Psychosocial Correlates of Suicidal Ideation in Adolescent Psychiatric Inpatients

The Beck Scale for Suicide Ideation (BSI) was administered to 121 inpatients between 12 and 17 years old who were diagnosed with mixed psychiatric disorders. Twelve background and clinical characteristics, previously found to be associated with adolescent suicidal ideation, were entered into a multiple regression to estimate the BSI scores, along with the Beck Anxiety Inventory, the revised Beck Depression Inventory (BDI), the Beck Hopelessness Scale (BHS), and the Youth Self-Report. The BHS and the BDI were the only two variables that contributed unique variance to the explanation of the BSI scores.     

The Clinical Application of MMPI Special Scales/MMPI Supplemental Scale Manual (Book)

Two studies involving a total of 200 participants examined the effect of individual versus group test administration on Rorschach Oral Dependency (ROD) scores. In Study 1, 60 college students completed the ROD scale via a group administration, and 60 students completed individual Rorschach protocols from which ROD scores were derived. Analyses revealed no differences in ROD means and standard deviations and no differences in the form of the ROD score distributions (i.e., skewness and kurtosis) as a function of mode of test administration. Virtually identical results were obtained in Study 2 (N = 80), where a within-participants design was used in lieu of the between-participants design of Study 1. Implications of these findings for the construct validity of the ROD scale are discussed.     

Clinical Correlates of MMPI Depression Scales

We investigated whether Scale 2 (Depression [D]) and the Wiggins Content Scale of Depression (DEP) of the Minnesota Multiphasic Personality Inventory (MMPI) have different clinical correlates when only one of these two scales is elevated. According, a group of patients who elevated DEP higher than Scale 2 (DEP > 2) were compared with a group of patients who elevated Scale 2 higher than DEP (2 > DEP). The patients with DEP > 2 were rated as being less severe than the patients with 2 > DEP on the following Brief Psychiatric Rating Scales: Somatic Concern (SOM), Emotional Withdrawal (WDRA), Depressive Mood (DEP), and Blunted Affect (AFF). The patients with DEP > 2 were rated as more severe on Excitement (EXC). The patients with DEP > 2 were more likely to receive the Axis I diagnoses of: bipolar disorder, manic, and alcohol abuse. Schizophrenia was equally probable for patients in the two groups. It appears that these two MMPI scales of depression have different clinical correlates when either one scale or the other is elevated.     

MMPI and Rorschach Indices of Schizophrenic and Depressive Diagnoses Among Adolescent Inpatients

Although adolescent norms have been developed for the MMPI (e.g., Marks, Seeman, & Haller, 1974) and Rorschach (e.g., Exner, 1986a), little is known regarding the discriminate diagnostic validity of these measures with adolescents. This study investigated the usefulness of these measures in the detection of depression and schizophrenia among adolescent inpatients. Subjects (mean age = 15.3) consisted of 134 adolescents who received Rorschach and MMPI administrations at hospital admission. Clinical diagnoses resulted in the following groupings for this sample: schizophrenia = 15, dysthymic disorder = 41, major depression = 26, conduct disorder = 28, personality disorder = 18. MMPI scale Sc elevation was found to be the most effective single predictor of schizophrenic diagnoses, with a hit rate of .76, sensitivity of .62, and specificity of .78. Neither MMPI scale D scores nor Rorschach DEPI scores were found to be significantly related to patients' diagnoses. Results were interpreted in terms of prior findings in adult psychiatric populations and in relation to implications for the clinical assessment of adolescents.     

The Construct Validity of the MMPI Alexithymia Scale With Psychiatric Inpatients

Relatively few studies have addressed the issue of the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale's construct validity. In this study, the validity of the scale is supported by the finding of a significantly lower percentage of alexithymic individuals in a large sample of psychiatric inpatients than in samples of patients with a variety of physical disorders (i.e., migraine headaches, asthma bronchitis/emphysema, and hypertension). Validity of the scale is further supported through a comparison of the alexithymic and nonalexithymic psychiatric inpatients on a series of Rorschach and MMPI variables. As predicted, alexithymics were less verbally productive, displayed less ability to fantasize, and demonstrated greater defensive pseudonormality. Results suggest the measure may be of value in studies of psychiatric patients as well as those with physical disorders.     

A Hostility Scale for the California Psychological Inventory: MMPI,Observer Q-Sort,and Big-Five Correlates

Using two samples, we developed and validated a hostility scale that can be scored from the California Psychological Inventory (CPI) and serves as an alternate for the Cook-Medley Hostility Scale (Ha; Cook & Medley, 1954). The CPI Hostility (H) scale consists of 33 items that are either duplicates or close equivalents of specific He items, and the two scales correlate at least .90 in samples differing in sex. The H and Ho scales show a similar pattern of correlations with conceptually relevant MMPI scales and with observer-rated personality attributes tapping Barefoot, Peterson, et al.'s (1991) five hostility categories of Hostile Affect, Cynicism, Aggressive Responding, Social Avoidance, and Hostile Attributions. These findings provide evidence for the equivalence of the two hostility scales, as well as external validation for those personality characteristics that are purported to underlie the construct of hostility as tapped by both the original Ho and the new CPI H scale.     

