The relationship between comorbid personality disorders and treatment received in patients with anxiety disorders

Few studies have addressed the relationship between the presence of a comorbid personality disorder and the amount of psychiatric treatment received by patients with an Axis I disorder. This issue has not been studied in patients with anxiety disorders. In a prospective, naturalistic, longitudinal study of anxiety disorders, 526 subjects were assessed with the Personality Disorder Examination, and types of treatment received in 1991 and 1996 were identified. In 1991, compared to subjects without a personality disorder, subjects with a personality disorder were as likely to receive medication and they received a greater number of medications. Subjects with borderline personality disorder were more likely to receive heterocyclic antidepressants and interventions characteristic of psychodynamic psychotherapy and cognitive therapy; they also reported receiving a greater number of medications and types of psychosocial treatment than other subjects. In 1996, subjects with borderline personality disorder were more likely to receive psychodynamic interventions. These findings suggest that in patients with an anxiety disorder, the presence of a comorbid personality disorder is associated with receiving a greater number of medications but not with a greater likelihood of receiving pharmacologic or psychosocial treatment. However, the presence of borderline personality disorder is associated with a greater likelihood of receiving, and receiving a greater number of, certain types of somatic and psychosocial treatments.     

Ethnic identity and interethnic dating in Portuguese young adults

Forty undergraduate Rutgers-Newark students (21 women and 19 men) of Portuguese descent, aged 18 to 28, participated in a study on identity com-mitment and attitudes toward interethnic dating. High commitment to a Portuguese identity was associated with a collectivist orientation and with having a social network densely populated with Portuguese people. High personal concern with the ethnicity of one's dating partner was positively correlated with commitment to a Portuguese identity, and with having a social network densely populated with Portuguese people. High importance placed on parents' opinions about the ethnicity of dating and marriage partners was associated with a collectivist orientation. For women but not men, commitment was associated with high concern with one's partner's ethnicity. Results are discussed in terms of gender and the development of commitment to an ethnic identity.     

An interdependence analysis of commuting decisions

The current research advances an interdependence analysis of commuting decisions (i.e. commuting by car versus public transportation), delineating the determinants of an individual's outcomes in terms of own decisions, other commuters' decisions, and the combination or interaction of own and others' decisions (Kelley & Thibaut, 1978). Consistent with hypotheses, findings revealed that a concern with comfort led to a higher overall personal preference for the car, and a lower overall preference for others to commute by public transportation, when compared to a concern with travel time. Additionally, consistent with the claim that commuter decisions are also guided by considerations broader than a concern with individual outcomes, findings revealed that individuals with prosocial orientations (i.e. those concerned with maximizing collective outcomes) in combination with high levels of trust (i.e. believing in the honesty and cooperative intentions of others) exhibited a greater overall personal preference for public transportation, and a reduced desire to avoid other commuters, relative to individuals with a prosocial orientation and low levels of trust, or a proself orientation (i.e. those concerned primarily with maximizing own outcomes), regardless of levels of trust. Finally, consistent with the current interdependence analysis, intention to commute by car was positively associated with not only overall personal preference for the car, but also with the desire to avoid other commuters. © 1997 John Wiley & Sons, Ltd.     

Joint Trajectories of Symptoms of Disruptive Behavior Problems and Depressive Symptoms During Early Adolescence and Adjustment Problems During Emerging Adulthood

The joint, longitudinal trajectories of symptoms of disruptive behavior problems and of depression were examined in a community sample drawn from neighborhoods with elevated rates of delinquency. Growth mixture modeling was applied to a 6?year transition period from childhood to adolescence, age 10 to 16?years, to identify latent classes of trajectories for each symptom type. Several classes emerged for the two types of symptoms, namely a group of youth with high levels of disruptive behavior, a group with increasing levels, and a group with low levels, as well as a group with increasing levels of depression, a group with high levels, a group with decreasing levels, and a group with low levels. Within each symptom type, membership in either the high or in the increasing classes was related to a variety of problematic outcomes during emerging adulthood. The co-occurrence of the disruptive behavior and depression classes was then evaluated using parallel process analysis. Youth exhibiting high depressive symptoms were at increased risk for disruptive behavior problems, and youth with increasing disruptive behavior problems were at risk for depressive symptoms. However, only a very small number of youth had both a high depression trajectory and a high disruptive behavior trajectory. Implications of the findings for the design of prevention and treatment programs are discussed.     

