Attachment styles and clinical correlates in people at ultra high risk for psychosis

Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.     

The development and validation of an implicit measure of competence need satisfaction

Research on self-determination theory has typically relied on explicit measures when examining the concept of competence need satisfaction. As a result, we know relatively little about competence need satisfaction that arises under conditions of automaticity. Across four studies, we developed and validated implicit measures of competence need satisfaction by drawing on two tasks: a relational variant of the implicit association test (IAT; Study 1, 3, and 4) and the implicit relational assessment procedure (IRAP; Study 2–3). Results across these studies revealed that both implicit measures were either unrelated or moderately related to their explicit counterpart. They were also unrelated to one another. Unlike the IRAP, the IAT was found to be reliable, to display discriminant validity, and to yield meaningful but modest relations with constructs in a nomological network. Together, these results provide modest support for the usefulness of the competence need satisfaction IAT but not of the competence need satisfaction IRAP as an implicit measure of the need for competence. Future research examining the unique predictive value of this IAT is needed, together with research on possible explanations for the low reliability of the IRAP.     

Student-Teacher Relationships and Early School Adaptation of Children with ASD: A Conceptual Framework

In this conceptual article, we integrate existing literature on early school transitions, ecological systems theory, and student-teacher relationships to propose a framework for investigating the transition to school for children with autism spectrum disorders (ASD). A review of the literature suggests that the quality of early student-teacher relationships may play an important role in this process for young children with ASD. Factors important in predicting student-teacher relationship quality, and ultimately, early school outcomes, are derived from the existing literature, which is heavily focused on the experiences of typically developing children. Hypothesized direct effects of child characteristics, teacher factors, classroom/school characteristics, and parent-school connectedness on student-teacher relationship quality are set forth. Potential moderators of the relation between student-teacher relationship quality and child outcomes are proposed, including child cognitive functioning, child relationships with other school staff, classroom placement, and parent involvement. Continued research on these factors will help identify malleable targets for school-based intervention with teachers and children with ASD to enhance student-teacher relationship quality and, in turn, school adjustment for this student population.     

International Adaptations of the Millon Clinical Multiaxial Inventory: Construct Validity and Clinical Applications

This article examines the influence of the Millon Clinical Multiaxial Inventory (MCMI) as a clinical and research instrument beyond the borders of the United States. The MCMI's theoretical and empirical grounding, its alignment with the Diagnostic and Statistical Manual of Mental Disorders (DSM), and scales that can be interpreted both categorically and dimensionally, are the primary features that make the test attractive. We begin with studies that evaluated the construct equivalence of the different language adaptations. Data from the most widely researched non English-language forms (Danish, Dutch, and Spanish) show excellent comparability with Millon's original. Nevertheless, significant problems were noted in efforts to create clinical groups that would allow for equivalence of diagnostic accuracy when using the cutoff scores. Although dimensional aspects of the scale scores were not affected by this, the adapted measures might show attenuated diagnostic accuracy compared with Millon's original. Next, we present MCMI studies conducted in clinical settings to document where the adapted tests have made their greatest impact in the international literature. A wide variety of clinical applications demonstrated broad utility, and given the high number of issues addressed, we think Millon's influence will certainly stand the test of time in different domains and settings.     

The Effect of Motive‐Trait Interaction on Satisfaction of the Implicit Need for Affiliation Among German and Cameroonian Adults

Research provided evidence that personality traits influence the realization of implicit motives: Extraversion supported the successful realization of the implicit motives for affiliation and power, whereas introversion deflected implicit motives away from significant goals and created difficulties in goal attainment. Based on those findings on motive‐trait interaction, we tested whether the traits of Neuroticism, Agreeableness, and Extraversion affect the satisfaction of the implicit affiliation motive (i.e., the need for establishing and maintaining close relationships with other people) approximately 18 months later. Data on personality traits, the implicit affiliation motive, and need satisfaction were assessed from 244 Cameroonian and German adults. As expected, across cultural groups, Neuroticism constrains but Agreeableness supports the realization of the implicit affiliation motive. No significant results could be found for Extraversion, even if the effect was in the assumed direction. The findings support the argument that different significant personality components ought to be taken into account in research on implicit motives and their psychological and behavioral correlates.     

