BackgroundThe aim of this study was to explore the construct validity and diagnostic properties of the Reading the Mind in the Eyes Test in non-demented patients with amyotrophic lateral sclerosis.MaterialsA total of 61 consecutive patients and 50 healthy controls were administered the 36-item RMET. Additionally, patients underwent a comprehensive assessment of social cognition via the Story-Based Empathy Task, which encompasses three subtests targeting Causal Inference, Emotion Attribution, and Intention Attribution, as well as global cognitive [the Edinburgh Cognitive and (...) Behavioral ALS Screen ] and behavioral screening [the Frontal Behavioral Inventory ; the Dimensional Apathy Scale ; the Beck Depression Inventory ; and the State and Trait Anxiety Inventory-Y]. The construct validity of the RMET was tested by regressing it within a stepwise model that encompassed as predictors the abovementioned cognitive and behavioral measures, covarying for demographic and motor confounders. Receiver-operating characteristics analyses allowed exploring intrinsic and post-test properties of the RMET both in discriminating patients from HCs and in identifying patients with a defective SET-EA performance.ResultsThe RMET was solely predicted by the SET-EA and SET-IA. RMET scores showed high accuracy both in discriminating patients from HCs and in identifying patients with a defective SET-EA score, with adequate-to-optimal both intrinsic and post-test properties.DiscussionThe RMET is a convergently and divergently valid measure of affective social cognition in non-demented ALS patients, also featuring optimal intrinsic and post-test diagnostic properties in both case-control and case-finding scenarios. (shrink)

Cognitive diagnostic assessment has been developed rapidly to provide fine-grained diagnostic feedback on students’ subskills and to provide insights on remedial instructions in specific domains. To date, most cognitive diagnostic studies on reading tests have focused on retrofitting a single booklet from a large-scale assessment. Critical issues in CDA involve the scarcity of research to develop diagnostic tests and the lack of reliability and validity evidence. This study explored the development and validation of the (...) class='Hi'>Diagnostic Chinese Reading Comprehension Assessment for primary students under the CDA framework. Reading attributes were synthesized based on a literature review, the national curriculum criteria, the results of expert panel judgments, and student think-aloud protocols. Then, the tentative attributes were used to construct three booklets of reading comprehension items for 2–6 graders at three key stages. The assessment was administered to a large population of students in grades 2–6 from 20 schools in a district of Changchun City, China. Q-matrices were compared and refined using the model-data fit and an empirical validation procedure, and five representative cognitive diagnostic models were compared for optimal performance. The fit indices suggested that a six-attribute structure and the G-DINA model were best fitted for the reading comprehension assessment. In addition, diagnostic reliability, construct, internal and external validity results were provided, supporting CDM classifications as reliable, accurate, and useful. Such diagnostic information could be utilized by students, teachers, and administrators of reading programs and instructions. (shrink)

In professional soccer, players, coaches, and researchers alike recognize the importance of cognitive skills. Research addressing the relevance of cognitive skills has been based on the cognitive component skills approach or the expert performance approach. Our project aimed to combine the strengths of both approaches to develop and validate cognitive tasks measuring inhibition and cognitive flexibility in a soccer-specific setting with a soccer-specific motor response. In the main study 77 elite youth soccer players completed a computerized version of the standard (...) flanker and number–letter tasks as well as flanker and number–letter tasks requiring a soccer-specific motor response in a soccer-specific setting. Results show good reliability for both tasks. For the SoccerBot360 number–letter task, switch effects for response times and accuracy and acceptable convergent validity were shown. A flanker effect for response time but not accuracy was apparent. Due to no acceptable convergent validity, the flanker task was revised and 63 adult soccer players participated in a follow-up validation study in the SoccerBot100. The revised flanker task showed the flanker effect for response time, but not for accuracy. However, acceptable convergent validity for response time was present. Thus, the soccer-specific number–letter and to some extent the soccer-specific flanker task show potential to be used as a valid cognitive diagnostic tool by soccer clubs. (shrink)

Background: A short version of the Posttraumatic Diagnostic Scale comprising only re-experiencing symptom items has been recently validated on Japanese adults. This short-version-PDS had good psychometric properties among Japanese adults with and without posttraumatic stress disorder. The aim of this study was to translate and culturally validate the short-version-PDS for the Brazilian sociolinguistic context.Methods: A translation of the short-version-PDS was performed based on established guidelines. We enrolled 53 patients with PTSD as a potential comorbidity. The translation and cross-cultural adaptation (...) of the short-version-PDS included forward and back-translation by a Japanese Brazilian researcher and a certified translator; synthesis was achieved by consensus, backward translation, pilot test, and finalization. Content validity coefficient was used to assess quality of adaptation. Internal consistency was calculated using Cronbach's alpha coefficient. Spearman correlations were between the new short-version-PDS and the Brazilian version of the posttraumatic Stress Disorder Checklist for DSM-5, and a receiver operating characteristic curve was used to determine the best cut-off values for the short-version-PDS.Results: The short-version-PDS was well accepted by all subjects, none of the questions were experienced as inappropriate, and all questions of the 3 items were judged important. Item 1 presented CVCt = 0.92; item 2 had a CVCt = 0.87 and item 3 had a CVCt = 0.95. The internal consistency of the final version as measured by Cronbach's alpha was 0.78. The short-version-PDS scale correlated positively with the DSM-5 scale with a Spearman rho of 0.64 (95%CI [0.4-0.8], p 31.0 with sensitivity and specificity are 86.4 and 93.5%, respectively.Conclusions: This Brazilian Portuguese version of the short-version-PDS had good psychometric properties among Brazilian adults with and without PTSD. Transferability and generalizability of the cut-off scores should be further analyzed. (shrink)

