A test of the repression hypothesis in agoraphobics

In a recent study Turner et al. (1983) employed Bell & Byrne's (1978) Repression-Sensitization (R-S) scale to test the hypothesis that agoraphobics utilize repression as a method of avoiding anxiety-arousing forms of cognition. However, no support was found for this view. Rather, the R-S scores indicated general sensitization and attention to negative affect. In this paper it is argued that, on both theoretical and psychometric grounds, the R-S scale cannot be considered a suitable measure of the repression-sensitization process. A study was carried out in which a number of other defensivity measures were used in addition to the R-S scale. Weak support was found for Goldstein & Chambless' (1978) view that a defensive cognitive style is characteristic of agoraphobic patients when compared with non-phobic psychiatric controls.     

The Physical Health Questionnaire (PHQ): construct validation of a self-report scale of somatic symptoms

The authors report the results of 3 studies that were conducted to evaluate the psychometric properties of the Physical Health Questionnaire (PHQ), a brief self-report scale of somatic symptoms. In Study 1, exploratory factor analysis results revealed 4 empirically distinct dimensions of somatic symptoms: gastrointestinal problems, headaches, sleep disturbances, and respiratory illness. In Study 2, this structure was replicated using confirmatory factor analysis, and correlations of the PHQ dimensions with measures of negative affect, psychological health, and job performance provided further validity evidence. In Study 3, a minor revision to the wording of several items helped to address the limitations of one of the PHQ subscales. Together, these results provide evidence of the construct validity of the PHQ.     

Personality subtyping and bulimia nervosa: psychopathological and genetic correlates

BACKGROUND: There is empirical evidence suggesting that individuals with bulimia nervosa vary considerably in terms of psychiatric co-morbidity and personality functioning. In this study, latent profile analysis was used to attempt to identify clusters of bulimic subjects based on psychiatric co-morbidity and personality. METHOD: A total of 178 women with bulimia nervosa or a subclinical variant of bulimia nervosa completed a series of self-report inventories of co-morbid psychopathology and personality, and also provided a buccal smear sample for genetic analyses. RESULTS: Three clusters of bulimic women were identified: an affective-perfectionistic cluster, an impulsive cluster, and a low co-morbid psychopathology cluster. The clusters showed expected differences on external validation tests with both personality and eating-disorder measures. The impulsive cluster showed the highest elevations on dissocial behavior and the lowest scores on compulsivity, while the affective-perfectionistic cluster showed the highest levels of eating-disorder symptoms. The clusters did not differ on genetic variations of the serotonin transporter gene. CONCLUSIONS: This study corroborates previous findings suggesting that the bulimia nervosa diagnostic category is comprised of three classes of individuals based on co-morbid psychopathology and personality. These differences may have significant etiological and treatment implications.     

Psychometric properties of the panic disorder severity scale: clinician-administered and self-report versions

The Panic Disorder Severity Scale (PDSS) is a seven-item scale designed to assess overall severity of panic disorder symptoms. Although the PDSS is widely used, there have been limited independent studies confirming reliability and validity, particularly of the self-report version of the PDSS, and even fewer studies directly comparing the two versions. Given the need for psychometrically sound measures that comprehensively assess the main features of panic disorder, this study examined the psychometric properties of both the clinician-administered and self-report versions of the PDSS. As the PDSS targets symptom severity across a number of specific domains, PDSS items were compared to several scales designed to measure similar constructs, including the Anxiety Sensitivity Index, Illness Intrusiveness Ratings Scale, Mobility Inventory for Agoraphobia and Agoraphobic Cognitions Questionnaire. Results indicated acceptable reliability for both the clinician-administered and self-report versions. Results indicated acceptable validity for the clinician-administered PDSS and promising validity for the self-report. However, correlations between both versions of the PDSS and comparison measures were lower than predicted. Results also indicated that scores on the self-report and clinician-administered versions were significantly associated, although correlations between specific PDSS items on the two versions were also lower than expected. Results suggest that total scores on each of the PDSS versions provide a useful indication of panic-related severity. However, clinicians and researchers are cautioned against relying on scores from individual items to measure specific constructs due to their poor specificity.     

The construct of problem solving in higher level neuropsychological assessment and rehabilitation.

