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The Effect of Hypnotically-Induced Mood Elevation as an Adjunct to Cognitive Treatment of Depression
Cognitive therapy for the treatment of depression has generated substantial research indicating its effectiveness and it is currently considered among the most viable conceptualizations of depression. However, it has remained controversial because its methods do not directly address emotional symptoms in depressed persons. Treatment of depressed emotions is a primary focus of hypnotic mood elevating techniques. These techniques enable depressed persons to experience positive emotions during hypnosis sessions and to re-experience them daily concurrent with performance of certain specified behaviors. This study evaluated the efficacy of a multicomponent treatment which combines the techniques of cognitive therapy and hypnotic mood elevation in the treatment of depressed persons. The three treatment conditions constructed for this investigation were cognitive therapy plus hypnotic mood elevation, cognitive therapy plus pseudo-biofeedback, and no treatment waiting list.
The Effect of Stress, Anxiety-Proneness and Previous Exposure to Familial Abuse on Violence in Later Relationships
Abuse in adult relationships as affected by stress, anxiety-proneness, and exposure to abuse as a child was examined using 579 North Texas State University undergraduates, Frequency and levels of abuse observed or received as a child and received or expressed as an adult were measured using a modification of Straus' Conflicts Tactics Scale (1979). Anxiety-proneness was determined by scores received on Spielberger's (1970) State-Trait Anxiety Inventory. Current levels of stress for the past two years were measured using the Life Experiences Survey (Sarason, 1978). Overall frequencies for received and expressed abuse (including physical and verbal abuse) in adult relationships were quite high (62.9 percent and 73.8 percent respectively). Females reported expressing significantly more abuse than did males. No gender differences were found for the receipt of abuse. Gender differences in types of violence were also examined. In addition, multiple regression was used to determine predictor variables for the expression and receipt of abuse. For males, receiving abuse as a child, positive stress scores, higher levels of anxiety-proneness, and observing father's abuse of mother significantly predicted expressing abuse as an adult. Observing mother's abuse of father and positive stress scores significantly predicted receiving abuse as an adult. For females, having received abuse as a child and trait anxiety were significant predictors for the expression of adult abuse. Receiving abuse as a child was the only significant predictor for the receipt of adult abuse. The greater impact of observing abuse between parents on males was discussed. In addition, difficulties confronting researchers in this area and the possible explanations for more frequent reports of female expression of abuse were examined.
The Effectiveness of Skin Temperature Biofeedback with versus without Cue-Controlled Training
This study compared biofeedback assisted cue-controlled skin temperature training with skin temperature biofeedback training in subjects attempting to raise the digital skin temperature of their dominant hand. In addition to classification according to training, the subjects were also divided into two diagnostic groups. One group was composed of subjects with cold hands and Raynaud's disease while the other group consisted of nonRaynaud's disease cold handed subjects. The treatment and diagnostic groups were compared along the dimensions of amount of posttreatment digital skin temperature change and degree of generalization of digital skin temperature control to a cold room challenge task.
Effectiveness of the Neurobehavioral Cognitive Status Examination in Assessing Alzheimer's Disease
Accurate, early diagnosis of Alzheimer's Disease is becoming increasingly important in light of its growing prevalence among the expanding older-aged adult population. Due to its ability to assess multiple domains of cognitive functioning and provide a profile of impairment rather than a simple global score, the Neurobehavioral Cognitive Status Examination (NCSE) is suggested to better assess such patterns of cognitive deficit for the purpose of diagnosis. The performance of the NCSE was compared with that of the Mini-Mental State Examination (MMSE) for diagnostic sensitivity in a sample of patients diagnosed as having probable Alzheimer's Disease. The strength of correlation between severity of cognitive impairment on these tests and report of behavior problems on the Memory and Behavior Problems Checklist (MBPC) was also explored, as was performance on the NCSE and report of behavior problems using the MBPC in predicting Single Photon Emission Computed Tomography (SPECT) scan results. The NCSE was found to exhibit greater sensitivity to physician diagnosis of probable Alzheimer's Disease relative to two versions (Serial 7's or WORLD) of the MMSE (.90, .77 and .68, respectively). While both measures were found to correlate significantly with the report of behavior problems, only a moderate proportion (NCSE = .22 and MMSE = .33) of the explained variance was accounted for by either test. Severity of cognitive impairment on the NCSE was found to be significant, though small in estimate of its effect size, for predicting the absence/presence of pathognomic findings on SPECT scans. In contrast, the report of behavior problems on the MBPC did not significantly predict SPECT scan outcomes. The NCSE would appear to be a sensitive tool for the identification of the extent and severity of cognitive impairment found among demented individuals; however, it may be "over"-sensitive to such diagnosis. Although relationships between cognitive impairment and behavior problems …
The Effectiveness of the PAI in Identifying Minimized Substance Use and Predicting Poor Treatment Outcomes in an Offender Population
The accurate evaluation of substance use is a critical component of forensic assessment due to the well-established link between drug use sentencing issues and risk of recidivism. Due to limited resources and chronic time constraints, practitioners typically rely only on self-report measures to assess substance use (SU) patterns. As these measures directly inquire about SU patterns, they remain vulnerable to response distortion. This can lead to ineffective treatment recommendations made to the Court and misuse of resources. The present study investigated the utility of the PAI and SASSI-3 in identifying SU patterns in offenders mandated to a long-term treatment facility. As a second major component, offenders were examined post-release to identify predictors for poor treatment outcomes. Results found the direct questioning approach best identified SU patterns in the present sample. In addition, while statistically significant differences in treatment outcomes were not observed between offenders who endorsed a more severe course of their SU problem versus those who endorsed a much less problematic pattern of use, they were trending in the expected direction. Specifically, offenders who used "hard" drugs regularly (e.g., cocaine, heroin), had more negative consequences directly related to their use (e.g., more arrests, prior treatment), and had a more complex clinical presentation (e.g., endorsing more personality pathology) did have worse outcomes by follow up. Methodological and statistical limitations are discussed in depth, and future directions to improve on this study and clarify these relationships are emphasized.
Effects of a Psychotherapy Presentation on Asians' Therapy Expectations and Help-Seeking Attitudes
The effectiveness of an educational psychotherapy presentation on Asians' therapy expectations and help-seeking attitudes was investigated. Subjects were foreign-born Asian university students. Compared to a non-Asian American normative sample, the Asian group demonstrated significantly less accurate expectations about therapy and less positive attitudes about seeking help for psychological problems. A psychotherapy presentation was used to modify expectations and attitudes. It consisted of an audiotaped lecture on therapist and client roles and the types of problems discussed in therapy. It also included a written transcript of therapist-client dialogues for subjects to read. The experimental group, which received the presentation, was compared to placebo control and delayed-treatment control groups. The psychotherapy presentation did not modify Asians' expectations or attitudes more than the control groups. Instead, all three groups showed improvement at posttest. Because there is a clear need to assess further the therapy expectations and attitudes of Asians, future research was recommended.
The Effects of an Experimentally-Induced Bodily Focus Experience on a Psychotherapist during a Psychotherapy Session
The purpose of this study is to contribute to the current process research by investigating a psychotherapist's experience during psychotherapy. Massage therapy and relaxation therapy were used to manipulate psychotherapist's bodily focus, physiology, and affective state. Topics discussed include: the bodily focus of the therapist, neurobiological models of experience, mind-body boundary issues, and a present-time focus. Doctoral level Counseling and Clinical graduate students were used as participants.