Clinical Utility of the MMPI in the Evaluation of Adolescent Suicide Attempters

MMPI profiles of female adolescents hospitalized on a general pediatrics floor following a suicide attempt were compared to a control group of medically hospitalized, female adolescents referred for psychiatric evaluation. The suicide attempters had only a lower score on the K scale when compared to the control group. Results do not suggest that a single MMPI profile differentiates suicide attempters from a comparison group of adolescents with emotional difficulties. Implications of these findings are discussed.     

Impulsivity and Suicidality in Adolescent Inpatients

Suicide is the second leading cause of death among adolescents, and impulsivity has emerged as a promising marker of risk. The present study tested whether distinct domains of impulsivity are differentially associated with suicide ideation, plans, and attempts. Adolescents (n?=?381; boys?=?106, girls?=?275) aged 13–19 years (M?=?15.62, SD?=?1.41) were recruited from an acute, residential treatment program. Within 48 h of admission to the hospital, participants were administered structured clinical interviews assessing mental health disorders and suicidality. Following these interviews, participants completed self-report questionnaires assessing symptom severity and impulsivity. Consistent with past research, an exploratory factor analysis of our 90-item impulsivity instrument resulted in a three-factor solution: Pervasive Influence of Feelings, Feelings Trigger Action, and Lack of Follow-Through. Concurrent analysis of these factors confirmed hypotheses of unique associations with suicide ideation and attempts in the past month. Specifically, whereas Pervasive Influence of Feelings (i.e., tendency for emotions to shape thoughts about the self and the future) is uniquely associated with greater suicidal ideation, Feelings Trigger Action (i.e., impulsive behavioral reactivity to emotions) is uniquely associated with the occurrence of suicide attempts, even after controlling for current psychiatric diagnoses and symptoms. Exploratory gender analyses revealed that these effects were significant in female but not male adolescents. These findings provide new insight about how specific domains of impulsivity differentially increase risk for suicide ideation and attempts. Implications for early identification and prevention of youth suicide are discussed.     

SCL--90--R Symptom Patterns for Adolescent Psychiatric Inpatients

We collected Symptom Check List-90-Revised (SCL-90-R) symptom pattern and severity data from a sample of 486 adolescent psychiatric inpatients. Preliminary comparison of these data with previously published data for adolescent nonpatients suggested no meaningful differences in overall symptom severity, although the data suggested higher Positive Symptom Distress index (PSDI) scores for inpatients, less severe somatization and psychoticism symptoms for inpatient males compared to nonpatient males, and more severe depressive symptoms for inpatient females compared to nonpatient females. Future studies should be directed toward farther analyses of such data and the development of representative and generalizable adolescent inpatient norms for the SCL-90-R.     

综合医院住院患者心理问题筛查量表的初编及临床意义探讨

编制简明实用的住院患者心理问题筛查量表,有助于临床工作中对心理问题的鉴别和处理。采用完全随机抽样,对某三甲综合医院住院患者进行调查,通过统计分析形成了20个条目的筛查量表,Cronbach＇s Alpha系数为0．797,分半信度为0．666,效标效度分别为0．524、0．525、0．476,最佳分界值为6分,其灵敏度为84．40／0,特异度为54．6％,阳性预测值为20．87％,阴性预测值为96．09％,曲线下面积为0．740。量表条目质量及信度、效度符合测量学要求,适合在综合医院患者中进行临床试用。     

The Difficulties in Emotion Regulation Scale: Factor Structure and Association with Nonsuicidal Self-Injury in Adolescent Inpatients

Research suggests that difficulties in emotion regulation are an important correlate of nonsuicidal self-injury (NSSI) in adults. Research examining this link in adolescents is limited by the lack of comprehensive instruments to assess difficulties in emotion regulation. Against this background, the aims of the current study were to (a) confirm the six-factor structure of the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, Journal of Psychopathology and Behavioral Assessment, 23(4), 253?C263, 2004) in a sample of adolescent inpatients (N?=?218); (b) explore the relation between different aspects of emotion dysregulation and lifetime NSSI while controlling for psychopathology and sex; and (c) assess the clinical utility of the DERS in detecting lifetime NSSI status. Fit indices obtained through Confirmatory Factor Analysis indicated that the six-factor structure of the DERS fit the data adequately and that most items loaded strongly on their respective latent factor. All six latent factors were significantly correlated with each other, with the exception of lack of emotional awareness and difficulties engaging in goal-directed behavioral when distressed. Regression analyses revealed that only the limited access to emotion regulation strategies subscale accounted for a significant portion of the variance in NSSI when controlling for other aspects of emotion dysregulation, sex, and psychopathology. Receiver Operating Characteristic analysis indicated that the DERS limited access to emotion regulation strategies subscale score has moderate diagnostic accuracy in detecting the presence of NSSI. The optimal cut-off score was 21.5 when detecting NSSI among inpatient adolescents. Results provide further support for the relation between emotion regulation difficulties and NSSI. The DERS appears to be a useful measure of detecting NSSI in clinical samples of adolescents.     

