Development and validation of the Maladaptive Daydreaming Scale (MDS)

This study describes the development of the Maladaptive Daydreaming Scale (MDS), a 14-item self-report instrument designed to gauge abnormal fantasizing. Our sample consisted of 447 English-speaking individuals from 45 different countries. A 3-correlated-factors model best presented the underlying dimensions Yearning, Kinesthesia and Impairment, capturing related rewarding experiences as well as psychological impairment of maladaptive daydreaming. MDS scores were associated with obsessive–compulsive behavior and thoughts, dissociative absorption, attention deficit, and high sense of presence during daydreaming, but less with psychotic symptoms. The MDS and its subscale demonstrated good validity, sound internal consistency and temporal stability and discriminated well between self-identified individuals with and without maladaptive daydreaming. Considering the instrument’s high sensitivity and specificity levels, it seems an excellent measure for future investigation of MD that will, hopefully, shed light on the etiology and psycho-biological mechanisms involved in this mental condition, as well as on the development of effective MD treatment methods.     

Excessive daydreaming: A case history and discussion of mind wandering and high fantasy proneness

This case study describes a patient presenting with a long history of excessive daydreaming which has caused her distress but is not incident to any other apparent clinical psychiatric disorders. We have treated this patient for over 10 years, and she has responded favorably to fluvoxamine therapy, stating that it helps to control her daydreaming. Our patient, and other psychotherpists, have brought to our attention other possible cases of excessive daydreaming. We examine the available literature regarding daydreaming, mind wandering, and fantasy proneness relative to current cognitive and neuroanatomical models of executive attention.     

Psychological Functioning of Partners of Australian Combat Veterans: Contribution of Veterans' PTSD Symptoms and Partners' Caregiving Distress

Previous research has found posttraumatic stress disorder (PTSD) symptoms in combat veterans to be associated with impaired psychological functioning in their partners. However, little is known about possible mediators of this association. The present study investigated the mediational properties of six dimensions of the revised Partners of Veterans' Distress Scale (MacDonell, Marsh, Hine, & Bhullar, 2010). Participants were 181 female partners of Australian combat veterans, age ranging from 43 and 83 years (M = 60.47, SD = 4.96), who completed measures assessing their caregiving distress levels, dyadic adjustment, mental health, and satisfaction with life. The combat veterans also completed a scale measuring their PTSD symptoms. Our results indicated that higher scores of veterans' PTSD were associated with lower levels of dyadic adjustment, mental health, and satisfaction with life in their partners. Partners reported that distress related to exhaustion and intimacy problems significantly mediated the relationship between veterans' PTSD symptoms and their partners' satisfaction with life, whereas partners' distress associated with intimacy problems was the sole significant mediator for their dyadic adjustment, and exhaustion was the only significant mediator for partners' mental health. Implications for programmes designed to address the significant needs of the partners of combat veterans are discussed.     

Sluggish cognitive tempo in children and adolescents with higher functioning autism spectrum disorders: Social impairments and internalizing symptoms

Sluggish cognitive tempo (SCT) was introduced in 1980s in the field of attention deficit hyperactivity disorder (ADHD). Studies indicate that symptoms of SCT are separate from symptoms of ADHD and independently associated with multiple domains of functioning in clinical groups and in typical development. We assessed whether similar pattern would apply to higher functioning autism spectrum disorders (ASD). Children with higher functioning ASD (N = 55; 5?15 years) were divided into the ASD+High SCT (n = 17), the ASD+Medium SCT (n = 18) and the ASD+Low SCT (n = 20) groups based on parent‐rated daydreaming and slowness on the Five to Fifteen questionnaire (FTF). The groups were compared on SCT‐related impairments found in previous studies: social skills, academic functioning, psychiatric symptoms, and processing speed. Assessment methods were the FTF, the Development and Well‐Being Assessment, and the Coding subtest of the WISC‐III. The ADHD symptoms were statistically controlled due to the overlap between SCT and ADHD. The ASD+High SCT and ASD+Medium SCT groups were significantly more likely to have the most pronounced social impairments, and the ASD+High SCT group had significantly higher rate of internalizing disorders compared to the ASD+Low SCT group. Our results suggest that children with higher functioning ASD and high or medium levels of SCT symptoms could be at higher risk for psychosocial impairments than children with higher functioning ASD with low levels of SCT symptoms. Co‐occurring ADHD symptoms do not explain the finding. Recognizing SCT symptoms in higher functioning ASD would be important to targeting preventive support.     

