Exploring Latent Profiles of Psychopathology in a Sample of Lonely People Seeking Treatment

Journal of Psychopathology and Behavioral Assessment - Loneliness is a common experience in populations experiencing mental health problems. Associations with symptoms of psychopathology are...     

The Bender-Gestalt Psychopathology Scale: Failure to Infer Validity in a School-Aged Sample

The concurrent validity of Hutt's (1977) empirical psychopathology scale of the Bender Visual-Motor Gestalt Test was evaluated among three groups of younger school-aged children within the 7-to-10- year age range (M = 109.1): adjustment disordered, conduct disordered, and nonclinical controls (n = 40/group). Excellent interscorer reliability was achieved with approximately 2 hr of self-study of the scoring manual. Although the conduct-disordered group was significantly more immature on Koppitz' Developmental Scoring System, there were no significant differences among groups on the psychopathology scale when visual-motor development was covaried (M = 50.5). This was an unexpected result, given Hutt's initial validation study among school-aged children. The psychopathology scale was not inferred to be valid among adolescents in the only known concurrent validation study. Pending supportive validation research, the psychopathology scale should not be employed in the clinical assessment of younger school-aged children.     

The Structure of Psychopathology in a Community Sample of Preschoolers

Despite growing interest in the development of alternative diagnostic classification systems for psychopathology in young children, little is known about the adequacy of the DSM symptom structure for describing psychopathology in this population. This paper examines the fit of the DSM-IV emotional (ED) and disruptive behavior disorder (DD) symptom structure in a community sample of 796 4-year-old children. Using the parent-report Child Symptom Inventory (CSI), the best model fit for ED included separate factors for Social Phobia, Separation Anxiety Disorder, Generalized Anxiety Disorder, and Major Depressive Disorder. For DD, the best model included separate Attention Deficit Hyperactivity Disorder-Inattentive type (ADHD-I), Attention Deficit Hyperactivity Disorder-Hyperactive/Impulsive type (ADHD-HI), and Oppositional Defiant Disorder diagnoses. These findings support using DSM-IV nosology to classify EDs in a community sample of preschool children, and suggest differentiation of ADHD into ADHD-I and ADHD-HI.     

Latent Profiles of Comorbid Depression as Predictors of PTSD Treatment Outcome

Posttraumatic stress disorder (PTSD) frequently co-occurs with major depressive disorder, and empirically supported PTSD treatments consistently improve depression. However, both diagnoses are heterogeneous and specific patterns of symptom overlap may be related to worse treatment outcome. Two hundred individuals with chronic PTSD participated in a doubly randomized preference trial comparing prolonged exposure and sertraline. Latent Profile Analysis was used to identify classes based on PTSD and depression symptoms prior to starting treatment. A three-class model best fit the data, with a high depression and PTSD severity class (distressed), a moderate depression and low PTSD avoidance class (depressive), and a low depression and high PTSD avoidance class (avoidant). The avoidant class showed the lowest rates of major depressive disorder diagnosis and transdiagnostic vulnerabilities to depression. Patients in the distressed class experienced more robust PTSD treatment response, with no differences between prolonged exposure and sertraline. These findings highlight the role of avoidance in nondepressed PTSD presentations while also demonstrating that co-occurring depression is not contraindicated in evidence-based PTSD treatment.     

Latent Profile Analysis of Observed Parenting Behaviors in a Clinic Sample

We examined typologies of parenting practices using latent profile analysis (LPA) in a sample of families with young children who had externalizing behavior disorders. We also examined mother and child characteristics associated with class membership using ratings from multiple informants. The sample included pooled data from five parenting treatment outcome research studies on oppositional defiant disorder (ODD) and/or conduct disorder (CD) conducted throughout the past 20 years. These studies included 21 separate cohorts of children resulting in a total of 514 families. All children met diagnostic criteria for ODD or CD and 78 % were male. Parenting practices were observed by independent raters using the Dyadic Parent–child Interactive Coding System-Revised (DPICS-R). Four summary scores (i.e., total critical statements, total commands, total positive, total supportive) from the DPICS-R were used as class indictors in the LPA. Four classes best characterized the parenting practices of this clinic sample, roughly comprising a quarter of the sample each: Positive Only, Negative Only, Positive/Negative, and Neither Positive/Negative. High observed child negative behaviors, low observed child warmth, high socioeconomic status, and low academic performance distinguished the two classes with high negative behaviors (Negative Only, Positive/Negative) from the other classes. These results provide markers of the most common parenting profiles at entry into treatment programs for behavior disorders in young children. Findings have significant implications for the tailoring parenting interventions and supports to specific family needs.     

