Preliminary relationships between adherence and outcome in dynamic deconstructive psychotherapy.

This study examined adherence to specific psychotherapeutic techniques as a predictor of outcome in dynamic deconstructive psychotherapy (DDP), a new psychodynamic therapy for treatment-resistant clients with borderline personality disorder (BPD). Ten clients dually diagnosed with BPD and alcohol use disorders underwent 12 months of DDP. Outcome indexes included measures of borderline symptoms, depression, dissociation, social support, alcohol misuse, parasuicide, and institutional care. Independent raters coded videorecorded sessions on adherence to DDP techniques, using a scale developed for this study, as well as therapeutic alliance and standard cognitive–behavioral and psychodynamic techniques. The adherence instrument demonstrated excellent interrater and test–retest reliability. Adherence to DDP techniques was positively related to improvement in BPD symptoms (ρ = .64) and most secondary outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Narcissistic vulnerability in the hyperaggressive child: The disregarded (unloved, uncared-for) self.

Efforts to treat hyperaggressive children frequently break down in a manner which reinforces the feeling that these children are beyond the reach of psychotherapeutic intervention. This study was undertaken in an attempt to elucidate the essential nature of the psychopathology of these children in order to provide a better foundation for the therapeutic enterprise. One finding was that much of their violent behavior is related to underlying narcissistic vulnerability, one facet of which is here termed the disregarded self. Much of the child's aggressive, antisocial behavior can be understood as an attempt to cope with and defend against the hurt, the anger, and the anxiety associated with this aspect of self-structure. Origins of the disregarded self are considered from a psychodynamic perspective integrating child-rearing, sociocultural, and psychobiological factors. The implications of this concept for individual psychotherapy and milieu treatment are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.

Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A qualitative investigation of eminent therapists' values within psychotherapy: Developing integrative principles for moment-to-moment psychotherapy practice.

Ample empirical research on values has demonstrated that clients' values tend to become increasingly like those of their therapist during therapy. There is little research, however, on how therapists negotiate value conflicts and the role of values in therapy. In order to better understand this process, 14 expert psychotherapists from four major psychotherapy orientations were interviewed about their use of values in the psychotherapeutic change process. A grounded theory analysis was conducted leading to an integrative understanding of how expert therapists from different orientations conceptualize the relationship of values and change in therapy and how they work with values in sessions. Based on this analysis, four transtheoretical principles were generated that can be applied to training and practice and used to inform research on psychotherapy process and integration. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The consequences of antisocial behavior in older male siblings for younger brothers and sisters.

The contribution of younger male and female siblings' conflict and involvement in deviant activities with their older brothers to younger siblings' adolescent adjustment problems was examined in the context of parenting. Ineffective parenting during younger siblings' childhood had no direct effects on adjustment but facilitated their exposure to older brothers' deviant peers and activities. The effect of sibling conflict on adjustment was mediated by younger siblings' coparticipation in deviant activities with their older brothers during adolescence. Early sibling conflict and coparticipation in deviant activities synergistically increased the risk for younger siblings' adolescent adjustment problems. These empirical relations held in the context of parental discipline of younger siblings during adolescence. Sibling relationships entail a set of iterative social processes that strongly influence risk for adolescent antisocial behavior, drug use, sexual behavior, and traumatic experience. Variations in sibling influence were observed conditional on the gender combination of the sibling pair and on sibling age differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Elevated trajectories of externalizing problems are associated with lower awakening cortisol levels in midadolescence.

A growing body of research suggesting a negative association between basal levels of cortisol and persistent antisocial behavior has emerged. The present study examined relations between awakening cortisol levels and antisocial trajectories from ages 5 to 15 years among individuals in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. Antisocial behavior was defined by semiparametric group modeling techniques, which revealed antisocial patterns parallel to Moffitt's (1993) taxonomy of antisocial trajectories. In contrast to the claim that biological diatheses are uniquely characteristic of individuals who demonstrate an early-onset pattern of antisocial behavior, our results suggest that individuals with elevated patterns of antisocial behavior between 5 and 15 years of age—irrespective of the timing of onset or desistance—are more likely to evidence lower awakening cortisol levels compared with individuals with persistently low levels of antisocial behavior. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Externalizing psychopathology in adulthood: A dimensional-spectrum conceptualization and its implications for DSM-V.

Mental disorders involving antisocial behavior and substance use are genetically linked and vary continuously. The authors present a review and integrative conceptualization of these observations in terms of a dimensional and hierarchically organized externalizing spectrum. As a foundation for this conceptualization, the authors introduce a quantitative, model-based approach to comparing categorical and continuous conceptions of psychopathology and apply this approach in an empirical study of patterns of comorbidity among externalizing disorders as defined in the Diagnostic and Statistical Manual of Mental Disorders. The authors present evidence that comorbidity among externalizing disorders is best modeled by an underlying normally distributed continuum of risk for multiple disorders within the externalizing spectrum. The authors conclude by discussing implications of the externalizing spectrum conceptualization for classification of disorders in the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An Investigation Into the Relationship Between Socially Desirable Responding and Offender Self-Report.