The Effects of Assessment Context on State Anxiety and a Neuropsychological Model of Attention
This study investigated the effects of assessment context on state anxiety and attention according to the Mirsky (1996) model of attention. Context varied in the physical testing environment, demeanor of the assessor, and explanation of the purpose of testing. A relaxed condition (RC) and structured medical condition (SMC) distinction was made prior to data collection and the two contexts were designed to reflect contrasting practices of neuropsychologists. Elements of attention evaluated included Encoding (Digit Span), Focusing/Executing (Visual Search and Attention Test), Shifting (Wisconsin Card Sorting Test: Computerized Version 2), Sustaining, and Stabilizing (Continuous Performance Test-Identical Pairs). Eighty healthy adult females participated in the study. The findings suggest that the SMC caused higher levels of anxiety and lower valence than the RC, which in turn caused poorer sustained attention and superior shifting attention for this condition. Such interpretations are consistent with several theories on the effects of anxiety on attention. It should be noted, however, that differences observed in attention were limited to select measures. Factor analysis also indicates that the encode, shift, and sustain elements of attention were largely consistent with the factor solution proposed by Mirsky, while findings on the focus/execute and stabilize elements bring into question the construct validity of these aspects of the model. Findings from the study are considered relevant to those interested in attention theory and particularly researchers and clinicians involved in the administration of neuropsychological testing.
The Effects of Attributional Styles on Perceptions of Severely Mentally Ill Offenders: a Study of Police Officer Decision-making
Police officers are allowed considerable discretion within the criminal justice system in addressing illegal behaviors and interpersonal conflicts. Broadly, such resolutions fall into two categories: formal (e.g., arrest) and informal outcomes. Many of these interventions involve persons who have historically faced stigmatization, such as those who have mental disorders, criminal histories, or both (i.e., mentally disordered offenders). On this point, stigma generally includes discriminatory behavior toward the stigmatized person or group and can be substantially influenced by internal and external attributions. In addition, researchers have suggested that internal attributions lead to punishing behaviors and external attributions lead to helping behaviors. The current study examined attributions about offender behavior made by police officers in an effort to evaluate the effectiveness of Corrigan’s model. Specifically, this study investigated the effects of officer attributions on their immediate decisions in addressing intentionally ambiguous and minor offenses. Officers provided one of two vignettes of a hypothetical offender who was either mentally disordered or intoxicated and provided their anticipated resolution of the situation. Encouragingly, disposition decision differed by offender condition, with a substantially higher rate of arrests for the intoxicated offender (i.e., the external condition). Corrigan’s model was initially successful for both offender conditions, but was overall more successful for the mentally disordered condition. Results are discussed within the broader context of police policy, such as crisis intervention training, and identification of officers who could benefit from additional mental health trainings.
Effects of Cautioning and Education in the Detection of Malingered Mild Traumatic Brain Injury
This study examined the effectiveness of cautioning and education on simulating a mild traumatic brain injury on several neuropsychological measures. The measures used included the Word Memory Test (WMT), Wechsler Adult Intelligence Scales® - Third Edition (WAIS®-III), Wechsler Memory Scales®-3rd Edition instrument (WMS®-III), 16-item version of the Rey Memory Test, and a self-report symptom checklist. Five experimental groups were used including clinical and non-clinical controls, as well as three simulation groups. The design and implementation of this study also attempted to correct several methodological short comings of prior research by increasing the incentives for participants, expanding the generalizability of findings and examining research compliance and participant self-perception through debriefing. Discriminant analysis was utilized to determine if specific functions existed that would correctly classify and distinguish each experimental group. Several discriminant functions had at least moderate canonical correlations and good classification accuracy. Results also include utility estimates given projected varying base rates of malingering.
The Effects of Cognitive Flexibility on Rorschach Interpretation
Although the Rorschach is one of the most widely used psychological assessment techniques, its empirical support has been equivocal. One possible explanation for this lack of empirical support is the tendency for researchers to study only the assessment tool with little regard for the clinician using it. In order to examine the relationship between accurate Rorschach interpretation and attributes of the clinicians employing the technique, 46 psychology graduate students were tested in terms of cognitive flexibility. Torrance's Thinking Creatively with Pictures and Cattell's 16-Personality Factor Questionnaire were used to derive various measures of cognitive flexibility. A two-stage multiple linear regression analysis was done. The most statistically reliable result was that flexibility of thought was found to be the single best mediator of accuracy of Rorschach interpretation. Other individual findings were noted and interpreted.
The Effects of Computer Versus Personal Administration on Measures of Verbal and Spatial Short-Term Memory
This study sought to investigate the influence of expressive task demand, as determined by amount of face-to face social interaction, level of subjects' expressive ability, sex of subject, and sex of experimenter on subjects' digit and visual-spatial short-term memory span performance. The amount of personal contact was manipulated by the automated versus person administrations of the memory measures. The automated administration was accomplished through the use of a microcomputer.
The Effects of Different Confidentiality Conditions on Adolescent Minor Patients' Self-Report of Behavioral and Emotional Problems
The primary purpose of the present study was to determine if information regarding potential parental or legal guardian access to mental health information would deleteriously impact male and female adolescent psychiatric patients' willingness to self-report personal problems and symptoms.
Effects of Enculturation in Neuropsychological Test Performance on the African Neuropsychological Battery in African Americans and First-Generation Sub-Saharan African Immigrants to the United States
This study used an archival data set of 26 healthy adult immigrants from a sub-Saharan African country to the United States (Mage 39.0, SD = 11.36; Meducation 16.33, SD = 2.88; 40.7% male). Additional archival data was used for 32 healthy African American adults (Mage 34.06, SD = 11.18; Meducation 16.16, SD = 2.49; 53.1% male). A bivariate correlation indicated that acculturation to African culture, as measured by the mBIQ (M 49.29, SD = 8.66), was significantly positively correlated with ethnicity, r = .632, p = .000, ηp2 = 0.399. Two-way ANOVAs revealed that African Americans were able to name more animals than African immigrants (F(1, 54) = 4.82, p = 0.32, ηp2 = 0.82) and exhibited greater organizational skills during a task of cognitive set shifting and problem solving than African immigrants, regardless of level of acculturation (F(1, 54) = 4.47, p =.039, ηp2 = 0.078). In contrast, African immigrants scored higher than African Americans on indigenous fruit (F(1, 54) = 7.60, p =.008, ηp2 = 0.123) and object naming (F(1, 54) = 5.59, p =.022, ηp2 = 0.094). Results of the study concluded that there are small variance effects in language tasks as well as strategy-based approaches to tasks of novel problem solving. Implications of these findings are discussed relative to future research as well as clinical practice in the assessment of culturally dissimilar people across a racially homogenous population by pushing the field forward with diversified approaches to neuropsychological testing.
Effects of Evaluative Modeling on Client Behavior and Self-Evaluation in Behavior Rehearsal for Assertive Training
A technique for altering subjects' self-evaluations and subsequent performance was developed and tested. Two types of therapist evaluative modeling, positive and critical, were compared, for effectiveness in training subjects to be assertive, with a no-modeling control and an insight treatment group. All modeling conditions used a behavior rehearsal paradigm, while the insight treatment employed a Rogerian therapy design. Dependent measures included a paper-and-pencil self-evaluation scale and a behavioral role-playing test of assertiveness. No significant differences were found among the modeling conditions, but the behavior rehearsal strategy brought about significantly greater increases in assertiveness among the severely unassertive subjects than did the insight treatment.
