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Full-Text Articles in Psychiatric and Mental Health

A Pilot Study On The Effects Of Exercise On Depression Symptoms Using Levels Of Neurotransmitters And Eeg As Markers, Timothy H. Barclay, Scott Richards, James Schoffstall, Chad Magnuson, Christine Mcphee, Josh Price, Stephen Aita, Audrey Anderson, Dan Johnson, Jerry Price Jan 2014

A Pilot Study On The Effects Of Exercise On Depression Symptoms Using Levels Of Neurotransmitters And Eeg As Markers, Timothy H. Barclay, Scott Richards, James Schoffstall, Chad Magnuson, Christine Mcphee, Josh Price, Stephen Aita, Audrey Anderson, Dan Johnson, Jerry Price

Faculty Publications and Presentations

Context: The prescribing of exercise by physicians has become a popular practice, yet the effectiveness of exercise on symptoms of depression is difficult to determine due to a lack of randomized controlled trials with clinical populations. Reports also indicate that only a small percentage of physicians advise their patients regarding exercise and confusion still exists as to how much and what types are best. Aims: To understand the mechanisms that make exercise a viable treatment in depression. Settings and Design: This study employed a six‑week, two group, single‑level trial, pre‑ and posttest design using self‑report of symptoms, blood …


An Introduction To Drugs And The Neuroscience Of Behavior, Adam J. Prus Jan 2014

An Introduction To Drugs And The Neuroscience Of Behavior, Adam J. Prus

Books

This up-to-date text provides an introductory overview of the nervous system actions and behavioral effects of the major classes of psychoactive drugs, using pedagogy unique among pharmacology texts to make the topic approachable.


Coping Similarity And Psychosocial Risk Factors In Couples With Chronic Pain, Amy M. Williams Jan 2014

Coping Similarity And Psychosocial Risk Factors In Couples With Chronic Pain, Amy M. Williams

Wayne State University Dissertations

Chronic pain is an important public health problem that is associated with a host of negative individual and relationship outcomes. Chronic pain is a chronic stressor that both the individual in pain and their spouse must cope with. The current study examined how pain coping similarity within the couple predicted not only patient adjustment, but also spouse adjustment in a longitudinal study. Participants were 108 heterosexual couples in which one partner had chronic pain. The participants completed measures at 3 time points at 6 month intervals. Both the patient and spouse individually completed questionnaires pertaining to their marriage, mood, pain …


Pre-Traumatic Factors Of Career-Related Ptsd: A Systematic Review Of The Literature, Michael G. Curtis, Russell T. Hurlburt Jan 2014

Pre-Traumatic Factors Of Career-Related Ptsd: A Systematic Review Of The Literature, Michael G. Curtis, Russell T. Hurlburt

McNair Poster Presentations

This paper examined and synthesized the (limited) available literature on the pre-traumatic predictors of PTSD, specifically targeting populations in which traumatic events are experienced frequently because of the requirements of their positions, i.e., firefighters, police, and military personnel. A total of 21 articles were included in the final literature review and were used to assess the current available knowledge of the pre-traumatic traits of career-related PTSD, and address potential gaps in the literature. The culmination of this research was used to create specific risk profiles for each of the high risk careers included in this review, firefighters, police, and military …


A Computational Perspective Of Schizophrenia, Ernesto H. Bedoy, Geoff Powell, Jefferson Kinney Jan 2014

A Computational Perspective Of Schizophrenia, Ernesto H. Bedoy, Geoff Powell, Jefferson Kinney

McNair Poster Presentations

The etiology of schizophrenia remains largely elusive, thus dampening the effectiveness of current treatment strategies. Abnormal neural migration and neurogenesis in the hippocampus have been suggested to be involved in schizophrenia (Jakob & Beckmann, 1994). A few approaches, including computational modeling, have investigated schizophrenia as a network disorder. Computational modeling uses mathematics to predict the behavior of biological systems based on the input of a set of parameters collected from laboratory experiments. In this study, we constructed a computational model to explore the ramifications of additional PV neurons migrating to an aberrant location in the hippocampus and interfering with a …


Exercise Habits, Mindfulness, And Indicators Of Mental Health Among College Students, Emily R. Faust Jan 2014

Exercise Habits, Mindfulness, And Indicators Of Mental Health Among College Students, Emily R. Faust

