Search

In recent years, there has been growing interest in examining the stimulus pull effects on respondent narratives to the Thematic Apperception Test (Murray, 1943) using standardized coding methods such as the Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995). The present study expands on prior work by examining sources of variance in SCORS-G dimensions and card pull effect patterns in an adult clinical sample characterized by high psychiatric comorbidity and clinical severity. A sample of 158 adult psychiatric patients in long-term residential treatment provided narratives to 10 TAT cards (five of which have not previously been studied for pull effects). Cards 2 and 7BM pulled for significantly more adaptive narratives (positive pull), whereas Card 13MF pulled for more pathological stories (negative pull). Like prior studies, variance in cognitive dimensions of the SCORS-G was most explained by person effects, whereas the largest source of variance for all other dimensions was best explained by a combination of the card and the person effects on the narrative. Finally, exploratory analyses of card pull effects within different gender groups were conducted. The implications of these findings for performance-based future studies and possible clinical applications of card pull findings are discussed.

While understanding how internalized representations of others (i.e., object relations) change over the course of treatment is essential for treatment planning and evaluation of progress, few studies have examined the nature of these changes through repeated psychological assessments. In this study, we applied the SCORS-G to Thematic Apperception Test narratives for 61 adult patients with complex psychiatric problems undergoing residential treatment over an 18-month period. Over the course of treatment, patient representations of self and others became more complex, indicating improvements in mentalization. Further, an analysis of default ratings (i.e., an aspect of story 'blandness') suggested that certain shifts in SCORS-G dimensional scores over time were accounted for by greater degree of scorable content across time points, rather than changes specific to the dimensions themselves. Findings from novel exploratory analyses aimed at evaluating the test-retest reliability of both default rating proportion and several emerging alternative scoring approaches (including changes in minimum, maximum and range of scores on individual dimensions) are reported. While the magnitude of change across mean dimensional scores was found to be lower compared to those previously found in outpatient populations, our results suggest that the SCORS-G remains capable of detecting changes in mentalization capacities in individuals contending with longstanding, severe psychiatric impairment and personality-based psychopathology. Implications for treatment, assessment and future research are discussed.

Hepatocyte transplantation (HcTx) is a promising approach for the treatment of metabolic diseases in newborns and children. The most common application route is the portal vein, which is difficult to access in the newborn. Transfemoral access to the splenic artery for HcTx has been evaluated in adults, with trials suggesting hepatocyte translocation from the spleen to the liver with a reduced risk for thromboembolic complications. Using juvenile Göttingen minipigs, we aimed to evaluate feasibility of hepatocyte transplantation by transfemoral splenic artery catheterization, while providing insight on engraftment, translocation, viability, and thromboembolic complications. Four Göttingen Minipigs weighing 5.6 kg to 12.6 kg were infused with human hepatocytes (two infusions per cycle, 1.00E08 cells per kg body weight). Immunosuppression consisted of tacrolimus and prednisolone. The animals were sacrificed directly after cell infusion ( n=2), 2 days ( n=1), or 14 days after infusion ( n=1). The splenic and portal venous blood flow was controlled via color-coded Doppler sonography. Computed tomography was performed on days 6 and 18 after the first infusion. Tissue samples were stained in search of human hepatocytes. Catheter placement was feasible in all cases without procedure-associated complications. Repetitive cell transplantations were possible without serious adverse effects associated with hepatocyte transplantation. Immunohistochemical staining has proven cell relocation to the portal venous system and liver parenchyma. However, cells were neither present in the liver nor the spleen 18 days after HcTx. Immunological analyses showed a response of the adaptive immune system to the human cells. We show that interventional cell application via the femoral artery is feasible in a juvenile large animal model of HcTx. Moreover, cells are able to pass through the spleen to relocate in the liver after splenic artery infusion. Further studies are necessary to compare this approach with umbilical or transhepatic hepatocyte administration.

The Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013) introduced the Alternative DSM–5 Model for Personality Disorders (AMPD). Criterio...

The Alternative Model for Personality Disorders (AMPD) construes personality disorder diagnosis in terms of levels of personality functioning (LPF) as well as dimensions of pathological personality traits. The Hierarchical Taxonomy of Psychopathology (HiTOP), which offers a comprehensive framework for conceptualizing psychopathology, integrates pathological personality traits into a model for understanding different disorders, deficits, and personality problems. Widiger et al. ( 2018 ) placed LPF within the HiTOP model, suggesting that LPF might already be subsumed by trait dimensions and other spectra representing severity of psychopathology. This commentary raises a number of questions about their underlying assumptions, and advocates for an expanded role for LPF to more fully capture the complexity and instability inherent in personality disorder pathology.

