抑郁患者的注意偏向

抑郁患者的注意偏向是抑郁认知研究中的重要问题。该文从研究范式、注意偏向特点及理论解释等方面进行了探讨,在研究范式上有Stroop范式、点探测任务和线索–靶子范式等,在抑郁患者注意偏向的特点上有对象为临床患者、需要阈上刺激、刺激内容针对抑郁患者和刺激强度不能太弱等,在理论解释上有注意成分、注意聚焦变窄、认知负荷和唤醒水平等,并对将来的研究方向进行了探讨     

抑郁症早期识别方法研究

抑郁症早期识别技术至今仍未解决,需要厘清研究思路。回顾以往研究可梳理出三类方法,即：前驱症状法、易感性法、生物内表型法。前驱症状法是依据前驱期症状识别早期患者,但现象学指标的客观性和特异性较差;易感性法是依据家系或个体风险因素界定风险人群,但缺少纵向研究支持,很难直接用于预警;生物内表型法是寻找与疾病相关的潜在生物学标记,但多为临床期研究,不能确定其中哪些可作为前驱期征象。今后的研究可考虑整合三类方法,即利用家系高风险设计寻找生物内表型,并以此识别可靠前驱症状,构建更精确的风险预测模型。     

Executive Functioning in Children and Adolescents with Major Depressive Disorder

The present investigation examined neurocognitive functioning, focusing on executive functioning (EF), in 39 children and adolescents with Major Depressive Disorder (MDD) and 24 healthy control subjects all ages 8 to 17 years. The Wechsler Intelligence Scale for Children-Third Edition along with several measures of executive functioning including the Wisconsin Card Sorting Task, Trail Making Test, Controlled Oral Word Association Test, and the Stroop Color Word Test were administered. The neurocognitive profiles for the group of depressed children and adolescents were grossly intact as most scores on intellectual and EF measures fell within the average range and did not differ from the comparison group. Mental processing speed was decreased in the MDD versus normal control group and 27% of the depressed group performed below average on the Trail Making Test. This investigation provided a good base from which to compare future literature on EF in outpatients with early-onset MDD.     

A Psychometric Evaluation of the Sex-Role Egalitarianism Scale with African Americans

The purpose of this study was to assess the psychometric properties of the Sex-Role Egalitarianism Scale—KK (King & King, 1990) in a sample of 171 African American college students. Examination of the Cronbach alpha reliability coefficients suggested that the SRES—KK is a reliable measure of gender role attitudes for African Americans. The construct validity of the instrument was assessed and supported by an examination of differences between men's and women's scores. The results of the study support the use of the SRES-KK with African American samples. Implications and future directions for research are discussed.     

A Psychometric Evaluation of the Career Decision-Making Self-Efficacy Scale

A thorough psychometric evaluation of the Career Decision-Making Self-Efficacy Scale (CDMSES; Taylor & Betz, 1983) is provided. The construct of career decision-making self-efficacy, stemming from Bandura's (1977) self-efficacy theory, is discussed. A summary of the initial construction and development of the scale is provided, followed by a comprehensive review of the results of various investigations on the reliability and validity of the CDMSES. An overall evaluation of the CDMSES's psychometric strengths and weaknesses is given. The article concludes with ideas for additional psychometric research of the CDMSES and discusses the usefulness of the scale in career counseling and career development research.     

Psychometric Evaluation of the Parent Anger Scale

This study assessed the factor structure and psychometric properties of the Parent Anger Scale in a sample of 326 parents of children ages 2–18 years. Exploratory factor analysis identified a two-factor solution: parent anger experience and parent anger expression. Subscales based on the items of each factor demonstrated excellent internal consistency and concurrent validity with measures of other negative affect and parent discipline. The Parent Anger Scale subscales also evidenced incremental validity, predicting discipline behaviors uniquely above that predicted by parents’ general anger and general anxiety. Specifically, analyses indicated that the Parent Anger Scale experience and expression scores were each unique predictors of inconsistent and punitive parental discipline after controlling for the influences of general anger and anxiety. However, only the Parent Anger Scale expression score had a significant incremental effect in negatively predicting positive parenting above the effects of parents’ general anger and anxiety. Results suggest that the Parent Anger Scale is a valid and useful measure for assessing anger specific to the parent-child context. However, additional research exploring the factor analytic structure and predictive value of the Parent Anger Scale in a clinical sample is needed.     

