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This study examined parent and child reports of parenting practices separately to predict child and parent reports of child externalizing and internalizing features, as well as delinquent activity. Participants included 98 children (51 male, 47 female) from a community sample, aged 9-15 at the beginning of the study. Results revealed that child reports of parenting practices were significantly correlated with a greater number of indices of delinquency and conduct problems than were parent reports. Child reports of parenting also showed some association with delinquency at three yearly follow-ups, whereas parent reports did not. Finally, reports of negative parenting from both informants were concurrently related to internalizing characteristics. Implications for child assessment and planning interventions for children and parents are discussed. [ABSTRACT FROM AUTHOR]

A widely acclaimed goal of the nursing profession is to increase the number of nurses involved in shaping U.S. health policy. This study describes 33 nurses holding positions in regulatory agencies, state legislatures, and congressional offices. [ABSTRACT FROM AUTHOR]

Objective: The present study investigated the association between social media engagement and factors related to well-being (e.g., depression, anxiety, sleep, loneliness, self-esteem). Participants: A sample of 1120 college student-athletes (338 males, 777 females, 5 identified as non-binary) from nine universities participated in this study. Method: Data were collected through self-report measures and screen shots of participants' screen time in the previous week. Results: Overall screen time taken from devices was not associated with self-reported well-being, whereas use of social media during daily activities was related to worse well-being across domains (e.g., lower self-esteem, higher fear of missing out, stress, anxiety, depression). In addition, student-athlete perceptions that social media interfere with their lives were related to worse well-being. Conclusions: The implications of these findings, including the possibility of using protective behavioral strategies (PBS) to reduce negative impacts of social media in college students, are discussed.

The Proposed Specifiers for Conduct Disorder (PSCD; Salekin in Pers Disord: Theory Res Treat 7:180-191, 2016) scale was designed to assess interrelated psychopathic trait domains in conjunction with symptoms of Conduct Disorder (CD) in children and adolescents (i.e., grandiose-manipulative, callous-unemotional, daring-impulsive). Variable-centered studies have provided support for a four-factor PSCD structure (Salekin et al. in Psychol Assess 34(10):985-992, 2022) in line with other adolescent and adult studies. The current person-centered study used latent profile analysis of the PSCD domains to examine whether theoretically meaningful and empirically robust PSCD subtypes emerged from a diverse sample (70.9% White, 20.1% Black, 3.6% Hispanic, and 5.4% other) of adolescents (modal age = 17) in a military style residential facility (N = 409; Males = 80.6%). As hypothesized, a four-class solution was best, consistent with adult psychopathy subtyping research (Hare et al. in Handbook of Psychopathy 39-79, 2018; Roy et al. in Pers Disord: Theory Res Treat, in press). The PSCD subtype profiles were uniform across sex and race/ethnicity. Adolescents evincing a psychopathic trait propensity profile (elevated on all four PSCD domains) displayed the greatest number of arrests and higher overall externalizing psychopathology, compared to the other three latent classes, as well as higher internalizing psychopathology compared to adolescents with general delinquency. The PSCD provides a sound measure of psychopathic trait propensities in youth and our results offer investigators and clinicians a means for understanding person-centered psychopathic traits versus antisocial profiles among at-risk adolescents. Taken together, the current results may offer a viable approach for examining specific treatment targets based on PSCD subtype profiles., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Adolescents often engage in behaviors such as substance use and risky sexual activity that can lead to negative health and psychological consequences for themselves and others. Accurate measurement of these behaviors in surveys is challenging given that the behaviors are often viewed as undesirable and/or are illegal, so it is important to test the psychometric properties of instruments used to assess adolescent risk behaviors. The current study aimed to assess the test-retest reliability of a widely used measure of youth risk-taking behavior, the Youth Risk Behavior Survey (YRBS). A sample of 156 at-risk adolescents aged 16-18 years (81% male; 61% White) completed the YRBS retrospectively across intervals ranging from 3 to 12 days during their stay in a residential program at which they were under close supervision and had limited ability to engage in new risk behaviors. Participants were asked to complete the YRBS based on their "typical" (pre-program) behavior at both administrations, which were 10-14 weeks into their stay. The reliability of responses was assessed using kappa and weighted kappa analyses. Findings indicate moderate to substantial reliability for nearly all items, suggesting that at-risk youth reliably reported their engagement in health risk behaviors across multiple administrations and supporting the psychometric strength of the YRBS measure for use with this population., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Adolescent personality assessment measures can aid in the identification of traits that are associated with various types of maladjustment. Externalizing personality pathology traits (e.g., antisocial, borderline, and narcissistic personality disorder features) are particularly relevant for many problematic outcomes, yet measures that assess these traits have not been validated extensively in diverse samples. The present study aimed to examine the properties of measures of externalizing personality pathology traits in a sample of White ( n  = 184) and Black ( n  = 99) adolescents participating in a residential program for at-risk youth. The fit of the proposed structure for these measures was tested in the sample as a whole and in each racial group separately. Associations between these measures and the count of disciplinary infractions received while in the program were also tested. Measures were found to have less than optimal fit in this sample, especially among Black adolescents. Suggestions for future research and clinical use of these measures are discussed.

