DSM-III—R, treatment validity, and functional analysis: Further considerations for school psychologists.

Comments on an article by F. Gresham and K. Gansle (see record 1993-11574-001) on the irrelevance of Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) for the practice of school psychology, and elaborates on issues surrounding the treatment validity construct. The issues in need of clarification are treatment validity, dimensions of DSM-III—R that would not permit analysis of its treatment utility; concern over whether DSM-III—R is useful in presenting differential treatments as a function of classification; and the manner in which treatments are designed and implemented. Because functional analysis represents an advance in the technology of assessment of academic and behavioral problems in applied and clinical settings, treatment utility has considerable potential in advancing school psychological assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic agreement between the SCID-II screening questionnaire and the Personality Disorder Examination

Instruments to assess personality disorders offer reliability, but at the cost of large amounts of a skilled clinician's time to make assessments. The Structured Clinical Interview for DSM-III Axis II (SCID-II; Spitzer, Williams, Gibbon, & First, 1990), incorporates a self-report screening questionnaire, reducing the number of items needing evaluation by the interviewer. However, false negative responses may cause clinically important areas to be overlooked. To establish the rate of false negative responses, we compared participant self-report on the SCID-II with Axis II diagnostic assessment done by clinicians using the Personality Disorder Examination (Loranger, Susman, Oldham, & Russakoff, 1987). The false negative rate was low for every diagnosis, supporting validity of following up with clinician questioning only those diagnostic elements endorsed in the self-report. Avoidant and dependent personality disorders were accurately self-reported. This, an efficient assessment instrument for personality disorders might combine self-report of those disorders where self-report is reliable, with clinician assessment where needed.     

The meaning of personality test scores.

The process of reexamining the methodological and metatheoretical assumptions of personality psychology over the past two decades has been useful for both critics and practitioners of personality research. Although the field has progressed substantially, some critics continue to raise 1960s-vintage complaints, and some researchers perpetuate earlier abuses. We believe that a single issue—construct validity—underlies the perceived and actual shortcomings of current assessment-based personality research. Unfortunately, many psychologists seem unaware of the extensive literature on construct validity. This article reviews five major contributions to our understanding of construct validity and discusses their importance for evaluating new personality measures. This review is intended as a guide for practitioners as well as an answer to questions raised by critics. Because the problem of construct validity is generic to our discipline, these issues are significant not only for personality researchers but also for psychologists in other domains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosis proneness and clinical psychopathology: Examination of the correlates of schizotypy.

The present report examined the associations between the Perceptual Aberration Scale (PAS), a prominent psychometric index of hypothetical psychosis proneness, and several measures of clinical psychopathology in a nonpsychotic psychiatric sample (N?=?101). Patients were examined by experienced clinicians using structured psychiatric interviews to assess Diagnostic and Statistical Manual of Mental Disorders-III—Revised (DSM-III—R) Axis I and II conditions and rated for anxiety, depression, severity of illness, and current adult social competence. Elevated scores on the PAS were most closely associated with anxiety and depression as well as schizotypal, schizoid, avoidant, and obsessive–compulsive personality disorder symptomatology. Hierarchical regression analysis identified schizotypal symptoms and anxiety as the two underlying psychopathological processes most useful in explaining variance in PAS scores. Results are interpreted as supporting both the clinical relevance and research utility of the PAS and enhancing the construct validity of Meehl's model of schizotypy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cross-cultural personality assessment in psychiatric populations: The NEO-PI—R in the People's Republic of China.

The Revised NEO Personality Inventory (NEO-PI—R) is a measure of the 5-factor model developed on volunteer samples in the United States. To examine its validity in a non-Western, psychiatric sample, an existing Chinese translation was modified for use in the People's Republic of China (PRC). The instrument was administered to 2,000 psychiatric in- and outpatients at 13 sites throughout the PRC. Internal consistency was low for some facet scales, but retest reliability was adequate and the hypothesized factor structure was clearly recovered. Correlations with age, California Psychological Inventory scales, and spouse ratings supported the validity of NEO-PI—R scales, and diagnostic subgroups showed meaningful personality profiles. The 5-factor model appears to be useful for the assessment of personality among Chinese psychiatric patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive personality: Associations with DSM-III-R mood and personality disorders and negative and positive affectivity, 30-month stability, and prediction of course of Axis I depressive disorders.

