Harmonizing federal interagency traumatic brain injury research data to examine depression and suicide-related outcomes

OBJECTIVE

This proof-of-concept study was conducted to establish the feasibility of compiling Federal Interagency Traumatic Brain Injury Research (FITBIR) data pertaining to depression and suicide risk, with the secondary goal of improving understanding regarding these outcomes. FITBIR is a national repository of participant-level traumatic brain injury (TBI) data designed to address methodological limitations (e.g., small sample size, heterogeneity of injuries).

METHOD

FITBIR studies with TBI severity and measures related to depression and suicidal ideation were identified. Data were harmonized across relevant studies and grouped to identify "probable depression" and suicidal ideation, resulting in a large, combined sample. Rates of probable depression and suicidal ideation were described across the available studies, considering the influence of demographic and/or injury-related factors on outcomes.

RESULTS

Cross-sectional studies meeting criteria included four studies with depression outcomes and two with suicidal ideation outcomes. Two studies reported data appropriate for comparative analyses on depression. Combined results suggested that approximately 71% of participants were categorized as having probable depression. Participants with a history of mild TBI had 2.54 greater odds of probable depression (95% confidence interval [1.93, 3.34]) than those without a history of TBI.

CONCLUSIONS

Methods, harmonization code, and meta-databases related to TBI, probable depression, and suicidal ideation are now publicly available on the FITBIR website. Even with limited data, harmonization of FITBIR studies can serve as the basis for ongoing TBI and mental health research. Analyses will be more robust in the future as more studies with relevant outcome data are added to the FITBIR database. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A - 138 Using the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System to Understand Complex Associations between Traumatic Brain Injury and Alcohol or Substance Use

OBJECTIVE

Associations between traumatic brain injury (TBI) and alcohol or substance use are complex and likely bidirectional. The purpose of this project was to conduct a proof-of-concept study demonstrating our ability to compile patient-level TBI data from shared studies in the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System to improve our understanding of key TBI outcomes.

METHOD

We searched the FITBIR database for shared studies reporting alcohol or substance use among participants with TBI. We merged and harmonized data across the relevant studies to determine rates of alcohol or substance use by TBI severity.

RESULTS

In the alcohol use sample (N = 1539), 82% of participants had a history of mild TBI and 46% met criteria for alcohol use disorder (AUD). Participants with a history of mild TBI had 1.34 greater odds of screening positive for AUD (95% CI: 0.98, 1.82) and males had 2.48 increased odds of screening positive for AUD (95% CI: 1.67, 3.68). Unfortunately, due to limited data on substance use we were unable to conduct the intended analyses for this outcome.

CONCLUSIONS

Data support research and theory suggesting that rates of AUD are higher among individuals with mild TBI versus those without, particularly among males. Additionally, this proof-of-concept study established methods, created data harmonization and analysis code, and provided the TBI-SUD meta dataset back to FITBIR for dissemination. Further, numerous additional datasets have been shared with the FITBIR platform since the time of these analyses, which will allow our team and others to extend these analyses over time.

A - 10 Comorbid Traumatic Brain Injury and Posttraumatic Stress Disorder: Evidence from the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System

OBJECTIVE

Although posttraumatic stress disorder (PTSD) is common following traumatic brain injury (TBI; Greer et al., 2020), the complex association between these conditions requires further explication. Data repositories, such as FITBIR, which is the product of a national effort to compile individual participant-level TBI data from multiple studies into a unified database, provide a useful avenue for exploring the PTSD-TBI relationship. The present project is a proof-of-concept study demonstrating the ability to harmonize data from numerous shared studies to better understand comorbid PTSD following TBI.

METHOD

We searched for, merged, and harmonized data from studies with TBI and PTSD variables to analyze rates of probable PTSD across TBI severity categories. The methods and code used to extract, clean, standardize, and harmonize the data have been publicly shared and as additional studies are contributed to FITBIR, they will be added to these meta-datasets.

RESULTS

After harmonizing key variables across FITBIR datasets, the final sample consisted of 1633 participants. Approximately 79% of participants across studies had a history of mild TBI (mTBI) and 32-37% screened positive for PTSD. Those with mTBI had 2.8 greater odds of screening positive for PTSD compared to those with no TBI (95% CI: 1.90, 3.90).

