Childhood Maltreatment Increases the Risk of Intimate Partner Violence via PTSD and Anger Personality Traits in Individuals Consulting for Sexual Problems

Childhood maltreatment is a significant risk factor for the perpetration of intimate partner violence (IPV) in adulthood. This study tested, in a clinical sample, a conceptual model suggesting that childhood maltreatment contributes to the development of anger personality traits, directly and indirectly via posttraumatic stress disorder (PTSD), and that anger personality traits, in turn, are associated with IPV. Adults consulting for sex therapy (n = 114) completed self-report measures of childhood maltreatment, PTSD, anger, and IPV. Participants were exposed to high rates of childhood maltreatment (83%). Path analysis supported the hypothesized model: Exposure to child maltreatment was associated with anger personality traits, and this association was partially mediated by PTSD symptoms. Anger personality traits were highly correlated with IPV.     

Perceived fraudulence in young adults: is there an "imposter syndrome"?

This investigation consists of two studies designed to examine perceived fraudulence, its measurement, and the personality traits associated with the experience in young adults. For Study 1, the Perceived Fraudulence Scale (PFS), a new measure constructed for this study, was administered to a sample of 50 college undergraduates, along with several other self-report measures; a semistructured interview and thought-listing exercise were added to provide convergent assessments of perceived fraudulence. Correlational patterns and regression analyses supported the investigators' conceptualization of perceived fraudulence as involving a combination of fraudulent ideation, depressive tendencies, self-criticism, social anxiety, achievement pressures, and self-monitoring skills. Study 2, in which 100 college undergraduates completed several personality questionnaires, replicated the factor structure of the PFS and provided some evidence for the discriminant validity of the construct of perceived fraudulence.     

Externalizing and internalizing subtypes of combat-related PTSD: a replication and extension using the PSY-5 scales

This study replicated and extended prior findings of internalizing and externalizing subtypes of posttraumatic response (M. W. Miller, J. L. Greif, & A. A. Smith, 2003). Cluster analyses of the Minnesota Multiphasic Personality Inventory--2 Personality Psychopathology--Five (MMPI-2 PSY-5; A. R. Harkness, J. L. McNulty, Y. S. Ben-Porath, 1995) profiles obtained from 736 veterans with posttraumatic stress disorder (PTSD) partitioned the sample into a low pathology cluster defined by personality scores in the normal range, an externalizing cluster characterized by low constraint and high negative emotionality, and an internalizing cluster with high negative emotionality and low positive emotionality. Externalizers showed the highest rates of alcohol-related and antisocial personality disorders; internalizers, the highest rates of panic and major depressive disorder. These findings support the development of a personality-based typology of posttraumatic response designed to account for heterogeneity in the expression of PTSD and associated psychopathology.     

The North Carolina Dissociation Index: A Measure of Dissociation Using Items From the MMPI-2

The development of a new measure of dissociation using items from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) is described. In Experiment 1,525 college students were administer ed a measure of hypnotic susceptibility and completed several specialized measures of dissociation or dissociation-like experiences. The new measure, the North Carolina Dissociation Index (NCDI), demonstrated adequate internal consistency and good convergent validity. In Experiment 2, the NCDI demonstrated adequate internal consistency and test-retest reliability with a different sample of college students. Moreover, NCDI scores showed a relatively strong correlation with an interview-based measure of dissociative symptoms. In addition, a small sample of students with dissociative disorders had significantly higher NCDI scores than students with anxiety disorders and normal control subjects. In Experiment 3, 19 gang combat veterans were administered a semi-structured diagnostic interview and the MMPI-2, Subjects who were diagnosed with Posttraumatic Stress Disorder (PTSD) scored significantly higher on the NCDI than subjects who did not have PTSD. The NCDI is intended primarily as a tool in settings where the MMPI-2 is routinely administered.     

Clinical Validation of the Swedish Version of the Quality of Life Inventory in Crime Victims with Posttraumatic Stress Disorder and a Nonclinical Sample

The Swedish version of the Quality of Life Inventory (QOLI) was cross-culturally validated with a crime victim sample (N = 53) with posttraumatic stress disorder (PTSD) and a nonclinical group (N = 100) with no lifetime and current psychiatric disorder from the general population in the Stockholm county of Sweden. The QOLI showed excellent internal consistencies in the clinical and the nonclinical sample. In addition, PTSD participants displayed a significantly lower self-perceived quality of life in 13 out of 16 domains of life than the nonclinical individuals. Furthermore, the QOLI was inversely correlated with interview and self-report measures of PTSD symptoms, depression, and anxiety. Overall, the results support the utility of the Swedish QOLI version as a potentially useful measure of self-perceived quality of life in Swedish clinical and nonclinical samples. The results are discussed in relation to the Swedish cross-cultural validation of the QOLI, methodological limitations and future directions.     

