The Low and Narrow: A Preliminary Test of the Association Between Depressive Symptoms and Deficits in Producing Divergent Inferences

Depression is associated with biased interpretations and beliefs that are resistant to change. This kind of cognitive rigidity may depend on two distinct factors—a reduced ability for processing information that conflicts with these interpretations and beliefs and a reduced ability for generating alternative representations. Although depressive symptoms are typically not associated with deficits in common divergent thinking tasks, these tasks may not be sensitive or specific enough to detect the rigid cognition associated with depression. Accordingly, a novel task was developed to assess divergent thinking in line with the level of construal and thematic contents typical of depressive cognition (the Divergent Inference Task—DIT). In a preliminary investigation using a nonclinical sample, depressive symptoms were correlated with deficits in producing divergent interpretations for realistic scenarios using the DIT. This finding may represent an important psychological mechanism that contributes to the persistence of biased interpretations and beliefs in depression.     

Clients’ experiences of dynamic interpersonal therapy (DIT): opportunities and challenges for brief,manualised psychodynamic therapy in the NHS

Dynamic interpersonal therapy (DIT) is a brief manualised psychodynamic intervention for depression. This is a first study exploring clients’ experiences of DIT specifically and brief, manualised psychodynamic psychotherapy (PP) in general. Interpretative phenomenological analysis was the methodology employed. Five participants completed a semi-structured interview, three weeks to ten months after completing DIT. The scores of pre- and post-therapy outcome measures of depression and anxiety were also available. Two emerging superordinate themes are presented here: (1) ‘The Distinct Features of DIT’, referring to how its therapeutic style and time limitations were experienced and (2) the ‘Impact of Therapy’, referring to perceived outcomes. While previous findings showed that therapist’s perceived limited activity in long-term PP was experienced as hindering/unhelpful, the perceived sense of direction in DIT appeared adequate to most participants. Secondly, the time limitations provoked complex responses. Reactions to the distinct elements of DIT are to be treated both as therapeutic opportunities and as challenges. Further, in line with psychoanalytic theory, most participants described relational changes that went beyond symptom relief and remained in progress after therapy ended. Intriguingly, there was no consistency between participants’ qualitative accounts of change and the scores of the outcome measures.     

Are DIT scores empirically distinct from measures of political identification and intellectual ability? A test using post‐9/11 data

Emler, Renwick, and Malone (1983) argued against a developmental interpretation of the Defining Issues Test (DIT), suggesting instead that it actually measures a social psychological phenomenon – political identification. On the other hand, Sanders, Lubinski, and Benbow (1995) have argued that DIT scores measure intellectual ability. In this study, we pitted the DIT against measures of political identification and intellectual ability in order to test its ability to incrementally predict variation in post‐9/11 attitudes. We found that both DIT‐2 scores and political identification were significant predictors of attitudes toward restricting human rights/civil liberties, while our index of intellectual ability (i.e. ACT scores) was not. DIT‐2 scores, political identification and intellectual ability each accounted for significant variation in attitudes toward President George W. Bush in our undergraduate college sample during the spring of 2004.     

Book reviews

Current research on medically unexplained somatic symptoms (MUSS) shows a renewed interest in psychodynamic approaches. Patients with MUSS lack the capacity to mentalize about their feelings. They have an attachment history characterized by insecure attachment relationships. They have a personality trait that can be best described as self-critical perfectionism. Their insecure early attachment relations have had a negative impact on the development of their stress regulatory system. Staff of Psychotherapeutisch Dagcentrum, affiliated with the Department of Psychiatry of a general hospital in Tilburg, found dynamic interpersonal therapy (DIT) a suitable treatment model for the treatment program that was run for patients with MUSS. DIT was developed by Lemma, Fonagy, and Target in the UK for the individual treatment of patients suffering from depression. Subsequently, a variant of DIT was developed in order to make it suitable for application in a multidisciplinary group setting.     

Dynamic interpersonal therapy in an NHS tertiary level specialist psychotherapy service

We describe the introduction of dynamic interpersonal psychotherapy (DIT) into an National Health Service (NHS) tertiary psychoanalytic specialist psychotherapy service. Training in DIT began as our contribution to Improving Access to Psychological Therapies and primary care services, supporting the training and supervision of their DIT practitioners. We then discovered DIT could be a valuable treatment within our own tertiary NHS service for patients with complex presentations. Currently fighting for survival, like many NHS psychoanalytic psychotherapy services nationally, we have adopted a manual-guided, psychoanalytically based therapy to broaden our tertiary clinical psychoanalytic service and accommodate trends in mental health service provision, whilst protecting the quality and integrity of our psychotherapy. DIT helped us continue providing relevant and beneficial psychoanalytic and psychodynamic services to individual patients despite limitations of the financially challenged NHS, NICE guidelines and Payment by Results. We outline the progress and outcomes for patients with complex mental health presentations, include individual case discussion and our experience of using the DIT approach within a traditionally longer term psychoanalytic psychotherapy service.     

