Toward a Model-Based Approach to the Clinical Assessment of Personality Psychopathology

Recent years have witnessed tremendous growth in the scope and sophistication of statistical methods available to explore the latent structure of psychopathology, involving continuous, discrete, and hybrid latent variables. The availability of such methods has fostered optimism that they can facilitate movement from classification primarily crafted through expert consensus to classification derived from empirically based models of psychopathological variation. The explication of diagnostic constructs with empirically supported structures can then facilitate the development of assessment tools that appropriately characterize these constructs. Our goal in this article is to illustrate how new statistical methods can inform conceptualization of personality psychopathology and therefore its assessment. We use magical thinking as an example, because both theory and earlier empirical work suggested the possibility of discrete aspects to the latent structure of personality psychopathology, particularly forms of psychopathology involving distortions of reality testing, yet other data suggest that personality psychopathology is generally continuous in nature. We directly compared the fit of a variety of latent variable models to magical thinking data from a sample enriched with clinically significant variation in psychotic symptomatology for explanatory purposes. Findings generally suggested a continuous latent variable model best represented magical thinking, but results varied somewhat depending on different indexes of model fit. We discuss the implications of the findings for classification and applied personality assessment. We also highlight some limitations of this type of approach that are illustrated by these data, including the importance of substantive interpretation, in addition to use of model fit indexes, when evaluating competing structural models.     

Correlations between psychometric schizotypy,scan path length,fixations on the eyes and face recognition

Psychometric schizotypy in the general population correlates negatively with face recognition accuracy, potentially due to deficits in inhibition, social withdrawal, or eye-movement abnormalities. We report an eye-tracking face recognition study in which participants were required to match one of two faces (target and distractor) to a cue face presented immediately before. All faces could be presented with or without paraphernalia (e.g., hats, glasses, facial hair). Results showed that paraphernalia distracted participants, and that the most distracting condition was when the cue and the distractor face had paraphernalia but the target face did not, while there was no correlation between distractibility and participants’ scores on the Schizotypal Personality Questionnaire (SPQ). Schizotypy was negatively correlated with proportion of time fixating on the eyes and positively correlated with not fixating on a feature. It was negatively correlated with scan path length and this variable correlated with face recognition accuracy. These results are interpreted as schizotypal traits being associated with a restricted scan path leading to face recognition deficits.     

Using stressful films to analyze risk factors for PTSD in analogue experimental studies – which film works best?

Abstract

To understand mental disorders, analogue paradigms provide an indispensable contribution. In posttraumatic stress disorder (PTSD), the stressful film paradigm is a frequently used analogue approach: Films depicting traumatic events are shown to non-clinical participants in order to elicit stress responses analogue to responses to traumatic events in real life. Previous studies used a large variety of films, which is problematic with regard to the comparability of results. The main goal of this study was to identify a film clip that (a) consistently provokes stress reactions and (b) provokes reactions that are as similar as possible to traumatic stress.

We randomly exposed 105 male and female participants to one of four stressful films, differing, e.g., in content and origin. Intrusive memories of the film, reported immediately after the film and during a diary phase of three days, as well as distress, heart rate, and several mood states were measured. A film clip depicting rape elicited the most consistent reactions that were characterized by a higher heart rate, more distress and more intrusive memories, compared to the other three clips. Intrusive memories across all films were especially related to an increase in heart rate and disgust in response to the film.     

Emerging perspectives on the structure and function of attitude strength

For more than 20 years, scholars have used the term “attitude strength” to refer to the durability and impactfulness of attitudes, and a large literature attests to the important leverage that this concept offers for understanding and predicting behaviour. Despite its prominence, however, a number of fundamental questions remain regarding the structure and function of attitude strength. In this chapter we draw on a wide range of evidence to clarify the nature of attitude strength. Rather than conceiving of attitude strength as a meaningful psychological construct, we argue that it is better conceptualised as an umbrella term that refers in only the most general way to multiple, separable classes of attitude outcomes, instigated by different antecedents and produced by distinct psychological processes. Although strong attitudes share a set of general qualities—resistance to change, persistence over time, impact on thought and behaviour—there are many distinct routes by which attitudes come to possess these qualities, and many diverse ways in which these qualities manifest themselves. Our analysis shifts the focus away from the structural properties of attitude strength and towards a fuller appreciation of the distinct sources from which attitudes derive their strength. We argue in particular for the value of attending more closely to the social bases of attitude strength, and we illustrate the value of this approach by reviewing several lines of research.     

