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Publication Dimensions of caregiver strain may partially mediate the relationship between youth symptomology and counseling utilization among Latinxs(PLOS One, 2024-04-19) Domenech Rodríguez, Melanie MWhether Latinx families use youth mental health services (MHS) depends on complex influences of barriers and facilitators within and outside of the home. This research sought to shed light on caregiver strain as part of the equation focused on parental identification and responses to youth mental health needs. We examined multiple dimensions of caregiver strain as potential mediators between youth mental health symptom severity and psychological counseling utilization. The present sample consisted of 598 Latinx caregivers to youths ages 6-18 who provided information on youth internalizing and externalizing problems, caregiver strain, and youth psychological counseling service utilization within the last year. Our findings suggest that youth symptom severity (internalizing and externalizing problems) was generally positively associated with dimensions of caregiver strain. Youth symptom severity through objective and subjective internalized strain pathways were associated with greater odds of youth MHS utilization. In contrast, youth symptom severity through subjective externalized strain reduced the odds that Latinx caregivers would report utilizing youth MHS. These models only partially mediated the relationship between youth problems and service use. Findings suggest that Latinx caregivers may navigate conflicting sources of strain related to their child's mental health problem severity in ways that may differentially impact the odds that they access youth MHS. Along with addressing structural and systemic barriers to care, utilization of psychological counseling services may also be improved through interventions that help Latinx caregivers view youth services as avenues for addressing caregiver strain and providing psychoeducation that frames externalized strain within a mental health lens.Publication A Cognitive Computational Approach to Social and Collective Decision-Making(Sage Journals, 2024-03-06) M Kurvers, Ralf H JCollective dynamics play a key role in everyday decision-making. Whether social influence promotes the spread of accurate information and ultimately results in adaptive behavior or leads to false information cascades and maladaptive social contagion strongly depends on the cognitive mechanisms underlying social interactions. Here we argue that cognitive modeling, in tandem with experiments that allow collective dynamics to emerge, can mechanistically link cognitive processes at the individual and collective levels. We illustrate the strength of this cognitive computational approach with two highly successful cognitive models that have been applied to interactive group experiments: evidence-accumulation and reinforcement-learning models. We show how these approaches make it possible to simultaneously study (a) how individual cognition drives social systems, (b) how social systems drive individual cognition, and (c) the dynamic feedback processes between the two layers.Publication Giving fruits and vegetables a tax break: lessons from a Dutch attempt(Public Health Nutrition, 2024-02-15) Mackenbach, Joreintje DingenaObjective: Food taxation can improve diets by making unhealthy foods more expensive and by making healthy foods cheaper. In the Netherlands, a political window of opportunity arose in December 2021 to reduce the value-added tax (VAT) on fruits and vegetables to zero percent. The policy is now facing institutional friction along several fronts, however, delaying and potentially averting its implementation. We analysed this institutional friction to inform future food tax policies. Design: We qualitatively analysed open-access fiscal and health experts’ position papers about benefits and downsides of the zero-rate that were discussed with members of parliament in June 2023. Setting: The Netherlands. Participants: Not applicable. Results: Health and fiscal experts expressed noticeably different viewpoints towards the utility of the zero-rate. One important argument fiscal experts based their negative advice upon pertained to the legal restrictions for distinguishing between healthier and unhealthier forms of fruits and vegetables (i.e. the principle of neutrality). A zero-rate VAT on unhealthier forms of fruits and vegetables, e.g. processed cucumber, mixed with salt and sugar, would be undesirable, but differentiating between raw and processed cucumber would offend the neutrality principle. Conclusions: The Dutch attempt to give fruits and vegetables a tax break highlights the need for crystal-clear food classifications when designing food tax policies. Public health nutritionists should combine classifications based on caloric density, palatability, degree of processing and nutrient content to provide a database for evidence-informed tax differentiation according to food item healthfulness.Publication The