Helping the child with cancer: what school personnel want to know

As more children with cancer survive, the importance of facilitating school reintegration as a part of maximizing the quality of life has become evident. Workshops have been presented to school personnel to acquaint them with the issues facing cancer patients and their families, but there are gaps in our knowledge of what school personnel really need or want to know. In this study, 18 teachers of children with cancer and 15 teachers with no prior contact with students with cancer completed a questionnaire designed to assess needs, beliefs, and priorities with regard to working with cancer patients in the classroom. Significant findings included: (a) a consensus that a certain core of information about medical/psychological issues would be useful, and presentation of such information by psychologists and medical personnel working with such families would be optimal; (b) teachers having cancer patients as students were less likely to see the adaptation of siblings as an important issue; (c) teachers associated working with a student with cancer with less stress and demands on their time than predictable from previous studies; and (d) cancer patients as a whole were rated as having fewer behavioral, emotional, and learning problems than randomly selected students without a major illness, suggesting a "halo effect" or contradiction of some literature. Preliminary findings are detailed and implications are discussed for those attempting to help teachers facilitate students' adjustment to school following diagnosis and treatment of cancer.     

Does power corrupt or enable? When and why power facilitates self-interested behavior

Does power corrupt a moral identity, or does it enable a moral identity to emerge? Drawing from the power literature, we propose that the psychological experience of power, although often associated with promoting self-interest, is associated with greater self-interest only in the presence of a weak moral identity. Furthermore, we propose that the psychological experience of power is associated with less self-interest in the presence of a strong moral identity. Across a field survey of working adults and in a lab experiment, individuals with a strong moral identity were less likely to act in self-interest, yet individuals with a weak moral identity were more likely to act in self-interest, when subjectively experiencing power. Finally, we predict and demonstrate an explanatory mechanism behind this effect: The psychological experience of power enhances moral awareness among those with a strong moral identity, yet decreases the moral awareness among those with a weak moral identity. In turn, individuals' moral awareness affects how they behave in relation to their self-interest.     

The Importance of Assessing for Childhood Abuse and Lifetime PTSD in Bariatric Surgery Candidates

For bariatric surgery candidates, history of child abuse and PTSD may be under-recognized or under-reported at pre-surgical evaluation. On a range of clinically relevant factors, we studied 3045 candidates for bariatric surgery: (1) those with a history of childhood abuse compared to those without such history; and (2) among candidates with a history of abuse, those with a lifetime diagnosis of PTSD compared to those without that diagnosis. We compared them on current and lifetime eating disorders, physical health problems, health behaviors, physical functioning, psychosocial functioning, psychiatric disorders, emotional wellness, body satisfaction, and self-esteem. We hypothesized that patients with a history of childhood abuse, and within that group, those with a lifetime PTSD diagnosis, would display greater overall impairment. Patients were interviewed with semi-structured interviews and completed self-report questionnaires. Results showed that (1) patients with a history of childhood abuse exhibited significantly greater impairment than those without abuse; and (2) among candidates with a history of abuse, those with a lifetime history of PTSD displayed significantly greater impairment than those without a PTSD diagnosis. The findings suggest that a history of both childhood abuse and lifetime PTSD should be thoroughly assessed for at pre-surgical evaluation, and that greater attention be paid to the experience of PTSD symptoms in abuse survivors presenting for bariatric surgery.     

