Sponge functional roles in a changing world.

Sponges are ecologically important benthic organisms with many important functional roles. However, despite increasing global interest in the functions that sponges perform, there has been limited focus on how such functions will be impacted by different anthropogenic stressors. In this review, we describe the progress that has been made in our understanding of the functional roles of sponges over the last 15 years and consider the impacts of anthropogenic stressors on these roles. We split sponge functional roles into interactions with the water column and associations with other organisms. We found evidence for an increasing focus on functional roles among sponge-focused research articles, with our understanding of sponge-mediated nutrient cycling increasing substantially in recent years. From the information available, many anthropogenic stressors have the potential to negatively impact sponge pumping, and therefore have the potential to cause ecosystem level impacts. While our understanding of the importance of sponges has increased in the last 15 years, much more experimental work is required to fully understand how sponges will contribute to reef ecosystem function in future changing oceans.

Archival oddities: Rosalie Rayner's application to take graduate classes.

In the history of psychology, Rosalie Rayner is known as a research assistant to behaviorist John B. Watson in the study of a baby named Albert, coauthor of articles describing that research, and coauthor of Psychological Care of Infant and Child. Rayner also wrote two magazine articles about her experience as a mother and the wife of Watson (Harris, 2014). Thanks to archivist James Stimpert, the author discovered that she was never a candidate for a graduate degree. In fall of 1919, she applied to take graduate classes at Hopkins and was accepted (Figure 1). However, she applied 2 weeks after classes had begun and never registered for any courses in the fall or spring semesters. Even more interesting, her application was approved by Watson on the same day she applied, which was a Saturday. The current author agrees with Romano-Lax and suggest that we appreciate Rayner's life and work without claiming her as a psychologist. While she deserves credit for her contributions to the Albert study and coauthored book on child care, her own voice is best heard when she looked beyond the field of psychology. In her 1932 article, "what future has motherhood?" she addressed the broader question of how the family could be restructured, which was being debated by feminists and other social reformers. While not consistently feminist, her perspective was dramatically different from her husband's. In Rayner Watson's view of the future, child care and other domestic work would be collectivized, as was being tried in the Soviet Union, freeing women for any activities they choose (Harris, 2014; R. R. Watson, 1932). Clearly, she had long left the laboratory, and her contributions should not be reduced to the "study of behavioral psychology" (Smirle, 2013). (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Notes from the archives: Margaret Floy Washburn and her cats.

Margaret Floy Washburn was one of the leading psychologists of her generation, whose most important work was The Animal Mind (Goodman, 1980). As E. G. Boring noted, that text "reflected her own love of animals and her intense interest in their behavior" (1971, p. 547). What about the role of animals in Washburn's personal life? (PsycInfo Database Record (c) 2023 APA, all rights reserved).

"Down with fascism, up with science": Activist psychologists in the U.S., 1932-1941.

At the height of the Depression, more psychologists in the U.S. were awarded degrees than could find jobs. Master's level graduates were particularly affected, holding positions that were tenuous, and they rejected second-class membership offered by the American Psychological Association. In response to this employment crisis, two Columbia University MA graduates created The Psychological Exchange, a journal that offered graduates and established colleagues a forum for news, job ads, and for discussing the expansion of psychology to address problems of the Depression. This article describes the Exchange and its unique window into psychologists debating how to reshape their field. In 1934, it was used by young Marxists to launch The Psychologists' League, which agitated for colleagues who lost their jobs, tried to make research socially relevant, and connected with movements for the "social reconstruction" of society. It raised the consciousness of its members and sympathizers by linking to worldwide antifascist struggles while fighting antisemitism and nativism at home. While previous accounts make the League seem a spontaneous eruption, this article shows how members of the Communist Party created it, then controlled its agenda and activities. During the Stalin-Hitler pact they followed Stalin's anti-war ideology and the League became a shell organization. Its members, nonetheless, creatively mixed psychological concepts and political ideology, drawing in colleagues through discussion groups, demonstrations, and social events. Sources for this work include unpublished correspondence, a diary, and Federal Bureau of Investigation files that reveal more complex lives than previously portrayed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Pilot study to evaluate hypercoagulation and inflammation using rotational thromboelastometry and calprotectin in COVID-19 patients.

