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Assessment of Feigning with the Trauma Symptom Inventory: Development and Validation of new Validity Scales with Severely Traumatized Patients

Description: Currently, only the TSI assesses complex traumatic reactions and patient response styles. However, its feigning scale, ATR, uses a flawed detection strategy and is potentially confounded by experiences of complex PTSD. As a consequence, clinicians using the TSI to evaluate severely traumatized patients have no useful method for discriminating genuine and feigned responding. Several detection strategies have demonstrated utility within evaluations of feigned trauma including the assessment of rare symptoms, symptom combinations, symptom selectivity, and symptom severity. The current study created scales on the TSI according to these strategies using a development sample of 107 severely traumatized patients. Validation of all TSI feigning scales was then performed with a second independent sample of 71 severely traumatized patients using a mixed simulation design. Results found support for each scale's convergent validity with SIRS primary scales (M rs = .52) and discriminant validity with measures of defensiveness on the SIRS (M rs = -.07) and TSI (M rs = -.19). Each scale also produced expectedly mild to moderate relationships with SADS-C clinical scales (M rs = .32) and the SCID-IV PTSD module (M rs = -.02). Support for their criterion validity was only moderate (M ds = .69) when comparing the scores of genuine patients to those simulating disability. Potential explanations for this trend were reviewed, including (a) the impact of comorbidity, (b) the restrictions associated with creating embedded feigning scales, and (c) the influence of simulator knowledge in analogue designs. Limitations of the study and future avenues of research were discussed.
Date: May 2011
Creator: Payne, Joshua W.

Attitudes and Treatment Knowledge by Medical Students Regarding Rape Victims

Description: The purpose of this study was to investigate the attitudes and treatment knowledge of medical student professionals regarding rape victims. In addition to generating normative data for a population which, as a function of their vocation may come in contact with victims, comparisons were made between a sample of those beginning their medical education process and those at the end of training in order to measure change in treatment knowledge and attitudes towards rape victims which occur during medical school. Also investigated were differences which exist in the attitude and treatment knowledge measures for rape victims compared to other emergency room patient populations, and the effect of gender of the physician upon those measures. A final element investigated the physicians' perceptions of a "real" rape as it relates to those measures.
Date: May 1983
Creator: Best, Connie Lee

Behavioral Treatment of Essential Hypertension: A Comparison of Cognitive Behavior and Multi-Element Self-Regulation Therapies

Description: Self-monitoring, lowered arousal training (i.e., biofeedback and relaxation training) and maintenance follow-up appeared to contribute to effective treatment of hypertension. Cognitive therapy, while effective in treatment of some stress-related disorders, has not been studied as a specific treatment component for hypertension. The present study explored the use of cognitive therapy as a treatment variable to reduce blood pressure in hypertensive persons. The effectiveness of a multi-element treatment including cognitive therapy, blood-pressure biofeedback, and relaxation training was also assessed. Self-monitoring and maintenance training were included as a part of each treatment process.
Date: May 1981
Creator: Cunningham, Diana Pinson

Characteristics and Predictors of Success at Two Coed Halfway Houses

Description: The present study evaluated offender characteristics associated with completion of halfway house placement by the inclusion of additional offender characteristics for analysis in addition to those studied in previous research, the analysis of a large number of representative cases, and the use of statistics allowing clear conclusions upon which to base decision making. Data analysis was done in three steps. The first Step was to identify offender characteristics which were associated with completion in halfway house placement. The second step was to see how accurate the offender characteristics identified were in predicting completion of an offender's halfway house stay. The third step was to identify any possible factors which underlie the offender characteristics identified. Discriminant analyses identified ten offender characteristics which were associated with completion of halfway house placement for 521 male offenders and four offender characteristics which were associated with halfway house completion for the group of 33 female offenders studied. These offender characteristics resulted in 75.38 percent correctly classified cases for the male offender group and 96.9 7 percent correctly classified cases for the group of female offenders. Factor analyses resulted in the identification of four factors for the group of male offenders and two factors for the female offender group. Suggestions for future research included replications of the present study leading to the identification of offender groups based on probabilities of successful halfway house completion, and the establishment of halfway house programs tailored to offenders identified as having high or low probabilities of completion.
Date: May 1985
Creator: Sperry, Robert M., 1953-