Discrepancy between Subjective and Objective Evaluations of Cognitive and Functional Ability among People with Schizophrenia: A Systematic Review(MDPI, 2023-12-30) Rempfer, MelisaBackground: An important aspect of recovery in schizophrenia relates to one’s subjective, lived experience. Self-report is a subjective measurement method with yet-uncertain utility in the assessment of functioning among individuals diagnosed with schizophrenia-spectrum disorder. No review to date has comprehensively synthesized existing research to evaluate the degree of correspondence, or lack thereof, between subjective and objective assessments of cognitive and everyday functioning, nor how extant data can inform the use of self-reported information in treatment and research. Methods: A systematic review was completed to provide a broad perspective of the literature on this topic. Relevant manuscripts were identified via a search strategy using key terms in PubMed and PsycINFO and a review of manuscript bibliographies. Twenty-six studies met the inclusion criteria. Results: These studies show minimal to modest associations between subjective assessments of cognition and everyday functioning and objective assessments of these domains, including informant reports and neuropsychological and behavioral measures. Individuals with schizophrenia appear to overestimate their functioning when compared to objective measures. Depression and greater cognitive ability tend to predict greater correspondence between subjective and objective assessments of cognition and everyday functioning. Discussion: This review discusses how we might understand the low correspondence between subjective and objective measures of functioning and provides recommendations for using and eliciting self-reported information in the pursuit of recovery-centered practices.Publication Differential effects of chronotype on physical activity and cognitive performance in older adults(Frontiers, 2023-04-17) Watts, AmberWe found no differences in total or peak physical activity between groups, which is inconsistent with findings from studies in younger samples. This suggests the role of chronotype on physical activity may change with age and points to the potential impact of methodological discrepancies. While evening-types exhibited worse executive function and attention performance, this finding disappeared when participants with sleep disorders were excluded. Sleep dysregulation rather than sleep timing may be driving this difference. Recent trends in physical activity research explore activity patterns across the 24-hour day and acknowledge codependence between different activity types. Our findings suggest chronotype and activity timing may be important as researchers advance this line of research in older adults.Publication The Italian food environment may confer protection from hyper-palatable foods: evidence and comparison with the United States(Frontiers Media, 2024-04-17) Fazzino, Tera L.; Summo, Carmine; Pasqualone, AntonellaBackground Multi-national food corporations may saturate country-level food systems with hyper-palatable foods. However, the degree to which global food corporations have been integrated into country-level food systems may vary. Italy has largely retained local food production and may have low hyper-palatable food (HPF) availability in the food supply. The study quantified the prevalence of HPF in the Italian food system and compared the hyper-palatability of similar foods across Italy and the United States, which has wide HPF saturation. Methods A national food system dataset was used to characterize HPF availability in Italy. A representative sample of foods commonly consumed in both Italy and the US were collected and compared. Foods represented six categories: cookies/biscotti, cakes/merendine, salty snacks, industrial bread, frozen pizza and protein/cereal bars. A standardized definition from Fazzino et al. identified HPF. Results Less than one third (28.8%) of foods in the Italian food system were hyper-palatable. US HPF items had significantly higher fat, sugar, and/or sodium across most food categories (p values = 0.001 to 0.0001). Italian HPF items had higher fiber and/or protein relative to US HPF from the same category (p values = 0.01 to 0.0001). Conclusion The Italian food system may confer protection from HPF exposure. HPF products in Italy had lower palatability-related nutrients and higher satiety-promoting nutrients.Publication Eating Pathology Clinical Outcome Tracker (EPCOT)(Center for the Advancement of Research on Eating Disorders, University of Kansas, 2024-06-17) Forbush, Kelsie T.The Eating Pathology Clinical Outcome Tracker (EPCOT) is a 24-item multidimensional self-report tool that can be used to help clinicians track weekly progress in their clients over time in therapy. The EPCOT can also be used in research contexts in which briefer, week-to-week assessments are needed. The eight scales include: Body Dissatisfaction, Binge Eating, Cognitive Restraint, Excessive Exercise, Muscle Building, Negative