Jousting with straw men: comment on Westen, Novotny, and Thompson-Brenner (2004)

Empirically supported treatments (ESTs) do not cure every patient, and the randomized trial is not a flawless methodology. Upon these often-noted and widely accepted points, D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004a; see record 2004-15935-005) built a critique of ESTs and EST research. However, important work developing effective, clinically relevant treatments for serious problems was omitted from the Westen et al. (2004a) review. Little documentation was offered for the purported "assumptions" of EST methodology that Westen et al. (2004a) criticized; and different review standards were applied to studies supporting versus those disagreeing with Westen et al.'s (2004a) views. Finally, the correlational research designs proposed as a remedy by Westen et al. (2004a) have far more serious weaknesses than randomized trials, thoughtfully applied to real-world clinical care.     

Assessing personality change in psychotherapy with the SWAP-200: a case study

Many studies document the efficacy of psychotherapy for acute syndromes such as depression, but less is known about personality change in patients treated for personality pathology. The Shedler-Westen Assessment Procedure (SWAP-200; Westen & Shedler, 1999a, 1999b) is an assessment tool that measures a broad spectrum of personality constructs and is designed to bridge the gap between the clinical and empirical traditions in personality assessment. In this article, we demonstrate the use of the SWAP-200 as a measure of change in a case study of a patient diagnosed with borderline personality disorder. We collected assessment data at the start of treatment and after 2 years of psychotherapy. The findings illustrate the personality processes targeted in intensive psychotherapy for borderline personality.     

Comparative validity of the Shedler and Westen Assessment Procedure-200

A predominant dimensional model of general personality structure is the five-factor model (FFM). Quite a number of alternative instruments have been developed to assess the domains of the FFM. The current study compares the validity of 2 alternative versions of the Shedler and Westen Assessment Procedure (SWAP-200) FFM scales, 1 that was developed on the basis of items identified by J. Shedler and D. Westen (2004) and 1 that used items identified by R. R. McCrae, C. E. Lokenhoff, and P. T. Costa (2005). The comparative validity of both measures was examined in a sample of persons who evidenced personality-related problems in living (N = 94). The McCrae et al. Neuroticism, Agreeableness, and Openness scales were superior to their respective Shedler and Westen scales. Both research teams developed comparably valid Extraversion and Conscientiousness scales. Implications of the results for future SWAP-200 research are discussed.     

The assessment of the social cognition and object relations scale on TAT and interview data

This study examines the reliability and convergent validity of 2 versions of the Social Cognition and Object Relations Scale (SCORS), one for use with Thematic Apperception Test narratives (SCORS-TAT; Westen, 1990) and one for use with clinical interview data (SCORS-CDI; Westen, Barends, Leigh, Mendel, & Silbert, 1990 ). Four SCORS dimensions were evaluated. Data were collected in a psychiatric sample (N = 74). Results show that although interrater reliability was good for all dimensions, internal consistency was low, especially for the affective dimensions. Structural equation modeling, in which a model with 2 factors (i.e., SCORS-TAT and SCORS-CDI) and 4 dimensions each was tested, indicated low convergence between corresponding dimensions of SCORS-TAT and SCORS-CDI. Correlational analyses suggested that this was due to a strong method factor. Regression analyses, however, revealed that the presence of a personality disorder operated as a moderator for convergence between corresponding cognitive-structural dimensions.     

Empirically supported psychotherapies: comment on Westen, Novotny, and Thompson-Brenner (2004)

D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004; see record 2004-15935-005) suggested that efforts to identify empirically supported treatments are misguided because they are based on assumptions that are not appropriate for some types of treatment and patients. The authors of this comment argue that Westen and colleagues are simply incorrect when they assert that empirically supported treatments require that psychopathology must be highly malleable, that treatments must be brief, or that the samples studied are unrepresentative of the kinds of patients typically encountered in clinical practice--comorbidity is common in many clinical trials. Randomized controlled trials remain the most powerful way to test notions of causal agency.     

The Shedler and Westen Assessment Procedure from the perspective of general personality structure

The Shedler and Westen Assessment Procedure (SWAP-200; J. Shedler & D. Westen, 2004) has received increasing support as a dimensional model of personality pathology. However, only 1 prior study has related empirically the SWAP-200 with any other measure of personality or personality disorder. The purpose of the current study was to determine whether the SWAP-200 personality disorder and personality dimension scales relate meaningfully to the domains and facets of the five-factor model (FFM; J. M. Digman, 1990) of general personality structure. Individuals (n = 94) with significant personality pathology were described on instruments of general personality and personality pathology. The results of the current study suggest that most of the SWAP-200 personality and personality disorder scales relate to the domains and facets of the FFM in a manner consistent with FFM theory and previous FFM personality disorder research. Inconsistent findings and limitations are discussed, along with suggestions for future research.     