Current suicide ideation and prior suicide attempts of bipolar patients as influences on caregiver burden

We examined whether caregivers of bipolar patients reporting current suicidal ideation and/or a history of a suicide attempt reported higher levels of burden and/or poorer health compared to caregivers of patients without these suicidality indices. In a cross-sectional design, caregivers (N = 480) associated with (a) patients with current suicidal ideation or (b) patients with a positive lifetime history of at least one suicide attempt, reported lower general health scores than caregivers associated with patients with neither of these indices. Parents of patients with at least one lifetime attempt reported more burden secondary to role dysfunction than spouses. Levels of depression in caregivers varied with whether the caregiver was a spouse or a parent, and whether patients had a history of suicide attempts, current suicidal ideation, or both.     

Life Satisfaction in Persons with Late Effects of Polio

To assess satisfaction with life as a whole and with ten domains of life satisfaction in Swedish persons with late effects of polio, to describe the relationship with sex, age, marital status, use of mobility aids and self-perceived needs of instrumental support, and to compare the level of life satisfaction with a Swedish reference sample. A cross-sectional study of 160 persons with verified late effects of polio answered a postal questionnaire including the Life Satisfaction Questionnaire (LiSat-11). A majority were to some degree satisfied with life as a whole and with all the ten domains of life satisfaction. Satisfaction with life as whole was not related to any of the sociodemographic or disability related factors and these factors had few relations to the ten domains of life satisfaction. The respondents were significantly less satisfied with life as a whole and with vocation, leisure, sexual life, activities of daily living, and somatic and psychological health compared to the Swedish reference sample, but were significantly more satisfied with economy and contacts with friends. Men and women with late effects of polio, regardless of age, marital status or disability, can experience a reduced life satisfaction. This emphasises the need to identify potential gaps between these persons’ aspirations and achievements in life and carry out appropriate rehabilitation interventions to enhance their life satisfaction.     

Assessing Fear of Storms and Severe Weather: Validation of the Storm Fear Questionnaire (SFQ)

To date, research on storm phobia has been limited by a lack of validated self-report measures for evaluating the severity of anxiety, phobic avoidance, and distress associated with storms and severe weather. The current research presents the development and validation of the Storm Fear Questionnaire (SFQ), a 15-item self-report questionnaire that assesses the cognitive, affective, and behavioral aspects thought to be associated with Storm Phobia in adults. Three studies were conducted to assess 1) the factor structure, internal consistency, and convergent and discriminant validity of the SFQ, 2) the test-retest reliability of the SFQ, 3) the extent that scores on the SFQ were associated with subjective anxiety ratings during a Behavioral Approach Test (BAT) involving exposure to a virtual thunderstorm, and the extent to which SFQ scores distinguished community participants with versus without a fear of storms. Exploratory factor analyses supported a one-factor model with good internal consistency (Cronbach’s α?=?.95), good convergent and discriminant validity with self-report measures of anxiety, worry, depression, and other specific phobias, and acceptable test-retest reliability. Moreover, there was a significant positive association between SFQ scores and anxiety ratings following the BAT involving exposure to a virtual thunderstorm and participants with a high fear of storms reported significantly higher SFQ scores than those with a low fear of storms. In sum, the SFQ has good psychometric properties and appears to be a valuable tool for assessing the severity of fear associated with storms and severe weather. Research evaluating the diagnostic and clinical utility of the SFQ is still needed.     

Entitativity and social identity complexity: The relationship between group characteristics and personal characteristics on group identification

The current study extends previous works on group identification by focusing on how social identity complexity and entitativity interact to impact group identification. The purpose of the current study is to test the hypothesis that people with a simple social identity identify more strongly with a highly entitative group and people with complex social identity identify more strongly with a group low in entitativity. Participants’ social identity complexity and entitativity about a group were manipulated, and with that group was measured. Results demonstrated that participants primed with a simple social identity identified more strongly with a more highly entitative group, whereas identification with the high and low entitativity groups did not differ for participants primed with a complex social identity.     

