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Transdiagnostic models of psychopathology address many of the shortcomings common to categorical diagnostic systems. These empirically derived models conceptualize psychopathology as a few broad interrelated and hierarchically arranged dimensions, with an overarching general psychopathology dimension, the p‐factor, at the apex. While transdiagnostic models are gaining prominence in mental health research, the lack of available tools has limited their clinical translation. The present study explored the potential of creating transdiagnostic scales from the joint factor structure of the Personality Assessment Inventory, Alternative Model of Personality Disorder trait scales (AMPD), and the clinical scales of the SPECTRA: Indices of Psychopathology (SPECTRA). Exploratory factor analysis in a clinical sample (n = 212) identified five factors corresponding to the Negative Affect/Internalizing, Detachment, Antagonism/Externalizing, Disinhibition/Externalizing, and Thought Disorder transdiagnostic dimensions. Goldberg's "Bass‐Ackward" method supported a hierarchical structure. Five composite transdiagnostic scales were created by summing each factor's highest loading PAI and SPECTRA scales. A global psychopathology scale was created by summing the five composite scales. All the composite scales demonstrated adequate internal consistency. Correlations between the composite scales and the NEO Five‐Factor Inventory‐3 provide initial validity evidence for four composite and global scales. The composite thought disorder scale had no conceptually corresponding NEO domain. Clinical implications and study limitations are discussed. [ABSTRACT FROM AUTHOR]

The SPECTRA: Indices of Psychopathology is a broadband assessment inventory compatible with contemporary hierarchical models of psychopathology (internalizing, externalizing, reality impairing dimensions and global psychopathology factor). This study explored the SPECTRA's construct validity using a wide range of life event (extra‐test) variables in a clinical sample. The life event variables included the following: education level, school failure, childhood adversity, suicide attempts, psychiatric hospitalizations, depression, psychotic symptoms, self‐injury, substance abuse, arrests, physical violence, marital status, employment status and current medications. Results showed that all SPECTRA clinical scales had significant life event correlations. For the higher‐order Spectra scales, the global index of psychopathology had the greatest number and range of life event correlations. Correlations for the externalizing and reality impairing Spectra scales provided solid validity evidence, while correlations for the internalizing Spectra scale were more diffuse. These findings provide the first non‐test‐based evidence of construct validity for the SPECTRA. [ABSTRACT FROM AUTHOR]

A corollary would be which is more predictive of life outcomes, the assessment of psychological phenomenon, the mind, or neurocognitive abilities, the brain? More important, I believe that patients bring both mind and brain to a psychological evaluation. From this understanding, I conceptualize psychological assessment as a method for exploring how mind-brain interactions affect functioning and psychological well-being, albeit one patient at a time. [Extracted from the article]

Psychological assessment is a complex professional skill. Competence in assessment requires an extensive knowledge of personality, neuropsychology, social behavior, and psychopathology, a background in psychometrics, familiarity with a range of multimethod tools, cognitive flexibility, skepticism, and interpersonal sensitivity. This complexity makes assessment a challenge to teach and learn, particularly as the investment of resources and time in assessment has waned in psychological training programs over the last few decades. In this article, we describe 3 conceptual models that can assist teaching and learning psychological assessments. The transtheoretical model of personality provides a personality systems-based framework for understanding how multimethod assessment data relate to major personality systems and can be combined to describe and explain complex human behavior. The quantitative psychopathology—personality trait model is an empirical model based on the hierarchical organization of individual differences. Application of this model can help students understand diagnostic comorbidity and symptom heterogeneity, focus on more meaningful high-order domains, and identify the most effective assessment tools for addressing a given question. The interpersonal situation model is rooted in interpersonal theory and can help students connect test data to here-and-now interactions with patients. We conclude by demonstrating the utility of these models using a case example. [ABSTRACT FROM PUBLISHER]

Self-report measures of psychiatric symptomatology are important components of treatment monitoring and service evaluation programs. However, the currently available measures have numerous limitations including being symptom or disorder specific, suited to a limited range of clinical settings, and having excessive burden. Consequently, there is a need for a brief and psychometrically robust measure of global symptomatology that is applicable across diverse clinical settings, therapeutic modalities and patient populations. This paper presents the development and initial validation of such a scale, the Brief Symptom Measure-25 (BSM-25). We report findings from multiple samples examining the reliability, validity, sensitivity to change and factor structure of the new instrument. The results suggest that the BSM-25 has good reliability, is suitable to multiple levels of care, sensitive to treatment induced change and has promising validity. Exploratory bifactor modelling revealed that all items loaded strongly on a general factor (bifactor) while also forming two minor group factors. Potential limitations of this study along with future research and clinical applications of the BSM-25 are discussed. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message The BSM-25 is a broad measure of symptom severity that is easy to administer and score, appropriate for divers patient populations, and suitable for monitoring progress in routine clinical practice. [ABSTRACT FROM AUTHOR]

