Predicting the completion of an integrative and intensive outpatient chronic pain treatment with the personality assessment inventory

The effects of intensive, integrative treatments for chronic pain are affected by patient compliance, and in many cases, selecting noncompliant individuals adversely impacts the cost-effectiveness of such programs. The pretreatment identification of individuals who are at risk for dropout could assist clinicians in augmenting treatments with motivational enhancement strategies for high-risk patients or using such information to select individuals who are most likely to complete a given intervention program. In this study, we tested the ability of indicators from the Personality Assessment Inventory (PAI; Morey, 1991), administered prior to treatment, to identify individuals who dropped out of a 20-day chronic pain program. Results replicate findings from outpatient psychotherapy research in finding that PAI Mean Clinical Elevation and Treatment Process Index significantly differentiated dropouts from graduates, particularly when the Treatment Rejection scale suggested patients were motivated for treatment. We discuss these results and offer recommendations for the prediction of treatment dropout in pain settings.     

Teacher expectations, classroom context, and the achievement gap

In two independent datasets with 1872 elementary-aged children in 83 classrooms, Studies 1 and 2 examined the role of classroom context in moderating the relationship between child ethnicity and teacher expectations. For Study 1 overall and Study 2 mixed-grade classrooms, in ethnically diverse classrooms where students reported high levels of differential teacher treatment (PDT) towards high and low achieving students, teacher expectations of European American and Asian American students were between .75 and 1.00 standard deviations higher than teacher expectations of African American and Latino students with similar records of achievement. In highly diverse low-PDT classrooms in Study 1 and highly diverse low-PDT mixed-grade classrooms in Study 2, teachers held similar expectations for all students with similar records of achievement. Study 3 estimated the contribution of teacher expectations to the year-end ethnic achievement gap in high- and low-bias classrooms. In high-bias classrooms, teacher expectancy effects accounted for an average of .29 and up to .38 standard deviations of the year-end ethnic achievement gap.     

In the Face of Uncertainty: A Twin Study of Ambiguous Information,Anxiety and Depression in Children

Anxiety and depression share genetic influences, and have been associated with similar cognitive biases. Psychological theories of anxiety and depression highlight threat interpretations of ambiguity. Little is known about whether genes influence cognitive style, or its links to symptoms. We assessed ambiguous word and scenario interpretations, anxiety and depression symptoms in 300 8-year-old twin pairs. There were significant correlations between both negative interpretations of ambiguous words and scenarios and depression symptoms after controlling for anxiety symptoms (r = .13 and .31, respectively), but no significant correlations with anxiety independent of depression. Genetic effects ranged from 16% for depression to 30% for ambiguous word interpretations. Non-shared environmental influences were large (68–70%). Both genetic and environmental influences contributed to the association between depression and ambiguous scenario interpretations. These findings support psychological theories, which emphasise the role of environmental stress both on the development of threat interpretations and on their links with symptoms. The data also support a role for genetic influence on threat interpretations, which may mediate responses to stress.     

Optimal Scoring of the Multidimensional Pain Inventory in a Chronic Pain Sample

The Multidimensional Pain Inventory (MPI) is one of the most commonly used self-report instruments in pain settings. The MPI can be used to classify patients into three clusters or its nine scales can be treated as dimensions in efforts to understand patient heterogeneity. Previous research suggests the existence of a fourth cluster, whose members have been labeled ‘repressors,’ that emerges with the addition of a defensiveness scale to the MPI. The current paper compared the abilities of MPI cluster and dimensional models with and without a measure of defensiveness to capture variability in validating variables related to personality, psychopathology, physical functioning, and treatment outcome in a chronic pain sample. Results suggest that dimensional models consistently outperform cluster models in explaining variance in outcome variables, and that the addition of a measure of defensiveness increments the validity offered by the MPI scales. Implications for the assessment of pain patients are discussed.

The description and classification of presidential threateners

Presidential threateners who received court-ordered psychiatric evaluations at the Medical Center for Federal Prisoners in 1981 and 1982 were studied. Using data from psychiatric reports and other background documents, the cases were analyzed according to demographic, legal, and psychiatric variables. Cases were also classified according to a system based on the characteristics of the threatener and the context in which the threat was made.