This study investigated the relations of adolescent COVID-19 knowledge, quarantine/lockdown experiences, and social media use with indices of their psychosocial adjustment. The sample consisted of 215 adolescents from throughout the United States, with adolescents ranging from ages 14 to 17. Better knowledge of COVID-19 was related to lower loneliness, stress, anxiety, depression, and fear of missing out (FoMO). Higher parent-reported restrictions during quarantine were associated with these difficulties as well. Further, the lowest anxiety was reported for adolescents with good COVID-19 knowledge who also checked social media relatively less frequently. The findings point to the importance of accurate information about COVID-19 for adolescents and the impact of quarantine/lockdown experiences on their perceived emotional and social adjustment., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

The Personality Assessment Inventory (PAI) Treatment Process Index (TPI) is a measure of treatment amenability based on an index of factors related to poor treatment outcomes (e.g., hostility, lack of social support, and poor impulse control). In this study, the formula used to calculate the TPI for the adult PAI was applied to PAI-Adolescent (PAI-As) protoocols completed by 372 adolescents (mean age: 16.8 years; 80% male) during a 22-week residential program for at-risk youth. The number of disciplinary infractions received during the program was used as an indicator of the participants' response to the program. Average PAI-A scale scores and TPI scores were higher than those previously reported for community samples, but lower than those found in clinical samples. TPI scores were positively associated with disciplinary infractions, particularly nonaggressive infractions, when controlling for demographic factors and other clinically relevant variables. Results suggest that the the TPI has relevance for adolescents completing the PAI-A.

The Proposed Specifiers for Conduct Disorder scale (PSCD; Salekin & Hare, 2016) is a new scale for the assessment of psychopathic characteristic domains in children and adolescents. The four domains are Grandiose-manipulative (GM), Callous-unemotional (CU), Daring-impulsive (DI), and Conduct Disorder (CD). We examined the properties of the self-report version of the PSCD in a large sample of adolescents ( n = 409; age = 16-19; 80.6% male) in a military-style residential facility. Factor analytic results supported a four-factor model consistent with other PSCD research (e.g., López-Romero et al., 2019; Luo et al., 2021). Structural equation model (SEM) indicated a superordinate PSCD factor accounted for significant variance in self-reported delinquency history. The PSCD had good internal consistency and strong convergent and discriminant validity with measures of externalizing and internalizing disorders. The present study provides encouraging data that the PSCD may provide a sound measure of psychopathic propensities in youth. However, additional data are needed to test the stability of the PSCD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: This study examines psychopathology and personality correlates of non-suicidal self-injury (NSSI) and suicide-related behavior (SRB) in an understudied sample of adolescents who have exhibited behaviors (e.g., delinquent acts, premature high school termination) that place them at-risk for poor psychosocial outcomes., Method: Participants included a predominantly White male sample of 182 adolescents (M age = 16.82 years). In addition to information about NSSI and SRB histories, participants self-reported various facets of personality and psychopathology on the Personality Assessment Inventory-Adolescent (PAI-A)., Results: Logistic regression analyses indicated that the Suicidal Ideation (SUI) scale on the PAI-A was the strongest predictor of both NSSI and SRB history, as it outperformed other relevant PAI-A scales and the Suicide Potential Index (SPI), an aggregate scale that was designed to assess for suicide risk using the PAI for adults. Receiver operating characteristic (ROC) curve analyses were also conducted to determine optimal cutoff scores for significant PAI-A predictors., Conclusions: Findings from the current study can be used to identify NSSI and SRB risk and target these life-threatening behaviors when working with at-risk adolescents.HighlightsPAI-A SUI outperformed other PAI-A variables in predicting NSSI and SRB risk.PAI SPI did not perform as well in adolescents compared to adult samples.Cutoff scores in the current sample were well below those in the PAI-A manual.

Acute graft-versus-host disease (aGvHD) is a rare complication of liver transplantation associated with high morbidity and mortality. Death typically occurs due to complications related to severe infection, shock, and multiorgan failure. The clinical presentation involves dysfunction of multiple organ systems with overlapping symptoms that often results in a diagnostic delay. As there are a limited number of cases reported in the literature, there are no clear guidelines for treatment. Many different therapeutic measures have been utilized that target various immune system pathways, but steroids remain the first line of therapy. We report on two patients who developed aGvHD after liver transplantation who were treated with ruxolitinib, a novel Janus kinase 1/2 (JAK) inhibitor that has been shown to improve outcomes in steroid refractory cases of aGvHD after allogenic hematopoietic stem cell transplantation. We reviewed the literature to discuss various therapeutic options currently available for aGvHD after liver transplantation., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Edward Kim et al.)

This study examines the validity of the Personality Assessment Inventory-Adolescent (PAI-A; Morey) in assessing callous-unemotional (CU) traits within two independent samples of at-risk adolescents from a residential intervention program. The study tests the extent to which CU traits are represented within PAI-A scales with respect to empirically- or theoretically-related indicators, such as antisociality, aggression, low warmth, low social connectedness, and subdued internalizing psychopathology. The PAI-A substantive scales statistically accounted for an average of 55.0% of the variance in total scores on the Inventory of Callous-Unemotional Traits (ICU; Frick) across samples. Broadly, PAI-A substantive scales evinced theoretically-consistent relations with CU traits. Consistent with expectations, CU traits were broadly related to PAI-A-assessed constructs of antisocial features, aggression, low warmth and social disconnection, but not to subdued internalizing symptoms. Moreover, some of the PAI-A clinical, treatment consideration, and interpersonal scales or subscales demonstrated differential relations across the traits. Implications for assessment of CU traits using the PAI framework are discussed. Overall, this research adds to the literature on CU traits in broadband personality assessment and provides a foundation for future research on CU traits using the PAI-A.

The purpose of this study was to evaluate the factor structure and measurement invariance of the Barratt Impulsiveness Scale-Brief version (BIS-Brief) in an archival sample of 315 adolescents (81% male; 63.5% Caucasian; M age = 16.7 years) participating in a military-style residential program for at-risk youths. Additionally, correlations between BIS scores and external measures of impulsivity-related behaviors were examined. Results showed support for a previously described two-dimensional structure for the BIS-Brief, which was invariant across racial groups. Additionally, the BIS-Brief performed similarly to the total BIS-11 score in relation to external measures of impulsivity-related behaviors. However, the two dimensions exhibited some significant differences in their associations with other measures. This study supports the utility of the BIS-Brief as a brief measure of impulsivity and suggests that the dimensions of the BIS-Brief may be useful in distinguishing how different aspects of impulsivity relate to problem behaviors such as binge drinking and self-injury.