Clinical Correlates of the PRF Androgyny Scale in an Alcoholic Population

Clinical correlates of the PRF Andro were examined in an alcoholic population. Measures included the Sensation Seeking Scale, Eysenck Personality Inventory, Symptom checklist—the Cornell Medical Index and Rotter's Locus of Control. Of 28 possible relationships, only five measures were found to be weakly associated with androgynous subtypes. Androgynous subtypes appear largely unrelated to the psychological and physical health of alcoholics.     

Clinical Validity of a Dimensional Assessment of Self- and Interpersonal Functioning in Adolescent Inpatients

The Social Cognition and Object Relations Scale–Global Version (SCORS–G) is a clinical rating system assessing 8 domains of self- and interpersonal relational experience that can be applied to narrative response data (e.g., Thematic Apperception Test [TAT; Murray, 1943], early memories narratives) or oral data (e.g., psychotherapy narratives, relationship anecdotal paradigms). In this study, 72 psychiatrically hospitalized adolescents consented and were rated by their individual and group therapist using the SCORS–G. Clinicians also rated therapy engagement, personality functioning, quality of peer relationships, school functioning, global assessment of functioning (GAF), history of eating-disordered behavior, and history of nonsuicidal self-injury. SCORS–G composite ratings achieved an acceptable level of interrater reliability and were associated with theoretically predicted variables (e.g., engagement in therapy, history of nonsuicidal self-injury). SCORS–G ratings also incrementally improved the prediction of therapy engagement and global functioning beyond what was accounted for by GAF scores. This study further demonstrates the clinical utility of the SCORS–G with adolescents.     

MMPI Correlates with Locus of Control in a Psychiatric Population

In this article, I review the empirical status of the Rorschach as it relates to potential use of the instrument in personnel selection procedures. As part of this review, I outline developing trends in personnel selection practices, discuss the Rorschach literature relevant to organizational performance, and weigh the benefits and drawbacks of using the instrument in this capacity. Based on this analysis, I argue that the Rorschach may represent a unique and potentially valuable tool for assessing personality as part of comprehensive personnel selection procedures. I conclude with a proposed trajectory for Rorschach research intended to better determine the instrument's viability in organizational settings.     

MMPI Adolescent Norms: Patterns and Trends Across 4 Decades

This article examines central issues involving the accuracy of Minnesota Multiphasic Personality Inventory (MMPI) adolescent norms through examination of findings from eight investigations (n = 17,286), reporting MMPI mean values for samples of normal adolescents conducted between 1949 and 1964, and four studies (n = 1,758), based on adolescent samples collected since 1975. issues related to sex and racial differences in adolescent samples are also examined. In addition, MMPI data from 1,315 normal adolescents, collected at the Mayo Foundation, and from 217 normal adolescents, collected in Norfolk, Virginia, are evaluated in relation to adult normative values on the Harris-Lingoes (Harris & Lingoes, 1955) content subscales to identify unique characteristics of adolescents' response patterns. Results support the adequacy of the adolescent norms, developed by Marks, Seeman, and Hailer (1974), for evaluation of samples of normal adolescents collected between 1947 and 1965. MMPI patterns, produced by contemporary samples of adolescents collected since 1975, are elevated above the Marks et al. norms on most clinical scales. This latter finding indicated the need for the development of new adolescent norms that more precisely reflect current adolescent response frequencies and patterns. Finally, results from Harris-Lingoes subscales are reviewed to highlight unique aspects of adolescent developmental experience and to underscore the necessity of development of age appropriate adolescent norms for MMPI special scales.     

Family Correlates of Adolescent Self-Monitoring and Social Competence

The purpose of this study was to investigate linkages between adolescent self-monitoring, global social competence, and parenting and family environment dimensions of support and encouragement of autonomy. The sample consisted of 233 young women and 199 young men at 2 southwestern universities. The primary measures used were the Family Environment Scale (R. H. Moos, 1981), the Parent Behavior Form (L. Worell & J. Worell, 1974), the revised Self-Monitoring Scale (M. Snyder, 1987), and the Texas Social Behavior Inventory (R. Helmreich, J. Stapp, & C. Ervin, 1974). Findings indicated that family variables are more strongly associated with social competence than with self-monitoring; family support was, overall, a more important ingredient of social competence than was autonomy. Women and men had different patterns of associations among specific variables.