Faculty Bibliography

Parents' cognitive schemas about parenting, personal vulnerabilities, and personal resources may affect their risk of engaging in parent-child aggression (PCA). This longitudinal study examined predictors of change in mothers' and fathers' PCA risk across the transition to parenthood, comparing trajectories of parents evidencing high versus low sociodemographic risk. Potential predictors involved parenting-relevant schemas (consistent with Social Information Processing theory, including approval of PCA, negative attributions of child behavior, and knowledge of nonphysical discipline options), personal vulnerabilities (psychopathology, intimate partner violence, substance use issues), and resources (problem-focused coping, emotion regulation, social support, and partner satisfaction). Results indicated that increases in PCA approval, negative child behavior attributions, and symptoms of psychopathology, as well as decreases in problem-focused coping skills, emotion regulation ability, and partner satisfaction, all significantly predicted changes in mothers' and fathers' PCA risk over time-regardless of risk group status. Notably, increases in intimate partner violence victimization and decreases in social support satisfaction predicted mothers' but not fathers' PCA risk change; moreover, increases in knowledge of nonphysical discipline alternatives or in substance use issues did not predict change in PCA risk for either mothers or fathers. Risk groups differed in PCA risk across all predictors with minimal evidence of differential trajectories. Overall, these findings have important implications for child abuse prevention programs involving both universal and secondary abuse prevention efforts.

Recent studies suggest that infants and toddlers evaluate others based on their prosocial and antisocial behaviors and engage in prosocial behaviors themselves. It is unknown to what extent infants' responses in such studies reveal stable individual differences in social and/or moral competence that persist throughout development. The current study (N = 63) demonstrates that infants' performance in sociomoral evaluation and action studies (mean age = 12 months) predicts social and behavioral adjustment at age 4 years. Specifically, a stronger preference for moral actions as an infant was associated with parent reports of fewer callous-unemotional traits, the domain most conceptually related to sociomoral evaluation and action, during preschool. Critically, preschool moral adjustment was uniquely associated with infants' sociomoral responding and not with other more general aspects of infant functioning. When 2 children with an autism spectrum disorder diagnosis were included in the sample, correlations between infant and preschool functioning were more widespread. Taken together, these results provide evidence for developmental continuity in the sociomoral domain and suggest that infants' early behavioral tendencies may be building blocks for subsequent sociomoral development.

BACKGROUND:The United States lags behind most other countries regarding the support for working mothers and parental leave. Data are limited to describe the experience of female hospital medicine physicians during pregnancy, parental leave, and their return to work in academic hospital medicine. METHODS:We conducted a qualitative descriptive study including interviews with 10 female academic hospitalists chosen from institutions across the country that are represented in Society of Hospital Medicine (SHM) Committees. Interview guides were based on the following domains: experience in pregnancy, parental leave, and return to work. Interviews were recorded, transcribed verbatim, and analyzed using a general inductive approach to theme analysis using the ATLAS.ti software (Scientific Software Development GmbH, Berlin, Germany). PRIMARY OUTCOME:Women in hospital medicine experience the following six common challenges in their experience as new parents, each of which has the potential to impact their career trajectory, wellness, and are associated with areas for institutional improvement: (1) access to paid parental leave, (2) physical challenges, (3) breastfeeding, (4) career opportunities, (5) colleague responses, and (6) empathy in patient care.

Episodic memory, everyday memory for events, is frequently impaired in patients with epilepsy. We tested patients undergoing intracranial electroencephalography (intracranial EEG) monitoring for the treatment of medically-refractory epilepsy on a well-characterized paradigm that requires episodic memory. We report that an anatomically diffuse network characterized by theta-band (4-7 Hz) coherence is activated at the time of target selection in a task that requires episodic memory. This distinct network of oscillatory activity is absent when episodic memory is not required. Further, the theta band synchronous network was absent in electrodes within the patient's seizure onset zone (SOZ). Our data provide novel empirical evidence for a set of brain areas that supports episodic memory in humans, and it provides a pathophysiologic mechanism for the memory deficits observed in patients with epilepsy.