The purpose of this study was to extend research on the Personality Assessment Inventory-Adolescent (PAI-A; Morey, 2007) to include an examination of mean PAI-A results and associations between the PAI-A and indicators of impulsivity in a large sample of at-risk adolescents ( M age  = 16.75; 79% male; 64% Caucasian) in a military-style residential program. Included in this study are archival records for a diverse sample of 497 youths who participated in the program during a 2-year period. Average T scores on PAI-A scales ranged from 44.67 to 65.41. Moderate to large positive associations ( r s = .30-.65) were found between relevant PAI-A scales and both UPPS-P scales and self-reported substance use. There were smaller effects ( r  = .17) for associations between the PAI-A and program disciplinary infractions. Small to large group differences (ds = .19-.93) on PAI-A scales differentiated youths who had experience with arrests or NSSI from those who did not. This study provides information about the under-studied but vulnerable youths occupying the space between the normative population and youths with identified clinical or legal problems. It also clarifies how impulsivity and impulsivity-related behaviors may be represented on the PAI-A.

The objective was to determine the longitudinal associations between callous-unemotional (CU) and oppositional defiant (OD) behaviors from the first to fourth grades for Spanish children. Four possible outcomes were evaluated: (a) CU behaviors in the first grade predict increases in OD behaviors in the fourth grade, controlling for OD behaviors in the first grade; (b) OD behaviors in the first grade predict increases in CU behaviors in the fourth grade, controlling for CU behaviors in the first grade; (c) both unique effects are significant; and (d) neither unique effect is significant. A longitudinal panel model with two latent variables (CU and OD behaviors), three sources (mothers, fathers, teachers), and two occasions (spring of the first and fourth grades) was used to evaluate the four possibilities among 758 (54% boys) first grade and 469 (53% boys) fourth grade Spanish children. For mother-, father-, and teacher-reports, OD behaviors in the first grade predicted increases in CU behaviors in the fourth grade, after controlling for CU behaviors in the first grade, whereas CU behaviors in the first grade did not predict increases in OD behaviors in the fourth grade, after controlling for OD behaviors in the first grade. OD behaviors thus conferred independent vulnerability to increases in CU behaviors 3 years later among young children.

Narcissism and callous-unemotional (CU) traits have demonstrated relations with youth aggression across studies. However, different forms of narcissism and internalizing problems may exacerbate the relation between CU traits and aggression. To that end, the current study examined the degree to which interactions among internalizing problems, CU traits, and dimensions of narcissism related to aggression in a sample of 219 adolescents (83.1% males), ages 16-19, enrolled in a military-style residential program. Consistent with previous research, psychopathy-linked narcissism significantly moderated the relation between CU traits and aggression. Addtionally, self-reported aggression was highest among adolescents who endorsed high levels of CU traits, psychopathy-linked narcissism, and internalizing problems. The same pattern of results was not evident for other forms of narcissism. These results suggest that internalizing problems further increase the probability of aggression among adolescents with psychopathic tendencies (i.e., CU traits, psychopathy-linked narcissism). Further implications are discussed., (© 2020 Wiley Periodicals, Inc.)

Studies on narcissism in social media have been numerous. Manifestations of narcissistic behaviors are typically viewed negatively by others online. However, previous study is limited by only examining agentic narcissism. This study investigated perceptions of both agentic and communal narcissism in the context of Facebook. Two hundred and sixty undergraduate students viewed fictitious Facebook profiles with narcissistic or neutral status updates and rated the target on likeability, successfulness, and whether they would want to be friends with the target. Narcissistic statuses were viewed more negatively than neutral statuses across domains. Agentic narcissistic statuses were viewed most harshly. Some gender differences emerged. Female participants rated agentic narcissistic statements from female targets and communal narcissistic statements from male targets more negatively than did male participants. Participants' self-reported communal narcissism was related to their ratings of others, whereas self-reported agentic narcissism was not. Implications of these findings are discussed.

The current study examined the reliability and validity of the Youth Psychopathic Traits Inventory-Short Version (YPI-S) in two different samples of at-risk adolescents enrolled in a residential program ( n = 160) and at a detention facility ( n = 60) in the United States. YPI-S scores displayed adequate internal consistency and were moderately associated with concurrent scales on other self-report psychopathy measures and externalizing behaviors. YPI-S scores were moderately related to interviewer-ratings of the construct using the four-factor model of the Psychopathy Checklist: Youth Version. Findings suggest that the YPI-S may be a clinically useful and valid tool for the assessment of psychopathic traits in juvenile settings. This may be particularly true given the differential predictive utility of each of its dimensions.

Limited prosocial emotions (LPE, also referred to as callous-unemotional [CU] traits) are considered to reflect a more trait- than state-like construct. Our first objective was to determine the amount true score variance in CU/LPE that was consistent (trait consistency) over two occasions (12-month interval) of measurement versus specific (occasion-specificity) to each occasion. Our second objective was to determine the convergent validity of the consistent (trait) and occasion-specific (state) variance in CU/LPE symptom ratings within and across settings. Mothers, fathers, primary teachers, and ancillary teachers rated the CU/LPE symptoms in sample of 811 Spanish children (55% boys) on two occasions (i.e., end of first and second grades). CU/LPE symptom ratings showed more trait consistency than occasion-specificity for mothers and fathers, slightly more occasion-specificity than trait consistency for primary teachers, and much more occasion-specificity than trait consistency for ancillary teachers. Convergent validity for trait consistency was strong for fathers with mothers but weaker for primary with ancillary teachers. There was essentially no convergent validity for either trait consistency or occasion-specificity across home and school settings. CU/LPE symptom ratings within this age range represented a more trait-like construct for mothers and fathers and more state-like construct for primary teachers and ancillary teachers. In contrast, earlier studies showed ADHD and ODD ratings to be trait-like within and across home and school. The study of CU/LPE in young children should therefore include multiple sources in multiple settings across occasions to better understand the consistent and occasion-specific nature of the CU/LPE construct.