The Effects of Imaging Ability, Guided Imagery, and Source of Themes on Interview Verbal Behavior
Eighty four female undergraduate students participated in a psychotherapy analog study to determine the effects of imagery ability, guided imagery therapy treatments, and personal versus supplied constructs upon self-disclosure variables in a 2 x 3 x 2 Anova design, with repeated measures on the final factor. Dependent variables were measured by reaction time, total talk time, speech duration, silence quotient, and Doster's (1971) Self-Disclosure Rating Scale. Subjects were divided into two imagery ability levels on the basis of local mean scores on Sheehan's (1967) modification of Betts' (1909) Questionnaire upon Mental Imagery. Three treatment procedures were employed: a guided focal imagery treatment, which encouraged imagery involving the interpersonal topics to be discussed, a guided relaxation imagery treatment which used standard sensory relaxation scenes, and a treatment which imparted ambiguous instructions. The final factor was repeated measures of the eight negative topics the subjects were asked to discuss. Four were chosen from the subjects' Role Construct Repertory Test grid (Kelly, 1955; Landfield, 1971), and four were selected from the Semantic Differential (Snider & Osgood, 1969).
Effects of Interviewer's Impersonal and Personal Self-Disclosures on Somatic Symptom Verbalizations of Psychiatric Outpatients
A literature review indicated that psychopathological symptomology must be considered within the social context of the patient. Recent research has suggested that the psychopathological symptoms of the psychotic patient function on a covert level of communication as a strategy to control the threat of interpersonal intimacy. The present investigation similarly examined the interpersonal function of another class of patient symptomology, somatic symptoms. It was hypothesized that somatic symptom verbalizations of psychiatric outpatients also can serve as covert messages to avoid the risk of interpersonal intimacy. Results indicated that only the high-somatic-symptom patients significantly increased their symptom verbalizations in response to demand. When the interviewer modeled impersonal self-disclosures, both groups showed a low rate of somatic verbalizations. The groups did not differ. When the interviewer modeled personal self-disclosures, both patient groups significantly increased their psychological symptom verbalizations compared to their counterparts in the impersonal condition. In addition, low somatic symptom patients under the demand for personal disclosure showed significantly less avoidance behavior than any other group. No differences were found among the experimental groups in terms of self-disclosure level. The results clearly lend support to Haley's (1963) intimacy-avoidance corollary; that is, symptoms of non-psychotic patients function as covert messages that avoid the formation of intimate interpersonal relationships by redefining the reciprocal role available to participants. In view of these findings, several cross-study comparisons were made. In addition, directions for future research were suggested.
The Effects of Mirror Confrontation on Body Image Ratings
There are conflicting data in the literature regarding the effects of mirror exposure on subjective body-image evaluation. Much of the objective self-awareness research by Duval and Wicklund concluded that the presence of a mirror leads people to evaluate themselves negatively, while other studies have reported contrary findings. The primary purpose of this study was to determine the effects of mirror confrontation on individuals' body image ratings. Subjects were 88 childless, female university students. Using the Eating Disorders Inventory-Body Dissatisfaction subscale (BDS) as a screener, subjects were assigned to either a High Satisfaction group or a Low Satisfaction group. The subjects then completed the Multidimensional Body-Self Relations Questionnaire (MBSRQ) in either a Mirror or No Mirror condition. Results suggest that the presence of the mirror had no measurable effect on the subjects' ratings of themselves on the MBSRQ. There was a main effect for satisfaction level, and no interaction was found between the satisfaction level and the mirror condition. Possible explanations for these findings are offered.
The Effects of Reduced Challenge at the Conclusion of Cognitive and Exercise Tasks
Research has suggested that memories for difficult or painful experiences seem related to a combination of the worst and most recent moments. This peak-end theory was tested in relation to an exercise task (eccentric quadriceps using a BIODEX machine) as well as a cognitive task (standardized quantitative test questions). For each type of task there were two trials: short and happy endings. The happy endings trial included the same task as the short trial with an additional 25% duration at a lesser intensity (80% of short task intensity). A 2 (task type) by 2 (trial type) repeated measures design was used. Participants made global ratings of difficulty immediately after each component, thus generating four ratings, and later indicated their preferences for hypothetical future trials. Results indicated support for the theory that the shorter trials are evaluated as more difficult, with the cognitive task being evaluated as more difficult overall than the exercise task. Preference scores, however, revealed a preference only for the happy endings cognitive task, with no preference indicated on the exercise task. Results confirm previous research in suggesting differences between judgements of tasks and future choices. However, confounds complicated interpretations, especially for the cognitive task. The most conservative interpretation of data suggests that in circumstances where "more is better," happy endings will result in more work with no higher level of discomfort. Implications for future research and applications of the theory are discussed.
The Effects of Stimulation and Depression of the Reticuloendothelial System on Sidman Avoidance Behavior
The present research explored the role of RES manipulation on ongoing Sidman avoidance behavior. Results of the first phase revealed that both experimental drugs significantly altered RES levels in predicted directions after the first measure; however, only stimulated subjects maintained significant differences after 5 days. No activity-level differences were noted in any subjects due to drugs across time. Sidman avoidance data indicated that RES-stimulated subjects showed significant deterioration in avoidance performance as compared to other groups for the first session. Stimulated subjects were also poorer on the second and third sessions, but statistical significance was not obtained because some saline subjects also showed poorer performance. A rank order correlation revealed that a significant negative correlation existed between RES stimulation and avoidance performance, based on changes in RES levels from baseline to the end of the shock program. These data suggest that increased stress resistance due to RES stimulation may reduce the aversive properties of the shock program, thus decreasing motivation for responding. It was concluded that artificial methods of inducing stress resistance by RES stimulation may be a useful therapeutic technique for patients experiencing psychological stress.
The Effects of Voluntary Lateral Orienting on Positive Manifold for Lateralized Cognitive Tasks
As an extension of previous studies (Urbanczyk, Angel, & Kennelly, 1988) examining the effects of unimanual finger tapping on lateralized cognitive tasks, lateral body orienting was added to an established dual task paradigm to generate differential hemispheric activation and shifts of attention. One hundred twenty university students retained sequences of digits or spatial locations for 20 seconds either alone or during finger tapping. By turning both head and eyes left or right, the hemisphere congruent with the sequences (LH for digits, RH for locations) or incongruent (vice versa) was activated. Activation had little effect on retention means but greatly affected resource composition supporting task performance. Congruent orientation produced significantly higher positive correlations between digit and location tasks than incongruent orientation. Females showed higher sequence retention correlations than males across both orienting groups. For females, congruent activation enhanced tapping rates and retention-tapping correlations. For males, activation affected neither of these. Discussed in light of neuroanatomical research, these results suggest that congruent attentional orienting may integrate regions of the less activated hemisphere into networks of the more activated hemisphere. This unification may occur more readily across the female corpus callosum, producing a greater dependence upon a general attentional resource than for males, who appear to depend more upon hemispheric resources.
