Selective speech motor, syntax and cognitive deficits associated with bilateral damage to the putamen and the head of the caudate nucleus: a case study

This article describes emotional distress in 44 women with Human Immunodeficiency Virus (HIV) symptomatic disease. Measures of self-reported symptoms of anxiety and depression revealed that emotional distress was prevalent in this group and may be sufficiently robust to warrant clinical diagnoses. Limits to functioning and disruptions in physical well-being were found to be associated with both anxiety and depression. Additionally, level of optimism was inversely related to anxiety and depression, and social support was inversely related to anxiety. These findings indicate that emotional distress in women with HIV disease is associated with, and could be ameliorated by, interventions targeted at functional status, social support, and level of optimism.     

Understanding the role of impulsivity and externalizing psychopathology in alcohol abuse: Application of the UPPS Impulsive Behavior Scale.

The present study explores the relation among 4 personality traits associated with impulsive behavior and alcohol abuse. Personality traits were measured using the 4 subscales of the UPPS Impulsive Behavior Scale (UPPS: S. P. Whiteside & D. R. Lynam. 2001). The UPPS and measures of psychopathology were administered to clinical samples of alcohol abusers high in antisocial personality traits (AAPD), alcohol abusers low in antisocial personality traits (AA), and a control group (total N = 60). Separate analyses of variance indicated that AAPDs had significant elevations on all 4 UPPS scales, whereas the AAs and controls differed only on the Urgency subscale. However, when controlling for psychopathology, group differences on the UPPS scales disappeared. The results suggest that personality traits related to impulsive behavior are not directly related to alcohol abuse but rather are associated with the elevated levels of psychopathology found in a subtype of alcohol abusers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological well-being after spinal cord injury: Perception of loss and meaning making.

Objective: This study examined the influence of medical injury severity, perceived loss of physical functioning (conceptualized as physical resource loss), and global meaning making on psychological well-being among 79 veterans living with a spinal cord injury. Measures: Structured interviews were completed to assess perceived loss of physical abilities using the Conservation of Resources—Evaluation and SF-36 Health Survey, global meaning making (Purpose in Life scale), and psychological well-being (Sense of Well-Being Inventory). Medical injury severity was calculated from medical records. Results: Medical injury severity was not related to psychological well-being, whereas perceived loss of physical functioning was inversely associated. Global meaning making was significantly related to and accounted for a large portion of the variance in psychological well-being. Results suggest that global meaning making partially mediates perceived loss of physical resources and psychological well-being. Conclusion: The perceived loss of physical abilities and the generation of meaning and purpose in life are important variables that relate to positive adaptation following spinal cord injury. Treatment implications related to factors that increase quality of life following spinal cord injury are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are normal healthy research volunteers psychologically healthy? A pilot investigation.

Most new drug development in Phase I clinical trials relies on the use of "normal healthy research volunteers" (NHRVs); however, little is known about the personality functioning of these volunteers. Determining whether NHRVs are similar to or different from individuals with "normal" personalities can impact participant recruitment, group assignment, and statistical interpretation of study results. This pilot study was undertaken to gain insight into the demographics, personality functioning, and potential psychopathology of the volunteers who participated in a Phase I confinement clinical drug trial. NHRVs (N=28) in an all-male, Phase I clinical trial completed a battery of questions, including the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and a sociodemographic questionnaire. Fifty percent of the sample showed clinically significant elevations on at least one of the scales. Current findings need to be replicated and expanded through future research. Results must be interpreted with caution because of the small, all-male sample. This preliminary study suggests that there is a difference in personality functioning between NHRVs and the general population. In addition, NHRVs may purposefully distort or conceal self-report information when participating in studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

MMPI profiles in PTSD as a function of comorbidity

A sample of 135 Vietnam veteran inpatients with combat-related PTSD was sorted into three groups, depending upon the presence of concurrent psychiatric disorders: Depression (n = 68), Psychosis (n = 31), and Other (n = 36). Pairwise comparisons were made on the MMPI with respect to the validity indicators, clinical scales, four relevant Harris-Lingoes subscales, the Psychoticism content scale, and the MMPI-PTSD subscale. Results indicate variations in scale elevations as a function of comorbid diagnosis. Various items and scales appear to differentiate the Psychosis group due to greater psychopathology. In general, the results spotlight the heterogeneous aspects that comorbidity brings to PTSD assessment.     

