Network Inference With the Lasso

Calculating confidence intervals and p-values of edges in networks is useful to decide their presence or absence and it is a natural way to quantify uncertainty. Since lasso estimation is often used to obtain edges in a network, and the underlying distribution of lasso estimates is discontinuous and has probability one at zero when the estimate is zero, obtaining p-values and confidence intervals is problematic. It is also not always desirable to use the lasso to select the edges because there are assumptions required for correct identification of network edges that may not be warranted for the data at hand. Here, we review three methods that either use a modified lasso estimate (desparsified or debiased lasso) or a method that uses the lasso for selection and then determines p-values without the lasso. We compare these three methods with popular methods to estimate Gaussian Graphical Models in simulations and conclude that the desparsified lasso and its bootstrapped version appear to be the best choices for selection and quantifying uncertainty with confidence intervals and p-values.

Multimodality and skewness in emotion time series

The ability to measure emotional states in daily life using mobile devices has led to a surge of exciting new research on the temporal evolution of emotions. However, much of the potential of these data still remains untapped. In this paper, we reanalyze emotion measurements from seven openly available experience sampling methodology studies with a total of 835 individuals to systematically investigate the modality (unimodal, bimodal, and more than two modes) and skewness of within-person emotion measurements. We show that both multimodality and skewness are highly prevalent. In addition, we quantify the heterogeneity across items, individuals, and measurement designs. Our analysis reveals that multimodality is more likely in studies using an analog slider scale than in studies using a Likert scale; negatively valenced items are consistently more skewed than positive valenced items; and longer time series show a higher degree of modality in positive and a higher skew in negative items. We end by discussing the implications of our results for theorizing, measurement, and time series modeling. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Network intervention analysis of anxiety-related outcomes and processes of acceptance and commitment therapy (ACT) for anxious cancer survivors

OBJECTIVE

Psychotherapies like Acceptance and Commitment Therapy (ACT) are thought to target multiple clinical outcomes by intervening on multiple mechanistic process variables. However, the standard mediation approach does not readily model the potentially complex associations among multiple processes and outcomes. The current study is one of the first to apply network intervention analysis to examine the putative change processes of a psychotherapy.

METHODS

Using data from a randomized trial of ACT versus minimally-enhanced usual care for anxious cancer survivors, we computed pre-to post-intervention (n = 113) residualized change scores on anxiety-related outcomes (general anxiety symptoms, cancer-related trauma symptoms, and fear of cancer recurrence) and putative processes of the intervention (experiential avoidance, self-compassion, and emotional approach coping). We estimated a network model with intervention condition and residualized change scores as nodes.

RESULTS

Contrary to the expectation that intervention effects would pass indirectly to outcomes via processes, network analysis indicated that two anxiety-related outcomes of the trial may have acted as primary mechanisms of the intervention on other outcome and process variables.

CONCLUSIONS

Network intervention analysis facilitated flexible evaluation of ACT's change processes, and offers a new way to test whether change occurs as theorized in psychotherapies.

Selbstmanagementförderung bei chronischer Krankheit für Menschen mit Migrationshintergrund – ein Gruppenkurs mit Peer-Ansatz als Beitrag zu gesundheitlicher Chancengerechtigkeit

Ziel: Begrenzte Gesundheits- und Sprachkompetenz erschweren Menschen mit Migrationshintergrund (MmM) den Zugang zu Gesundheitsinformationen und -versorgung, gerade bei chronischer Krankheit. Bei der Einführung eines Peer-geleiteten Stanford Selbstmanagementkurses bei chronischer Krankheit wurde in der Schweiz großes Interesse und hohe Motivation von MmM beobachtet. Daher wurde eruiert, ob das Kursprogramm auf Deutsch bei moderaten Sprachkenntnissen umsetzbar ist.

Methodik: Dies ist der explorative Teil der Begleitstudie zur Einführung des Stanford Programms in der Schweiz und im deutschsprachigen Europa. Angelehnt an Prinzipien der Grounded Theory wurden leitfadengestützte Fokusgruppen- und Einzelinterviews mit Kursteilnehmerinnen, -leiterinnen und -koordination (n=30) geführt, die thematisch ausgewertet wurden. Im Fokus der Datenerhebung standen die Durchführbarkeit, Zufriedenheit und Kursinhalte.

Ergebnisse: Der Kurs stößt bei MmM auf positive Resonanz und scheint auf Deutsch prinzipiell durchführbar zu sein, hohe Alltagsrelevanz zu haben sowie Impulse zur Integration zu setzen.

Schlussfolgerung: Zu prüfen ist ein weiterer Anpassungsbedarf auf den Migrationskontext, um den Kurs vulnerablen Gruppen besser zugänglich zu machen.

[Correction: Chronic Disease Self-management Support for People with a Migrant Background: towards a Peer-led Group Program to Improve Equity in Health]

Zanoni S, Gabriel E, Salis Gross C, Deppeler M, Haslbeck J. Selbstmanagementförderung bei chronischer Krankheit für Menschen mit Migrationshintergrund – ein Gruppenkurs mit Peer-Ansatz als Beitrag zu gesundheitlicher Chancengerechtigkeit. Gesundheitswesen 2016;

Bei diesem Beitrag wurde der engl. Titel korrigiert. Korrekt ist: Chronic Disease Self-management Support for People with a Migrant Background: towards a Peer-led Group Program to Improve Equity in Health

[Incidence and prevalence of postoperative acute confusion in heart surgery patients after coronary artery bypass and heart valve replacement surgeries]

Compared to foreign countries, Germany does not have data about the occurrence of acute confusion following heart-surgery. However, the occurrence of acute confusion does extend the hospital length of stay for up to 13 days. Thus, this phenomenon is of high relevance to nursing. This prevalence/incidence study was implemented with the goal of obtaining exact information on the incidence rate of acute postoperative confusion after a heart surgery through a multicenter evaluation. The data evaluation took place in the form of a convenience sample survey in three different German clinics specializing on heart surgeries. The observation period lasted from the day of the surgery up to the fifth postoperative day. In the context of this prospective Cohort-study all patients aged 18 and older who had heart surgery between February 1st and April 30th, 2000, were considered suitable as participants in the study. In the end, 860 patients were included in this study. 152 patients (17.4%) showed symptoms of acute confusion (confidence interval 14-20%). Certain circumstances seemed to predispose patients to acute confusion. A widespread occurrence could be observed particularly at night. Patients aged 81-91 were mainly affected. A confusion rate of 43.5% could be determined for this group. These results confirm the clinical importance and suggest interdisciplinary approaches for solution.