All Master's Theses

The differences in levels of mindfulness and indicators of mental health were examined between groups of individuals currently engaging in various types of exercise. Eighty-two undergraduate and graduate-level college students completed an online survey regarding their past and current exercise habits and their levels of mindfulness, stress, anxiety, and affect. Four exercise groups, matched on age and gender, were created based on the types of exercise that participants reported currently engaging in: (a) yoga plus any other type of exercise; (b) aerobic exercise only; ( c) more than one type of exercise; ( d) no current activity. The results showed …


Behavioral Relaxation Training: A Stress Management Tool For Graduate Students, Natalie Anne Juhlin Jan 2014

Behavioral Relaxation Training: A Stress Management Tool For Graduate Students, Natalie Anne Juhlin

All Master's Theses

Stress can have maladaptive effects on health and academic performance. This study examined the effectiveness of teaching Behavioral Relaxation Training (BRT) as a stress management technique for graduate students. BRT is a form of relaxation training that teaches individuals 10 relaxed behaviors to use when experiencing distressing emotions. A concurrent multiple probe design across four participants was used in conjunction with pretest and follow-up scores from the Perceived Stress Scale (PSS). Following baseline probes, participants received two BRT training sessions focusing on acquisition and proficiency of relaxed body postures. Results revealed that after BRT training all participants achieved greater than …


Caffeinated Alcohol Use And Expectancies For Caffeine Versus Alcohol, Cathy Lau-Barraco, Ashley N. Linden Jan 2014

Caffeinated Alcohol Use And Expectancies For Caffeine Versus Alcohol, Cathy Lau-Barraco, Ashley N. Linden

Psychology Faculty Publications

Background- Caffeinated alcoholic beverage (CAB) use is related to alcohol-related risk. Limited research has examined outcome expectancies and CAB consumption.

Objectives- This study tested the predictive utility of caffeine and alcohol expectancies in CAB use outcomes (i.e. quantity, frequency, and alcohol-related harms).

Methods- Participants were 419 (302 women) alcohol and caffeine users from a mid-sized urban university. Data collection occurred between August 2010 and December 2011. Participants completed measures of caffeine and alcohol expectancies, alcohol problems, alcohol use, and CAB use.

Results- Caffeine and alcohol expectancies contributed uniquely to approximately 12% of the variability in quantity, 8% in frequency, and …


Psychotherapy And The Embodiment Of The Neuronal Identity: A Hermeneutic Study Of Louis Cozolino's (2010) The Neuroscience Of Psychotherapy: Healing The Social Brain , Ari Simon Natinsky Jan 2014

Psychotherapy And The Embodiment Of The Neuronal Identity: A Hermeneutic Study Of Louis Cozolino's (2010) The Neuroscience Of Psychotherapy: Healing The Social Brain , Ari Simon Natinsky

Antioch University Dissertations & Theses

In recent years, there have been several ways in which researchers have attempted to integrate psychotherapy and neuroscience research. Neuroscience has been proposed as a method of addressing lingering questions about how best to integrate psychotherapy theories and explain their efficacy. For example, some psychotherapy outcome studies have included neuroimaging of participants in order to propose neurobiological bases of effective psychological interventions (e.g., Paquette et al., 2003). Other theorists have used cognitive neuroscience research to suggest neurobiological correlates of various psychotherapy theories and concepts (e.g., Schore, 2012). These efforts seem to embody broader historical trends, including the hope that neuroscience …


Big Five Personality Traits, Pathological Personality Traits, And Psychological Dysregulation: Predicting Aggression And Antisocial Behaviors In Detained Adolescents, Katherine S. L. Lau Dec 2013

Big Five Personality Traits, Pathological Personality Traits, And Psychological Dysregulation: Predicting Aggression And Antisocial Behaviors In Detained Adolescents, Katherine S. L. Lau

LSU New Orleans Theses and Dissertations

This study tested the utility of three different models of personality, namely the social and personality model, the pathological personality traits model, and the psychological dysregulation model, in predicting overt aggression, relational aggression, and delinquency in a sample of detained boys (ages 12 to 18; M age = 15.31; SD = 1.16). Results indicated that the three personality approaches demonstrated different unique associations with aggression and delinquency. The psychological dysregulation approach, composed of behavioral dysregulation, emotional dysregulation, and cognitive dysregulation, emerged as the overall best predictor of overt aggression, relational aggression, and delinquency. After controlling for the Big Five personality …


