Prevalence of DSM-IV borderline personality disorder in two community samples: 6,330 English 11-year-olds and 34,653 American adults

This study had two main objectives. The first was to assess the prevalence of DSM-IV borderline personality disorder and its constituent symptoms in a community sample of late-latency children. The second was to compare these rates to those found in a community sample of American adults. A birth cohort of 6,330 11-year-old children in Bristol, England, was interviewed concerning borderline psychopathology in 2002-2004. A community sample of 34,653 American adults was interviewed about borderline psychopathology in 2004-2005. Rates of chronic emptiness, physically self-damaging acts, and stormy relationships were very similar in both samples (<2% difference). However, a significantly higher percentage of children than adults reported being angry and moody. In contrast, a significantly higher percentage of adults than children reported being paranoid/dissociated, having a serious identity disturbance, being impulsive, and making frantic efforts to avoid abandonment. In addition, a significantly higher percentage of adults than children met DSM-IV criteria for BPD (5.9% vs. 3.2%). Statistically significant but clinically minor gender differences were also found between girls and boys as well as men and women. Taken together, the results of this study suggest that late-latency children are about half as likely as adults to meet DSM-IV criteria for BPD. They also suggest that gender does not play a defining role in symptom expression.     

Examining classification criteria: a comparison of three cut score methods

This study compared 3 different methods of creating cut scores for a screening instrument, T scores, receiver operating characteristic curve (ROC) analysis, and the Rasch rating scale method (RSM), for use with the Behavioral and Emotional Screening System (BESS) Teacher Rating Scale for Children and Adolescents (Kamphaus & Reynolds, 2007). Using the BESS norm data set, we compared the methods across 7 classification indices. Additional information about accuracy was used with a subset of children who had been given a prior diagnosis for selected disorders. The results showed that the methods were generally in concordance, with similarities identified across methods. RSM and ROC analysis methods performed similarly, with both methods identifying the same optimal cut-point. The method based on T scores appeared to be more conservative, identifying a lower cut score as optimal.     

Experiences and perspectives of African American, Latina/o, Asian American, and European American psychology graduate students: A national study

A national, Web-based survey of 1,219 African American, Latina/o, Asian American, and European American psychology graduate students revealed both similarities and differences in experiences and perspectives. Mentoring was found to be the strongest predictor of satisfaction across groups. Academic supports and barriers, along with perceptions of diversity within the academic environment, were also important predictors of satisfaction. Students of color perceived less fairness of representation of their ethnic group within psychology than European American students, and a greater linkage between aspects of the graduate school experience and their ethnicity. Limitations of the study and implications for future research and action are discussed.     

Integration of the pleasant events and activity restriction models: development and validation of a "PEAR" model of negative outcomes in Alzheimer's caregivers

This study examined an activity restriction/pleasurable activities mismatch model for psychosocial and health-related outcomes. A total of 108 spousal caregivers of patients with Alzheimer's Disease (AD) were assessed for their experience of social and recreational activities over the past month as well as their perception of how restricted they were for engaging in social and recreational activities. Participants were divided into three groups based on their reported activities and activity restriction: HPLR = High Pleasant Events + Low Activity Restriction (i.e., reference group; N = 28); HPHR/LPLR = Either High Pleasant Events + High Activity Restriction or Low Pleasant Events + Low Activity Restriction (N = 43); LPHR = Low Pleasant Events + High Activity Restriction (N = 37). We hypothesized that participants reporting low pleasant events combined with high activity restriction (LPHR) would demonstrate greater disturbance relative to other two groups in multiple outcome domains, including: (a) greater mood disturbance, (b) greater use of negative coping factors, (c) reduced use of positive coping strategies, (d) reduced report of psychological resource factors (e.g., personal mastery, self-efficacy), and (e) increased report of subjective health difficulties (e.g., sleep disturbance). Results generally supported our hypotheses, suggesting that assessment of both constructs is important for best predicting quality of well-being in AD caregivers, and potentially for establishing maximal effect in behavior therapy for caregivers.     

Distinguishing general and specific personality disorder features and implications for substance dependence comorbidity

Clinical and population-based samples show high comorbidity between Substance Use Disorders (SUDs) and Axis II Personality Disorders (PDs). However, Axis II disorders are frequently comorbid with each other, and existing research has generally failed to distinguish the extent to which SUD/PD comorbidity is general or specific with respect to both specific types of PDs and specific types of SUDs. We sought to determine whether ostensibly specific comorbid substance dependence-Axis II diagnoses (e.g., alcohol use dependence and borderline personality disorder) are reflective of more pervasive or general personality pathology or whether the comorbidity is specific to individual PDs. Face-to-face interview data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were analyzed. Participants included 34,653 adults living in households in the United States. We used hierarchical factor models to statistically partition general and specific personality disorder dimensions while simultaneously testing for specific PD-substance dependence relations. Results indicated that substance dependence-Axis II comorbidity is characterized by general (pervasive) pathology and by Cluster B PD pathology over and above the relationship to the general PD factor. Further, these relations between PD factors and substance dependence diagnoses appeared to largely account for the comorbidity among substance dependence diagnoses in the younger but not older participants. Our findings suggest that a failure to consider the general PD factor, which we interpret as reflecting interpersonal dysfunction, can lead to potential mischaracterizations of the nature of certain PD and SUD comorbidities.     

