Screening for personality disorders in a nonclinical population

Based on the Inventory of Interpersonal Problems (IIP), the IIP-PD and the IIP-C screening scales were developed to distinguish personality disorder (PD) from non-PD and Cluster C from other PD, respectively, in a clinic population. Two studies were conducted to determine (a) validity and reliability of these IIP scales for PD screening in a nonclinical population, (b) specificity of IIP-C for identifying Cluster C, and (c) usefulness of the IIP scales for screening Cluster A. College students were screened using the IIP scales (Study 1, N = 454, Study 2, N = 87). High and low scorers completed PD-related questionnaires in Study 1 and a clinical interview for PD symptomatology in Study 2. Results indicated strong test-retest reliability, internal consistency, and factorial, convergent, and external validity. The scales tapped a common deficit in interpersonal relatedness, with some distinction between externalizing and internalizing dimensions, respectively, and both scales were positively and significantly associated with schizotypal traits. In conclusion, the IIP-PD and IIP-C are useful and valid screening instruments for identifying any versus no PD in nonclinical populations.     

The role of self‐image as a predictor of psychotherapy outcome

The present study examined the relationship between self‐image and outcome in psychotherapy. Patients (n = 170) received treatment‐as‐usual at a university clinic, and met diagnostic criteria for mostly anxiety and depression related disorders. Self‐image was measured with the Structural Analysis of Social Behavior (SASB‐I) introject pre and post‐treatment. Using multiple regression analyses, higher levels of Self‐ignore and Self‐blame pre‐treatment predicted a poorer treatment outcome in terms of symptoms (SCL‐90‐R) and interpersonal problems (IIP‐64), respectively. Increase in Self‐love and decrease in Self‐blame (pre to post) predicted reduced symptoms at post‐treatment, whereas decrease in Self‐attack and Self‐control, as well as increase in Self‐affirm, predicted reduced interpersonal problems. The results suggest that self‐image improvement may be important in order to achieve a good outcome in psychotherapy.     

Personality and symptom change in treatment-refractory inpatients: evaluation of the phase model of change using Rorschach,TAT, and DSM-IV Axis V

In this study, we examined global treatment outcomes during 16 months of intensive, psychodynamic treatment for 77 inpatients suffering from treatment-refractory disorders. Hypotheses based on the phase model of treatment change (Howard, Lueger, Maling, & Martinovich, 1993; Howard, Moras, Brill, Martinovich, & Lutz, 1996) were supported in the study results. Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Axis V scales assessing behavioral functioning demonstrated large and medium effect size change, whereas stable, enduring personality functioning assessed by psychoanalytic Rorschach scales and the Social Cognition and Object Relations Scale (Westen, 1995) for the Thematic Apperception Test (Murray, 1943) demonstrated small and medium effect size change. We also report assessment of reliable change index and clinical significance. The ecological validity of Rorschach measures is supported by significant validity coefficients (in the hypothesized directions) between implicit measures of personality functioning and behavioral ratings.     

Generalization Across Instructional Settings by Autistic Children

Although parent training generally has been successful, sufficient data exist to indicate that treatment outcome is not always positive. Several investigators have suggested that problems in the family system may be responsible for the failures, which occur. The present paper reviews the relationship between three family problem variables (parental maladjustment, marital difficulties, and dysfunctional extra familial interactions) and child behavior problems and their treatment. The available data suggest that there is a positive relationship between child behavior problems and problems in each of the three types of family variables. Furthermore, although less conclusive, some data suggest that the outcome of parent training is affected adversely by poor parental personal, marital, and extra-familial adjustment. Assessment of generalization form parent training to family problems has yielded mixed results; generalization has occurred primarily to parental personal adjustment. Finally, comparisons of parent training alone to parent training plus treatment of family problems have not been undertaken, Areas for future investigation are discussed.     

Conceptions of perfectionism and interpersonal problems: evaluating groups using the structural summary method for circumplex data

This study examined two conceptions of perfectionism in relation to interpersonal problems. Two hundred and seventy-nine undergraduate participants completed the Almost Perfect Scale-Revised (APS-R) and the Dyadic Almost Perfect Scale (DAPS). The authors used empirically derived discriminant functions (APS-R) and cluster analysis (DAPS) to identify three groups for both measures: adaptive and maladaptive perfectionists and nonperfectionists. Analyses of group profiles were performed on the Inventory of Interpersonal Problems Circumplex (IIP-C) scales using the structural summary method for circumplex data. APS-R and DAPS groups were compared on interpersonal problems endorsement and IIP-C profile characteristics. For both measures, results supported the hypotheses that maladaptive perfectionists would exhibit elevated profiles reflecting hostile-dominant and friendly-submissive interpersonal problems, whereas the adaptive perfectionists would exhibit low profile elevation indicative of interpersonal adjustment. Overall, results supported Slaney and colleagues' (2001) model of perfectionism and provided evidence for the validity of the APS-R and DAPS.     