Treatment Of Psychiatric Inpatients With Relationship Dysfunction Using A Short Term Cognitive Interpersonal Intervention: A Pilot Study, Tamra Rasberry Jul 2013

Treatment Of Psychiatric Inpatients With Relationship Dysfunction Using A Short Term Cognitive Interpersonal Intervention: A Pilot Study, Tamra Rasberry

Doctoral Dissertations and Projects

Relationship conflict for the psychiatric patient can have significant detrimental effects. There are specific types of interactions that can increase conflict and predict the potential for relapse; these have been identified by research and designated as components of Expressed Emotion (EE). Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have been very effective when targeting specific psychiatric diagnoses, but less effective when addressing relationship conflict. The majority of studies addressing relationship conflict have taken place in an outpatient, long-term setting. There is limited research that utilizes an inpatient short-term intensive therapy with relationship conflict as its sole focus, targeting areas …


Diagnostic Interaction: First-Person Patient Narratives On Hacking's Looping Effects And The Normative Status Of Psychiatric Nosology, Corinne Jager May 2013

Diagnostic Interaction: First-Person Patient Narratives On Hacking's Looping Effects And The Normative Status Of Psychiatric Nosology, Corinne Jager

Honors College Theses

What is the interaction between a psychiatric patient and their diagnosis? How do they respond to being classified? A number of philosophical theories attempt to explain the interaction between the diagnosed patient and their classification. Ian Hacking develops an account of interaction which holds that objects of human science classification are influenced by the awareness of the classification in a way that changes both the classification and its object. Hacking thinks that psychiatric patients are “interactive kinds” whose awareness of their classification causes changes in the individuals' experience of themselves, and thus changes in their classification. Hacking claims that these …


Does Emotion Invalidation Cause Emotion Dysregulation? Evidence From A Healthy Sample Of College Students And Implications For The Development Of Borderline Personality Disorder, Melissa Jean Zielinski May 2013

Does Emotion Invalidation Cause Emotion Dysregulation? Evidence From A Healthy Sample Of College Students And Implications For The Development Of Borderline Personality Disorder, Melissa Jean Zielinski

Graduate Theses and Dissertations

Linehan's BioSocial theory is a widely accepted model of the development of borderline personality disorder (BPD). However, the tenet that experiences of invalidation causally influence the development of the emotion dysregulation that characterizes BPD has been subject to relatively little empirical attention. The purpose of this study thus was to experimentally investigate the effects of validation and invalidation on indices of emotion dysregulation including self-invalidation, distress tolerance, and Social problem solving. The current study used a laboratory-based emotion induction procedure in which ninety college students participated in validating or invalidating conversations about emotional events with a peer confederate. Contrary to …


The Cultural Manifestations Of Anorexia Nervosa, Aaron Volk May 2013

The Cultural Manifestations Of Anorexia Nervosa, Aaron Volk

Tredway Library Prize for First-Year Research

No abstract provided.


Les Enfants Dans Les Coins: Une Comparaison D’Autisme En France Et Aux Etats Unis, Danya J. M. Rubin Apr 2013

Les Enfants Dans Les Coins: Une Comparaison D’Autisme En France Et Aux Etats Unis, Danya J. M. Rubin

Scripps Senior Theses

The year 2012 was a year of great controversy surrounding autism in France. Thus it is an ideal time for an investigation of the treatment of and attitudes about autism in France, specifically in comparison with the United States. This investigation encompass several specific categories, and the Freudian psychoanalytic method against the behavior modification method, the French education system and the identification of autism, "Maternal Madness" - the connection between sexism and autism, the philosophy of humanity and the history of medical experimentation and psychiatry in France. This paper questions how is it that all these categories influence the opinions …


The Effects Of Mindfulness Meditation On Rumination In Depressed People, Rachel A. Sluder Apr 2013

The Effects Of Mindfulness Meditation On Rumination In Depressed People, Rachel A. Sluder

