Research and Publications - Department of Psychology
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Item The 2013 Doris Schwartz Gerontological Nursing Research Award(Slack, 2014) McDougall, Graham J., Jr.; University of Alabama TuscaloosaItem 25 years of neurocognitive aging theories: What have we learned?(Frontiers, 2022) McDonough, Ian M.; Nolin, Sara A.; Visscher, Kristina M.; University of Alabama Tuscaloosa; University of Alabama BirminghamThe past 25 years have provided a rich discovery of at least four fundamental patterns that represent structural and functional brain aging across multiple cognitive domains. Of the many potential patterns of brain aging, few are ever examined simultaneously in a given study, leading one to question their mutual exclusivity. Moreover, more studies are emerging that note failures to replicate some brain aging patterns, thereby questioning the universality and prevalence of these patterns. Although some attempts have been made to create unifying theories incorporating many of these age-related brain patterns, we propose that the field's understanding of the aging brain has been hindered due to a large number of influential models with little crosstalk between them. We briefly review these brain patterns, the influential domain-general theories of neurocognitive aging that attempt to explain them, and provide examples of recent challenges to these theories. Lastly, we elaborate on improvements that can be made to lead the field to more comprehensive and robust models of neurocognitive aging.Item Academic performance under COVID-19: The role of online learning readiness and emotional competence(Springer, 2022) Wang, Yurou; Xia, Mengya; Guo, Wenjing; Xu, Fangjie; Zhao, Yadan; University of Alabama Tuscaloosa; Beijing Normal UniversityThe COVID-19 pandemic caused school closures and social isolation, which created both learning and emotional challenges for adolescents. Schools worked hard to move classes online, but less attention was paid to whether students were cognitively and emotionally ready to learn effectively in a virtual environment. This study focused on online learning readiness and emotional competence as key constructs to investigate their implications for students' academic performance during the COVID-19 period. Two groups of students participated in this study, with 1,316 high school students (Mean age = 16.32, SD = 0.63) representing adolescents and 668 college students (Mean age = 20.20, SD = 1.43) representing young adults. Structural equation modeling was conducted to explore the associations among online learning readiness, emotional competence, and online academic performance during COVID-19 after controlling for pre-COVID-19 academic performance. The results showed that, for high school students, both online learning readiness and emotional competence were positively associated with online academic performance during COVID-19. However, for college students, only online learning readiness showed a significant positive relationship with online academic performance during COVID-19. These results demonstrated that being ready to study online and having high emotional competence could make adolescents more resilient toward COVID-19-related challenges and help them learn more effectively online. This study also highlighted different patterns of associations among cognitive factors, emotional factors, and online academic performance during COVID-19 in adolescence and young adulthood. Developmental implications were also discussed.Item Acoustic Correlates and Adult Perceptions of Distress in Infant Speech-Like Vocalizations and Cries(Frontiers, 2019) Yoo, Hyunjoo; Buder, Eugene H.; Bowman, Dale D.; Bidelman, Gavin M.; Oller, D. Kimbrough; University of Alabama Tuscaloosa; University of Memphis; University of Tennessee Health Science CenterPrior research has not evaluated acoustic features contributing to perception of human infant vocal distress or lack thereof on a continuum. The present research evaluates perception of infant vocalizations along a continuum ranging from the most prototypical intensely distressful cry sounds ("wails") to the most prototypical of infant sounds that typically express no distress (non-distress "vocants"). Wails are deemed little if at all related to speech while vocants are taken to be clear precursors to speech. We selected prototypical exemplars of utterances representing the whole continuum from 0 and 1 month-olds. In this initial study of the continuum, our goals are to determine (1) listener agreement on level of vocal distress across the continuum, (2) acoustic parameters predicting ratings of distress, (3) the extent to which individual listeners maintain or change their acoustic criteria for distress judgments across the study, (4) the extent to which different listeners use similar or different acoustic criteria to make judgments, and (5) the role of short-term experience among the listeners in judgments of infant vocalization distress. Results indicated that (1) both inter-rater and intra-rater listener agreement on degree of vocal distress was high, (2) the best predictors of vocal distress were number of vibratory regimes within utterances, utterance