A symptom profile of hospitalization-requiring depression among the elderly related to clinical subgroups. A way to improve diagnostics

The objectives were to study clinical symptoms of major depression in later life by using relevant assessment scales of psychopathology, behavioural disorders, and physical functioning. The evaluations on admission and at discharge were based on interdisciplinary observations and interview of patients. The study was carried out during twelve months in a psychogeriatric university department and encompassed 202 patients. All (N = 80) (40%) patients who had a principal diagnosis of major depression are accounted for. Mean age was 79.5 years. Results of the assessments all showed significant improvements (p = 0.0000-0.0024). The overall results of the assessments show that the key symptom of sadness is often missing, muted, or overshadowed by other symptoms, and that behavioural disturbancies and functional disability may be important symptoms in geriatric depression. In conclusion: adequate treatment of major depression in the elderly significantly improves psychopathology, behavioural disorders and physical functioning. When dealing with mental disorders in this age group, awareness of the five clinical presentations in major geriatric depression, i.e. dementoform, somatoform neurotiform, eretic and classic geriatric depression, may target the diagnostic procedure.     

An assessment of comorbid psychological problems in a residential criminal justice drug treatment program.

161 probationers remanded to 4 mo of mandatory treatment at a criminal justice substance abuse treatment facility were assessed for evidence of psychopathology by means of the Millon Clinical Multiaxial Inventory-II and other psychosocial functioning scales. Overall, 80% of the sample was classified as having psychological problems, 72% had significant drug abuse problems, and 58% had concurrent psychopathology and drug abuse problems (i.e., comorbidity). Comparisons between psychopathology-only, drug problem-only, and comorbid groups indicated that probationers with both drug use and psychological problems engaged in more preadmission illegal activity, had more social impairments, and indicated higher motivation for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence and geographical distribution of Giardia spp. and Cryptosporidium spp. in dairy farms in Québec

Many patients with psychotic disorders lack awareness of being ill. This often presents a serious impediment to treatment compliance. We hypothesized that exposing partially remitted patients to videotapes of themselves, made while they were acutely psychotic, might increase their insight into the nature of their illness. Eighteen acutely psychotic inpatients were assigned randomly to a control or experimental group and interviewed on videotape 24 to 48 hours after admission, using scales that measure insight (Insight and Treatment Attitudes Questionnaire [ITAQ]) and psychopathology (Brief Psychiatric Rating Scale [BPRS]). One to six weeks later, when judged to be significantly improved, subjects were shown either a videotape of their initial interview (experimental group) or a placebo videotape (control group) and then reinterviewed 24 to 48 hours later on videotape, using the BPRS and ITAQ scales. Evaluation of initial and final ITAQ and BPRS scores revealed significantly greater improvement in insight scores and in delusionality in the experimental group. However, no significant difference in overall psychopathology was seen for the two groups. These results suggest that exposure of hospitalized patients to videotapes of their own psychotic behavior may be a cost-effective therapeutic tool for developing personal insight into psychotic illness.     

The convergence and predictive validity of the Multidimensional Pain Inventory and the Personality Assessment Inventory among individuals with chronic pain.

Objective: To explore the convergence, redundancy, and validity of the Multidimensional Pain Inventory (MPI) and the Personality Assessment Inventory (PAI) in a chronic pain treatment setting. Participants: Data from intake (N=235) and follow-up (N=187) for individuals with an average of 9 years of chronic pain who participated in a 20-day integrative treatment program were analyzed. Outcome Measures: Oswestry Disability Index, Beck Depression and Anxiety inventories, Rand Short-Form Health Survey, and clinician-rated ability to stand and carry. Results: Conjoint factor analyses suggested that the MPI and PAI combine to tap five orthogonal factors: Negative Affect, Support, Externalizing, Physical Dysfunction, and Impulsivity. MPI and PAI scales significantly related to various aspects of client functioning, although these scales were more limited in predicting clinician-rated markers and change during treatment. Conclusion: Results support the combined use of the MPI and PAI to understand patient heterogeneity and predict treatment outcome in chronic pain samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical correlates of anhedonia and perceptual aberration in first-episode patients with schizophrenia and affective disorder.

Examined the association between scales measuring physical anhedonia, social anhedonia, and perceptual aberration and premorbid functioning, clinical state, and current level of adjustment in 91 psychotic Ss. The patients were examined at the onset of their 1st psychotic episode and again 18 mo later. For patients with schizophrenia, anhedonia was significantly related to premorbid functioning. No association was found between the scales and clinical state or level of adjustment at intake or follow-up. In affective disorder patients, no correlation was found between premorbid functioning (a stable characteristic) and scale scores, but moderately large correlations emerged between the scales and clinical state and level of adjustment at both assessment times. These results suggest that schizophrenic and affective disorder patients endorse items on these scales for different reasons. The authors hypothesize that for patients with schizophrenia the scales assess enduring personality characteristics, whereas for the affective disordered patients they assess clinical condition at the time of testing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is the SF-36 a valid measure of change in population health? Results from the Whitehall II Study