Aims: The Research Diagnostic Criteria for Temporomandi¬bular Disorders (RDC/TMD) Axis I diagnostic algorithms were demonstrated to be reliable but below target sensitivity and specificity. Empirical data supported Axis I algorithm revisions that were valid. Axis II instruments were shown to be both reliable and valid. An international consensus workshop was convened to obtain recommendations and finalization of new Axis I diagnostic algorithms and new Axis II instruments. Methods: A comprehensive search of published TMD diagnostic literature was (...) followed by review and consensus via a formal structured process by a panel of experts for revision of the RDC/TMD. Results: The recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for pain diagnoses and valid criteria for the most common pain-related TMDs and for one intra-articular disorder. The Axis II protocol retains selected RDC/TMD screening instruments augmented with new instruments to better assess the interactions between pain and psychosocial functioning. A comprehensive classification system is also presented. Conclusion: The recommended evidence-based DC/TMD protocol is appropriate for use in both the clinical and research settings. Simple Axis I and II screening tests augmented by validated Axis I and Axis II instruments allow for identification of simple to complex TMD patients. (shrink)

Next SectionThe current focus on early intervention trials in Alzheimer's disease research raises particular ethical issues. These arise out of problems of validating study results and translating them into general practice for one thing and out of unwanted effects of an uncertain diagnosis for diagnosed people for another. The first addresses the demands of scientific research compared to those of medical practice, questioning how the medical value of clinical trials is evaluated. The second relates the scientific and medical value of (...) early intervention trials to the normative value of an uncertain diagnosis. Are people who are diagnosed with a potential early form of AD in clinical studies patients proper—although they would not have been diagnosed with the given “disease” in non-research-oriented medical settings? The very problem of framing this question in terms of diagnostic misconceptions connects conceptual with ethical issues of research into preclinical stages of neurodegenerative diseases. (shrink)

The concept of a “validator” as a unit of evidence for the validity of a psychiatric category has been important for more than fifty years. Validator evidence is aggregated by expert committees (for the Diagnostic and Statistical Manual of Mental Disorders (DSM), these are referred to as “workgroups”), which use the results to make nosological decisions. Through an examination of the recent history of psychiatric research, this paper argues that it is time to reassess this traditional practice. It (...) concludes with specific suggestions for going forward. (shrink)

We raise a problem of applicability of RCTs to validate nuclear diagnostic imaging tests. In spite of the wide application of PET and other similar techniques that use radiopharmaceuticals for diagnostic purposes, RCT-based evidence on their validity is sparse. We claim that this is due to a general conceptual problem that we call Prevalence of Treatment, which arises in connection with designing RCTs for testing any diagnostic procedure in the present context of medical research, and is (...) particularly apparent in this case. We also identify three practical reasons why RCTs do not qualify as the best option for PET validation, which have to do with specific characteristics of nuclear diagnostic imaging, and of radiopharmaceuticals. The paper is meant to contribute both to the philosophical discussion on the EBM hierarchy of evidence, and on the specific debate on radiopharmaceuticals in nuclear medicine. (shrink)

Fusion validity assessments employ structural equation models to investigate whether an existing scale functions in accordance with theory. Fusion validity parallels criterion validity by depending on correlations with non-scale variables but differs from criterion validity because it requires at least one theorized effect of the scale, and because both the scale and scaled-items are included in the model. Fusion validity, like construct validity, will be most informative if the scale is embedded in as full (...) a substantive context as theory permits. Appropriate scale functioning in a comprehensive theoretical context greatly enhances a scale’s validity. Inappropriate scale functioning questions the scale but the scale’s theoretical embedding encourages detailed diagnostic investigations potentially challenging specific items, the procedure used to calculate scale values, or aspects of the theory, but also possibly recommends incorporating additional items into the scale. The scaled items should have survived prior content and methodological assessments but the items may or may not reflect a common factor because items having diverse causal backgrounds can sometimes fuse to form a unidimensional entity. Though items reflecting a common cause can be assessed for fusion validity, we illustrate fusion validity in the more challenging context of a scale comprised of diverse items and embedded in a complicated theory. Specifically we consider the Leadership scale from the Alberta Context Tool with care aides working in Canadian long-term care homes. (shrink)

A philosophical question divides the field of addiction research. Can a psychological disorder count as an addiction absent a common underlying physical basis (neurological or genetic) for every case of the disorder in the category? Or is it appropriate to categorize a disorder as an addiction if the symptoms of and diagnostic criteria for it are sufficiently similar to those of other disorders also classified as addictions—regardless of whether there is some underlying physical basis common to each case of (...) the disorder? The question concerns the scope and validity of the scientific concept of addiction and, more broadly, what is required for a psychological concept to count as scientific. The case of pathological gambling (PG) raises this question nicely. ‘‘Should pathological gambling be considered an addiction?’’ asks Howard Shaffer (2003, 176). He specifies the question further (2003, 177–178): ‘‘When clinicians and scientists identify a behavior pattern as an addiction, even if they can identify it reliably according to DSM criteria, how do they know that it is indeed an addiction?’’ He warns that, as it stands, ‘‘the concept of addiction represents a troublesome tautology’’ (2003, 178): a subject S is addicted if and only if S engages in repetitive behavior with negative consequences against S’s better judgment. The problem with this concept is that it provides no way to distinguish behavior that cannot be controlled from behavior that is merely in fact not controlled. This ‘‘lay’’ concept is of little scientific value, Shaffer (2003, 179) argues, saying that ‘‘for addiction to emerge as a viable scientific construct . . . investigators need to establish a ‘gold standard’ against which the presence or absence of the disorder can be judged.’’ PG has no such gold standard, says Shaffer. What would such a gold standard be? Shaffer suggests ‘‘neurogenetic or biobehavioral attributes’’ (ibid.).. (shrink)

