Using the Millon Behavioral Medicine Diagnostic (MBMD) to Evaluate the Need for Mental Health Services in Association with Biomarkers of Disease Status Among HIV Positive Men and Women

Psychological distress states have been related to rate of disease progression among HIV-positive individuals. However, the measures that have been used in this research as well as the treatment context of the populations studied are highly variable, making it challenging for clinicians to incorporate such measures into screening batteries. The present study examined the association of two summary scales of the Millon Behavioral Medicine Diagnostic (MBMD; Millon et al., Millon Behavioral Medicine Diagnostic. NCS Assessments, Minneapolis, 2001), with markers of HIV disease status (CD4 and CD8 cell counts, viral load) among an ethnically diverse sample of 147 HIV-positive individuals (52 men who have sex with men, 34 men who have sex with women, and 51 women) who had recently initiated Highly Active Antiretroviral Therapy (HAART). After controlling for age and months since HIV diagnosis, we found that higher scores on the overall MBMD Psych Referral Summary Scale, reflecting a need for mental health treatment, were related to greater HIV viral load but did not relate to CD4 or CD8 cell counts. Subgroup analyses revealed that Psych Referral scores were related to greater HIV viral load only for the men who have sex with men (MSM) subgroup. These results suggest that the MBMD may help in identifying psychosocial characteristics associated with some markers of disease status in persons with HIV and perhaps may also be useful in identifying individual differences in response to treatment and eventual disease outcome.     

Methods and mechanisms in the efficacy of psychodynamic psychotherapy

Comments on the original article, "The efficacy of psychodynamic psychotherapy," by J. Shedler (see record 2010-02208-012). Shedler summarized a large body of research that shows psychodynamic therapy to have a substantial effect size, comparable to that for many empirically supported treatments. This is an important finding, in part refuting the concerns raised by Bornstein (2001, 2002) regarding the future of psychodynamic approaches had there been no substantial changes in how practitioners and researchers approached the science to demonstrate efficacy. Further, Shedler showed that the efficacy of psychoanalytic psychotherapy is due to therapeutic methods commonly employed in cognitive behavior therapy (CBT), one of the most frequently cited empirically supported approaches for a wide range of psychological conditions. From a methodological perspective, there are some important limitations to the claim of psychodynamic psychotherapy's comparable efficacy to other empirically supported approaches.     

Affective Forecasting Errors in the 2008 Election: Underpredicting Happiness

Individuals tend to be very bad at predicting their emotional responses to future events, often overestimating both the intensity and duration of their responses, particularly to negative events. The authors studied affective forecasting errors in the 2008 election in a large sample of undergraduates at Dartmouth College. Replicating past research, McCain supporters overpredicted their negative affect in response to the (future) election of Barack Obama. Obama supporters, however, underpredicted their happiness in response to his victory. Results are discussed with reference to mechanisms proposed to underlie the impact bias, as well as the unique circumstances surrounding this historic election season.     

Late adolescent nonsuicidal self-injury: the roles of coping style, self-esteem, and personality pathology

This study examined the relationship between late adolescent nonsuicidal self-injury (NSSI) and coping style, self-esteem, and personality pathology. Participants were 302 late adolescent (18-19-year-old) college students who completed questionnaires on self-esteem, coping style, personality disorder symptoms, and NSSI. Participants who engaged in NSSI reported more personality pathology, more maladaptive coping styles, less rational coping, and lower self-esteem than did non self-harming participants. As hypothesized, total NSSI correlated with several personality disorders, emotional coping style, and inversely related to self-esteem and adaptive coping styles. Regression equations tested several mediation models to determine whether self-esteem or coping style mediates the relationship between personality disorder symptoms and NSSI. Emotional coping and self-esteem each fully mediated the relationship between various personality disorders and NSSI in the anticipated direction. Results also indicate self-esteem, rational, detached, and emotional coping partially mediate the relationship between several personality disorders and NSSI.     

