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Objective:
Therapist competence is considered essential for the success of psychotherapy. Feedback is an intervention which has the potential to improve therapist competence. The present study investigated whether competence feedback leads to an improvement of therapist competence and patient outcome.
Method:
Sixty-seven master-level clinical trainees were randomly assigned to either a competence feedback group (CFG) or a control group (CG). Patients with a diagnosis of major depression (N = 114) were randomly assigned to CFG or CG. Treatment included 20 individual sessions of cognitive behavioral therapy (CBT). In CFG, therapists received, parallel to the treatment, five competence feedbacks, based on videotaped therapy sessions. Independent raters assessed therapist competence with the Cognitive Therapy Scale (CTS) and provided the competence feedback. Patient outcome was evaluated with the Beck Depression Inventory-II (BDI-II) and therapeutic alliance (Helping Alliance Questionnaire [HAQ]) from both therapist's (HAQ-T) and patient's (HAQ-P) perspective were evaluated after each of the 20 sessions.
Results:
(a) Therapist competence (CTS) increased significantly more for CFG than CG. (b) Depression (BDI-II) decreased significantly across sessions for both groups, but without evidence for a group-differential benefit for the CFG. (c) Therapeutic alliance (HAQ-T/P) increased significantly across sessions for both groups from both perspectives, but without group differences. (d) There is a positive effect of BDI-II on CTS at the beginning and a negative effect of CTS on BDI-II at the end of therapy.
Conclusion:
Competence feedback improves therapists' independently rated competence, but there is no evidence that competence feedback in CBT leads to better outcome.
What is the public health significance of this article? This study suggests the substantial value of systematic competence feedback for improving therapist competence in the psychotherapy of depression. No significant effect of competence feedback on the reduction of reported depressive symptoms was found.
Previous studies (Hyona, Yan, & Vainio, 2018; Yan et al., 2014) have demonstrated that in morphologically rich languages a word's morphological status is processed parafoveally to be used in modulating saccadic programming in reading. In the present parafoveal preview study conducted in Finnish, we examined the exact nature of this effect by comparing reading of morphologically complex words (a stem + two suffixes) to that of monomorphemic words. In the preview-change condition, the final 3-4 letters were replaced with other letters making the target word a pseudoword; for suffixed words, the word stem remained intact but the suffix information was unavailable; for monomorphemic words, only part of the stem was parafoveally available. Three alternative predictions were put forth. According to the first alternative, the morphological effect in initial fixation location is due to parafoveally perceiving the suffix as a highly frequent letter cluster and then adjusting the saccade program to land closer to the word beginning for suffixed than monomorphemic words. The second alternative, the processing difficulty hypothesis, assumes a morphological complexity effect: suffixed words are more complex than monomorphemic words. Therefore, the attentional window is narrower and the saccade is shorter. The third alternative posits that the effect reflects parafoveal access to the word's stem. The results for the initial fixation location and fixation durations were consistent with the parafoveal stem-access view.
Sequential data assimilation of the stochastic SEIR epidemic model for regional COVID-19 dynamics
(2021)
Newly emerging pandemics like COVID-19 call for predictive models to implement precisely tuned responses to limit their deep impact on society. Standard epidemic models provide a theoretically well-founded dynamical description of disease incidence. For COVID-19 with infectiousness peaking before and at symptom onset, the SEIR model explains the hidden build-up of exposed individuals which creates challenges for containment strategies. However, spatial heterogeneity raises questions about the adequacy of modeling epidemic outbreaks on the level of a whole country. Here, we show that by applying sequential data assimilation to the stochastic SEIR epidemic model, we can capture the dynamic behavior of outbreaks on a regional level. Regional modeling, with relatively low numbers of infected and demographic noise, accounts for both spatial heterogeneity and stochasticity. Based on adapted models, short-term predictions can be achieved. Thus, with the help of these sequential data assimilation methods, more realistic epidemic models are within reach.
