An afterword: the utility of cognitive models for the field of psychopathology

Cognitive models of psychopathology provide opportunities and challenges for both the research psychopathologist and the clinician concerned with practical applications to individuals. Heterogeneity of individual pathology within diagnostic categories, heterogeneity of content within symptom categories, undue reliance on judgment-based ratings, and frequent emphasis on deficit rather than the overt behavior of the patients are some of the major issues. Others include the complex interaction between cognitive and affective processes and the fact that input-output functions are often nonlinear and marked by critical threshold values for the appearance of overt pathology. An important feature of models is the discipline that they introduce into theorizing about psychopathology plus the focus on precise quantification.     

Dimensional models for research and diagnosis: a current dilemma

This commentary focuses on the current dilemma regarding the application of dimensional models for research and diagnosis. Four articles are used to review the positive contributions of dimensional approaches. Although categorical approaches are integral in deciding the characteristics of the group to be studied (i.e., development of inclusion/exclusion criteria), the generation of cutpoints for categorical classification is, in reality, working with dimensional data. Ultimately, new methodological strategies need to be incorporated that address both categorical and dimensional aspects of the overall diagnostic framework. These refinements will be vital in determining the extent and reality of co-occurrence of disorder and the determination of boundaries across specific disorders.     

The use of latent trajectory models in psychopathology research

Despite the recent surge in the development of powerful modeling strategies to test questions about individual differences in stability and change over time, these methods are not currently widely used in psychopathology research. In an attempt to further the dissemination of these new methods, the authors present a pedagogical introduction to the structural equation modeling based latent trajectory model, or LTM. They review several different types of LTMs, discuss matching an optimal LTM to a given question of interest, and highlight several issues that might be particularly salient for research in psychopathology. The authors augment each section with a review of published applications of these methods in psychopathology-related research to demonstrate the implementation and interpretation of LTMs in practice.     

Attachment and family therapy: clinical utility of adolescent-family attachment research

The divide separating research and clinical work is narrowing. New therapies have been informed by research from specialties such as developmental psychology and developmental psychopathology. In this article, we attempt to illustrate the usefulness of research on attachment relations for family-based therapy with adolescents. We examine the clinical utility of adolescent attachment research within the context of multidimensional family therapy, an empirically supported treatment model that has incorporated developmental research, including basic research on attachment, in its assessment and intervention framework.     

Why mindfulness belongs in counseling psychology: A synergistic clinical and research agenda

Mindfulness has become an increasingly visible part of the landscape in psychology and medicine in the past several decades. Only recently has this same interest in mindfulness and mindfulness-based interventions appeared in counseling psychology. This article provides a brief synopsis of the mindfulness literature and explores the theoretical, ideological, and practical overlap between core values of counseling psychology and this burgeoning area of research and practice. In addition, the article explores ways in which counseling psychology can contribute uniquely to mindfulness research and practice through a focus on multiculturalism and social justice, psychotherapy process and outcome, and supervision and training. Further, ways in which mindfulness can inform counseling psychology’s mission are examined, including offering a strengths-based approach to psychological intervention and prevention and informing supervision and training. Lastly, five specific recommendations for a synergistic research agenda marrying mindfulness and counseling psychology are offered.     

Clinicians' judgments of clinical utility: a comparison of the DSM-IV and five-factor models

Clinical utility, or the usefulness of a diagnostic system in clinical practice, has been identified as an important construct in proposed revisions to the diagnostic nomenclature and a significant limitation of dimensional models of personality disorder, such as the 5-factor model (FFM). Only 1 study to date has addressed explicitly the clinical utility of the FFM, and the findings suggested significant limitations. In the current study, 245 practicing psychologists described 3 historic cases using both the FFM and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 2000) and then rated each model on 6 aspects of clinical utility. In contrast to prior research, the psychologists in this study considered the FFM to have greater clinical utility than the existing diagnostic categories.     

Orienting-reflex behavior and clinical psychopathology

The effects of diagnosis, sex, age and medication on the orienting-reflex behavior of 263 psychiatric patients and 58 normal subjects were studied. Significant differences between the normal and patient groups and within the patient groups in different diagnostic categories were found. In the patient populations, further variations by types of medication received were found, whereas sex and age did not affect the orienting reflex. On the basis of frequency of response only normal subjects and patients could be distinguished, whereas amplitude analysis revealed a continuum in which the highest responses were given by normal subjects and the lowest by patients with chronic organic brain damage. In all subgroups the amplitudes of the responses of patients receiving antidepressant medication were higher than those of patients receiving antipsychotic medication.     

Diathesis-stress models of psychopathology: A quantitative genetic perspective

When genetics is considered in diathesis-stress models of psychopathology, it is often assumed that heredity provides the diathesis and environmental factors are responsible for the stressor. We discuss two quantitative genetic models relevant to the diathesis-stress construct. One model focuses on genotype-environment interaction, which is the usual way in which genetic influence is represented in diathesis-stress models. A second model—genotype-environment correlation—provides an alternative that represents both genetic and environmental influences relevant to the development of psychopathology. Implications of these models for clinical research are discussed.     

