Don't Take Out This Appendix! Generalizability of the Global Assessment of Relational Functioning Scale

This study investigated the generalizability of the Global Assessment of Relational Functioning (GARF) Scale. Found in an appendix of the Diagnostic and Statistical Manual of Mental Disorders under "Criteria Sets for Axes Provided for Future Study," the GARF Scale provides a global rating of a relational unit (family or couple). Thirty-two raters assigned GARF ratings to five relational units. Generalizability analyses indicate extremely high dependability of GARF scores across raters. Higher generalizability coefficients were found for raters who had formal education in family systems theory. Overall, these results are an encouraging step towards adopting the GARF for widespread use.     

Global Assessment of Relational Functioning Scale (GARF): I. Background and Rationale

The Committee on the Family of the Group for the Advancement of Psychiatry has introduced the Global Assessment of Relational Functioning (GARF), a scale that describes and quantifies the relational context within which patients live and problems occur. The GARF is intended to serve as a device that alerts clinicians to pay attention to the evaluation not only of individuals but also of relational functioning. In this article, we describe from a historical perspective the scientific and political context within which this scale was developed. The GARF is analogous to Axis V of the DSM GAF scale (Global Assessment of Functioning) that is used to assess individual functioning. The GARF is a composite derivative of three major dimensionalized constructs, namely, joint problem solving, organization, and emotional climate. We provide five clinical vignettes to illustrate the process of arriving at GARF ratings. Finally, we discuss caveats and limitations for use of the GARF at present, and make recommendations for research projects and training methods that may enhance the value of this instrument in the future.     

Validity of the Global Assessment of Relational Functioning (GARF) When Used By Community-Based Therapists

Construct validity of the Global Assessment of Relational Functioning (GARF) was assessed using a health services research approach, a mode of study that captures the naturalistic practice of health service providers. A sample of 395 couple/family cases with GARF scores assigned pre- and post-therapy by 222 community-based marriage and family therapists yielded these results: 1) pretreatment GARF scores were negatively correlated with severity of client problems; 2) GARF change scores were positively correlated with client reported changes in functioning; 3) GARF change scores were positively correlated with therapist-reported client change; 4) GARF change scores were positively correlated with client satisfaction; 5) pretreatment GARF scores were negatively correlated with number of therapy sessions; and 6) pretreatment GARF scores and client diagnoses showed no relationship. Given these results the GARF appears to have construct validity in community settings, and is a promising brief assessment tool for relational functioning.     

Relatives' Awareness of Their Own Expressed Emotion as Measured by a Self-Report Adjective Checklist

Relatives' ratings of their affective attitudes toward a schizophrenic family member (N = 54 ) on a self-report adjective checklist were compared with two methods for rating expressed emotion (EE) — the original Camberwell Family Interview (CFI-EE) and a Five-Minute Speech Sample method (FMSS-EE). Eighty-four relatives were included in the sample. Results indicate that, in general, the relatives in the present sample perceive in themselves attitudes toward the patient that parallel those assessed by outside raters. A higher rate of correspondence was found between adjective ratings and concurrent FMSS-EE status than with prior CFI-EE status. Relatives classified as high-EE, critical by either method, were more readily discriminable in their adjective ratings from those rated low-EE than were relatives rated high-EE on the basis of emotional overinvolvement.     

Clinical Validity of a Dimensional Assessment of Self- and Interpersonal Functioning in Adolescent Inpatients

The Social Cognition and Object Relations Scale–Global Version (SCORS–G) is a clinical rating system assessing 8 domains of self- and interpersonal relational experience that can be applied to narrative response data (e.g., Thematic Apperception Test [TAT; Murray, 1943], early memories narratives) or oral data (e.g., psychotherapy narratives, relationship anecdotal paradigms). In this study, 72 psychiatrically hospitalized adolescents consented and were rated by their individual and group therapist using the SCORS–G. Clinicians also rated therapy engagement, personality functioning, quality of peer relationships, school functioning, global assessment of functioning (GAF), history of eating-disordered behavior, and history of nonsuicidal self-injury. SCORS–G composite ratings achieved an acceptable level of interrater reliability and were associated with theoretically predicted variables (e.g., engagement in therapy, history of nonsuicidal self-injury). SCORS–G ratings also incrementally improved the prediction of therapy engagement and global functioning beyond what was accounted for by GAF scores. This study further demonstrates the clinical utility of the SCORS–G with adolescents.     

