Medicare and Amyloid PET Imaging: The Battle Over Evidence

We examine a recent dispute regarding the Centers for Medicare and Medicaid Services’ (CMS) refusal to unconditionally pay for amyloid positron emission tomography (PET) imaging for Medicare beneficiaries being assessed for Alzheimer’s disease. CMS will only pay for amyloid PET imaging when patients are enrolled in clinical trials that meet certain criteria. The dispute reflects CMS’s willingness in certain circumstances to require effectiveness evidence that differs from the Food and Drug Administration’s standard for pre-market approval of a medical intervention and reveals how stakeholders with differing perspectives about evidentiary standards have played a role in attempting to shape the Medicare program’s coverage policies.     

Attitudinal and behavioral differences between cigarette users who do and do not identify as “smokers”

Objective: The current research aimed to understand differences in smoking-related identity among college students and to illustrate the distinct characteristics of nonidentified smokers (NIS). Participants: Students from 2 colleges in Massachusetts (N = 538; April 2016). Methods: Respondents reported by online survey whether or not they had smoked a cigarette in the past 30 days and if they self-identified as smokers. Nonsmokers (NIS) and identified smokers (IS) were then compared on their smoking attitudes and behavior. Results: NIS made up 12.5% of the sample and 64% of all tobacco users. NIS perceived themselves as less addicted and were more confident in their ability to quit smoking. They also were less likely to smoke alone, buy their own cigarettes, or have friends who smoked. Conclusions: College health officials can best motivate NIS to quit smoking by focusing on peer norms and the potential of long-term addiction.     

Community Informant Explanations for Unusual Neighborhood Rates of Child Maltreatment Reports

This study explored perceptions of community informants on socioenvironmental factors that explain why rates of child maltreatment reporting are different in neighborhoods with similar population characteristics. This study used data from the SoCal Neighborhoods and Child Welfare study, a multiphase, mixed-methods study of neighborhoods in Los Angeles and San Diego counties. Semistructured qualitative interviews with key informants (N = 28) in 22 census tracts explored factors that account for differences in maltreatment rates among sociodemographically similar neighborhoods. Thematic content analysis revealed three themes regarding neighborhood contributors to maltreatment behaviors and reporting: (a) community norms and values, (b) community resources and providers, and (c) housing dynamics and built environment. Findings indicate complexity in forces that affect maltreatment behavior and reporting. Adding to research on neighborhood social dynamics and child maltreatment, findings suggest that composite indicators of maltreatment within neighborhoods are affected by maltreatment behaviors and the definition, recognition, and reporting of maltreatment.     

Self-Reported Losses Versus Actual Losses in Online Gambling: An Empirical Study

Many research findings in the gambling studies field rely on self-report data. A very small body of empirical research also suggests that when using self-report, players report their gambling losses inaccurately. The aim of the present study was to evaluate the differences between objective and subjective gambling spent data by comparing gambler’s actual behavioral tracking data with their self-report data over a 1-month period. A total of 17,742 Norwegian online gamblers were asked to participate in an online survey. Of those surveyed, 1335 gamblers answered questions relating to gambling expenditure that could be compared with their actual gambling behavior. The study found that the estimated loss self-reported by gamblers was correlated with the actual objective loss and that players with higher losses tended to have more difficulty estimating their gambling expenditure (i.e., players who spent more money gambling also appeared to have more trouble estimating their expenses accurately). Overall, the findings demonstrate that caution is warranted when using self-report data relating to amount of money spent gambling in any studies that are totally reliant on self-report data.     