The objective was to evaluate a 4-item measure of the DSM-5 Limited Prosocial Emotions (LPE) specifier (a 4-item measure of prosocial emotions). Mothers, fathers, primary teachers, and ancillary teachers completed measures of prosocial emotions (PE), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD)-inattention (IN), ADHD-hyperactivity/impulsivity (HI), academic and social impairment on 811 Spanish first-grade children (46% girls). Confirmatory factor and structural regression analyses showed PE symptom scores to have (a) good reliability for the 4 sources (80% to 89% true score variance), (b) invariance of like-symptom loadings and intercepts across the 4 sources, (c) strong convergent and discriminant validity within home and school settings, (d) no convergent validity across settings, and (e) associations with academic and social impairment independent of the ODD dimension (the unique effects of PE also remained significant after controlling for ODD, ADHD-IN, and ADHD-HI for mothers and ancillary teachers). A graded response item response theory analysis indicated that PE scores provided an accurate measure of the PE trait across a wide trait range and especially at low PE trait levels (i.e., scores in the clinical range). Findings also supported the DSM-5 diagnostic criteria of 2 or more LPE symptoms in 2 or more settings (e.g., high levels of the LPE trait were associated with the occurrence of 2 or more symptoms with 4% of the sample showing 2 or more symptoms in both settings). Although additional studies are still required, the PE measure appears useful as a brief measure of the LPE specifier. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

This study investigated adolescent and parent reports of adolescent social media use and its relation to adolescent psychosocial adjustment. The sample consisted of 226 participants (113 parent-adolescent dyads) from throughout the United States, with adolescents (55 males, 51 females, 7 unreported) ranging from ages 14 to 17. Parent and adolescent reports of the number of adolescents' social media accounts were moderately correlated with parent-reported DSM-5 symptoms of inattention, hyperactivity/impulsivity, ODD, anxiety, and depressive symptoms, as well as adolescent-reported fear of missing out (FoMO) and loneliness. Lastly, anxiety and depressive symptoms were highest among adolescents with a relatively high number of parent-reported social media accounts and relatively high FoMO. The implications of these findings and need for related longitudinal studies are discussed., (Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.)

Objective: The present study extended recent work on communal narcissism to a sample of at-risk adolescents. Although narcissism is widely considered an agentic personality construct, Gebauer and colleagues (Gebauer, Sedikides, Verplanken, & Maio, 2012) demonstrated the existence and utility of a communal narcissism construct in adults. The extent to which this variant of narcissism applies to adolescents is not yet known. Because communal narcissism (e.g., feeling that one is the most helpful, is a great influence on others, will bring about world peace) may actually be aversive to others, we investigated the associated self- and peer perceptions of adolescent communal narcissism., Method: Participants were 136 adolescents (104 males, 32 females; 52.2% White, 42.2% Black, 5.6% Other) aged 16-19, who were attending a 22-week residential program together. Participants completed self-report measures of narcissism and interpersonal behavior, as well as a peer nomination procedure., Results: Self-reported communal narcissism was significantly related to self-reported pro-social behavior but was associated with peer-reported aggression, similar to the findings for nonpathological narcissism, which is considered agentic., Conclusions: Adolescent communal narcissism appears to be tied to negative peer perceptions. The implications for understanding the interpersonal consequences of adolescent grandiosity in communal domains are discussed., (© 2016 Wiley Periodicals, Inc.)

Context: Liver cancers (including hepatocellular carcinoma [HCC] and cholangiocarcinoma) are the fifth most common cause of cancer death. The most powerful independent histologic predictor of overall survival after transplantation for HCC is the presence of microscopic vascular invasion (VI)., Aims: Given that VI is known to have somewhat high interobserver variability in both HCC and other tumors, we hypothesized that pathologists with special interest and training in liver pathology would be more likely to identify and report VI in HCC than would general surgical pathologists., Settings and Design: We searched our departmental surgical pathology archives for transplant hepatectomies performed for HCC., Subjects and Methods: We identified 143 such cases with available sign-out reports and hematoxylin and eosin-stained slides., Statistical Analysis Used: Kappa results (level of agreement) were calculated., Results: Before surgical pathology subspecialty sign-out (SSSO) implementation, 49 of 88 HCC cases were reported as negative for VI; on rereview, 20 of these had VI. After SSSO implementation, 39 of 55 cases were reported as negative for VI; on our review, 8 of these had VI. Kappa (agreement) between general SO and subspecialty rereview was 0.562 (95% confidence interval [CI] = 0.411-0.714) "weak agreement." Kappa (agreement) between SSSO and rereview by select liver pathologists was 0.693 (95% CI = 0.505-0.880) "moderate agreement.", Conclusions: Our study is one of only a few so far that have suggested improved accuracy of certain parameters under SSSO.