Brief psychodynamic psychotherapy (BPP) begins with an assessment to gauge client appropriateness for treatment, generate treatment goals, and build a dynamic focus. During this assessment, other goals must also be achieved for treatment to have a successful start. Building a strong alliance, empathizing and bonding with the client, and clarifying the client's understanding of key therapeutic activities are all common factors known to improve treatment course and outcome. Although these goals are desirable across treatment approaches, clinicians typically pursue them in a manner aligned with their treatment orientation. Ideally, common factor goals are achieved alongside treatment-specific aims. In BPP, therapists strive to help clients develop insight, improve self-understanding, and enhance relational functioning. This article argues that exploration of relationship episodes, using techniques from the core conflictual relationship theme method during the assessment phase of BPP is an efficient way to simultaneously pursue common factor goals and BPP-specific aims. Specifically, exploring relationship episodes aids in the selection of treatment goals, bolsters the therapeutic alliance, and helps clarify the value of therapeutic endeavors, while also promoting greater insight and self-understanding. Exchanges from clinical cases are provided to demonstrate each of these points. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Assessors using storytelling assessment techniques have debated the relative importance of picture imagery (card pull) versus story content for interpreting clients' stories. This study used generalizability theory to compare sources of variance in scores for Feffer's Interpersonal Decentering as a function of persons, cards, raters, or interactions. Representing situational activation of mature role-taking (mentalizing of interpersonal processes), decentering activity should differ across interpersonal situations according to the social role norms involved, resulting in more variance due to card pull than for previously studied scoring systems. Decentering scores from stories told to heterosexual romantic-pull pictures were compared with those for other pictures and with scores from romantic versus nonromantic stories to identify score variance explained by card pull and story content. Considering cards as analogs for life situations, person-card interaction explained more decentering variance (53.7%) than did other effects. Heterosexual romantic-pull pictures stimulated more mature decentering than others; story content did not explain significant variance. Women told more mature decentering stories to heterosexual romantic-pull pictures than to other pictures, and more so than men did. Finding strong person-card interaction illuminates typically low internal consistency for content-based scoring systems. Recommendations for clinicians include implications for card selection and story content interpretation.

With the introduction in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) of a hybrid system of personality disorder assessment, the ability to assess patients' traits, as well as their level of personality functioning, has become increasingly important. To assess this criterion, the DSM-5 Levels of Personality Functioning Questionnaire (DLOPFQ) was developed. The DLOPFQ assesses individuals' self-impairments and other impairments in several domains (self-direction, identity, empathy, and intimacy) and across 2 contexts (work/school and relationships). A sample of 140 psychiatric and medical outpatients was administered the DLOPFQ and several other measures to assess its reliability and construct, incremental, and discriminant validity. The internal consistency and convergence with validation measures yielded generally meaningful and expected results. Several DLOPFQ scales and subscales were significantly correlated with measures of DSM-5 trait domains and levels of personality functioning. DLOPFQ scales also correlated with self-reported ratings of overdependence, detachment, healthy dependency, and overall mental health and well-being. The DLOPFQ also predicted interpersonal and general functioning beyond DSM-5 trait domains. These results support the reliability and validity of the DLOPFQ, which appears to be suitable for clinical use and warrants ongoing study. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The social cognition and object relations scale-global rating method is a clinical rating system assessing 8 domains of self and interpersonal functioning. It can be applied to score numerous forms of narrative data. In this study, we investigate the SCORS-G relationship to measures of alliance and readiness for psychotherapy with an adolescent inpatient sample. Seventy-two psychiatrically hospitalized adolescents were consented and subsequently rated by their individual and group therapist using the SCORS-G. The unit psychiatrist also completed an assessment of patients' readiness for inpatient psychotherapy. The patients completed a self-report of their alliance with the inpatient treatment team as a whole. SCORS-G ratings were positively correlated with assessments of readiness for inpatient psychotherapy and patient-reported alliance. This study further demonstrates the clinical utility of the SCORS-G with adolescents.

There continues to be a need in the field of psychology for measures that quantify qualitative data in dynamically rich and clinically meaningful ways. The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Westen, 1995) is a clinician-rated measure with a strong theoretical foundation that assesses sophisticated underlying constructs, specifically 8 dimensions of object relations (Stein & Slavin-Mulford, 2018 ). The SCORS-G has steadily increased in popularity and this special section of the Journal of Personality Assessment reflects this growing interest. In this introduction, we provide readers with a brief overview of the 5 articles in this special section and note ways in which they reflect and build on the existing SCORS-G empirical literature. Contextualizing these articles within the broader literature allows us to highlight how the measure is employed in clinical and research settings. Each of these 5 articles also highlights areas and opportunities for future research that would address gaps in the SCORS-G literature and strengthen the utility of the measure. We close by noting how each of studies can be seen as a model for future lines of research.

