A Review of the Agreement Between Clinicians’ Personality Disorder Diagnoses and Those From Other Methods and Sources

This review synthesizes a wide literature on the agreement of treating clinicians’ PD diagnoses with each other and their convergence with common research methods. Median interrater reliability between clinicians was moderate when calculated dimensionally (r = .46) or categorically (κ = .40). The agreement between clinicians’ diagnoses and those from research methods (e.g., self‐report questionnaire) was more modest. Median dimensional agreement across 27 studies ranged from .05 to .36, with an overall median of .23. This overall value was moderated by several factors. First, clinicians’ diagnoses agreed more with semi‐structured interviews than self‐report questionnaires. Second, convergence increased slightly when clinicians utilized more systematic diagnostic methods. Results suggest relatively little overlap between PD diagnoses assigned in research versus naturalistic settings.     

The relationship between nasopharyngeal CCL5 and microbiota on disease severity among infants with bronchiolitis

Emerging evidence suggests that the airway microbiota plays an important role in viral bronchiolitis pathobiology. However, little is known about the combined role of airway microbiota and CCL5 in infants with bronchiolitis. In this multicenter prospective cohort study of 1005 infants (age <1 year) hospitalized for bronchiolitis during 2011‐2014, we observed statistically significant interactions between nasopharyngeal airway CCL5 levels and microbiota profiles with regard to the risk of both intensive care use (P_interaction=.02) and hospital length‐of‐stay ≥3 days (P_interaction=.03). Among infants with lower CCL5 levels, the Haemophilus‐dominant microbiota profile was associated with a higher risk of intensive care use (OR, 3.20; 95%CI, 1.18‐8.68; P=.02) and hospital length‐of‐stay ≥3 days (OR, 4.14; 95%CI, 2.08‐8.24; P<.001) compared to the Moraxella‐dominant profile. Conversely, among those with higher CCL5 levels, there were no significant associations between the microbiota profiles and these severity outcomes (all P≥.10).     

Accessibility of salient beliefs about the outcomes of physical activity

Objectives. Attitudes may influence behaviour through both deliberative and automatic processes. To investigate the automatic influences of attitudes, this study explores the accessibility of modally salient beliefs about physical activity outcomes using response latency measures. Design. Response latencies for modally salient beliefs for physically activity outcomes were compared with latencies for non‐salient, hygiene outcomes. Possible relationships between self‐report and response latency was assessed between‐ and within‐subjects. Method. Regularly active participants (N=148) completed a computer‐based response latency task in which they indicated whether an outcome, for example more fit, was a likely or unlikely consequence of six different physical activities, for example go running. Self‐reports of the likelihood of these outcomes, their importance, intentions to participate in the physical activities and frequency of participation were obtained. Results. As expected, the physical activity outcomes were more accessible than control outcomes. In addition, the outcome strong heart was less accessible than the outcomes more fit and have fun. There was only weak evidence, however, of any relationship between self‐reports and the accessibility of the physical activity outcomes. Conclusion. Response latency data may represent a source of between‐subject variation that differs from self‐report. Discussion focuses on the possible origins of such a discrepancy.     

A Randomized trial of a cognitive‐behavioral therapy and hypnosis intervention on positive and negative affect during breast cancer radiotherapy

Breast cancer radiotherapy can be an emotionally difficult experience. Despite this, few studies have examined the effectiveness of psychological interventions to reduce negative affect, and none to date have explicitly examined interventions to improve positive affect among breast cancer radiotherapy patients. The present study examined the effectiveness of a multimodal psychotherapeutic approach, combining cognitive‐behavioral therapy and hypnosis (CBTH), to reduce negative affect and increase positive affect in 40 women undergoing breast cancer radiotherapy. Participants were randomly assigned to receive either CBTH or standard care. Participants completed weekly self‐report measures of positive and negative affect. Repeated and univariate analyses of variance revealed that the CBTH approach reduced levels of negative affect [F(1, 38)=13.49; p=.0007, ω²=.56], and increased levels of positive affect [F(1, 38)=9.67; p=.0035, ω²=.48], during the course of radiotherapy. Additionally, relative to the control group, the CBTH group demonstrated significantly more intense positive affect [F(1, 38)=7.09; p=.0113, d=.71] and significantly less intense negative affect [F(1, 38)=10.30; p=.0027, d=.90] during radiotherapy. The CBTH group also had a significantly higher frequency of days where positive affect was greater than negative affect (85% of days assessed for the CBTH group versus 43% of the Control group) [F(1, 38)=18.16; p=.0001, d=1.16]. Therefore, the CBTH intervention has the potential to improve the affective experience of women undergoing breast cancer radiotherapy. © 2009 Wiley Periodicals, Inc. J Clin Psychol 65: 1–13, 2009.     