INTRODUCTION: Abnormal coagulation and inflammation are hallmarks of SARs-COV-19. Stratifying affected patients on admission to hospital may help identify those who at are risk of developing severe disease early on. Rotational Thromboelastometry (ROTEM) is a point of care test that can be used to measure abnormal coagulation and calprotectin is a measure of inflammation. AIM: Assess if ROTEM can measure hypercoagulability on admission and identify those who will develop severe disease early on. Assess if calprotectin can measure inflammation and if there is a correlation with ROTEM and calprotectin. METHODS: COVID-19 patients were recruited on admission and ROTEM testing was undertaken daily for a period of 7 days. Additionally inflammatory marker calprotectin was also tested for the same period. RESULTS: 33 patients were recruited to the study out of which 13 were admitted to ITU and 20 were treated on the ward. ROTEM detected a hypercoagulable state on admission but did not stratify between those admitted to a ward or escalated to ITU. Calprotectin levels were raised but there was no statistical difference (p = 0.73) between patients admitted to a ward or escalated to ITU. Significant correlations were observed between FIBA5 (r = 0.62; p<0.00), FIBCFT (r = -0.57; p<0.00), FIBMCF (r = 0.64; p<0.00) and INMCF (r = 0.57; p<0.00) and calprotectin. CONCLUSION: COVID-19 patients were hypercoagulable on admission. The correlations between ROTEM and calprotectin underline the interactions between inflammation and coagulation.

Evaluating clinician experience in value-based health care: the development and validation of the Clinician Experience Measure (CEM).

BACKGROUND: Clinicians' experiences of providing care constitute an important outcome for evaluating care from a value-based healthcare perspective. Yet no currently available instruments have been designed and validated for assessing clinicians' experiences. This research sought to address this important gap by developing and validating a novel instrument in a public health system in Australia. METHODS: A multi-method project was conducted using co-design with 12 clinician leaders from a range of NSW Health Local Health Districts to develop the Clinician Experience Measure (CEM). Validity and reliability analyses were conducted in two stages, first assessing face and content validity with a pool of 25 clinicians and then using psychometric analysis with data from 433 clinicians, including nurses, doctors and allied health and representing all districts within one jurisdiction in Australia. RESULTS: Data gathered from 25 clinicians via the face and content validity process indicated that the initial 31-items were relevant to the range of staff employed in the NSW state health system, with minor edits made to the survey layout and wording within two items. Psychometric analysis led to a rationalised 18-item final instrument, comprising four domains: psychological safety (4-items); quality of care (5-items); clinician engagement (4-items) and interprofessional collaboration (5-items). The 18-item four-factor model produced a good fit to the data and high levels of reliability, with factor loadings ranging from .62 to .94, with Cronbach's alpha (range: .83 to .96) and composite reliability (range: .85 to .97). CONCLUSIONS: The CEM is an instrument to capture clinicians' experiences of providing care across a health system. The CEM provides a useful tool for healthcare leaders and policy makers to benchmark and assess the impact of value-based care initiatives and direct change efforts.

Archival Oddities: Leo Kamin Pounding out Copy for the Daily Worker.

This short research report focuses on psychologist Leon Kamin, who is best known for his research on what became known as the Kamin (blocking) effect. In the 1970s and 1980s he became prominent both inside and outside of psychology, not for laboratory research but for his writings on the heritability of intelligence. Kamin was no stranger to political activism. He joined the Communist Party U.S.A. at age 17, when he was a sophomore at Harvard. By 1949, he was writing for the Daily Worker (pen name: Leo Soft) and was employed as its New England editor in 1949-1950. In January 1954, Kamin was called to testify by Joseph McCarthy's anti-Communist Senate subcommittee, which was visiting Boston and justified its interest in Harvard by citing its winning research grants from the U.S. Department of Defense. Kamin refused to "name names" and he was indicted for contempt of the Senate. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Archival oddities: The manifesto of the upper left hand corner club.

Forty-two years ago, a small group within the Cheiron Society formed a dissident caucus, the Upper Left Hand Corner Club (ULHCC). The founding document, preserved in an old file folder, featured a diagram of the place of the history of psychology in relation to other fields, such as social history and the history of ideas. The goal of the caucus was to move the history of psychology to the upper left-hand corner of the diagram. That meant shifting the history of psychology from a somewhat immature version of the history of ideas, in which the precursors of late 20th century psychological theories could be discovered in the work of earlier figures ranging from Wilhelm Wundt and William James to William Wordsworth and Isaac Newton (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Eugenics, social reform, and psychology: The careers of Isabelle Kendig.