Given the increasing interest in demonstrating effectiveness in psychiatric treatment, the current paper seeks to advance outcome measurement in child psychiatry by demonstrating how more informative analytic strategies can be used to evaluate treatment in a real world setting using a brief, standardized parent-report measure. Questionnaires were obtained at intake for 1294 patients. Of these, 695 patients entered treatment and 531 (74%) had complete forms at intake and follow-up. Using this sample, we analyzed the data to determine effect sizes, rates of reliable improvement and deterioration, and rates of clinically significant improvement. Findings highlighted the utility of these approaches for evaluating treatment outcomes. Further suggestions for improving outcome measurement and evaluation are provided. [ABSTRACT FROM PUBLISHER]

Despite growing pressure for accountability, mental health professionals continue to debate the value of routinely measuring treatment outcomes. This paper sought to move the outcomes measurement debate forward by reviewing some of the current limitations in outcomes methodology and by providing initial strategies to address them. Using these strategies, we evaluated outcomes for a large diagnostically diverse group of adult outpatients receiving treatment as usual (TAU) within an academic medical centre. Initial self-report and clinician-rated assessments were obtained from 5546 patients, and follow-up data were obtained from 1572 (28%) patients. Using the subset of patients with the follow-up data, we determined treatment effect sizes, rates of reliable improvement (and deterioration) and rates of clinically significant improvement for all patients and for specific diagnostic groups (depression, anxiety, substance abuse, mood disorders not otherwise specified, bipolar and psychotic conditions). TAU outcomes for depression and anxiety were also compared with benchmarks derived from the randomized controlled trial literature. Lastly, the impact of patient or sample characteristics on outcome was explored. Overall, these findings generally support the benefit of TAU over no treatment while also highlighting both the utility and limitations inherent in the current approaches to evaluating treatment outcomes. Suggestions for improving outcomes measurement are provided. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message Routine outcomes measurement of real world treatment is valuable. [ABSTRACT FROM AUTHOR]

The article reviews rating scales in clinical psychiatry, including the Reliable Change Index (RCI), Hamilton Depression Rating Scale (HAM-D17) and Patient Health Questionnaire-9 (PHQ-(9). It explains that there are rating scales for every aspect of psychiatric practice, including cognitive function, psychosis, and personality pathology. The article also recommends the integration of rating scales into routine clinical practice to make a clinician's evaluations more standardized.

The article reports on research conducted to investigate the role of the therapeutic alliance in brief inpatient psychotherapy. Researchers evaluated 20 patients who received supportive-expressive psychotherapy. They found that patients rated the therapeutic alliance higher than therapists and that the level of functioning was associated with patients and therapists alliance ratings. They also found that alliance ratings were also negatively associated with improvement during hospitalization.

The purpose of this study was twofold: (a) to evaluate the scaling assumptions and component structure of and present normative data for the Rosenberg Self-Esteem Scale (RSES) using a sample of US adults (N = 503), both overall and across demographic subgroups and (b) to provide new data regarding the relationship between the two RSES subcomponents of self-competence (SC) and self-liking (SL), and other demographic and clinical variables. As hypothesized, all psychometric tests supported theunderlying structure of the RSES. Overall RSES scores varied significantly across age, racial and ethnic, education, employment status, income, and marital status groups. Furthermore, differences between SC and SL were also found across groups differing in gender, age, employment status, and marital status groups. The implications and limitations of this study are discussed, with an emphasis on clinical relevance. [ABSTRACT FROM AUTHOR]

Abstract: Normal personality and psychopathology have traditionally been conceptualized as separate or distinct areas of inquiry. However recent research exploring the hierarchical nature of personality traits suggests the possibility of integrating findings across these domains. This study used the Personality Assessment Inventory () and NEO-Personality Inventory-Revised () to investigate the joint factor structure of normal personality and psychopathology. Factor analysis revealed a well defined three factor structure with scales from both instruments having prominent loadings on all the factors. The first joint PAI–NEO factor was marked by Neuroticism, Anxiety, Depression and Borderline Personality traits, the second factor had negative loadings for Agreeableness and Conscientiousness and positive loadings for Drug Abuse and Antisocial Personality traits. The third joint factor had positive loadings for Extraversion, Openness and Mania plus a secondary negative loading for Depression. The joint PAI–NEO factor structure bore a clear resemblance to the Big Three model of personality traits depicted in personality hierarchy. While preliminary the current findings suggest that normal personality and psychopathology may share a common latent structure and their shared structure may integrate into the broader hierarchy of personality traits. [Copyright &y& Elsevier]

