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Objective: Maladaptive eating behaviors remain prevalent in the US population, and a significant percentage of US college students acknowledge engaging in maladaptive eating. Formally defined eating disorders (EDs) have one of the highest mortality rates among all mental illnesses. Suicide risk is substantially elevated among individuals diagnosed with EDs, and even subclinical levels of maladaptive eating behaviors are associated with suicidality. The current study examined associations between specific problematic eating behaviors measured dimensionally (eg, purging, binging, laxative use) and specific suicide-related constructs and behaviors as well as overall suicide risk., Methods: College students (N=188; 62% women) completed the Eating Disorder Examination-Questionnaire, a well-established measure of dysfunctional eating, as well as several self-report measures of theoretical components of suicidality, and, finally, a semistructured clinical interview to specify suicide risk category., Results: Results showed a general pattern of moderate and strong associations between the subscales and the overall score of the Eating Disorder Examination-Questionnaire and core suicide constructs of the interpersonal-psychological theory of suicide. Many substantive correlations were found between specific eating behaviors and specific suicide-related behaviors; for example, purging was the highest correlate of overall suicide risk (ρ=0.36)., Discussion: These results are discussed in terms of consistency with the interpersonal-psychological theory of suicide as well as practical implications for intervention., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Prevalence rates of perinatal mood disorders range from 5 to 25%. Furthermore, suicide is a leading cause of death in postpartum women. Various factors have been associated with an increased risk of suicide in postpartum women, including co-occurring mental health disorders, lack of mental health care, and substance use. It is important for mental health screening and psychological assessment used within OB-GYN clinics to be current with regard to postpartum mood dysfunction and suicide risk assessment. We collected data from a sample of 78 postpartum women (0-6-month post-delivery), focusing specifically on patterns of emotional/internalizing dysfunction, using three different screening measures as predictors. Contrary to hypotheses, our sample did not produce significant elevations on target criterion scales of the Minnesota multiphasic personality inventory-3 (MMPI-3). Although the multidimensional behavioral health screen (MBHS) was better at differentially capturing MMPI-3 elevations when compared to the Edinburgh postnatal depression scale (EDPS) and patient health questionnaire-9 (PHQ-9), two of the three comparisons were not statistically significant. Statistical analyses were challenged by our extremely low base rate for elevated suicide risk. Despite this, the MBHS performed better than the EPDS and PHQ-9 at accurately capturing elevated suicide risk., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Maladaptive eating behaviors are typically associated with significant impairment in psychological functioning more broadly. The Minnesota Multiphasic Personality Inventory (MMPI) family of instruments has traditionally been the most frequently used psychological assessment of psychopathology by clinical psychologists. The most recent version, the MMPI-3, features a new Eating Concerns (EAT) scale that screens for the presence of problematic eating behaviors. The goals of the current study were (a) to independently replicate validity correlations reported from the college sample during EAT scale development, (b) to evaluate the utility of EAT scale item-level correlations with other substantive MMPI-3 scales, and (c) to evaluate the ability of the EAT items to predict specific frequency counts of dysfunctional eating behaviors. The current study examined the MMPI-3 assessment of dysfunctional eating behaviors among 188 undergraduate participants. Results indicated that the EAT scale is meaningfully associated with core symptom dimensions of maladaptive eating, including binging, vomiting, restricting, and concerns about weight and shape. In addition, this study identified meaningfully distinct patterns of correlations with personality and psychopathology constructs, and specific behavioral frequencies, across the five individual EAT scale items. These results contribute to the enhanced utility of this important screening scale in clinical settings., 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.