duration, spectral ratio (spectral concentration) in vibratory regimes within utterances, and mean pitch, (3) individual listeners significantly modified their acoustic criteria for distress judgments across the 10 trial blocks, (4) different listeners, while showing overall similarities in ratings of the 42 stimuli, also showed significant differences in acoustic criteria used in assigning the ratings of vocal distress, and (5) listeners who were both experienced and inexperienced in infant vocalizations coding showed high agreement in rating level of distress, but differed in the extent to which they relied on the different acoustic cues in making the ratings. The study provides clearer characterization of vocal distress expression in infants based on acoustic parameters and a new perspective on active adult perception of infant vocalizations. The results also highlight the importance of vibratory regime segmentation and analysis in acoustically based research on infant vocalizations and their perception.Item The Acquisition of Survey Knowledge by Individuals With Down Syndrome(Frontiers Media, 2020-07-03) Himmelberger, Zachary M.; Merrill, Edward C.; Conners, Frances A.; Roskos, Beverly; Yang, Yingying; Robinson, Trent; University of Alabama Tuscaloosa; Montclair State UniversityPeople with Down syndrome often exhibit deficiencies in wayfinding activities, particularly route learning (e.g.,Courbois et al., 2013;Davis et al., 2014;Farran et al., 2015). Evidence concerning more sophisticated survey learning has been sparse. In the research reported here, two experiments are reported that evaluated survey learning of youth with DS and typically developing children (TD) matched on mental age. In Experiment 1, participants learned two overlapping routes consisting of three turns each through a virtual environment depicting 9 square city blocks. Following acquisition, they were tested on multiple measures of survey knowledge: finding a shortcut, identifying the direction of landmarks not currently visible from their location in the environment, and recognizing a bird's-eye representation of the overall environment. Under these conditions, which should provide relatively optimal opportunities for survey learning, the participants with DS performed comparably to TD participants matched on non-verbal ability on all of our measures of survey learning. Hence, we concluded that people with DS can acquire some survey knowledge when tasked with learning a small environment and given the opportunity to do so. In Experiment 2, the experimenter navigated participants through a large, relatively complex, virtual environment along a circuitous path, beginning and ending at a target landmark. Then, the participants were placed at a pre-specified location in the environment that they had viewed previously and instructed to navigate to the same target (a door) using the shortest possible path from their current location. They completed the task three times: once after being shown the environment one time, once after three exposures, and once after five exposures. Results indicated that the participants with DS exhibited significantly less skill at identifying the shortcut than did the TD participants, with differences emerging as the number of exposures increased. Participants with DS were also less able to recall landmarks at the end of the experiment. Overall, however, the performance of both groups was relatively poor in both experiments - with the performance of participants with DS being worse as conditions became less optimal. These results were discussed in terms of underlying mechanisms that may account for variations in survey learning as environmental complexity increases.Item Actigraphy Reliability with Normal Sleepers(Routledge, 2012-12) Ustinov, Yuriy; Lichstein, Kenneth L.; University of Alabama TuscaloosaIntroduction: Actigraphy has gained popularity as an objective method for measuring sleep in a home setting. We evaluated whether missing data affects the utility of actigraphy for the measurement of sleep parameters in normal sleepers. Methods: We evaluated actigraphy data from 60 normal sleepers who participated in a study of the effects of changes in setting on sleep. Participants were asked to wear a Mini Mitter Actiwatch actigraph for 35 days and to use event markers to record bedtime and arising time. Counts of nights on which participants failed to supply usable data were computed using the following criteria: missing nights, missing bedtime markers, missing arising time markers, and multiple markers supplied at bedtime or arising time. A night on which any of these problems occurred was counted as unscorable. Results: We evaluated a total of 2,100 nights, of which 559 (27%) nights were deemed unscorable due to missing data. Missing markers at bedtime (206) and arising time (172) accounted for the majority of missing data. Trends over the five weeks indicated that incidence of missing data increased over the assessment period. Conclusion: We found that missing data was a significant problem for long-term assessment of sleep using actigraphy. We suggest that researchers consider compensatory strategies, such as extending the assessment period