Eight-Year Course of Cognitive Functioning in Bipolar Disorder with Psychotic Features
The purpose of the current study was to examine neuropsychological functioning in patients with bipolar disorder (BD) with psychotic features. Data from a large, epidemiological study of patients with first-episode psychosis was used to examine verbal learning and working memory 10 years after onset of psychosis in patients with BD relative to patients with schizophrenia (SZ) and patients with psychotic major depressive disorder (MDD). Cross-sectional comparisons of verbal learning and working memory at the 10-year follow-up mirrored findings of relative performance at the 2-year follow-up (Mojtabai, 2000), as patients with SZ performed significantly worse than patients with psychotic affective disorders. When FEP patients' cognitive performance was examined longitudinally, all groups showed non-significant decline over time, with no significant diagnostic group differences after accounting for current symptoms. More frequent hospitalizations and longer treatment with antipsychotics were associated with poorer performance on cognitive testing 10 years after illness onset, but these associations disappeared when controlling baseline cognitive performance. Within the BD sample, current positive and negative psychotic symptoms were associated with poorer performance on cognitive testing. After controlling for baseline cognitive performance, markers of clinical course were unrelated to cognitive performance, consistent with existing literature on longitudinal cognitive functioning in patients with BD. The current findings support a neurodevelopmental model of verbal learning and working memory deficits in patients with bipolar disorder.
Elaboration and Content Analysis of Conceptual Structure in Posttraumatic Stress Disorder
Three recent studies attempted to substantiate Sewell and Cromwell's (1990) theory of Posttraumatic Stress Disorder (PTSD; American Psychiatric Association, 1994) based on personal construct theory (Kelly, 1955). One crucial aspect of the model that was tested in each of the studies is "elaboration," which is the process of bringing more of a person's repertoire of understanding (constructions) to a certain experience to give it meaning. Elaboration is representative of whether or not the individual is using an integrated set of constructs to deal with a traumatic event. A two-part study (1) reanalyzed existing data to assist in understanding discrepancies in past findings, and (2) content analyzed constructs given by subjects in all three studies. Findings concerning elaboration remained somewhat discrepant but suggested possible differences when investigating the emergent versus submerged poles of constructs.
Evaluating Preventative Interventions for Depression and Related Outcomes: a Meta-analysis
The burden of depression requires modalities other than individual psychotherapy if we are to reduce it. Over the past two decades preventative programs for depression have been developed and refined for different populations. The six years since the last meta-analysis of preventative interventions—inclusive of all program types—have seen a number of new studies. The current study used the greater statistical power provided by these new studies to analyze moderators of, and sub-group differences in, the effect of these interventions on depression. Moreover, this meta-analysis synthesized effect sizes for outcomes other than, but often related to, depression (e.g., anxiety) and for within-group change scores with the goal of better informing program implementation and evaluation. Twenty-nine studies met inclusion criteria and indicated that small, robust effects exist for reductions in depression diagnoses and symptomatology. Significant effects were also observed for anxiety, general health, and social functioning.
Evaluating Process Variables in Acceptance and Commitment Therapy
Acceptance and commitment therapy (ACT) was developed to specifically target experiential avoidance (EA) rather than any specific diagnostic category. A functional ACT manual was presented and used to treat diagnostically diverse clients in a large sliding fee-for-service training clinic. A multiple baseline across participants and behaviors research design was used to evaluate session-by-session changes in EA, values identification, valued action, and clinical distress. The Acceptance and Action Questionnaire-2 (AAQ2), Valued Living Questionnaire (VLQ), and Outcome Questionnaire (OQ-45) were given to measure processes and outcomes given the functional ACT model presented in the introduction to the paper. Baseline included the Structured Clinical Interview for DSM-IV Axis I and II Disorders given across 2-5 50- minute sessions. The treatment phase consisted of 7-10 50-minute sessions. Participants were 10 clients. Four participants completed sufficient treatment sessions (4-9) to test the study hypotheses. Participants generally improved across time, but most improvements could not be attributed to the functional application of ACT due to changes during baseline for AAQ, VLQ-Consistency, and OQ-45. VLQ-Importance significantly improved for all participants given ACT.
Evaluating the Effectiveness of a Parent training Protocol Based on an Acceptance and Commitment Therapy Philosophy of Parenting
Thirty-four parents were referred by their CPS caseworkers to participate in one of two ACT for Parenting workshops. These workshops followed a 12 hour treatment protocol based on an acceptance and commitment therapy philosophy of parenting. Briefly, an ACT philosophy of parenting maintains that effective parenting requires awareness and acceptance of thoughts and feelings as they occur in the context of the parent-child relationship. An ACT philosophy of parenting also relies heavily on the identification and commitment to parenting values. Participants were asked to track acceptance and valuing behavior on a daily basis for 25 days prior to the intervention and 25 days post-intervention, as well as to complete a package of self-report instruments designed to measure both ACT specific and general psychological processes, at three different points (pre-, post- and follow-up). Nineteen parents received the treatment, and of those, seventeen provided follow-up data 3-4 months post-intervention. Results indicate statistically significant changes in the expected directions for scores on the BASC-2 Externalizing Composite as well as on the Meta-Valuing Measure. A total of 10 parents also evidenced clinically significant change in the expected directions on a variety of outcome measures.
The Examination for the Professional Practice of Psychology (EPPP): An Examination of Criterion Validity
The Examination for Professional Practice in Psychology (EPPP) is a requirement for licensure as a psychologist across the entire United States as well as in numerous territories and provinces. Despite many longstanding criticisms and findings of bias, the EPPP is being expanded (adding a second, putatively competency-based, portion to the overall exam) and rebranded as the Enhanced EPPP. A review of literature reveals strong skepticism surrounding these developments, particularly with respect to the issue of criterion validity. The current study sought to examine the criterion validity of the EPPP by (1) drawing archival competency assessment data from existing measures (convergent validity) and (2) gathering new neurocognitive and emotional intelligence data, along with demographic data (discriminant validity), with copies of EPPP score reports from individuals who have recently taken the EPPP. Competency ratings did not significantly positively correlate with EPPP scores and, instead, indicated the opposite trend. Analyses also revealed a significant relationship between ethnicity and exam scores, with White individuals scoring higher than other ethnicities. Finally, performance on neurocognitive tests significantly positively correlated with exam scores, indicating that general test taking abilities play a larger role than abilities and competencies unique to the psychology field. Given the gatekeeping role the EPPP plays in the profession of psychology, external validation of the EPPP is of vital importance and was not supported in this study. Implications for the exam and the field are discussed.
An Examination of Resnick's Model of Malingering: a Pai Study of Feigned Ptsd
Malingered posttraumatic stress disorder (PTSD) poses a formidable clinical challenge in personal injury and disability cases because of the apparent ease in feigning PTSD and the supposed link (proximate cause) to the claimed damages. The effective assessment of feigned PTSD is particularly challenging because this diagnosis is both easier to fake than other Axis I disorders and more difficult to detect. As an additional confound, some patients with genuine PTSD produce highly variable, elevated profiles on multiscale inventories that are difficult to distinguish from feigned PTSD. The current study examined whether the Personality Assessment Inventory (PAI) can effectively differentiate between genuine and feigned PTSD in 109 inpatients from a trauma unit. The two most effective scales were the MAL and the NDS scales. As a primary focus, the current study was the first empirical investigation of Resnick's model of malingered PTSD that is comprised of three subtypes: pure malingering (pure-M), partial malingering (partial-M), and false imputation (false-I). The primary goal was to evaluate whether each feigning group was able to (a) effectively simulate PTSD symptoms and diagnoses and (b) avoid being classified as feigning. The partial-M group proved to be the best feigning group in achieving these two goals. Furthermore, the use of well-defined groups, including an indeterminate band (i.e., unclassified) around each cut score, was explored. Overall, the use of well-defined groups improved accuracy in classification and reduced the number of false-positives.