Three inter-related studies examine the construct of problem solving as it relates to the assessment of deficits in higher level outpatients with traumatic brain injury (TBI). Sixty-one persons with TBI and 58 uninjured participants completed measures of problem solving and conceptually related constructs, which included neuropsychological tests, self-report inventories, and roleplayed scenarios. In Study I, TBI and control groups performed with no significant differences on measures of memory, reasoning, and executive function, but medium to large between-group differences were found on timed attention tasks. The largest between-group differences were found on psychosocial and problem-solving self-report inventories. In Study II, significant-other (SO) ratings of patient functioning were consistent with patient self-report, and for both self-report and SO ratings of patient problem solving, there was a theoretically meaningful pattern of correlations with timed attention tasks. In Study III, a combination of self-report inventories that accurately distinguished between participants with and without TBI, even when cognitive tests scores were in the normal range, was determined. The findings reflect intrinsic differences in measurement approaches to the construct of problem solving and suggest the importance of using a multidimensional approach to assessment.     

Validity of the Chinese version of the General Health Questionnaire

The Chinese version of the General Health Questionnaire-30 was administered to 2,150 Chinese secondary school students, along with several other scales that measure somatic and psychological symptoms. GHQ scores were found to correlate significantly with all other measures of psychopathology for the various samples. Further analyses indicated that while the GHQ correlated more strongly with scales that assess acute symptoms than with scales that measure chronic problems, GHQ correlations were higher with measures of state as well as trait anxiety relative to indices that primarily reflect non-anxiety-related symptoms. Correlations between the various factor scores of the GHQ and other indices of psychopathology also were found to be mostly significant. These findings generally suggest that the Chinese GHQ-30 is a valid instrument that assesses "general" psychological health, and the data provide support for the validity of some of the factorial dimensions of this scale.     

Detection of underreporting of psychopathology on the MMPI: A meta-analysis

We reviewed the empirical literature on detection of underreporting of psychopathalogy on the MMPI. Meta-analytic techniques were applied to 25 studies in which subjects responding honestly were compared to subjects underreporting psychopathology. Several indices of underreporting were examined, including the L and K scales, F- K, L + K, social desirability scales, subtle/obvious scales, and the Positive Malingering scale. An overall mean effect size of 1.05 was obtained, suggesting that subjects underreporting psychopathology differ from subjects responding honestly by approximately 1 standard deviation, on the average, on these scales. The Positive Malingering scale and one of the social desirability scales showed promising effect sizes of approximately 1. 5 standard deviations. For the L and K scales, effect sizes of just under 1 standard deviation were noted. Cutting scores for detection of underreporting on these scales also were examined. A wide variety of cutting scores were employed in different studies, suggesting that consistently effective criteria have yet to be established. Applications of these findings to the recently published MMPI-2 are discussed.     

Intuition and meaning in life in persons with varying level of depressive symptoms and impairments in personality functioning

Objectives

The current research explored the interplay between intuition, meaning in life, and psychopathology. Specifically, we investigated whether experiential and reflective components of meaning in life are associated with depressive symptoms and personality pathology, whether intuition is related to the experience of meaning, and whether psychopathology has disruptive effects on intuition as well as on the link between intuition and the experience of meaning.

Methods

We tested our preregistered hypotheses in two independent studies. In Study 1, N = 448 participants completed self-report instruments assessing the experiential and the reflective dimensions of meaning in life, depressive symptoms, and impairments in personality functioning. Intuition was operationalized as the ability to intuitively detect semantic coherence in an experimental task. Additionally, self-reported confidence in intuition was assessed. In Study 2, we aimed to replicate our findings and hypotheses that emerged from Study 1 with a new sample of N = 1189 participants.

Results

In both studies, participants with more depressive symptoms or higher levels of personality pathology experienced life as less meaningful but reflected significantly more about meaning in life. The intuitive ability to discriminate between coherence and incoherence in the experimental task was neither related to the experience of meaning in life nor to psychopathology, but more confidence in intuition was associated with experiencing life as more meaningful and with less psychopathological symptoms. It was tentatively supported that the association between meaning in life and intuition was moderated by psychopathology.

Conclusion

The findings are discussed in terms of their clinical implications and regarding the cognitive-affective processes potentially underlying people's experience of life being meaningful.     

