Pharmacotherapy for the Pseudobulbar Affect in Individuals Who Have Sustained a Traumatic Brain Injury: a Systematic Review

Neuropsychology Review - Pseudobulbar affect is a debilitating condition that significantly reduces quality of life for many individuals following traumatic brain injury (TBI). It is characterized...     

MMPI-2 as a predictor of change in PTSD symptom clusters: a further analysis of the Forbes et al. (2002) data set

In this study, we reanalyzed the Forbes et al. (2002) data set to examine the Minnesota Multiphasic Personality Inventory (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) as a differential predictor of change across posttraumatic stress disorder symptom clusters following treatment in 141 Vietnam veterans. A series of partial correlation and linear multivariate regression analyses, controlling for initial symptom severity, identified several scales predictive of symptom change. None of the MMPI-2 scales, however, emerged as predictors of change in reexperiencing symptoms. Social alienation and marital distress were the most potent predictors for avoidance symptoms. Anger, alcohol use, and hypomania were the most potent predictors for the hyperarousal symptoms. Of the personality disorders, borderline personality was the strongest predictor of change in the avoidance and hyperarousal clusters. Further replication of the findings of this article and those reported by Forbes et al. (2002) is required.     

Extratest validity of selected personality assessment inventory scales and indicators in an inpatient substance abuse setting

The purpose of this study was to extend previous findings regarding the extratest validity of the Personality Assessment Inventory (Morey, 1991, 2007) scales and indicators in forensic contexts to an inpatient substance abuse setting. The Aggression Scale, and particularly the Physical Aggression subscale, related to assault history; the Suicide Scale and Suicide Probability Index related to history of suicide attempts; Antisocial Features, and particularly the Antisocial Behaviors subscale, predicted rule infractions; and the Treatment Process Index predicted treatment completion. We discuss clinical implications in the context of extant findings.     

Comparing the temporal stability of self-report and interview assessed personality disorder

Findings from several large-scale, longitudinal studies over the last decade have challenged the long-held assumption that personality disorders (PDs) are stable and enduring. However, the findings, including those from the Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000), rely primarily on results from semistructured interviews. As a result, less is known about the stability of PD scores from self-report questionnaires, which differ from interviews in important ways (e.g., source of the ratings, item development, and instrument length) that might increase temporal stability. The current study directly compared the stability of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) PD constructs assessed via the Schedule for Nonadaptive and Adaptive Personality (SNAP-2; Clark, Simms, Wu, & Casillas, in press) with those from the Diagnostic Interview for DSM-IV Personality Disorders (Zanarini, Frankenburg, Sickel, & Yong, 1996) over 2 years in a sample of 529 CLPS participants. Specifically, we compared dimensional and categorical representations from both measures in terms of rank-order and mean-level stability. Results indicated that the dimensional scores from the self-report questionnaire had significantly greater rank-order (mean r=.69 vs. .59) and mean-level (mean d=0.21 vs. 0.30) stability. In contrast, categorical diagnoses from the two measures evinced comparable rank-order (mean κ=.38 vs. .37) and mean-level stability (median prevalence rate decrease of 3.5% vs. 5.6%). These findings suggest the stability of PD constructs depends at least partially on the method of assessment and are discussed in the context of previous research and future conceptualizations of personality pathology.     

Evidence for the criterion validity and clinical utility of the Pathological Narcissism Inventory

In this study, the authors evaluated aspects of criterion validity and clinical utility of the grandiosity and vulnerability components of the Pathological Narcissism Inventory (PNI) using two undergraduate samples (N = 299 and 500). Criterion validity was assessed by evaluating the correlations of narcissistic grandiosity and narcissistic vulnerability with established indices of normal personality traits, psychopathology and clinical concerns, and pathological personality traits. Overall, the pattern of correlations supported the convergent and discriminant validity of grandiose and vulnerable conceptualizations of pathological narcissism as measured by the PNI. Clinical utility was assessed by evaluating the extent to which clinicians without specific training in pathological narcissism as well as clinicians with expertise in pathological narcissism could accurately predict the correlates of PNI grandiosity and vulnerability with normal and pathological personality traits and psychopathology. The r(contrast-cv) coefficient provided a global index of accuracy in clinicians' predictions that was more fully elaborated by examining systematic discrepancies across groups. Overall, novice and expert clinicians were generally able to predict criterion correlations, with some exceptions (e.g., counter to predictions, pathological narcissism was negatively associated with treatment resistance). These results provide further evidence regarding the validity and utility of the narcissistic grandiosity and narcissistic vulnerability constructs as measured by the PNI.     

Malingering on the Personality Assessment Inventory: Identification of Specific Feigned Disorders

Summary: Two nonverbal methods for assessing degree of interpersonal attraction were explored. Twenty children ranging from 11 to 13 years of age were asked to select two liked and two disliked classmates of the same sex. On four different trials, subjects selected one geometric block to represent themselves and one to represent a pre-selected classmate, then placed the figures on a ruled board. Distance between objects was measured and found to be significantly related to degree of peer liking. In addition, subjects were asked to draw each of the four peers. The human figure drawings were rated for total pictorial detail which was found to vary strongly across magnitude of liking for female subjects, and for parts integration which was found to vary with degree of peer liking for both sexes. The degree of rated positive affective tone of drawings was also found to increase with liking. Implications for the use of these two interpersonal assessment techniques in clinical practice were discussed.     

Connecting DSM-5 Personality Traits and Pathological Beliefs: Toward a Unifying Model

Dissatisfaction with the DSM-IV model of personality disorders has led to the development of alternative conceptualizations, including pathological trait models and models linked to particular theoretical approaches, such as Beck and Freeman’s (1990) cognitive framework. An important issue involves the potential to interweave such models into a single, parsimonious system that combines their distinct advantages. In this study, pathological trait and dysfunctional belief data from 616 individuals in a non-clinical sample were evaluated for commensurability using structural equation modeling. These models can be integrated via five higher-order factors, and that specific dimensions of dysfunctional beliefs can be differentiated based on features of the DSM-5 trait model. Overall, these results suggest that traits provide scaffolding for individual differences in pathological personality, within which dysfunctional beliefs offer specific vectors for clinical intervention in a cognitive framework. Implications of the empirical commensurability of trait and cognitive models are discussed.     

Genetic and environmental influences on personality trait stability and growth during the transition to adulthood: a three-wave longitudinal study

During the transition to adulthood individuals typically settle into adult roles in love and work. This transition also involves significant changes in personality traits that are generally in the direction of greater maturity and increased stability. Competing hypotheses have been offered to account for these personality changes: The intrinsic maturation hypothesis suggests that change trajectories are endogenous, whereas the life-course hypothesis suggests that these changes occur because of transactions with the social environment. This study investigated the patterns and origins of personality trait changes from ages 17 to 29 using 3 waves of Multidimensional Personality Questionnaire data provided by twins. Results suggest that (a) trait changes were more profound in the first relative to the second half of the transition to adulthood; (b) traits tend to become more stable during the second half of this transition, with all the traits yielding retest correlations between .74 and .78; (c) Negative Affectivity declined over time, and Constraint increased over time; minimal change was observed on agentic or communal aspects of Positive Emotionality; and (d) both genetic and nonshared environmental factors accounted for personality changes. Overall, these genetically informed results support a life-course perspective on personality development during the transition to adulthood.