BackgroundWhereas the majority of bereaved persons recover from their grief without professional assistance, a minority develops pathological grief reactions. Etiological models postulate that dysfunctional cognitions may perpetuate such reactions. The Grief Cognitions Questionnaire assesses thoughts after bereavement in nine interrelated domains. A short form with four domains is often used. However, an evaluation of the psychometric properties of the GCQ-SF and its utility compared to the GCQ is lacking and these instruments have not been validated in German.MethodGerman bereaved persons responded (...) to an online survey containing the GCQ, measures of grief severity, grief rumination, symptoms of depression and anxiety, and optimism and pessimism. 585 participants were included. Item analyses and confirmatory factor analyses were conducted. Correlations between the GCQ and GCQ-SF and grief rumination, optimism and pessimism assessed construct validity. Criterion-related validity was assessed by comparing whether the correlation of the GCQ with grief severity was higher than with anxious and depressive symptoms. Logistic regression and receiver-operator characteristics compared the questionnaires on their ability to predict probable prolonged grief ‘caseness’.ResultsInternal consistencies for both questionnaires were identical and excellent. Confirmatory factor analyses obtained a satisfactory fit for models with nine and four correlated subscales and respective higher-order factor models. The GCQ and the GCQ-SF correlated higher with grief severity than with other measures of psychopathology. The logistic regression showed a significant association between the GCQ-SF and prolonged grief ‘caseness’. Of the remaining subscales of the GCQ, only one subscale contributed to the prediction. The ROC analyses showed nearly identical areas under the curve.ConclusionThe translated GCQ and GCQ-SF demonstrated very good psychometric properties. The correlations with grief severity highlight the questionnaires’ clinical relevance. The questionnaires possessed identical diagnostic specificity and sensitivity. Whenever a timesaving assessment of the most typical grief-specific cognitions is important, the GCQ-SF represents an alternative to the GCQ. The original GCQ may still be superior when a more detailed description of a bereaved person’s cognitions is desirable. (shrink)

Analysis of the adequacy of engineering design methods, as well as analysis of the utility of concepts of function often invoked in these methods, is a neglected topic in both philosophy of technology and in engineering proper. In this paper, I present an approach—dubbed an explanationist perspective—for assessing the adequacy of function-based design methods. Engineering design is often intertwined with explanation, for instance, in reverse engineering and subsequent redesign, knowledge base-assisted designing, and diagnostic reasoning. I argue that the presented (...) approach is useful for validating function-based design methods with respect to their explanatory elements and that it supports assessment of the explanatory and design utility of “function”, and the different conceptualizations thereof, as used in such engineering design methods. I deploy two key desiderata from the explanation literature to assess the viability of function-based design methods: explanatorily relevant difference-making factors and counterfactual understanding defined in terms of what-if-things-had-been-different questions. I explicate the approach and its merits in terms of two case studies drawn from the engineering functional modeling literature: reverse engineering and redesign and malfunction analysis. I close the paper by discussing ramifications of the presented approach for the philosophy of design and the philosophy of explanation. (shrink)

The failure of psychiatry to validate its diagnostic constructs is often attributed to the prioritizing of reliability over validity in the structure and content of the Diagnostic and Statistical Manual of Mental Disorders. Here I argue that in fact what has retarded biomedical approaches to psychopathology is unwarranted optimism about diagnostic discrimination: the assumption that our diagnostic tests group patients together in ways that allow for relevant facts about mental disorder to be discovered. I consider (...) the Research Domain Criteria framework as a new paradigm for classifying objects of psychiatric research that solves some of the challenges brought on by this assumption. (shrink)

This article describes the development and validation of a diagnostic test of German and its integration in a programme of formative assessment during a one-year initial teacher-training course. The test focuses on linguistic aspects that cause difficulty for trainee teachers of German as a foreign language and assesses implicit and explicit grammatical knowledge as well as students' confidence in this knowledge. Administration of the test to 57 German speakers in four groups (first-year undergraduates, fourth-year undergraduates, postgraduate trainees, and native (...) speakers) provided evidence of its reliability and validity. (shrink)

Tamara Kayali Browne's proposal for an Ethics Review Panel for the Diagnostic and Statistical Manual of Mental Disorders conceives of a state-sponsored panel of academic experts—philosophers, sociologists, and bioethicists—dealing in a reflective, systematic, and standardized manner with the "value judgements" that are an "integral and unavoidable part of psychiatric nosology". The panel would consider existing and new diagnostic categories, and issue authoritative vetoes and/or modifications as appropriate. Browne asserts that, "it should not be necessary to have protests and (...) political activism, such as that involved in removing homosexuality from the DSM, in... (shrink)

This paper provides a historical analysis of a shift in the way animal models of mental disorders were conceptualized: the shift from the mid-twentieth-century view, adopted by some, that animal models model syndromes classified in manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM), to the later widespread view that animal models model component parts of psychiatric syndromes. I argue that in the middle of the twentieth century the attempt to maximize the face validity of (...) animal models sometimes led to the pursuit of the ideal of an animal model that represented a behaviorally defined psychiatric syndrome as described in manuals such as the DSM. I show how developments within psychiatric genetics and related criticism of the DSM in the 1990s and 2000s led to the rejection of this ideal and how researchers in the first decade of the twenty-first century came to believe that animal models of mental disorders should model component parts of mental disorders, adopting a so-called endophenotype approach. (shrink)