The authors addressed 5 issues bearing on the validity of the construct of depressive personality disorder (DPD): its relationship with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association. 1987) mood and personality disorders and normal personality dimensions of negative and positive affectivity, its stability over 30-months, and its impact on the course of Axis I depressive disorders. Two samples were used: 156 outpatients with mood disorders, personality disorders, or both, and 267 of their 1st-degree relatives. The association between DPD and dysthymia was fairly modest, whereas the associations with major depression and the personality disorders were quite low. DPD was moderately correlated with both negative and positive affectivity; however it contributed unique information beyond that available from the 2 emotional superfactors. Finally, DPD was moderately stable over a 30-month period and was associated with a poorer course of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and the DSM-IV criteria for antisocial personality disorder.

The Axis II Work Group of the Task Force on Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) has expressed concern that antisocial personality disorder (APD) criteria are too long and cumbersome and that they focus on antisocial behaviors rather than personality traits central to traditional conceptions of psychopathy and to international criteria. R. D. Hare et al describe an alternative to the approach taken in the DSM-III—Revised (DSM-III—R; American Psychiatric Association, 1987), namely, the revised Psychopathy Checklist. The authors also discuss the multisite APD field trials designed to evaluate and compare 4 criteria sets: the DSM-III—R criteria, a shortened list of these criteria, the criteria for dyssocial personality disorder from the 10th edition of the International Classification of Diseases (World Health Organization, 1990), and a 10-item criteria set for psychopathic personality disorder derived from the revised Psychopathy Checklist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

DSM-III—R personality disorders and the five-factor model of personality: An empirical comparison.

Examined the relationship between the 5-factor model (FFM) of personality and the Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) personality disorders in a sample of 54 psychiatric outpatients. Correlations between raw scores on the NEO-Personality Inventory (NEO-PI) and the number of DSM-III—R personality disorder symptoms rated present using a semistructured interview were computed. In addition, correlations between NEO-PI scores and scores on 2 self-report personality disorder inventories were also examined to determine which results replicated across instruments. Results indicate that the FFM personality dimensions of Neuroticism, Extraversion, and Agreeableness were most apparent in the DSM-III—R conceptualizations of the personality disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The long-term prediction of offender recidivism using diagnostic, personality, and risk/need approaches to offender assessment.

The present study examined the prediction of recidivism using diagnostic, personality, and risk/need approaches over a 10-year follow-up in a heterogeneous sample of 61 offenders (i.e., probationers and provincial and federal offenders). The Level of Service/Case Management Inventory (LS/CMI), Psychopathy Checklist-Revised (PCL-R), and DSM-III antisocial personality disorder (APD) were examined. The measures were highly correlated and demonstrated theoretically meaningful patterns of convergent validity. Although psychopathy was highly correlated with both LS/CMI and APD, the majority of the shared variance with LS/CMI and with APD was accounted for by Factor 2 and the criminality facet of the PCL-R. All three assessment measures predicted future violence, any future reincarceration upon release, and recidivism severity (as measured by aggregate sentence length). However, none of these measures made a significant incremental contribution to the prediction of recidivism beyond either of the other two measures. Differences between the predictive validities of the three measures were minimal. The results are discussed in terms of recent debates concerning the use of these instruments in the assessment of offender risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression screening scale validation in an elderly, community-dwelling population.