and using adjunctive measures, in order to obtain sufficient data for analysis. We also recommend that future improvements in actigraphy instruments should aim to address the sources of missing data.Item Adaptation of a Nursing Home Culture Change Research Instrument for Frontline Staff Quality Improvement Use(American Psychological Association, 2017) Hartmann, Christine W.; Palmer, Jennifer A.; Mills, Whitney L.; Pimentel, Camilla B.; Allen, Rebecca S.; Wewiorski, Nancy J.; Dillon, Kristen R.; Snow, A. Lynn; Boston University; Baylor College of Medicine; University of Massachusetts Amherst; University of Alabama TuscaloosaEnhanced interpersonal relationships and meaningful resident engagement in daily life are central to nursing home cultural transformation, yet these critical components of person-centered care may be difficult for frontline staff to measure using traditional research instruments. To address the need for easy-to-use instruments to help nursing home staff members evaluate and improve person-centered care, the psychometric method of cognitive-based interviewing was used to adapt a structured observation instrument originally developed for researchers and nursing home surveyors. Twenty-eight staff members from 2 Veterans Health Administration (VHA) nursing homes participated in 1 of 3 rounds of cognitive-based interviews, using the instrument in real-life situations. Modifications to the original instrument were guided by a cognitive processing model of instrument refinement. Following 2 rounds of cognitive interviews, pretesting of the revised instrument, and another round of cognitive interviews, the resulting set of 3 short instruments mirrored the concepts of the original longer instrument but were significantly easier for frontline staff to understand and use. Final results indicated frontline staff found the revised instruments feasible to use and clinically relevant in measuring and improving the lived experience of a changing culture. This article provides a framework for developing or adapting other measurement tools for frontline culture change efforts in nursing homes, in addition to reporting on a practical set of instruments to measure aspects of person-centered care.Item Addicted to Cellphones: Exploring the Psychometric Properties between the Nomophobia Questionnaire and Obsessiveness in College Students(Elsevier Ltd, 2018-11) Lee, Seungyeon; Kim, Minsung; Mendoza, Jessica S.; McDonough, Ian M.; University of Alabama TuscaloosaA potential new clinical disorder is arising due to the addiction to cellphones called nomophobia - or feelings of discomfort or anxiety experienced by individuals when they are unable to use their mobile phones or utilize the conveniences these devices provide. However, before being able to officially classify this disorder as clinically relevant, more research needs to be conducted to determine how nomophobia relates to existing disorders. In a sample of 397 undergraduate students, the present study examined the relationship between the Nomophobia Questionnaire (NMP-Q) and the Obsessiveness Content Scale (OBS) of the Minnesota Multiphasic Personality Inventory-2 (the MMPI-2). Confirmatory factor analysis (CFA) was used to test whether the OBS Content Scale would be related to a one-factor NMP-Q solution (Fig. 1) or a four-factor NMP-Q solution (Fig. 2). Convergent and divergent validity were also investigated. The four-factor model was a better fit than the one-factor model as indicated by most fit indices. The findings showed that the OBS latent variable was correlated with all of the four NMP-Q latent variables. Mixed support was found for convergent validity, but high support was found for the divergent validity of the NMP-Q factors. This study contributes to a growing body of literature seeking to better understand the addictive nature of cellphones and takes a new perspective on addiction research and obsessiveness. These findings provide a better understanding between pre-existing assessments of personality disorders (e.g., obsessiveness) that are emerging from the overuse of mobile phones or the excessive fear of losing one's cell phone.Item Adjacent-Categories Mokken Models for Rater-Mediated Assessments(Sage, 2017) Wind, Stefanie A.; University of Alabama TuscaloosaMolenaar extended Mokken's original probabilistic-nonparametric scaling models for use with polytomous data. These polytomous extensions of Mokken's original scaling procedure have facilitated the use of Mokken scale analysis as an approach to exploring fundamental measurement properties across a variety of domains in which polytomous ratings are used, including rater-mediated educational assessments. Because their underlying item step response functions (i.e., category response functions) are defined using cumulative probabilities, polytomous Mokken models can be classified as cumulative models based on the classifications of polytomous item response theory models proposed by several scholars. In order to permit a closer conceptual alignment with educational performance assessments, this study presents an adjacent-categories variation on the polytomous monotone homogeneity and double monotonicity models. Data from a large-scale