A growing number of clinical trials use invasive research procedures to obtain tissue for disease screening and to monitor the effects of drugs. These procedures can be ethically contentious because they often have neither therapeutic nor diagnostic value, and because research participants may not realize this, which could compromise the validity of their consent to the procedure. In the first section of this paper, we describe the burdens, risks, and benefits associated with certain common invasive, nondiagnostic research procedures. (...) We next offer a series of arguments about the general properties of a valid consent for such procedures, and we close by examining what is currently known about consent quality for invasive research procedures when measured against the standards laid out in the second section. We conclude that there is little evidence to either confirm or dispel concerns about participants’ consent quality for protocols involving invasive, nondiagnostic research procedures. (shrink)

What makes a high-quality biomarker experiment? The success of personalized medicine hinges on the answer to this question. In this paper, I argue that judgment about the quality of biomarker experiments is mediated by the problem of theoretical underdetermination. That is, the network of biological and pathophysiological theories motivating a biomarker experiment is sufficiently complicated that it often frustrates valid interpretation of the experimental results. Drawing on a case-study in biomarker diagnostic development from neurooncology, I argue that this problem (...) of underdetermination can be overcome with greater coordination across the biomarker research trajectory. I then sketch an account for how coordination across a research trajectory can be evaluated. I ultimate conclude that what makes a high-quality biomarker experiment must be judged by the epistemic contribution it makes to this coordinated research effort. (shrink)

The purpose of cognitive diagnostic modeling is to classify students' latent attribute profiles using their responses to the diagnostic assessment. In recent years, each diagnostic classification model makes different assumptions about the relationship between a student's response pattern and attribute profile. The previous research studies showed that the inappropriate DCMs and inaccurate Q-matrix impact diagnostic classification accuracy. Artificial Neural Networks have been proposed as a promising approach to convert a pattern of item responses into a (...) class='Hi'>diagnostic classification in some research studies. However, the ANNs methods produced very unstable and unappreciated estimation unless a great deal of care was taken. In this research, we combined ANNs with two typical DCMs, the deterministic-input, noisy, “and” gate model and the deterministic-inputs, noisy, “or” gate model, within a semi-supervised learning framework to achieve a robust and accurate classification. In both simulated study and real data study, the experimental results showed that the proposed method could achieve appreciated performance across different test conditions, especially when the diagnostic quality of assessment was not high and the Q-matrix contained misspecified elements. This research study is the first time of applying the thinking of semi-supervised learning into CDM. Also, we used the validating test to choose the appropriate parameters for the ANNs instead of using typical statistical criteria. (shrink)

This study applied cognitive diagnostic models to assess students’ learning progressions in energy. A Q-matrix was proposed based on existing literature about learning progressions of energy in the physical science domain and the Trends in International Mathematics and Science Study assessment framework. The Q-matrix was validated by expert review and real data analysis. Then, the deterministic inputs, noisy ‘and’ gate model with hierarchical relations was applied to data from three jurisdictions that had stable, defined science curricula. The results suggested (...) that the hypothesized learning progression was consistent with the observed progression in understanding the energy concept. We also found similarities in students’ attribute mastery across the three jurisdictions. In addition, we examined the instructional sensitivity of the selected item. We discuss several curriculum-related issues and student misconceptions that may affect students’ learning progressions and mastery patterns in different regions of the world. (shrink)

Forensic evidence often involves an evaluation of whether two impressions were made by the same source, such as whether a fingerprint from a crime scene has detail in agreement with an impression taken from a suspect. Human experts currently outperform computer-based comparison systems, but the strength of the evidence exemplified by the observed detail in agreement must be evaluated against the possibility that some other individual may have created the crime scene impression. Therefore, the strongest evidence comes from features in (...) agreement that are also not shared with other impressions from other individuals. We characterize the nature of human expertise by applying two extant metrics to the images used in a fingerprint recognition task and use eye gaze data from experts to both tune and validate the models. The Attention via Information Maximization model quantifies the rarity of regions in the fingerprints to determine diagnosticity for purposes of excluding alternative sources. The CoVar model captures relationships between low-level features, mimicking properties of the early visual system. Both models produced classification and generalization performance in the 75%–80% range when classifying where experts tend to look. A validation study using regions identified by the AIM model as diagnostic demonstrates that human experts perform better when given regions of high diagnosticity. The computational nature of the metrics may help guard against wrongful convictions, as well as provide a quantitative measure of the strength of evidence in casework. (shrink)