The current study examined the moderating influence that different aspects of narcissism have on the relation between callous-unemotional (CU) traits and aggression in a sample of 720 adolescents (500 males), ages 16-19 enrolled in a 22-week residential program. Findings from the two studies revealed that psychopathy-linked narcissism as assessed by the Antisocial Process Screening Device (APSD; Frick & Hare, 2001; Antisocial process screening device. Toronto: Multi-Health Systems.) and vulnerable narcissism as assessed using the Pathological Narcissism Inventory (PNI; Pincus et al., 2009; Initial construction and validation of the Pathological Narcissism Inventory. Psychological Assessment, 21, 365-379) significantly moderated the relation between CU traits and aggression in adolescents. Conversely, non-pathological narcissism assessed by the Narcissistic Personality Inventory for Children (NPIC; Barry, Frick, & Killian, 2003; The relation of narcissism and self-esteem to conduct problems in children. Journal of Clinical Child and Adolescent Psychology, 32, 139-152) and PNI grandiose narcissism did not significantly impact this relation. These results suggest that forms of narcissism most closely connected to internalizing problems combined with CU traits are associated with relatively heightened aggression in youth. The implications of these findings are discussed. Aggr. Behav. 43:14-25, 2017. © 2016 Wiley Periodicals, Inc., (© 2016 Wiley Periodicals, Inc.)

An important threat to validity in personality research pertains to an individual's motivation to respond in a socially desirable manner on self-report inventories. This issue was examined in this study in the context of narcissism, aggression, and prosocial behavior in a sample of at-risk adolescents. Participants were 161 adolescents (128 males, 29 females, 4 not reported) ranging in age from 16 to 19 years who were attending a residential program for youth who have dropped out of school. Overall, socially desirable response tendencies were negatively correlated with vulnerable narcissism and self-reported aggression. Moreover, low socially desirable responses strengthened the relation between narcissism and self-reported aggression. Socially desirable responding was not associated with self- or peer-reported prosocial behavior and did not moderate the relation between narcissism and prosocial behavior. These findings indicate that the relation between narcissism and aggression is attenuated by concerns with social desirability. However, further work is needed in broader samples of adolescents to more closely examine whether social desirability concerns actually mitigate aggression among some youth or signify underreporting of one's problem behaviors.

Background: Although the relation between impulsive-irresponsible psychopathic traits and substance use is well-documented, the path to developing substance use problems is less understood in adolescents with these characteristics., Objectives: To examine the associations between psychopathy, anxiety, and substance use motives and a mechanism by which anxiety and alcohol and marijuana coping motives mediate the relation between psychopathic traits and substance use-related problems., Methods: A sample of 185 at-risk adolescent males from a residential military-style program reporting past alcohol or marijuana use (M age = 16.74) participated in the study., Results: Impulsive-Irresponsible psychopathic traits were uniquely and incrementally predictive of alcohol and marijuana use-related problems and anxiety. Anxiety and coping motives appeared to partially explain the association between impulsivity-irresponsibility and substance use-related problems., Conclusions/importance: Findings suggest that youth expressing impulsive-irresponsible psychopathic traits may engage in problematic substance use at least partly as a function of heightened anxiety and a subsequent desire to alleviate distress by using alcohol or marijuana to cope.

Acute liver failure is life threatening liver injury with coagulopathy and hepatic encephalopathy within 26 weeks and generally, in the absence of preexisting liver disease. Fulminant liver failure occurs when hepatic encephalopathy occurs within 8 weeks of jaundice. The majority of patients with ALF are women with the median age of 38 years. In the United States, drug induced liver injury including acetaminophen causes the majority of ALF cases. The etiology of ALF should be determined, if possible, because many causes have a specific treatment. The mainstay for ALF is supportive care and liver transplantation, if necessary. There are multiple prognostic criteria available. Prognosis can be poor and patients should be referred to a liver transplantation center as soon as possible.

Although empathy deficits are thought to be associated with callous-unemotional (CU) traits, findings remain equivocal and little is known about what specific abilities may underlie these purported deficits. Affective perspective-taking (APT) and facial emotion recognition may be implicated, given their independent associations with both empathy and CU traits. The current study examined how CU traits relate to cognitive and affective empathy and whether APT and facial emotion recognition mediate these relations. Participants were 103 adolescents (70 males) aged 16-18 attending a residential programme. CU traits were negatively associated with cognitive and affective empathy to a similar degree. The association between CU traits and affective empathy was partially mediated by APT. Results suggest that assessing mechanisms that may underlie empathic deficits, such as perspective-taking, may be important for youth with CU traits and may inform targets of intervention.

Background: Liver cancer, of which hepatocellular carcinoma (HCC) is by far the most common type, is the second most deadly cancer (746,000 deaths in 2012). Currently, the only curative treatment for HCC is surgery to remove the malignancy (resection) or to remove the entire diseased liver followed by transplantation of healthy liver tissue. Given the shortage of healthy livers, it is crucial to provide transplants to patients that have the best chance of long-term survival. Currently, transplantation is determined via the Milan criteria-patients within Milan (single tumor < 5 cm or 2-3 tumors < 3 cm with no extrahepatic spread nor intrahepatic vascular invasion) are typically eligible for transplantation. However, combining microRNA expression profiling with the Milan criteria can improve prediction of recurrence. HCC often presents with multiple distinct tumor foci arising from local spread of a primary tumor or from the oncogenic predisposition of the diseased liver. Substantial genomic heterogeneity between tumor foci within a single patient has been reported; therefore, biomarker development must account for the possibility of highly heterogeneous genomic profiles from the same individual., Methods: MicroRNA profiling was performed on 180 HCC tumor samples from 89 patients who underwent liver transplantation at the University of Rochester Medical Center. The primary outcome was recurrence-free survival time, and patients were observed for 3 years post-transplantation., Results: MicroRNA expression profiles were used to develop a biomarker that distinguishes HCC patients at greater risk of recurrence post-transplantation. Unsupervised clustering uncovered two distinct subgroups with vast differences in standard transplantation selection criteria and recurrence-free survival times. These subgroups were subsequently used to identify microRNAs strongly associated with HCC recurrence. Our results show that reduced expression of five specific microRNAs is significantly associated with HCC recurrence post-transplantation., Conclusions: MicroRNA profiling of distinct tumor foci, coupled with methods that address within-subject tumor heterogeneity, has the potential to significantly improve prediction of HCC recurrence post-transplantation. The development of a clinically applicable HCC biomarker would inform treatment options for patients and contribute to liver transplant selection criteria for practitioners.

