Anxiety in eating disorders: a comparative study

Scientific literature shows that anxiety is an important factor in eating disorders. The aim of this case-control study was to compare the anxiety manifestations obtained by means of the Anxiety Situations and Responses Inventory of in a clinical sample of 74 females (46, anorexia nervosa; 28, bulimia) to those obtained by a control group (130 girls without disorders). The between-group ANOVA results showed higher anxiety scores in the clinical group with a medium effect size for the anxiety trait, finding a flat profile (within-group ANOVA) for the three response systems (cognitive, physiological and motor) and the four specific anxiety traits (test, interpersonal, phobic, and daily life situations). Moreover, high scores in anxiety involved a greater risk of being diagnosed with an eating disorder in the 8 bivariate comparisons. The estimations were more precise for cognitive anxiety and for the specific interpersonal anxiety trait.     

Measuring adjustment to chronic skin disorders: validation of a self-report measure

This article describes the development of a questionnaire that assesses problems in adapting to chronic skin disorders, the Adjustment to Chronic Skin Diseases Questionnaire. Patients (N = 442) with different skin disorders completed the original item pool. Principal-components analysis suggested a 6-factor solution that was largely replicated with 2 additional samples of 192 patients with psoriasis or atopic dermatitis and 165 patients with atopic dermatitis. Four of the subscales showed very good internal consistencies, retest reliabilities, and sufficient correlations with expert ratings: Social Anxiety/Avoidance, Itch-Scratch Cycle, Helplessness, and Anxious-Depressive Mood. Two short additional subscales, Impact on Quality of Life and Deficit in Active Coping, showed moderate internal consistencies, but good retest reliabilities. Correlations of the subscales with measures of depression, anxiety, and coping, and meaningful differences between dermatological subgroups support their construct validity. A treatment study showed that changes in some of the subscales correlated with changes in the severity of the skin condition.     

Millon's dimensional model of personality disorders: a comparative study

Millon has proposed six fundamental dimensions of general personality functioning as providing the underlying structure of personality disorders. However, this widely-cited theoretical model has been the subject of few empirical studies. The purpose of the current study was to directly compare the validity of this model to the five-factor model with respect to their hypothesized relationships with personality disorder symptomatology. Participants were administered the predominant measures of general personality functioning for each theoretical model, along with an assessment of personality disorder symptomatology. The results found only weak support for the theoretical model of Millon. Limitations and suggestions for future research are discussed.     

Cognitive therapy with obsessive-compulsive disorder: a comparative evaluation.

After a 4-week waiting period 21 obsessive-compulsives were randomly allocated to two treatment conditions (1) Rational Emotive Therapy (RET) and (2) exposure in vivo. RET consisted of analysing irrational thoughts; exposure in vivo was self-controlled. After six sessions and another 4-week waiting period all patients received six sessions of exposure in vivo. Both treatments resulted in significant improvement on anxiety/discomfort, Maudsley Obsessional Compulsive Inventory, and Dutch Obsessional Compulsive Questionnaire and in a reduction of scores on the Irrational Beliefs Test. Results were maintained to a follow-up 6 months later. No significant differences were found between the two conditions.     

The clinical approach: Triangulated program evaluation and adjustment

In the discussion about “enlightenment” or “utilization” in program evaluation, it is increasingly clear that the discussants implicitly refer to different professional contexts. Weiss, in Alkin (1990), using the “scientist” approach appears to reflect upon the academic context of the traditional university, where, beyond the land grant institutions, “enlightenment” is the honored objective. In contrast, Patton (Alkin, 1990) speaks from the clinical perspective of the organization consultant, with “utilization” the essential element in the evaluator-client relationship. Yet, those contextual differences notwithstanding, each party defends its case on the implicit assumption ofone methodological procedure of program evaluation—equally shared by both. Correcting this assumption, this article articulates major principles and methods of the “clinical” approach in program evaluation. The method has been tested in the field in western Europe and the United States. Its characteristic difference with the academic tradition is that in clinical evaluation, improving the program is part of the method. Mark van de Vall is professor of Sociology, Erasmus University Rotterdam and adjunct professor at SUNY / Buffalo.     