Honors Theses and Capstones

Mindfulness meditation is a practice of focus, awareness, and non-judgmental acceptance of one's thoughts (Deyo et al., 2009; Kenny et al., 2007). Rumination is a maladaptive pattern of thought that is common in people with depression and other mood disorders. It can lead to further episodes of depression, and can be very destructive in that way (Nolen-Hoeksema, 2008). This paper reviews several studies on mindfulness meditation, depression, and rumination, with a focus on certain areas and phenomena such as alpha asymmetry (Keune et al 2013) and gamma band activity (Berkovich-Ohana et al., 2012). Modalities such as fMRI and EEG are …


Research Brief: "Combat Exposure And Suicide Risk In Two Samples Of Military Personnel", Institute For Veterans And Military Families At Syracuse University Jan 2013

Research Brief: "Combat Exposure And Suicide Risk In Two Samples Of Military Personnel", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the relationship between suicide risk and combat exposure among veterans who are receiving mental health care and those not receiving mental health care. For policy and practice, veterans who are not receiving mental health care should be monitored for depression and PTSD; mental health professionals should understand the relationship between risk factors and suicide, and the VHA should encourage post-9/11 veterans to use their mental health care benefits provided to them by the VA. Suggestions for future research include using a more representative sample, analyzing the sample over time, and relying on methods other than self-reporting.


The Role Of Acquired Capability As A Differentially-Specific Risk Factor For Disordered Eating And Problematic Alcohol Use In Female College Students: A Measure Development And Validation Study, Christa D. Labouliere Jan 2013

The Role Of Acquired Capability As A Differentially-Specific Risk Factor For Disordered Eating And Problematic Alcohol Use In Female College Students: A Measure Development And Validation Study, Christa D. Labouliere

USF Tampa Graduate Theses and Dissertations

Traditional college students are members of an age bracket noted for high levels of risky behavior, and research has shown that certain risky behaviors, such as disordered eating and problematic alcohol use, are particularly common among undergraduates. It is well established that certain events in the learning history predispose vulnerable persons to engage in maladaptive risky behaviors. What is less clear is why some persons facing these events go on to develop maladaptive behavior while others do not, or why people facing similar events develop different varieties of maladaptive behaviors. Current research has focused extensively on risk factors that are …


Expression Of Borderline Personality Disorder Symptoms Across The Ovulatory Cycle: A Multilevel Investigation, Tory A. Eisenlohr-Moul Jan 2013

Expression Of Borderline Personality Disorder Symptoms Across The Ovulatory Cycle: A Multilevel Investigation, Tory A. Eisenlohr-Moul

Theses and Dissertations--Psychology

Borderline Personality Disorder (BPD) is a disabling condition characterized by chronic emotion dysregulation and behavioral impulsivity. Prospective studies that test proposed mechanisms of within-person change in BPD hold the key to improving symptom predictability and control in this disorder. A small body of evidence suggests that fluctuations in estradiol such as those occurring naturally at ovulation during the monthly female reproductive cycle may increase symptoms in women with BPD (DeSoto et al., 2003). Furthermore, there is preliminary evidence that both self-esteem and feelings of social rejection are highest at ovulation, when estradiol peaks (Durante and Hill, 2009; Eisenlohr-Moul et al., …


Alcohol Use And Trauma Exposure Among Male And Female Veterans Before, During, And After Military Service, Michelle L. Kelley, Jennifer Runnals, Matthew R. Pearson, Marinell Miller, John A. Fairbank, Va Mid-Atlantic Mirecc Women Veterans Workgroup Jan 2013

Alcohol Use And Trauma Exposure Among Male And Female Veterans Before, During, And After Military Service, Michelle L. Kelley, Jennifer Runnals, Matthew R. Pearson, Marinell Miller, John A. Fairbank, Va Mid-Atlantic Mirecc Women Veterans Workgroup

Psychology Faculty Publications

Background: The present study examined lifespan and combat-related trauma exposure as predictors of alcohol use among male and female veterans. Posttraumatic stress and depressive symptoms were examined as mediators of the effects of trauma exposure on alcohol use.

Methods: Data were examined from 1825 (1450 male, 375 female) veterans and active duty service members who took part in a multi-site research study conducted through the Department of Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (VISN 6 MIRECC).