Over the past 50 years, image-guided procedures have been established for a wide range of applications. The development and clinical translation of new treatment regimens necessitate the availability of suitable animal models. The juvenile Göttingen minipig presents a favourable profile as a model for human infants. However, no information can be found regarding the vascular system of juvenile minipigs in the literature. Such information is imperative for planning the accessibility of target structures by catheterization. We present here a complete mapping of the arterial system of the juvenile minipig based on contrast-enhanced computed tomography. Four female animals weighing 6.13 ± 0.72 kg were used for the analyses. Imaging was performed under anaesthesia, and the measurement of the vascular structures was performed independently by four investigators. Our dataset forms a basis for future interventional studies in juvenile minipigs, and enables planning and refinement of future experiments according to the 3R (replacement, reduction and refinement) principles of animal research.

The current study investigated the interrater reliability and validity of prototype ratings of 5 common adolescent psychiatric disorders: attention-deficit/hyperactivity disorder, conduct disorder, major depressive disorder, generalized anxiety disorder, and posttraumatic stress disorder. One hundred fifty-seven adolescent inpatient participants consented to participate in this study. We compared ratings from 2 inpatient clinicians, blinded to each other's ratings and patient measures, after their separate initial diagnostic interview to assess interrater reliability. Prototype ratings completed by clinicians after their initial diagnostic interview with adolescent inpatients and outpatients were compared with patient-reported behavior problems and parents' report of their child's behavioral problems. Prototype ratings demonstrated good interrater reliability. Clinicians' prototype ratings showed predicted relationships with patient-reported behavior problems and parent-reported behavior problems. Prototype matching seems to be a possible alternative for psychiatric diagnosis. Prototype ratings showed good interrater reliability based on clinicians unique experiences with the patient (as opposed to video-/audio-recorded material) with no training.

Objective We sought to identify patients at risk of incomplete transvaginal oocyte retrieval, develop a risk assessment formula to identify patients who would benefit from a transabdominal approach, and compare complication and pregnancy rates between these two approaches. Materials and Methods In this retrospective case control study in a private in vitro fertilization center, 95 cases of women undergoing transabdominal follicular aspiration for oocyte retrieval (15 transabdominal only and 80 transabdominal and vaginal combined) were compared with 278 controls of women undergoing the transvaginal aspiration only. Transabdominal oocyte retrieval was performed when one or more ovaries could not be retrieved via the transvaginal approach. Main study outcomes included need for transabdominal retrieval, pregnancy rates, and complications. Results A risk assessment scoring system was developed as follows: difficulty seeing ovaries on ultrasound (+4), history of pelvic surgery (+3), and body mass index of 30 kg/m 2 or greater (+2). With a cutoff score of 4 or greater, the overall sensitivity is 75%, specificity is 80%, positive predictive value is 57%, and negative predictive value is 90%. No statistically significant differences were found for pregnancy rates or complications. Conclusion The transabdominal approach is an alternative option that would increase the total number of oocytes retrieved with no statistical difference in complication or pregnancy rates. We also developed a scoring system that can serve as a useful screening tool for identifying women at increased risk of transabdominal oocyte retrieval.

This study assessed the construct validity of the Relationship Profile Test (RPT; Bornstein & Languirand, 2003) with a substance abuse sample. One hundred-eight substance abuse patients completed the RPT, Experiences in Close Relationships Scale (ECR-SF; Wei, Russell, Mallinckrodt, & Vogel, 2007), Personality Assessment Inventory (PAI; Morey, 1991), and Symptom Checklist-90-Revised (SCL-90-R: Derogatis 1983). Results suggest that the RPT has good construct validity when compared against theoretically related broadband measures of personality, psychopathology and adult attachment. Overall, health hependency was negatively related to measures of psychopathology and insecure attachment, and overdependence was positively related to measures of psychopathology and attachment anxiety. Many of the predictions regarding RPT detachment and the criterion measures were not supported. Implications of these findings are discussed.

ISG15 is an ubiquitin-like protein induced by type I interferon associated with antiviral activity. ISG15 is also secreted and known to function as an immunomodulatory molecule. However, ISG15's role in influencing the adaptive CD8 T-cell responses has not been studied. Here, we demonstrate the efficacy of ISG15 as a vaccine adjuvant, inducing human papilloma virus (HPV) E7-specific IFNγ responses as well as the percentage of polyfunctional, cytolytic, and effector CD8 T-cell responses. Vaccination with ISG15 conferred remarkable control and/or regression of established HPV-associated tumor-bearing mice. T-cell depletion coupled with adoptive transfer experiments revealed that ISG15 protective efficacy was CD8 T-cell mediated. Importantly, we demonstrate that ISG15 vaccine-induced responses could be generated independent of ISGylation, suggesting that responses were mostly influenced by free ISG15. Our results provide more insight into the immunomodulatory properties of ISG15 and its potential to serve as an effective immune adjuvant in a therapeutic tumor or infectious disease setting.