社会评价影响错误后调整效应

现有研究主要采用结果评价或结果反馈的方式考察评价对错误后调整效应的影响,但是任务前的社会评价怎样影响错误后调整效应尚不清楚。本研究采用社会评价任务,以错误后反应时和错误后正确率为指标,在两个实验中考察正性和负性评价对错误后调整效应的影响。结果发现,实验1和实验2中正性和负性评价条件下错误后减慢效应差异均不显著,说明正性和负性评价对错误后调整的作用是一致的,且不受实验任务的影响。在实验1中通过和无评价条件比较发现,评价条件下的正确后反应显著慢于无评价条件,但是评价条件下的错误后反应与无评价条件无差异,说明社会评价加速了个体错误后调整。而且在实验2中发现高低自我效能组个体错误后调整效应差异不显著,说明当前结果不受个体自我效能感的影响。因此,当前研究说明任务前的社会评价促进了个体错误后行为调整,但是错误后调整效应不受社会评价效价的影响。     

Comorbidity of DSM-IV Personality Disorders in unipolar and bipolar affective disorders: a comparative study

The aim of this study was to compare the prevalence of Personality Disorders assessed by Structured Clinical Interview for Axis-II in 155 inpatients diagnosed with Unipolar Disorder vs inpatients with Bipolar Disorder (39). The most frequent Axis II diagnoses among Unipolar inpatients were Borderline (31.6%), Dependent (25.2%), and Obsessive-Compulsive (14.2%) Personality Disorders. Among Bipolar inpatients, the most prevalent personality disorders were Borderline (41%), Narcissistic (20.5%), Dependent (12.8%), and Histrionic disorders (10.3%). Using chi squared analysis, few differences in distribution emerged between the two groups: Unipolar patients had more recurrent Obsessive-Compulsive Personality Disorder than Bipolar patients (chi(1)2=6.24, p<.005). Comorbid Narcissistic Personality Disorder was significantly more frequent in the Bipolar than in the Unipolar group (chi(1)2=6.34, P<.01). Considering the three clusters (DSM-IV classification), there was a significant difference between the groups, Cluster C (fearful, avoidant) diagnoses being more frequent in the Unipolar than in the Bipolar group (48.4% vs 20.5%, respectively). Cluster B (dramatic, emotionally erratic) diagnoses were found more frequently in patients with Bipolar Disorders (71.8% vs 45.2% in Unipolar patients, chi(2)2=10.1, p<.006). The differences in the distribution and prevalence of Personality Disorders between the two patient groups are discussed.     

Family secrecy: a comparative study of juvenile sex offenders and youth with conduct disorders

The reported research was designed to compare adjudicated male juvenile sexual offenders and youth with conduct disorders on five aspects of family secrecy and deception. Twenty-nine male juvenile sex offenders and 32 comparison youth from three child welfare agencies in New York State participated in the study. Research assistants, blind to the hypotheses of the study and status of the youth, coded agency records for five variables identified a priori as a basis of comparison. Analyses revealed that the two groups were different on three of the five and on the total number of items scored. Families of juvenile sex offenders told more lies, had more family myths, and were more likely to be involved in taboo behavior. Logistic regression revealed that this factor of family deception significantly increased the odds of sexual offending over and above other measures of family pathology. These data support the hypotheses of the study and have implications for both clinical practice and future research in this area.     

Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia

The aim of the present study was to evaluate the effectiveness of low-budget virtual reality (VR) exposure versus exposure in vivo in a between-group design in 33 patients suffering from acrophobia. The virtual environments used in treatment were exactly copied from the real environments used in the exposure in vivo program. VR exposure was found to be as effective as exposure in vivo on anxiety and avoidance as measured with the Acrophobia Questionnaire (AQ), the Attitude Towards Heights Questionnaire (ATHQ) and the Behavioral Avoidance Test (BAT). Results were maintained up to six months follow-up. The present study shows that VR exposure can be effective with relatively cheap hardware and software on stand-alone computers currently on the market. Further studies into the effectiveness of VR exposure are recommended in other clinical groups as agoraphobics and social phobics and studies in which VR exposure is compared with more emerging virtual worlds as presented in CAVE-type systems.     