Dimensionality of stress experiences: Factorial structure of the Perceived Stress Questionnaire (PSQ) in a population‐based Swedish sample

We investigated the factorial structure of the Perceived Stress Questionnaire (PSQ‐recent; Levenstein, Prantera, Varvo et al., 1993) in a large (N = 1516; 35–95 years) population‐based Swedish sample (Nilsson, Adolfsson, Bäckman et al., 2004; Nilsson, Bäckman, Erngrund et al., 1997). Exploratory principal components analysis (PCA) was conducted on a first, randomly drawn subsample (n = 506). Next, the model based on the PCA was tested in a second sample (n = 505). Finally, a third sample (n = 505) was used to cross‐validate the model. Five components were extracted in the PCA (eigenvalue > 1) and labeled “Demands,” “Worries/Tension,” “Lack of joy,” “Conflict,” and “Fatigue,” respectively. Twenty‐one out of the 30 original PSQ items were retained in a confirmatory factor analysis (CFA) model that included the five (first‐order) factors and, additionally, a general (second‐order) stress factor, not considered in prior models. The model showed reasonable goodness of fit [χ²(184) = 511.2, p < 0.001; CFI = 0.904; RMSEA = 0.059; and SRMR = 0.063]. Multigroup confirmatory factor analyses supported the validity of the established model. The results are discussed in relation to prior investigations of the factorial structure of the PSQ.     

The mixed blessings of migration: Life satisfaction and self‐esteem over the course of migration

We investigated the psychological adaptation of Ingrian–Finnish migrants from Russia to Finland between 2008 and 2013. Pre‐migration data (N = 225) were collected at the Finnish language courses that were part of the immigration training program. The three post‐migration follow‐ups were conducted half a year (N = 155), and 2 (N = 133) and 3 years (N = 85) after migration. Well‐being was assessed with measures of Life Satisfaction and Self‐Esteem. Life Satisfaction increased from pre‐migration to the first post‐migration measurement point, after which it stabilized. Self‐Esteem decreased throughout the study. Variables reflecting adjustment to the event of migration (e.g., acculturation stress, socio‐cultural adaptation) were primarily associated with well‐being at the first post‐migration measurement point. More general determinants of well‐being (e.g., social support and subjective economic situation) were more consistently associated with well‐being throughout the study. The results suggest that migration can be beneficial to some but detrimental to other types of well‐being.     

Reducing the risk of bias in health behaviour change trials: Improving trial design,reporting or bias assessment criteria? A review and case study

Objective: It has been suggested that randomised controlled trials (RCTs) of health behaviour change (HBC) interventions are less rigorously designed than – for example– drug trials. This study presents an approach to clarifying whether this is due to poor trial design, incomplete trial reporting and/or the inappropriateness of commonly applied risk of bias assessment criteria.

Design: First, a framework of key sources of bias and common strategies for reducing bias risk is developed based on a literature review. Second, we describe the design of a multi-site RCT evaluating the cost-effectiveness of an HIV-treatment adherence intervention (case study). The choices made by the multidisciplinary team trying to minimise the risk of bias are compared against the risk of bias framework.

Main outcome measures: Implementation of common strategies for reducing the risk of bias in the case study; alternative or additional strategies applied; a justification for each deviation from the risk of bias framework.

Results: Most of the common strategies for reducing the risk of bias could be implemented. Alternative strategies were developed for minimising the risk of performance bias and contamination. Several additional, domain-specific risk of bias strategies were implemented.

Conclusions: The literature provides useful guidance for reducing the risk of bias in HBC trials. Yet, the case study suggests that HBC trial designers may face specific challenges that require alternative/additional measures for reducing the risk of bias. Using the risk of bias justification table (RATIONALE) could lead to better-designed HBC trials, more comprehensive trial reports and the data necessary for evaluating the appropriateness of commonly applied risk of bias assessment criteria to HBC trials.