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PubMed1987

[Nosologic framework of mental deterioration in aged subjects. From clinical practice to epidemiology].

The difficulty of defining a precise nosologic framework for mental decline is linked, on the one hand, to the contradictions surrounding the term normalcy as age increases, and, on the other, to the fact that mental decline has been mired for years under a term that must be definitively proscribed: "psycho-compartmental disorders of senescence". In this catch-all++ proscribed: "psycho-compartmental disorders of senescence". In this catch++-all it is, in fact, essential to identify diseases whose nature, prognosis and, above all, therapeutic approaches differ fundamentally one from the other; to confuse them is to risk dramatic consequences. Standardization of diagnostic criteria through the combined use of clinical data, the DSM III classification, scored tests (MMS, Hachinsky, etc.), as well as scannography, presently makes it possible to arrive at the diagnosis of dementia with reasonable accuracy. This standardization++ has its limits and is not necessarily useful in atypical cases. It is nevertheless an indispensable tool for epidemiological studies and therapeutic trials.

Aged↗
PubMed1995

[The psychological and psychiatric study of children living in Kaluga and Bryansk provinces, Russia (the aftermath of the Chernobyl accident)].

According to WHO project "Brain Damage in Utero" in the framework of the screening phase of the programme, 1025 children (725 in experimental group-Novozybkov and Klintsy towns of Bryansk region; 300 in control group--Obninsk town of Kaluga region) and 600 parents (300 in experimental group and 300 in control group) were studied using standardized methods of psychological psychiatric assessment (Draw-a-man test, British picture vocabulary test, Raven coloured matrices, Parental and teacher Rutter Scales, CHQ-28, Verbal subtest of Wechsler test) for potential psychological and psychiatric effects of Chernobyl accident on child's intelligence, behavioural and emotional state, mental health of parents and parental intellectual level. The following results were obtained: comparison of verbal IQ scores in children revealed a 6-fold increase of these values in experiment group. Comparison of nonverbal IQ scores in children revealed that these values are 4 times higher in experimental group. Comparison of scores according to Rutter parental and teacher scales revealed that emotional and behavioural disorders are 1.5 times more prevalent in children of experimental group. All the above differences were statistically significant. Comparison of CHQ-28 scores was indicative of relative prevalence of these values in parents of experimental group, but there was no statistically significant difference between such score in experimental and control groups. Comparison of scores of parental IQ showed relative prevalence of these values in experimental group. The results obtained can not be completely estimated without thorough identification of individual doses received by mothers and their children. Only after obtaining these data it will be possible to solve the problem of dose effect.

Child↗
PubMed1994

Beliefs about breast cancer and mammography by behavioral stage.

PURPOSE/OBJECTIVES: To explore the relationships of Health Belief Model (HBM) variables and the Trans-theoretical Model with regard to behavioral stage of mammography adoption. DESIGN: Descriptive, correlational. SETTING: Large midwestern city. SAMPLE: 405 women over age 40 obtained through random digit dialing. Subjects had agreed to participate in a larger intervention study. METHODS: Data were collected during in-home interviews. Subjects completed six scales developed from the HBM and answered questions related to mammography compliance. MAIN RESEARCH VARIABLES: Perceptions of breast cancer susceptibility and seriousness, perceived benefits of and barriers to mammography, motivation to stay healthy, and perceived control over health; degree of mammography compliance. FINDINGS: Women complaint with mammography guidelines had significantly higher scores on seriousness, benefits, health motivation, and control as well as significantly lower scores on barriers. In addition, scores on susceptibility, seriousness, benefits, barriers, and health motivation were significantly different across stages of mammography (precontemplation, contemplation, and action/maintenance). CONCLUSIONS: Interventions should target attitudes about susceptibility and seriousness of breast cancer in women who do not comply with established guidelines for mammography. Women who are not in compliance and have no plans to seek mammography would benefit from additional emphasis on mammography benefits and from removal of barriers. Health motivation also must be addressed in noncompliant women. IMPLICATIONS FOR NURSING PRACTICE: These results promise to expand the understanding of a person's motivation to change health-seeking behaviors, specifically obtaining routine screening mammograms. Further research using this new framework is needed to substantiate these results with a cross section of women.

Adaptation, Psychological↗
PubMed2004

Linac radiosurgery versus whole brain radiotherapy for brain metastases. A survival comparison based on the RTOG recursive partitioning analysis.