Attitudes Toward Obesity, Purging, and Restricting. Scoring of the EPCOT involves summing (adding) items within scales. There is no total score for the EPCOT.Publication Human and machine recognition of dynamic and static facial expressions: prototypicality, ambiguity, and complexity(Frontiers Media, 2023-09-12) Kim, Hyunwoo; Küster, Dennis; Girard, Jeffrey M.; Krumhuber, Eva G.A growing body of research suggests that movement aids facial expression recognition. However, less is known about the conditions under which the dynamic advantage occurs. The aim of this research was to test emotion recognition in static and dynamic facial expressions, thereby exploring the role of three featural parameters (prototypicality, ambiguity, and complexity) in human and machine analysis. In two studies, facial expression videos and corresponding images depicting the peak of the target and non-target emotion were presented to human observers and the machine classifier (FACET). Results revealed higher recognition rates for dynamic stimuli compared to non-target images. Such benefit disappeared in the context of target-emotion images which were similarly well (or even better) recognised than videos, and more prototypical, less ambiguous, and more complex in appearance than non-target images. While prototypicality and ambiguity exerted more predictive power in machine performance, complexity was more indicative of human emotion recognition. Interestingly, recognition performance by the machine was found to be superior to humans for both target and non-target images. Together, the findings point towards a compensatory role of dynamic information, particularly when static-based stimuli lack relevant features of the target emotion. Implications for research using automatic facial expression analysis (AFEA) are discussed.Publication A pilot study evaluating the prefeasibility of a behavioral weight loss program in people with multiple sclerosis(Elsevier, 2023-09-22) Cozart, Julia S.; Bruce, Amanda S.; Befort, Christie; Siengsukon, Catherine; Lynch, Sharon G.; Punt, Stephanie; Simon, Stephen; Shook, Robin P.; Huebner, Joanie; Bradish, Taylor; Robichaud, Jade; Bruce, Jared M.Weight loss interventions seldom include individuals with neurologic disease. The aims of the present study were to: 1) develop and assess the prefeasibility of a 6-month telehealth behavioral weight loss program for people with multiple sclerosis (MS) and obesity and 2) examine changes in weight loss (primary outcome), physical activity, and fruit/vegetable consumption at follow-up. Participants with obesity and MS engaged in a 24-week weight loss program. Participants followed established diet, exercise, and self-monitoring guidelines and attended weekly online group meetings. Median percentage weight loss was 10.54 % (SD = 7.19). Participants who adhered more closely to the self-monitoring guidelines (r = 0.81, p =.02), and who averaged higher weekly active minutes (r = 0.91, p =.002) achieved greater percentage weight loss. Six of the eight pilot participants achieved clinically meaningful weight loss (>5%) after 6-months.Publication Longitudinal Impact of the COVID-19 Pandemic on Stress and Occupational Well-Being of Mental Health Professionals: An International Study(Oxford University Press, 2023-08-02) Kogan, Cary S; Garcia-Pacheco, José A; Rebello, Tahilia J; Montoya, Madeline I; Robles, Rebeca; Khoury, Brigitte; Kulygina, Maya; Matsumoto, Chihiro; Huang, Jingjing; Elena Medina-Mora, María; Gureje, Oye; Stein, Dan J; Sharan, Pratap; Gaebel, Wolfgang; Kanba, Shigenobu; Andrews, Howard F; Roberts, Michael C; Pike, Kathleen M; Zhao, Min; Luis Ayuso-Mateos, José; Sadowska, Karolina; Maré, Karen; Denny, Keith; Reed, Geoffrey MBackground Increased levels of occupational stress among health professionals during the COVID-19 pandemic have been documented. Few studies have examined the effects of the pandemic on mental health professionals despite the heightened demand for their services. Method A multilingual, longitudinal, global survey was conducted at 3 time points during the pandemic among members of the World Health Organization’s Global Clinical Practice Network. A total of 786 Global Clinical Practice Network members from 86 countries responded to surveys assessing occupational distress, well-being, and posttraumatic stress symptoms. Results On average, respondents’ well-being deteriorated across time while their posttraumatic stress symptoms showed a modest improvement. Linear growth models indicated that being female, being younger, providing face-to-face health services to patients with COVID-19, having been a target of COVID-related violence, and living in a low- or middle-income country or a country with a higher COVID-19 death rate conveyed greater risk for poor well-being and higher level of stress symptoms over time. Growth mixed modeling identified trajectories of occupational well-being and stress symptoms. Most mental health professions demonstrated no impact to well-being; maintained moderate, nonclinical levels of stress