A framework for integrating dimensional and categorical classifications of personality disorder

Although empirical evidence strongly supports a dimensional representation of personality disorder, there is strong resistance to dimensional classification due in part to concerns about clinical utility. Acceptance of an evidence-based dimensional classification would be facilitated by information on how such a system would map onto existing diagnoses. With this objective in mind, an integrated framework is proposed that combines categorical and dimensional diagnoses. A two-component classification is adopted that distinguishes between the diagnosis of general personality disorder and the assessment of individual differences in the form the disorder takes. Then, the DSM definition of personality disorders is extended by defining individual disorders as categories of trait dimensions. This makes it possible to develop an integrated classification organized around a set of empirically derived primary traits. Assessments of these traits may then be combined to generate categorical and dimensional diagnoses. It is argued that this approach would introduce an etiological perspective into the classification of personality disorder and improve categorical classification by providing an explicit definition of each diagnosis. The clinical utility of incorporating a dimensional classification is discussed in terms of convenience and acceptability, value in predicting outcomes and treatment planning, and usefulness in organizing and selecting interventions.     

The integration of visual and functional classifications in concept formation

Summary Simple motor responses of different similarity were assigned to geometric figures of different similarity. Subsequently, subjects had to learn hierarchical classifications of visually similar or dissimilar figures which were associated with either similar or dissimilar responses. In this way, the visual and the functional similarity of the conceptually united figures were orthogonally varied. It was found that visually similar figures are conceptually classified fastest regardless of their functional similarity. In contrast, functional similarity has a considerable impact on the hierarchical classification of visually dissimilar figures. Functionally similar figures are conceptually faster classified than dissimilar ones. From the results we conclude that concepts are autonomously formed as mediating representations in stimulus-response coordinations. The hierarchical organization of concepts is thereby based on the sequential organization of both the visual input and the behavioral output. Further consequences of this approach are discussed.Portions of this research were presented at the International Symposium on Structure and Function of Human Memory, in Memoriam Hermann Ebbinghaus, Berlin, July 1985     

Judged Likelihood of Different Second Crimes: A Function of Judged Similarity

Numerous studies have concluded that the judged probability of conviction for a crime is higher when information concerning a prior conviction is disclosed. This is even more true when the prior and present crimes are the same. This paper examines the argument that the influence of a hypothetical previous conviction on the judgment of predilection toward a hypothetical present crime is a continuous function of the degree of similarity between past and present crimes. The subjects were presented with all possible pairs of 10 crimes, the first being considered as a prior conviction and the second as a presently charged crime. The subjects judged the subjective likelihood that a person convicted of the first crime (C1) would, in fact, he of a mind and inclination to commit the second one (C2). Independent judgments of intercrime, undefined similarity also were obtained. The main experimental findings, as expected, were that the judged probability of C2. given C1, was: (a) greatest when C2 was a repeat of C1; (b) uniquely different for each C1; (c) predicted quite well by degree of intercrime similarity; (d) poorly predicted by crime seriousness values. Thus, the subject appears to make judgments of predilection on the basis of simple representativeness heuristics, which specify that certain crimes will be considered more likely if they are more semantically related to earlier ones. Such a mental device unfortunately would he systematically biased in courtroom settings because judgments of intercrime similarity are not influenced by real-world probabilities.     

Neurocognitive functioning in patients with conversion disorder/functional neurological disorder

Neurocognitive symptoms are common in individuals with somatic symptom and related disorders (SSRD), but little is known about the specific impairments in neurocognitive domains in patients with conversion disorder (CD)/functional neurological disorder (FND). This study examines neurocognitive functioning in patients with CD/FND compared to patients with other SSRD. The sample consisted of 318 patients. Twenty-nine patients were diagnosed with CD/FND, mean age 42.4, standard deviation (SD) = 13.8 years, 79.3% women, and 289 patients had other SSRD (mean age 42.1, SD = 13.3, 60.2% women). Patients completed a neuropsychological test battery that addressed a broad range of neurocognitive domains, including information processing speed, attention and executive functioning. Patients with CD/FND had clinically significant neurocognitive deficits in all neurocognitive domains based on normative data comparison. Patients with CD/FND also performed significantly worse than patients with other SSRD on information processing speed (Digit Symbol Substitution Test (V = .115, p = .035), Stroop Color–Word Test (SCWT) card 1 (V = .190, p = .006), and SCWT card 2 (V = .244, p < .001). No CD/FND vs. other SSRD differences were observed in other neurocognitive domains. These findings indicate the patients with CD/FND perform worse on information processing speed tests compared to patients with other SSRD.     