CONCLUSIONS

Study findings show that unifying patient-level data is possible and can contribute to knowledge of complex medical and psychiatric comorbidity. These methods allow for nuanced analyses addressing diversity, equity, and inclusion issues often left out of single studies due to small sample sizes of minoritized groups within individual studies.

B - 47 Attentional Risk Factors for Suicidal Thoughts and Behaviors: a Synthesis of the Literature and Meta-Analysis

OBJECTIVE

Theory suggests that attentional processes, such as attentional bias and attentional control, may contribute to suicidal thoughts and behaviors (STBs). Specifically, among individuals with suicidal ideation, attentional biases towards suicide-related information may increase distress. This combined with the inability to disengage and shift attention away from suicidal thoughts (i.e., deficits in attentional control) might contribute to increased risk for suicidal behavior. Despite this, there has been limited research examining associations between attentional biases and STBs or attentional control and STBs.

METHOD

We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search terms used to identify articles included: ("attention* bias" or "attentional control") AND (suicid*). The search returned 77 articles, 49 when duplicates were removed. Following full text reviews, a total of 16 articles were retained for meta-analysis.

RESULTS

A significant relationship was observed between attentional bias and STBs (r = 0.10, 95% CI: 0.05, 0.15), but not attentional control and STBs (r = -0.07, 95% CI: -0.24, 0.10). The funnel plot for attentional bias and STBs suggested low risk of publication bias. The limited number of studies identified, and therefore low power, precluded moderator analyses from being conducted.

CONCLUSIONS

Additional experimental and longitudinal research with diverse assessments of attentional risk factors (e.g., dot probe, eye tracking) is needed. Despite these limitations, the present study provides preliminary evidence for the association between attentional bias and STBs.

Investigating the specific domains of the cognitive attentional syndrome that predict posttraumatic stress symptoms: The moderating effect of attentional control

The metacognitive model of posttraumatic stress disorder (PTSD) suggests that persistent use of the maladaptive self-regulation strategies that comprise the cognitive attentional syndrome (CAS) increases the likelihood of developing PTSD symptoms following trauma exposure. The metacognitive model also suggests that flexible regulation of attention might be protective against developing maladaptive outcomes that are associated with the CAS. The aims of this study were to (1) examine associations between all seven domains of the CAS and PTSD symptoms using a recently developed, multidimensional measure of the CAS, and (2) examine the moderating effect of self-reported attentional control on associations between the CAS and PTSD symptoms. Participants were trauma-exposed community adults (N = 237) who completed a battery of self-report measures. Results from linear regression analyses showed that worry, substance use, and internal threat monitoring accounted for unique variance in PTSD symptoms when all seven CAS domains were entered into the same model. Moderation analyses showed that attentional control dampened the effect of the CAS, specifically external threat monitoring, on PTSD symptoms. Study results support attentional control as a protective factor against the maladaptive effects of the CAS on PTSD symptoms.

The interactive effect of mental contamination and cognitive fusion on anxiety

OBJECTIVES

Mental contamination and cognitive fusion have been identified as risk factors for anxiety. The purpose of this study was to examine the moderating effect of cognitive fusion on the relationship between mental contamination and anxiety.

METHOD

Participants (N = 504 community adults), recruited via Amazon's Mechanical Turk (MTurk), completed measures of mental contamination, cognitive fusion, and anxiety.

RESULTS

Results from a regression analysis showed that the interaction between mental contamination and cognitive fusion predicted anxiety (β = 0.15, p < 0.001). Simple slopes analysis revealed a positive association between mental contamination and anxiety that was significant at higher (β = 0.25, p < 0.001), but not lower (β = 0.01, p = 0.88), levels of cognitive fusion.

CONCLUSION

The development of risk profiles that incorporate mental contamination and cognitive fusion may be beneficial for early identification of individuals at high risk for anxiety.