Resume Introduction Les reconstructions mandibulaires par lambeau libre de fibula sont desormais de pratique courante en chirurgie maxillo-faciale, y compris pour le condyle. Pourtant les consequences sur l’articulation temporomandibulaire sont peu connues, et le type de reconstruction pour cette articulation reste sujet a controverse. Materiel et methode Six patients ont ete suivis apres reconstruction par lambeau libre de fibula d’une mandibulectomie interruptrice terminale. L’evaluation des resultats s’est faite sur des criteres fonctionnels et radiologiques. Resultats Aucun patient n’a presente de gene fonctionnelle liee a la reconstruction. Le remodelage du neocondyle etait modeste chez les adultes, mais tres important chez l’enfant, chez qui une modification de morphologie et d’architecture osseuse a eu lieu. Discussion Plusieurs techniques operatoires ont ete decrites afin d’ameliorer la congruence, le maintien et le remodelage de l’extremite libre du lambeau de fibula. Il semble que les seuls facteurs determinants sur la qualite du resultat sont l’âge du patient, la presence ou non du disque articulaire, les antecedents chirurgicaux et de radiotherapie dans la zone.

Abstract. The Social Cognition and Object Relations Scale-Global Ratings Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker-Aspen, 2011 ) is a reliable system for coding narrative data, such as Thematic Apperception Test (TAT) stories. This study employs a cross-sectional, correlational design to examine associations between SCORS-G dimensions and life events in two clinical samples. Samples were composed of 177 outpatients and 57 inpatients who completed TAT protocols as part of routine clinical care. Two experienced raters coded narratives with the SCORS-G. Data on the following clinically relevant life events were collected: history of psychiatric hospitalization, suicidality, self-harming behavior, drug/alcohol abuse, conduct-disordered behavior, trauma, and education level. As expected, the clinical life event variable associated with the largest number of SCORS-G dimensions was Suicidality. Identity and Coherence of Self was related to self-harm history across samples. Emotional Investment in Relationships and Complexity of Representations were also associated with several life events. Clinical applications, limitations of the study, and future directions are reviewed.

The Social Cognition and Object Relations Scales-Global Rating Method (SCORS-G) contains 8 scales for coding narrative content. This study explores the factor structure of this measure using college (n = 171), outpatient (n = 239), and inpatient (n = 78) samples. Participants told stories to the Thematic Apperception Test (TAT; Murray, 1943) cards. Stories were transcribed and coded by blind raters using the SCORS-G. Cases were randomly assigned to an exploratory or validation group. Exploratory factor analysis with the exploratory group suggested 2- and 3-factor models. The Emotional Investment in Relationships (EIR) scale did not obtain a primary loading on any factor and was not included in subsequentmodels. After modifications, confirmatory factor analysis indicated good-to-adequate fit for 2- and 3-factor models. Both models showed good fit in the validation group and met criteria for invariance across models. Findings indicated that some SCORS-G scales tap cognitive-structural elements, whereas others assess affective-relational components of narratives. We found mild support separating the affective-relational scales in terms of internal representations for the self and others and relationships. The results reported here indicate that clinicians and researchers can calculate a separate cognitive-structural composite score and an affective-relational composite score when using the SCORS-G to rate TAT stories.

Several studies have examined associations between client attachment status and therapeutic alliance. Most, however, measure alliance at a single time point only. This study is among the first to examine how client attachment relates to changes in the therapeutic alliance early in treatment. Forty-six outpatients from a university-based community clinic participated. Attachment status was assessed with the Relationship Questionnaire (Bartholomew & Horowitz, 1991) prior to beginning treatment. Participants rated therapeutic alliance after an evaluation feedback session and again early in psychotherapy. Fearful insecurity was associated with declines in therapeutic alliance, while attachment security was associated with increasing client–therapist bonds. Although unrelated to global alliance, preoccupied insecurity was associated with greater confident collaboration at both time points and declines in idealized relationship from the evaluation to the early therapy time point. Results are discussed in light of prior theoretical formulations and previous research. Limitations of the study are reviewed, implications for clinical practice are noted, and suggestions for future research are made. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message Assessing client attachment status can provide clinicians with information that helps them identify clients at risk for difficulties establishing a therapeutic alliance. Clients high in attachment security are more likely to develop strong bonds with therapists during the early portion of treatment. Clients high in fearful insecurity are at risk for developing weaker alliances early in treatment. Such clients appear more likely to experience declines in client–therapist bond, goal-task agreement and overall alliance early in the treatment process. Clients high in preoccupied insecurity may enter therapy with great confidence in the therapist and willing to engage in therapy but report more conflicts with therapists in the early phase of treatment.