Comparison of the brief psychiatric rating scale and the brief symptom inventory

General psychopathology rating scales have multiple uses and have been used extensively. These rating scales may be found in several forms including an interview procedure and self-report. The advantages of self-report measures, as well as their possible deficits, were discussed. Because there are so many varying kinds of rating scales, criteria were set forth as to how to evaluate scales. An interview with a rating scale, the Brief Psychiatric Rating Scale (BPRS), and a self-report measure, the Brief Symptom Inventory (BSI), were compared in this study. The BPRS has been widely used and has been evaluated as one of the very best rating scales. However, experienced raters and more time are needed to administer the BPRS. The BSI is highly evaluated as one of the best brief self-report measures and requires much less professional time. Both instruments have high reliability and validity. Correlations of the BPRS total score with the total scores on the BSI were significant, as were correlations of the depression, anxiety, and hostility subscales on each instrument. Therefore, either scale could be used for a brief assessment of overall symptomatology, depression, anxiety, and hostility. However, it is suggested that the subscales should be compared to other criteria to measure their convergent validity. © 1998 John Wiley & Sons, Inc. J Clin Psychol 54: 885–894, 1998.     

Validity of the pediatric inpatient behavior scale in an inpatient psychiatric setting.

Standardized assessment of children's behavior during psychiatric hospitalization is increasingly important for evaluation, chart documentation, treatment planning, and outcome monitoring, yet little research has been done to validate the use of behavior checklists developed specifically to assess in-hospital behavior. The Pediatric Inpatient Behavior Scale (PIBS) was evaluated for its validity as a measure of behavior of children hospitalized on a psychiatric unit. Nurses completed the PIBS for 41 children, based on behavior observed during the first week of hospitalization. DSM-IV diagnoses and major symptoms were coded based on chart review, and children completed self-report measures of depression and anxiety. The Pediatric Inpatient Behavior Scale subscale scores were related significantly to diagnosis, as well as to major symptoms, correctly classifying 75 to 85% of cases. The Pediatric Inpatient Behavior Scale subscale scores also significantly correlated with self-reported symptoms of depression, but not symptoms of state anxiety. Results support the use of the PIBS as a behavioral instrument for hospitalized children with severe psychopathology.     

Internal and external validity of attention-deficit hyperactivity disorder in a population-based sample of adults

BACKGROUND: Follow-up studies of childhood ADHD have shown persistence of the disorder into adulthood, but no epidemiological data are yet available. METHOD: ADHD DSM-IV symptoms were obtained by self-report in an adult population-based sample of 1813 adults (aged 18-75 years), that was drawn from an automated general practitioner system used in Nijmegen, The Netherlands. The structure of ADHD symptoms was analysed by means of confirmatory factor analyses. Other data used in this report are the General Health Questionnaire (GHQ-28), information about the presence of three core symptoms of ADHD in childhood, and about current psychosocial impairment. RESULTS: The three-factor model that allowed for cross-loadings provided the best fit in the entire sample. This result was replicated across gender and age subsamples. Inattentive and hyperactivity symptom scores were significantly associated with measures of impairment, even after controlling for the GHQ-28. Subjects with four or more inattentive or hyperactive-impulsive symptoms were significantly more impaired than subjects with two, one and no symptoms. The prevalence of ADHD in adults was 1.0% (95% CI 0.6-1.6) and 2.5% (1.9-3.4) using a cutoff of six and four current symptoms respectively, and requiring the presence of all three core symptoms in childhood. CONCLUSIONS: These results support the internal and external validity of ADHD in adults between 18 and 75 years. ADHD is not merely a child psychiatric disorder that persists into young adulthood, but an important and unique manifestation of psychopathology across the lifespan.     

