Streamlining screening of emotional function in Veterans with traumatic brain injury

ObjectivesThis study examined how depression, anxiety, and sleep items from the Neurobehavioral Symptom Inventory (NSI) predict results from longer inventories.MethodThis was a retrospective review from 484, predominantly male (96.1%) Veterans, mean age 29.7 years, who underwent brief neuropsychological screening during a comprehensive, multidisciplinary evaluation for mild traumatic brain injury (TBI). Participants completed the NSI, insomnia severity index (ISI), and hospital anxiety and depression scale (HADS).Results: Overall,97.1% who endorsed “severe”/“very severe” anxiety on the NSI had significant anxiety on the HADS; 85% reporting “severe”/“very severe” depression on the NSI, had significant depression on the HADS; and 97.7% reporting “severe”/“very severe” sleep problems on the NSI, had significant sleep difficulties on the ISI.ConclusionClose correspondence between “severe”/“very severe” symptoms on the NSI and lengthier checklists suggests additional checklists may be eliminated and individuals can be referred for mental health treatment. NSI reports of “mild”/“moderate” require further screening.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144598/1/jclp22595_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144598/2/jclp22595.pd

Failed back surgeries and minnesota multiphasic personality inventory (MMPI) profiles

MMPI profiles were evaluated for 105 prospective surgical patients who had previously undergone surgery or other procedures for treatment of back pain. Patients were classified into groups having undergone zero, one, two, three, or four or more previous surgeries. While all groups demonstrated a characteristic somatogenic profile, none of the MMPI validity or clinical scales significantly differentiated the groups and there was no relationship between increased number of surgeries and MMPI scale characteristics. These results support the nonoptimistic prognostication of the somatogenic MMPI profile for surgical intervention for back pain but show no clear relationship of MMPI profile characteristics to degree of experience of previously failed surgery.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44850/1/10880_2005_Article_BF01999744.pd

Changes in Mood States and Biomarkers During Peginterferon and Ribavirin Treatment of Chronic Hepatitis C

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74953/1/j.1572-0241.2008.02106.x.pd

Systematic screening for unsafe driving due to medical conditions: Still debatable

<p>Abstract</p> <p>Background</p> <p>Assessing people's ability to drive has become a public health concern in most industrialized countries. Although age itself is not a predictive factor of an increased risk for dangerous driving, the prevalence of medical conditions that may impair driving increases with age. Because the implementation of a screening for unsafe driving due to medical conditions is a public health issue, its usefulness should be judged using standardised criteria already proposed for screening for chronic disease. The aim of this paper is to propose standardised criteria suitable to assess the scientific validity of screening for unsafe driving due to medical conditions, and identify potential issues to be clarified before screening can be implemented and effective.</p> <p>Discussion</p> <p>Using criteria developed for screening for chronic diseases and published studies on driving with medical conditions, we specify six criteria to judge the opportunity of screening for unsafe driving due to medical conditions. This adaptation was needed because of the complexity of the natural history of medical conditions and their potential consequences on driving and road safety. We then illustrate that published studies pleading for or against screening for unsafe driving due to medical conditions fail to provide the needed documentation. Individual criteria were mentioned in 3 to 72% of 36 papers pleading for or against screening. Quantitative estimates of relevant indicators were provided in at most 42% of papers, and some data, such as the definition of an appropriate unsafe driving period were never provided.</p> <p>Summary</p> <p>The standardised framework described in this paper provides a template for assessing the effectiveness (or lack of effectiveness) of proposed measures for screening for unsafe driving due to medical conditions. Even if most criteria were mentioned in the published literature pleading for or against such a screening, the failure to find quantitative and evidence-based estimates of relevant indicators provides useful insight for further research.</p

A psycho-Geoinformatics approach for investigating older adults’ driving behaviours and underlying cognitive mechanisms

