Reliability, diagnostic efficiency, and validity of the Millon adolescent clinical inventory: examination of selected scales in psychiatrically hospitalized adolescents

This study examined the internal consistency, diagnostic efficiency, and validity of selected scales of the Millon adolescent clinical inventory (MACI; Millon et al., Manual for the Millon Adolescent Clinical Inventory, National Computer Systems, Minneapolis, MN, 1993). 241 psychiatrically hospitalized adolescents were administered the MACI and a battery of established self-report measures and a multidisciplinary team independently assigned DSM-IV psychiatric diagnoses at the time of discharge. The internal consistency of MACI scales ranged from 0.71 to 0.93. Conditional probabilities (sensitivity, specificity, positive predictive power, and negative predictive power) were calculated for selected disorders using independently generated clinical diagnoses as the standard. The diagnostic efficiencies for the selected scales were variable, with adequate performance for predicting classes of diagnoses but not for specific diagnoses. The MACI showed good criterion validity for most disorders, with participants with a clinical diagnosis having a significantly higher corresponding MACI scale score than participants not assigned that diagnosis. Concurrent validity, tested by correlating MACI scale scores with those of relevant, validated measures, was generally good. The MACI appears to be a psychometrically sound self-report instrument and appears valuable as a screening instrument for many problems found in adolescent psychiatric inpatients.     

Night-time eating in men and women with binge eating disorder

This study examined the frequency of night-time eating (NE) and its correlates in men and women with binge eating disorder (BED). Two-hundred and seven consecutively evaluated adults (45 men and 162 women) with BED were assessed with semi-structured interviews and a battery of behavioral and psychological measures. Overall, 28% (N = 58) of the participants reported NE. A significantly higher proportion of men (42%) than women (24%) reported NE. Overall, participants who reported NE had a significantly higher body mass index, but otherwise differed little from those who did not report NE. Men and women without NE differed little on behavioral and psychological measures, whereas women with NE had significantly higher levels of eating-, weight-, and shape-concerns than men with NE.     

Factorial structure and diagnostic efficiency of DSM-IV criteria for avoidant personality disorder in patients with binge eating disorder

This study examined the factorial structure and diagnostic efficiency of the DSM-IV criteria for avoidant personality disorder (AVPD). Two hundred and twenty-eight consecutive outpatients (181 females and 47 males) with a primary diagnosis of binge eating disorder were reliably assessed with diagnostic interviews. Internal consistency of AVPD criteria was good, as suggested by coefficient alpha of 0.87, the pattern of inter-item correlations (range 0.41 to 0.64), and the lack of changes in alpha if any criteria are deleted. Exploratory factor analysis revealed a one-factor solution (56% of variance) supporting the unidimensionality of the AVPD criteria. Diagnostic efficiency indices (conditional probabilities, total predictive power, and kappa coefficients) were calculated for each AVPD criterion, for the entire study group and separately by gender. Overall, the best inclusion criterion was 'fears being ridiculed,' which was also the best predictor overall. These psychometric findings did not differ by gender. The findings support certain important aspects of the AVPD diagnosis.     

Prediction of children's empathy-related responding from their effortful control and parents' expressivity

In this study, the linear and interactive relations of children's effortful control and parents' emotional expressivity to children's empathy-related responses were examined. Participants were 214 children, 4.5 to 8 years old. Children's effortful control was negatively related to their personal distress and was positively related to their sympathy. Parents' positive expressivity was marginally negatively related to children's personal distress and was marginally positively related to children's dispositional sympathy. Parents' negative expressivity was positively related to children's personal distress, but primarily at high levels of children's effortful control. Moreover, parents' negative expressivity was negatively related to children's situational sympathy at low levels of effortful control but was positively related to children's dispositional sympathy at high levels of effortful control. There were also quadratic relations between the measures of parents' expressivity and children's empathy-related responses.     

Can small lesions induce language reorganization as large lesions do?

Shift of the cortical mechanisms of language from the usually dominant left to the non-dominant right hemisphere has been demonstrated in the presence of large brain lesions. Here, we report a similar phenomenon in a patient with a cavernoma over the anterolateral superior temporal gyrus associated with epilepsy. Language mapping was performed by two complementary procedures, magnetoencephalography, and electrocorticography. The maps, indicated right temporal lobe dominance for receptive language and left frontal lobe dominance for expressive language. These results indicate that a small lesion, associated with epilepsy, may produce selective shifting of receptive language mechanisms as large lesions have been known to produce.     

Temporal coherence of criteria for four personality disorders

This study sought to investigate the coherence of changes observed in diagnostic criteria for borderline, schizotypal, obsessive-compulsive, and avoidant personality disorders. Five hundred, forty-nine patients were independently evaluated 2 years apart, and correlations of observed changes in each diagnostic criterion with changes in other criteria were examined to determine if there was within-syndrome consistency in these changes. The observed changes in criteria were consistent within syndrome (median alpha = 0.72 across 4 disorders), and reasonably specific to that syndrome relative to the other disorders. The results support the validity of these criterion sets as representing coherent syndromes.     

Age differences in memory control: evidence from updating and retrieval-practice tasks

Some contemporary approaches suggest that inhibitory mechanisms play an important role in cognitive development. In addition, several authors distinguish between intentional and unintentional inhibitory processes in cognition. We report two experiments aimed at exploring possible developmental changes in these two types of inhibitory mechanisms. In Experiment 1, an updating task was used. This task requires that participants intentionally suppress irrelevant information from working memory. In Experiment 2, the retrieval-practice task was used. Retrieval practice of a subset of studied items is thought to involve unintentional inhibitory processes to overcome interference from competing memories. As a result, suppressed items become forgotten in a later memory test. Results of the experiments indicated that younger children (8) were less efficient than older children (12) and adults at intentionally suppressing information (updating task). However, when the task required unintentional inhibition of competing items (retrieval-practice task), this developmental trend was not found and children and adults showed similar levels of retrieval-induced forgetting. The results are discussed in terms of the development of efficient inhibition and the distinction between intentional and unintentional inhibitions.     

Small steps and big leaps in an era of cultural transition: a crisis in a traditional Kosovar Albanian family

This ethnographic vignette details the way a difficult crisis in an extended Kosovar family was managed by its own members within the mandates of that overtly patriarchal culture while creating important avenues for change. The cultural and historic context for these events is provided, and the nuances of this solution-oriented, culturally congruent, "natural" (i.e., not in a therapeutic context) process are discussed.