Factorial experiments in research on memory, language, and in other areas are often analyzed using analysis of variance (ANOVA). However, for effects with more than one numerator degrees of freedom, e.g., for experimental factors with more than two levels, the ANOVA omnibus F-test is not informative about the source of a main effect or interaction. Because researchers typically have specific hypotheses about which condition means differ from each other, a priori contrasts (i.e., comparisons planned before the sample means are known) between specific conditions or combinations of conditions are the appropriate way to represent such hypotheses in the statistical model. Many researchers have pointed out that contrasts should be "tested instead of, rather than as a supplement to, the ordinary 'omnibus' F test" (Hays, 1973, p. 601). In this tutorial, we explain the mathematics underlying different kinds of contrasts (i.e., treatment, sum, repeated, polynomial, custom, nested, interaction contrasts), discuss their properties, and demonstrate how they are applied in the R System for Statistical Computing (R Core Team, 2018). In this context, we explain the generalized inverse which is needed to compute the coefficients for contrasts that test hypotheses that are not covered by the default set of contrasts. A detailed understanding of contrast coding is crucial for successful and correct specification in linear models (including linear mixed models). Contrasts defined a priori yield far more useful confirmatory tests of experimental hypotheses than standard omnibus F-tests. Reproducible code is available from https://osf.io/7ukf6/.
The present study sets out to address two fundamental questions in the reading of continuous texts: Whether semantic and phonological information from upcoming words can be accessed during natural reading. In the present study we investigated parafoveal processing during the reading of Korean sentences, manipulating semantic and phonological information from parafoveal preview words. In addition to the first evidence for a semantic preview effect in Korean, we found that Korean readers have stronger and more long-lasting phonological than semantic activation from parafoveal words in second-pass reading. The present study provides an example that human mind can flexibly adjust processing priority to different types of information based on the linguistic environment.
The present study explored the age-related changes of eye movement control in reading-that is, where to send the eyes and when to move them. Different orthographies present readers with somewhat different problems to solve, and this might, in turn, be reflected in different patterns of development of reading skill. Participants of different developmental levels (Grade 3, N = 30; Grade 5, N = 27 and adults, N = 27) were instructed to read sentences for comprehension while their eye movements were recorded. Contrary to previous findings that have been well documented indicating early maturation of saccade generation in English, current results showed that saccade generation among Chinese readers was still under development at Grade 5, although immediate lexical processing was relatively well-established. The distinct age-related changes in eye movements are attributable to certain linguistic properties of Chinese including the lack of interword spaces and word boundary uncertainty. The present study offers an example of how human eye movement adapts to the orthographic environment.
During the reading of alphabetic scripts and scene perception, eye movements are programmed more efficiently in horizontal direction than in vertical direction. We propose that such a directional advantage may be due the overwhelming reading experience in the horizontal direction. Writing orientation is highly flexible for Traditional Chinese sentences. We compare horizontal and vertical eye movements during reading of such sentences and provide first evidence of a text-orientation effect on eye-movement control during reading. In addition to equivalent reading speed in both directions, more fine-grained analyses demonstrate a tradeoff between longer fixation durations and better fixation locations in vertical than in horizontal reading. Our results suggest that with extensive reading experience, Traditional Chinese readers can generate saccades more efficiently in vertical than in horizontal direction.
This article introduces a new corpus of eye movements in silent readingthe Russian Sentence Corpus (RSC). Russian uses the Cyrillic script, which has not yet been investigated in cross-linguistic eye movement research. As in every language studied so far, we confirmed the expected effects of low-level parameters, such as word length, frequency, and predictability, on the eye movements of skilled Russian readers. These findings allow us to add Slavic languages using Cyrillic script (exemplified by Russian) to the growing number of languages with different orthographies, ranging from the Roman-based European languages to logographic Asian ones, whose basic eye movement benchmarks conform to the universal comparative science of reading (Share, 2008). We additionally report basic descriptive corpus statistics and three exploratory investigations of the effects of Russian morphology on the basic eye movement measures, which illustrate the kinds of questions that researchers can answer using the RSC. The annotated corpus is freely available from its project page at the Open Science Framework: https://osf.io/x5q2r/.