The psychologist Isabelle Kendig had two careers before earning her doctorate and rising to the position of chief psychologist at St. Elizabeths Hospital in Washington, DC. She began as a eugenic field worker in 1912, focusing on Shutesbury, Massachusetts, where she administered intelligence tests to the locals, collected gossip about their character, and created genealogical charts. When she presented her research to Charles Davenport and other social scientists concerned with social defect, Kendig dissented from eugenics orthodoxy. She was shunned by Davenport, who, in turn, falsified her findings to fit his beliefs. She was then hired by Massachusetts and New Hampshire to survey intellectual disability in each state. Following her work in eugenics, Kendig was briefly a leading figure in feminist and antimilitarist campaigns, including the National Women's Party and the 1924 presidential campaign of Senator Robert La Follette. In 1933, she earned a PhD in clinical psychology from Radcliffe and went on to help guide the field's post-WWII expansion. True to her feminist ideals and with the help of her husband, she juggled marriage, her three careers, and the parenting of four children. She thus serves as a noteworthy member of the second generation of women in psychology in the United States. Using unpublished correspondence between Kendig, her parents, and her future husband, this article offers a rare glimpse of a young feminist struggling to build a career and a life unconstrained by patriarchal norms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Are we asking the right questions? Working with the LGBTQ+ community to prioritise healthcare research themes.

BACKGROUND: Conversations about research priorities with members of the public are rarely designed specifically to include people who identify as Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) and are not researchers. METHODS: Generally, to address this gap, and specifically, to inform future research for CLS, we carried out a rapid review of published research priority sets covering LGBTQ+ topics, and an online workshop to prioritise identified themes. RESULTS: Rapid review: results. The rapid review identified 18 LGBTQ+ research priority sets. Some focussed on specific populations such as women or men, younger or older people or people living within families. Five addressed transgender and gender non- conforming populations. All of the research priority sets originated from English-speaking, high and middle-income countries (UK, US, Canada, and Australia), and date from 2016 onwards. Prioritization approaches were wide-ranging from personal commentary to expert workshops and surveys. Participants involved in setting priorities mostly included research academics, health practitioners and advocacy organisations, two studies involved LGBTQ+ public in their process. Research priorities identified in this review were then grouped into themes which were prioritised during the workshop. Workshop: results. For the workshop, participants were recruited using local (Cambridge, UK) LGBTQ+ networks and a national advert to a public involvement in research matching website to take part in an online discussion workshop. Those that took part were offered payment for their time in preparing for the workshop and taking part. Participants personal priorities and experiences contributed to a consensus development process and a final ranked list of seven research themes and participants' experiences of healthcare, mental health advocacy, care homes, caring responsibilities, schools and family units added additional context. CONCLUSIONS: From the workshop the three research themes prioritised were: healthcare services delivery, prevention, and particular challenges / intersectionality of multiple challenges for people identifying as LGBTQ+. Research themes interconnected in many ways and this was demonstrated by the comments from workshop participants. This paper offers insights into why these priorities were important from participants' perspectives and detail about how to run an inclusive and respectful public involvement research exercise. On a practical level these themes will directly inform future research direction for CLS.

Conversations about research priorities with members of the public who identify as Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ+) and are not researchers are not common.We reviewed published research priorities covering LGBTQ+ topics and held an online workshop. The review identified 18 LGBTQ+ research published priority sets. Some focussed on specific populations such as women or men, younger or older people or people living within families. Five were on transgender and gender non- conforming populations. Priorities were achieved by different methods such as workshops and surveys. People involved in setting priorities mostly included researchers, health practitioners and advocacy organisations, two studies involved LGBTQ+ public in their process. Research priorities identified in the review were grouped into themes which were prioritised during the workshop.For the online workshop, participants were recruited using local (Cambridge, UK) LGBTQ+ networks and a national advert and offered payment for their time. Participants personal priorities and experiences contributed to agreeing a final list of seven research themes in priority order. Participants' experiences of healthcare, mental health advocacy, care homes, caring responsibilities, schools and family units were helpful.From the workshop the three top research themes were: healthcare services delivery, prevention, and particular and multiple challenges of people identifying as lesbian, gay, bisexual, transgender or queer. Research themes interconnected in many ways as shown by the comments from workshop participants. This paper describes why these priorities were important from participants' perspective and offers information about how to run an inclusive and respectful public involvement research exercise.