rater-mediated writing assessment are used to illustrate the adjacent-categories approach, and results are compared with the original formulations. Major findings suggest that the adjacent-categories models provide additional diagnostic information related to individual raters' use of rating scale categories that is not observed under the original formulation. Implications are discussed in terms of methods for evaluating rating quality.Item Affective mediators of the association between pleasant events and global sleep quality in community-dwelling adults(Springer, 2016) Tighe, Caitlan A.; Shoji, Kristy D.; Dautovich, Natalie D.; Lichstein, Kenneth L.; Scogin, Forrest; University of Alabama TuscaloosaThis study explored the association of engagement in pleasant events and global sleep quality, as well as examined the intermediary roles of positive affect and depressive symptoms in this association. Data were derived from the Midlife in the United States-II study. The sample consisted of 1054 community-dwelling adults. Participants completed the Pittsburgh Sleep Quality Index and indicated the frequency and enjoyableness of experiences on a positive events scale. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Positive affect was measured using the Mood and Symptoms Questionnaire. Regression analyses indicated more frequent engagement in pleasant events was associated with better global sleep quality. Depressive symptoms, but not positive affect, partially mediated the association between pleasant events and global sleep quality. The findings suggest that behavioral engagement in pleasant events may be related to global sleep quality via depressive symptoms, but not positive affect. These findings highlight the potential for engagement in pleasant activities to influence both mood and sleep.Item Age of sign language acquisition has lifelong effect on syntactic preferences in sign language users(Sage, 2021) Krebs, Julia; Roehm, Dietmar; Wilbur, Ronnie B.; Malaia, Evie A.; Salzburg University; Purdue University; Purdue University West Lafayette Campus; University of Alabama TuscaloosaAcquisition of natural language has been shown to fundamentally impact both one's ability to use the first language and the ability to learn subsequent languages later in life. Sign languages offer a unique perspective on this issue because Deaf signers receive access to signed input at varying ages. The majority acquires sign language in (early) childhood, but some learn sign language later-a situation that is drastically different from that of spoken language acquisition. To investigate the effect of age of sign language acquisition and its potential interplay with age in signers, we examined grammatical acceptability ratings and reaction time measures in a group of Deaf signers (age range = 28-58 years) with early (0-3 years) or later (4-7 years) acquisition of sign language in childhood. Behavioral responses to grammatical word order variations (subject-object-verb [SOV] vs. object-subject-verb [OSV]) were examined in sentences that included (1) simple sentences, (2) topicalized sentences, and (3) sentences involving manual classifier constructions, uniquely characteristic of sign languages. Overall, older participants responded more slowly. Age of acquisition had subtle effects on acceptability ratings, whereby the direction of the effect depended on the specific linguistic structure.Item Aggression Prevention Training for Individuals With Dementia and Their Caregivers: A Randomized Controlled Trial(Elsevier, 2020) Kunik, Mark E.; Stanley, Melinda A.; Shrestha, Srijana; Ramsey, David; Richey, Sheila; Snow, Lynn; Freshour, Jessica; Evans, Tracy; Newmark, Michael; Williams, Susan; Wilson, Nancy; Amspoker, Amber B.; Baylor College of Medicine; University of Alabama TuscaloosaObjective: International appeals call for interventions to prevent aggression and other behavioral problems in individuals with dementia (IWD). Aggression Prevention Training (APT), based on intervening in three contributors to development of aggression (IWD pain, IWD depression, and caregiver-IWD relationship problems) aims to reduce incidence of aggression in IWD over 1 year. Design: Randomized, controlled trial. Setting: Three clinics that assess, diagnose, and treat dementia. Participants: Two hundred twenty-eight caregiver-IWD dyads who screened positive for IWD pain, IWD depression, or caregiver-IWD relationship problems randomized to APT or Enhanced Usual Primary Care (EU-PC). Intervention: APT, a skills-based intervention delivered over 3 months to address pain/depression/caregiver-IWD relationship issues. EU-PC included printed material on dementia and community resources; and eight brief, weekly support calls. Measurements: The primary outcome was incidence of aggression over 1 year, determined by the Cohen Mansfield Agitation Inventory-Aggression Subscale. Secondary outcomes included pain, depression, caregiver- IWD relationship, caregiver burden, positive caregiving, behavior problems, and anxiety. Results: Aggression incidence and secondary outcomes did not differ between groups. However, in those screening positive for IWD depression or caregiver-IWD relationship problems, those