The authors explore borderline pathology on a continuum of functioning. Rorschach variables relating to (1) aggression, (2) dependency, (3) object relations, (4) defenses, and (5) boundary disturbance were measured across a nonclinical (NC) and two clinical (borderline patients without self-mutilative behavior = N-BPD, and borderline patients with self-mutilative behaviors = SM-BPD) groups. Results demonstrated good discriminate ability (87%) between clinical and nonclinical protocols. Comparisons between N-BPD and SM-BPD groups revealed overall greater pathological scores for the SM-BPD group, specifically in dependency scores. Convergence with other studies and implications for future clinical and empirical work are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The purpose of this study was to: (1) assess the effectiveness of galantamine in the prevention of cognitive impairments during ECT treatment and (2) to explore the safety and tolerability of galantamine during ECT treatment. Methods: Nine consecutive ECT patients were given galantamine 4mg bid throughout the course of their ECT treatments followed by a second cohort of eight consecutive ECT patients who did not receive galantamine. Objective measures of cognitive functioning and depression severity were performed pre-ECT and post-ECT. Subjective ratings of depression, confusion, and side effects were obtained weekly. Results: The two groups were similar in age, gender and admission Global Assessment Functioning (GAF) scores. There were no significant between group differences found with regards to mean seizure duration, energy administered to induce seizures, blood pressure, or heart rate during and post-ECT treatment. None of the patients discontinued galantamine due to side effects and there were no severe adverse drug reactions. Patients receiving galantamine performed significantly better on delayed memory and abstract reasoning following ECT. The galantamine group showed a greater but non-significant mood improvement (repeated measure ANOVA). Conclusions: Our data support the hypothesis that galantamine may reduce cognitive impairment during ECT, especially with regards to new learning. In addition, galantamine may also enhance the antidepressant action of ECT. Galantamine was both safe and well tolerated during ECT. [Copyright &y& Elsevier]

Pediatric psychologists use the tools of assessment to evaluate the psychological functioning of youth with chronic and acute medical illnesses. This study is an exploration of the use of a performance-based measure, the Hand Test (HT; Wagner, 1983), with pediatric medical patients. A sample of medical inpatients (n = 27) and psychiatric outpatients (n = 24) were administered the HT, a self-report measure, and a parent-report behavior rating scale. Results indicate that the psychiatric group scored higher than the medical group on HT Aggression, Withdrawal, and Pathological scores. The Aggression (d = 0.90) and Pathological (d = 0.80) variables were particularly robust in differentiating between groups, but the Crippled variable did not differ between groups. Hierarchical logistic regression demonstrated the incremental validity of the HT over behavior ratings alone in the classification of clinical groups. Analyses indicated that the HT can add important information in the differentiation of medically ill children from those with psychological disturbance. [ABSTRACT FROM AUTHOR]

The Millon Clinical Multiaxial Inventory (MCMI; Millon, 1983) is a commonly used self-report instrument designed to aid in the assessment of Axis I and Axis II disorders. Concerns have been expressed regarding the procedures used in the normative research for the current version of the MCMI (MCMI-III; Millon, 1994) leading to a call for additional validity research on the MCMI-III (Retzlaff, 1996). In this study, we investigated the psychometric properties of the MCMI-III's Anxiety and Avoidant personality scales in a sample of patients diagnosed with Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) anxiety disorders. Our results suggest that the MCMI-III Avoidant scale is reliable (r = .89) and it was found to demonstrate appropriate convergent and divergent validity with other self-report measures. The MCMI-III Anxiety scale also showed adequate reliability (r = .78); however, our findings raise some concerns about the discriminant validity of this scale. A scale composed of the MCMI-III core anxiety items was found to have better discriminant validity. These findings are consistent with those reported by other researchers regarding the relationship between self-report measures of anxiety, avoidance, and depression. We conclude that the MCMI-III measures of anxiety and avoidance are consistent with other measures of these constructs and may provide valuable clinical information in this regard. [ABSTRACT FROM AUTHOR]

Discusses the application of paradigms, based on neurobiological theories, to the pharmacologic treatment of personality disorders. Existing paradigm used for the pharmacological treatment of personality disorders; Identification of the target symptoms; Application of specific classes of medications to patients with personality disorders.