During sentence reading, low spatial frequency information afforded by spaces between words is the primary factor for eye guidance in spaced writing systems, whereas saccade generation for unspaced writing systems is less clear and under debate. In the present study, we investigated whether word-boundary information, provided by alternating colors (consistent or inconsistent with word-boundary information) influences saccade-target selection in Chinese. In Experiment 1, as compared to a baseline (i.e., uniform color) condition, word segmentation with alternating color shifted fixation location towards the center of words. In contrast, incorrect word segmentation shifted fixation location towards the beginning of words. In Experiment 2, we used a gaze-contingent paradigm to restrict the color manipulation only to the upcoming parafoveal words and replicated the results, including fixation location effects, as observed in Experiment 1. These results indicate that Chinese readers are capable of making use of parafoveal word-boundary knowledge for saccade generation, even if such information is unfamiliar to them. The present study provides novel support for the hypothesis that word segmentation is involved in the decision about where to fixate next during Chinese reading.
Word recognition in sentence reading is influenced by information from both preview and context. Recently, semantic preview effect (SPE) was observed being modulated by the constraint of context, indicating that context might accelerate the processing of semantically related preview words. Besides, SPE was found to depend on preview time, which suggests that SPE may change with different processing stages of preview words. Therefore, it raises the question of whether preview time-dependent SPE would be modulated by contextual constraint. In this study, we not only investigated the impact of contextual constraint on SPE in Chinese reading but also examined its dependency on preview time. The preview word and the target word were identical, semantically related or unrelated to the target word. The results showed a significant three-way interaction: The SPE depended on contextual constraint and preview time. In separate analyses for low and high contextual constraint of target words, the SPE significantly decreased with an increase in preview duration when the target word was of low constraint in the sentence. The effect was numerically in the same direction but weaker and statistically nonsignificant when the target word was highly constrained in the sentence. The results indicate that word processing in sentences is a dynamic process of integrating information from both preview (bottom-up) and context (top-down).
Background: Dynamic balance keeps the vertical projection of the center of mass within the base of support while walking. Dynamic balance tests are used to predict the risks of falls and eventual falls. The psychometric properties of most dynamic balance tests are unsatisfactory and do not comprise an actual loss of balance while walking. Objectives: Using beam walking distance as a measure of dynamic balance, the BEAM consortium will determine the psychometric properties, lifespan and patient reference values, the relationship with selected “dynamic balance tests,” and the accuracy of beam walking distance to predict falls. Methods: This cross-sectional observational study will examine healthy adults in 7 decades (n = 432) at 4 centers. Center 5 will examine patients (n = 100) diagnosed with Parkinson’s disease, multiple sclerosis, stroke, and balance disorders. In test 1, all participants will be measured for demographics, medical history, muscle strength, gait, static balance, dynamic balance using beam walking under single (beam walking only) and dual task conditions (beam walking while concurrently performing an arithmetic task), and several cognitive functions. Patients and healthy participants age 50 years or older will be additionally measured for fear of falling, history of falls, miniBESTest, functional reach on a force platform, timed up and go, and reactive balance. All participants age 50 years or older will be recalled to report fear of falling and fall history 6 and 12 months after test 1. In test 2, seven to ten days after test 1, healthy young adults and age 50 years or older (n = 40) will be retested for reliability of beam walking performance. Conclusion: We expect to find that beam walking performance vis-à-vis the traditionally used balance outcomes predicts more accurately fall risks and falls. Clinical Trial Registration Number: NCT03532984.
On the ambiguity of interaction and nonlinear main effects in a regime of dependent covariates
(2017)
The analysis of large experimental datasets frequently reveals significant interactions that are difficult to interpret within the theoretical framework guiding the research. Some of these interactions actually arise from the presence of unspecified nonlinear main effects and statistically dependent covariates in the statistical model. Importantly, such nonlinear main effects may be compatible (or, at least, not incompatible) with the current theoretical framework. In the present literature, this issue has only been studied in terms of correlated (linearly dependent) covariates. Here we generalize to nonlinear main effects (i.e., main effects of arbitrary shape) and dependent covariates. We propose a novel nonparametric method to test for ambiguous interactions where present parametric methods fail. We illustrate the method with a set of simulations and with reanalyses (a) of effects of parental education on their children’s educational expectations and (b) of effects of word properties on fixation locations during reading of natural sentences, specifically of effects of length and morphological complexity of the word to be fixated next. The resolution of such ambiguities facilitates theoretical progress.
