Cholinergic nucleus 4 grey matter density is associated with apathy in Parkinson's disease.

Objective: The generation and maintenance of goal-directed behavior is subserved by multiple brain regions that receive cholinergic inputs from the cholinergic nucleus 4 (Ch4). It is unknown if Ch4 degeneration contributes to apathy in Parkinson's disease (PD). Method: We analyzed data from 106 pre-surgical patients with PD who had brain MRIs and completed the Frontal Systems Behavior Scales (FrSBe). Eighty-eight patients also completed the Beck Depression Inventory-2nd Edition. Cholinergic basal forebrain grey matter densities (GMD) were measured by applying probabilistic maps to T1 MPRAGE sequences processed using voxel-based morphometry methods. We used linear and hierarchical regression modelling to examine the association between Ch4 GMD and the FrSBe Apathy subscale scores. We used similar methods to assess the specificity of this association and potential associations between Ch4 target regions and apathy. Results: Ch4 GMD (p = .021) and Ch123 GMD (p = .032) were significantly associated with Apathy subscale scores on univariate analysis. Ch4 GMD, but not Ch123 GMD, remained significantly associated with apathy when adjusting for age, sex, levodopa equivalent doses, and disease duration. Centromedial amygdala GMD, which receives cholinergic inputs from Ch4, was also associated with apathy. Ch4 GMD was not associated with depression or disinhibition, nor was it associated with executive dysfunction when adjusting for clinical and demographic variables. Conclusions: Ch4 GMD is specifically associated with apathy in PD. Ch4 degeneration results in cholinergic denervation of multiple cortical and limbic regions, which may contribute to the cognitive and emotional-affective processing deficits that underlie the behavioral symptoms of apathy.

Factor structure of the BDI-II in Parkinson's disease.

OBJECTIVE: There is substantial heterogeneity in depressive symptomology for individuals with Parkinson's disease (PD). It is unknown whether the Beck Depression Inventory-Second Edition (BDI-II) is capable of identifying such phenotypic variations of depression. METHOD: We investigated the factor structure of the BDI-II and its associations with demographic characteristics and other nonmotor symptoms in PD. We reviewed the cases of 236 patients with a confirmed PD diagnosis. Evaluations included the BDI-II, Montreal Cognitive Assessment (MoCA), Apathy Scale (AS), and Geriatric Anxiety Inventory (GAI). We used exploratory structural equation modeling (ESEM) with target rotations as this method integrates aspects of exploratory and confirmatory factor analysis. We conducted hierarchical regressions to assess for associations between the BDI-II factors and gender, age, education, disease duration, cognition, anxiety, and apathy. RESULTS: ESEM supported the retention of a Somatic factor and an Affective factor that accounted for 53% of the model variance. Model goodness-of-fit measures were within normal limits. Higher AS scores were positively associated with the Somatic and Affective factors. Higher GAI scores were positively associated only with the Affective factor. There were no other significant relationships with factor scores. CONCLUSIONS: This study supports the retention of a two-factor model of the BDI-II in PD. These unique clusters of depressive symptoms in PD can be used to guide clinical decisions about the need for further psychiatric evaluation and the appropriateness of different therapeutic interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

An Online Educational Program to Increase Student Understanding of Threat Assessment.

BACKGROUND: Threat assessment is a widely recommended practice used by schools to investigate and respond to student threats of violence; however, students are often reluctant to disclose threats. METHODS: We developed an online educational program for students to increase their understanding of threat assessment and the need to report serious threats. We investigated 2 research questions: (1) How are student characteristics of sex, grade level, and ethnicity/race associated with student knowledge of threat assessment and willingness to report threats? (2) Does the program increase knowledge of threat assessment and willingness to report threats? The sample consisted of 2338 students from 6 middle schools and 3 high schools. RESULTS: Prior to program completion, boys were less willing than girls, and older students were less willing than younger students, to report threats. Post-program questions revealed that the program significantly increased knowledge and willingness to report threats across student groups, with effect sizes (Cohen's d) ranging from small (.30) to large (1.43). CONCLUSIONS: This program promotes school safety by teaching students about threat assessment and increasing willingness to report threats. The program is available online for other schools to use.

Authoritative school climate and sexual harassment: A cross-sectional multilevel analysis of student self-reports.

School sexual harassment (SH) is defined as unwelcome behavior of a sexual nature that interferes with a student's ability to learn. There is an important need for schools to assess the prevalence of SH and its relation to school climate to guide intervention efforts. This study investigated 3 research questions: (a) Is there psychometric support for a 4-item multilevel measure of SH? (b) What is the prevalence of SH in a statewide high school sample, and how does SH vary across gender, grade level, race-ethnicity, and socioeconomic status? (c) Is an authoritative school climate-characterized by strict but fair discipline and supportive teacher-student relationships-associated with lower levels of SH for students? A statewide sample of high school students (N = 62,679) completed a school climate survey that included a new 4-item measure of SH. Results of a multilevel confirmatory factor analysis indicated good fit for a single SH factor at both student and school levels. A multiway analysis of variance demonstrated the high prevalence of SH and variations across demographic groups. Multilevel hierarchical regression analyses indicated that an authoritative school climate accounted for 5.7% of the student-level variance and 38.3% of the school-level variance in SH scores. Routine assessment of SH can help school psychologists bring attention to this underrecognized problem. (PsycINFO Database Record (c) 2019 APA, all rights reserved).