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.     

Object relations and real life relationships: A cross method assessment

This study examines the relationship between the psychoanalytic concept of object relations and real life behavior of being in an intimate relationship among heterosexual women. In a multi‐method approach we used two different measures; the self‐report Bell Object Relations and Reality Testing Inventory (BORRTI; Bell, Billington & Becker, 1986 ) and the performance based Thematic Apperception Test (TAT) Social Cognition & Object Relations Scale‐ Global Rating Method SCORS‐G (Westen, 1995 ) to measure the object relations of 60 women. The Alienation subscale of the BORRTI and understanding of social causality subscale of the SCORS‐G explained 34.8% of variance of the intimate relationship variable. Thus, women involved in a romantic relationship reported lower rates of alienation on the BORRTI and produced TAT narratives that were more adaptive with regard to understanding of social causality as measured by the SCORS‐G than those not currently in a relationship. Results are discussed with reference to the relationship between object relations and real life measures of healthy individuals and in light of the need for a multi‐method approach of assessment.     

自编《中小学生非智力因素教师评价量表》的信、效度研究

通过自行编制的《中小学生非智力因素教师评价量表》,以天津市4所中、小学校的4个年级365名学生为被试考察了该量表的质量。研究结果表明：(1)《中小学生非智力因素教师评价量表》具有较高的信度;(2)《中小学生非智力因素教师评价量表》所构想的非智力因素结构模型是完全可以接受的,即有较好的结构效度。     

Exploring the construct validity of the social cognition and object relations scale in a clinical sample

The Social Cognition and Object Relations Scale-Global rating method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995) measures the quality of object relations in narrative material. This study employed a multimethod approach to explore the structure and construct validity of the SCORS-G. The Thematic Apperception Test (TAT; Murray, 1943) was administered to 59 patients referred for psychological assessment at a large Northeastern U.S. hospital. The resulting 301 TAT narratives were rated using the SCORS-G method. The 8 SCORS variables were found to have high interrater reliability and good internal consistency. Principal components analysis revealed a 3-component solution with components tapping emotions/affect regulation in relationships, self-image, and aspects of cognition. Next, the construct validity of the SCORS-G components was explored using measures of intellectual and executive functioning, psychopathology, and normal personality. The 3 SCORS-G components showed unique and theoretically meaningful relationships across these broad and diverse psychological measures. This study demonstrates the value of using a standardized scoring method, like the SCORS-G, to reveal the rich and complex nature of narrative material.     

初中生心理弹性与学校适应的关系

采用追踪研究设计考察了初中生的心理弹性与其学校适应之间的相互作用。通过整群取样的方法,对江苏省苏州市三所初中的470名初中生进行了为期一年的追踪。由初中生报告自己的心理弹性,由教师和家长分别报告初中生在学校的适应情况。结果表明：（1）在第一年和第二年,心理弹性和学校适应能力之间存在显著的正相关,与外显问题、内隐问题和学习问题存在显著的负相关;（2）在控制了变量自身的稳定性之后,第一年心理弹性能显著预测第二年学校适应,第一年学校适应无法预测第二年心理弹性。本研究的结果表明,心理弹性与学校适应之间存在单向作用关系。     

Investigating Psychometric Properties of Social Media Addiction Measures Among Adolescents

Assessment has a long history in counseling, with scholars noting multiple benefits to using assessment instruments in determining client strengths and needs as well as establishing relevant treatment goals. However, when counselors use unreliable or invalid instruments, they gather results that are ill equipped to inform clinical decision-making. Consequently, we evaluated and compared the psychometric properties of three scales of social media addiction—the Social Media Disorder Scale (van den Eijnden et al., 2016), the Bergen Social Media Addiction Scale (Andreassen et al., 2012, 2016), and the Social Media Addiction Scale (Al-Menayes, 2015)—to inform clinical use. Adolescents (N = 440) between the ages of 13 and 19 completed the scales. Results indicated that each scale provides a reliable and valid measurement of problematic social media use or addiction among adolescents. We provide recommendations for choosing a social media assessment and for future research.     

