Utility of the trauma symptom inventory's atypical response scale in detecting malingered post-traumatic stress disorder

The authors examined the Trauma Symptom Inventory's (TSI) ability to discriminate 88 student post-traumatic stress disorder (PTSD) simulators screened for genuine PTSD from 48 clinical PTSD-diagnosed outpatients. Results demonstrated between-group differences on several TSI clinical scales and the Atypical Response (ATR) validity scale. Discriminant function analysis using ATR revealed 75% correct patient classification but only 48% correct simulator classification, with an overall correct classification rate of 59% (positive predictive power [PPP] = .71; negative predictive power [NPP] = .51). Individual ATR cutoff scores did not yield impressive classification results, with the optimal cutoff (T score = 61) correctly classifying only 61% of simulators and patients (PPP = .66, NPP = .54). Although ATR was not developed as a malingered PTSD screen, instead serving as a general validity screen, caution is recommended in its current clinical use for detecting malingered PTSD.     

Psychological mechanisms of medically unexplained symptoms: an integrative conceptual model

Theories of medically unexplained illness based on the concepts of dissociation, conversion, and somatization are summarized. Evidence cited in support of these theories is described and the conceptual strengths and shortcomings of each approach are considered. It is argued that each of these approaches adds to the understanding of unexplained illness but that none is able to provide a comprehensive explanation of the phenomenon. An integrative conceptual model of unexplained illness based on cognitive psychological principles is then presented. This model attempts to combine existing theoretical approaches within a single explanatory framework, extending previous theory by explaining how compelling symptoms can exist in the absence of organic pathology. The clinical and empirical implications of the model are then considered.     

Psychometric evaluation of the behavioral inhibition/behavioral activation scales in a large sample of outpatients with anxiety and mood disorders

The latent structure, reliability, and validity of the Behavioral Inhibition/Behavioral Activation Scales (BIS/BAS; C. L. Carver and T. L. White, 1994) were examined in a large sample of outpatients (N = 1,825) with anxiety and mood disorders. Four subsamples were used for exploratory and confirmatory factor analyses. In addition to generally upholding a latent structure found previously in nonclinical samples, results indicated measurement invariance of the BIS/BAS between genders and a higher order structure of the BAS scales. Convergent and discriminant validity of the BIS/BAS were supported by findings that the subscales correlated most strongly with measures of neighboring personality constructs (e.g., BIS with neuroticism, BAS with positive affect) than with measures of current anxiety and depression symptoms. Overall, the results support the psychometric properties of the BIS/BAS in this clinical sample.     

A Testimony to Muzil: Hervé Guibert, Foucault, and the Medical Gaze

Testimony to Muzil: Hervé Guibert, Michel Foucault, and the Medical Gaze examines the fictional/autobiographical AIDS writings of the French writer Hervé Guibert. Locating Guibert's writings alongside the work of his friend Michel Foucault, the article explores how they echo Foucault's evolving notions of the medical gaze. The article also explores how Guilbert's narrators and Guibert himself (as writer) resist and challenge the medical gaze; a gaze which particularly in the era of AIDS has subjected, objectified, and even sometimes punished the body of the gay man. It is argued that these resistances to the gaze offer a literary extension to Foucault's later work on power and resistance strategies.     

In sight but out of mind: do competing views test the limits of perception without awareness?

Over a century's worth of research suggests that "perception" without awareness is a genuine phenomenon. However, relatively little research has explored the question of whether all visually presented information activates representations in long term memory without awareness. Two experiments explored the use of a figure-ground display consisting of competing views in which one view dominates the other such that subjects are (initially) unaware of the non-dominant view. Neither experiment provided evidence that the non-dominant view (an embedded word) activated its representation in long term memory when the subject failed to report being aware of the embedded word in that priming was not seen on a subsequent stem completion task. In contrast, priming was seen when subjects reported being aware of the embedded word. It is suggested that two competing figure-ground relations are not concurrently computed unconsciously.     