receiving EU-PC had significant increases in depression and significant decreases in quality of the caregiver-IWD relationship, whereas those receiving APT showed no changes in these outcomes over time. Conclusion: The cost to patients, family, and society of behavioral problems in IWD, along with modest efficacy of most pharmacologic and nonpharmacologic interventions, calls for more study of novel preventive approaches.Item Alpha-amylase reactivity in relation to psychopathic traits in adults(Pergamon, 2015) Glenn, Andrea L.; Remmel, Rheanna J.; Raine, Adrian; Schug, Robert A.; Gao, Yu; Granger, Douglas A.; University of Alabama Tuscaloosa; University of Pennsylvania; California State University System; California State University Long Beach; City University of New York (CUNY) System; Brooklyn College (CUNY); Arizona State University; Arizona State University-Tempe; Johns Hopkins University; Johns Hopkins Bloomberg School of Public HealthRecent investigations of the psychobiology of stress in antisocial youth have benefited from a multi-system measurement model. The inclusion of salivary alpha-amylase (sAA), a surrogate marker of autonomic/sympathetic nervous system (ANS) activity, in addition to salivary cortisol, a biomarker of the hypothalamic pituitary adrenal (HPA) axis functioning, has helped define a more complete picture of individual differences and potential dysfunction in the stress response system of these individuals. To the authors' knowledge, no studies have examined sAA in relation to antisocial behavior in adults or in relation to psychopathic traits specifically. In the present study, we examined sAA, in addition to salivary cortisol, in a relatively large sample (n=158) of adult males (M age=36.81, range = 22-67 years; 44% African American, 34% Caucasian, 16% Hispanic) recruited from temporary employment agencies with varying levels of psychopathic traits. Males scoring highest in psychopathy were found to have attenuated sAA reactivity to social stress compared to those scoring tower in psychopathy. No differential relationships with the different factors of psychopathy were observed. In contrast to studies of antisocial youth, there were no interactions between sAA and cortisol levels in relation to psychopathy, but there was a significant interaction between pre-stressor levels of sAA and cortisol. Findings reveal potential regulatory deficits in the fast-acting, 'fight or flight', component of the stress response in adult males with psychopathic traits, as well as abnormalities in how this system may interact with the HPA axis. (C) 2015 Elsevier Ltd. All rights reserved.Item Analyzing factors enabling colorectal cancer screening adherence in Korean Americans using the Andersen's Behavioral Model of Health Services Utilization(Routledge, 2019) Jin, Seok Won; Lee, Hee Yun; Lee, Jongwook; University of Memphis; University of Alabama Tuscaloosa; University of Minnesota Twin CitiesPurpose/objectives: Korean Americans (KAs) report suboptimal colorectal cancer (CRC) screening adherence. This study investigated factors that enable KAs to adhere to CRC screening guidelines using the Andersen's Behavioral Model of Health Services Utilization. Design: Cross-sectional survey using self-reported measures of CRC screening behaviors. Sample and methods: Purposive sampling was used to recruit 433 KAs aged 50-75 from the Atlanta metropolitan area who completed questionnaires measuring predisposing (i.e., gender, age, marital status, and educational attainment), enabling (income, health insurance, regular annual health checkups, doctor's recommendation English proficiency, CRC knowledge, self-efficacy for CRC screening, and decisional balance in CRC screening), and need (family cancer history and self-reported health status) factors associated with CRC screening. Findings: A multiple logistic regression model including all 14 predictor variables revealed that several enabling factors (i.e., income, regular annual health checkups, doctor's recommendation, self-efficacy, and decisional balance) independently predicted increased CRC screening adherence in KAs. No predisposing or need factors independently predicted CRC screening.Item Assessing Preknowledge Cheating via Innovative Measures: A Multiple-Group Analysis of Jointly Modeling Item Responses, Response Times, and Visual Fixation Counts(Sage, 2021) Man, Kaiwen; Harring, Jeffrey R.; University of Alabama Tuscaloosa; University of Maryland College ParkMany approaches have been proposed to jointly analyze item responses and response times to understand behavioral differences between normally and aberrantly behaved test-takers. Biometric information, such as data from eye trackers, can be used to better identify these deviant testing behaviors in addition to more conventional data types. Given this context, this study demonstrates the application of a new method for multiple-group analysis that concurrently models item responses, response times, and visual fixation counts collected from an eye-tracker. It is hypothesized that differences in behavioral patterns between normally behaved test-takers and those who have different levels of preknowledge about the test items will manifest in latent