Judged similarity in pitch of octave multiples

Subjects with musical training, who could identify musical intervals within octaves, were tested on their ability to identify musical intervals when the higher note was at several different octave multiples. Some subjects (but not all) showed very high scores on such cross-octave interval recognition tests. Two other groups of subjects were tested on ability to recognize pitch similarities for octave multiples. Only a few subjects showed evidence of perceiving pitch similarities. Our results do not support the hypothesis thatall subjects perceive a common pitchchroma at octave multiples.     

Depersonalization disorder: a functional neuroanatomical perspective

Clinical reports of depersonalization suggest that attenuated emotional experience is a central feature of the condition. Patients typically complain of emotional numbness and some patients ascribe their feelings of unreality to a lack of affective "colouring" in things perceived. Recent neuroimaging and psychophysiological studies support these assumptions as they show both attenuated autonomic responses in depersonalization, and decreased activity within neural regions important for the generation of affective responses to emotive stimuli. Furthermore, findings from neuroimaging studies indicate increased prefrontal cortical activity in depersonalised patients, particularly within regions associated with contextualization and appraisal of emotionally-salient information rather than mood induction per se. Taken together, these finding suggest that symptoms of depersonalization, and in particular emotional numbing, may be related to a reversal of normal patterns of autonomic and neural response to emotive stimuli.     

Reliability of multiple classifications

Cohen's kappa index is reformulated for multiple classifications based on exchangeable random variables. It is found that kappa is between 0 and 1 inclusive. Two characterizations for kappa are stated in terms of the relationship between such random variables. Within the normal test score model, kappa increases with test reliability and test length. Furthermore, when based on binary classifications, kappa is an inverse U-shaped function of the cutoff score. These trends also hold for the beta-binomial test score model.Paper read at the Spring meeting of the Psychometric Society, Bell Laboratories (Murray Hill, New Jersey), March 1976.The editorial assistance and helpful comments of Leonard S. Feldt, Sarah P. Seaman-Huynh, and the three referees are gratefully acknowledged.     

Characteristics of Clients Judged to Require Long-Term Counseling

This study examines one subgroup of clients seen at a university counseling center, namely, 72 clients who were expected by their counselor to remain in counseling for 10 or more interviews. Ratings were available on psychological characteristics for this sample and for the Counseling Center's total client population. In addition, the total university population could be compared with both of these groups on demographic characteristics. On the basis of pre- and post-counseling ratings of severity of problem, the sample being investigated was divided into Improved and Unimproved groups. Comparative data are examined with regard to class, college, sex, type of residence, type of problem, severity level at onset and termination, number of counseling interviews, motivation for counseling, defensiveness, and counselor's feelings toward client. Long-term counseling and improvement status are found to be a function of most of these variables.     

Schizophrenia and neuro-endocrine functional disorders--a case study on the problem of paranoid psychosis]

Schizophrenia and neuro-endocrine functional defects - a case report concerning the problem of paranoid psychosis: The case of a female patient with paranoic psychosis and endocrine defects has been reported. Under the present pathophysiological concepts the possibility of a combination of schizophrenic and neuro-endocrine symptomatic is suggested. The results of more recent investigations are discussed in respect of organic origin of schizophrenia that is based on potential reduction in the region of the limbic-hypothalamic nervous system.     

Cruelty and kinds: Scalia and Dworkin on the constitutionality of capital punishment

I here revisit a debate between Antonin Scalia and Ronald Dworkin concerning the constitutionality of capital punishment. As is well known, Scalia maintained that the consistency of capital punishment with the Eighth Amendment can be established on purely textualist principles; Dworkin denied this. There are, Dworkin maintained, two readings of the Eighth Amendment available to the textualist. But only on one of these readings is the constitutionality of capital punishment secured; on the other, ‘principled’, reading (favoured by Dworkin) it is not. Moreover, breaking the stalemate in favour of the former reading cannot be decided on textualist principles alone. To resolve the issue, Scalia (Dworkin argues) is forced to appeal to interpretive principles he has explicitly disavowed – principles that permit us to go beyond the text and invoke the framers’ intentions. In this paper, I argue that Dworkin has misdescribed the situation: there is in fact a plausible textualist argument that favours Scalia’s reading – one that, as per its textualist credentials, makes no reference to the framers’ intentions or expectations.     