Traumatic memories of war veterans: not so special after all

Several authors have argued that traumatic experiences are processed and remembered in a qualitatively different way from neutral events. To investigate this issue, we interviewed 121 Croatian war veterans diagnosed with posttraumatic stress disorder (PTSD) about amnesia, intrusions (i.e., flashbacks and nightmares), and the sensory qualities of their most horrific war memories. Additionally, they completed a self-report scale measuring dissociative experiences. In contrast to what one would expect on the basis of theories emphasizing the special status of traumatic memories, amnesia, and high frequency intrusions were not particularly typical for our sample of traumatized individuals. Moreover, traumatic memories were not qualitatively different from neutral memories with respect to their stability and sensory qualities. The severity of PTSD symptoms was not significantly correlated with dissociative experiences. Our findings do not support the existence of special memory mechanisms that are unique to experiencing traumatic events.     

Personality and self-reported preference for music genres and attributes in a German-speaking sample

Research of music preferences yielded consistent results about the relationship of music preference, biographic variables, and personality. This study replicates some of these findings in a German-speaking sample (N = 1329). We conducted an online study using self-report assessments. We confirmed the five-factor structure of music genre preference and the three-factor structure of music attribute preference using EFA and CFA. In addition to previous research, we showed that the three-factor structure of music attribute preference is also replicated in self-reported assessments. We examined the relationships of personality and music preferences using SEM. This study contributes to the overall picture of music preference research and provides additional insights into the little-examined field of the relationship of music attribute preference and personality.     

Personality-based latent classes of posttraumatic psychopathology: personality disorders and the internalizing/externalizing model

Prior research using the Brief Form of the Multidimensional Personality Questionnaire (MPQ-BF; Patrick, Curtin, & Tellegen, 2002) has shown evidence of 3 temperament-based subtypes--termed internalizing, externalizing, and simple PTSD--among individuals with symptoms of posttraumatic stress disorder (PTSD; Miller, Greif, & Smith, 2003). This study sought to replicate and extend research in this area by conducting a latent profile analysis of higher order temperament scales from the MPQ-BF using a new sample of 208 veterans with symptoms of PTSD. Results suggest that a 3-class solution reflecting internalizing, externalizing, and simple subtypes of posttraumatic psychopathology provided the best fit to the data. The externalizing subtype was characterized by features of antisocial, borderline, histrionic, and narcissistic personality disorders on the International Personality Disorder Examination (Loranger, 1999) as well as low levels of constraint and high levels of negative emotionality on the MPQ-BF. In contrast, individuals in the internalizing class exhibited features of schizoid and avoidant personality disorders, low levels of positive emotionality, and high levels of negative emotionality. The simple subtype was defined by low levels of comorbid personality disorder features and relatively normal personality profiles. Findings support the reliability of this typology and support the relevance of the internalizing and externalizing model to the structure of personality disorders.     

Scale of Unpredictability Beliefs: Reliability and Validity

Experiencing unpredictability in the environment has a variety of negative outcomes. However, these are difficult to ascertain due to the lack of a psychometrically sound measure of unpredictability beliefs. This article summarizes the development of the Scale of Unpredictability Beliefs (SUB), which assesses perceptions about unpredictability in one's life, in other people, and in the world. In Study I, college students (N = 305) responded to 68 potential items as well as other scales. Exploratory factor analysis yielded three internally consistent subscales (Self, People, and World; 16 items total). Higher SUB scores correlated with more childhood family unpredictability, greater likelihood of parental alcohol abuse, stronger causal uncertainty, and lower self-efficacy. In Study II, a confirmatory factor analysis supported the three-factor solution (N = 186 college students). SUB scores correlated with personality, childhood family unpredictability, and control beliefs. In most instances the SUB predicted family unpredictability and control beliefs beyond existing unpredictability measures. Study III confirmed the factor structure and replicated family unpredictability associations in an adult sample (N = 483). This article provides preliminary support for this new multi-dimensional, self-report assessment of unpredictability beliefs, and ideas for future research are discussed.     