Does the campaign against tobacco use necessarily reduce the attractions of smoking for young people? Identity issues surrounding initiation into tobacco consumption

The present study examines the attitude of Swiss adolescents towards tobacco consumption as a function of its implications for identity and their perception of the antismoking social norm. A total of 228 girls and 213 boys, aged 11–15 years, answered a questionnaire assessing personal attitude towards tobacco consumption (the main dependent variable), the salience of the antismoking norm (perceived attitudes of family, teachers, politicians and society in general), and their identification with smokers, as well as their self-image and their perception of the image (positive and negative) of smokers. The results show that a prosmoking attitude is associated with a stronger identification with smokers, a more positive (and less negative) image of smokers, a more negative self-image, and weaker salience of the antismoking norm. A pro-smoking attitude is also associated with a self-image that is closer to the image of the smoker, independently of the latter's valence. Finally, a prosmoking attitude is associated with a negative self-image specifically among those who identify more strongly with smokers but who also perceived a strong antismoking norm. This last result suggests that a strong antismoking norm can help to make smoking an attractive behaviour for young people, in particular those with a negative self-image.     

A Behavior Systems View of Conditioned States during Long and Short CS–US Intervals

In the behavior systems view, a long CS–US interval should differentially condition a general search mode and related behavior, while a short CS–US interval should differentially condition a focal search mode and related behavior. Two experiments paired a long or a short CS with food, and then, during an extinction test, compounded the CS with an unconditioned probe-stimulus of a rolling ball-bearing. Presuming that the long CS differentially conditions a general search mode, and that unconditioned contact of a moving stimulus is characteristic of that mode, presentation of the long CS should facilitate interaction with the ball-bearing. Similarly, presuming that a short CS differentially conditions a focal search mode, and that feeder-directed responses are characteristic of this mode, presentation of a short CS should facilitate nosing in the food-tray. Consistent with these predictions, ball-bearing contact increased in rats receiving the long CS, while nosing in the food-tray was higher with the short CS.     

Who is this?: Identity and presence in robot-mediated communication

Because a telepresence robot is intended for use in telecommunications, conveying the presence of a remote sender is an important issue. Even though certain characteristics of robots such as identity could be effective at generating a sense of presence, this risks yielding a distortion of presence in the remote sender. Thus, in order to find effective ways to increase presence, we executed an experiment comparing a telepresence robot with high identity and a telepresence robot with low identity. The 60 participants in this study engaged in a video call with a remote sender using either a telepresence robot with high identity or a telepresence robot with low identity. The results showed that participants felt more remote sender presence when interacting with the telepresence robot with low identity than they did with the one with high identity. On the other hand, when a telepresence robot has high identity, participants felt more presence toward the robot than they did toward the one with low identity. In the second study (N = 72), participants experienced two types of telepresence robots (identity level: a telepresence robot with high identity vs. a telepresence robot with low identity) with two types of remote senders (number of remote senders: single remote sender vs. multiple remote senders). The identity level of the robot and the number of remote senders affected the presence of the remote sender, telepresence, and the presence of the robot. We discuss in detail the implications for the design of telepresence robots in terms of increasing presence.     

Deep dysphasia: An analog of deep dyslexia in the auditory modality

A right-handed patient, with two left hemisphere lesions, a small one in the prefrontal lobe and a larger one in the temporal, presents an unusual syndrome: a massive deficit for oral language (expression and comprehension) contrasting with a fairly good preservation of written language (expression and comprehension). The processing of isolated words and sentences has been extensively tested with repetition and dictation tasks. The patient performs rather well with nouns, verbs, and adjectives, poorly with adverbs and function words, and completely fails with nonsense words. A remarkable feature of his repetition is the frequency of semantic paraphasias. Thus, this patient exhibits a behavior rather similar to deep dyslexia, hence the possible label "deep dysphasia." The paper presents a "preunderstanding" hypothesis to account for such behaviors.     