A Pilot Study of Psychotherapist Trainees' Alpha-Amylase and Cortisol Levels During Treatment of Recently Suicidal Clients With Borderline Traits

Psychotherapists often experience stress while providing psychotherapy, in particular when working with difficult presentations such as suicidality. As part of a larger study on the treatment of recently suicidal college students with borderline traits, 6 therapists in training collected their own salivary samples for alpha-amylase (AA) and cortisol (C) analyses immediately before and after sessions with 2 selected clients. On average, samples were collected for the same therapist-patient dyad throughout the year-long study to ensure that data reflected therapist responses across stages of treatment. Therapists also completed a working alliance questionnaire and rated perceived session difficulty immediately after each selected session. Contrary to expectations, therapists demonstrated elevated levels of stress as measured by AA and C at presession relative to postsession levels. Greater session difficulty was related to more pronounced declines in AA, whereas a stronger working alliance was linked to more pronounced reductions in C. Results suggest that physiological stress responses while working with recently suicidal clients with borderline traits occur primarily in terms of session anticipatory anxiety, whereas AA and C changes may be affected differently by factors such as session difficulty and working alliance. This is a pilot study, limited by its sample size, but the design, findings, and inclusion of physiological measures present an initial step in an essential line of research.     

A mutual acculturation model of multicultural campus climate and acceptance of diversity

This study examines the relationship between college students' perceptions of their campus' multicultural climate and their acceptance of racial/ethnic diversity. A two-mediator model, based on acculturation principles, was successfully fit to survey data from 434 college students of diverse racial/ethnic heritage. Results showed that valuing positive interactions with members of ethnocultural groups other than one's own is a positive mediator and strength of ethnocultural identity is a (much less important) negative mediator of the relationship between student perceptions of multicultural campus programming and personal acceptance of diverse racial/ethnic groups. Furthermore, each mediator independently contributed to the prediction of such acceptance. Overall, the model accounts for about 25% of the variance in acceptance of diversity and was a better fit to the data than a reverse path model. Follow-up analyses, separately by ethnic group, showed that perceptions of campus programming predicted acceptance of diversity for the White subsample, but not for the Latino subsample. Nevertheless, the two acculturation-related constructs were important for both groups, with the model accounting for 28% and 24% of their respective variances in acceptance of diversity. Practical implications are drawn.     

Should Happiness-Maximization be the Goal of Government?

Recent social surveys of happiness (subjective well-being) have given a new stimulus to utilitarian political theory by providing a statistically reliable measure of the ‘happiness’ of individuals that can then be correlated with other variables. One general finding is that greater happiness does not correlate strongly with increased wealth, beyond modest levels, and this has led to calls for governments to shift priorities away from economic growth and towards other social values. This paper notes how the conclusions of this research help to address some of the traditional objections to utilitarianism. The question of how happiness research findings can be used to set happiness-maximization goals for public policy needs careful examination, as the translation from research to policy is not always straightforward. Some empirical and ethical objections to this ‘new utilitarianism’ are raised. The complicating factors of public expectations of, and trust in, governments pose obstacles to any proposal that happiness research may lead to changes in public policy and hence to ‘happier’ populations.     

Bilateral capacity for speech sound processing in auditory comprehension: evidence from Wada procedures

Data from lesion studies suggest that the ability to perceive speech sounds, as measured by auditory comprehension tasks, is supported by temporal lobe systems in both the left and right hemisphere. For example, patients with left temporal lobe damage and auditory comprehension deficits (i.e., Wernicke's aphasics), nonetheless comprehend isolated words better than one would expect if their speech perception system had been largely destroyed (70-80% accuracy). Further, when comprehension fails in such patients their errors are more often semantically-based, than-phonemically based. The question addressed by the present study is whether this ability of the right hemisphere to process speech sounds is a result of plastic reorganization following chronic left hemisphere damage, or whether the ability exists in undamaged language systems. We sought to test these possibilities by studying auditory comprehension in acute left versus right hemisphere deactivation during Wada procedures. A series of 20 patients undergoing clinically indicated Wada procedures were asked to listen to an auditorily presented stimulus word, and then point to its matching picture on a card that contained the target picture, a semantic foil, a phonemic foil, and an unrelated foil. This task was performed under three conditions, baseline, during left carotid injection of sodium amytal, and during right carotid injection of sodium amytal. Overall, left hemisphere injection led to a significantly higher error rate than right hemisphere injection. However, consistent with lesion work, the majority (75%) of these errors were semantic in nature. These findings suggest that auditory comprehension deficits are predominantly semantic in nature, even following acute left hemisphere disruption. This, in turn, supports the hypothesis that the right hemisphere is capable of speech sound processing in the intact brain.