Clinical characteristics and outcomes of COVID-19 in a low-prevalence, well resourced setting, Sydney, Australia.

BACKGROUND: The Northern Sydney Local Health District was one of the first health regions to be affected by COVID-19 in Australia. AIMS: To describe the clinical characteristics, risk factors and outcomes in our low-prevalence Australian population. METHODS: This is a retrospective analysis of 517 laboratory-confirmed COVID-19 cases between January and June 2020. Patient information was collected as part of routine care within the COVID-19 Virtual Hospital system. Outcomes examined were death, recovery at 30 days and intensive care unit (ICU) admission. RESULTS: The case fatality rate was 1.8%. Multivariate analysis showed factors independently associated with death, composite outcome of death/ICU admission or incomplete recovery at 30 days were age >80 years and presence of two or more comorbidities. Most cases acquired COVID-19 through international (50.9%) or cruise ship travel (9.1%). Healthcare workers comprised 12.8% of the cohort and represented a disproportionately high percentage of the 'unknown' source group (27.6%). The median incubation period was 5 days (interquartile range 3-8); one patient had an incubation period of 15 days. Hospitalisation was required in 11.8%, ICU admission in 2.1% and ventilation in 1.4%. A Radiographic Assessment of Lung Oedema score on chest X-ray of >10 was independently associated with death. CONCLUSIONS: In this low prevalence, well resourced Australian setting, we report an overall low mortality. Factors associated with adverse patient outcomes on multivariate analysis were age greater than 80 and the presence of two or more comorbidities. These data can assist in early risk stratification of COVID-19 patients, and in surge capacity planning for hospitals.

The Snake Pit: Mixing Marx with Freud in Hollywood.

In 1948, the motion picture The Snake Pit was released to popular and critical acclaim. Directed by Anatole Litvak, the film told of the mental illness and recovery of one patient, who survived overcrowding and understaffing and was treated by a neo-Freudian psychiatrist known as Dr. Kik. It was based on a novel of the same title by Mary Jane Ward, who had been treated at Rockland State Hospital in New York. Building upon exposés of horrid hospital conditions in the press, The Snake Pit helped motivate reforms in the treatment of the mentally ill. Via unpublished correspondence and drafts of the film's screenplay, this article explores the populist and antifascist themes in The Snake Pit, which came from the director, screenwriters, and the politics of the immediate post-WWII era. It also describes the case history of Mary Jane Ward and her treatment by Gerard Chrzanowski, the real "Dr. Kik." (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Quantification of the geometric uncertainty when using implanted markers as a surrogate for lung tumor motion.

BACKGROUND: Fiducial markers are used as surrogates for tumor location during radiation therapy treatment. Developments in lung fiducial marker and implantation technology have provided a means to insert markers endobronchially for tracking of lung tumors. This study quantifies the surrogacy uncertainty (SU) when using endobronchially implanted markers as a surrogate for lung tumor position. METHODS: We evaluated SU for 17 patients treated in a prospective electromagnetic-guided MLC tracking trial. Tumor and markers were segmented on all phases of treatment planning 4DCTs and all frames of pretreatment kilovoltage fluoroscopy acquired from lateral and frontal views. The difference in tumor and marker position relative to end-exhale position was calculated as the SU for both imaging methods and the distributions of uncertainties analyzed. RESULTS: The mean (range) tumor motion amplitude in the 4DCT scan was 5.9 mm (1.7-11.7 mm) in the superior-inferior (SI) direction, 2.2 mm (0.9-5.5 mm) in the left-right (LR) direction, and 3.9 mm (1.2-12.9 mm) in the anterior-posterior (AP) direction. Population-based analysis indicated symmetric SU centered close to 0 mm, with maximum 5th/95th percentile values over all axes of -2.0 mm/2.1 mm with 4DCT, and -2.3/1.3 mm for fluoroscopy. There was poor correlation between the SU measured with 4DCT and that measured with fluoroscopy on a per-patient basis. We observed increasing SU with increasing surrogate motion. Based on fluoroscopy analysis, the mean (95% CI) SU was 5% (2%-8%) of the motion magnitude in the SI direction, 16% (6%-26%) of the motion magnitude in the LR direction, and 33% (23%-42%) of the motion magnitude in the AP direction. There was no dependence of SU on marker distance from the tumor. CONCLUSION: We have quantified SU due to use of implanted markers as surrogates for lung tumor motion. Population 95th percentile range are up to 2.3 mm, indicating the approximate contribution of SU to total geometric uncertainty. SU was relatively small compared with the SI motion, but substantial compared with LR and AP motion. Due to uncertainty in estimations of patient-specific SU, it is recommended that population-based margins are used to account for this component of the total geometric uncertainty.

