met carriers (n = 13) showing greater post-intervention potentiation of CSE compared to Val66Val homozygotes homozygotes (n = 37) following 20 min (p = 0.002) but not 10 min (p = 0.219) of stimulation. Moreover, Met carriers, but not Val/Val homozygotes, exhibited larger responses to TMS (p = 0.046) after 20 min atDCS, than following 10 min atDCS. On an individual level, two-step cluster analysis revealed a considerable degree of inter-individual variability, with under half of the total sample (42%) showing the expected potentiation of CSE in response to atDCS across both sessions. Intra-individual variability in response to different durations of atDCS was also apparent, with one-third of the total sample (34%) exhibiting LTP-like effects in one session but LTD-like effects in the other session. Both the inter-individual (p = 0.027) and intra-individual (p = 0.04) variability was associated with BDNF genotype. In older adults, the BDNF Val66Met polymorphism along with stimulation duration appears to play a role in modulating tDCS-induced motor cortex plasticity. The results may have implications for the design of NBS protocols for healthy and diseased aged populations.

ACROSTUDY: the Italian experience

ACROSTUDY is a world-wide non-interventional, post marketing surveillance study performed to monitor the safety and outcomes of pegvisomant (PEG) in clinical practice. We report data from acromegaly patients who have been included in the Italian ACROSTUDY registry. The data of 341 acromegaly patients (171 males) were available for analysis using data freeze (12/9/2012). Patients were enrolled in 25 Italian endocrine centres. Before and during PEG treatment IGF-I, liver enzymes, metabolic parameters, and pituitary MRI were assessed. Before PEG, 54.3% patients had been treated with medical therapy and surgery, 22.9% medical therapy only, and 15.8% medical plus radiation and surgical therapy. 199 adverse events were reported in 98 patients (28.7%). Serious adverse events were documented in 29 patients (8.5%). 71.1% of patients had no significant change in tumor volume. Central MRI reading was performed in 34 patients; in 7 patients, an increase in tumor volume was found. Hormonal efficacy progressively increased since the start of PEG. After 6 years, normal IGF-I levels were found in 70.9% of patients (mean daily dose 18.1 mg). 87.1% of patients were treated with daily PEG although in 8.8% of patients, it was administered 2-6 times per week and in 3.8% with weekly injections. 74.8% received a PEG dose 10-15 mg/daily. PEG is a drug with a favorable safety profile which is efficacious also considering that in Italy it is currently available as third-line therapy.

Malaysian parent and teacher ratings of the oppositional defiant disorder symptoms: measurement invariance and parent-teacher agreement

BACKGROUND

This study evaluated the measurement invariance and agreement across parent and teacher ratings of the DSM-IV-TR oppositional defiant disorder (ODD) symptoms.

METHOD

Malaysian parents and teachers of 934 children (between 6 and 11 years of age) completed rating scales comprising the ODD symptoms.

RESULTS

Findings showed support for full measurement invariance (configural, metric and thresholds). Additional results indicated low parent-teacher agreement for all symptoms.

DISCUSSION

The theoretical and clinical and implications of these findings are discussed.

The factor structure of anxiety and depressive disorders in a sample of clinic-referred adolescents

The current study used confirmatory factor analysis (CFA) to examine the factor structure of anxiety and depressive disorders in a sample of clinic-referred adolescents, aged between 12 and 18 years, for diagnoses based on parent (N = 655; male = 441) and adolescent (N = 626; male = 417) interviews. Three models were examined: a 1-factor model, with all anxiety and depressive disorders in a single factor; a DSM-based 2-factor model, with anxiety disorders in one factor, and depressive disorders in another factor; and an alternate 2-factor model, with fear related anxiety disorders in one factor, and other anxiety and depressive disorders in another factor. The findings indicated support for all three models. Also, ADHD and ODD/CD were associated with only the shared variances between the latent factors in the 2-factor models, and not their unique variance. The implications of the findings for taxonomy, comorbidity, and clinical practice are discussed.

The center for epidemiologic studies depression scale: support for a bifactor model with a dominant general factor and a specific factor for positive affect

OBJECTIVES

For the Center for Epidemiologic Studies Depression Scale (CES-D) ratings, the study examined support for a bifactor model, and also the internal consistency reliability and external validity of the factors in this model.

METHOD

Participants (N = 1,178) were older adults from the general community who completed the CES-D.

RESULTS

Confirmatory factor analysis of their ratings indicated support for the bifactor model. For this model, the general factor explained most of the covariance in the scores of the CES-D items for Depressed Affect, Somatic Symptoms and Retarded Activity, and Interpersonal Difficulties items. Most of the covariance in the scores of the Positive Affect (PA) scale was explained by its own specific factor. Additional analyses showed support for internal consistencies and external validities of general factors based on all the CES-D items, and when PA items were excluded, and also the PA-specific factor.

DISCUSSION

The findings support the use of a total CES-D score without the PA items and also the concurrent use of the PA scale score.