This study contrasted the relative effectiveness of an interviewer-rated instrument, the Hamilton Depression Rating Scale, and 2 self-report scales, the short form of the Beck Depression Inventory and the depression scale from the Brief Symptom Inventory, in identifying cases of depression. Cases of major depression, dysthymia, and depressive disorder not otherwise specified (NOS) were identified by means of the Structured Clinical Interview for DSM-III—R (SCID) in a sample of 177 elderly community-dwellers. Receiver operating curves were used to evaluate the relative abilities of the 3 screening instruments to identify cases of depression. All 3 instruments identified major depression and depressive disorder NOS. None was consistently sensitive to cases of dysthymia. The incremental utility of the interview-based instrument for screening was nonsignificant, suggesting that the increased expense in a community setting may not be justified. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Temporal stability and validity of two personality disorder inventories.

The 3-mo temporal stability of self-report personality disorder scores from the Personality Diagnostic Questionnaire—Revised (PDQ—R; S. Hyler and R. Rieder, 1987) and the MMPI-Personality Disorder scales (MMPI-PD; L. Morey, M. Waugh, and R. Blashfield, 1985) was examined in a sample of 51 psychiatric outpatients. In addition, the convergent and discriminant validity of the scales from the PDQ—R and MMPI-PD were also assessed. Results indicate that PDQ—R and MMPI-PD scores were relatively stable over time, but support was obtained for the validity of only several of the personality disorder scales. Issues concerning the overlap of personality disorders as well as the lack of a "gold standard" to be used for establishing the validity of personality disorder instruments are discussed. Future research aimed at combining multiple forms of Axis II assessment (e.g., self-report, interview, informant) is recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some effects of combining psychological tests on clinical inferences.

The study was designed to determine whether the reliability and validity of interpretations based on 3 frequently used psychological tests—Rorschach, TAT, MMPI—increased as a function of number of tests employed. 30 clinical psychologists completed personality questionnaires describing 5 Ss on the basis of identifying data alone, each test individually, pairs of tests, and all 3 combined. Reliability and validity did not increase as a function of number of tests, nor were there any differences between tests or pairs of tests. The validity scores for test data ranged from 66% to 73%, with a Mean of 68%. The reliability scores ranged from 56% to 72%, with a Mean of 64%. (18 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Generalized social phobia versus avoidant personality disorder: A commentary on three studies.

The findings of J. D. Herbert et al (see record 1992-27377-001), C. S. Holt et al (see record 1992-27380-001), and S. M. Turner et al (see record 1992-27401-001) are largely consistent. Avoidant personality disorder and generalized social phobia appear to be overlapping constructs that have only minor differences with respect to severity of dysfunction. This commentary addresses the implications of the findings with respect to the validity of the categorical distinction in the Diagnostic and Statistical Manual of Mental Disorders-III—Revised (DSM-III—R) between avoidant personality and generalized social phobia, revisions of their respective diagnostic criteria, and their reclassification as either an anxiety or a personality disorder. Methodological and substantive suggestions for future research are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early syphilis in an active duty military population and the surrounding civilian community, 1985-1993

The study of human aggression has been hindered by the lack of reliable and valid diagnostic categories that specifically identify individuals with clinically significant displays of impulsive aggressive behavior. DSM intermittent explosive disorder (IED) ostensibly identifies one such group of individuals. In its current form, IED suffers from significant theoretical and psychometric shortcomings that limit its use in clinical or research settings. This study was designed to develop a revised criteria set for IED and present initial evidence supporting its reliability and validity in a well characterized group of personality disordered subjects. Accordingly, research criteria for IED-Revised (IED-R) were developed. Clinical, phenomenologic, and diagnostic data from 188 personality disordered individuals were reviewed. IED-R diagnoses were assigned using a best-estimate process. The reliability and construct validity of IED-R were examined. IED-R diagnoses had high interrater reliability (kappa = .92). Subjects meeting IED-R criteria had higher scores on dimensional measures of aggression and impulsivity, and had lower global functioning scores than non-IED-R subjects, even when related variables were controlled. IED-R criteria were more sensitive than DSM-IV IED criteria in identifying subjects with significant impulsive-aggressive behavior by a factor of four. We conclude that in personality disordered subjects, IED-R criteria can be reliably applied and appear to have sufficient validity to warrant further evaluation in field trials and in phenomenologic, epidemiologic, biologic, and treatment-outcome research.     