BACKGROUND AND PURPOSE: For patients with inoperable brain metastases, whole brain radiotherapy (WBRT) has been the standard treatment for decades. Radiosurgery is an effective alternative strategy, but has failed to show a substantial survival benefit so far. The prognostic factors derived from the RTOG recursive partitioning analysis (RPA) provide a framework that allows a nonrandomized comparison of the two modalities. PATIENTS AND METHODS: From 1991 to 1998, 117 patients with one to three previously untreated cerebral metastases underwent single-dose linac radiosurgery (median dose 20 Gy) without adjuvant WBRT. After radiosurgery, 26/117 patients (22%) had salvage WBRT, radiosurgery or neurosurgical resection of recurrent (4/117) and/or new (24/117) metastases. Survival of these patients was compared to a historical group of 138 patients with one to three lesions treated by WBRT (30-36 Gy/3-Gy fractions) from 1978 to 1991; only nine of these patients (7%) had salvage WBRT. All patients were classified into the three RPA prognostic classes based on age, performance score, and presence of extracranial tumor manifestations. RESULTS: In RPA class I (Karnofsky performance score > or = 70, primary tumor controlled, no other metastases, age < 65 years), radiosurgery resulted in a median survival of 25.4 months (n = 23, confidence interval [CI] 5.8-45.0) which was significantly longer than for WBRT (n = 9, 4.7 months, CI 3.8-5.5; p < 0.0001). In RPA class III (Karnofsky performance score < 70), no significant difference in survival between radiosurgery (n = 20, 4.2 months, CI 3.2-5.3) and WBRT (n = 68, 2.5 months, CI 2.2-2.8) was found. In RPA class II (all other patients), radiosurgery produced a small, but significant survival advantage (radiosurgery: n = 74, 5.9 months, CI 3.2-8.5, WBRT: n = 61, 4.1 months, CI 3.4-4.9; p < 0.04). CONCLUSION: Radiosurgery in patients with one to three cerebral metastases results in a substantial survival benefit only in younger patients with a low systemic tumor burden when compared to WBRT alone. It cannot be excluded that this effect is partially caused by the available salvage options after radiosurgery.

Adult↗
PubMed2026

Population-scale detection of methylation outliers from long-read genome sequencing.

BACKGROUND: Aberrant DNA methylation can mediate the functional effects of rare genetic variation and contribute to imprinting disorders, repeat expansion diseases, and other pathogenic regulatory mechanisms. Long-read sequencing technologies now enable genome-wide detection of CpG methylation alongside genetic variation from a single assay. However, methods for systematic identification and interpretation of methylation outliers from long-read sequencing data remain limited. METHODS: We developed METAFORA, a computational workflow for detecting methylation outlier regions from PacBio and Oxford Nanopore long-read sequencing data. METAFORA constructs population-level methylation references, segments the genome into correlated CpG blocks, infers technical and biological sources of variation through hidden factor estimation, models uncertainty due to variable depth sequencing, and computes covariate-adjusted methylation outlier scores for individual samples. We applied METAFORA across large long-read sequencing cohorts and integrated methylation outliers with multi-omic data. METAFORA is implemented as a snakemake workflow available at https://github.com/tjense25/METAFORA. RESULTS: METAFORA identified methylation outlier regions associated with rare structural variants, tandem repeat expansions, and imprinting abnormalities. We found outlier regions were enriched for molecular outliers across transcriptomic and chromatin accessibility datasets, supporting their functional relevance in gene regulation. In a representative case, METAFORA identified an imprinting defect affecting the GNAS locus associated with an STX16 deletion. CONCLUSIONS: METAFORA enables scalable detection and interpretation of methylation outliers from long-read sequencing data and provides a framework for integrating epigenetic outliers with genomic and multi-omic analyses. These approaches may improve interpretation of rare regulatory variation and support discovery of clinically relevant epigenetic abnormalities in genomic medicine.

DNA methylation↗
PubMed2003

Evaluating the effectiveness of community health partnerships: a stakeholder accountability approach.