Anxiety sensitivity is the fear of anxiety-related sensations, and is measured by the 16-item Anxiety Sensitivity Index (ASI; Reiss, Peterson, Gursky, & McNally, 1986). Despite the popularity and utility of the ASI in research, a number of studies have provided evidence for the inadequacy of several items, and item-to-scale correlations for the ASI have not been published. In this study, a converging set of analyses to evaluate the item adequacy and factor structure of the ASI was used. The results of these multiple analyses converged nicely suggesting that Items 1, 5, 7, 8, and 13 should be considered for removal from the instrument. The impact of removing these problematic items from the scale was explored through the reanalysis of data from 3 previously published studies that compared the original ASI with the new 11-item version (the ASI minus the 5 problematic items). The results of these analyses suggest that the 2 scales function comparably in many respects but that the new version may be a more precise measure of anxiety sensitivity. The 11-item ASI appears to tap 2 primary aspects of anxiety sensitivity: fears of somatic sensations of anxiety and fears of loss of mental control. Suggestions for further development of the ASI are offered. [ABSTRACT FROM AUTHOR]

Reports on pregnancy complications and neonatal outcomes for live births in a group of women with eating disorders. Predictors of infant size in relation to gestational age; Comparison on the frequency of birth by cesarean section and postpartum depression between pregnant women with anorexia or bulimia and nonsymptomatic women.

Discusses a brief reminder about the documentation of the psychological consultation. History of present illness; Medical history; Mental status examination; Diagnostic impressions; Treatment plan or recommendations.

Despite their frequent conjoint clinical use, the incremental validity of Rorschach (Rorschach, 1921/1942) and MMPI (Hathaway & McKinley, 1943) data has not been adequately established, nor has any study to date explored the incremental validity of these tests for predicting Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) personality disorders (PDs). In a reanalysis of existing data, we used select Rorschach variables and the MMPI PD scales to predict DSM-IV antisocial, borderline, histrionic, and narcissistic PD criteria in a sample of treatment-seeking outpatients. The correlational findings revealed a limited relation between Rorschach and MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) variables, with only 5 of 30 correlations reaching significance (p < .05). . [ABSTRACT FROM AUTHOR]

Presents information on a study which investigated both the impact of eating disorders on pregnancy outcome and the impact of pregnancy on cognitive and behavioral symptoms of eating disorders. Methodology of the study; Results and discussion.

The SPECTRA : Indices of Psychopathology (SPECTRA) is a psychological inventory that measures psychopathology at three hierarchically related levels; symptom, spectra, and global. However, to date, the SPECTRA ' s hierarchical factor structure has not been evaluated in a clinical sample. The present study used second-order factor analysis to explore the SPECTRA ' s factor structure and the congruence between the SPECTRA ' s manifest (raw score) and factor derived higher-order scales in a clinical sample. The findings showed the SPECTRA ' s factor structure to be consistent with a tri-dimensional hierarchical model. The SPECTRA ' s manifest global psychopathology scale was highly correlated with the global second-order factor scale, with 92% shared variance. The manifest and factor derived first-order Internalizing, Externalizing, & Reality Impairing scales were also highly correlated, having 88% to 94% shared variance. The findings provide additional support for the SPECTRA ' s hierarchical structure and the correspondence its manifest higher-order scales. [ABSTRACT FROM AUTHOR]

Explores the relationship of select conceptually derived Rorschach scales to the DSM Borderline Personality Disorder (BPD) and identified core features of BPD. Role of Rorschach assessment data in identifying DSM BPD patients; Similarities in the structure of BPD and histrionic borderline personality.

Focuses on a short scale designed to measure the effectiveness of mental health treatment across a wide range of mental health services and populations. Measurement of a broad domain of psychological health; Potential to be broadly responsive to a variety of treatment effects; Applications across psychiatric and psychological treatments and populations.

Presents a study on the psychometric analysis of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) personality disorders (PD), using symptom level data. When the Axis II Personality Disorders were introduced; Who developed the DSM-III PD categories and their criteria; Number of patients identified as having DSM-III-R PD diagnosis; How the data was collected; Statistical analysis of the study; Results of the study.