An Examination of Risk and Resilience Factors Predicting Executive Functioning in Women following Psychological Trauma
Psychological trauma may affect higher-order executive functions, which include selective attention, inhibition, and task-switching processes. Difficulty in these executive processes can in turn influence individuals' daily functioning and may also negatively affect the psychological treatment of post-trauma symptoms. Women may be most at risk for developing problems with executive functioning following trauma, consistent with their overall greater risk of developing post-trauma symptoms. Yet, little is understood about the influence of psychological variables, premorbid functioning, and specific trauma factors in determining post-trauma cognitive functioning in women. Additionally, individual variability in susceptibility to psychological distress and neuropsychological deficits following trauma remains an open area of study. The present study investigated the relationship between psychological and trauma factors with neuropsychological outcomes in women with trauma histories as well as individual variability in risk for poor neuropsychological outcomes. In total, 60 participants' data (age M = 29.73, SD = 10.91) were included in analyses. The final sample consisted of 33 community members recruited from the UNT Psychology Clinic and the UNT student body and 27 veterans recruited from the Veterans Affairs North Texas Healthcare System (VANTHCS). Regression and path analysis identified premorbid intellectual functioning as a predictor of better neuropsychological outcomes and anxiety and depression symptoms as risk factors for worse neuropsychological functioning. Person-centered cluster analyses focused on individual differences in outcomes identified three groups differing in psychological distress and neuropsychological functioning. Additional analyses identified differences in trauma exposure, psychological functioning, and neuropsychological performance between subgroups of civilians and veterans and those with and without a history of PTSD.
Examining the Clinical Utility and Predictive Validity of Dimensional Models of Psychopathology
The Diagnostic and Statistical Manual of Mental Disorders arranges co-occurring clusters of symptoms into distinct disorder categories, which theoretically have specific etiologies, pathologies, and treatments. However, researchers and clinicians alike have consistently found DSM diagnoses to have high rates of comorbidity, low diagnostic specificity, and no disorder has proven to be a discrete category. There is mounting evidence that dimensional taxonomies more accurately capture the underlying structure of mental illness and clinical presentations. The recently proposed hierarchical taxonomy of psychopathology presumes to address the issues of categorical nosologies using a data driven approach to create a dimensional model of psychopathology. However, heretofore there are no empirical examinations of HiTOP's ability to predict psychotherapy treatment outcomes. This study compared the predictive validity DSM, RDoC, and HiTOP criteria using natural language processing on free text narrative notes. Of the three GMM run, only the model using DSM criteria as predictors had adequate model fit. Additionally, none of the nosologies significantly predicted treatment course. Implications for the application of RDoC and HiTOP are discussed.
Examining the Role of Emotion Dysregulation and Rumination in the Relationship between PTSD Symptom Severity and Sleep Disturbances
Emotion dysregulation and rumination are involved in the development, maintenance, and treatment of both posttraumatic stress disorder (PTSD) and sleep disturbances. We examined if and how these factors influenced the nature of the relationship between PTSD symptom severity and subjective sleep disturbances among trauma-exposed individuals. Using data gathered from a community sample of 199 trauma-exposed individuals (Mean age = 35.48; 59.80% female), we examined whether there were stronger significant associations between greater PTSD symptom severity and poorer sleep quality/lower sleep quantity at higher (vs. lower) levels of (1) negative emotion dysregulation and positive emotion dysregulation (both included in the same model) and (2) rumination. Participants recruited via Amazon's Mechanical Turk completed the PTSD Checklist for DSM-5, Brief Version of the Difficulties in Emotion Regulation Scale, Difficulties in Emotion Regulation Scale – Positive, Ruminative Thought Style Questionnaire, and sleep quality/quantity items from the Pittsburgh Sleep Quality Index. Results of simple and additive multiple moderation analyses showed that neither negative/positive emotion dysregulation nor rumination moderated the relationships between PTSD symptom severity and sleep quality/quantity. Exploratory analyses showed that negative emotion dysregulation (when examined independently) moderated the relationship between PTSD symptom severity and sleep quality. There were also significant associations between poorer sleep quality/lower sleep quantity and greater PTSD symptom severity at low to average levels of negative emotion dysregulation coupled with any level of positive emotion dysregulation. Findings inform theoretical perspectives on the PTSD-sleep relationship and clinical applications of targeting emotion dysregulation and rumination in the treatment of PTSD symptoms and sleep disturbances for trauma-exposed individuals.
Executive Functioning Processes in Simple and Complex Theory of Mind Tasks
Using a multimethod-multimodal approach, this study compared the contributions of executive function (EF) abilities (Go No-Go, Visual Search, 2-Back task, and Task Switching) to narrative comprehension tasks (False Belief, Strange Stories, Self-Reported Theory of Mind Inventory [TOMI-SR]) and a narrative production task (interpersonal decentering) in a sample of young adults. Separate regression models were conducted for each theory of mind (ToM) measure with EF measures as predictor variables and empirically selected demographic variables controlled. As expected, in this college student sample (N = 110), False Belief demonstrated a ceiling effect and was not associated with any EF ability. Task Switching and 2-Back accounted for significant variance in Strange Stories. No EF task significantly predicted performance on TOMI-SR or interpersonal decentering. Both story comprehension tasks (False Belief and Strange Stories) were significantly associated, but these tasks were not correlated with either self-reported ToM or interpersonal decentering. Several unanticipated demographic associations were found; having more siblings and English proficiency accounted for significant variability in Strange Stories; education, presence or absence of self-disclosed autism diagnosis and mental health diagnosis explained a large portion of variance in TOMI-SR; interpersonal decentering maturity differed significantly between cisgender men and cisgender women. Lastly, interpersonal decentering number of interactions demonstrated an advantage for individuals without diagnosed or suspected autism diagnosis. This study raises critical concerns regarding measurement method error variance and variability of task demands in explaining cognitive mechanisms relevant to social cognitive processes.
An exercise in story repair: A guided written disclosure protocol for fostering narrative completeness of traumatic memories.
The present study sought to build on the large body of past research into written disclosure of traumatic memories. This research has consistently found that participants who write about their traumatic experiences realize long-term physiological and psychological health benefits. More recently, it has been found that those participants who realize the most benefits are those who progressively include more elements of a good narrative, or story, in their writing about a traumatic experience over several sessions. Therefore, research has begun to examine the role of language and the structure of language in the health benefits gained from written disclosure of traumatic memories. A guided written disclosure protocol was designed for the present study, which sought to aid participants in supplying an increasing amount of narrative structure to their written disclosures of a single traumatic experience. Participants (N = 30) completed several measures of psychological and physiological health prior to and one month after completing the guided written disclosure protocol. Analyses revealed that participants who completed all four writing sessions showed statistically significant reductions in symptoms of general psychological distress, obsessive-compulsive symptoms, and intrusive and avoidant symptoms related to the traumatic experience. No significant self-reported physiological health benefits were found. The clinical and research implications of these findings are discussed.