Regulatory skill as a resilience factor for adults with a history of foster care: A pilot study

Individuals with a history of foster care (FC) are at elevated risk for emotion regulation‐related mental illness. The purpose of the current study was to characterize regulatory function in a group of adults with a history of FC (N = 26) relative to those without a history of FC (N = 27) and how regulatory function moderates adverse caregiving‐related outcomes (daily cortisol production and trait anxiety). Self‐report items (anxiety, emotion regulation strategies, inhibitory control, caregiving history) were collected along with more objective measures (computerized task and salivary cortisol). Inhibitory control was assessed via self‐report and a computerized task (emotional face go/nogo). Results showed that for adults with a history of FC, higher levels of inhibitory control were associated with higher accuracy on the emotional face go/nogo task and greater reported use of the emotion regulation strategy cognitive reappraisal. Greater use of cognitive reappraisal in turn was associated with healthier stress‐related outcomes (decreased trait anxiety and steeper sloped cortisol production throughout the day). Dose‐response associations were observed between self‐reported regulatory skills and FC experiences (i.e., number of placements and age when exited foster care). These findings suggest that adverse caregiving can have long‐term influences on mental health that extend into adulthood; however, individual differences in regulatory skills moderate these outcomes and may be an important target for intervention following caregiving adversity. © 2014 The Authors. Developmental Psychobiology published by Wiley Periodicals, Inc. Dev Psychobiol 57: 1–16, 2015.     

An examination of the role of perceptions in neighborhood research

Accumulating research demonstrates that both archival indicators and residents' self‐reports of neighborhood conditions are useful predictors of a variety of physical health, mental health, substance use, criminal, and educational outcomes. Although studies have shown these two types of measures are often related, no research has systematically examined their relationship. With a sample of Mexican Americans, this study examined this relationship and demographic factors that might account for variations of residents' perceptions of their neighborhoods. Results showed that country of birth, social class, family structure, and gender moderated relations between archival variables and adults' perceptions of danger. Thus using information from both archival data and self‐reports should improve the ability of neighborhood researchers to understand individual differences in responses to neighborhood conditions. © 2009 Wiley Periodicals, Inc.     

Individual differences in male body‐image: An examination of self‐objectification in recreational body builders

Objectives Male bodybuilders have been found previously to have higher levels of disordered eating and body‐image disturbance than do other men. This study investigated whether objectification theory ( Fredrickson & Roberts, 1997 ) could be used to explain these observed differences in male body‐image. Design A cross‐sectional, self‐report design was used. Methods Three samples of men were recruited: bodybuilders (N = 31), weightlifters (N = 17), and non‐athletic controls (N = 35). Participants completed a questionnaire containing measures of self‐objectification, self‐surveillance, body shame, appearance anxiety, and four outcomes: body dissatisfaction, drive for muscularity, bulimia, and depression. Results As predicted, bodybuilders had significantly higher levels of self‐objectification than weightlifters and controls, and higher levels of body dissatisfaction and drive for muscularity than controls. Overall, the relationships between self‐objectification and the outcome variables, and self‐surveillance and the outcome variables, were mediated by appearance anxiety. Conclusions . Bodybuilding is associated with outcomes that suggest it may not result in greater overall health for men. It was concluded that objectification theory provides a useful framework for examining body‐image differences in men.     

Stress,social support,and outcomes in two probability samples of homeless adults

This study investigated the main effects of social support measures and their stress‐buffering effects in two samples of homeless adults (Ns=249 and 219) obtained in the same large county (surrounding Detroit) at different points in time over an 8‐year period (1992–1994 and 2000–2002). The findings suggest that the construct of social support, commonly applied to broad community and student samples, can also be usefully applied to at‐risk groups such as the homeless. Although the study's main effects and stress‐buffering effects were generally consistent with existing research on social support, the findings point out that expected results do not consistently emerge even when similar sampling and measurement techniques are employed. For example, a measure of perceived support showed consistent main and stress‐buffering effects on psychological symptoms (but not other outcomes) and social network measures showed less consistent effects on outcomes (e.g., alcohol and drug abuse symptoms). © 2008 Wiley Periodicals, Inc.     

Treatment satisfaction, perceived treatment effectiveness, and dropout among older users of mental health services

Objectives: To examine the rates and correlates of treatment satisfaction, perceived treatment effectiveness, and dropout among older users of mental health services. Method: We used data from the Canadian Community Health Survey‐Mental Health and Well‐Being (CCHS‐1.2), which includes 12,792 individuals aged ≥55 years. The average age of these participants was 67 years and 53.2% were female. We examined the rates of treatment satisfaction, perceived treatment effectiveness, and dropout for those who had used mental health services in the past year, and used logistic regression to examine the correlates of these outcomes. Results: Of the older adults included in the CCHS‐1.2, 664 (5.3%) had used mental health services in the past year. The majority of these were satisfied with services (88.5%) and perceived treatment to be effective (83.6%), which is likely why only 15.5% dropped out in the past year. In logistic regression models, social support was significantly and positively related to both treatment satisfaction and perceived effectiveness. Perceived treatment effectiveness was the only variable related to dropout, with lower levels of perceived effectiveness associated with greater odds of dropping out of treatment. Conclusions: Results from this study indicate that older adults have very good self‐reported treatment outcomes. The modest influence of individual characteristics on treatment outcomes suggests the potential importance of contextual characteristics. © 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1197–1209, 2011.     