The Self- and Other-Blame Scale (SOBS). The background and presentation of a new instrument for measuring blame in families

This article presents an account of the development and reliability of an observational instrument to measure blame: the Self- and Other-Blame Scale (SOBS). Fifty-one eating disordered patients together with eighty of their relatives were interviewed using a semi-structured family interview. Videotapes were assessed by two independent raters. Inter-rater reliability was good for both dimensions of SOBS: self-blame (SB) and other-blame (OB). One of the aims in developing the instrument was to be able to explore the relationship between self- and other-blame and criticism. Preliminary data are presented showing the distribution of SOBS scores within families rated as high or low on Expressed Emotion (EE). High EE was associated with high levels of self-blame in the parents, but not in the patients. Fathers in high EE families were more blaming of the patient than those in Low EE families but this was not true for mothers' levels of daughter blaming.     

Psychometric Properties and Norms of the Family Needs Scale

We studied 205 low-income families, using the Family Needs Scale (FNS). Factor analysis of the FNS data resulted on a 7-factor solution with high internal consistency within the various subscales. We provide normative scores based on the factor structure of the FNS. A total of 53 parents completed the FNS on two occasions with an average of four weeks between these two ratings. In general, the test-retest reliabilities were low to moderate. A total of 61 pairs of parents independently rated their families with the FNS. Again, agreement between raters was low to moderate. Several factors that may have detracted from better test-retest and interrater reliability were identified. Our data point to the need for more psychometric studies with the FNS.     

Skills of Cognitive Therapy (SoCT): a new measure of patients' comprehension and use

The authors describe the development and psychometric properties of a new measure called the Skills of Cognitive Therapy (SoCT) in depressed adults and their cognitive therapists. The 8-item SoCT assesses patients' understanding and use of basic cognitive therapy (CT) skills rated from the perspectives of both observers (SoCT-O; therapists in this report) and patients (SoCT-P). Ratings of patients' skill usage are made on 5-point Likert-type scales ranging from 1 (never) to 5 (always or when needed). Higher scores reflect greater patient skill in applying cognitive therapy principles and coping strategies. To develop this scale, a 33-item pool was used, rated by both patients and their therapists at the middle and end of CT (Ns = 359-416), and evaluated the reliability and concurrent and predictive validity of both versions of the scale. The SoCT has excellent internal consistency reliability and moderate correlations between the observer and patient versions. It is important to note that the SoCT showed good predictive validity for response when collected at the midpoint of acute phase CT. Considering both patients' self-ratings and clinicians' SoCT ratings, the odds ratio for responding to CT was 2.6. The practical utility of the SoCT is discussed, as well as its theoretical importance in research of patient CT skills (e.g., acquisition, comprehension, and generalization) as putative moderators or mechanisms of symptom change in the therapy.     

Leipzig Affective Norms for German: A reliability study

To facilitate investigations of verbal emotional processing, we introduce the Leipzig Affective Norms for German (LANG), a list of 1,000 German nouns that have been rated for emotional valence, arousal, and concreteness. A critical factor regarding the quality of normative word data is their reliability. We therefore acquired ratings from a sample that was tested twice, with an interval of 2 years, to calculate test—retest reliability. Furthermore, we recruited a second sample to test reliability across independent samples. The results show (1) the typical quadratic relation of valence and arousal, replicating previous data, (2) very high test—retest reliability (>.95), and (3) high correlations between the two samples (>.85). Because the range of ratings was also very high, we provide a comprehensive set of words with reliable affective norms, which makes it possible to select highly controlled subsamples varying in emotional status. The database is available as a supplement for this article at http://brm.psychonomic-journals.org/content/supplemental.     

Rating scales for hyperactivity: Concurrent validity,reliability, and decisions to label for the Conners and Davids abbreviated scales

Rating scales have become the instrument of choice in labeling and assessing change in behavior of hyperactive children. However, several criticisms have recently have levied against their use. The present investigation examined the concurrent validity, and inter- and intrarater reliability for the Abbreviated Teacer Questionnaire (ATQ, Conners, 1973) and the Rating Scales for Hyperkinesis (Davids, 1971). Sixteen teachers from two special and two regular schools (grades 1-4) rated 211 normal and 49 special children using both scales. High correlations were found suggesting excellent predictability between scales and considerable stability across time and rater. Lower scores on a subsequent rating relative to an initial rating were demonstrated, dependent on time between ratings but independent of (a) teacher expectation of treatment gains, (b) bias produced by rating selected children, and (c) whether children were hyperactive or normal. Use of initial and infrequent rating scores versus subsequent, closely spaced ratings was related to the rater's objective (e.g., diagnosis, treatment, or assessment).     