Interpersonal problems,personality pathology,and social adjustment after cognitive therapy for depression

The authors examined the level and structure of the Inventory of Interpersonal Problems-Circumplex version (IIP-C; L. M. Horowitz, L. E. Alden, J. S. Wiggins, & A. L. Pincus, 2000) before and after 20 sessions of acute-phase cognitive therapy for depression (N = 118), as well as associations with the Schedule for Nonadaptive and Adaptive Personality (L. A. Clark, 1993b) and the Social Adjustment Scale--Self-Report version (M. M. Weissman & S. Bothwell, 1976). Interpersonal problems had a 3-factor structure (Interpersonal Distress, Love, and Dominance), with the latter 2 factors approximating a circumplex, both before and after therapy. Interpersonal Distress decreased and social adjustment increased with therapy, but the Love and Dominance dimensions were relatively stable, similar to personality constructs. Social adjustment related negatively to Interpersonal Distress but not to Love or Dominance. Personality pathology related broadly to Interpersonal Distress and discriminantly to Love and Dominance. These findings support the reliability and validity of the IIP-C and are discussed in the context of personality theory and measurement.     

A brief inventory of Interpersonal Problems-Circumplex using nonparametric item response theory: introducing the IIP-C-IRT

Nonparametric item response theory methods were applied to the responses of 1,000 college students on the 64 items of the Inventory of Interpersonal Problems-Circumplex (IIP-C; Alden, Wiggins, & Pincus, 1990) to develop an abbreviated 32-item version of the instrument. In a separate validation sample of 981 students, the newly selected scale items did not show evidence of differential item functioning across males and females. There was high convergence found between the new scales and IIP-C parent scales, along with commensurate or improved fits to the circular structural model relative to the full scale and its existing brief derivatives-the IIP-32 and the IIP-SC. Results provide evidence that the new brief scales can improve the level of precision and information yielded in brief assessments of interpersonal problems without gender bias.     

Interpersonal personality measures show circumplex structure based on new psychometric criteria

The importance of the interpersonal circle in organizing the interpersonal domain is complemented by its empirical relations with broader personality taxonomies and with more specific personality variables. Yet circumplex structure in interpersonal measures has often been investigated using the "eyeball test" rather than using circumplex criteria of known effectiveness. Simulations (Acton, 1999) showed the effectiveness of 5 exploratory criteria (3 entirely new) that assess the properties of equal spacing, constant radius, and no preferred rotation. Along with Browne's (1992) criterion, these were applied to the Interpersonal Checklist (ICL; LaForge & Suczek, 1955; N = 763), Interpersonal Adjective Scales (IAS; Wiggins, 1979; Ns = 716 and 187), Revised IAS (IAS-R; Wiggins, Trapnell, & Phillips, 1988; N = 474), Inventory of Interpersonal Problems Circumplex Scales (IIP-C; Alden, Wiggins, & Pincus, 1990; Ns = 616 and 1,381), and Inventory of Interpersonal Goals (IIG; Horowitz, Dryer, & Krasnoperova, 1997; N = 318). In corroboration of interpersonal theory, all showed circumplex structure.     

Circumplex structure and personality disorder correlates of the Interpersonal Problems model (IIP-C): construct validity and clinical implications

This study assessed the construct validity of the circumplex model of the Inventory of Interpersonal Problems (IIP-C) in Norwegian clinical and nonclinical samples. Structure was examined by evaluating the fit of the circumplex model to data obtained by the IIP-C. Observer-rated personality disorder criteria (DSM-IV, Axis II) were used as external correlates. The reliability of the IIP-C scales was acceptable and in the same range as in the original version. A multisample analysis strategy did not support an invariant circumplex model across the 2 groups. However, the estimated structures reflected mostly the same circular pattern of a quasi-circumplex model in the 2 groups. Departures from the ideal model were of negligible practical significance. The validity results examining personality disorder correlates of the IIP-C generally conformed to predictions, providing direct evidence for agreement between self-report and expert judgments of interpersonal problems.     

Are There Specific Relationships Between Symptom Patterns and Interpersonal Problems Among Psychiatric Outpatients?