Introduction: In the United States, primary medical care settings are the first accessed resource for both medical and behavioral health care. Thus, there is a clear need for accurate and efficient behavioral health screening in this setting, including routine surveillance screening for suicide risk. The Multidimensional Behavioral Health Screen (MBHS), a broadband but very brief screening tool developed specifically for primary care, has been updated to include an algorithm that classifies suicide risk based on the interpersonal-psychological theory of suicide, and associated interview and decision framework. This study aims to evaluate the predictive accuracy of the new MBHS 2.0 suicide risk algorithm, with actual risk determined by clinical suicide risk interview., Method: Data were collected as part of a larger study that, overall, included 551 college student participants. Of these, 309 completed the MBHS 2.0 and the clinical suicide risk interview, the two measures reported here. The final participant count was 299 following the removal of incomplete or invalid cases. Predicted suicide risk as determined by the MBHS 2.0 (Low, Mild, At least Moderate) was compared to actual risk as determined by clinical interview (Low, Moderate, Severe, Extreme)., Results: Utilizing chi-square analyses, data show a significant association between the predicted suicide risk category based on the MBHS 2.0 algorithm and the actual risk category based on the semi-structured clinical interview. Furthermore, classification analyses suggest that primary care providers will be able to confidently assess the suicide risk level for the majority of their patients when using the MBHS., Conclusion: Findings suggest that the MBHS 2.0 can be an accurate and efficient tool for use by primary care providers in classifying suicide risk. Future research will be useful to evaluate the utility of the suicide risk algorithm among primary care populations., (© 2023 The Authors. Suicide and Life-Threatening Behavior published by Wiley Periodicals LLC on behalf of American Association of Suicidology.)

The Hierarchical Taxonomy of Psychopathology (HiTOP; Kotov et al., 2017, 2021) is offered as a dimensional alternative to traditional categorical diagnostic nosologies such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD ). HiTOP researchers have recently published an open-source assessment system for clinical implementation, the HiTOP Digital Assessment and Tracker (Jonas et al., 2021). Here, we argue that the Minnesota Multiphasic Personality Inventory-3 (MMPI-3; Ben-Porath & Tellegen 2020a), given its structural similarities to HiTOP, can augment these efforts to shift the diagnostic paradigm, with the additional strength of being comprehensively validated, standardized, and normed. Sellbom et al. (2021) examined the factor structure of the MMPI-3 Specific Problems Scales (plus RC6 and RC8), finding a pattern of latent factors much like those proposed by HiTOP in both a general mental health sample and a prisoner sample. The present study is a partial replication of Sellbom et al. (2021) with a primary medical care outpatient sample ( n = 164) and a college student sample ( n = 529). A sequential factoring approach yielded emergent structures that are comparable to the HiTOP model. These findings with different and important samples support the generalizability of the MMPI-3 in assessing HiTOP constructs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Introduction: Health care and culture are important to patient care. Theoretical frameworks, service delivery, and self-awareness are important to the provider/patient. Provider care varies, and studies are needed to understand the current interactions between providers, patients, and culture. Methodology: This was a prospective, descriptive correlational pilot study. Providers and patients completed a baseline assessment of culture, as well as a Brief Mood Introspection Scale at each visit at the patient's standard of care visit (i.e., visit as part of clinical procedures). Results: The providers and baseline assessment of culture showed higher than average cultural awareness. All four mood subscales show no statistically significant differences in patient or providers' mood. There were no significant differences in mood when considering differences and similarities between gender, race, and ethnicity. Discussion: There was no difference in patient or provider mood in this study when based on the differences or similarities in gender, race, and ethnicity.

We report 281 individuals carrying a pathogenic recurrent NF1 missense variant at p.Met1149, p.Arg1276, or p.Lys1423, representing three nontruncating NF1 hotspots in the University of Alabama at Birmingham (UAB) cohort, together identified in 1.8% of unrelated NF1 individuals. About 25% (95% confidence interval: 20.5-31.2%) of individuals heterozygous for a pathogenic NF1 p.Met1149, p.Arg1276, or p.Lys1423 missense variant had a Noonan-like phenotype, which is significantly more compared with the "classic" NF1-affected cohorts (all p < .0001). Furthermore, p.Arg1276 and p.Lys1423 pathogenic missense variants were associated with a high prevalence of cardiovascular abnormalities, including pulmonic stenosis (all p < .0001), while p.Arg1276 variants had a high prevalence of symptomatic spinal neurofibromas (p < .0001) compared with "classic" NF1-affected cohorts. However, p.Met1149-positive individuals had a mild phenotype, characterized mainly by pigmentary manifestations without externally visible plexiform neurofibromas, symptomatic spinal neurofibromas or symptomatic optic pathway gliomas. As up to 0.4% of unrelated individuals in the UAB cohort carries a p.Met1149 missense variant, this finding will contribute to more accurate stratification of a significant number of NF1 individuals. Although clinically relevant genotype-phenotype correlations are rare in NF1, each affecting only a small percentage of individuals, together they impact counseling and management of a significant number of the NF1 population., (© 2019 The Authors. Human Mutation Published by Wiley Periodicals, Inc.)