The relationships between the three Modifier Indices (Disclosure X, Desirability Y, and Debasement Z) of the Millon Clinical Multiaxial Inventory-II (MCMI-II) and the validity and clinical scales of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) were explored. A sample of 125 psychiatric inpatients was administered both personality measures within 7 days of admission. The pattern of Pearson correlation coefficients and principal component factors was seen as generally supporting the validity of the three MCMI-II Modifier Indices. However, the Disclosure and Debasement Indices were highly intercorrelated and similar in their MMPI-2 associations. The Desirability Index functioned in a more unique manner and demonstrated both convergent and divergent relationships with MMPI-2 Validity and Clinical scales. [ABSTRACT FROM AUTHOR]

This study compared two Rorschach administration methods across a number of test variables. With a within-subjects, counter-balanced design, 20 female subjects randomly received either an initial Rapaport (Rapaport, Gill, & Schafer, 1968) or an Exner (Exner, 1974, 1986) Rorschach administration. Results showed that the Exner administration produced significantly more Color (C), Shading (Shd), and Blend (B) responses than did the Rapaport administration. Intersystem differences were most prominent on the first presentation of the two administrations. The first Exner administration produced significantly more C, Shd, and Blend responses than did the first Rapaport administration. Findings are discussed in light of their clinical implications, limitations in the experimental design, and suggestions for improving future research. [ABSTRACT FROM AUTHOR]

Rorschach assessment data have long been rationally linked to the psychiatric condition of hysteria. This study represents the first empirical attempt to explore the associations among select Rorschach variables, the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]: American Psychiatric Association, 1994) Histrionic Personality Disorder (HPD) criteria, and two self-report measures of hysteria. We correlated four Rorschach variables with total symptom scores for DSM-IV Cluster B Personality Disorders (Borderline, Antisocial, Narcissistic, and Histrionic). We found two Rorschach variables, FC+CF+C and T (Exner, 1993), to be significantly and meaningfully correlated with both the DSM-IV HPD total score (number of criteria) and the individual HPD criteria. Although not significantly associated with the HPD total score, Denial (DEN; Lerner & Lerner, 1980) was associated with one individual HPD criterion. Furthermore, DEN was significantly correlated with the MMPI-2 Hysteria (Hy) scale. The results are reviewed in terms of their clinical utility and the insights they offer into the psychological characteristics of the DSM-IV HPD. [ABSTRACT FROM AUTHOR]

Discusses the effectiveness of selective serotonin reuptake inhibitors (SSRI), atypical antidepressants and psychotherapy in the treatment of depression. Reduced side effect profile; Decreased fatality risk; Pharmacokinetics of atypical antidepressants; Pharmacokinetics of the SSRI affecting drug activity and selection.

The Personality Assessment Inventory (PAI) is a broadband measure of psychopathology that is widely used in applied settings. Researchers developed regression-based estimates that use the PAI to measure constructs of the Alternative Model for Personality Disorders (AMPD) – a hybrid dimensional and categorical approach to conceptualizing personality disorders. Although prior work has linked these estimates to formal measures of the AMPD, there is little work investigating the clinical correlates of this scoring approach of the PAI. The current study examines associations between these PAI-based AMPD estimates and life data in a large, archival dataset of psychiatric outpatients and inpatients. We found general support for the criterion validity of AMPD estimate scores, such that a theoretically consistent pattern of associations emerged with indicators such as prior academic achievement, antisocial behavior, psychiatric history, and substance abuse. These results provide preliminary support to this scoring approach for use in clinical samples. [ABSTRACT FROM AUTHOR]

Presents information on books related to personality assessment as of December 1, 2003. Overview of the book "Setting Performance Standards, Concepts, Methods, and Perspectives," written by G.J. Cizek.; Information on the book "Conduct and Oppositional Defiant Disorders: Epidemiology, Risk Factors, and Treatment," written by C.A. Essau; Appraisal of the book "Behavioral, Social, and Emotional Assessment of Children and Adolescents," 2nd ed., written by K.W. Merrell.

Presents several books on personality assessment. 'Evaluating Outcomes: Empirical Tools for Effective Practice,' by J.D. Cone; 'The Nature of Executive Leadership: A Conceptual and Empirical Analysis of Success,' by S.J. Zaccaro; 'Applied Logistic Regression Analysis,' Second Edition by S. Manard.

Announces books, software and psychological tests relating to the topic of personality assessment and released around August 2003. 'Personality as an Affect-Processing System,' by J. Block; Wechsler Abbreviated Scale of Intelligence.