Computerized medical personal registers are created for administrative purposes but are frequently used in research. It can be shown that this divergence of aims deeply affects the validity of the diagnosis in register research. The diagnostic process is embedded within the process of creating the data base. This process is guided by the aims for making diagnosis.Five different aims for making diagnosis in clinical practice have been analysed and eight suggestions for validity control are proposed on the (...) basis of the study. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Impact of Clinicians on the Diagnostic ManualThomas A. Widiger (bio)Keywordsdiagnosis, classification, DSM, taxonomy, clinical judgmentSurveys of clinicians’ opinions can be very informative. There is a long tradition within medicine that new disorders are discovered within clinical practice. The original edition of the American Psychiatric Association’s (APA) diagnostic manual (DSM) was based in large part on clinical experience. The recent editions have been governed more heavily by (...) more systematic research (Widiger and Clark 2000), but many of the new additions are still said to come from clinical practice. As described for the development of DSM-III (APA 1980), “if there is general agreement among clinicians, who would be expected to encounter the condition, that there are a significant number of patients who have it and that its identification is important in their clinical work, it is included in the classification” (Spitzer, Sheehy, and Endicott 1977, 3).Clinicians can also be surveyed with regard to their opinions concerning a proposed revision. The ultimate consumers of a diagnostic manual are practicing clinicians and any effort to develop an official nomenclature should consider the opinions of the persons who must use the classification within their clinical practice (First et al. 2004; Sadler 2005). Clinicians can also be surveyed (or studied) with respect to how the diagnostic manual is being implemented. Much of this research has demonstrated that clinicians might be failing to apply the diagnostic manual in a reliable or valid manner (Garb 2005; Kutchins and Kirk 1997).It is perhaps obvious, however, that a diagnostic manual should not be governed primarily by clinical opinion or current clinical practice. The authors of DSM-III (APA 1980) and DSM-III-R (APA 1987) indicated that they would include a new diagnosis within the official nomenclature if a group of clinicians indicated that it was important to their clinical practice (Spitzer et al. 1977). This liberal threshold led to the decision of the DSM-III-R Task Force to include such diagnoses as paraphiliac rapism, self-defeating personality disorder, and sadistic personality disorder despite the lack of systematic research supporting their validity and the likelihood that these new diagnoses would have harmful social and forensic applications (Widiger 1995). These diagnoses no longer even appear within the appendix of DSM-IV-TR (APA 2000) for proposed diagnoses needing further study.The authors of DSM-III avoided opinion surveys because “no one wanted to repeat the scene of the general membership voting on a presumably ‘scientific’ issue, as was done in 1973 on the [End Page 277] issue of the elimination of homosexuality from the DSM-II classification” (Spitzer, Williams, and Skodol 1980, 152). Matters of construct validity should probably be addressed through systematic research rather than through opinion polls. Decisions should be informed by a fair hearing of the diversity of perspectives, and these viewpoints and perspectives should be systematically and enthusiastically solicited. Nevertheless, the most scientifically valid decision may at times be “politically incorrect.” The authors of the diagnostic manual should have the authority to make innovative decisions that are scientifically justified even when they are contrary to general clinical consensus (Widiger and Clark 2000).Some persons, though, do suggest that the diagnostic manual should be modeled on how disorders are being diagnosed within clinical practice. This is perhaps most readily evident in the proposals of Westen and Shedler (2000) to diagnose mental disorders via prototypal matching. They eschew the provision of specific and explicit criterion sets in favor of simply matching the patient to a global (e.g., paragraph description) of a prototypic case. A purported strength of this approach is that it is said to “conform to the way clinicians think about psychiatric diagnoses” (First and Westen 2007, 473).There are, however, concerns with respect to prototypal matching. First, it is not really clear that clinicians actually provide diagnoses in this manner. There are data to suggest that clinicians instead reach a diagnostic decision on the basis of just one or two individual diagnostic criteria rather than matching to a global prototype (Herkov and Blashfield 1995).More important, it is unclear whether the diagnostic manual should in fact emulate what is occurring within clinical practice. There is a... (shrink)

Calibration errors are inevitable and should not be ignored during the estimation of item parameters. Items with calibration error can affect the measurement results of tests. One of the purposes of the current study is to investigate the impacts of the calibration errors during the estimation of item parameters on the measurement accuracy, average test length, and test efficiency for variable-length cognitive diagnostic computerized adaptive testing. The other purpose is to examine the methods for reducing the adverse effects of (...) calibration errors. Simulation results show that calibration error has negative effect on the measurement accuracy for the deterministic input, noisy “and” gate model, and the reduced reparameterized unified model; the average test lengths is shorter, and the test efficiency is overestimated for items with calibration errors; the compensatory reparameterized unified model is less affected by the calibration errors, and the classification accuracy, average test length, and test efficiency are slightly stable in the CRUM framework; methods such as improving the quality of items, using large calibration sample to calibrate the parameters of items, as well as using cross-validation method can reduce the adverse effects of calibration errors on CD-CAT. (shrink)

This article attempts an overall assessment of the Ecumenical Patriarchate document on Orthodox social ethics, For the Life of the World, articulated along three dimensions: a) Radicalism, in terms of the radical reminders on Orthodox morality that the document succeeds in highlighting, b) Pervasiveness, with regard to the question on how the principles exposed in the document are (or should be) valid across all local Orthodox Churches, and c) Consistency, as the inner harmony between these principles and other aspects of (...) Orthodox ecclesiastical life. It is opined that this document is of historical significance and that it can be of great benefit for the entire Church, if applied. Amidst an advanced modernity and on a critical crossroad with post-modernity, a renewal of Orthodox social ethics that both takes under consideration scientific findings and speaks a contemporary ‘language’ that faces subjectivity seriously, was especially necessary. Hereafter, what is at stake is the degree this document will be disseminated, accepted and influential. (shrink)

The target article focuses exclusively on System 2 and on reasoning rationality: the ability to reach valid conclusions from available information, as in the Wason task. The decision-theoretic concept of coherence rationality requires beliefs to be consistent, even when they are assessed one at a time. Judgment heuristics belong to System 1, and help explain the incoherence of intuitive beliefs.