A Cross-Cultural Psychometric Evaluation of the Athletic Identity Measurement Scale

The Athletic Identity Measurement Scale (AIMS) is a widely used measure of athletic identity (Brewer & Cornelius, 2001 Brewer, B. W. and Cornelius, A. E. 2001. Norms and factorial invariance of the Athletic Identity Measurement Scale. Academic Athletic Journal, 15: 103–113.  [Google Scholar]). Although the factor structure of the AIMS has been tested repeatedly in an American population, its psychometric properties remain largely unexplored cross-culturally. Therefore, the purposes of the study were to further test the psychometric properties of the abbreviated 7-item AIMS in an American population, while also exploring its utility cross-culturally. Results revealed the AIMS to be a psychometrically sound measure of athletic identity for male contact and collision athletes in both American and English-speaking Hong Kong Chinese populations.     

青少年重度抑郁患者自伤行为及危险因素研究

为探讨重度抑郁青少年非自杀性自伤(non-suicidial self-injury,NSSI)行为发生的风险因素,采用贝克自杀意念量表、焦虑自评量表、Barratt冲动量表、认知情绪调节量表、青少年生活事件量表、家庭亲密度及适应性量表对160例抑郁障碍青少年患者进行调查。结果发现,青少年重度抑郁发作患者中NSSI行为发生率较高,性别差异不显著。伴NSSI组患者的冲动性、自杀危险、焦虑、自我责难、灾难化及人际关系得分显著高于不伴NSSI组(P<0.05);计划、积极重新评价,家庭实际适应性得分显著低于不伴NSSI组(P<0.05)。二分类Logistic回归分析显示,自杀危险得分、冲动性总分、人际关系、自我责难是NSSI的危险因素。     

Exploring sudden gains in behavioral activation therapy for Major Depressive Disorder

Understanding the onset and course of sudden gains in treatment provides clinical information to the patient and clinician, and encourages clinicians to strive for these sudden clinical gains with their patients. This study characterizes the occurrence of sudden gains with Behavioral Activation (BA; Martell, Addis, & Jacobson, 2001), and the extent to which pre-treatment dysfunctional depressive thinking predicts sudden gains during treatment. We enrolled a sample of adults (n = 42) between ages 18-65 diagnosed with primary Major Depressive Disorder. All participants completed a 16-week course of BA, with clinical and self-report assessments at pre-, mid- and post-treatment. Results indicated that sudden gain and non-sudden gain participants showed differential improvement across treatment. No significant effects emerged for the dysfunctional cognitive style as a predictor of sudden gain status. Sudden gains may result from interaction of non-specific factors with the BA techniques implemented during early phases of therapy.     

Psychometric Evaluation of a Controlled Social Affiliation Paradigm: Findings From Anxiety,Depressive Disorder,and Healthy Samples

Social impairments are common across many psychiatric conditions. Standardized dyadic assessments intended to elicit social affiliation between unacquainted partners are used to elucidate mechanisms that disrupt relationship formation and inform possible treatment targets; however, the psychometric properties of such paradigms remain poorly understood. This study evaluated the psychometric properties of a controlled social affiliation paradigm intended to induce connectedness between a target participant and trained confederate. Individuals with an anxiety or depressive disorder diagnosis (clinical group; n = 132) and those without (control group; n = 35) interacted face-to-face with a trained confederate; partners took turns answering a series of increasingly intimate questions about themselves. Social connectedness, affect, and affiliative behavior measures were collected during the interaction. Participant symptom and social functioning measures were collected to examine validity. The paradigm elicited escalating social connectedness throughout the task for both participants and confederates. Parallel forms (i.e., different question sets) elicited similar affiliation outcomes. Self-reported (but not behavioral) affiliation differed across some demographic variables (e.g., participant gender, Hispanic ethnicity). Within-task affiliation measures were associated with one another and with global social connectedness and social anxiety symptom measures, but not with somatic anxiety measures. Clinical participants reported lower social affiliation and positive affect reactivity and higher negative affect reactivity than healthy participants. These findings provide initial psychometric support for a standardized and controlled dyadic affiliation paradigm that could be used to reliably probe social disconnection mechanisms across psychopathology.     

Aberrant Parasympathetic Stress Responsivity in Pure and Co-Occurring Major Depressive Disorder and Generalized Anxiety Disorder

Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) are highly comorbid; we know little, however, about the shared physiological features of these disorders. In the present study, we examined whether aberrant parasympathetic stress responsivity represents a transdiagnostic process in MDD, GAD, and co-occurring MDD-GAD. Adult women diagnosed with MDD only, GAD only, and co-occurring MDD-GAD and never-disordered controls (CTLs) completed a standardized laboratory task that involved anticipating, confronting, and recovering from a social stressor. Participants’ levels of respiratory sinus arrhythmia (RSA) were measured to index parasympathetic responses. The three clinical groups combined (participants with MDD only, GAD only, and co-occurring MDD-GAD) exhibited a similar pattern of RSA responsivity that differed significantly from that of the CTL group. Specifically, whereas CTL participants exhibited a sharp decrease in RSA when confronting the stressor and a sharp increase in RSA when recovering immediately following the stressor, the clinical participants exhibited a blunted response pattern that involved weaker fluctuations in RSA when confronting and recovering from the stressor. There were no significant differences among the three clinical groups in RSA responses. Interestingly, clinical and CTL participants did not differ in self-reported fluctuations in negative emotional arousal. Finally, for clinical participants patterns of RSA reactivity to the acute stressor were associated differentially with trait rumination and worry as maladaptive forms of emotion regulation. These findings support the formulation that aberrant parasympathetic stress responsivity is a shared feature of MDD, GAD, and co-occurring MDD-GAD that is characterized by diminished reactivity to and recovery from stress.     

An Integrated Sleep and Reward Processing Model of Major Depressive Disorder

Major depressive disorder with comorbid sleep disturbance has been associated with negative outcomes, including lower rates of treatment response and a greater likelihood of depressive relapse compared to those without sleep disturbance. However, little, if any, research has been conducted to understand why such negative treatment outcomes occur when sleep disturbance is present. In this conceptual review, we argue that the relationship of sleep disturbance and negative treatment outcomes may be mediated by alterations in neural reward processing in individuals with blunted trait-level reward responsivity. We first briefly characterize sleep disturbance in depression, discuss the nature of reward processing impairments in depression, and summarize the sleep/reward relationship in healthy human subjects. We then introduce a novel Integrated Sleep and Reward model of the course and maintenance of major depressive disorder and present preliminary evidence of sleep and reward interaction in unipolar depression. Finally, we discuss limitations of the model and offer testable hypotheses and directions for future research.     

A Feasibility Study of Behavioral Activation for Major Depressive Disorder in a Community Mental Health Setting

Behavioral activation (BA) is a well-supported treatment approach, but little research has been conducted on the effectiveness of this treatment within publicly funded community mental health settings. We examined the feasibility of conducting a randomized trial examining the effectiveness of nine sessions of BA as a treatment for major depressive disorder (MDD) in a community mental health clinic (CMHC) setting. Following adaptation of a BA manual and training of BA therapists, 80 patients seeking treatment at a CMHC were randomized, with a 3:1 randomization rate of BA to nine sessions of treatment as usual (TAU). Feasibility assessments indicated that only one eligible patient refused randomization and, of patients who attended at least one session, the median number of sessions was six for the BA group and eight for the TAU group. Of three postbaseline monthly assessments, 71.3% (171/240) were successfully obtained. On average, patients in the BA condition completed homework assignments 83.9% of the time. Treatment fidelity ratings indicated that substantially more BA techniques were delivered in the BA group compared to the TAU group (d = 2.11). Measures of BA mechanisms improved significantly over time and these changes were significantly associated with change in depressive symptoms. These results indicate that it is feasible to conduct a randomized study of BA for MDD in a CMHC setting. In addition, the study reconfirmed the potential importance of theory-relevant BA mechanism variables. Following these findings, further investigation into the effectiveness of BA in this setting is needed.     

Psychometric Evaluation and Standardization of the Self and Other Scale

This article evaluates and extends the psychometric properties of the Self and Other Scale (SOS). The scale is designed to measure two types of threat to self construction, namely, an insecurity threat (fear of exclusion) and an engulfment threat (fear of intrusion). Previous analysis of the SOS has been based on nonclinical student populations with a narrow age range. The present study addresses this limitation by examining the psychometric properties of the scale with an adult nonclinical population (N = 150) covering the life span and with varied socioeconomic status. Results are compared with those of the previous study. Statistical analysis supports the construct validity and the reliability of the scale. Clinical implications of the scale are explored.     

Development and Psychometric Evaluation of the Utrecht Grief Rumination Scale

Two different types of ruminative coping, depressive rumination and grief rumination, negatively influence bereavement outcome. Although grief-specific rumination is likely to be relevant in the bereavement context no internationally validated scale to measure grief rumination exists. Therefore, the current contribution aims to validate the Utrecht Grief Rumination Scale (UGRS), a scale developed to measure grief-specific rumination, in an English sample. Psychometric properties of the English UGRS were compared with those in a Dutch sample. 204 British adults (89 % women, 11 % men), bereaved on average 16 months ago, and 316 Dutch adults (88 % women, 12 % men), bereaved on average 12 months ago, filled out online questionnaires. Different types of rumination (grief rumination, brooding, reflection, trait rumination) and symptoms of psychopathology (anxiety, depression, complicated grief) were measured. A correlated five factor model provided the best fit for the UGRS. Multi-group comparisons showed that the factor structures of the English and Dutch version of the UGRS were highly similar across language groups. The UGRS showed excellent reliability. Results further supported the construct, convergent, divergent and concurrent validity of the English UGRS. The psychometric properties of the Dutch UGRS corroborated these findings. The UGRS appears a valid instrument to assess grief-specific rumination in international research and may have potential applicability as a clinical instrument to assess rumination in individuals with problematic grief.     