Cortisol Awakening Response as an Index of Mental Health and Well-Being in Adolescents

Physiological measures provide a useful complement to self-report indices of mental health and well-being. The cortisol awakening response (CAR) has been associated with mental distress, but less consistently so with positive functioning. In this study, the utility of two CAR indices as a measure of the full spectrum of mental health and well-being in a sample of healthy adolescents was explored. Forty-seven adolescents (14M, 33F; mean age 13.89, SD = .73) completed questionnaires on mental distress and positive functioning, and provided three saliva samples for cortisol analysis as well as demographic and life event information. Correlational analyses revealed that both absolute CAR (CARi) and area under the curve during awakening (CAR_AUC) indices correlated positively with measures of mental distress, and inversely with measures of positive functioning. When the significant life events score was controlled, moderate to strong effects were maintained with negative and positive affect, mental well-being, satisfaction with life and perceived social support from significant others. These findings provide the first data confirming that CAR is a reliable index of positive functioning in healthy adolescents.     

Health-related quality of life in chronic fatigue syndrome: predictors of physical functioning and psychological distress

This study investigated health-related quality of life (HRQoL; physical functioning and psychological distress) in an Australian chronic fatigue syndrome (CFS) population. The aims of the study were to compare HRQoL in those with CFS to the normal population, and to investigate the extent to which sociodemographic (age, gender, partner status, education), illness-related (illness duration, symptom frequency), and fatigue severity (physical, mental) variables predicted HRQoL. A total of 139 people meeting CFS criteria completed questionnaires. HRQoL was assessed using standardised measures of distress and physical functioning. Compared with norms, those with CFS obtained significantly lower scores on all physical functioning areas, whereas 63% of participants reported clinically significant psychological distress. Hierarchical regression analyses indicated that physical fatigue severity and symptom frequency were the strongest predictors of deficits in physical domain HRQoL. Physical HRQoL outcomes were also predicted by mental fatigue severity, older age, and female gender. All predictors were unrelated to psychological distress apart from weak positive associations with physical fatigue and symptom frequency. Results identify a potent set of predictors of HRQoL and show that CFS has a pervasive negative impact on quality of life, particularly physical and psychological functioning.     

The frequency of involuntary autobiographical memories and future thoughts in relation to daydreaming,emotional distress,and age

We introduce a new scale, the Involuntary Autobiographical Memory Inventory (IAMI), for measuring the frequency of involuntary autobiographical memories and involuntary future thoughts. Using the scale in relation to other psychometric and demographic measures provided three important, novel findings. First, the frequency of involuntary and voluntary memories and future thoughts are similarly related to general measures of emotional distress. This challenges the idea that the involuntary mode is uniquely associated with emotional distress. Second, the frequency of involuntary autobiographical remembering does not decline with age, whereas measures of daydreaming, suppression of unwanted thoughts and dissociative experiences all do. Thus, involuntary autobiographical remembering relates differently to aging than daydreaming and other forms of spontaneous and uncontrollable thoughts. Third, unlike involuntary autobiographical remembering, the frequency of future thoughts does decrease with age. This finding underscores the need for examining past and future mental time travel in relation to aging and life span development.     

Initial validation of self-reported trajectories in military veterans

Previous research suggests that functioning after potentially traumatic events tends to follow discrete trajectories. This research is limited in that longitudinal data can be difficult to collect. The aim of the current study was to examine self-reported trajectories in military veterans using an online survey. Consistent with longitudinal work, those who reported chronic distress reported higher symptoms of PTSD and Depression, higher negative affect, lower social support, and less satisfaction with life than those on a resilient trajectory. Two change trajectories demonstrated intermediate scores on relevant measures. These results provide support for a retrospective method to assess trajectories of posttrauma functioning.     

Life Satisfaction and Symptoms of Mental Disorder Among Older African American Public Housing Residents

This study examines life satisfaction and symptoms of mental disorder in a sample of 831 older African American residents of urban public housing developments. Symptoms of mental disorder included measures of emotional distress, alcohol-related problems, and cognitive impairment. Subjects reporting less life satisfaction had significantly greater emotional distress. Neither lifetime alcohol-related problems nor cognitive impairment were significantly related to life satisfaction. Stepwise multiple regression analyses indicated that emotional distress subscales accounted for most of the explained variance in life satisfaction. Social dysfunction was the strongest predictor of life satisfaction, accounting for 17% of the variance. Having a confidant, instrumental social support, religious support, or being female also contributed to the explained variance in life satisfaction.     