Clinic-Referred Mothers’ Autobiographical Narratives as Markers of Their Parenting Styles

Forty clinic-referred mothers completed questionnaires describing their children’s problems and the mothers’ parenting styles. In addition, each mother told three stories about their personal experiences in child care and one story about being cared for in their families of origin. Each story was transcribed and rated for coherence on six dimensions describing narrative clarity and richness. Results showed the narrative ratings to be fairly reliable and internally consistent, and the questionnaires proved to be psychometrically sound except for one of the parenting style scales that we dropped from further data analyses. Results showed the two remaining scales (authoritative and authoritarian styles) covaried with mothers’ reports about problems with their children. Correlations between mothers’ narrative coherence scores and their parenting style scores showed mixed results: authoritative style was not correlated with narrative coherence, but authoritarian style was negatively correlated with this narrative measure. Regression analyses using the six coherence scales and the authoritarian style scale showed the causality scale to account for most of the variance in authoritarian style. We speculated on the nature of this latter covariation.     

Ratings of Emotional Response to Pictorial Stimuli: Positive and Negative Affect Dimensions

The purpose of this study was to investigate the structure of emotional responses to pictorial stimuli within the affective space defined by orthogonal dimensions of positive affect (PA) and negative affect (NA). College student participants (N = 151) viewed 60 color photographic slides from the International Affective Picture System (Lang, Bradley, & Cuthbert, 1995) and rated their emotional responses to each slide using the Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988). Consistent with prediction, affective reactions to pleasant slides were characterized as high in PA, and low in NA. Unpleasant slides produced elevations on the NA scale, but contrary to expectation, also produced elevated ratings of PA, with the magnitude of PA scale scores increasing systematically with NA scale scores. The results suggest an interesting divergence between the structure of pictorially elicited affective reactions and that of ad hoc mood states. Directions for future research are discussed in relation to the unique properties of the slide viewing paradigm.     

Reliability and validity of the Social Cognition and Object Relations Scale (SCORS) in the assessment of dream narratives

In this study, we aimed to investigate the application of an externally rated measure of interpersonal representations (Social Cognition and Object Relations Scale [SCORS]; Westen, 1995) to dream narratives. A total of 80 student participants enrolled at a private university in the New York City metropolitan area completed a Dream Log and affect adjective checklist (Wellman, 2002) based on a recalled dream at both 1 month and 3 months following the September 11, 2001, terrorist attacks. Using the dreams provided in this study we examined the interrater reliability of SCORS ratings, the relationship of SCORS variables to an independently rated measure of dream distortion, and the relationship of SCORS variables to participants' own ratings of dream affect. Results indicated that dreams were reliably rated using the SCORS, 3 cognitive SCORS variables were significantly related to dream distortion, and affective SCORS variables were meaningfully related to participants' own ratings of affect in their dreams. Findings from this study provide support for the application of SCORS ratings to dream narratives. We discuss implications for further research and clinical application.     

Development and Validation of a Parent Report Measure for Assessing Social-Emotional Competencies of Children and Adolescents

Based on the premises that strength-based assessment of children and adolescents is an important emerging area, and that additional tools for this purpose are needed, this study details development and validation efforts on a new strength-based assessment: the Social-Emotional Assets and Resilience Scale, parent form (SEARS-P). Following careful development of a comprehensive research prototype assessment, a large and diverse nationwide sample of more than 2,000 ratings of school-age children and adolescents were obtained from their parents and other caregivers. Factor analytic procedures revealed a robust and replicable underlying factor structure, including Self-Regulation/Responsibility, Social Competence, and Empathy factors. The factor scores and total score of the SEARS-P were shown to have strong internal consistency reliability, as well as strong interrater reliability between mother-father pairs who rated the same child. Convergent construct validity of the SEARS-P was established through findings of significant correlations with two established strength-based rating scales for use by parents. Construct validity of the SEARS-P was further bolstered through findings of significant gender differences in scores (with females rated as having higher levels of competency than males), as well as significant differences in scores based on educational disability status. Limitations and future research needs are discussed, as are implications of this study for research and practice with children and families.     

The insula and evaluative processes

The insula has been implicated as a component of central networks subserving evaluative and affective processes. This study examined evaluative valence and arousal ratings in response to picture stimuli in patients with lesions of the insula and two contrast groups: a control-lesion group (the primary contrast group) and an amygdala-lesion group. Patients rated the positivity and negativity of picture stimuli (from very unpleasant to very pleasant) and how emotionally arousing they found the pictures to be. Compared with patients in the control-lesion group, patients with insular lesions reported reduced arousal in response to both unpleasant and pleasant stimuli, as well as marked attenuation of valence ratings. In contrast, the arousal ratings of patients with amygdala lesions were selectively attenuated for unpleasant stimuli, and these patients' positive and negative valence ratings did not differ from those of the control-lesion group. Results support the view that the insular cortex may play a broad role in integrating affective and cognitive processes, whereas the amygdala may have a more selective role in affective arousal, especially for negative stimuli.     