An Examination of the Factor Structure of the Multidimensional Psychological Flexibility Inventory

The Multidimensional Psychological Flexibility Inventory (MPFI), a 60-item self-report measure, assesses the Acceptance and Commitment Therapy Hexaflex. The factor structure of the MPFI was examined in this study. In a community sample of adults (N = 827), four models (correlated six-factor, one-factor, higher order, and bifactor) were tested for each of the constructs of interest (i.e., psychological flexibility and psychological inflexibility). All models, with the exception of the one-factor, provided adequate fit to the data. Differences between the three adequate fitting models were trivial in magnitude. Additional statistical indices from the bifactor models indicated that the general factors accounted for the large majority of reliable variance. The majority of the domain-specific factors evidenced redundancy with their respective general factors. Results from a series of structural regressions indicated that the domain-specific factors did not provide additional incremental utility above and beyond the general factors in predicting two relevant clinical constructs (i.e., health anxiety and depression). These results provide support for the use of the MPFI Flexibility and Inflexibility total scores, but not subscale scores. The MPFI may require further refinement to either greatly reduce the length of the measure, or to ensure that subscales have incremental utility.

The Moderating Effect of Attentional Control on the Relationship Between COVID Stress and Generalized Anxiety Symptoms

The recent global pandemic (i.e., COVID-19) has had a serious impact on psychological health, as the stress associated with the pandemic increases the likelihood of developing clinically significant anxiety. Evidence suggests that attentional control may protect those individuals with outcome-specific vulnerabilities from developing maladaptive psychological outcomes. In the present study, attentional control was examined as a moderator of the relation between COVID-19 stress and generalized anxiety symptoms in a community sample (N = 359 adults). As predicted, the relationship between COVID-19 stress and anxiety was moderated by attentional control. Specifically, as attentional control decreased, the strength of the association between COVID-19 stress and anxiety increased. The results suggest that, among those with higher levels of COVID-19 stress, attentional control may act as a protective factor against developing anxiety. It may be beneficial as a matter of standard public health guidance to recommend that the general public engages in activities that are known to improve attentional control and alleviate emotional distress (e.g., mindfulness-based techniques) at the outset of a pandemic or other global catastrophe to reduce the likelihood that prolonged event-related stress will lead to impairing anxiety.

Increasing cognitive load attenuates the moderating effect of attentional inhibition on the relationship between posttraumatic stress symptoms and threat-related attention bias variability

Theory and empirical evidence suggest that those with higher posttraumatic stress (PTS) symptoms and better attentional control (i.e., the strategic control of higher-order executive attention in regulating bottom-up, stimulus driven responses to prepotent stimuli; Sarapas et al., 2017) can use that ability to disengage and shift attention away from threat stimuli and reduce threat-related attentional dysregulation (i.e., avoidance/overcontrollers). Those with relatively worse attentional control lack the requisite resources to do this, leading to prolonged attentional engagement with threat stimuli and threat-related attention dysregulation (i.e., maintenance/undercontrollers). Given that attentional control is a limited resource, strategic avoidance of threat information or reduced threat-related attention dysregulation may not be possible among those with relatively higher attentional control when cognitive load is relatively high. To test this hypothesis, the interaction between PTS symptoms, attentional control, and cognitive load was examined as a predictor of threat-related attentional bias and threat-related attention bias variability. Participants (N = 125 undergraduate students) were randomly assigned to high or low load conditions. Participants completed self-report measures of PTS symptoms, a behavioral measure of attentional control, and a novel task that assessed threat-related attentional bias via eye movements and threat-related attention bias variability via button press. The results of a series of hierarchical regressions showed that attentional control moderated the relationship between PTS symptoms and threat-related attention bias variability in the low, but not high, load condition. This moderation effect was not observed for threat-related attentional bias assessed via eye-tracking. Consistent with theory, under conditions of higher cognitive load, overcontrollers may not be able to use attentional control to consistently regulate threat-related attention. Study findings suggest that it may be important to consider contextual factors that increase cognitive load, as well as individual differences in attentional control, when developing attention bias modification interventions to reduce PTS symptomatology.