Unlabelled: Vascular invasion provides a direct route for tumor metastasis. The degree to which microRNA (miRNA) expression plays a role in tumor vascular invasion is unclear. Here, we report that miR-494 is up-regulated in human hepatocellular carcinoma (HCC) tumors with vascular invasion and can promote HCC cell invasiveness by gene inactivation of multiple invasion-suppressor miRNAs. Our results show that ten eleven translocation (TET) methylcytosine dioxygenase, predominantly TET1 in HCC cells, is a direct target of miR-494. The reduced 5'-hydroxymethylcytosine levels observed in the proximal cytosine-phosphate-guanine (CpG) regions of multiple invasion-suppressor miRNA genes are strongly associated with their transcriptional repression upon miR-494 overexpression, whereas enforced DNA demethylation can abolish the repression. Furthermore, TET1 knockdown shows a similar effect as miR-494 overexpression. Conversely, miR-494 inhibition or enforced TET1 expression is able to restore invasion-suppressor miRNAs and inhibit miR-494-mediated HCC cell invasion., Conclusions: miR-494 can trigger gene silencing of multiple invasion-suppressor miRNAs by inhibiting genomic DNA demethylation by direct targeting of TET1, thereby leading to tumor vascular invasion., (© 2015 The Authors. Hepatology published by Wiley Periodicals, Inc., on behalf of American Association for the Study of Liver Diseases.)

Objectives: The precise measurement of fat accumulation in the liver, or steatosis, is an important clinical goal. Our previous studies in phantoms and mouse livers support the hypothesis that, starting with a normal liver, increasing accumulations of microsteatosis and macrosteatosis will increase the lossy viscoelastic properties of shear waves in a medium. This increase results in an increased dispersion (or slope) of the shear wave speed in the steatotic livers., Methods: In this study, we moved to a larger animal model, lean versus obese rat livers ex vivo, and a higher-frequency imaging system to estimate the shear wave speed from crawling waves., Results: The results showed elevated dispersion in the obese rats and a separation of the lean versus obese liver parameters in a 2-dimensional parameter space of the dispersion (slope) and shear wave speed at a reference frequency of 150 Hz., Conclusions: We have confirmed in 3 separate studies the validity of our dispersion hypothesis in animal models., (© 2015 by the American Institute of Ultrasound in Medicine.)

In the current study, we addressed several issues related to the forms (physical and relational) and functions (reactive and proactive) of aggression in community (n = 307), voluntary residential (n = 1,917), and involuntarily detained (n = 659) adolescents (ages 11-19 years). Across samples, boys self-reported more physical aggression and girls reported more relational aggression, with the exception of higher levels of both forms of aggression in detained girls. Further, few boys showed high rates of relational aggression without also showing high rates of physical aggression. In contrast, it was not uncommon for girls to show high rates of relational aggression alone, and these girls tended to also have high levels of problem behavior (e.g., delinquency) and mental health problems (e.g., emotional dysregulation and callous-unemotional traits). Finally, for physical aggression in both boys and girls, and for relational aggression in girls, there was a clear pattern of aggressive behavior that emerged from cluster analyses across samples. Two aggression clusters emerged, with one group showing moderately high reactive aggression and a second group showing both high reactive and high proactive aggression (combined group). On measures of severity (e.g., self-reported delinquency and arrests) and etiologically important variables (e.g., emotional regulation and callous-unemotional traits), the reactive aggression group was more severe than a nonaggressive cluster but less severe than the combined aggressive cluster.

The accumulation of fat droplets within the liver is an important marker of liver disease. This study assesses gradations of steatosis in mouse livers using crawling waves, which are interfering patterns of shear waves introduced into the liver by external sources. The crawling waves are detected by Doppler ultrasound imaging techniques, and these are analyzed to estimate the shear wave speed as a function of frequency between 200 and 360 Hz. In a study of 70 mice with progressive increases in steatosis from 0% to >60%, increases in steatosis are found to increase the dispersion, or frequency dependence, of shear wave speed. This finding confirms an earlier, smaller study and points to the potential of a scoring system for steatosis based on shear wave dispersion., (Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

We describe a surface-based approach to the generation of shear wave interference patterns, called crawling waves (CrW), within a medium and derive local estimates of biomechanical properties of tissue. In previous experiments, elongated bars operating as vibration sources were used to generate CrW propagation in samples. In the present study, however, a pair of miniature circular vibration sources was applied to the overlying skin to generate the CrW within the medium. The shape and position of the miniature sources make this configuration more applicable for in vivo implementation. A modified ultrasound imaging system is used to display the CrW propagation. A shear speed mapping algorithm is developed using a detailed analysis of the CrW. The proposed setup is applied to several biomaterials including a homogeneous phantom, an inhomogeneous phantom and an ex vivo human liver. The data are analyzed using the mapping algorithm to reveal the biomechanical properties of the biomaterials., (Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Prior research indicates that dimensions of adolescent narcissism differ in their associations with indicators of positive and negative psychological functioning (e.g., Barry, Frick, Adler, & Grafeman, 2007 ; Barry & Wallace, 2010 ). This study investigated correlates of 2 empirically derived factors of adolescent narcissism (i.e., pathological and nonpathological narcissism) from 2 measures thought to differ based on their inclusion of pathological versus nonpathological content. In a sample of 188 at-risk adolescents ages 16 to 18, pathological narcissism was associated with various indicators of maladjustment, including aggression, low self-esteem, internalizing problems, and poor perceived interpersonal relationships. On the other hand, nonpathological narcissism was positively associated with self-esteem and aggression but negatively associated with internalizing problems. The implications for the conceptualization of adolescent narcissism are discussed.