Community health partnerships (CHPs) are promoted as effective cooperative interorganizational relationships to improve community health status while conserving resources. However, relatively little is known about the effectiveness of these partnerships in achieving their goals. Using concepts from a network effectiveness framework (Provan and Milward, 2001) and a network accountability framework (Gamm, 1998), the authors propose that successful CHPs are those that are effective in multiple levels (community, network, organization/particpants) and/or accountability dimensions (political, commercial, clinical/patient, and community). The combined frameworks serve to identify a number of community health stakeholders and associated interests that vary according to accountability dimensions to which CHPs respond. Using survey data from over 400 participants in 25 Community Care Networks, the authors assess the usefulness of the conceptual framework in evaluating CHP effectiveness. The results suggest that CHP participants recognize three different levels of analysis in their evaluation of network effectiveness: community, network, and organization/participant. Furthermore, the results show that respondents distinguish between two different organization/participant benefits: enabling and client services. While respondents rated the intangible resources or enabling benefits (e.g., legitimacy and learning) of partnership participation most highly, client services resulting from CHP participation (e.g., client services and referrals) received the lowest ratings. Community benefit (e.g., improving community health status) and network effectiveness (e.g., ability to provide efficient, high quality health and human services) received ratings that fall between the enabling and client services. Given the relatively good scores (above 60%) received by CHPs on all four effectiveness dimensions considered here, it appears that the majority of respondents find at least some evidence of network effectiveness across all three levels of network effectiveness and all four dimensions of accountability.

Community Health Planning↗
PubMed2006

Medical students' attitudes toward underserved patients: a longitudinal comparison of problem-based and traditional medical curricula.

Medical education has been shown to negatively influence student attitudes toward certain types of patient populations. Past research does not inform current educational practice because today's medical school environment is different from when most of the published research was conducted. There are more female students, curricular innovations such as problem-based learning have changed the framework for educational delivery, and longitudinal studies, which could inform when interventions may be needed, are uncommon. The purposes of this longitudinal, prospective cohort study were to compare the attitudes of Problem-based learning and Traditional curriculum students toward providing care for medically indigent patients as they progressed through the four-year undergraduate medical education curriculum, and to determine if gender differences were apparent and persisted over time. Attitudes of one cohort of students enrolled in separate curricula were studied. The outcome measure was the Medical Student Attitudes Toward the Underserved questionnaire, which was administered three times. A linear mixed effects regression analysis was performed to examine changes in factor scores over time and whether these changes differed between Problem-based and Traditional students, and males and females. Longitudinal findings revealed that commitment to caring for the medically underserved was greater when students entered medical school than when they graduated. Students in both curricula, as well as male and female students, experienced increasingly negative attitudes over the four year period. Decline in attitudes toward medically underserved patients was similar to previous research results. This study showed that attitudes of students were not influenced by the preclinical curriculum they experienced.

Adult↗
PubMed1999

Cognitive dedifferentiation in eidetics and synaesthesia: hunting for the ghost once more.

Both synaesthesia and eidetics have a common characteristic of cognitive dedifferentiation. Synaesthesia (e.g. colour-hearing) entails the dedifferentiation of the sensory modalities, while eidetic imagery entails the dedifferentiation of imagery and perception. One can profitably gain by investigating both within the same study. Moreover, some of the same issues have arisen in these, hitherto, separate research literatures. This behoves a common framework for analysis and investigation. We applied a technique previously used for identifying child eidetikers, for screening the adult population, looking at both phenomena in the same sample. After screening, we selected a total of twenty-nine individuals for controlled testing of both phenomena and their variants (structural eidetic imagery, typographic eidetic imagery, colour-hearing synaesthesia, colour-mood synaesthesia). Our participants also completed a number of questionnaires of relevance (absorption, dissociation, and hallucination). We found that the personality trait of absorption underlies the commonality of experience tapped by both typographic and structural eidetic imagery. Furthermore, the latter phenomena were found to have a common pseudohallucinatory experiential base. For subjects scoring relatively high on the absorption scale, there is a negative correlation between structural eidetic imagery and colour-mood synaesthetic differentiation, replicating to a degree results reported earlier.

Adult↗
PubMed2002

Graduate nursing students' precourse and postcourse perceptions and preferences concerning completely web-based courses.

Web-based nursing courses have proliferated rapidly in recent years, but few data are available about course outcomes. A pretest/posttest survey design of student perceptions and preferences was used to evaluate two graduate-level on-line nursing courses (required research and elective aging issues courses; N = 31 and N = 29, respectively) on the basis of Billings' outcomes evaluation framework for nursing Web-based courses. Students in both courses were favorable or at least neutral in their perceptions of outcomes at both pretest and posttest, but favorable shifts in perceptions also occurred from pretest to posttest. Most students remained stable in their preferences for format of instruction (on-line or classroom), and most favored an on-line format. Almost all students indicated they would take the course they took if they had the decision to make over again. Students who took the elective aging issues course had somewhat more favorable perceptions overall at posttest, compared to the required research course, but some differences were accounted for by pretest score differences between the groups. While outcomes were positive for both courses, the results also highlight specific needs for adequate socialization and support of students, particularly for first-year graduate students who are taking Web-based courses.