Cognitive‐behavior therapy in chronic fatigue syndrome: is improvement related to increased physical activity?

This multiple case study of cognitive‐behavioral treatment (CBT) for chronic fatigue syndrome (CFS) compared self‐report and behavioral outcomes. Eleven relatively high‐functioning participants with CFS received 6–32 sessions of outpatient graded‐activity oriented CBT. Self‐report outcomes included measures of fatigue impact, physical function, depression, anxiety, and global change. Behavioral outcomes included actigraphy and the 6‐minute walking test. Global change ratings were very much improved (n=2), much improved (n=2), improved (n=5), and no change (n=2). Of those reporting improvement, clinically significant actigraphy increases (n=3) and decreases (n=4) were found, as well as no significant change (n=2). The nature of clinical improvement in CBT trials for high‐functioning CFS patients may be more ambiguous than that postulated by the cognitive‐behavioral model. © 2009 Wiley Periodicals, Inc. J Clin Psychol, 65:1–20, 2009.     

The persistence of socially instructed threat: Two threat‐of‐shock studies

Learning to anticipate threat is crucial in guiding protective behavior. In classical conditioning, single trial learning can result in long‐lasting fear associations. To examine whether threat learned through social communication is equally stable, an instructed fear paradigm was used with two repeated sessions on 1 day (Study 1; N = 43) and with separate sessions on 3 consecutive days (Study 2; N = 30). Startle EMG, skin conductance level (SCL), and self‐report data were recorded during alternating periods of instructed threat and safety. Within 1 day, threat‐potentiated startle was present across sessions but threat‐enhanced SCL decreased (Study 1). Across days, threat effects subsided with different timing for startle EMG, SCL, and self‐report (Study 2). The present findings are a laboratory analog for the persistence of socially transmitted fear, which can be amazingly resistant to extinction (e.g., in specific phobias) even in the absence of aversive experiences.     

The psychometric characteristics of the traumatic experiences checklist (TEC): first findings among psychiatric outpatients

The objective of the study was to assess the reliability and validity of a retrospective self‐report measure of potential traumatic experiences among psychiatric outpatients. The range of evaluated experiences includes emotional neglect and abuse. Participants completed the Traumatic Experiences Checklist (TEC) (N = 153), a self‐report trauma questionnaire of known psychometric qualities, i.e. the Stressful Life Experiences Questionnaire (SLESQ), and self‐report measures of somatoform dissociation (SDQ‐20), psychoform dissociation (DES). A majority (N = 115) completed the TEC twice, and also completed a measure of posttraumatic stress symptoms (PTSD‐ss). The TEC's internal consistency and test–retest reliability were good, and the TEC strongly correlated with the SLESQ. Associations between the TEC and the PTSD‐ss, DES, and SDQ‐20 supported the criterion‐related validity of the TEC. The internal consistency, test–retest reliability and criterion‐related validity of TEC trauma area presence and severity scores were also satisfactory. Preliminary findings suggest that the psychometric characteristics of the TEC are good. Future study of the TEC should include larger samples of psychiatric patients, as well as non‐clinical groups. Copyright © 2002 John Wiley & Sons, Ltd.     

The atypical IκB protein IκBNS is important for Toll‐like receptor‐induced interleukin‐10 production in B cells

Although a major function of B cells is to mediate humoral immunity by producing antigen‐specific antibodies, a specific subset of B cells is important for immune suppression, which is mainly mediated by the secretion of the anti‐inflammatory cytokine interleukin‐10 (IL‐10). However, the mechanism by which IL‐10 is induced in B cells has not been fully elucidated. Here, we report that IκB_NS, an inducible nuclear IκB protein, is important for Toll‐like receptor (TLR)‐mediated IL‐10 production in B cells. Studies using IκB_NS knockout mice revealed that the number of IL‐10‐producing B cells is reduced in IκB_NS^?/? spleens and that the TLR‐mediated induction of cytoplasmic IL‐10‐positive cells and IL‐10 secretion in B cells are impaired in the absence of IκB_NS. The impairment of IL‐10 production by a lack of IκB_NS was not observed in TLR‐triggered macrophages or T‐cell‐receptor‐stimulated CD4⁺ CD25⁺ T cells. In addition, IκB_NS‐deficient B cells showed reduced expression of Prdm1 and Irf4 and failed to generate IL‐10⁺ CD138⁺ plasmablasts. These results suggest that IκB_NS is selectively required for IL‐10 production in B cells responding to TLR signals, so defining an additional role for IκB_NS in the control of the B‐cell‐mediated immune responses.     