Disgust Sensitivity and Anxiety Disorder Symptoms: Psychometric Properties of the Disgust Emotion Scale

Recent research has implicated disgust sensitivity in the etiology of specific anxiety disorders. The Disgust Emotion Scale (DES) is a newly developed measure that was designed to improve the assessment of disgust sensitivity. The present study examines the psychometric properties of the DES. Exploratory factor analysis in Study 1 revealed five factors of disgust towards: (1) rotting foods, (2) blood and injection, (3) smells, (4) mutilation and death, and (5) small animals. The DES demonstrated adequate internal consistency and convergent validity. Significant positive correlations were found between the five factors of the DES and blood-injection-injury fears and obsessive-compulsive disorder symptoms. Confirmatory factor analysis in Study 2 provided support for the five-factor model. However, there was indication of item overlap within the factors. These findings suggest that the DES is a reliable measure of disgust as it relates to specific anxiety disorder symptoms.     

Differentiating Bipolar Disorder from Major Depressive Disorder Using the MMPI-2-RF: A Receiver Operating Characteristics (ROC) Analysis

We examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) to differentiate patients with lifetime bipolar disorder (BD) from patients with lifetime major depressive disorder (MDD), and to differentiate patients with BD who are currently depressed from patients with current MDD. Sixty-one patients with BD (BD-I n = 51, BD-II n = 10) and 381 patients with MDD were administered the MMPI-2; MMPI-2-RF scale scores were derived from these MMPI-2 protocols. Receiver operating characteristics analysis revealed that the MMPI-2-RF Activation (ACT) scale had the largest Area Under the Curve (AUC), which was 0.74. Using a cut-off score of 4 on the ACT scale resulted in 71% of patients being correctly classified as having BD or MDD (sensitivity = 0.67, specificity = 0.71). An examination of currently depressed patients with BD (n = 29) and a randomly selected sample of MDD patients (n = 29) revealed that the ACT scale correctly classified 72% of patients (AUC = 0.75, sensitivity = 0.69, specificity = 0.76). Implications and limitations of these findings were discussed.     

A Psychometric Evaluation of the Approach and Avoidance of Alcohol Questionnaire (AAAQ) in Alcohol Dependent Outpatients

The Approach and Avoidance of Alcohol Questionnaire (AAAQ; McEvoy et al. in Addiction 99:482–497, 2004) was administered to a clinical sample of 138 alcohol dependent men and women. An exploratory factor analysis was used to determine the AAAQ factor structure and a confirmatory analysis run on a second administration of the AAAQ. Convergent validity was examined by conducting an alcohol cue reactivity test and by administering the Timeline Follow-Back (TLFB), a retrospective calendar method for assessing alcohol consumption, and several measures of alcohol-related problems. The factor analysis supported a two-factor solution representing approach and avoidance dimensions. Regressions predicting measures of alcohol cue reactivity, alcohol consumption, and other alcohol-related constructs with the AAAQ provide support for its convergent validity. The results suggest that alcohol craving may be viewed as a multi-dimensional construct that includes both approach and avoidance inclinations which may vary depending on the population under examination.

Psychometric evaluation of the Fear of Positive Evaluation Scale in patients with social anxiety disorder

The Fear of Positive Evaluation Scale (FPES; J. W. Weeks, R. G. Heimberg, & T. L. Rodebaugh, 2008) was designed to assess fear of positive evaluation, a proposed cognitive component of social anxiety. Although previous findings on the psychometric properties of the FPES have been highly encouraging, only 1 previous study has examined the psychometric profile of the FPES in a sample of patients with social anxiety disorder (T. A. Fergus et al., 2009). The primary purpose of the present study was to conduct a large multisite examination of the psychometric profile of the FPES among patients with a principal diagnosis of social anxiety disorder (n = 226; generalized subtype = 97.8%). Responses of nonanxious control participants (n = 42) were also examined. The factorial validity, internal consistency, test-retest reliability, construct validity, and treatment sensitivity of the FPES were strongly supported by our findings. Furthermore, an FPES cutoff score was identified for distinguishing levels of fear of positive evaluation characteristic of patients with social anxiety disorder from those characteristic of the control group. Results provide additional support for the psychometric properties of the FPES in clinical samples.