The Shedler-Westen Assessment Procedure-200 as a basis for modifying DSM personality disorder categories

The Shedler-Westen Assessment Procedure-200 (SWAP) is a Q-sort instrument designed to assess personality pathology on the basis of clinician ratings. On the basis of research with the SWAP, its creators have proposed a group of 12 personality disorder (PD) diagnoses that can be used to replace or modify current Axis II categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The authors discuss conceptual and empirical issues that require clarification before this proposal can be properly evaluated. They identify problematic psychometric features of the SWAP, including its unrepresentative normative sample, its reliance on a fixed skewed distribution, and anomalies in its T-score approach to diagnoses. In addition, a review of research on SWAP-based PD categories indicates that important information regarding diagnostic coverage, validity, and temporal stability is presently lacking. The authors conclude that research evidence is currently insufficient to justify the use of SWAP-based PD categories to guide revision of the DSM.     

Multidimensional Suicide Inventory-28 (MSI-28) Within a Sample of Military Basic Trainees: An Examination of Psychometric Properties

Suicide and suicidal ideation are serious public health concerns. Accurate detection and assessment are critical first steps in addressing this challenging issue. The present study examined self-reported suicidal ideation in a sample of United States Air Force enlisted active duty basic trainees (N = 470) using the Multidimensional Suicide Inventory (MSI-28). Exploratory factor analyses revealed a 4-factor structure for the MSI-28 in this sample. Together, these 4 factors explained approximately 72% of the variance in the MSI-28. The MSI-28 evidenced moderate to strong associations with measures of resilience (Dispositional Resilience Scale-15; DRS-15) and psychological distress (Outcome Questionnaire; OQ-30.2). These findings demonstrate that the MSI-28 is a promising tool for clinical measurement of self-reported suicidality. Future directions for further validation of the MSI-28 are discussed.     

The Impact of the United States Air Force Deployment Transition Center on Postdeployment Mental Health Outcomes

The United States Air Force Deployment Transition Center (DTC) operates a 2-day third-location decompression program that commenced operations during the summer of 2010 in Ramstein, Germany, with the aim to assist Air Force service members (AFSMs) who are returning from deployment as they prepare to reintegrate back into their home lives and work stations. The present study evaluated the impact of DTC attendance on later mental health outcomes. Because participants are not randomly assigned to attend the DTC, propensity score weighting was used to compare DTC participants (N = 1,573) to a weighted control group of AFSMs (N = 1,570) in the same job specialties who returned from deployment during the same time period. Rates of endorsement to items on the Postdeployment Health Reassessment were examined and compared, as were rates of mental health diagnoses from AFSMs’ official medical records. Key findings indicate that DTC participants reported lower levels of depressive and posttraumatic stress symptoms and lower levels of relationship conflict following return from deployment, as compared to weighted control participants. Mental health diagnostic rates were comparable for the 2 groups during the first 6 months following return from deployment. These findings suggest that participation in the DTC program had notable benefits for redeploying AFSMs and support the continued use of the program.     

A Minimalist Theory of Truth

This article, after briefly discussing Alfred Tarski's influential theory of truth, turns to a more recent theory of truth, a deflationary, or minimalist, theory. One of the chief elements of a deflationary, or minimalist, theory of truth is that it replaces the question of what truth is with the question of what “true” does. After setting out the central features of the minimalist theory of truth, the article explains the motivation for opting for such a position. In addition, it provides some reasons for thinking that such a theory of truth is “minimal” or “deflationary” in the way that contemporary truth theorists have claimed it to be.     

Coming to grips with negative evidence for the Comprehensive System for the Rorschach: a comment on Gacono, Loving, and Bodholdt; Ganellen; and Bornstein

The Comprehensive System (CS; Exner, 1991, 1993) for the Rorschach is currently engulfed in controversy. This comment article responds to 3 articles by Rorschach proponents in this issue of the Journal of Personality Assessment. Contrary to the claims of Gacono, Loving, and Bodholdt (this issue), CS scores do not bear a well-demonstrated relationship to psychopathy, antisocial personality disorder, or conduct disorder. Contrary to the claims of Ganellen (this issue), both the original and the revised CS Depression Index (Exner, 1993) bear little or no relationship to depression diagnoses. Furthermore, the scoring reliability of some CS scores is problematic. Although we agree with Bornstein (this issue) that Rorschach scores generally bear little or no relation to psychiatric diagnoses or self-report questionnaires, we believe this lack of relationship tends to disconfirm hypotheses concerning the validity of the Rorschach. In the spirit of the philosopher Sir Karl Popper, the Rorschach community should not minimize negative evidence or engage in post hoc arguments to immunize the CS against falsification.     

The diagnosis of neurological disorders in older adults

Are neurological disorders overdiagnosed in older adults? Previous reports suggest that age bias may lead to diagnostic inaccuracies for older adult clients. In the present study, the average test scores for community-dwelling 38-year-old and 74-year-old individuals were presented as the results for a 38-year-old client and a 74-year-old client, respectively. Neuropsychologists did not make diagnoses of neurological disorder or dementiafor either of the clients. The results from this study indicate that age bias is not as serious a problem among neuropsychologists as many psychologists once believed.