Depressive symptomatology in young people with Gilles de la Tourette Syndrome-- a comparison of self-report scales

BACKGROUND: Few studies have examined depressive symptomatology in children and adolescents with Tourette Syndrome (TS) using standardised measures and none have compared different self-report scales in the context of TS. METHODS: Seventy-two consecutive young people attending a TS clinic were evaluated using standardised rating scales for TS and associated behaviours, severity and psychopathology. All the patients completed the Birleson Depression Self Report Scale (BDSRS) and the Children's Depression Inventory (CDI). RESULTS: A strong correlation was noted between BDSRS and CDI. Depression scores were also noted to correlate with Obsessive Compulsive Behaviours (OCB) and Attention Deficit Hyperactivity Disorder (ADHD). Other correlates of depressive symptomatology included current severity of TS as indicated by Yale Global Tic Severity Rating Scale (YGTSS) and the lifetime cumulative severity as evidenced by scores on the Diagnostic Confidence Index (DCI). LIMITATIONS: The study was undertaken in a tertiary referral specialized clinic for TS thus limiting the generalizability of the findings, and the study did not include any control subjects. CONCLUSIONS: The results provide support for the need and usefulness of both BDSRS and CDI as screening tools for depressive symptoms in children and adolescents with TS. Furthermore, the findings suggest the possibility of a complex inter-relationship between TS severity, comorbid OCB and ADHD as well as the occurrence of depression.     

Examining the links between spiritual struggles and symptoms of psychopathology in a national sample

The present study investigated the relationship between spiritual struggles and various types of psychopathology symptoms in individuals who had and had not suffered from a recent illness. Participants completed self-report measures of religious variables and symptoms of psychopathology. Spiritual struggles were assessed by a measure of negative religious coping. As predicted, negative religious coping was significantly linked to various forms of psychopathology, including anxiety, phobic anxiety, depression, paranoid ideation, obsessive-compulsiveness, and somatization, after controlling for demographic and religious variables. In addition, the relationship between negative religious coping and anxiety and phobic anxiety was stronger for individuals who had experienced a recent illness. These results have implications for assessments and interventions targeting spiritual struggles, especially in medical settings.     

Sleep difficulties are associated with increased symptoms of psychopathology

Sleep problems often co-occur with psychopathological conditions and affective dysregulation. Individuals with mood disorders have significantly higher rates of sleep disturbances than healthy individuals, and among those with mood disorders, sleep problems are associated with lower rates of remission and response to treatment. Sleep disruption may itself be a risk factor for various forms of psychopathology, as experimental sleep deprivation has been found to lead to increased affective, cognitive, and somatic symptoms within healthy volunteers. However, little is known about the relationship between recurring sleep complaints in a naturalistic environment and symptoms of psychopathology among healthy individuals. In the present study, 49 healthy adults (21 males and 28 females) reported sleep quality and completed the Personality Assessment Inventory, a standardized self-report assessment of symptoms of psychopathology. Consistent with prior published findings during total sleep deprivation, individuals endorsing self-reported naturally occurring sleep problems showed higher scores on scales measuring somatic complaints, anxiety, and depression. Furthermore, the reported frequency of sleep disturbance was closely linked with the severity of self-reported symptoms. While causal directionality cannot be inferred, these findings support the notion that sleep and emotional functioning are closely linked.     

The Pain Distress Inventory: development and initial psychometric properties

A new 26-item self-report measure, the Pain Distress Inventory (PDI), was designed to assess affective distress symptoms related to physical pain. Phases 1 to 3 were designed to construct the PDI using contemporary test development strategies. Studies 1 and 2 were conducted to define and confirm the four-factor oblique structure of the PDI: PDI-Depression, PDI-Anger, PDI-Pain Sensitivity, and PDI-Somatic Anxiety. The internal consistency reliability estimates were high for both the PDI total and scale scores. Study 3 examined relationships of the PDI with demographic variables and pain- and psychological-related responses. Scores on the PDI were useful in predicting scores on a pain-interference index and a pain-symptom index. Study 4 was designed to replicate previous findings of reliability and validity. The PDI total and scale scores were useful in differentiating between the responses of the clinic and nonclinic study participants. Limitations and potential uses of the PDI are discussed.     

SCL-90-R Norms for Dissociative Identity Disorder

ABSTRACT

Norms for dissociative identity disorder (DID) have been provided for a variety of structured interviews, self-report measures and computer-scored instruments. The SCL-90-R is a widely used self-report measure of general psychopathology, but prior to this report norms for DID were not available. The authors provide scores on the SCL-90-R for 101 participants with DID at baseline, and for 36 of the participants on two-year follow-up.     

Measuring counterdependency in patients with chronic pain.