The term justice-involved youth encompasses a broad range of youth. It can include youth who have not been detained and have been placed on probation or diversion programs, as well re-entry populations transitioning out of detention facilities or stated custody and placed on probation or parole. There are more than 1.3 million juvenile arrests per year, and on any given day there are 50,821 youth incarcerated in the United States. Of the 716,000 delinquency cases, probation is court-ordered for approximately half.¹ Even among these youth who are supervised in the community, rates of mental health and substance use disorders are high, with more than two-thirds reporting substance use problems or other mental health disorders.² However, these youth often have a hard time connecting to and staying in treatment,³ and recidivism is high-most commonly for failing to satisfy the myriad (and well intentioned) conditions of their probation.⁴ Dual diagnosis (ie, co-occurring psychiatric and substance use disorders) in justice-involved youth is one of the most significant predictors of recidivism,⁵ and, as such, closing the gap between need and receipt of substance use and mental health treatment for justice-involved youth could potentially offset rates of re-offending into adulthood.⁶ Despite high rates of mental health and substance use disorders among justice-involved adolescents, only 15% of detained youth receive mental health treatment for their condition(s); this number falls to 8% once these youth re-enter the community.⁷ These statistics regarding treatment receipt among justice-involved youth are important to consider not only from a health care perspective but also in terms of public health significance and policy.

Publications on the prevalence of unicompartmental knee arthroplasty in the United States using a single database may have underestimated the "true" number of cases performed, given that several unicondylar knee arthroplasty (UKA) patients are <65 years and have private insurance. The prevalence of UKA in elderly (≥65 years) and younger (<65 years) populations was evaluated using the 2002 to 2011 5% sample of the Medicare data (Part B) and the 2004 to June 2012 MarketScan Commercial and Medicare Supplemental databases, respectively. The prevalence of UKA was stratified by age, gender, census region, Charlson comorbidity index, Medicare buy-in status, and diagnosis. The annual rate of change in the UKA rate was examined using Poisson regression to evaluate temporal changes considering year as a covariate. A total of 5235 and 23,310 UKA procedures were identified from the 5% Medicare and MarketScan databases, respectively. The rates of UKA generally increased until 2008, after which there was a decline. In both cohorts, gender and year of operation were found to be significantly associated with UKA rate. Analysis of data obtained over the past few years revealed that males 55 to 64 years, 65 to 69 years, and 70 to 74 years were the only age-gender groups whose UKA rates appeared to be trending upward. From 2002 to 2011, the rate of UKAs performed in the United States has increased, and a significant proportion of the surgeries were performed in younger (<65 years) patients.

OBJECTIVE:This study examined associations between 3 distinct parent factors (parent personal distress, parenting stress, and spina bifida (SB)-specific parenting stress) and youth and parent proxy reports of youth health-related quality of life (HRQOL) over time. METHOD:Participants were recruited as part of a longitudinal study, and data were collected at 3 time points, spaced 2 years apart. Parents and youth completed questionnaires, and youth completed neuropsychological assessment tasks to determine youth intelligence quotient during home visits. RESULTS:Analyses revealed that higher levels of maternal SB-specific parenting stress were related to lower levels of youth-reported HRQOL at time 1. Other parent factors were not associated with youth report of HRQOL at the earlier time points, although higher levels of maternal SB-specific parenting stress and paternal parenting stress were associated with lower levels of youth HRQOL at time 3. For mothers and fathers, increased parent personal distress, parenting stress, and SB-specific parenting stress were associated with decreased proxy report of youth HRQOL. Of these three parent factors, SB-specific parenting stress was consistently the most strongly associated with parent proxy-report of youth HRQOL. CONCLUSION:Parenting stress and distress are important targets for interventions, and these interventions may improve youth outcomes, especially as youth age. Future research is needed to identify other factors influencing youth HRQOL over time.