Dimensional models of personality disorder: coverage and cutoffs

Two major challenges that must be addressed by dimensional models, if they are to be considered viable alternatives to the present categorical system for diagnosing personality disorders, involve the issues of coverage and cutoffs. Several dimensional models of personality and personality pathology are evaluated with these issues in mind. There is growing consensus for the relevance of at least four higher-order domains of personality functioning that are clearly related to personality pathology: neuroticism/negative affectivity/emotional dysregulation, extraversion/positive emotionality, dissocial/antagonistic behavior, and constraint/compulsivity/conscientiousness. A proposal for developing a dimensionally based diagnostic system for personality disorders incorporating these higher-order traits is offered.     

Random utility models with equality: An apparent,but not actual,generalization of random utility models

A probabilistic model for choice, and preference, is introduced that includes (Tversky's) elimination by aspects model, and the random utility model, as special cases. The model is based on a covert sequential elimination process, the element that is finally chosen in a simple choice experiment being the eventual lone survivor of the elimination process. The model leads us to question the usual form of simple choice experiments, in which a subject must (eventually) choose one of the currently available alternatives, and to suggest that a much more realistic experimental design would allow the subject the no-choice option, i.e., he may refuse to accept any of the currently available alternatives.     

Sexuality and cyberporn: Towards a new agenda for research

This article presents theoretical considerations based on cultural analysis approaches to studying pornography and sexuality as a means of starting to suggest a new agenda for cyberporn research. By bringing to the forefront concepts of how subjectivity and sexuality are produced within the computer/Internet apparatus, I hope to diversify the focus in cyberporn research away from social science approaches and pre-Foucaultian assumptions of the subject which obscure understandings of new media and cyberporn use. Through a summary of visual culture studies and reception studies of pornography, I argue that cyberporn must be understood as contingent within the encoding and decoding processes and discourses of sexuality (Foucault) in which it is produced and consumed. My focus here is the home office/terminal as the site of reception/cyberporn use. While there is potential for a great variety of cultural analytic approaches to the study of cyberporn and how new media use influences sexuality, I end with specific suggestions for researching cyberporn reception in the home. The computer’s allure is more than utilitarian or aesthetic; it is erotic. Instead of a refreshing play with surfaces, as with toys or amusements, our affair with information machines announces a symbiotic relationship and ultimately a mental marriage to technology. Rightly perceived, the atmosphere of cyberspace carries the scent that once surrounded Wisdom. The world rendered as pure information not only fascinates our eyes and minds, but also captures our hearts. We feel augmented and empowered. Our hearts beat in the machines. This is Eros. (Michael Heim, The Metaphysics of Virtual Reality)     

Neuroimaging and disorders of consciousness: envisioning an ethical research agenda

The application of neuroimaging technology to the study of the injured brain has transformed how neuroscientists understand disorders of consciousness, such as the vegetative and minimally conscious states, and deepened our understanding of mechanisms of recovery. This scientific progress, and its potential clinical translation, provides an opportunity for ethical reflection. It was against this scientific backdrop that we convened a conference of leading investigators in neuroimaging, disorders of consciousness and neuroethics. Our goal was to develop an ethical frame to move these investigative techniques into mature clinical tools. This paper presents the recommendations and analysis of a Working Meeting on Ethics, Neuroimaging and Limited States of Consciousness held at Stanford University during June 2007. It represents an interdisciplinary approach to the challenges posed by the emerging use of neuroimaging technologies to describe and characterize disorders of consciousness.     

Posttraumatic stress and panic psychopathology: clinical import, research advances, and future directions--introduction to the special issue

There has been a relative dearth of empirical attention focused on the study of the co-occurrence of posttraumatic stress and panic psychopathology. Since these conditions represent two prevalent and impairing psychiatric conditions, the study of their diagnostic and phenomenological comorbidity is clinically meaningful and theoretically warranted. The articles in this series discuss the possible cognitive-affective mechanisms relevant to both conditions and elucidate innovations in applicable clinical intervention approaches. Thus, the overarching purpose of this series is to underscore key empirical questions, to showcase emerging research, and to stimulate further scientific inquiry into the co-occurrence of posttraumatic stress and panic psychopathology.     

Cultural variation in psychopathology: From research to practice

In the context of a Professional Doctorate in Psychoanalytic Research, we examined how a group of psychoanalytic therapists responded to the ethos and methods of qualitative research. Although experienced therapy practitioners, the students were mostly new to qualitative research. We were interested in the extent to which students found psychoanalytic training and qualitative research compatible or in conflict. The data for the study was a focus group in which students discussed the experience of becoming researchers. The focus group was recorded, transcribed and analysed using Discursive Psychology but also informed by psychoanalytic analysis, in an iterative process including the participants. We concentrate here on some of the main discourses emerging, including intrinsic and extrinsic motivations for the course – bound up with life stage, sense of previous unfulfilled aspirations and the current challenges of working in UK mental health services. We also focus on tensions with the concept of developing a researcher identity, both concerning clinician identities and other roles. The sense of an uncomfortable ‘assimilation’ into a ‘foreign territory’ was explored, both in the focus group and the analysis. We use this to highlight some of the expectations and taboos of both psychoanalytic and research communities.