Correction to: A Family Socialization Model of Transdiagnostic Risk for Psychopathology in Preschool Children

Research on Child and Adolescent Psychopathology - A correction to this paper has been published: https://doi.org/10.1007/s10802-021-00812-1     

Resilience to Interpersonal Trauma and Decreased Risk for Psychopathology in an Epidemiologic Sample

Quantitative measures of psychological resilience related to discrete stressors, such as interpersonal (IP) trauma, are lacking. The current study examined whether a novel, quantitative measure of resilience was related to decreased risk for a broad range of lifetime DSM-IV axis I disorders in an epidemiologic sample. Resilience was defined as the residual resulting from the difference between the individual’s predicted and observed PTSD symptom count, based on their cumulative exposure to IP traumatic events. Participants were 6288 adults (59.5% women; M _age  = 46.9, SD = 14.5) from the National Epidemiologic Study on Alcohol and Related Conditions endorsing at least one lifetime IP traumatic event. Logistic regressions were conducted to examine the relationship between resilience and axis I diagnoses, covarying for age, sex, education level, social support, and recent stressful life events. Greater resilience scores were associated with decreased likelihood of major depression (OR = .64, p < .001), generalized anxiety disorder (OR = .65, p < .001), social anxiety disorder (OR = .74, p < .001), panic disorder (OR = .65, p <. 001), and alcohol dependence (OR = .85, p < .001). Discrepancy between expected and observed PTSD symptom severity based on IP trauma load may represent a useful, quantitative measure of resilience.     

Exploring Psychological wellbeing in a Sample of Australian Actors

Objective

The objective of the current study was to explore what factors might impact the psychological wellbeing of adult, Australian professional actors.

Method

Twenty South Australian actors were recruited using purposive and snowball sampling. Ten were male and 10 female, ranging in age from 22 to 66 years old, with self‐reported professional experience ranging from 1 to 50 years. The participants were interviewed in‐depth about their experiences of being an actor, with a particular focus on wellbeing, and the data were analysed using thematic analysis, with numerous checks in place for methodological rigour.

Results

Two broad categories of themes were established; environmental and personal factors. Environmental factors included power, lifestyle, fringe‐dwelling, engagement, the tribe, and taking care of yourself. Personal factors included pursuit, strengths, the calling, precariousness and looking within.

Conclusions

Themes were considered in terms of contemporary wellbeing theory, along with clinical implications relating to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM5). Findings included: actors experience a range of threats to wellbeing, such as problems with autonomy, lack of environmental mastery, complex interpersonal relationships and high self‐criticism. Factors facilitating wellbeing include ongoing personal growth and a sense of purpose. The findings also suggest that actors are vulnerable to depression, generalised anxiety symptoms, vicarious trauma, and perfectionism.     

Exploring the Impact of Parental Psychopathology and Emotion Regulation on Evidence-Based Parenting Interventions: A Transdiagnostic Approach to Improving Treatment Effectiveness

Parenting interventions, particularly those categorized as parent management training (PMT), have a large evidence base supporting their effectiveness with most families who present for treatment of childhood behavior problems. However, data suggest that PMTs are not effective at treating all families who seek services. Parental psychopathology has been identified as one important factor moderating their effectiveness, yet few PMTs pay explicit attention to the role of parental psychopathology in treatment. Given growing support for a transdiagnostic model of psychopathology, which posits that disruptions in emotions and emotion regulation (ER) may underlie various forms of psychopathology, one way to address the impact of parental psychopathology on PMT may be by targeting parental ER. This paper will review the available literature on PMT and parental psychopathology, as well as existing evidence on relations between ER and both parental psychopathology and parenting behaviors. The limited research on PMTs that include explicitly parent-focused components will be reviewed, and suggestions for augmenting existing PMT curricula by including intervention around parental ER will be presented.     

Profiles of Chronic Illness Knowledge in a Community Sample of American Adults

The author identified profiles of chronic illness knowledge (i.e., heart disease, cancer, diabetes) in a community sample of American adults and examined the effect of sociodemographic influences on relations of illness knowledge to health practices and well-being. Participants were 181 women and 120 men who completed measures of illness knowledge, sociodemographics, personal health practices (e.g., diet, exercise, substance abuse, adaptive healthcare use), well-being (e.g., self-rated physical health, depression, social support), and perceived illness risk. Two-step cluster analyses performed on random subsets of the sample identified three levels of illness knowledge: low, medium, and high. Knowledge groups were differentiated on most measures of health practices, well-being and perceived illness risk. However, effects were substantially attenuated after controlling for differences in age and SES. Findings indicate that age and other sociodemographic factors are related not only to levels of illness knowledge but also to the application of knowledge in relation to health practices and well-being.     

