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The National Neuropsychology Network (NNN) is a multicenter clinical research initiative funded by the National Institute of Mental Health (NIMH; R01 MH118514) to facilitate neuropsychology’s transition to contemporary psychometric assessment methods with resultant improvement in test validation and assessment efficiency.
The NNN includes four clinical research sites (Emory University; Medical College of Wisconsin; University of California, Los Angeles (UCLA); University of Florida) and Pearson Clinical Assessment. Pearson Q-interactive (Q-i) is used for data capture for Pearson published tests; web-based data capture tools programmed by UCLA, which serves as the Coordinating Center, are employed for remaining measures.
NNN is acquiring item-level data from 500–10,000 patients across 47 widely used Neuropsychology (NP) tests and sharing these data via the NIMH Data Archive. Modern psychometric methods (e.g., item response theory) will specify the constructs measured by different tests and determine their positive/negative predictive power regarding diagnostic outcomes and relationships to other clinical, historical, and demographic factors. The Structured History Protocol for NP (SHiP-NP) helps standardize acquisition of relevant history and self-report data.
NNN is a proof-of-principle collaboration: by addressing logistical challenges, NNN aims to engage other clinics to create a national and ultimately an international network. The mature NNN will provide mechanisms for data aggregation enabling shared analysis and collaborative research. NNN promises ultimately to enable robust diagnostic inferences about neuropsychological test patterns and to promote the validation of novel adaptive assessment strategies that will be more efficient, more precise, and more sensitive to clinical contexts and individual/cultural differences.
Aggressive behaviour is a prevalent and harmful phenomenon in patients with borderline personality disorder (BPD). However, no short-term, low-cost programme exists that specifically focuses on aggression.
Attuning therapy modules to pathogenetic mechanisms that underlie reactive aggression in BPD, we composed a 6 week mechanism-based anti-aggression psychotherapy (MAAP) approach for the group setting, which we tested against a non-specific supportive psychotherapy (NSSP).
A cluster-randomised two-arm parallel-group phase II trial of N = 59 patients with BPD and overt aggressive behaviour was performed (German Registry for Clinical Trials, DRKS00009445). The primary outcome was the externally directed overt aggression score of the Modified Overt Aggression Scale (M-OAS) post-treatment (adjusted for pre-treatment overt aggression). Secondary outcomes were M-OAS irritability, M-OAS response rate and ecological momentary assessment of anger post-treatment and at 6 month follow-up, as well as M-OAS overt aggression score at follow-up.
Although no significant difference in M-OAS overt aggression between treatments was found post-treatment (adjusted difference in mean 3.49 (95% CI −5.32 to 12.31, P = 0.22), the MAAP group showed a clinically relevant decrease in aggressive behaviour of 65% on average (versus 33% in the NSSP group), with particularly strong improvement among those with the highest baseline aggression. Most notably, significant differences in reduction in overt aggression between MAAP and NSSP were found at follow-up.
Patients with BPD and aggressive behaviour benefited from a short group psychotherapy, with improvements particularly visible at 6 month follow-up. Further studies are required to show whether these effects are specific to MAAP.
In Germany, sheep are the main source of human Q fever epidemics, but data on Coxiella burnetii (C. burnetii) infections and related risk factors in the German sheep population remain scarce. In this cross-sectional study, a standardised interview was conducted across 71 exclusively sheep as well as mixed (sheep and goat) farms to identify animal and herd level risk factors associated with the detection of C. burnetii antibodies or pathogen-specific gene fragments via univariable and multivariable logistic regression analysis. Serum samples and genital swabs from adult males and females of 3367 small ruminants from 71 farms were collected and analysed using ELISA and qPCR, respectively. On animal level, univariable analysis identified young animals (<2 years of age; odds ratio (OR) 0.33; 95% confidence interval (CI) 0.13–0.83) to reduce the risk for seropositivity significantly (p < 0.05). The final multivariable logistic models identified lambing all year-round (OR 3.46/3.65; 95% CI 0.80–15.06/0.41–32.06) and purchases of sheep and goats (OR 13.61/22.99; 95% CI 2.86–64.64/2.21–239.42) as risk factors on herd level for C. burnetii infection detected via ELISA and qPCR, respectively.
How does the gender of a political leader affect policy compliance of the public during a public health crisis? State and national leaders have taken a variety of policy measures to combat the COVID-19 pandemic, with varying levels of success. While many female leaders have been credited with containing the spread of COVID-19, often through implementing strict policy measures, there is little understanding of how individuals respond to public health policy recommendations made by female and male leaders. This article investigates whether citizens are more willing to comply with strict policy recommendations about a public health issue when those recommendations are made by a female leader rather than a male leader. Using a survey experiment with American citizens, we compare individuals’ willingness to comply with policy along three dimensions: social distancing, face covering, and contact tracing. Our findings show that a leader's gender has little impact on policy compliance in general during the pandemic. These findings carry important implications for successful crisis management as well as understanding how a crisis in a nonmasculine issue context influences the effectiveness of a leader's ability to implement measures to mitigate the crisis.
