Evaluation of bizarre-idiosyncratic thinking scale as a measure of thought disorder in children and adolescents with severe psychiatric disorders

To investigate the prevalence of thought disorder and the possible appropriateness of the Bizarre-Idiosyncratic Thinking Scale for children and adolescents with severe psychiatric disorders, 96 child and adolescent inpatients and day hospital patients, ages 6 to 18 years, at a state psychiatric hospital were rated by review of retrospective records using Marengo and Harrow's 1986 Evaluation of Bizarre-Idiosyncratic Thinking Scale for the presence of thought disorder in the Thematic Apperception Test and Rorschach Inkblot Test responses. Although the Evaluation of Bizarre-Idiosyncratic Thinking Scale had not been previously used with children and adolescents, the analysis suggested possible indications of thought disorder in several diagnostic groups. No significant differences were found on the Rorschach between patients with Schizophrenia and Psychosis, Not Otherwise Specified and those with Attention Deficit Hyperactivity Disorder, Major Depression, and Conduct Disorder. On the basis of the Thinking Scale ratings, the Thematic Apperception Test responses showed significantly higher ratings of thought disorder for patients with Schizophrenia and Psychosis, Not Otherwise Specified. There was no general relation between thought disorder and age or IQ, but schizophrenic patients, aged 13 and older, had more thought disorder than schizophrenic patients who were younger than 13.     

Concordance of the MCMI-II, the MMPI, and Axis I discharge diagnosis in psychiatric inpatients.

Discriminant functions of the MMPI and the MCMI-II were compared in a sample of 166 hospitalized psychiatric patients with discharge diagnoses of affective disorder (63), schizophrenia (26), substance abuse (35), and other disorders (42). Of special interest was the comparative diagnostic utility of the two instruments in regards to DSM-III-R Axis I diagnoses. Both tests performed reasonably well in the discriminant function analyses; however, the MCMI-II achieved a somewhat superior overall hit rate with this sample of inpatients (79% to 68%). This difference was tied to greater accuracy of the MCMI-II for identifying the affective disorders group.     

Last night I had the strangest dream: Varieties of rational thought processes in dream reports

From the neurophysiological perspective, thinking in dreaming and the quality of dream thought have been considered hallucinatory, bizarre, illogical, improbable, or even impossible. This empirical phenomenological research concentrates on testing whether dream thought can be defined as rational in the sense of an intervening mental process between sensory perception and the creation of meaning, leading to a conclusion or to taking action. From 10 individual dream journals of male participants aged 22–59 years and female participants aged 25–49 years, we delimited four dreams per journal and randomly selected five thought units from each dream for scoring. The units provided a base for testing a hypothesis that the thought processes of dream construction are rational. The results support the hypothesis and demonstrate that eight fundamental rational thought processes can be applied to the dreaming process.     

A longitudinal investigation of social causation and social selection processes involved in the association between socioeconomic status and psychiatric disorders.

Social causation theory and social selection theory have been put forth to explain the finding that low socioeconomic status (SES) is associated with risk for psychiatric disorders. The predictions of both theories were investigated using data from a community-based longitudinal study. Psychosocial interviews were administered to 736 families from 2 counties in New York State in 1975, 1983, 1985-1986, and 1991-1993. Results indicated that (a) low family SES was associated with risk for offspring anxiety, depressive, disruptive, and personality disorders after offspring IQ and parental psychopathology were controlled, and (b) offspring disruptive and substance use disorders were associated with risk for poor educational attainment after offspring IQ and parental psychopathology were controlled. These findings indicate that social causation and social selection processes vary in importance among different categories of psychiatric disorders.     

Study instrument for psychopathology in computer-assisted analysis of findings (Structured Psychopathologic Detection System)

With the Structured Psychopathological Evaluation-System (SPES) an instrument existed for employment of objective criteria. This study was designed to present an evaluation system based on new scientific results, that is applying on the strength of a reduced catalogue of symptoms (94 compared with 198 Items at SPES-A) to clinical routine. Additional findings differentiated by this system be able to classify by the help of an operational decision system.     

Effectiveness of Beck Depression Inventory-II subscales in screening for major depressive disorders in adolescent psychiatric inpatients

The Beck Depression Inventory-II (BDI-II) was administered to 45 male and 55 female psychiatric inpatients who were 12 to 17 years old, and the Mood Module from the Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to determine whether these patients met criteria for a diagnosis of a DSM-IV major depressive disorder (MDD). Binormal receiver-operating-characteristic (ROC) analyses found that BDI-II total scores, Cognitive subscale scores, Noncognitive subscale scores, and embedded BDI FastScreen for Medical Patients subscale scores were comparably effective in differentiating inpatients who were and were not diagnosed with a MDD; the areas under the ROC curves were, respectively, .92 (95% confidence interval [CI]: .85-.96), .90 (95% CI: .82-.95), .90 (95% CI: .83-.95), and .90 (95% CI: .83-.95).     