This paper presents a validation study of a new questionnaire of self-control as an individual trait. The questionnaire has two parallel versions, one based on self-reports and another one based on informant reports. Each version consists of three subscales, called Inhibition, Switching, and Goal Monitoring. Eight samples of participants took part in the validation study. Both versions obtained satisfactory indices of internal consistency, assessed with Cronbach’s alpha and split-half coefficients. Selfcontrol assessed with this scale proved to be entirely independent of (...) general intelligence. However, AS-36 and AS-36-3 scores tended to correlate with other self-report measures of trait self control, such as Tangney, Baumeister, and Boone’s self-control scale. We conclude that AS-36 is a valid and reliable tool, suitable for assessment of self-control in both research and diagnostic settings. (shrink)

Feigning symptoms distorts diagnostic evaluations. Therefore, dedicated tools known as symptom validity tests have been developed to help clinicians differentiate feigned from genuine symptom presentations. While a deviant SVT score is an indicator of a feigned symptom presentation, a non-deviant score provides support for the hypothesis that the symptom presentation is valid. Ideally, non-deviant SVT scores should temper suspicion of feigning even in cases where the patient fits the DSM’s stereotypical yet faulty profile of the “antisocial” feigner. Across (...) three studies, we tested whether non-deviant SVT scores, indeed, have this corrective effect. We gave psychology students and clinical experts a case alluding to the DSM profile of feigning. In successive steps, they received information about the case, among which non-deviant SVT outcomes. After each step, participants rated how strongly they suspected feigning and how confident they were about their judgment. Both students and experts showed suspicion rates around the midpoint of the scale and did not respond to non-deviant SVT outcomes with lowered suspicion rates. In Study 4, we educated participants about the shortcomings of the DSM’s antisocial typology of feigning and the importance of the negative predictive power of SVTs, after which they processed the case information. Judgments remained roughly similar to those in Studies 1–3. Taken together, our findings suggest that students and experts alike have difficulties understanding that non-deviant scores on SVTs reduce the probability of feigning as a correct differential diagnosis. (shrink)

Generalized anxiety disorder can cause significant socioeconomic burden and daily life dysfunction; hence, therapeutic intervention through early detection is important. This study was the final stage of a 3-year anxiety screening tool development project that evaluated the psychometric properties and diagnostic screening utility of the Mental Health Screening Tool for Anxiety Disorders, which measures GAD. A total of 527 Koreans completed online and offline versions of the MHS: A, Beck Anxiety Inventory, Generalized Anxiety Disorder-7, and Penn State Worry Questionnaire. (...) The participants had an average age of 38.6 years and included 340 females. Participants were also administered the Mini-International Neuropsychiatric Interview. Internal consistency, convergent/criterion validity, item characteristics, and test information were assessed based on the item response theory, and a factor analysis and cut-off score analyses were conducted. The MHS: A had good internal consistency and good convergent validity with other anxiety scales. The two versions of the MHS: A were nearly identical. It had a one-factor structure and showed better diagnostic accuracy for GAD detection than the GAD-7 and BAI. The IRT analysis indicated that the MHS: A was most informative as a screening tool for GAD. The MHS: A can serve as a clinically useful screening tool for GAD in Korea. Furthermore, it can be administered both online and offline and can be flexibly used as a brief mental health screener, especially with the current rise in telehealth. (shrink)

Rapid individual cognitive phenotyping holds the potential to revolutionize domains as wide‐ranging as personalized learning, employment practices, and precision psychiatry. Going beyond limitations imposed by traditional lab‐based experiments, new efforts have been underway toward greater ecological validity and participant diversity to capture the full range of individual differences in cognitive abilities and behaviors across the general population. Building on this, we developed Skill Lab, a novel game‐based tool that simultaneously assesses a broad suite of cognitive abilities while providing an (...) engaging narrative. Skill Lab consists of six mini‐games as well as 14 established cognitive ability tasks. Using a popular citizen science platform (N = 10,725), we conducted a comprehensive validation in the wild of a game‐based cognitive assessment suite. Based on the game and validation task data, we constructed reliable models to simultaneously predict eight cognitive abilities based on the users’ in‐game behavior. Follow‐up validation tests revealed that the models can discriminate nuances contained within each separate cognitive ability as well as capture a shared main factor of generalized cognitive ability. Our game‐based measures are five times faster to complete than the equivalent task‐based measures and replicate previous findings on the decline of certain cognitive abilities with age in our large cross‐sectional population sample (N = 6369). Taken together, our results demonstrate the feasibility of rapid in‐the‐wild systematic assessment of cognitive abilities as a promising first step toward population‐scale benchmarking and individualized mental health diagnostics. (shrink)

Objective performance measures are vastly used in sport psychology despite their inherent limitations (e.g., unaccounted baseline differences). Founded on the nature of group goals in team sports, we aimed at developing the Perceived Performance in Team Sports Questionnaire (PPTSQ) to capture the team members’ perception of their team’s performance. Accordingly, three dimensions were hypothesized:effort investment, skills execution, andperceived outcome. To measure these dimensions, items were generated to address the players’ perception of their team performance as a whole. Four samples of (...) athletes were used to test the psychometric properties of the PPTSQ: professional (n= 231), collegiate (n= 222), professional—retest (n= 89), and mixed professional–collegiate (n= 139). Exploratory and confirmatory factor analyses were used to estimate construct and content validities. These procedures revealed a better data fit to a two-dimensional model that consists of effort investment and perceived outcome. The reliability analyses for the PPTSQ provide satisfactory evidence that the questionnaire is a reliable measure of perceived performance in team sport. Adequate internal consistency emerged for both dimensions (0.75 < ω < 0.89). Furthermore, a high correlation was obtained for temporal stability. Concurrent validity was addressed by correlating the PPTSQ scores with the Group Environment Questionnaire and the Team Assessment Diagnostic Instrument. Correlational analysis between the PPTSQ and an objective measure of performance was used to test its predictive validity. The correlations strongly support the concurrent and predictive validities of the PPTSQ. We conclude that our perceived performance questionnaire can address various objective measures shortcomings (e.g., considering base-rate biases) resulting in a more meaningful team performance metric. Implication of the PPTSQ for sport psychology research and applied work enhancement are discussed in detail. (shrink)