The complexity of eye-movement control during reading allows measurement of many dependent variables, the most prominent ones being fixation durations and their locations in words. In current practice, either variable may serve as dependent variable or covariate for the other in linear mixed models (LMMs) featuring also psycholinguistic covariates of word recognition and sentence comprehension. Rather than analyzing fixation location and duration with separate LMMs, we propose linking the two according to their sequential dependency. Specifically, we include predicted fixation location (estimated in the first LMM from psycholinguistic covariates) and its associated residual fixation location as covariates in the second, fixation-duration LMM. This linked LMM affords a distinction between direct and indirect effects (mediated through fixation location) of psycholinguistic covariates on fixation durations. Results confirm the robustness of distributed processing in the perceptual span. They also offer a resolution of the paradox of the inverted optimal viewing position (IOVP) effect (i.e., longer fixation durations in the center than at the beginning and end of words) although the opposite (i.e., an OVP effect) is predicted from default assumptions of psycholinguistic processing efficiency: The IOVP effect in fixation durations is due to the residual fixation-location covariate, presumably driven primarily by saccadic error, and the OVP effect (at least the left part of it) is uncovered with the predicted fixation-location covariate, capturing the indirect effects of psycholinguistic covariates. We expect that linked LMMs will be useful for the analysis of other dynamically related multiple outcomes, a conundrum of most psychonomic research.
This longitudinal study investigated patterns of developmental problems across depression, aggression, and academic achievement during adolescence, using two measurement points two years apart (N = 1665; age T1: M = 13.14; female = 49.6%). Latent Profile Analyses and Latent Transition Analyses yielded four main findings: A three-type solution provided the best fit to the data: an asymptomatic type (i.e., low problem scores in all three domains), a depressed type (i.e., high scores in depression), an aggressive type (i.e., high scores in aggression). Profile types were invariant over the two data waves but differed between girls and boys, revealing gender specific patterns of comorbidity. Stabilities over time were high for the asymptomatic type and for types that represented problems in one domain, but moderate for comorbid types. Differences in demographic variables (i.e., age, socio-economic status) and individual characteristics (i.e., self-esteem, dysfunctional cognitions, cognitive capabilities) predicted profile type memberships and longitudinal transitions between types.
As a contribution to a theoretical debate about the degree of high-level influences on saccade targeting during sentence reading, we investigated eye movements during the reading of structurally ambiguous Chinese character strings and examined whether parafoveal word segmentation could influence saccade-target selection. As expected, ambiguous strings took longer to process. More critically there were theoretically relevant interactions between ambiguity and launch site when first-fixation location and saccade amplitude served as dependent variables: Ambiguous strings in the parafovea triggered longer saccades and more rightward fixations for close launch sites than unambiguous ones; the reverse result was obtained for far launch sites. These crossover interactions indicate that parafoveal word segmentation influences saccade generation in Chinese and provide support of the hypothesis that high-level information can be involved in the decision about where to fixate next.
Saccades to single targets in peripheral vision are typically characterized by an undershoot bias. Putting this bias to a test, Kapoula [1] used a paradigm in which observers were presented with two different sets of target eccentricities that partially overlapped each other. Her data were suggestive of a saccadic range effect (SRE): There was a tendency for saccades to overshoot close targets and undershoot far targets in a block, suggesting that there was a response bias towards the center of eccentricities in a given block. Our Experiment 1 was a close replication of the original study by Kapoula [1]. In addition, we tested whether the SRE is sensitive to top-down requirements associated with the task, and we also varied the target presentation duration. In Experiments 1 and 2, we expected to replicate the SRE for a visual discrimination task. The simple visual saccade-targeting task in Experiment 3, entailing minimal top-down influence, was expected to elicit a weaker SRE. Voluntary saccades to remembered target locations in Experiment 3 were expected to elicit the strongest SRE. Contrary to these predictions, we did not observe a SRE in any of the tasks. Our findings complement the results reported by Gillen et al. [2] who failed to find the effect in a saccade-targeting task with a very brief target presentation. Together, these results suggest that unlike arm movements, saccadic eye movements are not biased towards making saccades of a constant, optimal amplitude for the task.