The latent structure of posttraumatic stress disorder: a taxometric investigation of reactions to extreme stress

Mental health professionals have debated whether posttraumatic stress disorder (PTSD) can be qualitatively distinguished from normal reactions to traumatic events. This debate has been fueled by indications that many trauma-exposed individuals evidence partial presentations of PTSD that are associated with significant impairment and help-seeking behavior. The authors examined the latent structure of PTSD in a large sample of male combat veterans. Three taxometric procedures-MAMBAC, MAXEIG, and L-Mode-were performed with 3 indicator sets drawn from a clinical interview and a self-report measure of PTSD. Results across procedures, consistency tests, and analysis of simulated comparison data all converged on a dimensional solution, suggesting that PTSD reflects the upper end of a stress-response continuum rather than a discrete clinical syndrome.     

The impact of dissociation and depression on the efficacy of prolonged exposure treatment for PTSD

This study investigates the impact of dissociative phenomena and depression on the efficacy of prolonged exposure treatment in 71 patients with posttraumatic stress disorder (PTSD). Diagnoses, comorbidity, pretreatment depressive symptoms, PTSD symptom severity, and dissociative phenomena (trait dissociation, numbing, and depersonalization) were assessed at pretreatment using semi-structured interviews and questionnaires. In a pretreatment behavioral exposure test, patients were imaginally exposed to (part of) their trauma memory for 9 min, during which subjective fear was assessed. At posttreatment and 6 months follow-up PTSD, depressive and dissociative symptoms were again assessed in the completers (n = 60). Pretreatment levels of dissociative and depressive symptoms were similar in dropouts and completers and none of the dissociative phenomena nor depression predicted improvement. Against expectations, dissociative phenomena and depression were associated with enhanced rather than impeded fear activation during the behavioral exposure test. However, these effects disappeared after controlling for initial PTSD severity. Hence, rather than supporting contraindication, the current results imply that patients presenting with even severe dissociative or depressive symptoms may profit similarly from exposure treatment as do patients with minimal dissociative or depressive symptoms.     

The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors

This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.     

Internalizing and externalizing subtypes in female sexual assault survivors: implications for the understanding of complex PTSD

This study replicated and extended findings of internalizing and externalizing subtypes of posttraumatic psychopathology (Miller, M. W., Greif, J. L., & Smith, A. A. (2003). Multidimensional Personality Questionnaire profiles of veterans with traumatic combat exposure: Internalizing and externalizing subtypes. Psychological Assessment, 15, 205-215; Miller, M. W., Kaloupek, D. G., Dillon, A. L., & Keane, T.M. (2004). Externalizing and internalizing subtypes of combat-related PTSD: A replication and extension using the PSY-5 Scales. Journal of Abnormal Psychology, 113, 636-645) to a female sample of rape survivors with chronic PTSD. Cluster analyses of Schedule for Nonadaptive and Adaptive Personality (Clark, L. A. (1996). SNAP-Schedule for Nonadaptive and Adaptive Personality: Manual for administration, scoring, and interpretation. Minneapolis: University of Minnesota Press.) temperament scale profiles from 143 women with PTSD partitioned the sample into a simple PTSD cluster, defined by normal range personality scores and moderate symptomatology, and 2 more "complex" clusters distinguished by more severe tendencies towards externalizing or internalizing psychopathology. Externalizers were characterized by disinhibition, substance dependence, and Cluster B personality disorder features; internalizers by low positive temperament, high rates of major depressive disorder, and elevations on measures of schizoid and avoidant personality disorder.     

Development and validation of a brief self-report measure of trauma exposure: the Trauma History Screen

Although information about individuals' exposure to highly stressful events such as traumatic stressors is often very useful for clinicians and researchers, available measures are too long and complex for use in many settings. The Trauma History Screen (THS) was developed to provide a very brief and easy-to-complete self-report measure of exposure to high magnitude stressor (HMS) events and of events associated with significant and persisting posttraumatic distress (PPD). The measure assesses the frequency of HMS and PPD events, and it provides detailed information about PPD events. Test-retest reliability was studied in four samples, and temporal stability was good to excellent for items and trauma types and excellent for overall HMS and PPD scores. Comprehensibility of items was supported by expert ratings of how well items appeared to be understood by participants with relatively low reading levels. In five samples, construct validity was supported by findings of strong convergent validity with a longer measure of trauma exposure and by correlations of HMS and PPD scores with posttraumatic stress disorder (PTSD) symptoms. The psychometric properties of the THS appear to be comparable or better than longer and more complex measures of trauma exposure.     