Prevalence of DSM-III conduct and adjustment disorders for adolescent psychiatric inpatients

The prevalence of DSM-III conduct and adjustment disorders in two adolescent psychiatric facilities, both located near large U.S. cities, was investigated. Overall, 31.6% of the adolescent inpatients were conduct disordered while 12.5% were adjustment disordered. The conduct disorders were primarily "aggressive" subtypes suggesting that this characteristic may influence hospitalization and diagnostic decisions. Such data on prevalence assists future treatment planning, allowing anticipation of case loads.     

Coping in childhood: A comparative evaluation of different relaxation techniques

Abstract

This paper reports on the evaluation of relaxation trainings to improve the coping of children with stress situations. Over five training sessions, different relaxation techniques were presented to children to evaluate their short-term and long-term effects on different criteria. Included were a sensoric approach to relaxation (the Progressive Muscle Relaxation), an imaginative approach, and an imaginative approach with additional sensoric elements (combined training). Two control conditions were added. One of them presented non-tension producing stories instead of supplying a systematic relaxation training. The children of the second control condition participated at the measurements without any intervention. The participants were 826 children aged 7–14. The results show clear short-term effects on physiological parameters (blood pressure, pulse rate, body temperature) as well as on subjective ratings of the children's mood and somatic condition. In relation to the overall changes, the differences between the training conditions are comparatively small. Moreover, the long-term effects (recorded one week and two months after the five training sessions) were small in relation to the short-term effects.     

The MCMI-III personality disorders scores predicted by the NEO-FFI-R and the ZKPQ-50-CC: a comparative study

This study was designed to compare the NEO-FFI-R versus the ZKPQ-50-CC in their relationships with the fourteen MCMI-III personality disorder scales in a Spanish non-clinical sample (N = 674). Previous studies showed consistent relationships between the Five Factor Model and the DSM-IV personality disorders (PD), but there is no comparative study between both Five Factor and Zuckerman's personality models. The aim was to replicate previous results about relationships between the Big-Five and PDs using the revised short version of the NEO-PI-R, and to compare the NEO-FFI-R versus the ZKPQ-50-CC regarding the relationships with MCMI-III personality disorder scales. Results showed no sharp differences between the NEO-FFI-R and ZKPQ-50-CC scales. Each instrument explained around 30% of the PDs MCMI-III scales variance. Using conjointly the 10 personality scales from the NEO-FFI-R and ZKPQ-50-CC, the PDs accounted variance rose to 38%. Differences and similarities between both short personality questionnaires are discussed.     

Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial

The aim of this study was to investigate the effect of mindfulness-based stress reduction (MBSR) for patients with heterogeneous anxiety disorders. Seventy-six self-referred patients were randomized to MBSR or a waiting-list control condition. Eight participants did not complete the eight-week MBSR intervention. Treatment completers improved significantly on all outcome measures compared to controls. The completer sample showed medium to large effect sizes on measures of anxiety (Cohen’s d = 0.55–0.97), and a large effect size for symptoms of depression (Cohen’s d = 0.97). Intention-to-treat analyses yielded effect sizes in the small to moderate range (Cohen’s d = 0.32–0.76). Gains were maintained at six months follow-up. The percentage of participants reaching recovered status was highest for symptom measures of depression and anxiety, and lower for worry and trait anxiety. Mediation analyses indicated that mindfulness fully mediated changes in acute anxiety symptoms, and partially mediated changes in worry and trait anxiety. However, the present study did not find evidence of temporal precedence for the proposed mediator. In the absence of true mediation and an active control condition, it cannot be ruled out that results are due to non-specific aspects of treatment. Despite these and other limitations, we conclude that MBSR is an effective treatment for anxiety disorders and related symptomatology.     

The diagnosis of borderline disorders: criteria and their empirical evaluation

Until now "Borderline-Syndrom" is a controversial diagnosis especially because of many uncertainties to determine the definition. In our examination various discrimination analyses were realised on a sampling of 62 patients (32 neurotic and 30 Borderline-Patients) and 47 variables in order to get various selective combinations of variables. Useful as a screening to separate neurotic and Borderline-Patients seems to be a combination of the items "often changing partnership", "homosexually episodes" and "incrimination/disciplinary punishment" with an error rate of 6.5 per cent.