Composite monoclonal B‐cell lymphocytosis and MYD88 L265P‐positive lymphoplasmacytic lymphoma in a patient with IgM light chain amyloidosis: Case report

Monoclonal B‐cell lymphocytosis (MBL) is an early or precursor asymptomatic proliferation of chronic lymphocytic lymphoma (CLL)‐like B‐cells. Lymphoplasmacytic lymphoma (LPL), often clinically associated with Waldenström macroglobulinemia, is a B‐cell neoplasm characterized by frequent MYD88 L265P mutation. Here, we report a rare composite MBL and LPL in a patient with IgM light chain (AL) amyloidosis. A 74‐year‐old male with a known IgM monoclonal protein developed proteinuria. No lymphocytosis was detected. Renal biopsy showed deposition of AL λ amyloid in the glomeruli and vessels. Subsequent bone marrow biopsy revealed nodular atypical CLL‐like small B‐cell proliferation and scattered peripheral LPL. Immunohistochemistry and/or flow cytometry revealed that the atypical CLL‐like population expressed CD19, CD20, CD5, weak CD23, LEF‐1 and diminished surface Igκ. The LPL was positive for CD19, CD20 and surface Igλ. Using laser‐capture microdissection and allele‐specific polymerase chain reaction, we confirmed that MYD88 L265P was detectable in the LPL but not in the atypical CLL‐like population. Thus, we demonstrated that these two populations were clonally independent, and made the diagnosis of composite MBL and LPL. An integrated clinical, pathological, immunophenotypic and genetic assessment is essential in such complicated cases, and especially ‘clone‐specific’ MYD88 genotyping may facilitate the differential diagnoses of low‐grade B‐cell lymphomas.     

Pilot detection study of alpha1 antitrypsin deficiency in a targeted population

Screenings for the genetic disorder alpha₁ antitrypsin deficiency (AAT Deficiency) have been one of two models: large screenings of general populations and small targeted detection programs in high‐risk groups. The most appropriate screening and detection methodologies in terms of target populations, subject participation and yield of positive tests, however, have not been well defined. The major objective of this pilot study was to evaluate the effectiveness in terms of participation of two different AAT Deficiency detection programs using a self‐administered fingerstick blood test. Individuals ages 30–60 under the care of a pulmonary physician and with a diagnosis of emphysema, COPD, chronic bronchitis, or bronchiectasis were the targeted population. Participants were offered AAT Deficiency testing in the pulmonary physician's office compared with testing offered through mail. Participation (i.e., frequency of subject participation in the detection program) of two different AAT Deficiency detection programs. Non‐participation was due to fear of self‐administered testing and research studies; women were more likely to participate than men. Eligible subjects were significantly more likely to participate when offered testing by their pulmonary physician in‐office (83%) than mail‐only (42%) (P < 0.02). Although self‐administered genetic testing is available, highest participation in AAT Deficiency detection program was found when offered directly by the physician. This finding may have implications for screening and detection of other genetic diseases. Future studies need to evaluate the yield (i.e., frequency of positive tests) of these detection methodologies in highly targeted populations. © 2001 Wiley‐Liss, Inc.     

Self‐referential processing in adolescents: Stability of behavioral and ERP markers

The self‐referential encoding task (SRET)—an implicit measure of self‐schema—has been used widely to probe cognitive biases associated with depression, including among adolescents. However, research testing the stability of behavioral and electrocortical effects is sparse. Therefore, the current study sought to evaluate the stability of behavioral markers and ERPs elicited from the SRET over time in healthy, female adolescents (n = 31). At baseline, participants were administered a diagnostic interview and a self‐report measure of depression severity. In addition, they completed the SRET while 128‐channel ERP data were recorded to examine early (P1) and late (late positive potential [LPP]) ERPs. Three months later, participants were readministered the depression self‐report measure and the SRET in conjunction with ERPs. Results revealed that healthy adolescents endorsed, recalled, and recognized more positive and fewer negative words at each assessment, and these effects were stable over time (rs = .44–.83). Similarly, they reported a faster reaction time when endorsing self‐relevant positive words, as opposed to negative words, at both the initial and follow‐up assessment (r = .82). Second, ERP responses, specifically potentiated P1 and late LPP positivity to positive versus negative words, were consistent over time (rs = .56–.83), and the internal reliability of ERPs were robust at each time point (rs = .52–.80). As a whole, these medium‐to‐large effects suggest that the SRET is a reliable behavioral and neural probe of self‐referential processing.