The classic charge against Freudian theory is that the therapeutic success of psychoanalysis can be explained without appeal to the mechanisms of repression and insight. Whatever therapeutic success psychoanalysis might enjoy would then provide no support for the diagnostic claim that psychological disorders are due to repressed desires or for the therapeutic claim that the gains in psychoanalysis are due to insight into repressed causes. Adolf Grünbaum has repeated the charge in The Foundations of Psychoanalysis (1984), arguing that Freud's (...) response to it in what he calls the "Tally Argument" is woefully inadequate. Grünbaum claims that Freud's defense depends on the view that only psychoanalytic techniques can yield therapeutic effects, and therefore that the transience of some psychoanalytic "cures", the existence of alternative treatment modalities, and the frequency of spontaneous remission undermine Freud's defense of psychoanalysis. I argue that, whatever the merits of psychoanalysis, Freud is not logically committed to any view as extreme as that attributed to him by Grünbaum; and, furthermore, Grünbaum's rendering of Freud is historically inaccurate. (shrink)

This paper addresses philosophical issues concerning whether mental disorders are natural kinds and how the DSM should classify mental disorders. I argue that some mental disorders (e.g., schizophrenia, depression) are natural kinds in the sense that they are natural classes constituted by a set of stable biological mechanisms. I subsequently argue that a theoretical and causal approach to classification would provide a superior method for classifying natural kinds than the purely descriptive approach adopted by the DSM since DSM-III. My argument (...) suggests that the DSM should classify natural kinds in order to provide predictively useful (i.e., projectable) diagnostic categories and that a causal approach to classification would provide a more promising method for formulating valid diagnostic categories. (shrink)

Jonathan Y. Tsou examines and defends positions on central issues in philosophy of psychiatry. The positions defended assume a naturalistic and realist perspective and are framed against skeptical perspectives on biological psychiatry. Issues addressed include the reality of mental disorders; mechanistic and disease explanations of abnormal behavior; definitions of mental disorder; natural and artificial kinds in psychiatry; biological essentialism and the projectability of psychiatric categories; looping effects and the stability of mental disorders; psychiatric classification; and the validity of the (...) DSM's diagnostic categories. The main argument defended by Tsou is that genuine mental disorders are biological kinds with harmful effects. This argument opposes the dogma that mental disorders are necessarily diseases that result from biological dysfunction. Tsou contends that the broader ideal of biological kinds offers a more promising and empirically ascertainable naturalistic standard for assessing the reality of mental disorders and the validity of psychiatric categories. (shrink)

A large part of the controversy surrounding the publication of DSM-5 stems from the possibility of replacing the purely descriptive approach to classification favored by the DSM since 1980. This paper examines the question of how mental disorders should be classified, focusing on the issue of whether the DSM should adopt a purely descriptive or theoretical approach. I argue that the DSM should replace its purely descriptive approach with a theoretical approach that integrates causal information into the DSM’s descriptive (...) class='Hi'>diagnostic categories. The paper proceeds in three sections. In the first section, I examine the goals (viz., guiding treatment, facilitating research, and improving communication) associated with the DSM’s purely descriptive approach. In the second section, I suggest that the DSM’s purely descriptive approach is best suited for improving communication among mental health professionals; however, theoretical approaches would be superior for purposes of treatment and research. In the third section, I outline steps required to move the DSM towards a hybrid system of classification that can accommodate the benefits of descriptive and theoretical approaches, and I discuss how the DSM’s descriptive categories could be revised to incorporate theoretical information regarding the causes of disorders. I argue that the DSM should reconceive of its goals more narrowly such that it functions primarily as an epistemic hub that mediates among various contexts of use in which definitions of mental disorders appear. My analysis emphasizes the importance of pluralism as a methodological means for avoiding theoretical dogmatism and ensuring that the DSM is a reflexive and self-correcting manual. (shrink)