Presents information on books and software used for personality assessment. Preview of books' contents; Description of a computer program for meta-analysis.

Several books have been published on personality assessment, as of April 2003. E. Weiss K.A. Aronow had written the book 'A Practical Guide to the Thematic Apperception Test.' Another book 'Clinical Personality Assessment: Practical Approaches' was written on personality assessment which was edited by J.N. Butcher. P.A. Lichtenburg edited the book 'Handbook of Clinical Assessment in Clinical Gerontology' on personality assessment which was a disappointment for its readers.

We examined discrepancies in 81 patient‐therapist dyads' alliance ratings early in treatment (3rd or 4th session) in relation to Personality Assessment Inventory clinical scales, subscales and global psychopathology. Results indicated that PAI global psychopathology (mean clinical elevation) and the scales of Aggression [AGG], Somatization [SOM], and Anxiety‐Related Disorders [ARD] were significantly, negatively associated with an absolute difference of patient and therapist alliance ratings at Session 3. Higher initial scores on these clinical scales at treatment onset are associated with less difference (i.e., more convergence) in patient/ therapist ratings of alliance at Session 3. Correlations between PAI clinical subscales and absolute differences of patient and therapist alliance ratings at Session 3 also demonstrated statistically significant inverse relationships for several PAI subscales of Aggression‐ Attitude [AGG‐A], Aggression‐Physical [AGG‐P], Somatic‐ Health Concerns [SOM‐H], Anxiety‐Related Disorders‐Traumatic Stress [ARD‐T], Anxiety‐Related Disorders‐ Obsessive Compulsive [ARD‐O], Borderline Features‐Affective Instability [BOR‐A], Borderline‐ Self‐Harm [BOR‐S], Anxiety‐Physiological [ANX‐P], Depression‐Physiological [DEP‐P] and Antisocial‐Stimulus Seeking [ANT‐S]. Again, higher scores on these subscales at treatment onset are associated with less difference (i.e., more convergence) in patient/therapist ratings. We also examined group differences between patients rating alliance higher (Group 1) and therapists rating alliance higher (Group 2) and found that Group 1 had significantly lower scores on Mania‐Activity Level [MAN‐A]. Clinical implications of results are discussed. [ABSTRACT FROM AUTHOR]

This study contributes to the convergent and discriminant validity of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) by investigating its correlations with the relevant clinical scales of the Personality Assessment Inventory (PAI) and life space variables, such as relationship status, education level, job loss, and history of suicide attempts. Bivariate correlations were calculated for a sample of 254 psychiatric outpatients. The results indicated that the PDSQ scales demonstrated good to excellent convergent and discriminant validity with target scales from the PAI. They were also found to be meaningfully associated with a variety of life space variables. For example, five of the subscales and the Total Score correlated positively with a recent job loss, and eight of the subscales were negatively associated with education and/or employment status. Some incongruence with hypothesized relationships was discovered for life correlates classified as markers of psychiatric severity. Overall, these findings add to the emerging body of evidence corroborating the convergent and discriminant validity of the PDSQ. [ABSTRACT FROM AUTHOR]

The article presents information on two books, "Neuropsychological Assessment," 4th ed., by M. Lezak, D. Howieson and D. Loring, and "The Art and Science of Brief Psychotherapy: A Practitioner's Game," by M. Dewan, B. Steenbarger and R. Greenberg. Lezak's book expands one's view of psychology and sparks a continuing interest in brain-behavior relationships and neuropsychological assessment. The new book maintains the well received organization of previous editions. The book by Dewan and others on brief therapy is the first real contender to replace "Theory and Practice of Brief Therapy." The book is unique in that while it does introduce the reader to a number of styles of brief therapy it is more than a survey book; it actually offers many important insights and tips on the practice of brief therapy.

Introduces the review section of the 'Journal of Personality Assessment.' Aims of the section; Materials reviewed in the section.