OBJECTIVE: To measure within-person change in scores on the short form general health survey (SF-36) by age, sex, employment grade, and disease status. DESIGN: Longitudinal study with a mean of 36 months (range 23-59 months) follow up, with screening examination and questionnaire to detect physical and psychiatric morbidity. SETTING: 20 civil service departments originally located in London. PARTICIPANTS: 5070 male and 2197 female office based civil servants aged 39-63 years. MAIN OUTCOME MEASURES: Change in the eight scales of the SF-36 (adjusted for baseline score and length of follow up) and effect sizes (adjusted change standard deviation of differences). RESULTS: Within-person declines (worsening health) with age were greater than estimated by cross sectional data alone. General mental health showed greater declines among younger participants (P for linear trend < 0.001). Employment grade was inversely related to change; lower grades had greater deteriorations than higher grades (P < 0.001 for each scale in men; P < 0.05 for each scale in women except general health perceptions and role limitations due to physical problems). The greatest declines were seen among participants with disease at baseline, with the effects of physical and psychiatric morbidity being additive. Effect sizes ranged from 0.20 to 0.65 in participants with both physical and psychiatric morbidity. CONCLUSIONS: Health functioning, as measured by the SF-36, changed in hypothesised directions with age, employment grade, and disease status. These changes occurred within a short follow up period, in an occupational, high functioning cohort which has not been the subject of intervention, suggesting that the SF-36 is sensitive to changes in health in general populations.     

Adolescent and family predictors of physical aggression, communication, and satisfaction in young adult couples: A prospective analysis.

This study tested a model wherein the family conflict, depression, and antisocial behavior of 254 adolescents (mean age?=?17 years; 63% female) are prospectively related to functioning within a marital (51 %) or dating relationship in young adulthood (mean age?=?23 years). Family aversive communication in adolescence and adolescent antisocial behavior predicted couple physical aggression. Family aversive communication predicted dyadic satisfaction and aversive couple communication for married women and dating men. Among those with partners who reported little antisocial behavior, adolescent antisocial behavior inversely predicted couple satisfaction and facilitative behavior. Partner antisocial behavior did not mediate the relation between adolescent characteristics and couple functioning. Findings emphasize the importance of the early family environment and psychopathology of the adolescent in the development of adaptive couple relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social-learning theory, social desirability, and the MMPI.

Recent factor analytic interpretations of the MMPI have emphasized response sets as sources of variance, and the tendency to answer items in socially desirable or undesirable ways has been interpreted as the primary factor. It is contended that the primary factor is better interpreted as degree of psychopathology and both social-learning theory and empirical data are presented to support this view. In brief, socially desirable behaviors are typically those which conform to group standards, and the deviant behaviors which define psychopathology are usually socially undesirable. Accordingly, the tendency for MMPI scales to load inversely to social desirability on the primary factor is a consequent of the actual inverse relationship between deviancy and social acceptability of behavior. (61 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychometric properties of the Accident Fear Questionnaire: An analysis based on motor vehicle accident survivors in a rehabilitation setting.

ABSTRACT. Objective: To evaluate the reliability and validity of the Accident Fear Questionnaire (AFQ; K. Kuch, B. J. Cox, & D. M. Direnfeld, 1995), a self-rated instrument developed for efficient screening of posttraumatic stress disorder (PTSD) and phobic avoidance after involvement in a motor vehicle accident (MVA). Participants: One hundred thirteen individuals receiving rehabilitation after an MVA. Setting: Tertiary rehabilitation center. Main Measures: The AFQ, comprising a 10-item accident profile and a 10-item phobic avoidance (PA) subscale; a structured clinical interview; and other self-report measures of psychopathology, personality and pain. Results: Correlations between the AFQ-PA total score and measures of psychopathology and personality indicated adequate convergent and discriminant validity. Patients diagnosed with PTSD or accident phobia scored higher on the AFQ-PA subscale and 6 of its 10 items than did those with neither diagnosis. An AFQ-PA cutoff score of 15 appears suitable for screening of patients in a rehabilitation setting. Hierarchical logistic regression indicated that the AFQ-PA was the only self-report measure that possessed incremental power over and above general negative affectivity in predicting group membership… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5 Part I: Description and rationale.