Cigarette Smoking Behavior: Self-Managed Change

Description: In the present study, three self-managed treatment programs were compared with respect to their ability to effect and maintain change in the cigarette smoking behavior of 27 subject volunteers from the population of employees of a Veterans Administration hospital. Subjects were randomly assigned to a self—imposed delay group, a self-directed relaxation group, and a self-monitoring group. The experimental program lasted 6 weeks with a 20-minute individual meeting each week. Three months following treatment, subjects were contacted by mail and were asked to monitor their smoking behavior for one week, and to return their average daily smoking rate by mail. The results provide support for the effectiveness of the self-management technique of self-imposed delay as a durability—enhancing treatment procedure. The effectiveness of self-management techniques as a general class of treatment strategies was not supported. A task for future research would be to establish the effectiveness of the delay technique implemented earlier in the cigarette smoking chain, as well as to determine whether effectiveness is increased or decreased by a specification of the content of a delay interval.
Date: May 1977
Creator: Taylor, Paul Wesley

Comparative Models of the Impact of Social Support on Psychological Distress in Cancer Patients

Description: This study tested the relationship between Social Support, Psychological Distress, and Illness Stress in individuals who report cancer as a health condition. This study was based on archival data obtained from the Wave 1 of the Health and Retirement Study (HRS). The HRS provides a nationally representative sample of individuals aged 51 to 61 in 1992 and their spouses. The study sample was limited to cancer patients with a spouse or partner (n = 503). A structural equation modeling analysis procedure was used to test the theoretical models. Measures of social support were limited to variables assessing the participant's satisfaction with social support. Evidence was found for the Stress Prevention and the Support Deterioration models. This is congruent with previous research using measures of social support perception. Both the Stress Prevention and the Support Deterioration models predict a negative relationship between Illness Stress and Social Support. In addition, a univariate analysis of variance was used to test the stress buffering model. Similarly to other studies measuring the individual's degree of integration, or its perception, in the social network, the present research supported the only the Main Effect model and not the Stress Buffering model.
Date: May 2000
Creator: Forjaz, Maria João Bettencourt Pereira

A Comparison of Drug Treatment for Insomnia and the Effect of Causal Attribution

Description: A double-blind comparison was conducted using typical doses of soporific agents from three drug classes and a placebo. Drugs which were used in the study included secobarbital, flurazepam hydrochloride, and thioridazine. Subjects were 40 outpatient volunteers whose primary complaint was difficulty in falling to sleep. Subjects were randomly assigned to one of the three drug groups or the placebo group. One of the drugs or the placebo was administered to each subject for 3 nights. Half of the subjects in each of the four groups were told the drug had caused any observed changes in their sleep behavior and were in this way led to attribute any changed sleep behavior externally to the drug. The other half were told the drugs were not typically used to treat insomnia and changes in their sleep were due to changes made in their own behavior, thus attributing any changes in sleep behavior internally. The implication for clinicians was that a short course of drug therapy using a placebo or one of several soporific drugs might be used equally effectively to treat primary latency insomnia. Additionally, the results demonstrated that clinicians might expect the effectiveness of treatment to be maintained following treatment. Recommendations included a suggestion for future research with soporific drugs in other classes.
Date: May 1979
Creator: Gifford, Susan Dalton

A Comparison of Short-Term Systematic Desensitization and Implosive Therapy under Therapeutic Level of Aspiration

Description: Systematic desensitization and implosive therapy have surfaced as two of the primary behavioral therapy techniques to decrease phobic responses during the past decade. Although attempts have been made to compare the efficiency and effectiveness of these two techniques, results have been unclear because of the failure of researchers to duplicate the procedures as described by their respective originators. This experiment is designed to explore the joint effects of the therapies and level of therapeutic aspiration. A second objective, and a byproduct of the data produced in achieving the primary objective, was to analyze the goal discrepancy and attainment discrepancy scores accruing throughout the therapy sessions. Several hypotheses were advanced. Further analysis of the three criterion measures by means of ANOVA resulted in significant main sessions effects for each of the three independent analyses. Results suggest that all subjects, regardless of treatment subgroup, did make significant therapeutic gains in their approach scores, fear thermometer scores, and speed of approach scores from the first to the last session. Possible explanations for results were discussed. Furthermore, approach test absolute goal discrepancy, fear thermometer absolute goal discrepancy, approach test absolute attainment discrepancy, and fear thermometer absolute attainment discrepancy scores were calculated for all goal-setting subjects. Results from independent ANOVA suggest that the typical university student is able to make fairly accurate and consistent predictions concerning his future behavior, based on his past experiences.
Date: May 1978
Creator: Brooks, Franklin Ramon

A Comparison of the MMPI, Faschingbauer's Abbreviated MMPI and the MMPI-168 with Selected Medical Patients and Medical School Applicants