Recent research has shown that offenders high on impression management report fewer antisocial attitudes and less antisocial history and are objectively rated at less risk to commit a criminal offense. Further, impression management has been shown to be significantly and negatively related to criminal behavior. The present research investigated the hypothesis that this relationship may be due to the honest responding of offenders to items measuring relatively minor antisocial and criminal behaviors. The Balanced Inventory of Desirable Responding (now the Paulhus Deception Scales; D. L. Paulhus, 1994, 1998) is shown to be confounded with criminal-risk variance, and it may lead to incorrect conclusions when used with correctional samples. The discussion centers on the relationship of socially desirable responding with other constructs important in the prediction of reoffending within a correctional population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

School performance and genetic and environmental variance in antisocial behavior at the transition from adolescence to adulthood.

Antisocial behavior increases in adolescence, particularly among those who perform poorly in school. As adolescents move into adulthood, both educational attainment and the extent to which antisocial behavior continues have implications for adolescents’ abilities to take on constructive social roles. The authors used a population-representative longitudinal twin study to explore how links among genetic and environmental influences at ages 17 and 24 may be implicated in the developmental processes involved. At age 17, expression of both genetic and nonshared environmental vulnerabilities unique to antisocial behavior was greater among those with low GPA than among those with higher GPA. This suggested that maintenance of high GPA buffered the impact of both genetic and environmental influences encouraging antisocial behavior. When GPA was high, both genetic and environmental influences involved in both traits encouraged good school performance and restrained antisocial behavior. At age 24, however, correlated family environmental influences drove the association between educational attainment and antisocial behavior. Antisocial characteristics involving school performance and educational attainment that transcend generations may slot individuals into social categories that restrict opportunities and reinforce antisocial characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental structure of genetic influences on antisocial behavior across childhood and adolescence.

It is necessary to determine if causal influences on developing antisocial behavior change with age to guide both research and theory on its origins. The extent to which the same genetic factors influence antisocial behavior across 4–17 years of age was estimated using 2,482 sibling pairs of varying genetic relatedness. Assessments of antisocial behavior by mothers (4–9 years), mothers and youth (10–13 years), and youth (14–17 years) reflected the changing validity of informants across development. Genetic influences on antisocial behavior at 14–17 years were entirely shared with those on antisocial behavior at 10–13 years according to both informants. Genetic influences on antisocial behavior at 14–17 years were distinct from those at 4–9 years, however. These age differences in genetic influences cannot be fully distinguished from informant differences across age, but the present findings indicate that youth reported to be persistently antisocial during childhood and adolescence are influenced by one set of genetic factors influencing parent-report conduct problems in childhood and a second set of genetic influences on youth-reported delinquency that come into play around the time of the pubertal transition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commentary: Causal processes leading to antisocial behavior.

Conceptual, and empirical, questions are raised regarding the notion that physical aggression is the main individual risk factor for antisocial behavior; that language impairment also constitutes a risk factor; the meaning of the male preponderance for antisocial behavior; the findings on environmentally mediated risk; the role of biosocial interplay; social context effects; the construct of antisocial behavior; developmental trends; processing of experiences; and transactional effects. The main blocks to using research to develop policy are the lack of evidence on (a) the mediators of the causal processes, (b) what is needed to bring about change, (c) ways to ensure that individuals who need interventions actually receive them, and (d) differences in levels of antisocial behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical Maltreatment Victim to Antisocial Child: Evidence of an Environmentally Mediated Process.

The well-documented finding that child physical maltreatment predicts later antisocial behavior has at least 2 explanations: (a) Physical maltreatment causes antisocial behavior, and (b) genetic factors transmitted from parents to children influence the likelihood that parents will be abusive and that children will engage in antisocial behavior. The authors tested these hypotheses in the representative Environmental-Risk cohort of 1,116 twin pairs and their families, who were assessed when the twins were 5 and 7 years old. Mothers reported on children's experience of physical maltreatment, and mothers and teachers reported on children's antisocial behavior. The findings support the hypothesis that physical maltreatment plays a causal role in the development of children's antisocial behavior and that preventing maltreatment can prevent its violent sequelae. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Association of Antisocial Behavior and Depressive Symptoms Between Partners and Risk for Aggression in Romantic Relationships.

This study examined the extent to which antisocial behavior and depressive symptoms were associated between romantic partners and whether the partner's antisocial behavior and depressive symptoms affected the individual's aggression toward the partner above and beyond the contribution of his or her own symptoms. Questions were examined concurrently and longitudinally for 79 couples from a young, at-risk sample. There were reliable associations between partners' antisocial behavior and depressive symptoms. Women's antisocial behavior and depressive symptoms were significantly related to concurrent levels of men's physical and psychological aggression. Women's depressive symptoms remained significant in predicting men's psychological aggression over time. Overall, men's risk factors had little effect on their partners' aggression. Findings suggest that interventions to reduce partner violence need to consider the potential influence of partner, as well as perpetrator characteristics. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic influences on the overlap between low IQ and antisocial behavior in young children.

