Search

Abstract Patients experiencing mental health crises often seek help through messaging-based platforms, but may face long wait times due to limited message triage capacity. Here we build and deploy a machine-learning-enabled system to improve response times to crisis messages in a large, national telehealth provider network. We train a two-stage natural language processing (NLP) system with key word filtering followed by logistic regression on 721 electronic medical record chat messages, of which 32% are potential crises (suicidal/homicidal ideation, domestic violence, or non-suicidal self-injury). Model performance is evaluated on a retrospective test set (4/1/21–4/1/22, N = 481) and a prospective test set (10/1/22–10/31/22, N = 102,471). In the retrospective test set, the model has an AUC of 0.82 (95% CI: 0.78–0.86), sensitivity of 0.99 (95% CI: 0.96–1.00), and PPV of 0.35 (95% CI: 0.309–0.4). In the prospective test set, the model has an AUC of 0.98 (95% CI: 0.966–0.984), sensitivity of 0.98 (95% CI: 0.96–0.99), and PPV of 0.66 (95% CI: 0.626–0.692). The daily median time from message receipt to crisis specialist triage ranges from 8 to 13 min, compared to 9 h before the deployment of the system. We demonstrate that a NLP-based machine learning model can reliably identify potential crisis chat messages in a telehealth setting. Our system integrates into existing clinical workflows, suggesting that with appropriate training, humans can successfully leverage ML systems to facilitate triage of crisis messages.

The psychometric trait approach to human life history, based on common factor modeling, has recently come under some criticism for neglecting to inquire into the developmental progression that orients and executes human life history trajectories (Copping, Campbell, Muncer, 2014). It was asserted that the psychometric approach wholly focuses on creating a higher-order latent factor of life history by subsuming individual differences with developmental and social experiences, ignoring ontogenetic progression. Implicit in the critique is the assumption that developmental perspectives and latent approaches are mutually exclusive and incompatible with each other. The response to this critique by Figueredo and colleagues (2015) proposed instead that developmental perspectives and latent trait approaches are both compatible and necessary to further research on human life history strategies. The current paper uses three independent cross-sectional samples to examine whether models of human life history are best informed by a developmental perspective, psychometric trait approach, or both.

The process of mediation is of critical importance to the social and behavioral sciences and to evolutionary social psychology in particular. As with the concept of evolutionary adaptation, however, one can argue that causal mediation is in need of explicit theoretical justification and empirical support. Mainstream evolutionary social psychology proposes, for example, that organisms are “adaptation executers”, and not “fitness maximizers”. The execution of adaptations is triggered by fitness-relevant ecological contingencies at both ultimate and proximate levels of analysis. This logic is essentially equivalent to what methodologists refer to as the process of mediation; the adaptations to be executed (or not, depending upon the prevailing environmental circumstances) causally mediate the effects of the ecological contingencies upon the fitness outcomes. Thus, the process of mediation can be generally conceptualized as a causal chain of events leading to a given outcome or set of outcomes. If a predictor variable operates through an intervening variable to affect a criterion variable, then mediation is said to exist. Nevertheless, it does not appear that some psychologists (particularly evolutionary-social psychologists) are sufficiently well-versed in the fundamental logic and quantitative methodology of establishing causal mediation to support such claims. In the current paper, we set out to review the ways researchers support their use of mediation statements and also propose critical considerations on this front. We start with more conventional methods for testing mediation, discuss variants of the conventional approach, discuss the limitations of such methods as we see them, and end with our preferred mediation approach. DOI:10.2458/azu_jmmss_v04i1_figueredo3

The purpose of the present article is to propose an alternative short form for the 199-item Arizona Life History Battery (ALHB), which we are calling the K-SF-42, as it contains 42 items as compared with the 20 items of the Mini-K, the short form that has been in greatest use for the past decade. These 42 items were selected from the ALHB, unlike those of the Mini-K, making direct comparisons of the relative psychometric performance of the two alternative short forms a valid and instructive exercise. A series of secondary data analyses were performed upon a recently completed five-nation cross-cultural survey, which was originally designed to assess the role of life history strategy in the etiology of interpersonal aggression. Only data from the ALHB that were collected in all five cross-cultural replications were used for the present analyses. The single immediate objective of this secondary data analysis was producing the K-SF-42 such that it would perform optimally across all five cultures sampled, and perhaps even generalize well to other modern industrial societies not currently sampled as a result of the geographic breadth of those included in the present study. A novel method, based on the use of the Cross-Sample Geometric Mean as a criterion for item selection, was used for generating such a cross-culturally valid short form.