Description: The Minnesota Multiphasic Personality Inventory (MMPI) is often used for evaluating candidates for gastric bypass surgery, chronic pain patients, head trauma victims, and medical school applicants. However, due to the considerable time involved in completing and scoring the standard MMPI, researchers have attempted to devise short versions of this instrument to reduce the time required while providing similar results. In recent years, the Faschingbauer Abbreviated MMPI (FAM) and the MMPI-16 8 have been proposed as viable MMPI substitutes. The present study examined the comparability between profiles using these short versions of the MMPI with the patterns obtained using the entire measure. Participants consisted of equal numbers of gastric bypass candidates, chronic pain patients, head trauma victims, and medical school applicants. Scores on the FAM tended to be similar to scores on the complete MMPI for gastric bypass, chronic pain and head trauma patients. In contrast, the MMPI-16 8 yielded profiles which were similar to complete MMPI profiles with chronic pain and head trauma patients.
Date: May 1984
Creator: Martin-Cannici, Cynthia Elaine

Contingency Contracting Effects on Psychotherapy Attendance and Termination at Two Community Mental Health Centers

Description: Contingency management has been utilized to improve treatment compliance and attendance in a medical setting. A related question involves the effect of contingency management on attendance in outpatient psychotherapy. Sixty-nine individuals ranging in age from 8 to 50 years agreed to participate in such a study. These individuals agreed to sign a contract specifying consequation for failure to notify the centers 24 hours in advance of an impending absence. Data on attendance and notification of impending absences were collected weekly for five sessions. After five sessions, dropouts and remainers were interviewed and the course of treatment was discussed. For the purpose of this study, a "dropout" occurred whenever an individual terminated therapy by missing an appointment and not rescheduling, or whenever an individual missed three consecutive appointments.
Date: May 1981
Creator: Adams, Joe B. (Joe Bayless), 1949-

A Criterion Validity Study of the MMPI-2 and PAI Spanish Versions with DIS Diagnosis: Implications for Clinical Practice

Description: New Spanish versions of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Personality Assessment Inventory (PAI) were assessed with the Spanish translation of the Diagnostic Interview Schedule (DIS) as the gold standard. Findings from categorical and dimensional analyses suggest that, although the degree of diagnostic concordance of both measures with the DIS was found to be moderately high, the MMPI-2 clinical scales yielded greater specificity but lower sensitivity than the PAI scales on two of four diagnostic categories (i.e., Major Depression, and Schizophrenia). Both measures failed to correctly diagnose Anxiety Disorders, while the MMPI-2 also showed poor diagnostic accuracy with Alcohol Dependence.
Date: May 1995
Creator: Fantoni, Patricia (Patricia Maria Angelica)

Depression: Assessment of Factors

Description: Depression received much attention in the professional literature as a stimulus both for experimental as well as applied research. It continued to be the subject of much controversy in respect to its definition, identification, and classification. Attempts were made to objectify the assessment of depression using self-report scales to tap various aspects though to be related to its etiology as well as its symptomology. Two of the most popular and reportedly well-validated self-report scales identified in the literature for determining and quantifying depressive symptoms were the Beck Depression Inventory (Beck) and the Zung Self-Rating Depression Scale (Zung).The present study was designed to determine if there were factors in common between the Beck and the Zung scales and, in addition, to test whether these factors would differentiate subjects by sex class membership, diagnostic category, and by some linear combination of biographical or life-history information. The major purpose was the identification of outstanding charactersitics of depression predicted from biographical data and the determination of the relationship of these data to self-rating psychometric measures of depression. This study makes it clear that the Beck and Zung scales are measuring different aspects of depression and thus are likely based on separate constructs. The need of developing a depression index based on separate factor scores is highlighted. Also, a multimodal approach to assessment in general is indicated. Studies relating biographical information to factors of depression are suggested. This study makes several inroads, generating descriptive factors and significant biographical or life history correlates. These findings could be expanded and further research could lead to the development of assessment tools useful in the identification of patients with distinct depressive syndromes, as well as at-risk subject groups, in order to implement both primary and secondary prevention.
Date: May 1980
Creator: Cozort, Donna

Effects of Cautioning and Education in the Detection of Malingered Mild Traumatic Brain Injury

Description: 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.
Date: May 2006
Creator: Scholtz, Brendon P.

The Effects of Computer Versus Personal Administration on Measures of Verbal and Spatial Short-Term Memory

Description: 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.
Date: May 1985
Creator: McFarlane, Gilbert John

The Effects of Different Confidentiality Conditions on Adolescent Minor Patients' Self-Report of Behavioral and Emotional Problems

Description: 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.
Date: May 1992
Creator: Drake, David Warren

Effects of Evaluative Modeling on Client Behavior and Self-Evaluation in Behavior Rehearsal for Assertive Training

Description: 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.
Date: May 1980
Creator: Lloyd, Sidney William

The Effects of Stimulation and Depression of the Reticuloendothelial System on Sidman Avoidance Behavior

Description: 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.
Date: May 1977
Creator: Stowe, Judith E.