An understanding of the latent structure of oppositional defiant disorder (ODD) is essential for better developing causal models, improving diagnostic and assessment procedures, and enhancing treatments for the disorder. Although much research has focused on ODD-including recent studies informing the diagnostic criteria for DSM-5-research examining the latent structure of ODD is sparse, and no known study has specifically undertaken a taxometric analysis to address the issue of whether ODD is a categorical or dimensional construct. To address this gap, the authors conducted two separate studies using a set of taxometric analyses with data from the NICHD Study of Early Child Care and Youth Development (child study; n = 969) and with data from a large mixed sample of adults, which included participants reporting psychiatric difficulties as well as healthy controls (adult study; n = 600). The results of a variety of non-redundant analyses across both studies revealed a dimensional latent structure for ODD symptoms among both children and adults. These findings are consistent with previous studies that have examined latent structure of related constructs (e.g., aggression, antisocial behavior) as well as studies that have examined the dimensional versus categorical structure of ODD using methods other than taxometric analysis., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The current study explored the influences of social stress and resilience on the relation between psychopathy-linked personality characteristics (i.e., narcissism, dimensions of CU traits) and aggression with the expectation that social stress would exacerbate the relation, whereas resilience would mitigate it. In a sample of 154 at-risk adolescents (ages 16-18; 84% male), contrary to expectations, high social stress attenuated the relations of narcissism and callousness with aggression. Self-reported resilience attenuated the relation between callousness and aggression. The implications for understanding the role that these moderators might play in the association between adolescent psychopathic tendencies, particularly callousness, and aggression are discussed., (© 2013 Wiley Periodicals, Inc.)

Previous studies have found that narcissistic individuals are often viewed negatively by those who know them well. The present study sought to extend these previous findings by examining whether normal and pathological aspects of narcissism were associated with perceiver ratings of narcissistic characteristics and aggression. This was accomplished by having each of our undergraduate participants (288 targets) recruit friends or family members to complete ratings of the target who recruited them (1,296 perceivers). Results revealed that perceived entitlement was strongly associated with perceived aggression. Further, self-reported levels of pathological narcissism moderated these results such that vulnerable narcissism exacerbated the association between perceived entitlement and aggression, whereas grandiose narcissism mitigated the association. The discussion will focus on the implications of these results for understanding the various features of narcissism., (© 2012 The Authors. Journal of Personality © 2012, Wiley Periodicals, Inc.)

Researchers continue to debate the role of self-esteem in aggression, but research has shown a consistent association between narcissism and aggression in adults and adolescents [e.g., Barry et al., 2007; Bushman and Baumeister, 1998; Stucke, 2007]. The primary aim of the current study was to examine whether locus of control (LOC) moderated the relation between self-perception variables (i.e., self-esteem and narcissism) and aggression in adolescents. Participants were 174 youth (145 males, 26 females) between the ages of 16 and 19 who were enrolled in a voluntary residential program for youth who have dropped out of school. The results showed that LOC moderated the association between self-esteem and aggression such that low self-esteem was associated with higher levels of aggression for individuals with an external LOC. Contrary to expectations, LOC failed to moderate the narcissism-aggression relation. The implications of this study for understanding how self-perception is related to adolescent aggression are discussed., (© 2012 Wiley Periodicals, Inc.)

Donor livers are precious resources and it is, therefore, ethically imperative that we employ optimally sensitive and specific transplant selection criteria. Current selection criteria, the Milan criteria, for liver transplant candidates with hepatocellular carcinoma (HCC) are primarily based on radiographic characteristics of the tumor. Although the Milan criteria result in reasonably high survival and low-recurrence rates, they do not assess an individual patient's tumor biology and recurrence risk. Consequently, it is difficult to predict on an individual basis the risk for recurrent disease. To address this, we employed microarray profiling of microRNA (miRNA) expression from formalin fixed paraffin embedded tissues to define a biomarker that distinguishes between patients with and without HCC recurrence after liver transplant. In our cohort of 64 patients, this biomarker outperforms the Milan criteria in that it identifies patients outside of Milan who did not have recurrent disease and patients within Milan who had recurrence. We also describe a method to account for multifocal tumors in biomarker signature discovery., (© 2011 The American Society of Transplantation and the American Society of Transplant Surgeons.)

Crawling waves, which are interfering shear wave patterns, can be generated in liver tissue over a range of frequencies. Some important biomechanical properties of the liver can be determined by imaging the crawling waves using Doppler techniques and analyzing the patterns. We report that the dispersion of shear wave velocity and attenuation, that is, the frequency dependence of these parameters, are strongly correlated with the degree of steatosis in a mouse liver model, ex vivo. The results demonstrate the possibility of assessing liver steatosis using noninvasive imaging methods that are compatible with color Doppler scanners and, furthermore, suggest that liver steatosis can be separated from fibrosis by assessing the dispersion or frequency dependence of shear wave propagations., (Copyright © 2012 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

During the human B cell (Bc) recall response, rapid cell division results in multiple Bc subpopulations. The TLR-9 agonist CpG oligodeoxynucleotide, combined with cytokines, causes Bc activation and division in vitro and increased CD27 surface expression in a sub-population of Bc. We hypothesized that the proliferating CD27(lo) subpopulation, which has a lower frequency of antibody-secreting cells (ASC) than CD27(hi) plasmablasts, provides alternative functions such as cytokine secretion, costimulation, or antigen presentation. We performed genome-wide transcriptional analysis of CpG activated Bc sorted into undivided, proliferating CD27(lo) and proliferating CD27(hi) subpopulations. Our data supported an alternative hypothesis, that CD27(lo) cells are a transient pre-plasmablast population, expressing genes associated with Bc receptor editing. Undivided cells had an active transcriptional program of non-ASC B cell functions, including cytokine secretion and costimulation, suggesting a link between innate and adaptive Bc responses. Transcriptome analysis suggested a gene regulatory network for CD27(lo) and CD27(hi) Bc differentiation.