Based on the results of prior research, we examined relationships between Personality Assessment Inventory (PAI) items on clinical scales of antisocial features (ANT) and anxiety‐related disorders (ARD) with patient‐ and therapist‐rated alliance early in treatment (third or fourth session). We also explored the relationship between the PAI treatment rejection scale (RXR) and early session therapist‐rated alliance, despite null findings in previous work. We used PAI protocols from a clinical outpatient sample (N = 80). Data were analysed using backwards linear regressions. Results indicated that a group of ANT items from different ANT subscales predicted patient‐rated therapeutic alliance, F(8,59) = 5.182, p =.000, R2 of.413, f2 = 0.70. Additionally, a group of ARD items from different ARD subscales significantly predicted therapist‐rated alliance, F(6,62) = 3.007, p =.012, R2 of.225, f2 = 0.29. No significant relationships were found for RXR items and therapist‐rated alliance, consistent with prior findings. Clinical implications are discussed. [ABSTRACT FROM AUTHOR]

The Body Dysmorphic Disorder Symptom Scale (BDD-SS) is a self-report tool that captures an array of representative behavioral and cognitive symptoms commonly displayed by individuals with BDD. The BDD-SS is regularly used among experts in the field, though its utility as a measure of treatment response has not yet been formally evaluated. Results from two clinical trials of BDD treatment were pooled from an archived database to create a sample of 220 BDD participants who received either psychosocial or medication-based interventions for BDD. We used baseline BDD-SS scores to describe psychometric properties, baseline correlations with other scales to examine the content validity of the BDD-SS, and longitudinal symptom data to evaluate capacity to detect clinically relevant change. Results indicated that the BDD-SS has good psychometric properties and is able to detect symptom change over time, although it showed lower rates of reliable change with treatment relative to the gold standard rater-administered Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS). The BDD-SS offers meaningful information about treatment response in a self-report format and may be particularly useful to employ in clinical practice settings as a means of gathering symptom and treatment response data via self-report when rater-administered interviews are not feasible, although it may underestimate the extent of improvement with treatment. [ABSTRACT FROM AUTHOR]

The current study evaluated the construct validity and sensitivity to change of the Spectra: Indices of Psychopathology in an inpatient psychiatric sample (N = 83). Admission diagnoses were generally split between Depression / Anxiety (27.7%), Substance Use Disorders (27.7%), Bipolar Disorder (22.9%), and Primary Psychotic Disorders (21.7%). Results indicate the three higher-order spectra scores (Internalizing, Externalizing, and Reality Impairing) effectively differentiated between known clinical groups, with effect sizes (ηp2) ranging from 0.13 (Internalizing) to 0.44 (Externalizing). Hypothesized spectra scores also discriminated between groups with and without a history of suicide attempts (Internalizing Cohen's d = 0.60), arrests within the last five years (Externalizing Cohen's d = 0.60), and a primary psychotic disorder diagnosis at admission (Reality Impairing Cohen's d = 1.12). Concurrent validity was supported when examining patterns of correlations with the Personality Assessment Inventory; all target correlations were statistically significant (p < 0.05) and ranged from r = 0.36 (Psychotic Experience) to r = 0.76 (Depression). Finally, sensitivity to change assumptions were met when comparing admission and discharge scores for the subsample (N = 47) of patients who also completed the instrument at discharge. The implications with respect to application and clinical utility in acute (inpatient) settings are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Post-myocardial infarction (MI) anxiety, independent of demographic and medical variables, has been linked to in-hospital cardiac complications in prior studies, but such studies have not included a concomitant assessment of depressive symptoms. The aim of this exploratory study was to determine whether post-MI anxiety was associated with in-hospital cardiac complications, independent of depressive symptoms. Methods: Subjects within 72 hours of acute MI (n=110) were prospectively assessed for anxiety [using the Beck Anxiety Inventory (BAI)] and depressive symptoms (using the Beck Depression Inventory-II and structured interview diagnoses of major depressive disorder). Individual in-hospital complications and pooled serious cardiac complications (defined as recurrent ischemia, reinfarction, congestive heart failure, and ventricular arrhythmia requiring intervention) were recorded via chart review. Results: On hierarchical multiple logistic regression analysis that accounted for demographic variables, cardiac illness, and depressive symptoms, post-MI anxiety was significantly associated with pooled serious in-hospital cardiac complications (P=.003). In addition, when the anxiety measure was limited to only the psychological symptoms of anxiety (“BAI-P”), post-MI anxiety remained an independent predictor of cardiac complications (P=.015). Conclusions: These findings suggest that the association of post-MI anxiety with in-hospital cardiac complications exists above and beyond the effects of depression. Larger studies are needed to confirm these findings, and treatment studies are needed to determine the impact of anxiety treatment on in-hospital cardiac outcomes. [Copyright &y& Elsevier]