Family Environments of Women Seeking BRCA1/BRCA2 Genetic Mutation Testing: An Exploratory Analysis

Although there is some understanding of the shared characteristics and predictors of psychological distress of women participating in hereditary breast and ovarian cancer registries, these same characteristics are only beginning to be identified in research on community women seeking genetic testing for BRCA1/BRCA2 gene mutations. This study provides an initial exploration of characteristics associated with family environments for 51 community women waiting to receive such genetic testing results. Thirty-four of the 36 women classified on family environment type of the Family Environment Scale (FES) were from Personal Growth-Oriented families. Comparisons of women with and without personal cancer histories resulted in a trend for women with personal cancer histories to be classified as from Independence-Oriented families. Reported distress appears to vary for different family emphases based on family and personal cancer history. A moral-religious family emphasis consistently appeared to be associated with decreased psychological distress. Preliminary analyses comparing these community women (who were not part of a hereditary registry but were self- or physician-referred) seeking genetic testing with normal and distressed family means found that increased cohesion and expressiveness may be related to decreased conflict, indicative of potentially supportive family environments for these women. When compared with normative data, a subset consisting of the Ashkenazi Jewish women showed a trend of less cohesion than normal families, but similar cohesion levels as distressed families.     

GENDER AS A FACTOR IN THE RESPONSE OF THE LAW-ENFORCEMENT SYSTEM TO VIOLENCE AGAINST PARTNERS

…it is the worst oppression, that is done by colour of justice --Sir Edward Coke A sign that says "men only" looks very different on a bathroom door than on a courthouse door. --U.S. Supreme Court Justice Thurgood Marshall "Is Parkinson's the toughest opponent you've ever faced, Muhammed?" someone asked. "Toughest was my first wife," he said. --Former World Heavyweight Boxing Champion Muhammed Ali A great deal of sociological evidence has been collected in the past three decades on the prevalence of abuse among adult heterosexual partners in domestic relationships of some degree of permanence. Partly as a result of this information, partner abuse has been identified as an important social ill that must be addressed aggressively through public-awareness campaigns, the funding of a broad range of support services, and the re-training of law-enforcement authorities--including police, prosecutors, and judges. However, in at least one important respect, these policy initiatives diverge substantially from what the sociological data, which ostensibly motivates them, would indicate: they have been, to date, overwhelmingly gender specific. That is, partner abuse is routinely portrayed and acted upon as though it were almost exclusively about men abusing and victimizing innocent women and, by extension, their children--despite the overwhelming sociological evidence that a significant amount of abuse is also suffered by male partners. Persistent anecdotal reports from victims and even some participants in the law-enforcement system suggest that this ideological emphasis on the male as perpetrator has had a deleterious effect on the impartial administration of justice, resulting in men being treated much more harshly than women who are accused of partner violence. This study attempts to determine whether the anecdotes are scientifically supportable.     

Identification of tone duration, line length, and letter position: an experimental approach to timing and working memory deficits in schizophrenia

Patients with schizophrenia display numerous cognitive deficits, including problems in working memory, time estimation, and absolute identification of stimuli. Research in these fields has traditionally been conducted independently. We examined these cognitive processes using tasks that are structurally similar and that yield rich error data. Relative to healthy control participants (n = 20), patients with schizophrenia (n = 20) were impaired on a duration identification task and a probed-recall memory task but not on a line-length identification task. These findings do not support the notion of a global impairment in absolute identification in schizophrenia. However, the authors suggest that some aspect of temporal information processing is indeed disturbed in schizophrenia.     

An emerging postural response: is control of the hip possible in the newly walking child?

Previous researchers have proposed that because of their slow muscle-response latencies, 1- to 2-year-old children are unable to control hip-dominant postural responses when responding to balance threats (G. McCollum & T. Leen, 1989). To test that proposition, the authors exposed 41 children to backward support-surface translations and recorded muscle activations and movement kinematics. Children between 10 months and 10 years of age stood on a platform that was unexpectedly moved. Passive hip-dominant responses were observed among the least experienced walkers. In contrast, older children produced an active response, signified by higher levels of abdominal and quadriceps muscle activity and accompanied by larger hip flexor torques. Greater success in withstanding large magnitudes of perturbations were associated with actively generated hip responses.