Associations between symptoms and interpersonal problems, assessed with the Symptom Checklist–90 (SCL–90–R) and the Inventory of Interpersonal Problems–64-item version (IIP–64), are examined in a large psychiatric outpatient sample. On the basis of the IIP–64 scores, the sample was divided into 8 subgroups, made up of different types of predominant interpersonal problems. These octant groups were used as independent variables in analyses testing hypothesized associations with symptom subscales of the SCL–90–R. In general, strong associations between symptoms and interpersonal problems were found. In addition, hostile and paranoid ideation symptoms displayed significant differences among octant groups, and were associated with interpersonal problems of the vindictive/self-centered kind. Phobic anxiety was associated with interpersonal problems of the socially inhibited kind. Assessing specific combinations of symptoms and interpersonal problems might be useful in treatment planning and evaluation.     

Self-esteem and interpersonal functioning in psychiatric outpatients

This study explored associations between self-esteem and interpersonal functioning in a one-year clinic cohort of psychiatric outpatients ( n = 338). At intake, patients completed questionnaires measuring self-esteem, interpersonal problems, interpersonal style, and general symptomatic distress. They were also diagnosed according to the ICD-10. Interpersonal behaviour was measured along the agency and communion dimensions of the Inventory of Interpersonal Problems – Circumplex [IIP-C]. The results show that lower self-esteem was associated with higher levels of interpersonal problems in general. Further, lower self-esteem was first and foremost linked to frustrated agentic motives, as measured by the IIP-C. Hence, the study concludes that fostering patient agency should be considered as an important goal in psychotherapy. Furthermore, the analyses revealed an interaction effect of agency and communion on self-esteem, indicating a need for balancing the two motive dimensions. Finally, some questions are raised concerning the interpretation of the IIP-C subscales in general.     

A Preliminary Study of Clinical Process in Relation to Outcome in Psychodynamic Psychotherapy for Panic Disorder

This study identified psychotherapeutic processes that relate meaningfully to psychotherapeutic outcome for patients with panic disorder undergoing Panic-Focused Psychodynamic Psychotherapy (PFPP) (Milrod et al., 1997). Subjects were 21 patients who participated in an open clinical trial of PFPP (Milrod et al., 2000; Milrod et al., 2001). The Interactive Process Assessment (IPA) (Klein, Milrod, and Busch, 1999), a process measure developed specifically to identify the process of PFPP, was used. Process-outcome relationships were calculated between process factors at early, mid, and late treatment and outcome measures at termination. Results showed that the therapist's focus on the transference late in treatment was associated with a decrease in panic symptoms. Transference focus early in the treatment, however, was correlated with an increase in related symptomatology, as measured by the HAM-A and SDS. It was unclear from the present study how focusing on panic symptomatology affected the treatment. This process might be better investigated by comparing this aspect of PFPP with alternative psychotherapies.     

Understanding academic attitudes and achievement in mexican-origin youths: ethnic identity, other-group orientation, and fatalism

This study tested the relationships among ethnic identity, other-group orientation, fatalism, and 2 dependent variables: attitude toward education and school, and grade point average (GPA). Mexican-origin adolescents (N = 222) completed the Multigroup Ethnic Identity Measure (J. S. Phinney, 1992), the fatalism scale of the Multiphasic Assessment of Cultural Constructs-Short Form (I. Cuellar, B. Arnold, & G. Gonzalez, 1995), and the attitude scale of the Learning and Study Strategies Inventory-High School (C. E. Weinstein & D. R. Palmer, 1990a). Other-group orientation was positively related to attitude and GPA, and a negative relationship between fatalism and attitude was demonstrated. No relationship emerged between ethnic identity and the dependent variables.     

Interpersonal Personality Measures Show Circumplex Structure Based on New Psychometric Criteria

The importance of the interpersonal circle in organizing the interpersonal domain is complemented by its empirical relations with broader personality taxonomies and with more specific personality variables. Yet circumplex structure in interpersonal measures has often been investigated using the "eyeball test" rather than using circumplex criteria of known effectiveness. Simulations (Acton, 1999) showed the effectiveness of 5 exploratory criteria (3 entirely new) that assess the properties of equal spacing, constant radius, and no preferred rotation. Along with Browne's (1992) criterion, these were applied to the Interpersonal Checklist (ICL; LaForge & Suczek, 1955; N = 763), Interpersonal Adjective Scales (IAS; Wiggins, 1979; Ns = 716 and 187), Revised IAS (IAS-R; Wiggins, Trapnell, & Phillips, 1988; N = 474), Inventory of Interpersonal Problems Circumplex Scales (IIP-C; Alden, Wiggins, & Pincus, 1990; Ns = 616 and 1,381), and Inventory of Interpersonal Goals (IIG; Horowitz, Dryer, & Krasnoperova, 1997; N = 318). In corroboration of interpersonal theory, all showed circumplex structure.     