Background: Genomic analyses of cancer rarely show significant overlap in reported significant genes from one study to the next. We posit that viewing transcriptomic data from the broader view of gene pathways and biologic processes will yield a more coherent and meaningful understanding compared with analyzing lists of individual genes., Materials and Methods: To this end, we collected publicly available data from hepatocellular carcinoma (HCC) gene expression studies and collectively analyzed them using ANOVA, Gene Set Enrichment Analysis, and gene pathway analyses., Results: The degree of pathway and function overlap was very high between datasets compared with individual gene overlap. Analysis of pathways shared among all the datasets showed that processes such as cell proliferation, cell cycle control, and apoptosis were highly represented in the HCC samples, and liver-specific processes such as lipid synthesis, coagulation protein synthesis, and drug metabolism were present in normal liver cells. Specific gene networks known to be important in HCC, such as WNT, PCNA, TGF, and TP53, are present in the study., Conclusions: We describe a generalizable method to combine multiple genomic datasets generated from diverse experimental platforms and study populations into an intuitive and biologically meaningful format. This approach allows the delineation of biologic processes of clinical significance that can predict important endpoints such as survival and tumor recurrence., (Published by Elsevier Inc.)

This study examined the structure of a self-report measure of the forms and functions of aggression in 855 adolescents (582 boys, 266 girls) aged 12 to 19 years recruited from high school, detained, and residential settings. The Peer Conflict Scale (PCS) is a 40-item measure that was developed to improve upon existing measures and provide an efficient, reliable, and valid assessment of four dimensions of aggression (i.e., reactive overt, reactive relational, proactive overt, and proactive relational) in youths. Confirmatory factor analyses showed that a 4-factor model represented a satisfactory solution for the data. The factor structure fit well for both boys and girls and across high school, detained, and residential samples. Internal consistency estimates were good for the 4 factors, and they showed expected associations with externalizing variables (i.e., arrest history, callous-unemotional traits, and delinquency). Reactive and proactive subtypes showed unique associations consistent with previous literature. Implications for the use of the PCS to assess aggression and inform intervention decisions in diverse samples of youths are discussed.

Given the propensity for clinical assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) to focus on core behavioral symptoms, the current study examined how well other predictors classified children who were diagnosed with ADHD by licensed practitioners. Participants were 91 children (39 ADHD-identified, 52 without ADHD), aged 8 to 13 years. In addition to significantly more ADHD symptoms, the ADHD-identified group exhibited significantly more externalizing problems and internalizing symptoms, less adaptive functioning, and greater problem pervasiveness and severity. Binary logistic regression analyses indicated that problem pervasiveness and severity significantly predicted diagnostic group membership when controlling for other predictors, and pervasiveness added unique variance beyond measures of core ADHD symptoms. Diagnostic utility analyses showed measurement of problem pervasiveness and severity to be a useful tool in the identification of ADHD. Findings provide support for the practical use of a parent-report measure of impairment in the home as part of evidence-based assessment of ADHD.

Background: The Accreditation Council for Graduate Medical Education requires fellows in many specialties to demonstrate attainment of 6 core competencies, yet relatively few validated assessment tools currently exist. We present our initial experience with the design and implementation of a standardized patient (SP) exercise during gastroenterology fellowship that facilitates appraisal of all core clinical competencies., Methods: Fellows evaluated an SP trained to portray an individual referred for evaluation of abnormal liver tests. The encounters were independently graded by the SP and a faculty preceptor for patient care, professionalism, and interpersonal and communication skills using quantitative checklist tools. Trainees' consultation notes were scored using predefined key elements (medical knowledge) and subjected to a coding audit (systems-based practice). Practice-based learning and improvement was addressed via verbal feedback from the SP and self-assessment of the videotaped encounter., Results: Six trainees completed the exercise. Second-year fellows received significantly higher scores in medical knowledge (55.0 ± 4.2 [standard deviation], P  =  .05) and patient care skills (19.5 ± 0.7, P  =  .04) by a faculty evaluator as compared with first-year trainees (46.2 ± 2.3 and 14.7 ± 1.5, respectively). Scores correlated by Spearman rank (0.82, P  =  .03) with the results of the Gastroenterology Training Examination. Ratings of the fellows by the SP did not differ by level of training, nor did they correlate with faculty scores. Fellows viewed the exercise favorably, with most indicating they would alter their practice based on the experience., Conclusions: An SP exercise is an efficient and effective tool for assessing core clinical competencies during fellowship training.

The present study investigated the relations of self-reported and peer-nominated relational aggression (RA) with self-esteem and narcissism among 43 at-risk 16- to 18-year-olds. Self-reported and peer-nominated RA were positively intercorrelated, and each was positively correlated with narcissism. An interaction between self-esteem and narcissism predicted peer-nominated RA, such that narcissism was related to peer-nominated RA particularly for individuals with high self-esteem. Maladaptive, but not adaptive, narcissism uniquely predicted peer-nominated RA. The implications and limitations of this study for research on adolescent self-perception and RA are discussed.

The present study explores the relation between narcissism and delinquency among 372 at-risk 16-18-year-olds. The study also considered the relation between narcissism and self-esteem, as well as the potential interaction between narcissism and self-esteem for predicting delinquency in this age group. Narcissism and self-esteem were positively interrelated; however, only narcissism was significantly correlated with delinquency. The results suggested that low self-esteem was actually associated with delinquency when controlling for narcissism. So-called adaptive narcissism was positively correlated with self-esteem, but maladaptive narcissism was not related to self-esteem. Limitations and directions for future research in this area are discussed.