Although eye movements during reading are modulated by cognitive processing demands, they also reflect visual sampling of the input, and possibly preparation of output for speech or the inner voice. By simultaneously recording eye movements and the voice during reading aloud, we obtained an output measure that constrains the length of time spent on cognitive processing. Here we investigate the dynamics of the eye-voice span (EVS), the distance between eye and voice. We show that the EVS is regulated immediately during fixation of a word by either increasing fixation duration or programming a regressive eye movement against the reading direction. EVS size at the beginning of a fixation was positively correlated with the likelihood of regressions and refixations. Regression probability was further increased if the EVS was still large at the end of a fixation: if adjustment of fixation duration did not sufficiently reduce the EVS during a fixation, then a regression rather than a refixation followed with high probability. We further show that the EVS can help understand cognitive influences on fixation duration during reading: in mixed model analyses, the EVS was a stronger predictor of fixation durations than either word frequency or word length. The EVS modulated the influence of several other predictors on single fixation durations (SFDs). For example, word-N frequency effects were larger with a large EVS, especially when word N-1 frequency was low. Finally, a comparison of SFDs during oral and silent reading showed that reading is governed by similar principles in both reading modes, although EVS maintenance and articulatory processing also cause some differences. In summary, the EVS is regulated by adjusting fixation duration and/or by programming a regressive eye movement when the EVS gets too large. Overall, the EVS appears to be directly related to updating of the working memory buffer during reading.
Although eye movements during reading are modulated by cognitive processing demands, they also reflect visual sampling of the input, and possibly preparation of output for speech or the inner voice. By simultaneously recording eye movements and the voice during reading aloud, we obtained an output measure that constrains the length of time spent on cognitive processing. Here we investigate the dynamics of the eye-voice span (EVS), the distance between eye and voice. We show that the EVS is regulated immediately during fixation of a word by either increasing fixation duration or programming a regressive eye movement against the reading direction. EVS size at the beginning of a fixation was positively correlated with the likelihood of regressions and refixations. Regression probability was further increased if the EVS was still large at the end of a fixation: if adjustment of fixation duration did not sufficiently reduce the EVS during a fixation, then a regression rather than a refixation followed with high probability. We further show that the EVS can help understand cognitive influences on fixation duration during reading: in mixed model analyses, the EVS was a stronger predictor of fixation durations than either word frequency or word length. The EVS modulated the influence of several other predictors on single fixation durations (SFDs). For example, word-N frequency effects were larger with a large EVS, especially when word N-1 frequency was low. Finally, a comparison of SFDs during oral and silent reading showed that reading is governed by similar principles in both reading modes, although EVS maintenance and articulatory processing also cause some differences. In summary, the EVS is regulated by adjusting fixation duration and/or by programming a regressive eye movement when the EVS gets too large. Overall, the EVS appears to be directly related to updating of the working memory buffer during reading.
The Smoothing Spline ANOVA (SS-ANOVA) requires a specialized construction of basis and penalty terms in order to incorporate prior knowledge about the data to be fitted. Typically, one resorts to the most general approach using tensor product splines. This implies severe constraints on the correlation structure, i.e. the assumption of isotropy of smoothness can not be incorporated in general. This may increase the variance of the spline fit, especially if only a relatively small set of observations are given. In this article, we propose an alternative method that allows to incorporate prior knowledge without the need to construct specialized bases and penalties, allowing the researcher to choose the spline basis and penalty according to the prior knowledge of the observations rather than choosing them according to the analysis to be done. The two approaches are compared with an artificial example and with analyses of fixation durations during reading.