Is cognition integral to psychopathology? A population-based cohort study.

BACKGROUND: Lower cognitive functioning has been documented across psychiatric disorders and hypothesized to be a core deficit of mental disorders. Situating psychopathology and cognition as part of a unitary construct is therefore important to understanding the etiology of psychiatric disorders. The current study aims to test competing structural models of psychopathology and cognition in a large national cohort of adolescents. METHODS: The analytic sample consisted of 1189 participants aged 16-17 years, screened by the Israeli Draft Board. Psychopathology was assessed using a modified version of the Brief Symptom Inventory, and cognition was assessed based on four standardized test scores ((1) mathematical reasoning, concentration, and concept manipulation; (2) visual-spatial problem-solving skills and nonverbal abstract reasoning; (3) verbal understanding; (4) categorization and verbal abstraction). Confirmatory factor analysis was implemented to compare competing structural models of psychopathology with and without cognition. Sensitivity analyses examined the models in different subpopulations. RESULTS: Confirmatory factor analysis indicated a better model fit of psychopathological symptoms without cognition (RMSEA = 0.037; TLI = 0.991; CFI = 0.992) than with cognition (RMSEA = 0.04-0.042; TLI = 0.987-0.988; CFI = 0.988-0.989). Sensitivity analyses supported the robustness of these results with a single exception. Among participants with low cognitive abilities (N = 139), models that integrated psychopathological symptoms with cognition had a better fit compared to models of psychopathology without cognition. CONCLUSIONS: The current study suggests that cognition and psychopathology are, generally, independent constructs. However, within low cognitive abilities, cognition was integral to the structure of psychopathology. Our results point toward an increased vulnerability to psychopathology in individuals with low cognitive abilities and may provide valuable information for clinicians.

From face-to-face to remote evaluation of teacher-education candidates during the COVID-19 pandemic.

Although teacher's personality is an essential component of successful classroom learning, most teacher education programs accept students solely on the basis of scholastic ability scores such as school grades, national test scores (SAT, GRE) or undergraduate college transcripts. To ensure suitability to teaching, a personality-evaluation system was developed in Israel for teacher education candidates. This evaluation system includes non-cognitive measures, such as group dynamic exercises, simulations, a teaching exercise, situational judgement tests, personality tests and an inter-personal interview, all performed face-to-face (FTF) at a testing center. The outbreak of COVID-19 in 2020 brought about lockdowns and social distancing, precluding the administration of this FTF evaluation system. Therefore, the development team adapted the system to online remote testing, using Zoom technology. The present study examined the effect of this transition to remote evaluation on the quality of selection for teaching, looking at suitability-to-teaching scores and the subjective views of applicants and evaluators. A comparison of the 2020 remote scores with the 2019 FTF scores revealed that scores on remote evaluation were slightly lower than FTF scores, and were more centralized. While the candidates found that remote evaluation provided fewer opportunities to express themselves, both candidates and evaluators were satisfied with the administration and convenience of the evaluation day. The Discussion chapter summarizes the unique affordances and constraints of remote evaluations and presents suggestions for changes which might be made when moving an assessment online that could take advantage of this new environment.

Capturing adolescents in need of psychiatric care with psychopathological symptoms: A population-based cohort study.

BACKGROUND: The current study aims to overcome past methodological limitations and capture adolescents in need of psychiatric care with psychopathological symptoms in a cohort with unrestricted access to mental health professionals. METHODS: The study source population consisted of a random sample of adolescents aged 16-17 years (N=1,369) assessed by the Israeli Draft Board. An adapted version of the Brief Symptom Inventory was used to identify clinically relevant psychopathological symptoms with scores categorized as severe if they were in the top 10th percentile of symptoms, otherwise not severe. An independent interview with a subsequent referral to a mental health professional was used to categorize adolescents in need of psychiatric care. To examine the association between severe psychopathological symptoms and the need for psychiatric care, logistic regression models were fitted unadjusted and adjusted for age, sex, and intellectual assessment scores. Adjusted classification measures were estimated to examine the utility of severe psychopathological symptoms for clinical prediction of need for psychiatric care. RESULTS: Information on 1,283 adolescents was available in the final analytic sample. Logistic regression modeling showed a statistically significant (p<0.001) association between self-reported severe psychopathological symptoms and the need for psychiatric care (OR adjusted: 4.38; 95% CI: 3.55-5.40). Severe psychopathological symptoms had a classification accuracy of 83% (CI: 81%-85%). CONCLUSIONS: Severe psychopathological symptoms, although accounting for a fair proportion of treatment seeking, would perhaps be better useful for classification purposes alongside other variables rather than in isolation.

Self-reported mental health difficulties and subsequent risk for schizophrenia in females: a 5-year follow-up cohort study.

BACKGROUND: Patients with schizophrenia often report a history of premorbid mild to severe psychological distress. We investigated the association between self-reported mental health difficulties and later psychiatric hospitalization for schizophrenia. METHODS: 13,357 females aged 17, mandatory assessed by the Israeli Draft Board were followed up over 5 years for psychiatric hospitalization by means of the Israeli National Psychiatric Hospitalization Case Registry. Seventeen females, judged healthy at Draft Board assessment, were hospitalized for schizophrenia or schizoaffective disorder over the follow-up period. RESULTS: There was a significant monotonic association between increasing self-reported mental health difficulties (psychological distress and increasing need for psychological counseling) and prevalence of schizophrenia [odds ratios over four levels: 1.56; 95% CI:1.04 to 2.34; chi2 (1) = 4.62, p = 0.03], after controlling for low IQ, immigration, SES, and presence of psychiatric disorders at age 17. Increasing severity of self-reported mental health difficulties was related to earlier age of first hospitalization [r = -0.48, p = 0.05]. CONCLUSIONS: Increased undifferentiated self-reported mental health difficulties are associated with increased risk of later hospitalization for schizophrenia prior to age 23 in females. This may reflect the prodromal phase of the illness.