Trait Versus Task-Induced Emotional Reactivity and Distress Intolerance in Hoarding Disorder: Transdiagnostic Implications

Evidence from analogue samples suggests that deficits in emotional functioning, namely elevated emotional reactivity and distress intolerance, are implicated in the development and maintenance of hoarding disorder. We aimed to extend previous research in this area by investigating emotional reactivity and distress intolerance in a sample of individuals diagnosed with hoarding disorder (n = 24) in comparison to clinical controls (n = 21) and nonclinical community controls (n = 26) using a combination of self-report, physiological, and behavioral measures. We found that trait distress intolerance was significantly and independently associated with greater hoarding severity. The hoarding and clinical control groups reported more trait emotional reactivity and distress intolerance than the community control group, but did not differ from each other on these traits. The hoarding group reported more subjective distress before beginning a frustrating behavioral task, but did not evidence more physiological arousal. Moreover, the hoarding group experienced similar increases in distress during the task and did not differ from either group in regard to time persisting on this task. The clinical control group, however, terminated the frustrating task significantly faster than the community control group, who tended to persist until the task timed out. Lastly, trait distress intolerance evidenced a small-to-moderate but nonstatistically significant independent relationship with task persistence time. Given the desynchrony between subjective distress and physiological arousal, we encourage researchers to utilize multimodal assessment in the future. We also suggest that clinicians start to use behavioral experiments, as has been done with other psychological disorders, to improve distress intolerance among persons who experience hoarding disorder.     

The Relationship Between Neuropsychological Functioning and Mental Health Outcomes of Chronic Alcohol Users Involved in Counselling: Prediction of Treatment Outcome

This study examined the neuropsychological profile, mental health outcomes, and coping strategies of chronic alcohol users involved in drug and alcohol counselling and investigated whether these factors could predict treatment outcome. The findings indicated that as compared with controls, chronic alcohol users demonstrated significant deficits in visuospatial, memory and executive functioning, and a higher level of emotional distress. At a 3‐month follow‐up, memory ability was found to significantly predict the percentage of goals achieved in counselling, the likelihood of dropout from therapy, and the likelihood of remaining abstinent. The value of further research into the influence of additional factors, such as executive functioning, mood, and coping strategies, on treatment outcomes in a larger sample was also supported.     

Depression and appearance-related distress in functioning with lipedema

Lipedema is a chronic, progressive adipose tissue disorder that may impact the quality of life of women who suffer from it. The main aim of this study was to asses the role of perceived symptom severity, physical and psychological functioning with the disease in predicting quality of life in patients with lipedema. We conducted an online study with 329 participants who responded to five questionnaires measuring quality of life (World Health Organization Quality of Life BREF), lipedema symptom severity, mobility (Lower Extremity Functional Scale), depression (Patients Health Questionnaire-9), and appearance-related distress (Derriford Appearance Scale 24). Multiple hierarchical regression analyses showed that appearance-related distress and depression explained significantly more variance in quality of life when added to the symptom severity and mobility. Lower quality of life was predicted by higher symptom severity, lower mobility, higher appearance-related distress and higher depression severity. Appearance-related distress and depression constitute important aspects of psychological functioning in women with lipedema. Considering their relationship with quality of life, their assessment should be included in lipedema treatment with appropriate interventions aimed at decreasing appearance-related distress, as well as preventing and addressing depression.     

Psychometric assessment of cardiac transplantation candidates

Psychometric assessment protocols were used to chart the course of 287 end-stage cardiac patients' psychological adjustment at pretransplantation and, again, in 34 who were subsequently transplanted. The regression and repeated-measures analyses suggested that psychological distress is typical of the adult transplantation candidate, although impaired cognitive functioning is more typical of the acute postoperative stage. Negative affect, cognitive, personality, and coping measures are interrelated at pretransplantation; depression and mental control show significant decreases at 2 weeks posttransplantation. Whereas the transplantation process is inherently distressing, psychological testing may identify cognitive and personality features that require more specific clinical attention.     

Relationships among parental reports of child, parent, and family functioning.

Most children with psychosocial problems do not present for treatment in mental health settings. They are managed by primary care physicians. Children with psychosocial problems often have parents and/or families with psychosocial distress. The present study measured associations between parental reports of child, parent, and family functioning in individuals in the general population. Participants were 226 parents of children, aged 2-16 years, who presented for routine primary care. Parents reported on the psychosocial functioning of themselves, their child, and their family. All correlations of measures were significant, ranging from .55 to .23. Similar to data from psychiatric samples, the psychological functioning of children, parents, and families were significantly correlated. Unlike in psychiatric settings, child mental health problems were not as closely related to parent or family distress as parent and family distress were related to each other and to child behavior problems.     

Prioritizing Happiness has Important Implications for Mental Health,but Perhaps Only if you Already are Happy

Happiness is frequently posited as an important outcome of quality of life and characteristic of well-adjusted and functioning individuals. Happy individuals are less likely to report adverse mental health. Understanding the importance that individuals place on happiness is less clearly articulated and inconsistent. Valuing or placing higher importance of happiness appear to confer both benefits and risk for mental health outcomes. The primary aim of this study was to examine the relationship between the importance of happiness and mental health outcomes and whether the relationship between happiness and mental health is moderated by the importance individuals place on happiness. We utilised data from two studies, a university student sample (n = 413) and a community sample (n = 248) to examine the study aims. Mental health was operationalised in terms of psychological distress and symptoms of depression and anxiety. Happiness and the level of importance individuals ascribed to happiness were associated with adverse mental health outcomes. In multi-variate analyses, level of happiness was more strongly related to mental health. Interactions between happiness and the importance of happiness revealed that the effect of happiness was moderated by the importance that individuals placed on happiness. Overall happiness and to a lesser extent, the importance of happiness, are significantly associated with mental health outcomes. Happiness was most strongly related to mental health amongst those who rated the importance of happiness more highly.