characteristics of the different data types. A Bayesian estimation scheme is used to fit the proposed model to experimental data and the results are discussed.Item Association Between ADHD and COVID-19 Infection and Clinical Outcomes: A Retrospective Cohort Study From Electronic Medical Records(Sage, 2023) Heslin, Kathleen P.; Haruna, Aminat; George, Regina A.; Chen, Shiyu; Nobel, Ishak; Anderson, Kathryn B.; Faraone, Stephen, V; Zhang-James, Yanli; State University of New York (SUNY) Upstate Medical Center; University of Alabama Tuscaloosa; University of Pittsburgh; Northwell HealthObjective: Though psychiatric illnesses have been associated with increased COVID-19 infection risk, limited information exists about the relationship between ADHD and COVID-19. Methods: Using the TriNetX COVID-19 Research Network, we examined the impact of ADHD diagnosis and treatment on COVID-19 infection rates and outcomes. Results: ADHD patients had greater risk of COVID-19 (risk ratio (RR) 1.11, 95% CI [1.09, 1.12]). Increased risk was higher in females than males, and highest among Asian and Black patients. Within 60 days after COVID-19 diagnosis, ADHD patients had lower rates of hospitalization (RR 0.91, 95% CI [0.86, 0.96]) and mechanical ventilation (RR 0.69, 95% CI [0.58, 0.83]), and a nonsignificant reduced death rate (RR 0.65, 95% CI [0.42, 1.02]). Patients who recently received ADHD medication had higher rates of COVID-19 (RR 1.13; 95% CI [1.10, 1.15]). Conclusion: ADHD poses increased risk for COVID-19, but may reduce risk of severe outcomes. ADHD medications modestly impacted COVID-19 risk.Item The association between the number of chronic health conditions and advance care planning varies by race/ethnicity(Routledge, 2020) Choi, Shinae; McDonough, Ian M.; Kim, Minjung; Kim, Giyeon; University of Alabama Tuscaloosa; Ohio State University; Chung Ang UniversityObjectives: Although a national consensus exists on the need to increase the rates of advance care planning (ACP) for all adults, racial/ethnic differences in ACP have been consistently observed. This study investigated the intersection of racial/ethnic differences and the number of chronic health conditions on ACP among middle-aged and older adults in the United States. Method: Responses from 8,926 adults from the 2014 wave of the Health and Retirement Study were entered into multilevel hierarchical logistic regression analyses with generalized linear mixed models to predict ACP focused on assigning a durable power of attorney for healthcare (DPOAHC) and having a written living will after adjusting for covariates. Results: We found a significant positive relationship between the number of chronic health conditions and ACP. Non-Hispanic Blacks/African Americans and Hispanics were less likely to engage in ACP than non-Hispanic Whites/Caucasians. Racial/ethnic disparities were even starker for completing a living will. The number of chronic health conditions had a greater effect for Hispanics than non-Hispanic Whites/Caucasians on ACP through assigning a DPOAHC and having a living will. The initial disparity in ACP among Hispanics with no chronic health conditions decreased as the number of chronic health conditions increased. Conclusion: Our findings suggest that more chronic health conditions increase the likelihood that Hispanics will complete ACP documents. These ACP differences should be highlighted to researchers, policymakers, and healthcare professionals to reduce stark racial/ethnic disparities in ACP. A comprehensive and culturally caring decision-making approach should be considered when individuals and families engage in ACP.Item The Association of Delayed Care With Depression Among US Middle-Aged and Older Adults During the COVID-19 Pandemic: Cross-sectional Analysis(JMIR Publications, 2021) Luo, Yan; University of Alabama TuscaloosaBackground: During the COVID-19 pandemic, the depression level among US adults has significantly increased. Age disparity in depression during the pandemic has been reported in recent studies. Delay or avoidance of medical care is one of the collateral damages associated with the COVID-19 pandemic, and it can lead to increased morbidity and mortality. Objective: This study aimed to assess the prevalence of depression and delayed care among US middle-aged adults and older adults during the pandemic, as well as investigate the association of delayed care with depression among those 2 age groups. Methods: This cross-sectional study used data from the 2020 Health and Retirement Study (HRS) COVID-19 Project (Early, Version 1.0). Univariate analyses, bivariate analyses, and binary logistic regression were applied. US adults older than 46 years were included. Depression was measured by the Composite International Diagnostic Interview-Short Form (CIDI-SF). Delayed care was measured by the following 4 items: delayed surgery, delayed seeing a doctor, delayed dental care, and other delayed care. Results: A total of 3246 participants were identified. More than half of the participants were older than 65 years (n=1890, 58.2%), and 274 (8.8%) participants had depression during the pandemic. Delayed dental care was positively associated with depression among both middle-aged adults (OR 2.05, 95% CI 1.04-4.03; P=.04) and older adults (OR 3.08, 95% CI 1.07-8.87; P=.04). Delayed surgery was positively associated with depression among older adults (OR 3.69, 95% CI 1.06-12.90; P=.04). Self-reported pain was positively related to depression among both age groups. Middle-aged adults who reported higher education levels (some college or above) or worse self-reported health had a higher likelihood of having depression. While perceived more loneliness was positively associated with depression among older adults, financial difficulty was positively associated with depression among middle-aged adults. Conclusions: This study found that depression was prevalent among middle-aged and older adults during the pandemic. The study highlighted the collateral damage of the COVID-19 pandemic by identifying the association of delayed surgery and dental care with depression during the pandemic. Although surgery and dental care cannot be delivered by telehealth, telehealth services can still be provided to address patients'concerns on delayed surgery and dental care. Moreover, the implementation of telemental health services is needed to address mental health symptoms among US middle-aged and older adults during the pandemic. Future research that uses more comprehensive measurements for delayed care is needed to decipher the path through which delayed care is associated with depression.Item Associations between psychopathic traits and brain activity during instructed false responding(Elsevier, 2017) Glenn, Andrea L.; Han, Hyemin; Yang, Yaling; Raine, Adrian; Schug, Robert A.; University of Alabama Tuscaloosa; Children's Hospital Los Angeles; University of Pennsylvania; California State University System; California State University Long BeachLying is one of the characteristic features of psychopathy, and has been recognized in clinical and diagnostic descriptions of the disorder, yet individuals with psychopathic traits have been found to have reduced neural activity in many of the brain regions that are important for lying. In this study, we examine brain activity in sixteen individuals with varying degrees of psychopathic traits during a task in which they are instructed to falsify information or tell the truth about autobiographical and non-autobiographical facts, some of which was related to criminal behavior. We found that psychopathic traits were primarily associated with increased activity in the anterior cingulate, various regions of the prefrontal cortex, insula, angular gyrus, and the inferior parietal lobe when participants falsified information of any type. Associations tended to be stronger when participants falsified information about criminal behaviors. Although this study was conducted in a small sample of individuals and the task used has limited ecological validity, these findings support a growing body of literature suggesting that in some contexts, individuals with higher levels of psychopathic traits may demonstrate heightened levels of brain activity.Item Attachment Style Is Associated With Perceived Spouse Responses and Pain-Related Outcomes(American Psychological Association, 2012) Forsythe, Laura P.; Romano, Joan M.; Jensen, Mark P.; Thorn, Beverly E.; University of Alabama Tuscaloosa; University of Washington; University of Washington SeattlePurpose/Objective: Attachment theory can provide a heuristic model for examining factors that may influence the relationship of social context to adjustment in chronic pain. This study examined the associations of attachment style with self-reported pain behavior, pain intensity, disability, depression, and perceived spouse responses to pain behavior. We also examined whether attachment style moderates associations between perceived spouse responses and self-reported pain behavior and depressive symptoms, as well as perceived spouse responses as a mediator of these associations. Method: Individuals with chronic pain (N = 182) completed measures of self-reported attachment style, perceived spouse responses, and pain-related criterion variables. Results: Secure attachment was inversely associated with self-reported pain behaviors, pain intensity, disability, depressive symptoms, and perceived negative spouse responses; preoccupied and fearful attachment scores were positively associated with these variables. In multivariable regression models, both attachment style and perceived spouse responses were uniquely associated with self-reported pain behavior and depressive symptoms. Attachment style did not moderate associations between perceived spouse responses to self-reported pain behavior and pain criterion variables, but negative spouse responses partially mediated some relationships between attachment styles and pain outcomes. Conclusions/Implications: Findings suggest that attachment style is associated with pain-related outcomes and perceptions of spouse responses. The hypothesized moderation effects for attachment were not found; however, mediation analyses showed that perceived spouse responses may partially explain associations between attachment and adjustment to pain. Future research is needed to clarify how attachment style and the social environment affect the pain experience.