Geometric uncertainty analysis of MLC tracking for lung SABR.

PURPOSE: The purpose of this work was to report on the geometric uncertainty for patients treated with multi-leaf collimator (MLC) tracking for lung SABR to verify the accuracy of the system. METHODS: Seventeen patients were treated as part of the MLC tracking for lung SABR clinical trial using electromagnetic beacons implanted around the tumor acting as a surrogate for target motion. Sources of uncertainties evaluated in the study included the surrogate-target positional uncertainty, the beam-surrogate tracking uncertainty, the surrogate localization uncertainty, and the target delineation uncertainty. Probability density functions (PDFs) for each source of uncertainty were constructed for the cohort and each patient. The total PDFs was computed using a convolution approach. The 95% confidence interval (CI) was used to quantify these uncertainties. RESULTS: For the cohort, the surrogate-target positional uncertainty 95% CIs were ±2.5 mm (-2.0/3.0 mm) in left-right (LR), ±3.0 mm (-1.6/4.5 mm) in superior-inferior (SI) and ±2.0 mm (-1.8/2.1 mm) in anterior-posterior (AP). The beam-surrogate tracking uncertainty 95% CIs were ±2.1 mm (-2.1/2.1 mm) in LR, ±2.8 mm (-2.8/2.7 mm) in SI and ±2.1 mm (-2.1/2.0 mm) in AP directions. The surrogate localization uncertainty minimally impacted the total PDF with a width of ±0.6 mm. The target delineation uncertainty distribution 95% CIs were ±5.4 mm. For the total PDF, the 95% CIs were ±5.9 mm (-5.8/6.0 mm) in LR, ±6.7 mm (-5.8/7.5 mm) in SI and ±6.0 mm (-5.5/6.5 mm) in AP. CONCLUSION: This work reports the geometric uncertainty of MLC tracking for lung SABR by accounting for the main sources of uncertainties that occurred during treatment. The overall geometric uncertainty is within ±6.0 mm in LR and AP directions and ±6.7 mm in SI. The dominant uncertainty was the target delineation uncertainty. This geometric analysis helps put into context the range of uncertainties that may be expected during MLC tracking for lung SABR (ClinicalTrials.gov registration number: NCT02514512).

When and why did Laurel Furumoto become a historian of psychology?

Laurel Furumoto was a pioneer in establishing the history of women in psychology as a research specialty. Knowing Laurel and her work, the author was surprised to read recently in the Journal of the History of the Behavioral Sciences that for the 1974 EPA meeting, "Laurel Furumoto was recruited [by Tom Cadwallader] to research Mary Whiton Calkins since she taught at Wellesley College where Calkins spent her career." Although it was probably inadvertent, this attribution erased Laurel's interest in Calkins as a graduate student and her 4 years of historical research. Instead, she was portrayed as being given an assignment by a male colleague in 1973 because she taught at Wellesley. Fortunately, the author recently unearthed a letter that Laurel gave him long ago in which John Popplestone acknowledged her plan to work exclusively on Calkins beginning in 1969 and suggested she collaborate with someone scheduled to present a paper on Calkins. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Journals, referees, and gatekeepers in the dispute over Little Albert, 2009-2014.