Clinical diagnosis of borderline personality: Examination of professional differences.

We examined the influence of clinicians' professional affiliations on the assignment of DSM-III/DSM-III—R borderline personality disorder to clients. Practicing psychologists and psychiatrists provided data on patients who had been clinically diagnosed as manifesting personality disorder. Clinicians also were asked to indicate those features that best described their clients' symptomatology, using a checklist of the Axis II criteria that yielded a diagnosis based on DSM-III criteria. Results indicated that minimal differences existed between the two clinician groups in their diagnoses of borderline personality disorder and that both professional groups relied on the criteria specified in DSM-III. However, several differences in the professionals' weightings of specific features were found. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing the cognitive content-specificity hypothesis with anxious and depressed youngsters.

A. T. Beck's (1976) cognitive model of psychopathology stipulates that each emotional disorder can be characterized by a cognitive content specific to that disorder. Although other aspects of Beck's theory have been empirically supported with youngsters, few have tested the applicability of the cognitive content-specificity hypothesis to children. 45 youngsters in Grades 4–7 who met diagnostic criteria of the DSM-III—R for a depressive or anxiety disorder and 18 controls completed measures of anxious and depressive cognitions. Analysis revealed that the valence of depressive cognitions played an important role in distinguishing the anxious group from the depressed and mixed groups. Specifically, negatively worded items did not differentiate between groups as well as positively worded items. The anxious, depressed, and mixed depressed-anxious groups were not differentiated on the basis of the anxious cognitions. The results provide partial support for Beck's cognitive content-specificity hypothesis and the broader positive–negative affectivity construct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic Interview for Borderlines: Psychometric properties and validity.

The Diagnostic Interview for Borderlines (DIB) developed by J. G. Gunderson and J. E. Kolb (1976) performed well in distinguishing 59 patients with Diagnostic and Statistical Manual of Mental Disorders (DSM-III) diagnoses of borderline personality disorder from 31 psychotic inpatients and 50 personality-disordered outpatients (ages 16–55 yrs). However, there was no evidence to support the psychometric rationale for combining the 29 statements used to assess the borderline construct into the 5 area scores (social adaptation, impulse, affects, psychosis, and interpersonal relations) presently utilized in making a DIB borderline diagnosis. Findings do not replicate a previous discriminant function model (Gunderson and Kolb; see record 1979-23763-001) and suggest that further improvements in the construct validity of the DIB will require a clearer delineation of the features of the construct as well as additional studies of the psychometric properties of the present instrument. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new frame for frame-of-reference training: Enhancing the construct validity of assessment centers.

The authors undertook a comprehensive examination of the construct validity of an assessment center in this study by (1) gathering many different types of evidence to evaluate the strength of the inference between predictor measures and constructs (e.g., reliability, accuracy, convergent and discriminant relationships), (2) introducing a theoretically relevant intervention (frame-of-reference [FOR] training) aimed at improving construct validity, and (3) examining the effect of this intervention on criterion-related validity (something heretofore unexamined in the assessment center literature). Results from 58 assessees and 122 assessors suggested that FOR training was effective at improving the reliability, accuracy, convergent and discriminant validity, and criterion-related validity of assessment center ratings. Findings are discussed in terms of implications and future directions for both FOR training and assessment center practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing the construct validity of differential response latencies for personality test items.

Evaluated the effects of increasing scale reliability and of priming dimensional activation on the construct validity of personality test item differential response latencies. 93 undergraduates were computer-administered items from the 3 lengthened scales of the Personality Research Form. Findings show that differential response latencies can demonstrate remarkably strong evidence for their construct validity. In addition, the priming of personality traits may enhance the construct validity of their corresponding differential response latencies. Results support a model of test item responding where differential item response latencies reflect the interaction of an individual's schema with test item content. (French abstract) (PsycINFO Database Record (c) 2011 APA, all rights reserved)