The validity of the PTSD checklist as a measure of symptomatic change in combat-related PTSD

Little research to date has examined the ability of self-report measures to assess changes in symptom severity and diagnostic status as a function of treatment. This study investigated the validity of the posttraumatic stress disorder (PTSD) checklist (PCL) as a measure of symptomatic change following programmatic treatment. A sample of 97 Vietnam veterans with combat-related PTSD was assessed using the clinician-administered PTSD scale (CAPS) and the PCL prior to, and 9 months following, participation in a PTSD treatment program. Using the CAPS as the "gold standard" measure of PTSD symptomatology, the PCL demonstrated high diagnostic accuracy pre- and posttreatment. However, significant variations in accuracy were evident in the ability of the PCL to determine the presence and severity of individual symptoms at each time point. In addition, as symptoms improved from pre- to posttreatment, and approached the threshold criteria, the PCL demonstrated reductions in diagnostic accuracy. As a measure of overall symptomatic change, the PCL underrated improvement in comparison to the CAPS. The results supported the use of an overall cut-off score of 50 on the PCL for a diagnosis, and an item score of 3 for symptom criterion, in this population.     

A comparison of the validity of the five-factor model (FFM) personality disorder prototypes. Using FFM self-report and interview measures

Recent studies have demonstrated that personality disorders (PDs) can be assessed via a prototype-matching technique, which enables researchers and clinicians to match an individual's five-factor model (FFM) personality profile to an expert-generated prototype. The current study examined the relations between these prototype scores, using interview and self-report data, and PD symptoms in an outpatient sample (N = 115). Both sets of PD prototype scores demonstrated significant convergent validity with PD symptom counts, suggesting that the FFM PD prototype scores are appropriate for use with both sources of data.     

DSM-III-R personality disorders and the five-factor model of personality: an empirical comparison.

The relationship between the five-factor model (FFM) of personality and the Diagnostic and Statistical Manual of Mental Disorders (rev. 3rd ed.; DSM-III-R) personality disorders was examined in a sample of 54 psychiatric outpatients. Correlations between raw scores on the NEO-Personality Inventory (NEO-PI) and the number of DSM-III-R personality disorder symptoms rated present using a semistructured interview were computed. In addition, correlations between NEO-PI scores and scores on two self-report personality disorder inventories were also examined to determine which results replicated across instruments. Results indicated that the FFM personality dimensions of Neuroticism, Extraversion, and Agreeableness were most apparent in the DSM-III-R conceptualizations of the personality disorders.     

Assessing the DSM-IV structure of personality disorder with a sample of Chinese psychiatric patients

The validity of the three-cluster system of personality disorders (PDs) in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 1994) was examined in a sample of Chinese psychiatric patients (n = 227), who completed the self-report Personality Disorders Questionnaire for DSM-IV (PDQ-4; Hyler, 1994) and who were also administered the clinician-rated Personality Disorders Interview-IV (PDI-IV; Widiger, Mangine, Corbit, Ellis, & Thomas,). Using confirmatory factor analysis, a three-factor model corresponding to the DSM-IV clusters was tested and compared statistically to a one-factor model and a set of random, three-factor models. Only the clinician-rated instrument supported the DSM-IV three-cluster model, and then only when the factors were allowed to correlate. Results from the theoretically more rigorous uncorrelated model testing did not support the DSM-IV model for either assessment modality.     

Confirmatory Factor Analyses of Self- and Parent- Report Inventory of Callous-Unemotional Traits in 8- to 10-Year-Olds

The factorial structure of the Inventory of Callous-Unemotional Traits (ICU; Frick 2004) has been inconsistent across various studies using different rater versions and samples. In this study the factorial structure of the self- and parent-report versions of the ICU was examined in a community sample of 340 boys and girls aged 8- to 10- years. A series of confirmatory factor analyses revealed that (1) for self-report ICU, a two-factor model comprising one Uncaring and one Callousness factor fit the data best; the factorial structure was invariant across sex, although boys showed higher scores than girls on the Uncaring factor; (2) for the parent-report ICU, a three-factor structure was supported, and boys and girls did not differ on factor structure or levels of the factors. For both versions, CU traits were positively associated with the count of Oppositional Defiant Disorder/Conduct Disorder and internalizing behavior symptoms, demonstrating ICU’s good convergent albeit unsatisfactory discriminant validity. Findings suggest further refinement of this instrument for the self-report and parent versions separately.