Background: A diagnosis of cancer, specifically a brain neoplasm, can be daunting and confusing to patients and their family members. It is important to find ways to provide education about diagnosis, symptoms, medications, treatment, and side effects in a usable and retrievable format., Objectives: The aim of this study was to examine the impact of the following three teaching strategies on patients' knowledge and understanding of their diagnosis., Methods: This was a prospective pre-/post-test pilot study including patients who had been diagnosed with brain neoplasms., Findings: Among 30 patients enrolled during a seven-month period, those who received strategy 3 had higher mean post-test knowledge scores compared to those who received strategy 1 or 2, but the difference was not statistically significant. The results suggest that TEAL-reinforced education is helpful for keeping appointments and may be associated with better knowledge retention regarding disease process and medications. In addition, fewer calls were made to the healthcare team in the strategy 3 group compared to the strategy 1 and 2 groups.

Background: Pupillary dysfunction is recognized as a sign of acute neurological deterioration due to worsening mass effect in patients with hemispheric strokes. Recent neuroimaging studies suggest that horizontal displacement of brain structures may be more important than vertical displacement in explaining these pupillary findings. Pupillometers allow objective and standardized evaluation of the pupillary light reflex. We hypothesized that pupillary data (Neurological Pupil index [NPi] and constriction velocity [CV]) obtained with a hand-held pupilometer, correlate with horizontal intracranial midline shift in patients with ischemic and hemorrhagic strokes., Methods: The ENDPANIC registry is a prospective database of pupillometer readings in neurological patients. There were 134 patients in the database with an acute ischemic stroke or intracerebral hemorrhage who had at least 2 neurologic imaging studies (CT or MRI) and pupillometer assessments performed within 6 hours of the imaging. Horizontal shift of the septum pellucidum (SPS) was measured in 293 images. We computed the correlation between SPS and the following pupillary variables: size, NPi, CV (left, right, and left-right difference), followed by a regression model to control for confounders., Results: There were 94 patients (70.1%) with an ischemic stroke and 40 patients (29.9%) had an intracerebral hemorrhage. After controlling for age, race, and gender, there was a significant correlation between the SPS and NPi (left [P < .001], right [P < .001]), CV (left [P < .005], right [P < .001]) pupillary asymmetry (absolute difference between right and left; P < .05), but not between SPS and pupillary size (left or right). There was a significant correlation between the NPi and CV for the right pupil when there was a right-to-left SPS (P < .001 and P < .05, respectively), but none between the NPi and CV for the left pupil and left-to-right SPS., Conclusions: In patients with ischemic and hemorrhagic strokes, there is a significant correlation between SPS and the NPi, CV and pupillary asymmetry, but not with pupillary size., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The present study investigated the comparability of laptop computer- and tablet-based administration modes for the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Employing a counterbalanced within-subjects design, the MMPI-2-RF was administered via both modes to a sample of college undergraduates ( N = 133). Administration modes were compared in terms of mean scale scores, internal consistency, test-retest consistency, external validity, and administration time. Mean scores were generally similar, and scores produced via both methods appeared approximately equal in terms of internal consistency and test-retest consistency. Scores from the two modalities also evidenced highly similar patterns of associations with external criteria. Notably, tablet administration of the MMPI-2-RF was substantially longer than laptop administration in the present study (mean difference 7.2 minutes, Cohen's d = .95). Overall, results suggest that varying administration mode between laptop and tablet has a negligible influence on MMPI-2-RF scores, providing evidence that these modes of administration can be considered psychometrically equivalent.