The link between alliance and treatment outcome is robust. Nevertheless, few, if any, self-report measures exist to assess the alliance between hospitalized adolescents and their treatment team as a whole. The present study looks to extend the use of a brief self-report measure of inpatient treatment alliance designed for adult inpatients to be used with adolescents. The scale is designed incorporating items that tap the three factors of alliance (bond, goals and collaboration) to assess the alliance that the patient has with his or her treatment team. Our results show that the Inpatient-Treatment Alliance Scale is unifactoral, shows good psychometrics and is linked in theoretically meaningful ways to global clinician ratings of engagement in individual psychotherapy. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message Inpatient treatment of adolescents requires the assessment of alliance to be between the patient and his or her treatment team rather than an individual clinician. Assessment of the alliance can benefit clinicians treating hospitalized adolescents especially because these patients are difficult to engage with in treatment. This study shows that the Inpatient-Treatment Alliance Scale is a promising measure for assessing treatment alliance on an adolescent inpatient setting.

The proliferation of media platforms raises questions among marketers about their relative value. This study tests a neuroscience-informed model of immersive-versusflexible audience engagement and demonstrates television’s heightened ability to sustain nonconscious emotional response over online viewing. Employing biometrics and eye tracking, 251 participants experienced 24 brands on television, online, or both. Findings indicate that brand advertising proved far more emotionally engaging when experienced on television alone or combined with online viewing. This emotional connection using both platforms proved strongest when the television program and Web site content were related. The results support prior research that demonstrates television’s ability to engage and sustain emotional response.

Personality's link to emotional experience has been demonstrated, but specific biological responses to emotion as a function of personality have not been well-established. Here, the association between personality and physiological responses (heart rate, skin conductance, and respiration) to emotional videos was assessed. One-hundred sixty-nine participants self-reported on their Big 5 personality traits and underwent ambulatory monitoring as they watched four brief video clips from primetime television content showing scenes containing violence, fear, sadness, and tension. Generally, the negatively-toned emotional scenes provoked increases in skin conductance response and declines in heart rate. We found that physiological outcomes depended on the particular emotional scene and on personality, most notably Extraversion and Neuroticism. Extraversion, and to a lesser degree, Neuroticism, were associated with increases in autonomic arousal responses to the scenes. Gender also interacted with personality to predict responses, such that women who scored higher on measures of Extraversion, Neuroticism, and Conscientious tended to show more physiological arousal than men. Overall, the emotional scenes evoked increases in arousal and more controlled attention. The findings are discussed in context of the limited capacity model and shed light on how personality and gender affect physiological reactions to emotional experiences in everyday life.

There has been surprisingly little research into the stimulus properties of the Thematic Apperception Test Cards (TAT; Murray, 1943). This study used the Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011 ; Westen, 1995 ) to explore the stimulus properties of select TAT cards in a clinical sample. The SCORS-G is a theoretically based and empirically validated measure of object relations that has widely been used in TAT research. A sample of 80 patients referred for psychological assessment at a large Northeastern hospital were administered the TAT (Cards 1, 2, 3BM, 4, 13MF, 12M, and 14) as part of their assessment battery. Trained raters scored the narratives using the SCORS-G. The SCORS-G ratings were analyzed to determine the nature and degree of object representation "pull" both across and within the TAT cards. The results showed that Cards 3BM and 13MF exhibited the greatest card pull for negative pathological object representations, and Card 2 displayed the highest card pull for adaptive and mature object representations. Both clinical and research related implications are discussed.

Research over the last decade has been promising in terms of the incremental utility of psychometric tools in predicting important clinical outcomes, such as mental health service utilization and inpatient psychiatric hospitalization. The purpose of this study was to develop and validate a new Level of Care Index (LOCI) from the Personality Assessment Inventory (PAI). Logistic regression was initially used in a development sample (n = 253) of psychiatric patients to identify unique PAI indicators associated with inpatient (n = 75) as opposed to outpatient (n = 178) status. Five PAI variables were ultimately retained (Suicidal Ideation, Antisocial Personality-Stimulus Seeking, Paranoia-Persecution, Negative Impression Management, and Depression-Affective) and were then aggregated into a single LOCI and independently evaluated in a second validation sample (n = 252). Results indicated the LOCI effectively differentiated inpatients from outpatients after controlling for demographic variables and was significantly associated with both internalizing and externalizing risk factors for psychiatric admission (range of ds = 0.46 for history of arrests to 0.88 for history of suicidal ideation). The LOCI was additionally found to be meaningfully associated with measures of normal personality, performance-based tests of psychological functioning, and measures of neurocognitive (executive) functioning. The clinical implications of these findings and potential utility of the LOCI are discussed.