An Experimental Study of Mindfulness and Acceptance-Based Skills for Internalized Ageism in Older Adults and College Students
This project explored whether mindfulness and acceptance-based practices (MABPs) for older adults would reduce the negative effects of ageism and negative attitudes and beliefs related to aging. In addition, state affect and stress were explored. This study used an experimental design to compare two groups of older adults and two groups of undergraduate students – those who received a MABP and those who did not, after being presented with negative ageist stereotypes. Condition and condition by age sample comparisons revealed several findings. Following the MABP, undergraduates who received a MABP had significantly lower ageism scores than did undergraduates who did not. Older adult findings were opposite of proposed hypotheses, with older adults having higher scores on ageism after receiving the MABP, as compared to the scores of older adults who were in the comparison condition. Differences in state mindfulness were seen between conditions, with the MABP condition exhibiting more state mindfulness than in the comparison condition. However, there was no significant condition by age sample interaction effect. Change scores for state affect after the MABP were non-significant at either level of analysis, and older adults showed no difference in digit span stress scores based on their condition assignment. Exploratory analyses revealed some research consistent, as well as nuanced, findings. These findings suggest that undergraduates may respond to MABPs for recontextualizing aging, discrimination, and stigma. These findings also suggest that older adults may employ different coping strategies when confronted with ageism in an experimental context when asked to reflect, as oppose to participate in MABPs. Overall, a need for aging education, experimental research with older adults, and empirical understandings of MABPs for age-related issues, is needed. Limitations and future directions are discussed.
Explaining the Relationship Between Borderline Personality Features and Suicidal Ideation
Researchers have previously identified substance use and borderline personality disorder as factors that increase risk for suicidal thoughts and behaviors. This study explored the relationship between these factors in samples of students and individuals seeking outpatient treatment. Supplemental data collected via the internet (MTurk) also looked at experiential avoidance (EA) with the Avoidance and Fusion Questionnaire for Youth. The Structured Clinical Interview for the DSM-IV, Alcohol Use Disorders Identification Test, Scale for Suicide Ideation, and Personality Assessment Inventory- Borderline Features Scale elicited information regarding severity and/or frequency of substance use, suicidal thoughts, and borderline features respectively. Additionally, the Psychiatric Diagnostic Screening Questionnaire was administered to the UNT sample. The UNT sample analyses indicate substance use moderates, strengthening, the relationship between borderline features and current suicidal thoughts. However, severity of suicidal thoughts was lower for individuals high in both borderline features and substance use disorder symptoms compared to those low in borderline features and high in substance use symptoms. The MTurk sample analyses suggest substance use functions as a mediator. A robust relationship existed between substance use severity and EA, showing substance use as a behavioral marker for EA. In conclusion, concurrent treatment of substance use and borderline personality features would be beneficial in reducing risk for suicidal thoughts. Further investigation into the role and utility of addressing EA is warranted.
Explanatory Style and College Performance in Students with Physical Disabilities
Seventy students (38 with physical disabilities and 32 without physical disabilities) were matched on age (a criterion of ± 4 years was used) and sex. Members of both groups, Persons With Physical Disabilities (PWPD) and those Persons Not Physically Disabled (PNPD), were asked to complete the University Services Inventory, Academic Goals Questionnaire, Academic Attributional Style Questionnaire (AASQ), and Beck Depression Inventory (BDI) to determine how these variables were related to explanatory style (ES, as determined by AASQ scores). ES has its origins in the reformulated learned helplessness model (Abramson, Seligman, & Teasdale, 1978). According to this model, individuals who made attributions that were internal-stable-global (pessimistic ES) were more likely to experience mood and behavior deficits in the wake of bad events. The present study examined college achievement (GPA), utilization of university services, goal specificity, goal efficacy, and responses to academic setbacks, as these variables were related to ES. Additionally, ES scores were examined with regards to differences in gender and disability status (both between different disability groups and between individuals with and without physical disabilities).
An Exploration of Parenting Styles’ Impact on the Development of Values
The term emerging adulthood was coined during the 21st century to describe human development between adolescence and adulthood, during the ages of 18-25 (Arnett, 2000). During this stage, individuals can explore life areas. Emerging adults beginning college have a unique opportunity to form their identities and develop value systems (Hauser & Greene, 1991). With increasing autonomy, college students have possibilities for positive development and risk; values may be imperative in that differentiation. Furthermore, value systems are believed to play a major role in decision-making (Schwartz, 1992). Parents are influential in values development (Simpson, 2001; Steinberg & Sheffield Morris, 2001). During emerging adulthood, individuals have opportunities to notice discrepancies between their parents’ value system and society. Thus, emerging adults evaluate and choose personal values, which may or may not be similar to those of their parents, peers, or broader culture. Findings from this study indicate female caregivers’ parenting styles and closeness of the parent-child relationship have significant direct effects on the degree to which values are freely chosen. Specifically, Authoritarian parenting style (β = -.43 B = -1.70, p < .001), Authoritative parenting style (β = .12, B = .53, p < .001), and Emotional Support (β = .30, B = 6.80, p < .001) significantly predicted the degree to which values are intrinsically chosen. Only one significant relationship was found for male caregivers; there was a significant positive relationship between the authoritative parenting style and quality of the parent-child relationship (β = .64, B = .10, p < .001).
Exploring Psychological Intimate Partner Violence Using Brief Expressive Writing Essays
Non-physical intimate partner violence (NPIPV) is the most pervasive type of abuse, yet literature has predominantly focused on physical IPV victimization. This study employed a mixed-methods design utilizing archival expressive writing data previously collected to identify the presence of NPIPV victimization. Participants wrote about their experience after a relationship dissolution using the expressive writing paradigm. They were asked to share their deepest thoughts and feelings across two sessions. A constructivist grounded theory approach established the theoretical framework for coding the presence of NPIPV acts between romantic partners. Four themes of NPIPV were established (degradation, isolation, control, and jealousy). Disclosure of NPIPV and other themes were also evident in these data. Quantitative analyses assessed changes in participants' psychological distress after completing a brief writing intervention. The intervention increased the likelihood of NPIPV victimization being mentioned from Time 1 to Time 2 writing sessions. This study increases clinical awareness regarding NPIPV by providing insights into this longest-sustained IPV subtype. All participants reported a reduction in avoidance symptoms after completing the writing intervention. Finally, gender continues to complicate this field as researchers must acknowledge both the existence of men's victimization experiences and the greater severity of women's victimization. Clinical implications demonstrate a strength in narrative therapy when processing relationship dissolution particularly when NPIPV victimization is present.