Chapter 7 turns to closing the gendered qualification gap. I develop and experimentally test three strategies to close the gendered qualification gap. I show that simply providing voters with more information about female candidate qualifications is not enough to close the gendered information gap, and thereby the gendered qualification gap. Putting qualification information in context that tells voters that female candidates have more or better qualifications than male candidates effectively closes the gendered qualification gap. Self-promotion does not close the gendered qualification gap. This chapter points to the need for more research on how to disrupt the implicit biases voters bring with them to the ballot.
Chapter 3 addresses the question: How do ideas about gender, namely femininity and masculinity, affect what it means, from the voter’s perspective, to be qualified for political office? I apply social role theory to the development of political leadership in the United States to show how masculinity determines the expectations voters have for what a qualified political candidate looks like. Ideas about femininity and masculinity shape the expectations individuals hold for the different types of roles and occupations women and men hold. Caregiving roles are bound up in norms of femininity, and there is an intrinsic link between masculinity and leadership roles. The expectation that leaders have masculine qualities extends back to America’s founding and, indeed, well before the United States came into existence. I use two empirical tests of how masculinity influences thinking about political leadership and qualifications.
In Chapter 5, I draw on shifting standards theory, derived from social psychology research, to determine how and when voters hold candidates to gendered typicality standards. These standards provide voters with a comparative metric to assess whether a female and a male candidate have the qualifications needed for political office. These standards also clarify the subtle and pernicious role gender stereotypes play in how voters rate the qualifications of political candidates. The experiments I use in this chapter allow me to control the qualification information about the female and male candidates to trace how being a woman affects the way voters use this information in decision-making. I am also able to measure voters’ qualification expectations more directly to assess just how high the gendered qualification bar is for female candidates. This chapter shows that less qualified male candidates generally have a baseline electoral advantage over highly qualified female candidates.
Chapter 4 asks: What information do voters have about candidate qualifications? More specifically, this chapter hones in on whether there is a gendered information gap. I investigate the qualification information environment through content analyses of campaign websites as well as analyses of news coverage from the 2016 Senate elections. I gathered data on how female and male Senate candidates in 2016 presented their qualifications on their campaign websites. Female candidates, the results show, talk about their professional experiences much more than male candidates. I pair the campaign website analysis with an exhaustive content analysis of campaign news coverage of the 2016 Senate candidates. These results show a disjuncture in the information female candidates provide about themselves and the information presented in news coverage. Most female candidates talk about their political experience, but female candidates receive less political experience coverage relative to male candidates. The benefit of conducting content analyses in this chapter is that the method has a high level of external validity as I can draw conclusions about the actual amount of qualification information voters have about high-profile female candidates running in actual elections.
Chapter 1 lays the groundwork for developing my theory of the gendered qualification gap and the empirical tests I conduct in later chapters. I start by defining the gendered qualification gap. The gendered qualification gap explains the empirical phenomenon where female candidates are just as likely to win their elections as male candidates but win by smaller margins and run in more competitive races. This empirical outcome is taken by some scholars and political pundits to mean that there is no consequential bias in voter decision-making. Yet these successful women have better qualifications than their equally successful male counterparts. This means that highly qualified female candidates are just as likely to win their elections as less qualified male candidates. If there were no gender bias in voter decision-making, then female candidates would be more likely to win their elections compared with less qualified male candidates. This chapter discusses how current explanations overlook the role that gender bias plays in how voters evaluate candidate qualifications. Past research examines how institutional barriers and socialization patterns contribute to the gendered qualification gap, but missing from the extant body of scholarship is how voters contribute to the qualification gap.
Stereotypes about women and men influence how voters evaluate the qualifications of political candidates, but stereotypes about gender sharply intersect with stereotypes about political parties. Chapter 6 builds on Chapter 5 and investigates how stereotypes about Democrats and Republicans affects evaluations of Democratic and Republican female candidates. Voters stereotype Democrats as feminine and Republicans as masculine. These stereotypes, I contend, create a set of gendered partisan-typicality standards that affect how voters select candidates in primary elections. Republican female candidates face obstacles in primary elections where Republican voters are more likely to support a Republican male relative to a Republican female candidate. Partisan-typicality standards shaped by gender stereotypes contribute to the partisan gender gap in political representation.
Chapter 8 highlights the broader implications of this research for women seeking to enter positions characterized by masculine expectations and traditionally dominated by men. The gendered qualification gap applies not only to political leadership but to the many public institutions that underrepresent women. Women, in general, need better qualifications than men to succeed in business leadership, the legal field, STEM industries, higher education, and other institutions traditionally dominated by men. The gendered qualification gap creates steep entry barriers for women pursuing professions that typically underrepresent women. The result is that women are noticeably absent from public life.
Chapter 2 presents a brief history of women in political leadership. Arguments used to deny women suffrage and the full political rights of citizenship were deeply rooted in stereotypes that women lacked the stamina to excel in public life and that women’s proper roles were as mothers and caregivers. These beliefs that women lacked the qualifications needed to operate in political spheres still affect how voters view the political acumen of women running for political office today. I not only discuss the historic exclusion of women from positions of political leadership through the lens of gender stereotypes, but I also analyze over time public opinion data about the role of women in politics. Polling data offer an optimistic picture about the prospects of electing a qualified woman to the presidency. These data, however, do not provide insight into who constitutes a qualified female political candidate, and how the public might assess those qualifications. I answer these questions in subsequent chapters.