Me,Myself, and Money II: Relative Deprivation Predicts Disordered Gambling Severity via Delay Discounting,Especially Among Gamblers Who Have a Financially Focused Self-Concept

In the current research, we examined whether the known link between relative deprivation and disordered gambling (via delay discounting; i.e., preferences for immediate smaller rewards relative to delayed larger rewards) is moderated by the extent to which gamblers have a financially focused self-concept. Specifically, we hypothesized that delay discounting would be a strong predictor of disordered gambling among those who base their self-worth on their financial success. To test this moderated-mediation model, a community sample of gamblers (N = 239) completed measures that assessed relative deprivation, delay discounting, financially focused self-concept, and disordered gambling severity. As predicted, people who felt more relative deprivation reported more severe symptoms of disordered gambling and this association was mediated by delay discounting. Importantly, this mediated relationship was moderated by the extent to which participants’ self-concept was focused on financial success. Among participants whose self-concept was high in financial focus, greater delay discounting (stemming from relative deprivation) was a strong predictor of disordered gambling. Among people whose self-concept was low in financial focus, delay discounting (stemming from relative deprivation) was a weak predictor of disordered gambling. Thus, the magnitude of the indirect effect of relative deprivation on disordered gambling severity was larger among people with a more financially focused self-concept—an effect mediated by delay discounting. These findings suggest that targeting gamblers’ financial focus in prevention and treatment interventions may be instrumental in curtailing the development and maintenance of disordered gambling.     

Caring is not enough: the importance of Internet skills for online privacy protection

This article explains Internet users’ self-help activities in protecting their privacy online using structural equation modeling. Based on a representative survey of Swiss Internet users, it reveals past experiences with privacy breaches as a strong predictor of current protective behavior. Further, in line with the ‘privacy paradox’ argument, caring about privacy (privacy attitudes) alone does not necessarily result in substantial self-protection. Most strikingly, however, general Internet skills are key in explaining users’ privacy behavior. These skills enable users to reduce risks of privacy loss while obtaining the benefits from online activities that increasingly depend on the revelation of personal data. Consequently, Internet skills are an essential starting point for public policies regarding users’ self-help in privacy protection.     

A Mixed-Methods Inquiry Into Trans* Environmental Microaggressions on College Campuses: Experiences and Outcomes

ABSTRACT

The experiences, including with environmental microaggressions, and well-being of trans* collegians remain an under-researched topic. In this mixed-methods study of a survey sample of 152 trans* collegians, multivariable regression findings suggest that the frequency of experiencing select trans* environmental microaggressions (e.g., not having access to comfortable bathrooms as a trans* person) are associated with increased risk for poorer academic outcomes (e.g., developmental challenges) but are not associated with mental health outcomes. Furthermore, interviews with 18 trans* collegians suggest that students face several systemic microaggressions, including difficulties advancing trans* inclusion. Various reactions, including paths of resistance, were identified. Implications are discussed.     

Inappropriate Comparisons: The LGB Population's Missing Reference Group

ABSTRACT

Given that many professional organizations emphasize the need for comparing assessment results to appropriate reference groups in their codes of ethics, we consider this practice through an ecological perspective as it applies to the lesbian, gay, and bisexual (LGB) population. The purpose of norming and types of assessment bias is discussed with respect to LGB population, which frequently lack specific norming data. The authors discuss whether the LGB population has characteristics similar to other commonly normed for groups and explore how group-shared constructs such as minority stress and internalized homophobia may introduce bias and affect the validity of assessments. A social anxiety assessment as well as a personality disorder inventory are examined for bias as case examples explaining how these assessments may exhibit bias when used with the LGB population. Increases in validity and effects on treatment planning are discussed as benefits of providing LGB-specific norms. Risks of providing these norms, such as minimizing subgroup differences and possibly increasing the risk of discrimination are also addressed before providing clinicians with recommendations as to how they may minimize the risk of bias in their assessment process.     

Sociopolitical and Cultural Correlates of Internalized Homonegativity in Gay and Bisexual Men: Findings from a Global Study

Objectives: Based on the premise that internalized homonegativity (IH) is a product of the incorporation of environmental heterosexism, the authors examined the influence of sociopolitical and individual influences on IH. Methods: The cross-sectional study consisted of 109,382 gay and bisexual men across 77 countries. Results: Variables at the (European) country-level that were associated with higher levels of IH included lack of laws recognizing same-sex relationships and perceived and actual negative gay-related public opinion about homosexuals. Individual-level variables significantly associated with IH were public opinion about homosexuals and exposure to gay-related victimization/discrimination. Conclusions: An improved sociopolitical climate for LGB individuals is needed.