Introduction: Safe driving constantly challenges the driver’s ability to respond to the dynamic traffic scene under space and time constraints. It is of particular importance for older drivers to perform sufficient visual and motor actions with effective coordination due to the fact of age-related cognitive decline. However, few studies have been able to integrate drivers’ visual-motor behaviours with environmental information in a spatial-temporal context and link to the cognitive conditions of individual drivers. Little is known about the mechanisms that underpin the deterioration in visual-motor coordination of older drivers. Development: Based on a review of driving-related cognitive decline in older adults and the context of driver-vehicle-environment interactions, this paper established a conceptual framework to identify the parameters of driver’s visual and motor behaviour, and reveal the cognitive process from visual search to vehicle control in driving. The framework led to a psycho-geoinformatics approach to measure older drivers’ driving behaviours and investigate the underlying cognitive mechanisms. The proposed data collection protocol and the analysis and assessments depicted the psycho-geoinformatics approach on obtaining quantified variables and the key means of analysis, as well as outcome measures. Conclusions: Recordings of the driver and their interactions with the vehicle and environment at a detailed scale give a closer assessment of the driver’s behaviours. Using geoinformatics tools in driving behaviours assessment opens a new era of research with many possible analytical options, which do not have to rely on human observations. Instead, it receives clear indicators of the individual drivers’ interactions with the vehicle and the traffic environment. This approach should make it possible to identify lower-performing older drivers and problematic visual and motor behaviours, and the cognitive predictors of risky driving behaviours. A better targeted regulation and tailored intervention programs for older can be developed by further research

Dviejų trumpų psichometrinių depresijos pažinimo funkcijos mastų diagnostinis tikslumas: vyresnio amžiaus ambulatorinių pacientų studija

We compared the diagnostic accuracy (sensitivity and specificity) of the Geriatric Depression Scale (GDS) and the Mini-Mult Depression Scale (Mini-D) in a sample of 87 geriatric medical outpatients who were classified as depressed or non-depressed with the DSM-III-based Symptom Checklist for Major Depressive Disorders (SCMDD). In addition, we evaluated the relationship between GDS and Mini-D depression classifications and performances on three tests of the overall cognitive functioning. Although GDS and Mini-D classifications were in moderate agreement with those of the SCMDD (71%), the former measure produced more false-positive errors and the latter produced more false-negative errors. Because neither the GDS nor the Mini-D affords entirely satisfactory diagnostic accuracy, appreciation of these operating characteristics will enable practitioners to select the instrument that yields the most acceptable balance of Type I and Type II errors within their particular clinical settings. Although participants demonstrated signs of a mild cognitive compromise, no relationship was noted between depression classification and overall cognitive functioning. We believe that this finding reflects our dichotomous, rather than continuous, operationalization of “depression”.Lyginome Senyvųjų depresijos skalės (Geriatric Depression Scale) ir Mažosios daugkartinės depresijos skalės (Mini-Mult Depression Scale) diagnostinį tikslumą (jautrumą ir tikslų apibrėžimą). Tyrime dalyvavo 87 senyvi gydomi pacientai, kai kurie jų buvo depresyvūs, o kai kurie nedepresyvūs (buvo naudojamasi DSM-III simptomų sąrašu, nurodančiu didžiosios depresijos sutrikimą (SCMDD)). Be to, įvertinome Senyvųjų depresijos skalės ir Mažosios daugkartinės depresijos skalės klasifikacijų santykį naudodami tris bendro pažinimo funkcijos testus. Nors Senyvųjų depresijos skalė ir Mažoji daugkartinės depresijos skalė pagal DSM-III sąrašą rodė vidutinį lygumą (71 %), pirmoji grupė darė daugiau pozityvių klaidų, o antroji – daugiau negatyvių klaidų. Kadangi nei Senyvųjų depresijos skalės, nei Mažosios daugkartinės depresijos skalbės diagnostinis tikslumas nėra pakankamas, dėmesio atkreipimas į šias charakteristikas turėtų paskatinti naudojančiuosius jas savo klinikiniame darbe pasirinkti priemonę, kurios 1-o ir 2-o tipo klaidų balansas geriausias. Nors pacientų pažinimo sutrikimo požymiai buvo neryškūs, jokio santykio tarp depresijos klasifikacijos ir bendro pažinimo funkcionavimo neaptikome. Manome, kad šis rezultatas rodo, jog, vartojant „depresijos“ sąvoką, yra dichotomija, o ne vientisumas