     

Relationship distress in partners of combat veterans: the role of partners' perceptions of posttraumatic stress symptoms

Partners of combat veterans with posttraumatic stress disorder report elevated relationship and psychological distress, but little is known about the mechanisms by which such distress develops. In two separate samples, we examined partners' perceptions of veterans' PTSD symptoms, with a specific focus on the simultaneous associations of partners' distress with their perceptions of veterans' reexperiencing, withdrawal/numbing, and hyperarousal symptom clusters. The first sample consisted of 258 partners of Operation Enduring- and Iraqi Freedom-era veterans who completed questionnaires. The second sample consisted of 465 partners of Vietnam-era veterans who completed interviews as part of the National Vietnam Veterans Readjustment Study. In both samples, path analyses revealed that, when examined simultaneously, partners' perceptions of withdrawal/numbing symptoms were associated with greater distress, but perceptions of reexperiencing symptoms were unrelated to psychological distress and significantly associated with lower levels of relationship distress. Given the cross-sectional nature of the data in both samples, there are multiple plausible interpretations of the results. However, the pattern is consistent with an attributional model of partner distress, whereby partners are less distressed when symptoms are more overtly related to an uncontrollable mental illness. Potential clinical implications are discussed.     

Life Change and Psychological Distress: The Role of Perceived Control and Desirability

Two studies were conducted to specify what attributes of life change events increase the risk of future psychological distress. It was hypothesized that the events perceived as both undesirable and uncontrollable would be most likely to be linked to subsequent distress. In the fiist study, which employed a retrospective methodology, 117 college students reported the life changes that occurred to them over a 3-month span and indicated the desirability and controll-ability of each event. These subjects also responded to an inventory, used in studies of community mental health, to assess symptoms of psychological distress. The findings indicated that only events perceived as both undesirable and uncontrollable were related to the incidence of psychological distress symptoms. Study 2 examined the same hypothesis in a prospective methodology. As in Study 1, only undesirable, uncontrollable life events were significantly related to subsequent psychological distress symptoms. The results of both studies implicate the importance of perceptions of control over aversive events in understanding the link between real life outcomes and illness.     

Markers of Resilience and Risk: Adult Lives in a Vulnerable Population

In this report, we drew on data from an ongoing longitudinal study that began in 1978 (Hauser, Powers, Noam, Jacobson, Weiss, & Folansbee, 1984). Focusing on late, young-adult life among individuals who were psychiatrically hospitalized during adolescence, we examined markers of resilience empirically defined in terms of adult success and well-being. The study includes a demographically similar group recruited from a public high school. Major goals were to (a) develop preliminary models of adaptive functioning among adults in their 30s, (b) examine the extent to which adults with histories of serious mental disorders can be characterized by these models, and (c) explore predictors of successful adult lives from indicators of individuals' psychosocial adjustment at age 25.Results showed significant cohort effects on indexes of adaptive functioning, especially for men. Findings suggest that social relations as well as self-views of competence and relatedness play important roles in characterizing adjustment during the adult years. In addition, indexes of psychosocial adjustment as well as symptoms of psychiatric distress and hard drug use at age 25 made a difference in adult social functioning and well-being, providing hints of possible mechanisms likely to facilitate the ability to "bounce back" after a difficult adolescence.     

Prevalence of dual diagnosis in an institution for individuals who are developmentally handicapped

The prevalence of dual diagnosis (developmental handicap with accompanying mental illness) was examined in a population of 71 persons who are institutionalized and developmentally handicapped. The Reiss Screen for Maladaptive Behavior (Reiss, 1988) revealed that 69% of the popula- tion had a dual diagnosis. The incidence of dual diagnosis was not related to level of functioning, although the type of psychopathology varied considerably across levels of functioning. In contrast to findings from the Reiss Screen, previous psychiatric diagnosis indicated a much lower rate of dual diagnosis (26.8%), as did current psychiatric assessment. There was little agreement between the two psychiatric assessments, or between the Reiss Screen and the psychiatric assessments. The Reiss Screen appears to provide information of more practical value for community placement decisions than is provided by the psychiatric assessments. Limitations to the concept of ?dual diagnosis’? for characterizing the mental health needs of persons with a developmental handicap are discussed.