The goal of this investigation was the development of an inconsistency scale (ICN-SF) for the personality assessment inventory-short form (PAI-SF). In Study 1, 503 inpatient profiles were randomly assigned to a derivation or cross-validation sample. Ten correlated item pairs were identified using the derivation sample and placed on the ICN-SF. Psychometric properties of the ICN-SF total scores were comparable in the derivation and cross-validation samples. Total ICN-SF scores in both samples were significantly lower than scores obtained from computer-generated random samples. Diagnostic efficiency statistics are reported using multiple cut-off scores at various base rate estimates. ICN-SF scores greater than 8 reasonably balanced sensitivity and specificity rates. This cutoff correctly classified 92% of the random protocols and inaccurately classified 9% of the patient protocols in study 1. In study 2, PAI-SF scores from 627 forensic and civil inpatients produced similar results, effectively identifying cases with elevated scores on the full-form inconsistency scale. Overall the results of both studies suggest that the ICN-SF can aid examiners in assessing for inconsistent responding.

The Social Cognition and Object Relations Scale-Global rating method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford,Pinsker, 2011; Westen, 1995) measures the quality of object relations in narrative material. This study employed a multimethod approach to explore the structure and construct validity of the SCORS-G. The Thematic Apperception Test (TAT; Murray, 1943) was administered to 59 patients referred for psychological assessment at a large Northeastern U.S. hospital. The resulting 301 TAT narratives were rated using the SCORS-G method. The 8 SCORS variables were found to have high interrater reliability and good internal consistency. Principal components analysis revealed a 3-component solution with components tapping emotions/affect regulation in relationships, self-image, and aspects of cognition. Next, the construct validity of the SCORS-G components was explored using measures of intellectual and executive functioning, psychopathology, and normal personality. The 3 SCORS-G components showed unique and theoretically meaningful relationships across these broad and diverse psychological measures. This study demonstrates the value of using a standardized scoring method, like the SCORS-G, to reveal the rich and complex nature of narrative material.

As part of their overall care, patients with borderline personality disorder may require inpatient hospitalization for containment and stabilization in the context of severe distress, increased risk for self-harm, or after self-harming acts. Though data suggests that such patients are frequently hospitalized, the benefits of brief hospitalizations can sometimes be questionable. In some cases, the hospitalization environment may increase patient distress. Additionally, frequent serial hospitalizations can disrupt or sidetrack longer-term outpatient treatments. The present paper presents a Goal-Oriented Limited-Duration Borderline Personality Disorder Inpatient Treatment approach. The approach integrates elements from many other expert-based approaches for working in brief hospital settings and centers on the creation of a preadmission treatment agreement with a planned discharge date. This agreement involves clear goals for treatment and specifies how staff will be involved. Establishing a discharge date early in treatment allows staff to immediately begin working with feelings of rejection or abandonment. At discharge, recommendations are made and criteria for future admissions are set forth. This paper provides a description of the approach, information to consider in determining appropriateness, discussion of methods for clarifying goals, review of the discharge planning approach, and several examples of clinician-patient exchanges. This paper concludes with a case example in which the approach was used and discussions of future directions and potential benefits and limitations of the approach.

Psychologists in medical settings are frequently tasked with providing comprehensive evaluations of patients with complex medical and psychiatric conditions. In order to achieve these aims, standardized measures of neurocognitive and psychological functioning are often employed to empirically assess a patient's level of functioning across an array of relevant clinical domains. However, less is known about the degree to which cognitive impairment affects a patient's ability to complete these more comprehensive assessments, raising questions about test validity. The current study sought to contribute to this growing body of literature by examining whether neurocognitive functioning is associated with profile validity on the Personality Assessment Inventory (PAI) in both outpatient (N = 321) and inpatient (N = 131) psychiatric settings. In Study 1, results indicate that while multiple cognitive domains are associated with overall profile validity in psychiatric outpatients, attentional impairment specifically was found to be a significant predictor of profile invalidity after accounting for the effects of overall intellectual functioning (accounting for 13% of the variance overall). The magnitude of attentional impairment specifically, and number of impaired cognitive domains more generally, were also found to be meaningfully associated with overall profile validity. Likewise, in Study 2, PAI profile validity was found to be meaningfully associated with gross cognitive impairment on the WMS-IV Brief Cognitive Status Examination (BCSE) in an inpatient psychiatric setting, with almost half of the patients in the most impaired group yielding invalid PAI profiles. The clinical implications of these findings are discussed.