symptoms; or showed improvements after an initial period of difficulty. However, some participant groups exhibited deteriorating well-being approaching the clinical threshold (25.8%) and persistently high and clinically significant levels of posttraumatic stress symptoms (19.6%) over time. Conclusions This study indicates that although most mental health professionals exhibited stable, positive well-being and low stress symptoms during the pandemic, a substantial minority of an already burdened global mental health workforce experienced persistently poor or deteriorating psychological status over the course of the pandemic.Publication An interpretable machine learning model of cross-sectional U.S. county-level obesity prevalence using explainable artificial intelligence(PLOS ONE, 2023-10-05) Allen, BenBackground There is considerable geographic heterogeneity in obesity prevalence across counties in the United States. Machine learning algorithms accurately predict geographic variation in obesity prevalence, but the models are often uninterpretable and viewed as a black-box. Objective The goal of this study is to extract knowledge from machine learning models for county-level variation in obesity prevalence. Methods This study shows the application of explainable artificial intelligence methods to machine learning models of cross-sectional obesity prevalence data collected from 3,142 counties in the United States. County-level features from 7 broad categories: health outcomes, health behaviors, clinical care, social and economic factors, physical environment, demographics, and severe housing conditions. Explainable methods applied to random forest prediction models include feature importance, accumulated local effects, global surrogate decision tree, and local interpretable model-agnostic explanations. Results The results show that machine learning models explained 79% of the variance in obesity prevalence, with physical inactivity, diabetes, and smoking prevalence being the most important factors in predicting obesity prevalence. Conclusions Interpretable machine learning models of health behaviors and outcomes provide substantial insight into obesity prevalence variation across counties in the United States.Publication Attachment Security Priming Affecting Mating Strategies Endorsement among College Students(SAGE Publications, 2022-07-18) Uhlich, Maximiliane; Gillath, Omri; Schachner, Dory A.; Shaver, Phillip R.Exposure to environmental cues reflecting potential threats to future survivability is associated with a stronger endorsement of short-term mating strategies. Less is known, however, about the effects of safety and security cues. In four studies, we examined the effects of attachment-related security cues compared to neutral cues on preferences for short- and long-term mating strategies. Preferences were assessed using self-report and behavioral measures. In line with Life History Theory (LHT) and our hypotheses, exposure to attachment-related security cues was mainly associated with a stronger preference for long-term mating strategies and a weaker preference for short-term strategies. Our internal meta-analysis of the experimental security manipulations across studies provided further support for the association between state attachment security and endorsement of mating strategies. We also found some predictable effects of gender and relationship status. Implications for LHT and attachment theory are discussed. (139 words)Publication Religiously Diverse Populations(Center for the Advancement of Research on Eating Disorders, 2023-06-15) Forbush, Kelsie T.; Loeb, Katharine; Levinson, Devorah; Chapa, Danielle A. N.In the final panel of the series, Dr. Kelsie Forbush meets with Dr. Katharine Loeb, Devorah Levinson, and Dani Chapa to discuss eating disorder treatment and intervention within religiously diverse populations. Dr. Loeb’s area of expertise is in teaching diversity in clinical psychology with a focus on the Orthodox Jewish Community. Devorah Levinson has expertise in treatment options for eating disorders specifically within the Orthodox Jewish Community. Dani Chapa has experience in clinical practice in working with patients with eating disorders from religiously diverse backgrounds. Topics in the discussion include food resources for different religious parameters, in-patient care differences, fasting, working with spiritual leaders, conflicting beliefs within families, therapist self-disclosure, learning cultural competence, and making treatment materials more inclusive.Publication Racial and Ethnic Minority Populations(Center for the Advancement of Research on Eating Disorders, 2022-09-25) Forbush, Kelsie T.; Perez, Marisol; Lui, Priscilla; Burke, NatashaIn this panel discussion, Dr. Kelsie Forbush meets with Dr. Marisol Perez, Dr. Priscilla Lui, and Dr. Natasha Burke to discuss eating disorders in racial and ethnic minority populations. Dr. Perez’s area of expertise is in the clinical presentation of eating disorder symptoms among ethnic minority populations, specifically