Results: For both men and women, depressive symptoms significantly mediated the effects of non-combat trauma exposure experienced before, during and …


Counselor Discomfort With Sexual Issues And Supervisory Role, Barbara Lofrisco Jan 2013

Counselor Discomfort With Sexual Issues And Supervisory Role, Barbara Lofrisco

USF Tampa Graduate Theses and Dissertations

ABSTRACT

Sexual issues are common among the general population; therefore it is likely that clients suffer with them whether or not they are presenting issues. Because unresolved sexual issues may contribute to harm, counselors have an ethical obligation to ensure these issues are addressed during therapy. Yet, many fail to do so for a variety of reasons. Because clinical supervisors are in a unique position to nurture and mentor novice counselors, their influence is salient to this issue.

Although some research has been done to address this issue, results are inconclusive and somewhat contradictory. This study attempts to fill in …


Research Brief: "Impact Of The Seeking Safety Program On Clinical Outcomes Among Homeless Female Veterans With Psychiatric Disorders", Institute For Veterans And Military Families At Syracuse University Oct 2012

Research Brief: "Impact Of The Seeking Safety Program On Clinical Outcomes Among Homeless Female Veterans With Psychiatric Disorders", Institute For Veterans And Military Families At Syracuse University

Institute for Veterans and Military Families

This brief is about the effect of the Seeking Safety program's services on improvement in PTSD, psychiatric symptoms, and social support among homeless female veterans. In policy and practice, clinicians should be trained on how to use the program to better serve homeless female veterans, and policymakers should push for clinician training for those who work with homeless veterans. Suggestions for future research include applying this study and the Seeking Safety program to non-VA healthcare systems, assessing substance use within the program, and assessing the long-term effects of the Seeking Safety program.


Expressed Emotion And Attitudes Toward Body Image And Food, Toni Marie Maraldo May 2012

Expressed Emotion And Attitudes Toward Body Image And Food, Toni Marie Maraldo

Undergraduate Honors Thesis Collection

In numerous studies over the years, body image and dysfunctional attitudes toward food have shown to be related to the genesis of eating disorders. Recent research has particularly focused on the influence that families have on both the development of eating disorders as well as their impact on their child's body image and eating attitudes. In general, higher levels of expressed emotion are often found in families with children who have either anorexia nervosa or bulimia nervosa. However, there is a lack of research on sub-clinical populations. Therefore, the purpose of this study is to analyze the influence that expressed …


Suicide Rates Among Young, Married Women In Nepal, Kirra L. Hughes May 2012

Suicide Rates Among Young, Married Women In Nepal, Kirra L. Hughes

Capstone Collection

In 2009, a Maternal Mortality and Morbidity (MMM) report carried out in Nepal by the Family Health Division of the Department of Health Services accidently stumbled upon a surprising leading cause of death in Nepali women of reproductive age (15 - 49). The result: suicide. And the numbers are still on the rise. There have since been no comprehensive follow-up studies and none, to my knowledge, that are currently ongoing. This leaves an urgent need for research to be done on the causes of these suicides (Benson and Shakya, 2011; Bertolote et al, 2005; Pradhan et al, 2009).

Globally, there …


Culture Ontogeny: Lifespan Development Of Religion And The Ethics Of Spiritual Counselling, Glen Milstein, Amy Manierre Jan 2012

Culture Ontogeny: Lifespan Development Of Religion And The Ethics Of Spiritual Counselling, Glen Milstein, Amy Manierre

Publications and Research

The counsellor has an ethical obligation to treat the whole person. Humans are cultural beings and the foundation of most cultures is religion. Religion and culture are received from our early relation~ ships and modified through later relationships across the lifespan. The paper introduces the term "culture ontogeny" to emphasize that this is a biological process wherein abstract ideas of culture and religion become material in the developing neurophysiology of each brain. A framework and methods are offered to examine the changing roles of religion in clients' emotional self~ structure, inclusive of those who describe themselves as spiritual, not religious. …


The Relationship Of Rehabilitation Counselors' Knowledge Of The Americans With Disabilities Act 1990, Attitudes Toward Reasonable Accommodation, And Job Development Efficacy, Joy Elizabeth Inniss-Johnson Jan 2012

The Relationship Of Rehabilitation Counselors' Knowledge Of The Americans With Disabilities Act 1990, Attitudes Toward Reasonable Accommodation, And Job Development Efficacy, Joy Elizabeth Inniss-Johnson