A major reconceptualization of personality psychopathology has been proposed for DSM-5 that identifies core impairments in personality functioning, pathological personality traits, and prominent pathological personality types. A comprehensive personality assessment consists of four components: levels of personality functioning, personality disorder types, pathological personality trait domains and facets, and general criteria for personality disorder. This four-part assessment focuses attention on identifying personality psychopathology with increasing degrees of specificity, based on a clinician's available time, information, and expertise. In Part I of this two-part article, we describe the components of the new model and present brief theoretical and empirical rationales for each. In Part II, we will illustrate the clinical application of the model with vignettes of patients with varying degrees of personality psychopathology, to show how assessments might be conducted and diagnoses reached. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Remembering, forgetting, and the effects of trauma on memory: a developmental psychopathology perspective

A developmental psychopathology framework, with its emphasis on an interdisciplinary perspective, the interplay between work conducted with normal and atypical populations, and its focus on investigating functioning in multiple domains of development concurrently, possesses significant potential for advancing work on memory and trauma. A brief historical overview of memory and trauma is provided. Significant issues are highlighted that must be confronted in order to advance the understanding of the effects of trauma on memory and the utility of a developmental psychopathology perspective for informing research efforts is examined. The implications of a developmental psychopathology perspective for guiding research, clinical, and social policy initiatives of relevance to trauma and memory are discussed.     

Identifying adolescent runaways: the predictive utility of the personality inventory for children

This study investigated whether runaway behavior could be related to six problematic areas. Selected scales of the Personality Inventory for Children, representative of the six areas, were hypothesized to discriminate between an adolescent runaway group and a control group. Four scales correctly classified 95.1% of the runaway subjects and 100% of the control subjects with a total correct classification rate of 97.52%. It was further hypothesized that the runaway group was not significantly different from a known clinical group with moderate to severe psychopathology. Results indicated that the runaway group was not significantly different except on one scale, Delinquency (DLQ). On the DLQ scale the runaway group had a significantly higher mean score than the clinical group. Application and recommendations are presented.     

Psychometric evaluation of the restructured clinical scales of the MMPI-2.

Conceptual overlap and heterogeneity have long been noted as weaknesses of the Minnesota Multiphasic Personality Inventory's clinical scales. Restructured clinical (RC) scales recently were developed to address these concerns (A. Tellegen et al., 2003). The authors evaluated the psychometric properties of the RC scales in psychology clinic clients (N=285) and military veterans (N=567). The RC scales were as internally consistent as the clinical scales and correlated strongly with their original counterparts (except for RC3/Hysteria). They also were less intercorrelated, produced conceptually clearer relations with measures of personality and psychopathology, and yielded somewhat greater incremental utility than the clinical scales. Thus, the RC scales demonstrated several psychometric strengths while utilizing 60% fewer items, but the 2 sets of scales cannot be used interchangeably. Interpretive considerations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of a psychopathology rating scale for children with mental retardation.

A total of 583 children and adolescents with mental retardation were rated on a new psychometric instrument designed to screen for dual diagnosis (psychopathology in individuals with mental retardation). Two psychiatrists and 2 clinical psychologists judged the items to have face validity as expressions of psychopathology in children and adolescents with mental retardation. Cronbach's alpha coefficient was .91 for the total score and varied between .57 and .86 for 10 psychometric scales. Children and adolescents who had a dual diagnosis obtained total scores approximately 1 standard deviation higher than those who did not have a dual diagnosis. Each of 4 diagnostic groupings had test profiles in accordance with expectation. The results suggest that the instrument is particularly well suited for use in screening and for help in the analysis of the relationships between certain behavior problems and psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The temporal dynamics of tics in Gilles de la Tourette syndrome

BACKGROUND: Statistical characterization of tic behavior in Gilles de la Tourette syndrome (GTS) may provide insight into the dynamic functioning of the human central nervous system, as well as improve the quantitative assessment of tic symptom severity. METHODS: Twenty-two medication-free GTS subjects underwent videotaping of their tics. The intervals between temporally adjacent tics were measured, and the statistical properties of these intervals were assessed through graphical representation of frequency distributions, autoregressive integrated moving average (ARIMA) modeling, spectral analysis, and construction of first return maps. RESULTS: The frequency distribution of tic interval durations followed an inverse power law of temporal scaling. Spectral analyses similarly demonstrated that the spectral power density of tic interval duration scales inversely with frequency. ARIMA modeling suggested that the time series for tics are nonstationary as well as moving average processes. The first return maps demonstrated "burstlike" behavior and short-term periodicity in tics, and proved that successive tic intervals are not statistically independent. Graphic display of the time series confirmed shortterm periodicity, and in addition suggested the presence of period doubling. CONCLUSIONS: These findings are suggestive though not conclusive evidence for the presence of a fractal, deterministic, and possibly chaotic process in the tic time series. These analytic methods provide insight into the temporal features of tics that commonly are described clinically (such as short-term bouts or bursting, and longer term waxing and waning), and they reveal certain important temporal features of tics that have not been clinically described. The methods may also prove useful in the improved characterization of tic symptom severity.