OBJECTIVE: Some reports have characterized patients with chronic pain as counterdependent, that is, having emotional suppression, idealization of relationships, strong work ethic, a caregiver role-identity, and self-reliance. However, research has been hampered because formal measures of these traits have been lacking. In this article, we describe a five-item self-report questionnaire, the Counterdependency Scale (CDS), designed to elicit each of these traits on a Likert scale. METHODS: The CDS was administered to 150 consecutive patients evaluated in an outpatient psychiatry consultation program. RESULTS: CDS scores were normally distributed and had significant interitem correlations and test-retest reliability (r = 0.68). As expected, subjects with chronic pain (N = 100) had higher mean CDS scores than those without chronic pain (t = 5.6, p = .000). CDS scores were independent of demographic variables and measures of anxiety, depression, alexithymia, and somatic amplification. CONCLUSIONS: These results suggest that counterdependency can be described by a distinct and measurable cluster of traits associated with chronic pain.     

Peer victimization, cue interpretation, and internalizing symptoms: preliminary concurrent and longitudinal findings for children and adolescents.

This study examined hostile intent and causal, critical self-referent attributions for ambiguous peer cues to examine the hypothesis that these latter interpretations would be uniquely associated with symptoms of depression, social anxiety, and loneliness. Critical self-referent attributions were assessed in 116 kindergarteners (Study 1) and 159 adolescents (Study 2) using a hypothetical vignette procedure, replicating past work on social information processing. In both samples, critical self-referent attributions were concurrently associated with depressive symptoms as reported by teacher (Study 1), peer, and self-report (Study 2). Critical self-referent attributions also were concurrently associated with loneliness and with actual peer experiences, including peer rejection in both studies. Results from both studies support a cognitive vulnerability-stress model, suggesting that the tendency to derive critical self-referent attributions from ambiguous peer experiences is most closely associated with depressive symptoms when accompanied by high levels of peer victimization. Longitudinal findings (Study 2) offers preliminary evidence for this cognitive vulnerability-stress model as a predictor of adolescents' depressive symptoms over a 17-month interval.     

Experience of subjective symptoms in euthymic patients with bipolar disorder

Bipolar patients often experience subjective symptoms even if they do not have active psychotic symptoms in their euthymic state. Most studies about subjective symptoms are conducted in schizophrenia, and there are few studies involving bipolar patients. We examined the nature of the subjective symptoms of bipolar patients in their euthymic state, and we also compared it to that of schizophrenia and normal control. Thirty bipolar patients, 25 patients with schizophrenia, and 21 normal control subjects were included. Subjective symptoms were assessed using the Korean version of the Frankfurter Beschwerde Fragebogen (K-FBF) and the Symptom Check List 90-R (SCL90-R). Euthymic state was confirmed by assessing objective psychopathology with the Positive and Negative Syndrome scale of Schizophrenia (PANSS), the Young Mania Rating Scale (YMRS), and the Montgomery Asberg Depression Rating Scale (MADRS). K-FBF score was significantly higher in bipolar patients than in normal controls, but similar to that in schizophrenia patients (F=5.86, p=0.004, R2=2033.6). In contrast, SCL90-R scores did not differ significantly among the three groups. Euthymic bipolar patients experience subjective symptoms that are more confined to cognitive domain. This finding supports the hypothesis that subtle cognitive impairments persists in euthymic bipolar patients.     

Applying Depression-Distortion Hypotheses to the Assessment of Peer Victimization in Adolescents

This study examined whether adolescents' depressive symptoms and aggressive behavior were associated with discrepancies between self- and peer-reports of peer victimization experiences. A sample of 203 10th-grade adolescents completed self-report measures of victimization and depressive symptoms as well as peer nominations of victimization and aggression. Residual scores were computed as a measure of discordance between peer- and self-reported peer victimization. Adolescents' aggressive behavior was associated with underestimations of peer victimization on self-reported measures, as compared to peer-reports, whereas depressive symptoms were associated with overestimations of peer victimization on self-report, as compared to peer-reports. Different patterns of findings were revealed for different forms of victimization (overt, relational, reputational) and by gender. Findings have implications for studies of adolescent peer victimization using multiple reporters and suggest that adolescents with high levels of depressive symptoms may be vulnerable to misperceptions of their social experiences among peers.