Getting to the Root of Relationship Attributions: Family-of-Origin Perspectives on Self and Partner Views

A large body of research has been devoted to the study of family-of-origin (FOO) experience influences on future relationship outcomes and processes. In addition, substantial information exists regarding the role relationship attributions play in connection with relationship quality and stability. Yet, limited information has been forthcoming regarding how the FOO experience has an influence on attributions made in romantic relationships. Structural Equation Modeling (SEM) was employed to assess the impact of the FOO experience on attributions made about one’s own communication and personality variables, as well as the communication and personality variables of one’s partner from a sample of individuals who had completed the RELATionship Evaluation (N = 6,649). Results show evidence of a relationship between the FOO experience and the attributions made about oneself and one’s partner. Results were particularly pronounced for the communication variables. Gender differences also were found. The utility of study findings for couple and family researchers and practitioners is discussed.     

Diverse Perceptions of the Informed Consent Process: Implications for the Recruitment and Participation of Diverse Communities in the National Children’s Study

We examined the experiences, perceptions, and values that are brought to bear when individuals from different ethnic and cultural backgrounds consider participating in health research. Fifty-three women from Latino, Asian American, Middle Eastern, or Non-Latino, White backgrounds participated in seven English or Spanish focus groups facilitated by trained investigators using a standard protocol. Investigators described the National Children’s Study (NCS) and then asked questions to elicit potential concerns, expectations, and informational needs. Group sessions were audio-recorded, transcribed verbatim, and analyzed using qualitative thematic methods. A major theme that emerged during focus groups was participant self-identification as a member of a cultural group or community when raising issues that would influence their decision to participate in research. A related theme was the belief by some that communities may differ in the ease of participation in the NCS. Identified themes related to the informed consent process included perceived risks, anticipated burden, perceived benefits, informational needs, and decision-making strategies. Although themes were shared across groups, there were cultural differences within themes. Findings indicated that individuals from diverse backgrounds may have different perspectives on and expectations for the research process. To effectively recruit representative samples, it will be important to address a range of issues relevant for informed consent and to consider the impact of participation on both individuals and communities.     

A brief primer on sleep for pediatric and child clinical neuropsychologists

Sleep problems are common in the children seen by pediatric and child clinical neuropsychologists, and these problems have the potential to significantly impact the child and his or her family. All are treatable to some degree, and some respond extremely well to existing treatments. This article provides a brief overview of the impact, nature, screening, and treatment for childhood sleep problems, with a particular emphasis on issues relevant to practicing neuropsychologists.     

Development and initial validation of the medical fear survey-short version

The present investigation employs item response theory (IRT) to develop an abbreviated medical fear survey (MFS). Application of IRT analyses in study 1 (n = 931) to the original 50-item MFS resulted in a 25-item shortened version. Examination of the location parameters also resulted in a reduction of the Likert-type scaling of the MFS by removing the last response category ("terror"). The five subscales of the original MFS were highly correlated with those of the MFS-short version. The short version also displayed comparable convergent and discriminant validity with the original MFS in relation to measures of fear, disgust, and anxiety. Confirmatory factor analysis in Study 2 revealed that the five-factor structure of the MFS-short form fit the data well in U.S. (n = 283) and Dutch (n = 258) samples. The short form also had comparable convergent and discriminant validity with the original MFS in relation to domains of disgust in both samples. Receiver operating characteristic (ROC) analysis in Study 3 demonstrated that the subscales of the short version were comparable with the original MFS in classifying participants high (n = 40) and low (n = 40) in blood/injection phobia. Last, structural equation modeling in Study 4 (n = 113) revealed that the MFS-short form demonstrated excellent convergent/discriminant validity with strong associations with injection fear and no association with spider fear. These findings suggest that the MFS-short form has considerable strengths, including decreased assessment time, while retaining sound psychometric properties.     

Developing work–family balance through conflict management*

An often‐neglected perspective is that work–family incompatibilities are not only intrapersonal role conflicts but also typically involve interpersonal conflicts. This study adopts an episodes approach and uses the theory of cooperation and competition to understand the interaction that promotes resolving work–family conflict incidents. Two‐hundred and four Chinese dual‐career parents each described a specific work–family conflict incident and responded to specific questions to code the interaction. Structural equation analyses indicated that cooperative goals facilitated constructive controversy that in turn promoted high quality resolutions, strong relationships, and confidence in the future of their work and family lives.