The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion

In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined.     

The course of adult experiences of abuse in patients with borderline personality disorder and Axis II comparison subjects: a 10-year follow-up study

The first objective of this study was to assess the rates of adult experiences of verbal, emotional, physical, and sexual abuse reported by borderline patients and Axis II comparison subjects over 10 years of prospective follow-up. The second objective was to determine time-to-cessation, recurrence, and new onset of each type of abuse. The Abuse History Interview (AHI) was administered to 290 borderline patients and 72 Axis II comparison subjects at baseline. The AHI Follow-up Version (AHI-FUV) was administered at five contiguous follow-up waves. Over 10 years of follow-up, the rates of all four types of abuse declined significantly for borderline patients. For borderline patients, rates of cessation were high for all types of abuse (>90%). However, recurrences and new onsets of verbal and emotional abuse were relatively common (>60%). Contrastingly, they were relatively uncommon for physical and sexual abuse (<30%), suggesting that verbal and emotional abuse represent more stable forms of abuse.     

Parenting Young Children (PARYC): Validation of a Self-Report Parenting Measure

The measurement of parenting behaviors is important to the field of psychology and the goal of remediating problematic parenting as a means of reducing child problem behaviors. The Parenting Young Children (PARYC) is a self-report measure designed to address parenting behaviors relevant for the caregivers of young children, and was assessed in sample of 579 high risk families. The measure assesses the frequency of several parenting behaviors, the perception of the parenting behaviors as problematic, and the degree to which the caregiver would like to make changes in specific parenting skills. An examination of the validity of the parenting behavior items revealed three parenting scales: (1) Supporting Positive Behavior (2) Setting Limits, and (3) Proactive Parenting. Confirmatory factor analysis results corroborate the findings of the exploratory factor analysis, supporting the measurement structure of these parenting scales. Tests of convergent validity indicate the PARYC scale is a suitable measure of parenting behaviors. In addition, the self-perception of parenting behaviors as problematic predicted concurrent levels of service utilization while controlling for simultaneous child behavior problems.     

Job and educational level of company managers: their relations with job satisfaction

In a previously published study, we used a Satisfaction Inventory to measure the job satisfaction of managerial staff (the Inventaire de Satisfaction Appliqué aux Cadres , ISAC). The method of construction and certain metric qualities of the inventory were explained (Frances, 1983).