Exploring Psychopathic Personality Traits and Moral Development in a Non-criminal Sample
This study explored psychopathic personality traits among a non-criminal, college undergraduate sample. Much research has been done on conceptualizing the construct of psychopathy, but this work has been conducted primarily with incarcerated individuals using a structured interview, The Psychopathy Checklist – Revised (PCL-R; Hare, 1991, 2003). The goal of the current study was to assess psychopathic traits among non-criminal individuals using The Self-Report Psychopathy Scale - Version Four (SRP-IV; Paulhus, Neumann, & Hare, in press), and compare how SRP-IV scores were associated with a well recognized semi-structured interview for psychopathy, The Psychopathy Checklist – Screening Version (PCL: SV; Hart, Cox, & Hare, 1995). The study also examined whether psychopathic personality traits could be predicted using a measure of normal-range personality, based on the five-factor model (FFM; Digman, 1990), and a measure developed by Loevinger (1976) related to ego development. Five-Factor Model Rating Form (FFMRF; Mullins-Sweat, Jamerson, Samuel, Olson, & Widiger, 2006) scores and Total Protocol Ratings (TPR score) on the Washington University Sentence Completion Test (WUSCT; Hy & Loevinger, 1996) were used to predict psychopathy scores. Correlations of SRP-IV scores and PCL: SV scores with FFMRF scores and WUSCT TPR scores were also examined for their uniformity. As predicted, there were significant, negative correlations between FFM domains, Agreeableness and Conscientious, and SRP-IV scores, as well as significant, negative correlations between WUSCT TPR scores and SRP-IV scores. These correlations ranged from small to strong for both SRP-IV overall scores and for SRP-IV factor scores (i.e., Interpersonal Manipulation, Callous Affect, Erratic Lifestyle, and Criminal Tendencies). Additionally, FFM domain scores and WUSCT TPR scores significantly predicted SRP-IV scores. FFM domains, Agreeableness and Conscientiousness, and WUSCT TPR scores, were the strongest predictors of SRP-IV scores. Similar results were found when FFM domain scores and WUSCT TPR scores predicted SRP-IV factor scores. Results also indicated …
Exploring the Connections between Personality, Social Cognition, and Prejudice
Very few studies have attempted to directly explore the relationship between psychopathic traits and prejudice. Among the scant studies that do exist, interpretation is often clouded by measurement limitations. The current study surveyed a large sample of adults from the general U.S. population to further our understanding of the associations between psychopathic traits and prejudicial attitudes, as well as critical constructs linked to prejudice. By using modern and well-validated measures of the target constructs new relationships were documented for the first time. A path analytic framework was utilized to represent the network of construct inter-relations. Finally, the current study examined the relationships between psychopathic traits, in relation to the other members of the Dark Triad and positive human traits, referred to as the Light Triad, as well as how the latter may serve as ‘buffers' from prejudicial attitudes.
Exploring the Relationships between Psychopathic Traits and Ethnocentric Attitudes
The current study employed both a variable- and person-centered approach to analyze data taken from a large sample of U.S. adults (N = 602, 59% males). For the former, structural equation modeling was utilized to empirically articulate the links between the four facets of psychopathy (interpersonal, affective, lifestyle, antisocial) and the six facets of ethnocentrism. For the person-centered approach, descriptive discriminant analysis was used to assess for differences in psychopathic trait profiles between those elevated or low in ethnocentric attitudes. Consistent with expectations, the affective dimension positively predicted denigration of out-group members whereas the lifestyle domain negatively predicted all facets of ethnocentrism. Unexpectedly, the antisocial facet positively predicted group cohesion and devotion towards one's ethnic in-group. Additionally, those elevated in ethnocentrism had higher interpersonal and affective scores and lower lifestyle scores relative to those low in ethnocentric attitudes. Results are discussed in the context of risk assessment for hate-based violence and the overlap in the nomological network of psychopathy and prejudicial attitudes.
External Validation of the MMPI-A-RF with Youth with Mental Health Needs: A Systematic Examination of Symptom-Based Correlates and Interpretive Statements
Over the last several decades, the Minnesota Multiphasic Personality Inventory - Adolescent (MMPI-A) has remained one of the most extensively studied and commonly used adolescent assessment measures. Most recently, the MMPI-A was revised, published as the Minnesota Multiphasic Personality Inventory - Adolescent Restructured Form (MMPI-A-RF). Given the infancy of the extant MMPI-A-RF literature, the current dissertation sought to be one of the first criterion studies since the test manual to establish its relevant clinical correlates in a sample of youth referred for mental health services. Following in line with previous clinical correlate research, the psychometric properties of the MMPI-A-RF were determined. Under this approach, the present study bolstered support for the construct validity of the RC scales through the identification of clinically relevant, scale and item-level correlates. In particular, the RCd and RC4 evidenced especially strong convergent and discriminant validity. As a result, the current study highlighted the MMPI-A-RF's efficacy in detecting psychopathology along the broad externalizing and internalizing spectrum. In addition, the role of gender and its effect on MMPI-A-RF clinical interpretations were explored. Practical recommendations for ensuring a gender-specific approach to MMPI-A-RF interpretation were outlined.
Facets of Positive Affect and Emotion Regulation in Daily Life
Positive affect, which has been broken down into four lower-level facets (i.e., joviality, attentiveness, self-assurance, serenity), has demonstrated numerous ties to physical and mental health. The experience of positive affect can be regulated by emotion regulation strategies. However, few studies have assessed their relationship, and no studies have examined the relationship using the lower level facets of positive affect. The link between positive affect and emotion regulation may be of particular importance for individuals at increased risk for bipolar disorder, as both are disrupted in individuals with the condition. The aim of the present study was to examine the relationship between positive affect and emotion regulation while also exploring whether risk for bipolar disorder moderated their relationship. Undergraduates (N = 155) completed measures of emotion regulation, affect, and bipolar disorder risk at baseline. Using ecological momentary assessment (EMA), participants completed surveys 3 times a day for 7 days. Hierarchical linear models were estimated and revealed significant effects between certain baseline emotion regulation tendencies (experiential avoidance/ psychological inflexibility, rumination, behavioral social avoidance) and daily positive affect facets as well as between daily emotion regulation use (i.e., reappraisal, acceptance, reflection, savoring, mindfulness social support, suppression, rumination, procrastination) and daily positive affect facets. Bipolar disorder risk was not found to moderate the relationship. Findings support the use of strategies emphasized in evidence-based treatments and highlight the importance of daily practice of emotion regulation skills.
Factors Affecting Revictimization in Survivors of Childhood Sexual Abuse
Structural equation modeling was used to examine how childhood sexual abuse (and other associated variables, such as family functioning and experiencing multiple forms of abuse) relates to revictimization and psychological distress. Participants were women who participated in Project HOW: Health Outcomes of Women interviews, a longitudinal study that spanned six waves of interviews. Only women with a history of childhood sexual abuse were included in the present study (n=178). Experiencing nonsexual child maltreatment in addition to childhood sexual abuse appears directly related to adult sexual and physical revictimization and indirectly related to psychological distress. Childhood sexual abuse alone was not predictive of revictimization or psychological abuse. This suggests that other mediating factors may explain the relation between CSA and revictimization found in other research. Clinical implications based on the results of the present study emphasize the importance of identifying children who have experienced multiple forms of abuse as particularly at risk for future victimization. In addition, providing interventions with a focus on education and empowerment might decrease risk for future violence and subsequent emotional maladjustment. Potential future research could examine the treatment outcomes and efficacy of these interventions as well as identify those mediating factors that increase the risk for adult revictimization for those individuals who experience only childhood sexual abuse.