Reliability of diagnosis in older psychiatric patients using the structured clinical interview for DSM-III-R

We conducted one of the few studies that has examined the reliability of the Structured Clinical Interview for DSM-III-R Axis I (SCID-I) with a mixed inpatient and outpatient population of adults 55 years old and over (range, 56–84 years; mean, 67.33 years). All SCID interviews were videotaped or audiotaped and were administered by Master's-level clinicians working toward their doctorate degrees in clinical psychology. Interrater reliability estimates (kappa and percentage agreement) were calculated for current major depressive episode (47% base rate) and the broad diagnostic categories of anxiety disorders (15% base rate) and somatoform disorders (12% base rate). Kappa values were .70, .77, and 1.0. Respective percentage agreement was 85% for major depression, 94% for anxiety disorders, and 100% for somatoform disorders. Overall percentage agreement was 91%. We conclude that the SCID-I can be effectively administered by relatively inexperienced clinicians to diagnose older psychiatric patients reliably. Directions that future research might take are offered.     

A model for brief assessment of attachment and its application to women in inpatient treatment for trauma-related psychiatric disorders

We adapted self-report measures of attachment style to the psychological assessment of women in specialized inpatient treatment for trauma-related disorders. The study employed 2 measures of adult attachment style, the Relationship Questionnaire (Bartholomew & Horowitz, 1991) and the Adult Attachment Scale (Collins & Read, 1990) as well as our Current Attachment Relationships questionnaire, which assesses the extent of social support in secure attachments. We administered these measures to 99 patients and to a convenience sample of 154 women in the community. We found modest correspondence between the 2 attachment style measures and substantial relations between attachment styles and range of secure attachment relationships. Women in the trauma sample reported insecure attachment styles and relatively few secure attachment figures. We discuss the implications of these findings for clinical assessment.     

Validity of post-proline splitting dipeptidyl aminopeptidase activities in the cerebrospinal fluid for neurologic and psychiatric diagnosis

The dipeptidyl-peptidase activity of 650 liquores cerebrospinalis was obtained by means of the substrate Gly-Pro-NHNp (Gly-Pro-4-nitroanilid) at pHs of 5.5 and 7.4. In comparison with a reference collective, the suitability of the method as a supplementary liquor parameter in neurological psychiatric diagnosis was examined. The introduction of the measurement at pH 7.4 can be particularly recommended for the distinguishing of bacterial and nonbacterial meningitis.     

Item response theory analysis of diagnostic criteria for alcohol and cannabis use disorders in adolescents: implications for DSM-V

Item response theory (IRT) has advantages over classical test theory in evaluating diagnostic criteria. In this study, the authors used IRT to characterize the psychometric properties of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) alcohol and cannabis use disorder symptoms among 472 clinical adolescents. For both substances, DSM-IV symptoms fit a model specifying a unidimensional latent trait of problem severity. Threshold (severity) parameters did not distinguish abuse and dependence symptoms. Abuse symptoms of legal problems and hazardous use, and dependence symptoms of tolerance, unsuccessful attempts to quit, and physical-psychological problems, showed relatively poor discrimination of problem severity. There were gender differences in thresholds for hazardous use, legal problems, and physical-psychological problems. The results illustrate limitations of DSM-IV criteria for alcohol and cannabis use disorders when applied to adolescents. The development process for the fifth edition (DSM-V) should be informed by statistical models such as those used in this study.     

Sex bias in the diagnosis of personality disorders: an evaluation of the DSM-IV criteria.

This study considered whether the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) is biased against women by requiring less dysfunction for the personality disorders that are more commonly diagnosed in women (e.g., histrionic). Clinicians estimated the extent of social dysfunction, occupational dysfunction, and personal distress suggested by each of the diagnostic criteria for 6 personality disorders. The results failed to suggest a bias against women, as there was no difference in the overall level of dysfunction associated with the female-typed personality disorder diagnostic criteria (fewer criteria are also required for the male-typed diagnoses). However, the considerable variation in dysfunction across disorders and criteria, and the minimal degree of impairment implied by some of the diagnostic criteria, also raise more general issues that should perhaps be addressed in future editions of the diagnostic manual.     

Identification of two-tone images; some implications for high- and low-spatial-frequency processes in human vision

Unlike most multitone images, two-tone images such as print, geometric figures, and line drawings are as easy to interpret in photographic negative as in positive form. However, images derived from a multitone original in which intensity values are quantised to two levels are not. Bi-level quantised images, distinct from most other two-tone images, are shown to contain picture related components in their low spatial frequencies. Since it is the low-spatial-frequency components alone of negative images that present difficulties for vision, it is proposed that images which are as easy to interpret in negative as in positive form are those which are readily identified using only their high spatial frequencies.     

The study of emotional processes in communication: I. Measuring emotionalization in everyday face-to-face communicative interaction

The drawbacks of traditional research into emotional processes have led us to develop a set of methodologies for investigating them in everyday face-to-face communication. The conceptual basis of these procedures is a model of the eliciting conditions of emotional processes as well as a conceptualization of the emotional processes themselves. On the basis of the assumption of conversation as a rule-governed process, one can describe its default temporal, formal, and functional features, for which we use the MAS EDIT and SEQ programs, and the minimal model of communicative exchange, respectively. Violations of these default rules can be identified as unexpected/temporally unpredictable events eliciting emotionalization. The nature of emotionalization is determined by the psychological principle of “standard and deviation.” Its investigation under natural conditions requires the following: A noninvasive method of data acquisition (including procedures for rejecting faulty or missing values), measurement (high-resolution recording of physiological, psychomotor, and vocal variables), and the (nonstatistical) construction of an inventory or “relevant effects” (contrastive and template analysis). Finally, we depict three routes of investigating time courses of activation changes as dependent and independent variables and as a target of modification and reflection.