Examining the Factor Structure and Incremental Validity of the Barkley Deficits in Executive Functioning Scale - Short Form in a Community Sample

The Barkley Deficits in Executive Functioning Scale - Short Form (BDEFS-SF; Barkley, 2011) was developed to assess deficits in five facets of executive functioning. Theoretical assumptions surrounding the BDEFS-SF presume that executive dysfunction is an overarching construct that consists of five domain-specific factors (i.e., a hierarchical model; Barkley, 2011). Prior research has supported a correlated five-factor model, but the tenability of hierarchical or bifactor models of the BDEFS-SF have not yet been tested. In the present study (N = 1,120 community adults), confirmatory factor analysis was used to compare four theoretically relevant models of the BDEFS-SF (i.e., one-factor, correlated five-factor, hierarchical, and bifactor models). The bifactor model provided the best fit to the data. However, the general factor accounted for the overwhelming majority of variance in BDEFS-SF scores and none of the domain-specific factors exhibited adequate construct replicability or factor determinancy. Further, the general factor accounted for the overhelming majority of variance in criterion variables (i.e., executive attention and health anxiety); the Organization and Emotion factors accounted for a small amount of unique variance in executive attention and the Emotion factor accounted for a small amount of unique variance in health anxiety. Taken together, study findings suggest that the BDEFS-SF has a strong general factor and independent use of the domain-specific factors is contraindicated.

Threat Bias and Emotion Recognition in Victims of IPV

Although there is growing evidence of the association between threat bias and psychopathology in many trauma-exposed populations, there are few studies with intimate partner violence (IPV) victims. The present study assessed threat bias in IPV victims. It also examined potential differences in facial recognition ability between victims and nonvictims. Participants were 153 female college students currently in a dating relationship. Participants completed demographic and abuse severity measures. They then completed a dot-probe task to assess threat bias, and a facial expression recognition task to assess speed and accuracy of recognition. Approximately 32% of the students sampled were currently in a physically abusive relationship. Results indicated that IPV victims had a bias toward fearful faces, and showed worse recognition of happy faces than nonvictims. These data suggest that the psychological impact of threat bias might vary temporally. Vigilance during threat may serve as a protective mechanism, whereas postthreat vigilance might be associated with psychopathology. Researchers should carefully consider the presence of threat bias in victim samples and include other victim groups in future assessments of threat bias. It will be important to test these relationships in other IPV victim samples, such as help-seeking victims and other community living victims.

The interactive effect of event centrality and maladaptive metacognitive beliefs on posttraumatic stress symptoms and posttraumatic growth

OBJECTIVE

Event centrality, the extent to which a traumatic event becomes a reference point for understanding the world and one's role in it, is related to both posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG). Given that higher event centrality is associated with both of these seemingly disparate postevent trajectories, research on potential moderators of these relationships is needed to better understand the conditions under which event centrality relates to one or both outcomes. Maladaptive metacognitive beliefs (i.e., beliefs about thinking, Wells & Matthews, 1994, 1996) might be one individual difference factor that influences the degree to which event centrality is related to PTS symptoms and PTG.

METHOD

In a laboratory session, undergraduate students (N = 149) completed self-report measures of event centrality, maladaptive metacognitive beliefs (negative and positive), PTS symptoms, and PTG. Analyses were conducted using structural equation modeling in order to account for shared variance between PTS symptoms and PTG.

RESULTS

As predicted, the positive relationship between event centrality and PTS symptoms became increasingly stronger as maladaptive metacognitive beliefs increased (i.e., both positive and negative metacognitive beliefs). The positive relationship between event centrality and PTG was stronger as maldaptive negative, but not positive, metacognitive beliefs decreased.

CONCLUSIONS

Study findings suggest that treatments designed to reduce maladaptive metacognitive beliefs could lead to reductions in PTS symptoms and increased opportunity for PTG among those with highly central traumatic events. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The interactive effect of emotional reactivity and maladaptive metacognitive beliefs on anxiety

Emotional reactivity has been implicated in the development and maintenance of anxiety. The metacognitive model suggests that maladaptive metacognitive beliefs (i.e. beliefs about thinking) may increase the impact of emotional reactivity on anxiety. As such, the purpose of the present study was to examine maladaptive metacognitive beliefs as a moderator of the relationship between emotional reactivity and anxiety in an undergraduate student sample (N = 78). Participants completed a battery of self-report measures and a negative emotion induction procedure during a single laboratory session. As predicted, higher levels of maladaptive metacognitive beliefs strengthened the relationship between emotional reactivity and anxiety. This effect was found in relation to negative (e.g. "My thoughts are uncontrollable"), but not positive (e.g. "Worrying will keep me safe"), metacognitive beliefs. Study results support the proposal that maladaptive metacognitive beliefs potentiate the effect of emotional reactivity on anxiety and suggest that preemptive efforts to reduce negative metacognitive beliefs may be beneficial among individuals prone to emotional reactivity.