Where No Mind Has Gone Before: Exploring Laws in Distant and Lonely Worlds

Do the laws of nature supervene on ordinary, non‐nomic matters of fact? Lange’s criticism of Humean supervenience (HS) plays a key role in his account of natural laws. Though we are sympathetic to his account, we remain unconvinced by his criticism. We focus on his thought experiment involving a world containing nothing but a lone proton and argue that it does not cast sufficient doubt on HS. In addition, we express some concern about locating the lawmakers in an ontology of primitive subjunctive facts and suggest that a ‘mixed’ metaphysics to the lawmaker question might be attractive.     

Health Anxiety: Latent Structure and Associations with Anxiety-related Psychological Processes in a Student Sample

Although currently classified as a somatoform disorder, cognitive-behavioral models conceptualize hypochondriasis (HC) as a severe form of health anxiety. The Short Health Anxiety Inventory (SHAI) is a measure derived from this conceptualization that measures health anxiety symptoms across the range of severity. Previous studies have reported inconsistent findings regarding this measure’s factor structure, but these studies employed factor analytic tools that did not account for the categorical nature of SHAI items. The present psychometric study was designed to address these inconsistencies using categorical factor analysis. Using data from a large student sample we found that the SHAI had two factors: Illness Likelihood and Illness Severity. We also examined the relationship between these domains and cognitive variables associated with other anxiety disorders. Results suggested that the psychological processes present in obsessive-compulsive disorder and panic disorder are also associated with health anxiety. Implications for the conceptualization and classification of severe health anxiety are discussed.     

A Comparison of Psychopathic Trait Latent Profiles in Service Members

This study used latent profile analysis (LPA) to identify differing classes of psychopathic traits in a large sample of military personnel (90.7% Army National Guard) and examined how membership across profiles can be differentiated by mean scores on external correlates relevant to psychopathy and/or to military service (e.g., aggression, posttraumatic stress symptoms, impulsivity). Psychopathy was operationalized via the three-factor model of the Levenson Self-Report Psychopathy Scales (LSRP; Brinkley et al. 2008; Levenson et al. 1995). LPA revealed optimal fit for a four-profile solution. Three profiles had roughly equivalent within-profile means across the three factors, characterized by below average, average, and above/high average LSRP scores. The fourth profile emerged as qualitatively different: high on LSRP-Callous but below average on LSRP-Egocentricity and LSRP-Antisocial. The four profiles were differentiable based on their mean scores on external correlates, suggesting varied implications for externalizing and internalizing features across psychopathic trait configurations in a military sample. Implications for studying psychopathy in military and other novel samples are discussed.

     

Psychopathology according to behaviorism: a radical restatement

This article is a radical restatement of the predominant psychopathology, which is characterized by nosological systems and by its approach towards a neurobiological conception of the so-called mental disorders. The "radical" sense of this restatement is that of radical behaviorism itself. As readers will recall, "radical" applied to behaviorism means total (not ignoring anything that interests psychology), pragmatic (referring to the practical sense of knowledge), and it also derives from the Latin word for "root" (and thus implies change beginning at a system's roots or getting to the root of things, in this case, of psychological disorders). Based on this, I introduce the Aristotelian distinction of material and form, which, besides being behaviorist avant la lettre, is used here as a critical instrument to unmask the hoax of psychopathology as it is presented. The implications of this restatement are discussed, some of them already prepared for clinical practice.     

Exploring Perceptions of Xenophobia in a Sample of South African Employees

This brief report aimed to explore the perceptions of xenophobia within a sample of South African employees. Data on participants' views regarding xenophobia, related xenophobic violence and causes were collected from 127 respondents (males=43%, females=57%, with the majority of respondents being Afrikaans speaking=53% and white=68.5%). Responses were thematically analysed. Seventy-four percent of respondents did not approve of xenophobic behaviour. Only twenty percent of the respondents empathised with South Africans with xenophobia. Six percent of the respondents were indifferent to xenophobia. Participants considered having xenophobia to be related to unemployment, poverty, poor governance, a lack of education and involvement in crime.     

