Assessing the impact of insurance type on COVID-19 mortality in black and white patients in the largest healthcare system in the state of georgia.

IMPORTANCE: The increased COVID-19 mortality for Black individuals over White individuals may be explained by the known racial disparities in access to insurance. OBJECTIVE: To determine whether racial disparities in COVID-19 mortality still exist when Blacks and Whites are equally insured. DESIGN: Routinely collected data on race, mortality, type of insurance, known risk factors, and lab results from the EPIC Patient Management System were analyzed using a multivariable logistic regression model. SETTING: Piedmont Healthcare is the largest hospital system in Georgia. Due to its multiple locations across the state of Georgia, it receives a relatively equitably insured population. PARTICIPANTS: All patients hospitalized with a positive COVID-19 status between March 1 and November 30, 2020. MAIN OUTCOMES: We hypothesized that Black patients would not have higher odds of mortality than White patients, and that type of insurance would predict COVID-19 mortality. RESULTS: 6,881 (3,674 Black, 3,207 White; 48% male, mean age = 60) patients were included. Race was not a significant predictor of COVID-19 mortality (p>0.05). When controlling for age and insurance, the mortality rate for Black patients was not statistically significant from that for White patients (p>0.05). Compared to those relying on Medicare, patients with commercial (OR=0.68, 95% CI: 0.48-0.96) or out-of-pocket (self-pay) insurance (OR=0.22, 95% CI: 0.03-0.88) had lower odds of mortality. CONCLUSIONS: National trends of racial disparities in COVID-19 mortality may be partially explained by disparities in insurance.

Structure of Dark Triad Dirty Dozen Across Eight World Regions.

The Dark Triad (i.e., narcissism, psychopathy, Machiavellianism) has garnered intense attention over the past 15 years. We examined the structure of these traits' measure-the Dark Triad Dirty Dozen (DTDD)-in a sample of 11,488 participants from three W.E.I.R.D. (i.e., North America, Oceania, Western Europe) and five non-W.E.I.R.D. (i.e., Asia, Middle East, non-Western Europe, South America, sub-Saharan Africa) world regions. The results confirmed the measurement invariance of the DTDD across participants' sex in all world regions, with men scoring higher than women on all traits (except for psychopathy in Asia, where the difference was not significant). We found evidence for metric (and partial scalar) measurement invariance within and between W.E.I.R.D. and non-W.E.I.R.D. world regions. The results generally support the structure of the DTDD.

Emerging adult reactions to labeling regarding age-group differences in narcissism and entitlement.

Both academic and popular literatures have repeatedly contended that emerging adults are the most narcissistic and entitled age-group in modern times. Although this contention is fiercely debated, the message that emerging adults are narcissistic and entitled has saturated popular culture. Despite this saturation, relatively little empirical work has examined how emerging adults might react to such labels. Across three studies in five samples in the U.S., the present work sought to address this deficit in research. Results from cross-sectional samples of university students at two universities, as well as an online convenience sample of web-using adults (Study 1), indicated that emerging adults believe their age-group and the one following them (e.g., adolescents) to be the most narcissistic and entitled age-groups, that they have generally negative opinions of narcissism and entitlement, and that they respond negatively to being labeled as narcissistic and entitled. Additionally, results from adult web-users revealed that, while all age groups tend to view adolescents and emerging adults as more narcissistic and entitled than older age-groups, these opinions are more exaggerated among members of older age-groups. Finally, across two experimental studies (Studies 2 & 3), results indicated that emerging adults react negatively to labeling of their age-group as narcissistic and entitled, but no more negatively than they do to potentially related undesirable labels (e.g., oversensitive). Collectively, these results indicate that emerging adults are aware of and somewhat distressed by messaging that casts their age-group as the most narcissistic and entitled age-group ever.

Thinking Structurally About Narcissism: An Examination of the Five-Factor Narcissism Inventory and Its Components.

The Five-Factor Narcissism Inventory (FFNI) is a self-report measure of the traits linked to grandiose and vulnerable narcissism, as well as narcissistic personality disorder (NPD), from a five-factor model perspective (FFM). In the current studies, the factor structure of the FFNI was explored and the results supported the extraction of three factors: Antagonism (e.g., Arrogance), Neuroticism (e.g., Need for Admiration), and Agentic Extraversion (e.g., Authoritativeness). In Study 2, the FFNI factors manifested convergent validity with their corresponding Big Five domains and diverging relations with measures of grandiose and vulnerable narcissism, NPD, and self-esteem. Ultimately, the FFNI factors help explicate the differences between various expressions of narcissism such that all are related to Antagonism but differ with regard to Neuroticism (relevant to vulnerable narcissism and NPD) and Agentic Extraversion (relevant to grandiose narcissism and NPD). The results also highlight the complex relation between self-esteem and the traits that comprise narcissism measures.

A Psychological Exploration of Engagement in Geek Culture.

Geek culture is a subculture of enthusiasts that is traditionally associated with obscure media (Japanese animation, science fiction, video games, etc.). However, geek culture is becoming increasingly mainstream; for example, in the past year alone, Dragon*Con, a major Geek convention in Atlanta, Georgia, attracted an attendance of over 57,000 members. The present article uses an individual differences approach to examine three theoretical accounts of geek culture. Seven studies (N = 2354) develop the Geek Culture Engagement Scale (GCES) to quantify geek engagement and assess its relationships to theoretically relevant personality and individual differences variables. These studies present evidence that individuals may engage in geek culture in order to maintain narcissistic self-views (the great fantasy migration hypothesis), to fulfill belongingness needs (the belongingness hypothesis), and to satisfy needs for creative expression (the need for engagement hypothesis). Geek engagement is found to be associated with elevated grandiose narcissism, extraversion, openness to experience, depression, and subjective well-being across multiple samples. These data lay the groundwork for further exploration of geek culture as well as provide a foundation for examining other forms of subculture participation.

A comparison of the criterion validity of popular measures of narcissism and narcissistic personality disorder via the use of expert ratings.

The growing interest in the study of narcissism has resulted in the development of a number of assessment instruments that manifest only modest to moderate convergence. The present studies adjudicate among these measures with regard to criterion validity. In the 1st study, we compared multiple narcissism measures to expert consensus ratings of the personality traits associated with narcissistic personality disorder (NPD; Study 1; N = 98 community participants receiving psychological/psychiatric treatment) according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) using 5-factor model traits as well as the traits associated with the pathological trait model according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; American Psychiatric Association, 2013). In Study 2 (N = 274 undergraduates), we tested the criterion validity of an even larger set of narcissism instruments by examining their relations with measures of general and pathological personality, as well as psychopathology, and compared the resultant correlations to the correlations expected by experts for measures of grandiose and vulnerable narcissism. Across studies, the grandiose dimensions from the Five-Factor Narcissism Inventory (FFNI; Glover, Miller, Lynam, Crego, & Widiger, 2012) and the Narcissistic Personality Inventory (Raskin & Terry, 1988) provided the strongest match to expert ratings of DSM-IV-TR NPD and grandiose narcissism, whereas the vulnerable dimensions of the FFNI and the Pathological Narcissism Inventory (Pincus et al., 2009), as well as the Hypersensitive Narcissism Scale (Hendin & Cheek, 1997), provided the best match to expert ratings of vulnerable narcissism. These results should help guide researchers toward the selection of narcissism instruments that are most well suited to capturing different aspects of narcissism.