Factors of Depression in the Elderly: Assessment and Implications for Diagnosis
The problem of assessment and diagnosis of depression in the elderly begins with the definition of depression being indefinite. In this study, the theory of learned helplessness was chosen because of its value in organizing research within a learning theory framework. The Beck Depression Inventory, measures of fluid and crystallized intellectual ability, locus of control, and attribution of success and failure were chosen as variables for an exploratory factor analysis. The purpose of selecting these variables was to assess the cognitive, motivational, and affective components of learned helplessness as they affected the responses of elderly subjects to depression items. Self report measures of income, education, and health, were included to assess the relationship of these variables to depression. A somatic factor was predicted to correlate with an affective factor of depression.
Family Rituals and Resilience: Relationship Among Measures of Religiosity, Openness to Experience, and Trait Anxiety
Rituals are an integral part of society. The focus of research on rituals has been shifting to highlight the effect rituals may produce on individual resilience and ability to function. This study examined the relationships between participation in family rituals and several conceptually related facets of the human experience, including religiosity, openness to experience, and anxiety. Participants responded to questions on an assessment instrument (Family Ritual Questionnaire) designed to measure participation in a broad variety of identified family rituals; they were grouped according to responses on that questionnaire, and the resulting groups were compared on their responses to questionnaires addressing religiosity (Religious Background and Behavior Questionnaire), openness to experience (Revised NEO Personality Inventory Openness to Experiences scale), and anxiety (State-Trait Anxiety Inventory). The four-group classification system did not produce significant differences on measures of religiosity, openness to experience, or trait anxiety. Nor were there any significant differences noted when the groups were examined on the basis of the demographic characteristics of age, gender, separation time from family of origin, or academic status. The demographic descriptive which was associated with specific group differences related to adult composition of family of origin: participants described the adults present in their families of origin, and the family types were grouped into traditional, mixed, and nontraditional families. A difference was identified between the traditional and nontraditional families on level of ritualization. This finding may be indicative of a useful direction for subsequent research inquiry.
Feigning ADHD: Effectiveness of Selected Assessment Tools in Distinguishing Genuine from Simulated ADHD
Research indicates that some college students may be strongly motivated to feign AHDD symptoms for desired external incentives, such as stimulant medication or academic accommodations. To date, literature examining feigned ADHD has been primarily focused on ADHD specific self-report measures (e.g., CAARS) and continuous performance tests (e.g., CPTs); however, little attention has been devoted to the use of multi-scale inventories in detecting feigned ADHD. For CPT measures, virtually no literature exists on the effectiveness of the TOVA to identify feigned ADHD, despite its frequent clinical use for establishing this diagnosis. The current study utilized a between-subjects simulation design to validate feigning cut scores on ADHD-specific measures using 66 feigners and 51 confirmed ADHD cases. As prior literature suggested, the results convincingly demonstrated that face-valid ADHD assessment measures were easily faked. Across both TOVA modalities (e.g., Auditory and Visual), the ADHD simulators performed significantly poorer than those diagnosed with ADHD. As an innovative approach, a Dissimulation-ADHD (Ds-ADHD) scale was developed and initially validated. The Ds-ADHD is composed of ten MMPI-2-RF items mistakenly believed to be clinical characteristics associated with ADHD. Requiring cross-validation, Ds-ADHD optimized cut scores and classification of ADHD feigners appears promising. They were clearly distinguishable from ADHD client, as well as those feigning general psychopathology. Recommendations for the utilization of the Ds-ADHD scale, and future directions for research are discussed.
Feigning Cognitive Deficits on Neuropsychological Evaluations: Multiple Detection Strategies
Individuals undergoing forensic neuropsychological evaluation frequently stand to gain in some manner if neurocognitive dysfunction is diagnosed. As a result, neuropsychologists are customarily asked to test for neurocognitive feigning during the assessment. The current study employed an analogue design with a clinical comparison group to examine the utility of the TOCA (Rogers, 1996) as a measure of feigned neurocognitive impairment. Two groups of simulators (one cautioned about the presence of detection strategies and one not cautioned) were compared to clinical and normal control groups. Fourteen scales were developed based on five detection strategies: symptom validity testing, performance curve, magnitude of error, response time, and floor effect. Each was employed during both verbal and nonverbal tasks. Significant differences were revealed among groups when subjected to ANOVA. Classification rates from subsequent utility estimates and discriminant function analyses on the scales ranged from 58.8% to 100%. Combining strategies yielded a classification rate of 95.7%. The effect of cautioning simulators was modest; however, a trend was noted on some scales for cautioned simulators to appear less obviously impaired than noncautioned. Although the results require crossvalidation, preliminary data suggest that the TOCA is a sensitive and specific measure of feigned neurocognitive performance. Strengths and weaknesses of the study are discussed and directions for future research are proposed.
Female Psychopathy Predictors: Cluster B Traits and Alexithymia
Psychopathy has long been lauded as a premier predictor of negative behavioral outcomes because of its demonstrated associations with violence, antisocial conduct, and institutional maladjustment. Traditional conceptualizations of psychopathy highlight the relatively equal importance placed on personality features (i.e., a grandiose, deceitful interpersonal style and deficits in affective experience) and behavioral elements (i.e., an impulsive and irresponsible lifestyle marked by social deviance) of the syndrome. However, little research to date has investigated psychopathy dimensions in female samples, particularly as they relate to maladaptive behaviors beyond forensic settings. The current study comprehensively examined personality (i.e., Axis II Cluster B traits and alexithymia) and behavioral (i.e., suicide-related behavior and aggression) expressions of psychopathy in a sample of female inpatients recruited from trauma and dual-diagnosis units at a psychiatric hospital in Dallas, Texas. Contrary to expectations, the essential components of psychopathy in female psychiatric patients emphasized APD and NPD traits over features of HPD and BPD, which were relatively similar to elements traditionally highlighted in male psychopathy. On this point, two latent dimensions comprehensively addressed female psychopathy in the current sample: impulsive antisociality and narcissistic and histrionic interpersonal style. Interestingly, psychopathy (M r = .01) and Cluster B traits (M r = .05) were virtually unrelated to suicide-related behavior in female patients with trauma and substance use histories, but APD and BPD traits were more discerning for impulsive and premeditated aggression than variants of psychopathy. Aggression's relationship to BPD traits is at least partially mediated by alexithymia. These results are discussed in terms of improving evaluation and intervention efforts aimed at identifying and managing psychopathic females beyond forensic settings.
Female Sexual Orientation: Behavior and Developmental History
The present study investigated female sexuality by examining a range of experiential, historical, attitudinal, and behavioral variables, and conceptualizing sexual orientation along several dimensions on a heterosexual/homosexual continuum. The focus was on determining what, if any, important etiological factors emerged, as well as differences in behavior, attitudes, and preferences among women with various sexual orientations. It was concluded that a nonconventionality factor could be interacting with certain experiential and situational variables to produce a bisexual or homosexual lifestyle. Consequently, the ideosyncratic variable nature of such a paradigm could partially explain inconsistencies in past research. Results of this study were comparable to previous ones indicating that the women were similar (across sexual orientations) in their emphasis on emotional aspects of a relationship, history of heterosexual dating and coitus, few (relative to males) sex partners, and a less (than males) actively assertive sexual pattern of behavior. Future research might include males in the investigation of the role of a nonconventionality factor in sexual orientation. Also, relationship between cognitive/perceptual styles and sexual orientation could be explored.
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