The development of a brief group intervention (Dynamic Interpersonal Therapy) for patients with medically unexplained somatic symptoms: a pilot study

The primary aim of this equivalence study was to compare the outcome of a brief group therapeutic intervention, based on the principles of dynamic interpersonal therapy (DIT) with an intervention based on cognitive behavioural therapy (CBT) in patients suffering from medically unexplained somatic symptoms (MUSS). Participants were 89 patients (aged 18 to 62) who were offered 20 sessions of either DIT or CBT, as central part of a treatment package, consisting of art therapy, psychomotor therapy, social therapy and physical therapy. Measurements were conducted at baseline, 10 weeks and 20 weeks, using self-rating scales measuring the level of anxiety and depression, the severity of medically unexplained symptoms and quality of life. Results showed that CBT and DIT were comparable. The conclusion was that it is recommended to design a larger scale randomised controlled trial to further elaborate the short-term and long-term effects of this novel psychodynamic group therapy for MUSS patients.     

Moral Reasoning Effects on Political Participation

In this study, respondents who agreed to participate in a computer-administered interview were presented with information and questions about public interest groups, followed by the Defining Issues Test of moral reasoning (DIT). Respondents with high DIT scores stressed morally central over morally peripheral considerations in deciding whether to participate in public interest groups. Less sophisticated reasoners showed the opposite pattern. Morally central considerations also had a much greater impact on the probability that sophisticated respondents would attempt to participate in public interest groups after completing the interview. The analysis included controls for potential confounding variables such as cognitive ability, education, prior political participation, and gender. The findings imply motivational differences between advantaged and disadvantaged population groups. Such differences may help to account for the differing strategies and successes of political organizations mobilizing these groups.     

Type of Offense and Level of Moral Development Among Adult Male Inmates

The Defining Issues Test (DIT) was administered to three groups of adult male inmates in two categories to compare their levels of moral development. The distribution of DIT scores was found to be similar to those of nonfelonious samples. Implications for the treatment of offender populations are discussed.     

Political identification and the defining issues test: reevaluating an old hypothesis

Research on the association between the development of moral judgment (as measured by the Defining Issues Test [DIT]; J. R. Rest, 1979) and political attitudes has demonstrated that these factors are often reliably related. N. Emler (1987, 1990) and colleagues have asserted that DIT scores actually measure test-takers' political identity rather than their developmental level. To test this claim, these researchers have designed "faking studies" in which respondents are asked to complete the DIT as if they were of a particular political orientation, regardless of their real political views. These faking studies have yielded contradictory conclusions, whereas tests of the incremental validity of the DIT have provided some evidence for its empirical distinctiveness. In the present study, the authors reexamined this issue by pitting scores on the DIT, Version 2 (DIT-2; J. R. Rest, D. Narvaez, S. J. Thoma, & M. J. Bebeau, 1999) against several more concrete measures of political identification in several predictive models of attitudes toward human rights and civil liberties. DIT-2 scores and political identification emerged as significant predictors in nearly all regression analyses.     

Moral reasoning development and graduate education

The Defining Issues Test (DIT) of moral reasoning development was administered to 20 advanced and 20 first-year graduate students, plus 40 college graduates matched to the graduate groups on sex, age, and verbal ability. A two-way ANOVA design was used to infer whether graduate education, selection, maturation, or a combination of these effects is (are) associated with group differences on the DIT. Results suggest that differences found between the graduate students and college graduates can be accounted for by a combination of maturational and selection effects, contrary to the hypothesized effects of formal education.     

The Moral Judgments of Chinese Students

Abstract

The Defining Issues Test (DIT) was translated into Chinese and administered to 84 male and 84 female Chinese subjects in Hong Kong. No significant sex differences in all of the stage scores derived from DIT ratings and rankings were found. In addition, the Pearson correlation matrix of Stage 2 through 6 scores for the females but not for the males approximated a simplex-like pattern. The unrotated factor loadings of the Principal Components Analysis for the female subjects provided clear support to the claim of an ordered sequence of Kohlberg's stages measured by the DIT. The factor loadings on the higher stages (4, 5, and 6), however, were less discriminating and consistent in the male factor pattern.     

Competing Conceptions of Justice: Faculty Moral Reasoning About Affirmative Action

College faculty (N = 115) were recruited to investigate the influence of moral reasoning on hiring decisions about affirmative action dilemmas. Participants completed the Defining Issues Test (DIT), a standard test of moral reasoning, a measure that presented two hypothetical moral dilemmas about affirmative action that manipulated candidates' race and moral issues, and a scale evaluating the use of external norms versus self-chosen principles. Results indicated that moral issue but not race of a minority candidate affected hiring decisions. Faculty used greater percentages of principled reasoning when solving the more salient affirmative action dilemmas than when solving the hypothetical dilemmas of the DIT. Higher scores on the DIT were related to the use of principles rather than norms when making hiring decisions. Findings suggest that faculty decisions about hiring a hypothetical affirmative action candidate are more influenced by moral reasoning level and competing conceptions of justice than racial bias or ambivalence.     