OBJECTIVE:This study aimed to improve our understanding of how to best assist marginalized youth during their transition to adulthood, and how to provide them services that help them achieve independence within existing public systems of care. METHOD/METHODS:Using purposive sampling methods, 17 direct service providers and supervisors of a large behavioral health organization participated in individual interviews and focus groups. RESULTS:A team of analysts identified eight primary themes: (a) the primacy of consistent and caring relationships with adults; (b) working with youth and family concurrently; (c) the complicated dance of autonomy and independence; (d) engagement of alumni and peers in service delivery; (e) transition navigator: an active not passive approach to becoming an adult; (f) youth as the drivers of treatment and recovery; (g) provider training and resources to address the unique needs of transition-age youth; and (h) broadening the definition of treatment. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE/CONCLUSIONS:Our findings have important implications for practice, including (a) adapting clinical practice to meet the unique needs of transition-age youth and young adults; (b) engaging and expanding positive support systems; and (c) shifting the mindset of transition-age youth and young adults, their caregivers, and providers from a perspective of "aging out" of the mental health system to a perspective of "continuing on" in the management of their mental health through treatment and rehabilitation as needed as young adults. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

In psychological experiments, behavioral speed varies across trials, and this variation is often associated with corresponding fluctuations in cortical activity. Little is known about such cortical variations in semantic priming tasks where target words are matched with preceding sensory object cues. Here, two visually presented target words ("pear" and "lilac") were repeatedly cued by corresponding odors or pictures, and the participants were to indicate matching or nonmatching combinations. Data were split in behaviorally "fast" versus "slow" trials. We hypothesized that slow trials would be associated with higher prestimulus alpha activity and reduced ERP amplitudes, and that response-time differences between odor-cued and picture-cued trials would be especially large in slow behavioral trials. Results confirmed that slow trials showed increased alpha-band activity prior to word target onset, as well as amplitude decreases in the sensory P1 and semantic N400 components. However, no interactions between cue-modality and processing speed were observed. Instead, odor-cue integration responses were uniquely delayed on incongruent trials, a novel behavioral effect that was not observed in EEG measures. The results show that semantic integration speed is reflected in cortical activity before and during stimulus processing. Behavioral interactions with cue modality did not correspond to observed cortical activity changes, perhaps because olfactory circuits are not readily observed in scalp-recorded EEG. We conclude that combining behavioral speed variability and cortical EEG measures is useful in understanding the fluctuating nature of cognitive processing sequences. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

BACKGROUND:Preexposure prophylaxis (PrEP) reduces risk of human immunodeficiency virus infection for many gay and bisexual men (GBM); however, bacterial sexually transmitted infections associated with decreasing condom use among users is of concern. Center for Disease Control and Prevention's guidelines for PrEP use recommend bacterial sexually transmitted infection screening every 6 months. We sought to investigate comprehensive PrEP care, defined as: (1) discussion of sexual behavior, (2) blood sample, (3) urine sample, (4) rectal sample (rectal swab), and (5) throat sample (throat swab), provided at the user's last PrEP appointment. METHODS:The PrEP-using GBM in New York City (n = 104) were asked about their last PrEP care visit. We examined associations of demographics (age, race/ethnicity, and education), recent number of condomless anal sex events, time on PrEP, and health care provider type on receiving comprehensive care at last visit using fully adjusted binary logistic regression. RESULTS:At their last visit, nearly all men (94%) gave blood for testing, 88% provided a urine sample, and 77% discussed sexual behavior with their provider. However, only 51% reported having a rectal swab, and 48% an oral swab. Only 32% of men received comprehensive PrEP care at their last PrEP visit. Odds of receiving comprehensive care were significantly higher among younger men, men with a bachelor's degree or more education, and those who reported more condomless anal sex. CONCLUSIONS:Less than one third of GBM received comprehensive human immunodeficiency virus/sexually transmitted infection counseling and testing at their last visit. These findings indicate further efforts are needed to prepare health care providers for prescribing and managing patients on PrEP.