The Interactive Effect of Happiness Emotion Goals and Emotion Regulation Self-Efficacy on Anxiety and Depression

Overvaluation of happiness might be a transdiagnostic risk factor for psychopathology. However, emotion regulation self-efficacy may influence the association between happiness emotion goals and psychopathology. The purpose of the present study was twofold. First, we sought to replicate prior findings showing that happiness emotion goals and depressive symptoms are positively related, but only among those with lower emotion regulation self-efficacy. Second, we examined whether the noted interaction effect would relate to generalized anxiety symptoms in a sample of general population adults (N = 504). Results from regression analyses were consistent with our predictions suggesting that individuals with unrealistic happiness emotion goals and low emotion regulation self-efficacy may be particularly prone to experiencing negative emotional states and psychological distress. Further, study findings suggest the possibility that the noted interaction has transdiagnostic value and it may be important to target emotion regulation self-efficacy in the service of alleviating internalizing psychopathology.

Addressing Psychometric Limitations of the Attentional Control Scale via Bifactor Modeling and Item Modification

The purpose of this three-part study was to identify and correct psychometric limitations of the Attentional Control Scale (ACS; Derryberry & Reed, 2002) via bifactor modeling and item modification. In Study 1 (N = 956), results from exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs) suggested that the multidimensionality of the ACS might be a function of a method effect (i.e., reverse coding). In Study 2 (N = 478), reverse-coded items were recoded in a straightforward manner and submitted to EFA. Results supported retention of 15 items and 2 factors. In Study 3 (N = 410), CFA was used to test the model identified in Study 2 and compare it to competing models (i.e., 1-factor, bifactor). The bifactor model exhibited the best fit to the data. However, results from bifactor analysis suggested that the structure of the ACS is more consistent with a unidimensional rather than multidimensional model. Additionally, the second domain-specific factor appears to be redundant with the general factor and both domain-specific factors are poorly defined and might be of little practical value. Taken together, results caution the use of the ACS subscales independent of the total score. Moreover, they support coding ACS items in a straightforward manner.

Identification and characterization of novel senescence-associated genes from barley (Hordeum vulgare) primary leaves

Leaf senescence is the final developmental stage of a leaf. The progression of barley primary leaf senescence was followed by measuring the senescence-specific decrease in chlorophyll content and photosystem II efficiency. In order to isolate novel factors involved in leaf senescence, a differential display approach with mRNA populations from young and senescing primary barley leaves was applied. In this approach, 90 senescence up-regulated cDNAs were identified. Nine of these clones were, after sequence analyses, further characterized. The senescence-associated expression was confirmed by Northern analyses or quantitative RealTime-PCR. In addition, involvement of the phytohormones ethylene and abscisic acid in regulation of these nine novel senescence-induced cDNA fragments was investigated. Two cDNA clones showed homologies to genes with a putative regulatory function. Two clones possessed high homologies to barley retroelements, and five clones may be involved in degradation or transport processes. One of these genes was further analysed. It encodes an ADP ribosylation factor 1-like protein (HvARF1) and includes sequence motifs representing a myristoylation site and four typical and well conserved ARF-like protein domains. The localization of the protein was investigated by confocal laser scanning microscopy of onion epidermal cells after particle bombardment with chimeric HvARF1-GFP constructs. Possible physiological roles of these nine novel SAGs during barley leaf senescence are discussed.

[Acetosulfam, a new sweetener. 1. synthesis and properties (author's transl)]

A survey is given of synthesis, chemical and physical properties, and hydrolytic stability of the new sweetener Acetosulfam (3,4-Dihydro-6-methyl-1,2,3-oxathiazin-4-one-2,2 dioxide potassium salt).