Assessing personality disorders using a systematic clinical interview: evaluation of an alternative to structured interviews

The aim of this study was to assess interrater reliability and provide initial data bearing on the validity of a method of assessing personality disorders (PDs) that does not presume that patients can accurately self-report personality pathology. In a sample of 24 outpatients, two clinician-judges independently applied the Shedler-Westen Assessment Procedure-200 (SWAP-200; Westen & Shedler, 1999a, 2000), a 200-item Q-sort procedure for assessing personality pathology, to data from the Clinical Diagnostic Interview (Westen, 2002), a systematic clinical interview that mirrors and standardizes methods used by experienced clinicians to diagnose personality. In 16 of the 24 cases, the treating clinician also independently described the patient using the SWAP-200 Q-sort, based on longitudinal knowledge of the patient over the course of treatment, blind to the interview data. Interrater reliability was uniformly high, with median correlations between interviewers at r > .80. Interviewer-treating clinician correlations were also high, with median convergent validity coefficients at r > .80. Diagnostic overlap (discriminant validity) was moderate for dimensional DSM-IV diagnoses, reflecting extensive comorbidity among disorders, but minimal for empirically derived diagnoses identified in prior research. Treating clinicians' dimensional PD diagnoses using this method also strongly predicted interviewer-rated measures of adaptive functioning. The findings provide preliminary support for the reliability and validity of an alternative to structured interviews for diagnosing personality pathology, and suggest that the way to improve validity of personality diagnosis may not be to minimize clinical inference but to quantify it using psychometric instruments.     

The Emotion Regulation Index for Children and Adolescents (ERICA): A Psychometric Investigation

There is increased recognition of the importance of children learning how to regulate emotions in a functional and adaptive manner for healthy psychological development. However, there is a paucity of tools for assessing emotion regulation during the middle childhood and adolescent years. This study reports on the psychometric evaluation of the 16-item self-report Emotion Regulation Index for Children and Adolescents (ERICA) involving a sample of 1,389 (768 girls, 621 boys) Australian children and adolescents aged 9 to 16 years. Convergent validity for the ERICA is reported with measures of self-conscious emotions (shame, guilt), empathy, childhood depressive symptomatology, and the perceived parenting dimensions of Care and Overprotection. Construct validity assessment using Principal Components Analysis and Confirmatory Factor Analysis yielded three factors: (1) Emotional Control, (2) Emotional Self-Awareness, and (3) Situational Responsiveness. The ERICA was also found to have good internal consistency and to be relatively stable over a four week test-retest period and to be sensitive to age and sex differences. It is concluded that the ERICA is a psychometrically sound measure for the assessment of the identified key aspects of emotion regulation in children and adolescents.     

General and maladaptive personality dimensions and the assessment of callous-unemotional traits in adolescence

Associations between callous-unemotional traits and general and maladaptive personality dimensions are examined in adolescence. More specifically, it was investigated to what extent general and maladaptive personality dimensions can account for the variance in callous-unemotional (CU) scores. Adolescents (N = 509) and their mothers completed the Inventory of Callous-Unemotional Traits (ICU; Frick, 2003), the Hierarchical Personality Inventory for Children (HiPIC; Mervielde & De Fruyt, 1999, 2002), and the Dimensional Personality Symptom Item Pool (DIPSI; De Clercq, De Fruyt, Van Leeuwen, & Mervielde, 2006). Both personality measures accounted for substantial variance in ICU scores and the overall CU profile in terms of the HiPIC and DIPSI was consistent with psychopathy conceptualizations and consistent across informant. Implications for the assessment of early externalizing trait pathology are discussed.     

New Nomenclature for Sexually Abusive Youth: Naming and Assessing Sexually Violent and Predatory Offenders

New nomenclature is presented identifying two subsets of sexually abusive youths currently not defined in the literature or in existing models or risk assessment tools: sexually violent youth (YSV) and predatory sexually violent youth (YPSV). Distinctively and qualitatively different, these youths are more dangerous, manifest higher levels of coercion (e.g., threats of bodily injury, use of weapons), or are predatory sexually violent toward strangers or casual acquaintances. Discussed is the innovative, empirically guided risk assessment tool Multiplex Empirically Guided Inventory of Ecological Aggregates for Assessing Sexually Abusive Children and Adolescents (Ages 19 and Under) (MEGA) (Miccio-Fonseca, 2006a Miccio-Fonseca, L. C. August 2006a. Multiplex Empirically Guided Inventory of Ecological Aggregates for Assessing Sexually Abusive Children and Adolescents (Ages 19 and Under)—MEGA, August, San Diego, CA: Author.  [Google Scholar]) for assessing the level of risk for all youths (male and female) under the age of 19 years, including YSVs and YPSVs.