Interpersonal dependency has been linked to psychological distress, depression, help seeking, treatment compliance, and sensitivity to interpersonal cues in adult samples. However, there is a dearth of research focusing on dependency in child and adolescent samples. The current study examined the construct validity of a measure of interpersonal dependency. The authors investigated how interpersonal dependency and detachment relate to behavioral problems, subjective well-being, interpersonal problems, and global symptom severity in adolescent inpatients. Destructive overdependence (DO) and dysfunctional detachment (DD) were positively related to interpersonal distress, behavioral problems, and symptom severity and negatively related to psychological health and well-being. Healthy dependency (HD) was associated with fewer behavioral problems and less symptom severity and positively related to subjective well-being. The clinical implications of these findings are discussed.

Health care professionals are coming under increased pressure to empirically monitor patient outcomes across settings as a means of improving clinical practice. Within the psychiatric and primary care communities, many have begun utilizing brief psychometric measures of psychological functioning to accomplish these goals. The purpose of this study was to evaluate the psychometric properties and clinical utility of the Depression, Anxiety, and Stress Scales-21-item version (DASS-21), and contribute normative data to facilitate interpretation using a sample of U.S. adults (N = 503). Item-scale convergence was generally supported, although assumptions of item-scale divergence were not met. Only 86%, 50%, and 43% of Depression, Anxiety, and Stress items, respectively, correlated significantly greater with their hypothesized scales than other scales. Internal consistency reliability was acceptable for all scales and comparable to existing research (αs = .91, .80, and .84 for Depression, Anxiety, and Stress, respectively). Scale-level correlations were greater than what has been reported elsewhere (range of rs = .68 to .73), and principal components analysis supported the extraction of only one component accounting for 47% of the item-level variance. However, confirmatory factor analysis (CFA) favored a three-factor structure when compared to a one-factor model. The implications for the health care professions are discussed.

This present study examined the relationship between the Social Cognition and Object Relations Scale (SCORS) and two measures of adult attachment: the Relationship Questionnaire (RQ) and the Experiences in Close Relationships Questionnaire-Revised (ECR-R). Forty-five patients (76% female) at a university-based outpatient treatment clinic participated in this study. We hypothesized that higher levels of attachment security would be associated with higher, more adaptive ratings on the SCORS variables. Results indicated that the SCORS Self-Esteem (SE) variable was significantly positively related to the RQ's Secure Attachment ratings and negatively related with the ECR-R's Anxious Attachment scale. Additionally, negative trends were noted between SE and the RQ's Fearful and Preoccupied Attachment scores. The SCORS Emotional Investments in Relationships and Affective Quality of Representations variables were associated with higher Secure scores and lower, more maladaptive Preoccupied scores on the RQ. It was also associated with greater attachment anxiety as measured by the ECR-R. Using both clinician (SCORS) and participant-rated measures (ECR-R and RQ), this study provides further understanding on how object representations and attachment style relate within a clinical sample. Results are discussed in light of prior research examining relationships between object relations and adult attachments, and clinical implications are also reviewed. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Individuals with higher levels of attachment anxiety may enter therapy with more self-image problems. • Individuals with higher levels of attachment anxiety may enter therapy with more maladaptive expectations about relationships. • Patients who endorse high levels of attachment anxiety (e.g., fearful and preoccupied) may be more likely to present with Axis II complaints. • Examining a patient's attachment style and object relations using different measures of assessment (e.g., explicit and implicit) can help gain a deeper and more comprehensive understanding of a patient.

This study investigated the relationship between individual differences in attachment and the free recall of childhood memories. Specifically, it focuses on how attachment anxiety and attachment avoidance, using the Experiences in Close Relationship Scale self-report, relate to the affective quality and the presence of caregivers in memories from childhood. Participants were 79 undergraduate and masters students attending a northeast university. Participants completed a memory task designed to elicit freely recalled memories from childhood. They then rated the affective valence (positive/negative) and intensity of each memory, and identified memories in which caretakers were present. Attachment avoidance was related to recalling more negative memories involving caretakers and was negatively related to the average intensity of memories involving caretakers. The results support and extend previous research suggesting that affect regulation strategies employed by individuals high in attachment anxiety and high in attachment avoidance are linked to differences in how information about the past is recalled.