Establishing praise as a conditioned reinforcer: Pairing with one versus multiple reinforcers

Praise and other forms of attention may not function as reinforcers for the behavior of children with autism. Previous research demonstrated that contingently pairing praise with reinforcers (response stimulus) can establish praise as a conditioned reinforcer. We evaluated a procedure for establishing praise as a generalized conditioned reinforcer (pair praise with four reinforcers) and compared it with a procedure to establish praise as a conditioned reinforcer (pair praise with one reinforcer). We compared the two conditions in a reversal design with “praise” and “no programmed consequence” conditions rapidly alternated after pairing phases. With three out of five participants with autism, responding in the “pair‐with‐four” condition showed higher levels of responding or more increasing trends compared with that in “pair‐with‐one” condition. We also replicated previous contingent pairing research with two participants in a multiple baseline across participants design. A limitation was the absence of manipulating motivating operations in assessing the efficacy of praise as a generalized conditioned reinforcer. Nevertheless, these data contribute to the research on establishing praise as a reinforcer, and we recommend directions for future research.     

Social influences on smoking in middle-aged and older women

The purpose of this study was to examine the role of 2 types of social influence--general social support and living with a smoker--on smoking behavior among middle-aged and older women in the Women's Health Initiative (WHI) Observational Study. Participants were postmenopausal women who reported smoking at some time in their lives (N=37,027), who were an average age of 63.3 years at baseline. Analyses used multiple logistic regression and controlled for age, educational level, and ethnicity. In cross-sectional analyses, social support was associated with a lower likelihood and living with a smoker was associated with a higher likelihood of being a current smoker and, among smokers, of being a heavier smoker. Moreover, in prospective analyses among baseline smokers, social support predicted a higher likelihood and living with a smoker predicted a lower likelihood of smoking cessation 1-year later. Further, in prospective analyses among former smokers who were not smoking at baseline, social support predicted a lower likelihood and living with a smoker predicted a higher likelihood of smoking relapse 1-year later. Overall, the present results indicate that social influences are important correlates of smoking status, smoking level, smoking cessation, and smoking relapse among middle-aged and older women.     

Progress in Reconciliation: Evidence from the Right and the Left

For a number of years now I have argued for a reconciliation of contemporary conceptions of justice. I have argued that a libertarian conception of justice with its ideal of liberty, a welfare liberal conception of justice with its ideal of fairness, a socialist conception of justice with its ideal of equality, a communitarian conception of justice with its ideal of the common good, and a feminist conception of justice with its ideal of androgyny can all be seen to support the same practical requirements, specifically the practical requirements that are usually associated with a welfare liberal conception of justice, namely, a right to welfare and a right to equal opportunity. Since most people endorse one or another of these conceptions of justice, to reach agreement in practice it should suffice to show them that all these conceptions support the same practical requirements of a right to welfare and a right to equal opportunity.     

Suicide attempts and family history of suicide in three psychiatric populations

The influence of a family history of suicide on suicide attempt rate and characteristics in depression, schizophrenia, and opioid dependence was examined. One hundred sixty inpatients with unipolar depression, 160 inpatients with schizophrenia, and 160 opioid-dependent patients were interviewed. Overall, a family history of suicide was associated with a higher risk for suicide attempt, with high-lethality method, with repeated attempts, and with number of attempts, while the interaction between family history and diagnostic group was not significant. Thus, a positive family history of suicide was a risk factor for several suicide attempt characteristics independent of psychiatric diagnosis.     

Peer harassment and satisfaction with appearance in children with and without a facial difference

This study investigated associations between perceived peer harassment and satisfaction with appearance in the presence or absence of a facial difference. A cross-sectional sample of 661 children aged 10 or 16, with a cleft lip and/or palate, completed measures of satisfaction with appearance and peer harassment. Results indicated that the presence of a visible versus a nonvisible cleft was not associated with appearance dissatisfaction or higher levels of peer harassment for children aged 10 or for adolescent boys. Peer harassment was related to dissatisfaction with appearance in both age groups. In the adolescent group, there was an interaction between cleft visibility and gender, girls with a visible cleft being least satisfied with appearance. However, the association between cleft visibility and satisfaction with appearance was fully mediated by experiences of peer harassment. The results highlight the need to further explore the role of social interactions for subjective perceptions of appearance.