Clinical Competence↗
PubMed1997

Comparison of three visit-specific patient satisfaction instruments: reliability and validity measures and the effect of four methods of data collection on dimensions of patient satisfaction.

The purposes of this study were to evaluate the reliability and validity of three short-form patient satisfaction instruments and to examine the effects of data collection methods on patient satisfaction ratings. With a framework to assess quality of care from the patient's perspective, acceptability, accessibility, patient satisfaction rating, provider recommendation, and patient demographic data were collected using three patient surveys: the Health Outcomes Institute questionnaire (HOI); the Nalle Clinic survey (Nalle); and a commercially marketed survey (COM). The four methods of data collection were (1) receptionist-distributed at check-in, (2) student-distributed at check-out, (3) mail, and (4) phone. Data were collected on a systematically selected sample of 1,840 patients who were appointed in two family practice departments of the Nalle Clinic in Charlotte, North Carolina. From the 925 completed surveys, the results indicated that the HOI instrument scored higher on the reliability and validity measures in this patient sample than the Nalle or COM surveys. Analysis of variance was then conducted on the HOI scores across the four methods of data collection. The conclusion was that the method of data collection did not significantly influence any of the patient satisfaction indicators in the family practice sample.

Data Collection↗
PubMed1996

Dissociation, somatization, and affect dysregulation: the complexity of adaptation of trauma.

OBJECTIVE: A century of clinical research has noted a range of trauma-related psychological problems that are not captured in the DSM-IV framework of posttraumatic stress disorder (PTSD). This study investigated the relationships between exposure to extreme stress, the emergence of PTSD, and symptoms traditionally associated with "hysteria," which can be understood as problems with stimulus discrimination, self-regulation, and cognitive integration of experience. METHOD: The DSM-IV field trial for PTSD studied 395 traumatized treatment-seeking subjects and 125 non-treatment-seeking subjects who had also been exposed to traumatic experiences. Data on age at onset, the nature of the trauma, PTSD, dissociation, somatization, and affect dysregulation were collected. RESULTS: PTSD, dissociation, somatization, and affect dysregulation were highly interrelated. The subjects meeting the criteria for lifetime (but not current) PTSD scored significantly lower on these disorders than those with current PTSD, but significantly higher than those who never had PTSD. Subjects who developed PTSD after interpersonal trauma as adults had significantly fewer symptoms than those with childhood trauma, but significantly more than victims of disasters. CONCLUSIONS: PTSD, dissociation, somatization, and affect dysregulation represent a spectrum of adaptations to trauma. They often occur together, but traumatized individuals may suffer from various combinations of symptoms over time. In treating these patients, it is critical to attend to the relative contributions of loss of stimulus discrimination, self-regulation, and cognitive integration of experience to overall impairment and provide systematic treatment that addresses both unbidden intrusive recollections and these other symptoms associated with having been overwhelmed by exposure to traumatic experiences.

Adaptation, Psychological↗
PubMed2005

Systematic survey reveals general applicability of "guilt-by-association" within gene coexpression networks.

BACKGROUND: Biological processes are carried out by coordinated modules of interacting molecules. As clustering methods demonstrate that genes with similar expression display increased likelihood of being associated with a common functional module, networks of coexpressed genes provide one framework for assigning gene function. This has informed the guilt-by-association (GBA) heuristic, widely invoked in functional genomics. Yet although the idea of GBA is accepted, the breadth of GBA applicability is uncertain. RESULTS: We developed methods to systematically explore the breadth of GBA across a large and varied corpus of expression data to answer the following question: To what extent is the GBA heuristic broadly applicable to the transcriptome and conversely how broadly is GBA captured by a priori knowledge represented in the Gene Ontology (GO)? Our study provides an investigation of the functional organization of five coexpression networks using data from three mammalian organisms. Our method calculates a probabilistic score between each gene and each Gene Ontology category that reflects coexpression enrichment of a GO module. For each GO category we use Receiver Operating Curves to assess whether these probabilistic scores reflect GBA. This methodology applied to five different coexpression networks demonstrates that the signature of guilt-by-association is ubiquitous and reproducible and that the GBA heuristic is broadly applicable across the population of nine hundred Gene Ontology categories. We also demonstrate the existence of highly reproducible patterns of coexpression between some pairs of GO categories. CONCLUSION: We conclude that GBA has universal value and that transcriptional control may be more modular than previously realized. Our analyses also suggest that methodologies combining coexpression measurements across multiple genes in a biologically-defined module can aid in characterizing gene function or in characterizing whether pairs of functions operate together.