The Spiritual Well-Being of Elderly People: A Study of a French Sample

The aim of our research was to identify predictors of the spiritual well-being of elderly people. More specifically, we postulated that subjective well-being and its components would be predictors of spiritual well-being, and more so than age and health status. We invited 133 people aged 60–95 to complete a questionnaire that included the French adaptation (Velasco and Rioux in Revue Canadienne des Sciences du Comportement 41(2):102–128, 2009) of Paloutzian and Ellison’s (Loneliness: A sourcebook of current theory, research and therapy, Wiley-Interscience, New York, 1982) Spiritual Well-Being Scale, Ryff and Essex’s (Psychol Aging 7:507–517, 1992) Psychological Well-Being Scale (translated by Lapierre and Desrochers 1997), Salamon and Conte’s (Meas Eval Guid 15(3):194–200, 1982) Life Satisfaction in the Elderly Scale (validated by Rousseau and Dubé in 1993), and the French version (Blais et al. in Can J Behav Sci 21:210–223, 1989) of Diener et al. (J Pers Assess 49:71–75, 1985) Satisfaction with Life Scale. The results only partially confirm our hypothesis, because only satisfaction with life as a whole and two items in “Life Satisfaction in the Elderly Scale” make it possible to predict the spiritual well-being of elderly people. Moreover, neither health status nor age was found to be a significant predictor of spiritual well-being. This research helps understand better the links between the concept of spiritual well-being and that of subjective well-being of elderly people and could contribute to the development of a tool that could take into account the spiritual well-being of elderly people, whether they be believers, agnostic, or atheist.     

Relationships among Proactive Coping,Posttrauma Gratitude,and Psychopathology in a Traumatized College Sample

Scant previous research has examined associations of proactive coping and psychopathology, although two preliminary findings suggest that proactive coping might be negatively associated with posttraumatic stress disorder (PTSD) and general depression symptom level. This study examined associations of proactive coping with PTSD and anhedonic depression in a sample of 169 traumatized undergraduates. As expected, women tended to report more severe PTSD symptoms and less life threat than men. No other gender differences were found. Most important, proactive coping and posttrauma state gratitude were independently negatively associated with PTSD symptom level, after controlling for trauma history and female gender. Further, proactive coping was independently negatively associated with anhedonic depression, beyond the effect of traumatic life threat. The implications of the findings for models of posttrauma psychopathology development are discussed.     

Effects of Incest in Aging Survivors: Psychopathology and Treatment Issues

Most older people who have been sexually abused in childhood have probably never been treated for the consequences of their destructive experiences. The character pathology and long-term effects of child sexual abuse are described. Parallels were drawn between delayed Posttraumatic Stress Disorder seen in older veterans and World War II victims and later-life onset of posttraumatic psychopathology in aging incest survivors. Special geropsychological treatment issues, such as the appropriateness of explicit inquiry regarding a history of abuse and the role of power, gender, and shame in the psychotherapeutic relationship, are presented. The dilemma of uncovering repressed malignant childhood trauma in aging individuals is discussed. With proper medical and psychological preparation, demanding curative interventions with older survivors may be considered.     

Comparing Binary Transgender and Nonbinary People: Factors Associated with Psychological Well-Being Among a Predominately People of Color Sample

Binary transgender and nonbinary people face interpersonal and societal discrimination which can contribute to minority stress and negative mental health. Thus, it is important that family therapists understand what factors contribute to psychological well-being to be able to offer helpful and inclusive therapy services to these communities. This study addresses a gap in the literature regarding differences in factors contributing to psychological well-being between binary transgender and nonbinary people as well as understanding these factors in a predominantly People of Color (POC) sample. Utilizing secondary data from the Social Justice Sexuality Project (Battle and DeFreece in Women Gend Fam Color 2(1):1–31. https://doi.org/10.5406/womgenfamcol.2.1.0001, 2014; Battle et al. in Social justice sexuality survey: cumulative codebook, City University of New York-Graduate Center, New York, 2012), this study examined the relationships between perceived family support, religiosity, community connectedness and psychological well-being in a sample of binary transgender and nonbinary people. Results from a multiple group path analysis show that perceived family support, religiosity and being connected to an LGBT community were significantly associated with psychological well-being for binary transgender people, while only LGBT community connectedness was significantly associated with psychological well-being for nonbinary people. Implications for family therapists include helping families support binary transgender and nonbinary family members, deconstructing non-affirming religious messages about gender identity and connecting clients to affirmative religions and religious leaders, and being knowledgeable about community resources for binary transgender and nonbinary POC.