Hispanic and Latinx populations. Dr. Lui’s area of expertise is the impact of culture, ethnicity, and race on addictive behaviors. Dr. Burke’s area of expertise is measurement and modeling techniques used in underrepresented populations and intersectionality in eating disorders. Topics discussed include Western-based measurement/treatment, collectivism, participatory treatment, intersectionality, interpersonal interactions, language accessibility across groups, recruiting techniques, inclusivity at touchpoints, barriers in treatment, and increased training in working with diverse populations.Publication Men and Masculine Populations(Center for the Advancement of Research on Eating Disorders, 2022-10-17) Forbush, Kelsie T.; Lavender, Jason; Nagata, Jason; Perko, VictoriaIn this panel discussion, Dr. Kelsie Forbush meets with Dr. Jason Lavender, Dr. Jason Nagata, and Dr. Victoria Perko to discuss eating disorders and treatment within male and masculine-identifying populations. Dr. Lavender has expertise in psychotherapies and ED treatment for men with eating disorders. Dr. Nagata has expertise in medical management for adolescents and young adults with eating disorders. Dr. Perko has expertise in new assessments for eating disorders in underrepresented populations. Topics discussed include inclusivity in measurements, limited research, the influence of gender norms, language awareness, minimization of symptoms, body image, muscle-building concerns, metabolic requirements, decreasing stigma, misdiagnosis, intersectionality, gender dysphoria, potential resistance to diagnosis, and distinguishing between healthy and unhealthy muscle building activity.Publication Food Insecurity and Rural Populations(Center for the Advancement of Research on Eating Disorders, 2023-03-31) Forbush, Kelsie T.; Zickgraf, Hana; Christensen, Kara; Davis, HeatherIn this panel discussion, Dr. Kelsie Forbush meets with Dr. Hana Zickgraf, Dr. Kara Christensen, and Dr. Heather Davis to discuss how food insecurity and rural populations can affect eating disorder treatment. Topics discussed include prevalence of food insecurity in eating disorders, the feast or famine cycle, higher BMIs, diet culture and the thin ideal, utilizing trauma informed care, resource acquisition, intersectionality, supplements, and measurements to assess food insecurity.Publication Developmental Disability and Athletic Populations(Center for the Advancement of Research on Eating Disorders, 2022-11-21) Forbush, Kelsie T.; Chapa, Danielle A. N.; Richson, BrianneIn the third part of the panel discussion series, Dr. Kelsie Forbush meets with Dr. Dani Chapa and Dr. Brianne Richson to discuss eating disorders within developmental disability and athletic populations. Dr. Chapa has expertise in exercise behaviors in people with eating disorders. Dr. Richson has expertise in pediatric care of children with neurodevelopmental disorders alongside an eating disorder. Topics discussed include CBT for ARFID, weight restoration, preferences in treatment, relative energy deficiency in sport, sport continuation, cental coherence, adapting higher levels of care for autistic patients, and diet cultures effect on the identification of DEBs and exercise misuse.Publication The Building Healthy Eating and Self-Esteem Together for University Students Mobile App to Treat Eating Disorders: User-Centered Research Design and Feasibility Study(JMIR Publications, 2023-07-12) Forbush, Kelsie T.; Christensen Pacella, Kara A.; Thomeczek, Marianna L.; Gould, Sara R.; Chapa, Danielle A. N.; Richson, Brianne N.; Perko, Victoria L.; Ayres, Joseph; Chen, Yiyang; Negi, SonakshiBackground: University students are an at-risk group for the development of eating disorders (EDs); however, many college campuses lack sufficient resources to provide ED specialty care. Students report unique reasons for not seeking ED treatment, including the desire to solve the problem on their own (eg, seeking help from friends, self-medicating, or waiting to see if their problems improve), inability to afford treatment, lack of time to participate in the treatment, fear of seeing their primary care physician, and lack of recognition of their issues as an ED. Mobile health (mHealth) apps may be a cost-effective, helpful adjunctive tool to overcome personal and systemic barriers and encourage help seeking. Objective: This paper describes the development, usability, and acceptability of the Building Healthy Eating and Self-Esteem Together for University Students (BEST-U) mHealth smartphone app, which is designed to fill critical gaps in access to ED treatment on college campuses. Methods: We undertook a 4-phase iterative development process that focused on user-centered design. The 4 phases included needs assessment based on literature reviews, prototype development and initial evaluation in a pilot trial, redesign, and further pilot-testing to assess the usability and acceptability of the final version of the mHealth app. Acceptability and user satisfaction were assessed using an ad hoc survey that