Se realizó un despistaje serológico y recolección de vectores en cuatro comunidades rurales del municipio Andrés Eloy Blanco, Estado Lara, Venezuela. La muestra fue escogida en forma sistemática y aleatoria basada en conglomerados familiares. Se muestrearon 869 habitantes para determinar anticuerpos anti-Trypanosoma cruzi y anti-Leishmania sp. por inmunofluorescencia indirecta, aceptando como positivo diluciones > a 1:32 para anticuerpos anti-T. cruzi no reactivos para antígenos de Leishmania sp., obteniendo una frecuencia de anticuerpos en la muestra de 6,9% (n = 60); de los cuales 46,66% son femeninos, 53,33% masculinos y 60% mayores de 40 años. Se observó que 5 (8,33%) de los seropositivos eran menores de 10 años y 10 (16,66%) menores de 20 años. Rhodnius prolixus y Panstrongylus geniculatus fueron los triatominos capturados, con índice de infestación de 1,9 y 10,54%, índice de colonización, del 0 y 18,18% en las viviendas infestadas e índice de infección a T. cruzi del 20 y 5,07%, respectivamente. Los resultados sugieren que existe una transmisión activa de la enfermedad de Chagas en el Municipio Andrés Eloy Blanco en las últimas dos décadas y que P. geniculatus está substituyendo a R. prolixus como vector de la enfermedad de Chagas.A seroepidemiological survey and vector captures were performed in four rural communities in Andrés Eloy Blanco, Lara State, Venezuela. Systematic random sampling was based on family clusters, with samples drawn from 869 individuals to determine anti-Trypanosoma cruzi and anti-Leishmania sp. antibodies by indirect immunofluorescence. Positive individuals were defined as > 1:32 for anti-T. cruzi antibody and non-reactive to Leishmania sp. antigen, revealing an antibody frequency of 6.9% (n = 60), of whom 46.66% were females and 53.33% males and 60% were over 39 years of age. Some 5 (8.33%) seropositive individuals were under 10 years of age and 10 (16.66%) under 20 years. Rhodnius prolixus and Panstrongylus geniculatus were the triatomines captured, with infestation rates of 1.9% and 10.54%, colonization index of 0% and 18.18% in infested houses, and a T. cruzi infection index of 20% and 5.07%, respectively. The results suggest active Chagas disease transmission in Andrés Eloy Blanco in the last two decades and that P. geniculatus is replacing R. prolixus as the Chagas disease vector.

Copping, Campbell, and Muncer (2014) have recently published an article critical of the psychometric approach to the assessment of life history (LH) strategy. Their purported goal was testing for the convergent validation and examining the psychometric structure of the High-K Strategy Scale (HKSS). As much of the literature on the psychometrics of human LH during the past decade or so has emanated from our research laboratory and those of close collaborators, we have prepared this detailed response. Our response is organized into four main sections: (1) A review of psychometric methods for the assessment of human LH strategy, expounding upon the essence of our approach; (2) our theoretical/conceptual concerns regarding the critique, addressing the broader issues raised by the critique regarding the latent and hierarchical structure of LH strategy; (3) our statistical/methodological concerns regarding the critique, examining the validity and persuasiveness of the empirical case made specifically against the HKSS; and (4) our recommendations for future research that we think might be helpful in closing the gap between the psychometric and biometric approaches to measurement in this area. Clearly stating our theoretical positions, describing our existing body of work, and acknowledging their limitations should assist future researchers in planning and implementing more informed and prudent empirical research that will synthesize the psychometric approach to the assessment of LH strategy with complementary methods.