Few studies have assessed the psychometric properties of the Personality Assessment Inventory short-form (PAI-SF) clinical scales, and none have conducted these evaluations using participants from psychiatric inpatient units. The present study evaluated item-level tests of scaling assumptions of the PAI-SF using a large (N=503) clinical sample of participants who completed the PAI during their admission to a psychiatric inpatient unit. Internal consistency reliability was high across scales, and tests of item-scale convergence and discrimination generally confirmed hypothesized item groupings. Scale-level correlations supported unique variance being measured by each scale. Finally, agreement between the PAI short- and full-form scales was found to be high. The results are discussed with regards to scale interpretation.

Research focusing on the Personality Assessment Inventory (PAI) has increased substantially over the past decade. However, there has been relatively little focus on the PAI short-form (PAISF). The current study evaluated the psychometric characteristics of the PAI-SF clinical scales using participants admitted to a large northeastern hospital under forensic (N = 178) and civil (N = 320) statutes. Results indicate that the internal consistency of the PAI-SF clinical scales is adequate for both the Forensic (range of alphas: 0.74 to 0.88) and Civil (0.79 to 0.91) samples, and assumptions of item-scale convergence and divergence were generally met with some exceptions. Finally, the PAI-SF exhibited strong agreement with the full-form PAI scores overall, and at the upper extreme (T ≥ 70) of the distributions for both samples. The results are discussed in terms of how they extend prior research on the PAI-SF.

Super Bowl advertisements have become almost as famous as the game itself. Between production costs and the price of air time, companies who advertise in the Super Bowl do so at considerable expense. Return on investment for Super Bowl advertisements is strengthened by wide viewership, pregame media chatter, and postgame buzz among consumers. Not all advertisements, however, generate the same degree of buzz. Recent models of advertising effectiveness have emphasized the importance of emotions, suggesting that advertisements that engage consumers on emotional levels will be most effective. This study examines how emotional engagement with Super Bowl advertisements relates to an important area of consumer response: online buzz. A biologically-based measure of audience engagement was used to monitor a sample of adults (N = 30) as they viewed Super Bowl XLII live. Advertising scores derived from biometric response ratings for Super Bowl advertisements were highly correlated with online buzz (i.e., the number of times an advertisement was commented on and the number of times it was viewed online). Results of the study are discussed with regard to the role of emotions in advertising and the utility of biometric measures for assessing consumers9 emotional engagement with advertising content.

This study assessed factors associated with extended length of stay (ELOS) for patients presenting to a psychiatric emergency service (PES). Two hundred six subjects with a length of stay of 24 h or longer were compared with time-matched controls (patients that presented directly after the ELOS patient). Binary logistic regression was used to identify risk factors for ELOS. ELOS was associated with suicidal ideation, disposition to an inpatient unit, homicidal ideation, lack of insurance, homelessness, male gender, past history of psychiatric hospitalization, diagnosis of substance abuse, significant psychiatric co-morbidity (represented by three or more Axis I diagnoses), and diagnosis of a psychotic disorder. Lack of insurance, suicidal ideation, disposition to inpatient unit, and homicidal ideation all made nonredundant contributions to predicting stays of 24 h or longer.

Despite increased research focusing on the impact of digital video recorder (DVR) use, there continues to be a notable lack of data on viewers’ direct experience of time-shifted television ads. The...

In this study, we sought to explore the diagnostic accuracy of the Personality Assessment Inventory (PAI; Morey, 1991) Validity scales (Negative Impression Management [NIM] and Positive Impression Management [PIM]) and indexes (Malingering index, Defensiveness index [DEF]; Morey, 1993, 1996; Cashel Discriminant Function; Cashel, Rogers, Sewell,Martin-Cannici, 1995; and Rogers Discriminant Function [RDF]; Rogers, Sewell, Morey,Ustad, 1996) to identify differences in profiles completed by psychiatric inpatients under standardized instructions (Time 1) and after random assignment (Time 2) to a fake good (n=21), fake bad (n=20), or retest (n=21) scenario. Repeated measures analysis of variance revealed a significant interaction effect. Whereas the retest group did not show any significant changes on the PAI variables from Time 1 to Time 2, both faking groups showed changes in expected directions. Discriminant function analyses revealed that NIM, RDF, and lower scores on DEF best differentiated between the faking bad and retest groups. PIM was the only nonredundant significant score discriminating the faking good and retest groups. Cutoffs for these scales and indexes established in prior research were supported using diagnostic efficiency statistics. Results suggest that NIM and RDF in faking bad scenarios and PIM in faking good scenarios are most sensitive to unsophisticated attempts to dissimulate by inpatient psychiatric patients.

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 PAI'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. Conversely, 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.