Animals↗
PubMedDate not supplied

Reliability and validity of the compliance belief scales among patients with heart failure.

BACKGROUND: Lack of medication and dietary compliance leads to troublesome symptoms and hospitalization in patients with heart failure. Compliance behaviors are influenced by beliefs about the behavior. OBJECTIVE: The purpose of this study was to evaluate the reliability and validity of the Beliefs about Medication Compliance Scale (BMCS) and the Beliefs about Dietary Compliance Scale (BDCS) among patients with heart failure. THEORETICAL FRAMEWORK: This study's theoretical framework is the Health Belief Model. METHODS: A convenience sample of 234 patients with heart failure completed the BMCS and the BDCS. Patients completed the scales at baseline by face-to-face interviews and at 8 and 52 weeks after baseline by telephone interview. RESULTS: Construct validity of the scales was supported by confirmatory factor analysis. Both the BMCS and the BDCS had benefits and barriers scales with clear factor loadings. The internal consistency reliability estimates of the scales ranged from.63 to.88, with the BMCS having some estimates lower than.70. The test-retest reliability estimates ranged from.07 to.57. The intraclass correlation coefficient estimates were higher between the 8-week and 52-week scores for all scales. Possible reasons for the varying estimates are discussed. CONCLUSIONS: The BMCS and the BDCS have documented reliability and validity. Future work should be directed at evaluating the responsiveness of the scales to changing patient conditions and testing interventions to improve medication and dietary compliance through changing beliefs.

Adult↗
PubMed2025

Foundation model based multimodal transformer framework for survival analysis in HER2 stratified breast cancer.

Objective. To improve survival prediction for HER2-positive breast cancer by integrating histopathological, molecular, and clinical data using a multimodal transformer framework.Approach. We propose a multimodal transformer framework for breast cancer survival prediction using HER2 stratified (SurvMBC), a foundation model-enhanced architecture that fuses three data modalities: whole-slide images, clinical narratives, and molecular features. Tumor microenvironment features are extracted using a pathology language and image pre-training (PLIP), clinical narratives are processed with BioBERT, and miRNA expression plus DNA methylation data are embedded using Gen2Vec. These representations are integrated through a cross-modal transformer with attention mechanisms for survival prediction.Main results. The model was evaluated on 1,095 HER2-positive breast cancer patients from The Cancer Genome Atlas. SurvMBC achieved a concordance index (C-index) of 0.857 (95% CI: 0.834, 0.880), a low integrated Brier score, and a strong inverse negative binomial log-likelihood. Risk stratification based on model outputs significantly separated high- and low-risk groups (log-rankp< 0.01) and showed strong associations with tumor stage, grade, and hormone receptor status (allp< 0.05).Significance. SurvMBC demonstrates the effectiveness of multimodal fusion in addressing tumor heterogeneity and improving prognostic accuracy. The attention-based integration enables context-aware learning of survival-relevant features across modalities, supporting individualized risk stratification and risk-adaptive treatment planning for HER2 stratified breast cancer patients.

Breast Neoplasms↗
PubMed2006

CASPAR: a hierarchical bayesian approach to predict survival times in cancer from gene expression data.

MOTIVATION: DNA microarrays allow the simultaneous measurement of thousands of gene expression levels in any given patient sample. Gene expression data have been shown to correlate with survival in several cancers, however, analysis of the data is difficult, since typically at most a few hundred patients are available, resulting in severely underdetermined regression or classification models. Several approaches exist to classify patients in different risk classes, however, relatively little has been done with respect to the prediction of actual survival times. We introduce CASPAR, a novel method to predict true survival times for the individual patient based on microarray measurements. CASPAR is based on a multivariate Cox regression model that is embedded in a Bayesian framework. A hierarchical prior distribution on the regression parameters is specifically designed to deal with high dimensionality (large number of genes) and low sample size settings, that are typical for microarray measurements. This enables CASPAR to automatically select small, most informative subsets of genes for prediction. RESULTS: Validity of the method is demonstrated on two publicly available datasets on diffuse large B-cell lymphoma (DLBCL) and on adenocarcinoma of the lung. The method successfully identifies long and short survivors, with high sensitivity and specificity. We compare our method with two alternative methods from the literature, demonstrating superior results of our approach. In addition, we show that CASPAR can further refine predictions made using clinical scoring systems such as the International Prognostic Index (IPI) for DLBCL and clinical staging for lung cancer, thus providing an additional tool for the clinician. An analysis of the genes identified confirms previously published results, and furthermore, new candidate genes correlated with survival are identified.