Genetic and Environmental Transmission of Political Orientations

This article reports results from the first twin study of adults in the United States that focuses exclusively and comprehensively on political traits. These data allow us to test whether a common set of genetic and environmental influences act upon a broad variety of values, personality traits, and political attitudes. In short, it allows us to empirically investigate whether there are a core set of predispositions that form the basis of our political orientations and, if so, whether these predispositions are shaped by the same environmental and innate forces. The key finding from our analysis is that there are core political predispositions that are rooted in common genetic and environmental influences and that these predispositions are empirically distinct from broader personality traits.     

Prevalence and correlates of hoarding behavior in a community-based sample

Little is known about the prevalence and correlates of hoarding behavior in the community. We estimated the prevalence and evaluated correlates of hoarding in 742 participants in the Hopkins Epidemiology of Personality Disorder Study. The prevalence of hoarding was nearly 4% (5.3%, weighted) and was greater in older than younger age groups, greater in men than women, and inversely related to household income. Hoarding was associated with alcohol dependence; paranoid, schizotypal, avoidant, and obsessive-compulsive personality disorder traits; insecurity from home break-ins and excessive physical discipline before 16 years of age; and parental psychopathology. These findings suggest that hoarding may be relatively prevalent and that alcohol dependence, personality disorder traits, and specific childhood adversities are associated with hoarding in the community.     

Is human decision making under ambiguity guided by loss frequency regardless of the costs? A developmental study using the Soochow Gambling Task

Converging developmental decision-making studies have demonstrated that until late adolescence, individuals prefer options for which the risk of a loss is low regardless of the final outcome. Recent works have shown a similar inability to consider both loss frequency and final outcome among adults. The current study aimed to identify developmental changes in feedback-monitoring ability to consider both loss frequency and final outcome in decision making under ambiguity. Children, adolescents, and adults performed an adapted version of the Soochow Gambling Task. Our results showed that children and adolescents presented an exclusive preference for options associated with infrequent punishment. In contrast, only adults seemed to consider both loss frequency and the final outcome by favoring the advantageous options when the frequency of losses was low. These findings suggest that the ability to integrate both loss frequency and final outcome develops with age. Moreover, the analysis of strategic adjustments following gains and losses reveals that adults switch less often after losses compared with children and adolescents. This finding suggests that psychological tolerance to loss may facilitate learning the characteristics of each option and improve the ability to choose advantageously.     

Gadamer: Psychotherapy as conversation

Outcome research into psychotherapy shows that therapeutic approaches may all be equally valid forms of therapy despite the mutually exclusive theories on which they are based. Reviews of what therapists do in practice suggest a largely atheoretical and eclectic approach in which non-specific factors such as empathy, clinical management and persuasion are prominent. This paper proposes that a hermeneutic approach based on the work of the German philosopher Hans-Georg Gadamer can be useful in providing a non-dogmatic basis for therapy which makes room for these non-specific qualities. It outlines a hermeneutic mode of therapy and shows how this can allow for the rhetorical, interpretative and poetic dimensions of therapy-in-action.     

Perceptions of stressful life events as turning points are associated with self-rated health and psychological distress

Abstract

We test the hypothesis that changes in physical and psychological health are associated with construals of stressful life events. At two points in time, approximately 10 years apart, participants (n=1038) rated their physical health and psychological distress. At the second assessment, participants also reported their most stressful life event since the first assessment and indicated whether they considered the event a turning point and/or lesson learned. Lower self-ratings of health and higher ratings of psychological distress, controlling for baseline health and distress, and relevant demographic factors, were associated with perceiving the stressful life event as a turning point, particularly a negative turning point. The two health measures were primarily unrelated to lessons learned. How individuals construe the most stressful events in their lives are associated with changes in self-rated health and distress.