The Health Professional Ethics Rubric: Practical Assessment in Ethics Education for Health Professional Schools

A barrier to the development and refinement of ethics education in and across health professional schools is that there is not an agreed upon instrument or method for assessment in ethics education. The most widely used ethics education assessment instrument is the Defining Issues Test (DIT) I & II. This instrument is not specific to the health professions. But it has been modified for use in, and influenced the development of other instruments in, the health professions. The DIT contains certain philosophical assumptions (??Kohlbergian?? or ??neo-Kohlbergian??) that have been criticized in recent years. It is also expensive for large institutions to use. The purpose of this article is to offer a rubric??which the authors have named the Health Professional Ethics Rubric??for the assessment of several learning outcomes related to ethics education in health science centers. This rubric is not open to the same philosophical critiques as the DIT and other such instruments. This rubric is also practical to use. This article includes the rubric being advocated, which was developed by faculty and administrators at a large academic health science center as a part of a campus-wide ethics education initiative. The process of developing the rubric is described, as well as certain limitations and plans for revision.     

“Mummy,keep it steady”: phonetic variation shapes word learning at 15 and 17 months

Fifteen‐month‐olds have difficulty detecting differences between novel words differing in a single vowel. Previous work showed that Australian English (AusE) infants habituated to the word‐object pair DEET detected an auditory switch to DIT and DOOT in Canadian English (CanE) but not in their native AusE (Escudero et al., 2014 ). The authors speculated that this may be because the vowel inherent spectral change variation (VISC) in AusE DEET is larger than in CanE DEET. We investigated whether VISC leads to difficulty in encoding phonetic detail during early word learning, and whether this difficulty dissipates with age. In Experiment 1, we familiarized AusE‐learning 15‐month‐olds to AusE DIT, which contains smaller VISC than AusE DEET. Unlike infants familiarized with AusE DEET (Escudero et al., 2014 ), infants detected a switch to DEET and DOOT. In Experiment 2, we familiarized AusE‐learning 17‐month‐olds to AusE DEET. This time, infants detected a switch to DOOT, and marginally detected a switch to DIT. Our acoustic analysis showed that AusE DEET and DOOT are differentiated by the second vowel formant, while DEET and DIT can only be distinguished by their changing dynamic properties throughout the vowel trajectory. Thus, by 17 months, AusE infants can encode highly dynamic acoustic properties, enabling them to learn the novel vowel minimal pairs that are difficult at 15 months. These findings suggest that the development of word learning is shaped by the phonetic properties of the specific word minimal pair.     

Promoting Student Cognitive Development

This study focused on a theoretically grounded counselor preparation curriculum that was designed to enhance the moral reasoning and cognitive complexity of students as well as teach them the basic skills and theories of counselor education. The curriculum for the counselor training was rooted in a teaching–learning framework that included conditions for facilitating cognitive–developmental growth and skill and theoretical training components. The purpose of the study was to evaluate the developmental effects of the counselor training program as measured in 2 domains of cognitive development: conceptual level and level of moral reasoning. The participants were assessed at 3 different times: prior to entering the counseling program, 1-year into the program, and the month marking the completion of their 2nd year in the program. The Paragraph Completion Method (PCM) and the Defining Issues Test (DIT) were used as estimates of cognitive–developmental level. Analysis of the results revealed a significant gain for the group on the PCM between the 2nd and 3rd assessments and a positive but nonsignificant trend for the DIT.     

Ego development and the ethics of care and justice: the relations among them revisited

This study examined the links among ego development and the ethics of care and justice in 144 Norwegian men and women, 15 to 48 years old, taking into consideration age, sex, education, and verbal intelligence. As expected, the relationship between Loevinger's model of ego development and care-based moral reasoning as measured with Skoe's Ethic of Care Interview (ECI) was significantly stronger than the one between ego development and justice as measured with Rest's Defining Issues Test (DIT). Both ethics correlated significantly with verbal ability. Analyses showed that beyond its overlap with verbal intelligence, the variance shared between the ECI and ego development was substantial. By contrast, when verbal intelligence was controlled, the DIT was not significantly related to ego development or to the care ethic.     

MORAL DEVELOPMENT OF CHINESE STUDENTS IN HONG KONG

The Defining Issues Test (DIT) of moral judgment by Rest was administered to 242 Chinese secondary school and university students in Hong Kong. Metric unfolding analysis on the stage scores of different groups of both sexes and various educational levels revealed that the moral development of the Chinese students were in agreement with Kohlberg's major distinctions of preconventional, conventional and postconventional levels. The sequence of stage development within the same level (e.g., between stages 5 and 6), however, was sometimes ambiguous. Results also showed that older university students were morally more mature than the younger secondary school students in their P%, D, and stages 5 and 6 scores. The applicability of DIT in the Chinese culture and the universality of Kohlberg's 6-stage model were generally supported.