Confirmatory factor analysis, latent profile analysis, and factor mixture modeling of the syndromes of the Child Behavior Checklist and Teacher Report Form

The current study used confirmatory factor analysis (CFA), latent profile analysis (LPA), and factor mixture modeling (FMM) to examine the co-occurrence of the childhood syndromes using the Child Behavior Checklist (CBCL) and Teacher Report Form (TRF). Parents and teachers completed the CBCL and TRF, respectively, for a clinic-referred sample of 720 children, ages 7-12 years. For the CBCL, the analyses indicated most support a 2-class 2-factor FMM, and for the TRF, there was most support for a 2-class 3-factor model. The classes were all syndromes at average levels and all syndromes at high levels. The findings indicate high syndrome co-occurrence. The implications of the findings for understanding syndrome co-occurrence in the CBCL and TRF, theories of syndrome co-occurrence, and the clinical use of the CBCL and TRF are discussed.

Housing type and depressive symptoms among older adults: a test of sense of belonging as a mediating and moderating variable

OBJECTIVES

Higher levels of depression have been documented among older adults who reside in an assisted living facility, compared with those who remain in their own homes. The aims of the current study were to test whether the relationship between housing type and depressive symptoms was mediated by a sense of belonging and whether housing type and sense of belonging interact to influence the depressive symptoms among older adults (moderation model).

METHOD

A sample of 257 older adults who lived in their own homes and 166 older adults who lived in an assisted living facility completed the psychological subscale of the Sense of Belonging Instrument and the Center for Epidemiologic Studies Depression Scale.

RESULTS

Results showed that a sense of belonging partially mediated the relationship between housing type and depressive symptoms, such that living in a nursing home was associated with lower levels of belonging, and lower levels of belonging were, in turn, associated with higher levels of depressive symptoms. Residing in an assisted living facility was associated with depressive symptoms at low and average levels of belonging.

CONCLUSION

Results highlight the need for more research on the role of sense of belonging as an influencing factor on depressive symptoms among institutionalised older adults for both theoretical and treatment goals.

Behavioral effects of endogenous or exogenous estradiol and progesterone on cocaine sensitization in female rats

Cocaine sensitization is a marker for some facets of addiction, is greater in female rats, and may be influenced by their sex hormones. We compared the modulatory effects of endogenous or exogenous estradiol and progesterone on cocaine-induced behavioral sensitization in 106 female rats. Ovariectomized female rats received progesterone (0.5 mg/mL), estradiol (0.05 mg/mL), progesterone plus estradiol, or the oil vehicle. Sham-operated control females received oil. Control and acute subgroups received injections of saline, while the repeated group received cocaine (15 mg/kg, ip) for 8 days. After 10 days, the acute and repeated groups received a challenge dose of cocaine, after which locomotion and stereotypy were monitored. The estrous cycle phase was evaluated and blood was collected to verify hormone levels. Repeated cocaine treatment induced overall behavioral sensitization in female rats, with increased locomotion and stereotypies. In detailed analysis, ovariectomized rats showed no locomotor sensitization; however, the sensitization of stereotypies was maintained. Only females with endogenous estradiol and progesterone demonstrated increased locomotor activity after cocaine challenge. Estradiol replacement enhanced stereotyped behaviors after repeated cocaine administration. Cocaine sensitization of stereotyped behaviors in female rats was reduced after progesterone replacement, either alone or concomitant with estradiol. The behavioral responses (locomotion and stereotypy) to cocaine were affected differently, depending on whether the female hormones were of an endogenous or exogenous origin. Therefore, hormonal cycling appears to be an important factor in the sensitization of females. Although estradiol increases the risk of cocaine sensitization, progesterone warrants further study as a pharmacological treatment in the prevention of psychostimulant abuse.

ADHD and personality: a meta-analytic review

We report a meta-analysis of up to 40 data sets that examined the personality dimensions in the Five-Factor Model (FFM) and the integrated Five-Factor Model (IFFM) in relation to ADHD symptom domains of inattention (IA) and hyperactivity/impulsivity (HI). The IFFM incorporated the dimensions of other personality models (in particular, those of Eysenck, Tellegen, and Cloninger, as well as the FFM). Major findings were: (1) IA and HI were both associated with low conscientious inhibition/conscientiousness, and low agreeable inhibition/agreeableness, and with high negative emotionality/neuroticism; (2) conscientious inhibition and conscientiousness were more strongly related to IA than HI; (3) agreeable inhibition and agreeableness were more strongly related to HI than IA; and (4) the association of conscientious inhibition and conscientiousness with HI was moderated by age group and source from where participants were recruited (associations were stronger in children than adults, and clinical samples than community samples). These findings are discussed in relation to single and multiple pathway theories, underlying factors and processes for the personality-ADHD link, and clinical implications.

ADHD bifactor model based on parent and teacher ratings of Malaysian children

BACKGROUND

The study used confirmatory factor analysis to ascertain support for the bifactor model of the Attention Deficit/Hyperactivity Disorder (ADHD) symptoms, based on parent and teacher ratings for a group of Malaysian children.

METHODS

Malaysian parents and teachers completed ratings of ADHD and Opposition Defiant Disorder (ODD) symptoms for 934 children.

RESULTS

For both sets of ratings, the findings indicating good fit for the bifactor model, and the factors in this model showed differential associations with ODD, thereby supporting the internal and external validity of this model.

DISCUSSION

The theoretical and clinical implications of the findings are discussed.