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.     

Item analysis and differential item functioning of a brief conduct problem screen

Research has shown that boys display higher levels of childhood conduct problems than girls, and Black children display higher levels than White children, but few studies have tested for scalar equivalence of conduct problems across gender and race. The authors conducted a 2-parameter item response theory (IRT) model to examine item characteristics of the Authority Acceptance scale from the Teacher Observation of Classroom Adaptation-Revised (AA-TOCA-R; L. Larsson-Werthamer, S. G. Kellam, & L. Wheeler, 1991) in 8,820 kindergarten children and estimated the degree of differential item functioning (DIF) by gender and race/urban status. The mean level of latent conduct problems was best represented by behaviors such as being stubborn, breaking rules, and being disobedient, whereas breaking things and taking others' property best represented the construct at one standard deviation above the mean. DIF by gender was detected, such that at equivalent levels of latent conduct problems, males received more endorsements of overt behaviors from teachers, whereas females received more endorsements of nonphysical behaviors. Moreover, overt behaviors were better discriminators of latent conduct problems for males, and nonphysical behaviors were better discriminators of latent conduct problems for females. Differences across race/urban status were not found to be conceptually meaningful. The authors' analyses also suggest that the item scaling of the AA-TOCA-R may be best represented by 5e categories instead of 6. These findings provide support for the use of IRT modeling to examine item characteristics of conduct problem scales and DIF to test for scalar equivalence across diverse subpopulations.     

Managing Behavioral Health Needs of Veterans with Traumatic brain injury (TBI) in Primary Care

Traumatic brain injury (TBI) is a frequent occurrence in the United States, and has been given particular attention in the veteran population. Recent accounts have estimated TBI incidence rates as high as 20 % among US veterans who served in Afghanistan or Iraq, and many of these veterans experience a host of co-morbid concerns, including psychiatric complaints (such as depression and post-traumatic stress disorder), sleep disturbance, and substance abuse which may warrant referral to behavioral health specialists working in primary care settings. This paper reviews many common behavioral health concerns co-morbid with TBI, and suggests areas in which behavioral health specialists may assess, intervene, and help to facilitate holistic patient care beyond the acute phase of injury. The primary focus is on sequelae common to mild and moderate TBI which may more readily present in primary care clinics.     

Clinical Interviewing With Older Adults

Over the next few decades the older adult population will increase dramatically, and prevalence rates of psychiatric disorders are also expected to increase in the elderly cohort. These demographic projections highlight the need for diagnostic instruments and methods that are specifically tailored to older adults. The current paper discusses the benefits and drawbacks of clinical interviewing with older adults, using two popular interview protocols as illustrative examples. Drawing upon preexisting basic research and our own observations collected in clinical and research settings over a 10-year period, we suggest procedures and suggestions for augmenting existing interview protocols to increase their usefulness with older adults in research and clinical settings. Strategies to optimize interview duration and enhance retrospective data accuracy and the pros and cons of dimensional versus dichotomous response formats, among other relevant topics, are discussed.     

Bringing social identity to work: the influence of manifestation and suppression on perceived discrimination, job satisfaction, and turnover intentions

In the current article, we explored whether manifesting or suppressing an identity (race/ethnicity, gender, age, religion, sexual orientation, or disability) at work is related to perceived discrimination, job satisfaction, and turnover intentions. Participants included 211 working adults who completed an online survey. The results showed that efforts to suppress a group identity were positively (and behavioral manifestations of group identity negatively) related to perceived discrimination, which predicted job satisfaction and turnover intentions. These results suggest that diverse employees actively manage their nonwork identities while at work and that these identity management strategies have important consequences.     

Problems in the Theory of Democratic Authority

This paper identifies strands of reasoning underlying several theories of democratic authority. It shows why each of them fails to adequately explain or justify it. Yet, it does not claim (per philosophical anarchism) that democratic authority cannot be justified. Furthermore, it sketches an argument for a perspective on the justification of democratic authority that would effectively respond to three problems not resolved by alternative theories—the problem of the expert, the problem of specificity, and the problem of deference. Successfully resolving these problems is at least evidence for the viability of a justification of democratic authority. This perspective integrates procedural concerns with those about the quality of democratic outcomes. It shows that democratic authority, if there is such a thing, requires reliable democratic procedures as the only sort citizens could rationally accept.     

The effect of viewing ultra-fit images on college women's body dissatisfaction

Modern ideals of female attractiveness include an extremely toned and fit appearance in addition to extreme thinness. Although viewing thin models has a negative effect on women's body image, research has not tested the effect of exposure to the ultra-fit physique separate from the thin-ideal. This randomized, posttest-only experiment tested the effects of the athletic aspect of the current ideal by exposing 138 undergraduate women to thin and athletic models, normal weight athletic models, or a control condition consisting of neutral objects. The study also tested the moderating effects of thin-ideal and athletic-ideal internalization. Exposure to thin ultra-fit models, but not normal weight ultra-fit models, produced an increase in body dissatisfaction and neither internalization variable moderated this effect. Findings suggest that interventions that focus on the benefits of fitness while challenging the desirability of thinness may offer promising results.     

An Ecological View of School Satisfaction in Adolescence: Linkages Between Social Support and Behavior Problems

This study investigated the relationships among school satisfaction, social support, and problem behaviors in adolescents. Modest associations were found between school satisfaction and the demographic variables of gender, race, age, and grade level. Support from teachers, parents, and classmates contributed unique variance to ratings of school satisfaction; with teacher support contributing the most unique variance. School satisfaction mediated the relationship between social support and internalizing and externalizing behaviors. School satisfaction did not moderate the relationship between social support and problem behavior; however, it did serve as a protective factor across all levels of social support. Implications are discussed, including suggestions for developing interventions that focus on increasing support for adolescents in efforts to improve school satisfaction and reduce problem behaviors.     

Test-taking behaviors by hypertensive and normotensive individuals

Systematic ratings were made on the Tulane Test-Behavior Scale of the global and integrated behaviors observable for hypertensive and normotensive subjects as they worked to complete a battery of neuropsychological tests--the degree of attention and effort displayed, for example, self-confidence and self-criticism. The results for 82 subjects (41 subject pairs matched for age, race, and education) revealed substantial and consistent differences between groups. Early, mild hypertensive subjects (unmedicated) displayed significantly less optimal behaviors than did normotensive controls. These may be best understood as subtle functional consequences of the abnormal physiological state imposed on the brain by a chronically elevated blood pressure, just as the functional disruptions of reduced kidney filtration fraction or minor abnormalities of the electrocardiogram appear early in the course of the disorder for other target organs. Certain testable implications of this hypothesis are discussed.