In this article, I examine the rise and fall of recent claims about the identity of John B. Watson and Rosalie Rayner's subject "Albert B." (Watson & Rayner, 1920). Using medical records from 1919 to 1920 and close readings of published work, I argue that articles by Beck, Fridlund, and colleagues (Beck, Levinson, & Irons, 2009; Fridlund, Beck, Goldie, & Irons, 2012) were based on questionable logic and selective reporting of data. Using unpublished correspondence, media coverage, and editorial exchanges, I offer a backstage look at the process by which claims about Albert's identity were published and then contradicted by new research. In publicizing both sides of this controversy, textbook authors and journalists played a more constructive role than critics of popularization might expect. Rather than a simple case of truth winning out over falsehood, this seems to have been a clash of rhetorical styles and sources of authority. That clash complicated the process of peer review, which became a negotiation over conflicting criteria from different disciplines. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Practicing mind-body medicine before Freud: John G. Gehring, the "Wizard of the Androscoggin".

This article describes the psychotherapy practice of physician John G. Gehring and places it in historical context. Forgotten today, Gehring was a highly sought-after therapist from the 1890s to the 1920s by prominent figures in the arts, sciences, business, and law. He practiced a combination of work therapy, suggestion, and autosuggestion that has similarities to Cognitive Behavior Therapy and Behavioral Activation. Using biographies, memoirs, and archival records, the details of Gehring's work are reconstructed and the reasons for its success are analyzed. His invisibility in the history of psychiatry is attributed to the later dominance of Freudianism within the field.

From a small local audit to a regional quality improvement project - Improving lung protective ventilation.

BACKGROUND: Lung protective ventilation with tidal volumes (VT) of 6-8 ml per kg ideal body weight have been shown to reduce mortality in patients with acute respiratory distress syndrome and reduce post-operative pulmonary complications in major abdominal surgery. Following a local audit on weight recording, the Southcoast Perioperative Audit and Research Collaboration (SPARC) conducted a regional multi-disciplinary survey on the current practice in lung protective ventilation in the Wessex region. This resulted in a quality improvement project improving lung protective ventilation across these intensive care units. METHODS: Over one-week period in January over two consecutive years, lung protective ventilation parameters of mandatory ventilated patients (above the age of 18 years) were audited in intensive care units in the Wessex region. RESULTS: A total 1843 hours of mandatory ventilation were audited. The quality improvement project led to an improvement of lung protective ventilation with an average of 30% higher duration of ventilation with VT < 8 ml/kg ideal body weight. There was a suggestion that documentation of height and weight on admission to intensive care units improved compliance with lung protective ventilation. CONCLUSIONS: Adherence to lung protective ventilation is variable across intensive care units but can be improved by recording patient's weight and height accurately and using simple chart to help calculate the appropriate tidal volume. Additionally, this project demonstrates how a regional audit and quality improvement network can help to facilitate regional quality improvement.

A comparison of the neuropsychological profiles of people living in squalor without hoarding to those living in squalor associated with hoarding.

OBJECTIVE: Squalor affects 1 in 1000 older people and is regarded as a secondary condition to other primary disorders such as dementia, intellectual impairment and alcohol abuse. Squalor frequently is associated with hoarding behaviour. We compared the neuropsychological profile of people living in squalor associated with hoarding to those presenting with squalor only. METHODS: This study is a retrospective case series of hospital inpatient and community healthcare services of 69 people living in squalor (49 from aged care, 16 from aged psychiatry, 3 from acute medical and 1 from a memory clinic). Forty per cent had co-morbid hoarding behaviours. The main outcomes were neuropsychologists' opinions of domain-specific cognitive impairment. RESULTS: The squalor-hoarding group (M age 75.8, SD = 6.9,) was significantly older (p < 0.05) than the squalor-only group (M age 69.9 years, SD = 13.1), significantly more likely to have vascular or Alzheimer's type neurodegeneration (p < 0.05) and significantly less likely to have alcohol-related impairment (p < 0.05). Chi-square analyses revealed significantly greater rates of impairment for the squalor-only group (p < 0.05) in visuospatial reasoning, abstraction, planning, organisation, problem solving and mental flexibility, compared with the squalor-hoarding group. Logistic regression analysis indicated that impaired mental flexibility was a significant predictor and strongly indicated squalor only (odds ratio = 0.07; 95% confidence interval: 0.01-0.82). CONCLUSIONS: Preliminary evidence suggests that squalor associated with hoarding may have distinct neuropsychological features compared against squalor only. Future work should be conducted using a larger sample and a common neuropsychological battery to better understand the deficits associated with hoarding-related squalor. Copyright © 2016 John Wiley & Sons, Ltd.