Purpose: Neurofibromatosis type 1 (NF1) is characterized by a highly variable clinical presentation, but almost all NF1-affected adults present with cutaneous and/or subcutaneous neurofibromas. Exceptions are individuals heterozygous for the NF1 in-frame deletion, c.2970&#95;2972del (p.Met992del), associated with a mild phenotype without any externally visible tumors., Methods: A total of 135 individuals from 103 unrelated families, all carrying the constitutional NF1 p.Met992del pathogenic variant and clinically assessed using the same standardized phenotypic checklist form, were included in this study., Results: None of the individuals had externally visible plexiform or histopathologically confirmed cutaneous or subcutaneous neurofibromas. We did not identify any complications, such as symptomatic optic pathway gliomas (OPGs) or symptomatic spinal neurofibromas; however, 4.8% of individuals had nonoptic brain tumors, mostly low-grade and asymptomatic, and 38.8% had cognitive impairment/learning disabilities. In an individual with the NF1 constitutional c.2970&#95;2972del and three astrocytomas, we provided proof that all were NF1-associated tumors given loss of heterozygosity at three intragenic NF1 microsatellite markers and c.2970&#95;2972del., Conclusion: We demonstrate that individuals with the NF1 p.Met992del pathogenic variant have a mild NF1 phenotype lacking clinically suspected plexiform, cutaneous, or subcutaneous neurofibromas. However, learning difficulties are clearly part of the phenotypic presentation in these individuals and will require specialized care.

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Purpose: This study assessed the effectiveness of patient-directed interventions for improving sleep quality in patients with cystic fibrosis and pulmonary hypertension., Methods: A nonrandomized, prospective pilot study was used to monitor the effectiveness of patient-initiated sleep preferences in 15 hospitalized patients., Results: During their stay, 53.3% of patients reported better sleep associated with the intervention, supporting the need for and efficacy of patient-driven sleep interventions., Conclusion: Patients unanimously recognized the need for sleep interventions and were open to seeking a good sleep hygiene regimen to improve their sleep quality while in the hospital.

Background: The quality of perimortem care received by patients who died at our hospitals was unknown., Objective: To describe the quality of hospital care experienced in the last week of life, as perceived by decedents' families., Design: Telephone survey that included established measures and investigator-developed content., Setting: Large, tertiary care center known for high-quality, cost-effective care., Participants: Family members of 104 patients who died in-hospital (10% of annual deaths) over the course of 1 year., Intervention: None., Measurements: Participant perceptions of the decedent's care, including symptom management, personal care, communication, and care coordination., Results: Decedents were mostly male (64%), white (96%), married (73%), and Christian (91%). Most survey participants were spouses of the decedent (68%); they were predominately white (98%), female (70%), and Christian (90%) and had a median age of 70 years (range, 35-91 years). Overall satisfaction was high. Pain, dyspnea, and anxiety or sadness were highly prevalent among decedents (73%, 73%, and 55%, respectively) but largely well managed. Most participants believed that decedents were treated respectfully and kindly by staff (87%) and that sufficient help was available to assist with medications and dressing changes (97%). Opportunities for improvement included management of decedents' anxiety or sadness (29%) and personal care (25%), emotional support of the family (57%), communication regarding decedents' illness (29%), and receiving contradictory or confusing information (33%)., Conclusion: Despite high satisfaction with care overall, we identified important unmet needs. Addressing these gaps will improve the care of dying patients.

Objective: Will emerging genetic research strengthen tobacco control programs? In this empirical study, we interview stakeholders in tobacco control to illuminate debates about the role of genomics in public health., Methods: The authors performed open-ended interviews with 86 stakeholders from 5 areas of tobacco control: basic scientists, clinicians, tobacco prevention specialists, health payers, and pharmaceutical industry employees. Interviews were qualitatively analyzed using standard techniques., Results: The central tension is between the hope that an expanding genomic knowledge base will improve prevention and smoking cessation therapies and the fear that genetic research might siphon resources away from traditional and proven public health programs. While showing strong support for traditional public health approaches to tobacco control, stakeholders recognize weaknesses, specifically the difficulty of countering the powerful voice of the tobacco industry when mounting public campaigns and the problem of individuals who are resistant to treatment and continue smoking., Conclusions: In order for genetic research to be effectively translated into efforts to minimize the harm of smoking-related disease, the views of key stakeholders must be voiced and disagreements reconciled. Effective translation requires honest evaluation of both the strengths and limitations of genetic approaches., (Copyright © 2011 S. Karger AG, Basel.)

[reaction: see text] A novel method for the synthesis of Delta(1)-1,2-diazetines is presented. Diels-Alder cycloaddition of dienophile 4 with five dienes afforded cycloadducts in good to excellent yields. Four of the obtained cycloadducts were converted to the corresponding diazetines.