Interpersonal subtypes within generalized anxiety disorder

In this study, we addressed the heterogeneity in interpersonal problems across patients with generalized anxiety disorder (GAD). We assessed interpersonal problems by the Inventory of Interpersonal Problems (IIP-C; Horowitz, Alden, Wiggins, & Pincus, 2000) in a sample of 78 GAD patients. We used IIP-C profiles describing interpersonal characteristics of the total GAD sample as well as clustered GAD interpersonal subtypes. Although the overall sample was located in the friendly submissive quadrant of the circumplex model, this was true only for the Exploitable cluster, which includes more than 50% of the patients. Importantly, clusters of GAD patients with other locations reporting predominantly Cold, Nonassertive, or Intrusive interpersonal problems were also identified. The 4 clusters did not differ in terms of gender, comorbid disorders, or the severity of depression or anxiety. Thus, the assessment of interpersonal problems provides additional diagnostic information covering the heterogeneity of GAD patients. This information could be used for differential indication and individual case formulation in GAD.     

Stereotype activation is unintentional: Behavioural and event‐related potenials evidence

In this study, a priming Stroop paradigm was used to determine whether stereotype activation is unintentional. Priming conditions (priming/no‐priming) and the relationship between priming and target (consistent/inconsistent/no‐relation) were the independent variables; accuracy, reaction time and N400 amplitude were used as dependent variables. The reaction time revealed that stereotype activation is, to some extent, unintentional. Furthermore, the event‐related potenial (ERP) results showed that N400 amplitude was larger for inconsistent conditions than for consistent conditions. This result supported the notion that stereotype activation is an unintentional and automatic process.     

The Associations Between Intensive Residential Couple Therapy and Change in a Three-Year Follow-Up Period

This Norwegian couple therapy effectiveness therapy study explored the course and prediction of relationships between depressive symptoms, interpersonal problems, and dyadic adjustment during residential treatment and over a 3-year post-treatment period (N = 117). All measures indicated significant improvement (p < .001) between admission and discharge (effect sizes .25 to .67), and improvement was maintained at 3-year follow-up. The proportion of recovered patients during treatment was stable at follow-up. Finding that initial levels of the Inventory of Interpersonal Problems (IIP) predicted dyadic adjustment change in the follow-up period, we discuss how such interpersonal problems may influence the course of couple therapy.     

家庭功能对青少年情绪问题的作用机制

本研究以探索家庭功能发挥过程和发挥结果之间的关系并检验两者对青少年情绪问题的作用大小和机制为目的,采用Skinner等人编制的家庭评价量表(FAM,测量家庭功能发挥过程)和Olson编制的家庭适应性、亲密度量表(FACESⅢ,测量家庭功能发挥结果)、流调中心抑郁量表(CES-D)和焦虑自评量表(SAS)对422名中学生进行匿名问卷施测,通过相关分析、分层回归和结构方程模型统计分析发现:(1)总体上青少年的情绪处于良好状态;(2)家庭功能发挥过程和发挥结果各变量之间呈显著相关;(3)家庭功能发挥过程比家庭功能发挥结果对青少年情绪问题预测作用更大;(4)家庭功能发挥结果是家庭功能发挥过程与青少年情绪问题的部分中介变量。     

Prose Reading in Neglect

Prose reading has been shown to be a very sensitive measure of Unilateral Spatial Neglect. However, little is known about the relationship between prose reading and other measures of neglect and its severity, or between prose reading and single word reading. Thirty participants with a first stroke in the right hemisphere and clear symptoms of spatial neglect in everyday life were assessed with tests of prose reading (text in one column book-like, and in two columns magazine-like), single words reading, and a battery of 13 tests investigating neglect. Seventy percent of these participants omitted words at the beginning of the text (left end), showing Prose Reading Neglect (PRN). The participants showing PRN differed from those not showing PRN only for the overall severity of neglect, and had a lesion centred on the insula, putamen and superior temporal gyrus. Double dissociations emerged between PRN and single word reading neglect, suggesting different cognitive requirements between the two tests: parallel processing in single word reading vs. serial analysis in text reading. Notably, the pattern of neglected text varied dramatically across participants presenting with PRN, including dissociations between reading performance of one and two columns text. Prose reading proved a complex and unique task which should be directly investigated to predict the effects of unilateral neglect. The outcome of this study should also inform clinical assessment and advises given to patients and care-givers.