What determines a feeling's position in affective space? A case for appraisal

The location of verbally reported feelings in a three-dimensional affective space is determined by the results of appraisal processes that elicit the respective states. One group of participants rated their evaluation of 59 pictures from the International Affective Picture System (IAPS) on a profile of nine appraisal criteria. Another group rated their affective reactions to the same pictures on the classic dimensions of affective meaning (valence, arousal, potency). The ratings on the affect dimensions correlate differentially with specific appraisal ratings. These results can be interpreted as showing that the reactions to the IAPS pictures are predictably produced through appraisal of picture content. The relevance of the findings for emotion induction paradigms and for emotion theory in general is discussed.     

The impact of arbitrarily applicable relational responding on evaluative learning about hypothetical money and shock outcomes

Evaluative learning comprises changes in preferences after co-occurrences between conditioned stimuli (CSs) and an unconditioned stimulus (US) of affective value. Co-occurrences may involve relational responding. Two experiments examined the impact of arbitrary relational responding on evaluative preferences for hypothetical money and shock outcomes. In Experiment 1, participants were trained to make arbitrary relational responses by placing CSs of the same size but different colours into boxes and were then instructed that these CSs represented different intensities of hypothetical USs (money or shock). Liking ratings of the CSs were altered in accordance with the underlying bigger/smaller than relations. A reversal of preference was also observed: the CS associated with the smallest hypothetical shock was rated more positively than the CS associated with the smallest amount of hypothetical money. In Experiment 2, procedures from Relational Frame Theory (RFT) established a relational network of more than/less than relations consisting of five CSs (A-B-C-D-E). Overall, evaluative preferences were altered, but not reversed, depending on (a) how stimuli had been related to one another during the learning phase and (b) whether those stimuli referred to money or shocks. The contribution of RFT to evaluative learning research is discussed.     

Integration of Test Results with Clinical Observations A Diagnostic Case Study

In this study, we aimed to investigate the application of an externally rated measure of interpersonal representations (Social Cognition and Object Relations Scale [SCORS]; Westen, 1995) to dream narratives. A total of 80 student participants enrolled at a private university in the New York City metropolitan area completed a Dream Log and affect adjective checklist (Wellman, 2002) based on a recalled dream at both 1 month and 3 months following the September 11, 2001, terrorist attacks. Using the dreams provided in this study we examined the interrater reliability of SCORS ratings, the relationship of SCORS variables to an independently rated measure of dream distortion, and the relationship of SCORS variables to participants' own ratings of dream affect. Results indicated that dreams were reliably rated using the SCORS, 3 cognitive SCORS variables were significantly related to dream distortion, and affective SCORS variables were meaningfully related to participants' own ratings of affect in their dreams. Findings from this study provide support for the application of SCORS ratings to dream narratives. We discuss implications for further research and clinical application.     

Independent effects of emotion and attention on sensory and affective pain perception

The present study investigated whether attention and emotion independently influence sensory and affective pain ratings. Fifty-four (27 female) participants rated sensory and affective pain in response to painful mechanic pressure stimulation while exposed to positive, neutral and negative slides from the International Affective Picture System. In doing so, participants were assigned to one of three groups, which focused attention either on the pictures or on the sensory or on the affective aspects of the pressure stimulation. Consistent with the motivational priming hypothesis, sensory and affective pain ratings were generally lower during exposure to positive compared to negative and neutral slides. In line with our assumptions, attention modulated sensory pain ratings with lowest ratings in the picture focusing group and highest in the affective pain focusing group. No attention effect for affective pain ratings and no interactions between emotional and attentional effects on pain perception were found.     

The effects of unconditional stimulus valence and conditioning paradigm on verbal,skeleto-motor,and autonomic indices of human Pavlovian conditioning

The effects of unconditional stimulus (US) valence (aversive electro-tactile stimulus vs. non-aversive imperative stimulus of a RT task) and conditioning paradigm (delay vs. trace) on affective learning as indexed by verbal ratings of conditional stimulus (CS) pleasantness and blink startle modulation and on relational learning as indexed by electrodermal responses were investigated. Affective learning was not affected by the conditioning paradigm; however, electrodermal responses and blink latency shortening indicated delayed learning in the trace procedure. Changes in rated CS pleasantness were found with the aversive US, but not with the non-aversive US. Differential conditioning as indexed by electrodermal responses and startle modulation was found regardless of US valence. The finding of significant differential blink modulation and electrodermal responding in the absence of a change in rated CS pleasantness as a result of conditioning with a non-aversive US was replicated in a second experiment. These results seem to indicate that startle modulation during conditioning is mediated by the arousal level of the anticipated US, rather than by the valence of the CS.