The present studies focus on strategies for detecting back irrelevant responding (BIR) on the Personality Assessment Inventory (PAI; L. C. Morey, 1991). Moderate BIR levels can greatly affect the clinical scales of the PAI. Further, the PAT's Inconsistency and Infrequency validity scales are less than optimal for detecting BIR. L. C. Morey and C. J. Hopwood (2004) developed an alternative strategy for detecting BIR that involves comparison of 2 scales from the PAI short-form with the same 2 scales from the PAI full-instrument. The present study examines how different BIR levels affect the clinical, treatment, and interpersonal scales of the PAI in 2 psychiatric inpatient samples. The effectiveness of various strategies for detecting BIR in an inpatient setting is also discussed. Consistent with previous research, moderate rates of BIR impacted several PAI scales in a meaningful way. The Inconsistency and Infrequency validity scales of the PAI were relatively ineffective for detecting low-to-moderate BIR levels. Con- versely, the short-form full-instrument comparison strategy was much more sensitive to BIR. Finally, a new BIR detection indicator is presented that improves sensitivity rates for detecting all BIR levels in an acute setting. The implications of these results for detecting BIR in inpatient settings are discussed. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the ability of providers (medical residents and nurse practitioners) on inpatient cardiac units to recognize and appropriately treat patients with clinically significant depression and anxiety among a cohort admitted with acute myocardial infarction. Patients within 72 hours of acute myocardial infarction underwent screening with the Standardized Clinical Instrument for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition module for major depressive disorder (MDD), the Beck Depression Inventory (BDI-II), and the Beck Anxiety Inventory (BAI). In addition, the study psychiatrist and a treatment team clinician independently assessed whether they believed that patients had clinically significant depression or anxiety. Prescription of antidepressants and benzodiazepines during hospitalization was recorded by chart review. Assessments were completed for 74 patients. Providers identified <15% of patients with current MDD or with a BDI score ≥10; 11% of patients with current MDD had appropriate treatment with antidepressants. There was no significant correlation of providers’ assessment of depression with current MDD, BDI scores, or psychiatrists’ clinical assessment of depression. In contrast, providers identified 31% of patients with a BAI score ≥10 and 50% of patients who were assessed by psychiatrists as anxious; >80% of patients with high anxiety received benzodiazepines. Providers’ assessments of anxiety were significantly correlated with BAI scores and with psychiatrists’ clinical assessments. In conclusion, medical residents and nurse practitioners routinely under-recognize and undertreat depression among patients with acute myocardial infarction on inpatient cardiac units. Recognition and treatment of anxiety is substantially better, up to 50% of patients who are found to be anxious by psychiatrists after acute myocardial infarction remain unrecognized. [Copyright &y& Elsevier]

The lack of culturally appropriate psychometric instruments for the assessment of cognitive and emotional functioning in minority populations has been a concern often discussed in the assessment literature. With the increased focus on the measurement of outcome in mental health treatment, the lack of appropriate instruments for minorities has become readily apparent in this venue as well. We report on the Spanish translation of a brief and reliable measure of psychological health and well-being that has been shown to be sensitive to treatment outcomes. The original and Spanish translated versions of this measure are highly correlated, providing clinicians and organizations with a instrument that can be used for assessment of psychological well-being and treatment outcomes with Hispanic patients. [ABSTRACT FROM AUTHOR]

The Social Cognition and Object Relations Scale‐Global Rating Method (SCORS‐G) measures the quality of object relations in narrative material. The reliability and validity of this measure have been well established. However, a psychometric oddity of this scale is that default ratings are given to select dimensions when the relevant construct is not present. This can result in narrative 'blandness' and may impact clinical findings. The aim of these two studies is to understand these phenomena both psychometrically and clinically. In the first study, we identified 276 outpatients who had SCORS‐G ratings for TAT Cards 1, 2, 3BM, and 14, set criteria for narrative 'blandness' across all eight dimensions, and examined group differences. In Study 2, we used a subset (N = 99) of Study 1 and examined how percentage of formal default ratings for Emotional Investment in Values and Moral Standards (EIM), Experience and Management of Aggressive Impulses (AGG), Self‐Esteem(SE), and Identify and Coherence of Self (ICS) impacted robustness of correlations across tests of intelligence, psychopathology, and normal personality functioning. Taken together, we identified clinical characteristics of patients who are more likely to produce 'bland' narratives and increased percentages of formal default ratings. Also, an excess of default ratings per protocol impacts robustness of correlations and weakens significant correlations. As cut‐off scores increase (>25% and >28.12%), the likelihood of being able to interpret EIM, AGG, SE, and ICS decreases. Psychometric and clinical implications are discussed. [ABSTRACT FROM AUTHOR]