ranged from 1 (strongly disagree) to 7 (strongly agree). Results: Our needs assessment identified a lack of accessible and affordable treatments for university students. To help meet this need, the BEST-U prototype was designed as an 11-week program that provided interactive, weekly modules that focused on second- and third-wave cognitive behavioral skills. The modules focused on topics such as psychoeducation, reducing thought distortions and body checking, improving body image, interpersonal effectiveness, and behavior chain analysis. The content included interactive quizzes, short answer questions, daily and weekly logs, and surveys completed in the app. BEST-U was paired with brief 25-30 minutes of weekly telehealth coaching sessions provided by a licensed provider or supervised trainee. Pilot-testing revealed minor issues with one module of the app content, which some participants viewed as having low relevance to their experience and therapist concerns about the organization of the app content. These issues were addressed through the removal, addition, and reorganization of BEST-U modules, with the help of therapists-in-training across 2 workshops. The revised version of the BEST-U app had a grand mean acceptability rating of 5.73 out of 7. The participants completed 90.1% (694/770) of the BEST-U modules, indicating high compliance. Conclusions: BEST-U is a new, acceptable, and user-friendly mHealth app to help therapists deliver brief, evidence-based cognitive behavioral interventions. Owing to its acceptability and user-friendly nature, BEST-U has high user compliance and holds promise for future implementation and dissemination in university mental health settings.Publication Evidence for Two Mechanisms to Account for the Speech to Song Illusion, the Verbal Transformation Effect, and the Sound to Music Illusion(Taylor and Francis Group, 2023-07-25) Vitevitch, Michael S.; Phillips, Elizabeth R.; Norkey, Evan A.; Kodwani, AnishaIntroduction Five studies examined the speech to song illusion, the verbal transformation effect, and the sound to music illusion in order to determine if they were distinct phenomena and to assess if they could be accounted for by a single perceptual/cognitive mechanism. Methods In Study 1, word lists varying in length from 1 word (as often used to study the verbal transformation effect) to 4 words (as often used to study the speech to song illusion) were presented to participants for 4 minutes to investigate the percepts that were elicited. In Study 2 participants were asked to indicate YES/NO if they experienced the speech to song illusion when listening to word-lists modified by a vocoder. In Studies 3–5 participants were asked to click a button as soon as the shift in percept occurred from speech (or sound) to a music-like percept to assess the time-course of the speech to song (or sound to music) illusion. Results Study 1 shows that the verbal transformation effect and the speech to song illusion elicit similar percepts. In Study 2 participants indicated that the speech-like stimuli elicited the speech to song illusion more than the noise-like stimuli. In Studies 3–5 similar time-courses were observed for the speech to song illusion and the sound to music illusion. Discussion Previous, single-mechanism accounts of the speech to song illusion are discussed, but none of them adequately account for all of the results presented here. A new model is proposed that appeals to both a perceptual/“lower-level” mechanism and a cognitive/“higher-level” mechanism.Publication Identifying the phonological backbone in the mental lexicon(Public Library of Science, 2023-06-23) Vitevitch, Michael S.; Sale, MaryPrevious studies used techniques from network science to identify individual nodes and a set of nodes that were “important” in a network of phonological word-forms from English. In the present study we used a network simplification process—known as the backbone—that removed redundant edges to extract a subnetwork of “important” words from the network of phonological word-forms. The backbone procedure removed 68.5% of the edges in the original network to extract a backbone with a giant component containing 6,211 words. We compared psycholinguistic and network measures of the words in the backbone to the words that did not survive the backbone extraction procedure. Words in the backbone occurred more frequently in the language, were shorter in length, were similar to more phonological neighbors, and were closer to other words than words that did not survive the backbone extraction procedure. Words in the backbone of the phonological network might form a “kernel lexicon”—a small but essential set of words that allows one to communicate in a wide-range of situations—and may provide guidance to clinicians and researchers on which words to focus on to facilitate typical development, or to accelerate rehabilitation efforts. The backbone extraction method may also prove useful in other applications of network science to the speech, language, hearing and cognitive sciences.