Medicine and Health Sciences Commons^™

Low Vision Depression Prevention Trial In Age-Related Macular Degeneration: A Randomized Clinical Trial., Barry W. Rovner, Robin J Casten, Mark T Hegel, Robert W Massof, Benjamin E Leiby, Allen C Ho, William S Tasman

Department of Psychiatry and Human Behavior Faculty Papers

PURPOSE: To compare the efficacy of behavior activation (BA) + low vision rehabilitation (LVR) with supportive therapy (ST) + LVR to prevent depressive disorders in patients with age-related macular degeneration (AMD).

DESIGN: Single-masked, attention-controlled, randomized, clinical trial with outcome assessment at 4 months.

PARTICIPANTS: Patients with AMD and subsyndromal depressive symptoms attending retina practices (n = 188).

INTERVENTIONS: Before randomization, all subjects had 2 outpatient LVR visits, and were then randomized to in-home BA+LVR or ST+LVR. Behavior activation is a structured behavioral treatment that aims to increase adaptive behaviors and achieve valued goals. Supportive therapy is a nondirective, psychological treatment …

Who's Your Expert? Use Of An Expert Opinion Survey To Inform Development Of American Psychiatric Association Practice Guidelines., Joel Yager, Robert Kunkle, Laura J. Fochtmann, Sara M. Reid, Robert Plovnick, James E. Nininger, Joel J. Silverman, Michael J. Vergare

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: For many clinical questions in psychiatry, high-quality evidence is lacking. Credible practice guidelines for such questions depend on transparent, reproducible, and valid methods for assessing expert opinion. The objective of this study was to develop and demonstrate the feasibility of a method for assessing expert opinion to aid in the development of practice guidelines by the American Psychiatric Association (APA).

METHODS: A "snowball" process initially soliciting nominees from three sets of professional leaders was used to identify experts on a guideline topic (psychiatric evaluation). In a Web-based survey, the experts were asked to rate their level of agreement that …

Personality And Functional Vision In Older Adults With Age-Related Macular Degeneration, Barry W. Rovner, R. J. Casten, Mark T. Hegel, Robert W. Massof, Benjamin E. Leiby, Allen C. Ho, William S. Tasman

Department of Psychiatry and Human Behavior Faculty Papers

Introduction: The purpose of the study was to determine whether personality traits influence self-reported functional vision in patients with age-related macular degeneration (AMD). Methods: This is a prospective cross-sectional analysis of baseline data from the Low Vision Depression Prevention Trial. Participants (N = 182) over age 65 with bilateral AMD, visual acuity worse than 20/70 in the better-seeing eye, and subthreshold depression were recruited from the Wills Eye Hospital retina practice. Assessments included visual acuity, contrast sensitivity, National Eye Institute Visual Function Questionnaire-25 plus Supplement (NEI VFQ-25) near and distance subscales, depression, and personality testing. Structural equation models were used …

Depression And Risk Perceptions In Older African Americans With Diabetes, Barry W. Rovner, Md, Julia A. Haller, Md, Robin J. Casten, Phd, Ann P. Murchison, Md, Mph, Lisa A. Hark, Phd, Rd

Department of Psychiatry and Human Behavior Faculty Papers

Introduction: The purpose of this study is to describe the impact of depression on perceptions of risks to health, diabetes self-management practices, and glycemic control in older African Americans with type 2 diabetes.

Methods: The authors analyzed data on depression, risk perceptions, diabetes self-management, and hemoglobin A1C in African Americans with type 2 diabetes.T tests, chi square, and multivariate regression were used to analyze the data.

Results: The sample included 177 African Americans (68% women) whose average age was 72.8 years. Thirty four (19.2%) participants met criteria for depression. Compared to non-depressed participants, depressed participants scored significantly higher on Personal …

Exploration And Confirmation Of The Latent Variable Structure Of The Jefferson Scale Of Empathy., Mohammadreza Hojat, Marianna Lanoue

Department of Psychiatry and Human Behavior Faculty Papers

OBJECTIVE: To reaffirm the underlying components of the JSE by using exploratory factor analysis (EFA), and to confirm its latent variable structure by using confirmatory factor analysis (CFA).

METHODS: Research participants included 2,612 medical students who entered Jefferson Medical College between 2002 and 2012. This sample was divided into two groups: Matriculants between 2002 and 2007 (n=1,380) and be-tween 2008 and 2012 (n=1,232). Data for 2002-2007 matriculants were subjected to EFA (principal component factor extraction), and data for matriculants of 2008-2012 were used for CFA (structural equation modeling, and root mean square error for approximation.

RESULTS: The EFA resulted in …

Empathy, Self-Reflection, And Curriculum Choice, Suely Grosseman, Mohammadreza Hojat, Pamela M. Duke, Stewart Mennin, Stephen Rosenzweig, Dennis Novack

Department of Psychiatry and Human Behavior Faculty Papers

We administered the Jefferson Scale of Empathy and the Groningen Reflection Ability Scale to 61 of 64 entering medical students who self-selected a problem-based learning curricular track and to 163 of 198 who self-selected a lecture-based track (response rates of 95.3% and 82.3%, respectively, with no statistically significant differences in mean age or sex). Mean empathy and self-reflection ability scores were significantly higher among students who chose problem-based learning. Women scored higher than men in empathy. Women choosing problem-based learning had the highest empathy scores. Studies comparing students’ performance and achievements in different curricular tracks should consider differences in personal …

Influence Of The X-Chromosome On Neuroanatomy: Evidence From Turner And Klinefelter Syndromes., David S Hong, Fumiko Hoeft, Matthew J Marzelli, Jean-Francois Lepage, David Roeltgen, Judith L. Ross, Allan L Reiss

Department of Psychiatry and Human Behavior Faculty Papers

Studies of sex effects on neurodevelopment have traditionally focused on animal models investigating hormonal influences on brain anatomy. However, more recent evidence suggests that sex chromosomes may also have direct upstream effects that act independently of hormones. Sex chromosome aneuploidies provide ideal models to examine this framework in humans, including Turner syndrome (TS), where females are missing one X-chromosome (45X), and Klinefelter syndrome (KS), where males have an additional X-chromosome (47XXY). As these disorders essentially represent copy number variants of the sex chromosomes, investigation of brain structure across these disorders allows us to determine whether sex chromosome gene dosage effects …

Assessments Of Empathy In Medical School Admissions: What Additional Evidence Is Needed?, Mohammadreza Hojat

Department of Psychiatry and Human Behavior Faculty Papers

The Association for the Study of Medical Education (ASME) sponsored a symposium on the theme of Examin-ing the Evidence with Regard to Character, Personality and Values in Medical School Selection which was held on October 14, 2013 at the University of Sheffield Medical School in the United Kingdom. I was invited to speak about credibility issues related to personality assessments in health profession educations. To my pleasant surprise, I found the European audience receptive (more than their counterparts in the United States) to the idea of using personality assess-ments in admission decisions. There seems to be a hesita-tion among leaders …