The well-documented relation between the phenotypes of low IQ and childhood antisocial behavior could be explained by either common genetic influences or environmental influences. These competing explanations were examined through use of the Environmental Risk Longitudinal Twin Study 1994-1995 cohort (Moffitt & the E-Risk Study Team, 2002) of 1,116 twin pairs and their families. Children's IQ was assessed via individual testing at age 5 years. Mothers and teachers reported on children's antisocial behavior at ages 5 and 7 years. Low IQ was related to antisocial behavior at age 5 years and predicted relatively higher antisocial behavior scores at age 7 years when antisocial behavior at age 5 years was controlled. This association was significantly stronger among boys than among girls. Genetic influences common to both phenotypes explained 100% of the low IQ-antisocial behavior relation in boys. Findings suggest that specific candidate genes and neurobiological processes should be tested in relation to both phenotypes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multisystemic treatment of serious juvenile offenders: Long-term prevention of criminality and violence.

Examined the long-term effects of multisystemic therapy (MST) vs individual therapy (IT) on the prevention of criminal behavior and violent offending among 176 juvenile offenders at high risk for committing additional serious crimes. Results from multiagent, multimethod assessment batteries conducted before and after treatment showed that MST was more effective than IT in improving key family correlates of antisocial behavior and in ameliorating adjustment problems in individual family members. Moreover, results from a 4-year follow-up of rearrest data showed that MST was more effective than IT in preventing future criminal behavior, including violent offending. The implications of such findings for the design of violence prevention programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Affiliation with antisocial peers, susceptibility to peer influence, and antisocial behavior during the transition to adulthood.

Developmental theories suggest that affiliation with deviant peers and susceptibility to peer influence are important contributors to adolescent delinquency, but it is unclear how these variables impact antisocial behavior during the transition to adulthood, a period when most delinquent individuals decline in antisocial behavior. Using data from a longitudinal study of 1,354 antisocial youth, the present study examined how individual variation in exposure to deviant peers and resistance to peer influence affect antisocial behavior from middle adolescence into young adulthood (ages 14 to 22 years). Whereas we find evidence that antisocial individuals choose to affiliate with deviant peers, and that affiliating with deviant peers is associated with an individual’s own delinquency, these complementary processes of selection and socialization operate in different developmental periods. In middle adolescence, both selection and socialization serve to make peers similar in antisocial behavior, but from ages 16 to 20 years, only socialization appears to be important. After age 20, the impact of peers on antisocial behavior disappears as individuals become increasingly resistant to peer influence, suggesting that the process of desistance from antisocial behavior may be tied to normative changes in peer relations that occur as individuals mature socially and emotionally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories of family management practices and early adolescent behavioral outcomes.

Stage–environment fit theory was used to examine the reciprocal lagged relations between family management practices and early adolescent problem behavior during the middle school years. In addition, the potential moderating roles of family structure and of gender were explored. Hierarchical linear modeling was used to describe patterns of growth in family management practices and adolescents' behavioral outcomes and to detect predictors of interindividual differences in initial status and rate of change. The sample comprised approximately 1,000 adolescents between ages 11 years and 15 years. The results indicated that adolescents' antisocial behaviors and substance use increased and their positive behavioral engagement decreased over time. As adolescent age increased, parental knowledge of their adolescent's activities decreased, as did parental rule making and support. The level and rate of change in family management and adolescent behavioral outcomes varied by family structure and by gender. Reciprocal longitudinal associations between parenting practices and adolescent problem behavior were found. Specifically, parenting practices predicted subsequent adolescent behavior, and adolescent behavior predicted subsequent parenting practices. In addition, parental warmth moderated the effects of parental knowledge and rule making on adolescent antisocial behavior and substance use over time. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Developmental trajectories of co-occurring depressive, eating, antisocial, and substance abuse problems in female adolescents.

Growth trajectories of co-occurring symptomatology were examined in a community sample of 493 female adolescents who were followed annually from early to late adolescence. On average, depression, eating disorder, and substance abuse symptoms increased over time, whereas antisocial behavior decreased. Increases in each symptom domain were associated with relative increases in all other domains. Initial depressive and antisocial behavior symptoms predicted future increases in the other; substance abuse and antisocial behavior symptoms also showed prospective reciprocal relations. Initial depression predicted increases in eating disorder and substance abuse symptoms. Initial eating disorder symptoms predicted increases in substance abuse problems. Finally, the results suggest that the developmental covariation between depressive and eating disorder symptoms and between antisocial behavior and substance abuse symptoms was accounted for by distinct but related 2nd-order growth parameters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)