Wayne State University Dissertations

The purpose of this research was to evaluate the relationship between the rehabilitation counselors' level of knowledge, attitudes towards reasonable accommodations and job development efficacy. The more knowledgeable rehabilitation counselors are about ADA, reasonable accommodations, and their attitude toward job development, the less likely their attitudes will be expected to fluctuate. In addition, there has been very little research in terms of evaluating rehabilitation counselor's level of job placement efficacy. A survey-based design was utilized to create both a quantitative description of knowledge of the ADA, beliefs about reasonable accommodations and job placement efficacy and qualitative information concerning the barriers …


Psychotherapy As Cultivating Character, Mike W. Martin Jan 2012

Psychotherapy As Cultivating Character, Mike W. Martin

Philosophy Faculty Articles and Research

Duff R. Waring argues that, in some instances, psychotherapy should be viewed as healing (or alleviating) mental disorders and also as cultivating good character in patients (Waring 2012). In these instances, psychotherapists should understand their patients as having character faults that are manifested as mental disorders, as having nascent virtues they can build on during therapy, and as moving toward goals that can be specified in terms of both improved mental health and greater moral virtue. Waring’s discussion is deeply illuminating, but it suffers from a major difficulty: the failure to take adequate account of the differences between the perspectives …


Hospital Loneliness And The Patient-Physician Relationship: A Preliminary Analysis Of Associations With Recovery In Bone Marrow Transplant Patients, Lindsay E. Balfour Jan 2012

Hospital Loneliness And The Patient-Physician Relationship: A Preliminary Analysis Of Associations With Recovery In Bone Marrow Transplant Patients, Lindsay E. Balfour

UNF Graduate Theses and Dissertations

The purpose of the present study was to examine general loneliness, hospital loneliness, and the patient-physician relationship in regards to their associations with Bone Marrow Transplant (BMT) recovery outcome variables (days until engraftment and quality of life). Fifteen (66.7% female, 33.3% male; 93.3% white, 6.7% Black/African American; average age 61.73) individuals who had an allogeneic or autologous BMT at The Mayo Clinic of Jacksonville completed the FACT-BMT, UCLA-Loneliness Scale Version 3, the CARE Measure, and provided disease and treatment information at the 6 month posttransplant date (+/- 30 days). Patients recovering from BMT indicated significantly higher scores of hospital loneliness …


Treating Detained Juveniles: Measuring Mental Health Traits And Gender Differences, Todd L. Grande, Janelle M. Hallman, Lee A. Underwood, Kellie M. Warren, Mark Rehfuss Jan 2012

Treating Detained Juveniles: Measuring Mental Health Traits And Gender Differences, Todd L. Grande, Janelle M. Hallman, Lee A. Underwood, Kellie M. Warren, Mark Rehfuss

Counseling & Human Services Faculty Publications

An understanding of gender-specific differences between detained male and female youth and how these differences relate to mental health is fundamental to understanding, assessing, and treating this population. This study examined the prevalence of mental health symptoms among a sample of 4,015 incarcerated juveniles who were assessed at intake using the BASC-2, MAYSI-2, and Trauma Symptom Checklist for Children. Significant differences were found between males and females on many of the instruments’ clinical scales, the effect size, however, was small. The prevalence of mental health symptoms varied greatly based on the instrument used (12% and 70% for males; 18% and …


A Dual-Factor Model Of Mental Health In High School Students: Group Characteristics And Social Functioning, Amanda Lynn Thalji Jan 2012

A Dual-Factor Model Of Mental Health In High School Students: Group Characteristics And Social Functioning, Amanda Lynn Thalji

USF Tampa Graduate Theses and Dissertations

A dual-factor model of psychological functioning examines the presence of wellness (i.e., subjective well-being; SWB) and psychopathology (i.e., internalizing and externalizing behavior problems) in explaining youth mental health functioning. Using a dual-factor model, previous research has yielded four unique groups of elementary and middle school youth as well as college-age adults with distinct levels of wellness and psychopathology. The present empirical investigation included valid data from 500 adolescents from two high schools (grades 9 to 11). This exploratory study produced four groups of students with unique mental health profiles aligned with previous studies investigating the dual-factor model. Tukey-Kramer comparisons determined …