Bayes Theorem↗
PubMed2005

Knowing the diagnosis and counselling the relatives of a person with dementia: the perspective of home nurses and home care workers in Belgium.

Home nurses and home care workers share the care for a person with dementia with family caregivers, and are confronted with their needs for medical and service-related information, for advice on how to cope with the behaviour changes, and for emotional support. The first objective of the present study was to describe some of the conditions for effective counselling, such as the perception that knowing the diagnosis has positive consequences for the formal caregivers. A second objective was to describe the formal caregivers' counselling practice, and ascertain its relationship with the psychological variables of attitudes, self-efficacy and subjective norm. A postal questionnaire was sent to 287 home nurses and 1259 home care workers in a defined region of Belgium; the questionnaire was returned by 169 home nurses (58.9% response) and 665 home care workers (52.8% response). The Theory of Planned Behaviour was the organising framework which underpinned the development of the instruments. Only the 168 home nurses and 601 home care workers reporting experience with caregiving to people with dementia were included in the analysis. Formal caregivers indicated that knowing the diagnosis was important, but it could facilitate or hinder caregiving. They were able to describe behavioural characteristics which are indicative of dementia, but only in a limited way, and their strategies to uncover the diagnosis were also limited. Formal caregivers reported that they supported family members emotionally, advised about communication with the person with dementia and informed family caregivers about services. However, providing family caregivers with information about dementia lagged behind these forms of support. In general, nurses scored higher than home care workers. Multiple linear regression analysis was used to investigate the relationships between self-reported practice and the concepts of the model. In both professions, attitudes and self-efficacy were found to be strong independent predictors, and the implications for practice are discussed.

Aged↗
PubMedDate not supplied

Association between continuing education and job satisfaction of nurses employed in long-term care facilities.

BACKGROUND: The purpose of this descriptive, correlational study was to investigate the relationship between continuing education and job satisfaction among RNs and licensed practical nurses (LPNs) employed in long-term care facilities. METHOD: Herzberg's Motivational-Hygiene Theory was used as a framework to guide the design of the study. The Professional Educational Activities Scale and the McCloskey/Mueller Satisfaction Scale were completed by 110 nurses employed in long-term care facilities. RESULTS: No difference was found between type of employment status (full-time versus part-time) on the level of professional educational activities. However, RNs participated in more continuing education activities than LPNs. Nurses who reported higher family incomes also had greater participation in educational activities. Registered nurses reported greater job satisfaction than LPNs. No significant difference was found between the degree of job satisfaction for Black and White nurses. The results of this study indicated nurses who participated in more continuing education activities scored higher on the job satisfaction scale. CONCLUSION: As the elderly population increases, a critical need exists for nurses to be knowledgeable about current research-based information, including the economic and psychosocial effects of illness in later life. To provide the most effective care for the elderly population, nurses in long-term care must be knowledgeable about the complexity and specific characteristics of chronic illnesses. Continuing education activities are an important way to access this information.

Adult↗
PubMed2005

Application of Bayesian inference using Gibbs sampling to item-response theory modeling of multi-symptom genetic data.

Several "genetic" item-response theory (IRT) models are fitted to the responses of 1086 adolescent female twins to the 33 multi-category item Mood and Feeling Questionnaire relating to depressive symptomatology in adolescence. A Markov-chain Monte Carlo (MCMC) algorithm is used within a Bayesian framework for inference using Gibbs sampling, implemented in the program WinBUGS 1.4. The final model incorporated separate genetic and non-shared environmental traits ("A and E") and item-specific genetic effects. Simpler models gave markedly poorer fit to the observations judged by the deviance information criterion (DIC). The common genetic factor showed major loadings on melancholic items, while the environmental factor loaded most highly on items relating to self-deprecation. The MCMC approach provides a convenient and flexible alternative to Maximum Likelihood for estimating the parameters of IRT models for relatively large numbers of items in a genetic context. Additional benefits of the IRT approach are discussed including the estimation of latent trait scores, including genetic factor scores, and their sampling errors.

Adolescent↗