Neurocognitive predictors of performance‐based functional capacity in bipolar disorder

Neurocognitive impairment can predict functional capacity in individuals with bipolar disorder, though little research has examined whether different neurocognitive domains impact specific types of tasks. This study examined the relationship between several neurocognitive variables and the UCSD Performance‐Based Skills Assessment (UPSA; Patterson et al., 2011) to identify the domains and tests that best predict the performance across the subscales. Forty‐seven euthymic participants who were diagnosed with either Bipolar I or Bipolar II were recruited and assessed on a battery of neuropsychological measures and the UPSA. Correlational and regression analyses were run to identify neurocognitive predictors of UPSA subscales. Per the literature, verbal learning and memory and executive function composites were first examined. Verbal learning and memory predicted the Communication subscale and Total score variables above and beyond the estimated FSIQ and symptom rating scales. In a secondary exploratory analysis, the Benton Judgment of Line Orientation subtest predicted the Finance subscale while the California Verbal Learning Test predicted the UPSA total score. Verbal learning and memory emerged as the strongest predictor of functional capacity, suggesting that this domain should be investigated in future mediational and longitudinal studies with the UPSA.     

从语言哲学看货币的本质

在当今中国现存经济学思想领域和大学正在施教的实际操作中,同时存在着几乎是不可通约的两大范式(paradigms):一是深深根植于古典经济学的马克思主义政治经济学,一是建立在边际分析基础之上的当代西方经济学。这两大经济学体系,不仅代表着两大分析套路截然不同的两种范式,甚至连它们所使用的语言也难以通约。尽管如此,在什么是货币和货币的职能是什么这类问题上,这两套经济学的分析语言体系却有着许多交叉和惊人的一致之处。严格来说,是当代西方主流经济学家们继承、吸纳了古典经济学家和马克思货币理论中的许多洞见,尽管他们拒绝了马克思的…     

Judged school problems and competencies of referred children with varying family background characteristics

The school adjustment problems and competencies of referred children with varying family background histories were compared. Children from homes characterized by low parent interest in education had more severe learning problems and fewer competencies than either matched referred controls without such a history or matched referred children under family pressure to succeed. The relationship of these findings to other studies of school adjustment and family background was considered.This research was done with grant support from the NIMH Experimental and Special Training Branch (MH 11820-06), which the authors acknowledge with gratitude.     

Finding genes for bipolar disorder in the functional genomics era: from convergent functional genomics to phenomics and back

Psychiatric genetics, while promising to unravel the mechanisms of psychiatric disorders, has proven to be a challenging field. Psychiatric disorders, like other common genetic traits, are complex and heterogeneous. Psychiatric genetics has also suffered from a lack of quantifiable, biology-based phenotypes. However, the field is currently at an opportune moment. The work of various investigators is on the verge of paying rich dividends. Efforts at positional cloning are being greatly accelerated by the fruits of the Human Genome Project. New tools of functional genomics, such as expression profiling and proteomics, are being applied to animal models. These two methods can complement each other in an approach we have termed convergent functional genomics. Lastly, improvements in the measurement of biologically distinct endophenotypes--or phenomic--will lead to a better understanding of the mapping of genes to phenotypes in both animal and human systems.     

Social identity and psychosis: Explaining elevated rates of psychosis in migrant populations

A substantial body of literature suggests that migrants are at greater risk of developing psychotic symptoms, such as paranoia, compared to non‐migrants. To date, researchers have been unable to identify the primary cause of this effect, finding scarce support for biological, diagnostic, and economic explanations. Social determinants have received little empirical attention in this domain, which we assert is a critical gap in the literature. Here, we propose that the social identity approach offers a framework to help explain the elevated rates of psychosis among migrants, and in turn inform policies and interventions to address this important mental health issue. We propose that cultural identities play a central role in mitigating the psychological precursors of psychosis and that disidentification and social disconnection subsequent to migration could initiate or exacerbate psychosis for multiple generations. We draw together research from social and clinical psychology to detail a social identity approach to psychosis in migrant populations, and make recommendations for future research.