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was published in 2013. This manual classifies all known mental disorders and provides operationalized criteria for their diagnosis. The goal of this manual is to facilitate communication, treatment and research with reliable and valid diagnoses. This article will provide a study of what this diagnostic validity actually entails. Firstly, it will include a discussion of the different conceptions of validity that have appeared in the (...) literature so far. To decide between these different conceptions, diagnostic validity will be defined as ”picking out a natural kind’. Secondly, two different accounts of natural and psychiatric kinds are examined, namely, essentialism and pragmatism. Both of these will be rejected in favor of conceiving natural kinds as causal-epistemic kinds. Thirdly, it is argued that the multidimensional complexity of psychiatric disorders does not exclude the possibility of psychiatric kinds being natural kinds. However, pragmatic considerations in classifying disorders have meant that the DSM most likely does not distinguish causal-epistemic kinds very well. I argue that the need to have a single classification both for clinicians and researchers and the priority given to reliability rather than validity has ultimately compromised the diagnostic validity of the DSM. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Multiple Personality and Moral Responsibility”Daniel W. Shuman (bio)Stephen Braude’s essay, “Multiple Personality and Moral Responsibility,” discusses a number of important issues about the moral and legal responsibility of persons diagnosed with multiple personality disorder (MPD), known in DSM-IV as Dissociative Identity Disorder (DID). One issue that is fundamental to this debate, which Braude does not address, however, is the empirical reality underlying the debate. Does MPD/DID exist? (...) A prerequisite to a debate about the legal consequences of MPD/DID is legally sufficient proof of its existence and its behavioral consequences.Proof that MPD/DID exists, its impact on legal standards of responsibility, and that the defendant suffers from it, must come from expert testimony; it is not part of the common knowledge or experience of the typical judge or juror. Courts are, however, increasingly, unwilling to assume that because an expert has impressive qualifications, he or she will necessarily present scientifically valid evidence. Particularly in cases of psychiatric and psychological evidence, courts that once looked solely at the expert’s qualifications to determine the admissibility for expert scientific evidence, now understand that the expert’s qualifications are a necessary but not a sufficient condition for the presentation of accurate expert testimony. Courts increasingly want to know how experts know what they claim to know and whether their methods of knowing meet the hallmarks of good science.Thus, from a legal standpoint, a prerequisite to admissibility of the evidence that serves as a basis for a discussion of the legal implications of MPD/DID is rigorous scientific proof of its existence. Proof of the existence of MPD/DID has not, however, been the subject of rigorous scientific research, but instead has consisted of non-falsifiable clinical experience where the risk of iatrogenesis (i.e., hypnosis and suggestion) is ever present. While these clinical observations and opinions may ultimately be proven valid by subsequent research, there is simply no way to know whether that is so in the absence of rigorous scientific research. If proof of the existence of MPD/DID is clinically but not scientifically grounded, legal rules based upon it are suspect. Moreover, claims of MPD/DID often arise in a legal context where there are significant benefits to be gained from receiving the diagnosis which heightens the importance of rigorous scientific scrutiny.Diagnostic validity and reliability matters in different ways in the forensic context than it does in the therapeutic context. These contextual differences [End Page 59] are reflected in disparate standards for scrutinizing each. There is no threshold requirement, for example, that a psychotherapist prove that a diagnostic category is valid or that a psychotherapeutic treatment used for a person suffering from it is generally recognized as safe and effective before using it; however, there is a threshold requirement of rigorous scientific scrutiny before admission of this information in evidence. If a therapist’s diagnostic hypothesis that there are two personality states influencing a patient’s behavior is not borne out, it can be revised in later sessions. Even if MPD/DID does not exist, treatment that assumes it does may nonetheless be effective because therapeutic outcome is more closely tied to the nature of the therapist-patient relationship than the content of therapy, or because multiple personality states is an effective therapeutic metaphor. Moreover, if the patient is not satisfied that the diagnosis or treatment rendered is helpful, the patient can leave therapy or seek another therapist.In contrast, judicial determinations are a one-shot determination which cannot be revisited in light of subsequently acquired knowledge. The defendant/patient is not free to change courts, or withdraw from the legal proceedings. Thus, it would be entirely appropriate for psychiatrists and psychologists to treat patients presenting symptoms of what they label MPD/DID and for courts to reject exculpatory evidence from psychiatrists and psychologists of that disorder.Related ArticlesFeature Article: Multiple Personality and Moral ResponsibilityCommentary: Commentary by ClarkCommentary: Commentary by ShumanDaniel W. Shuman Daniel W. Shuman, Professor of Law, Southern Methodist University, Dallas, TX 75235, USA.Copyright © 1996 The Johns Hopkins University Press... (shrink)

Researchers studying at-risk and socially disenfranchised child and adolescent populations are facing ethical dilemmas not previously encountered in the laboratory or the clinic. One such set of ethical challenges involves whether to: (a) share with guardians research derived information regarding participant risk, (b) provide participants with service referrals, or (c) report to local authorities problems uncovered during the course of investigation. The articles assembled for this special section address the complex issues of deciding if, when, and how to report or (...) provide referrals for research participants who are minors (referred to hereafter as minor research participants). This paper focuses on two factors underlying these decisions: the validity of risk estimates and meta-ethical positions on scientific responsibility. It is suggested that, before sharing information about minor research participants investigators should do the following: critically examine the diagnostic validity of developmental measures, include the scope and limitations of information sharing in informed consent procedures, and become familiar with state reporting laws. I discuss the impact of the traditionally accepted act utilitarian meta-ethical position on the investigator-participant relationship, and I recommend consideration of alternative positions as a step toward developing a research ethic of scientific responsibility and care. (shrink)

Attention-deficit hyperactivity disorder is one of the most common neurodevelopmental disorders in children and adolescents. People who have this disorder are characterized by presenting difficulties in the processes of sustained attention, being very active, and having poor control of their impulses. Despite the high prevalence of this disorder and the existence of various tests used for its diagnosis, few data are available regarding the usefulness and diagnostic validity of these tools. Given the difficulties that these subjects present in (...) executive functions, the aim of this study was to evaluate whether the Neuropsychological Assessment of Executive Functions battery for Children allows to establish specific profiles of executive performance for people with attention-deficit hyperactivity disorder. The sample was made up of 197 participants of both sexes, aged between 6 and 12 years age. A nonexperimental design was followed, using a comparative descriptive study method. The results indicated that the scales of phonological fluency, color path, rings, and interference are the most associated with the diagnosis of ADHD, providing data on inhibition, mental flexibility, sustained and selective attention, planning, verbal fluency, and working memory, among others. The practical implication of these results is in line with providing support in the clinical diagnosis that is carried out in children’s mental health units. In addition, the ENFEN tool can be valued as a suitable psychometric instrument in the psychoeducational field, helping professionals in a school environment to be more aware of the areas of cognitive development in which a student diagnosed with ADHD will have more difficulties and, in doing so, providing more adjusted and effective psychopedagogical measures when it comes to supporting students in their adaptation to the school environment. (shrink)