An exercise in story repair: A guided written disclosure protocol for fostering narrative completeness of traumatic memories.

Description: Flutists have reported musculoskeletal pain from practicing and performing their instrument. This study was a statistical approach to investigate potential causal risk factors for flute related pain among high school and college students. The study focused on the relationship between flute related pain and musical background or anthropometric measurements including size, strength and flexibility. Subjects included thirty high school and college-aged flutists who were assessed using a questionnaire, bi-lateral anthropometric measurements of the upper-extremities, upper-extremity performance tests for range of motion, isometric strength and rotation speed, and instrument specific questions. Four questions regarding pain associated with flute playing were treated as dependent variables and used for correlation and regression analyses with other independent variables. A six-factor regression model was created and each model was statistically significant. Results of this study show that strength, flexibility, pain spots, and exposure are risk factors for flute related pain. Both left and right pinch strength and right isometric pronation strength were significantly correlated to flutists experiencing pain while playing. Knowledge of these factors in relationship to pain is needed in flute pedagogy to help teachers and performers understand why flutists report pain during and after playing. Additional studies are warranted for replication of this study and for determining the clinical and pedagogical relevance of these findings.
Date: May 2008
Creator: Tomczyk, Daniel A.

Exploring Psychopathic Personality Traits and Moral Development in a Non-criminal Sample

Description: 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 ...
Date: May 2013
Creator: Bewsey, Kyle

Imagery, Psychotherapy, and Directed Relaxation: Physiological Correlates

Description: Thirty outpatients being treated at Wilford Hall USAF Medical Center Department of Behavioral Health Psychology were randomly assigned to either a relaxation/imagery training class (R/I), a short-term psychotherapy group (P/G) or a no treatment control group. Subjects had psychological, physiological and immunological data taken before and after treatment. Results indicated that support for the hypothesis that relaxation/imagery training improves the psychological, physiological, and immunological functioning of participants was found.
Date: May 1992
Creator: Baldridge, Jeffrey T. (Jeffrey Turner)

Implementation of a Therapy Group for Wives of Veterans with Posttraumatic Stress Disorder: Development and Preliminary Outcomes

Description: The purpose of this study was to develop a manualized therapy group for wives or significant others of veterans with posttraumatic stress disorder and to evaluate its effectiveness in reducing wives' psychological symptoms. A second aim of the study was to determine if women's involvement in the wives group resulted in decreases in their husbands' PTSD symptoms. Women recruited for the study were administered pre-test measures during a screening session. They then participated in a 9-session manualized therapy group designed by the researcher that included psychoeducational, process, and support components. Examples of group topics included psychoeducation regarding PTSD, assertiveness and communication, intimacy, self-care, and stress management. After completing the group sessions, participants were asked to complete post-test measures. Other factors explored in this study included marital satisfaction, perceived social support, general satisfaction with the group, and demographic variables. Results indicated that wives who participated in the group treatment exhibited significant decreases in secondary stress symptoms and increases in marital satisfaction from pre-test to post-test. The majority of participants also reported high levels of satisfaction with the group process. Therefore, it appears that the group protocol presented in this study could be a useful tool in the treatment of wives of veterans with PTSD. The results of this study have potential implications regarding the clinical treatment of families of veterans with PTSD and the development of future programs within the VA system.
Date: May 2011
Creator: Reck-Gordy, Jennifer K.

Life Stress and Adjustment: Effects of Cognitive Content and Cognitive Organization

Description: Individual differences of cognitive organization and content were investigated as they relate to adaptation to remote, recent, and immediate life stress. Outside the field of stress, prior researchers have implicated cognitive organization with adjustment and cognitive content with specific psychopathology. As for behavioral adaptation to life stress, cognitive organization was viewed as a major factor in emotional vulnerability and adjustment, and cognitive content as a major factor in the mood disturbance of depression. Behavioral adaptation was defined in terms of current emotional vulnerability, adjustment and negative changes in the immediate (last six months), recent (over six months), and remote (over one year) past.
Date: May 1985
Creator: Hickox, Sherrie Danene

Locus of Control of Reinforcement Applied to the Prediction of Use of Medical Services

Description: Increases in the number of users of the medical delivery system, along with an ever-increasing variety of available services, makes it desirable to identify those individuals who will benefit most from its services. With the growing reliance on third party payment, economic limitations no longer effectively restrict the use of the system's resources to those individuals who are truly ill. A framework is needed whereby individuals who are medically ill can be separated from those whose needs might be more effectively addressed by other services. A variety of means, including locus of control, has been used in the attempt to make such discriminations. In conclusion, it was observed that the low magnitude of obtained relationships presents opportunities for future research, but disallows meaningful prediction at the present time.
Date: May 1980
Creator: Flynn, Michael Howard