Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: A 3-month randomised controlled clinical trial

Dialectical behaviour therapy (DBT) has proven to be an effective treatment in borderline personality disorder (BPD). However, the effectiveness in BPD of DBT skills training (DBT-ST) alone is not known. This study aimed at comparing the efficacy of DBT-ST and standard group therapy (SGT) for outpatients with BPD. Sixty patients meeting the DSM-IV diagnostic criteria for BPD, as assessed by two semi-structured diagnostic interviews, were included in a 3-month, single-blind randomised controlled trial. A total of 13 weekly group psychotherapy sessions of 120 min of either SGT or DBT-ST were conducted. Assessments were carried out every 2 weeks by two blinded evaluators. Observer-rater, self-report scales and behavioural reports were used as outcome measures. DBT-ST was associated with lower dropout rates, 34.5% compared to 63.4% with SGT. It was superior to SGT in improving several mood and emotion areas, such as: depression, anxiety, irritability, anger and affect instability. A reduction in general psychiatric symptoms was also observed. Three-months weekly DBT-ST proved useful. This therapy was associated with greater clinical improvements and lower dropout rates than SGT. DBT-ST seems to play a role in the overall improvement of BPD seen with standard DBT intervention. It allows straightforward implementation in a wide range of mental health settings and provides the additional advantage that it is cost effective.     

Are defeat and entrapment best defined as a single construct?

The concepts of defeat and entrapment have been employed in evolutionary accounts of clinical phenomena such as depression and suicide. Recently theorists have argued that both concepts may be best conceptualised as a single distinct factor. The current study is the first to empirically test this assertion. A sample of 305 students completed measures of defeat and entrapment. Their responses were then analysed via exploratory factor analysis. The results strongly suggest that a single factor underlies both defeat and entrapment. These findings have considerable implications for past studies and theoretical accounts that rely on the distinction between defeat and entrapment.     

Incarcerated adolescent girls: personality, social competence, and delinquency

The aim of this study was to gain greater insight into the relationship of delinquency to personality and social competence in incarcerated girls. It was hypothesized that agreeableness and conscientiousness would correlate negatively with delinquency, and that the sensation-seeking aspect of extroversion would correlate positively. Two theoretical views were used to predict the relationship between social competence and delinquency: (a) delinquency as an expression of lack of social competence (i.e., social deficit), and (b) delinquency as socially competent and rationally analyzed behavior. The first view implies a negative correlation between delinquency and social competence, while the second indicates a positive one. The participants were thirty-three 12- to 18-year-old incarcerated girls. An adaptation of the Self-Reported Delinquency Scale was used for measuring delinquency; personality was measured using the Five-Factor Personality Inventory; and the Scale for Interpersonal Behavior was used to measure social competence. Agreeableness was not found to correlate with the overall delinquency score or with any specific type of delinquency or crime. The more crimes the girls reported, the less conscientious they were, and the more neurotic and open they were. The correlation between delinquency and extroversion was not statistically significant. A higher level of delinquency was accompanied by higher social competence when negative self-assertion was required (i.e., a low level of tension was felt in expressing negative feelings that were appropriate to the situation). In other social situations, however, the girls reported more situation-inappropriate feelings of tension. It was concluded that some personality factors and aspects of social competence can predict delinquency.     

The School Adjustment of Rural Adolescents with and Without Disabilities: Variable and Person-Centered Approaches

This study examined the school adjustment of adolescents with disabilities and their nondisabled peers in a national sample of rural high school students. The total sample consisted of 7,376 students: 6,704 nondisabled students, 70 students with emotional and behavioral disorders (EBD), 512 students with learning disabilities (LD), and 90 students identified as English language learners (ELL). Teacher ratings on the Interpersonal Competence Scale-Teacher (ICS-T) were used to assess students’ adjustment on seven factors: academic, affiliative, aggressive, internalizing, popular, Olympian, and shy. Cluster analyses were used to identify distinct configurations of competence and risk separately for boys and girls. Differences between educational classifications were identified for the ICS-T factors and for the interpersonal competence configurations. Students with EBD were overrepresented in Multi-risk configurations (aggressive high-risk profiles), students with LD were overrepresented in both the Multi-risk and Disengaged (non-aggressive high-risk profiles) configurations, and students identified as ELL were overrepresented in Disengaged configurations.     

How social context moderates the self-evaluative emotions experienced due to health risk behaviour

When people are confronted with the potential negative physical outcomes of their own health risk behaviour, they experience a self-threat. This threat is felt as negative self-evaluative emotions. We hypothesise that the threat will lead to more private self-evaluative emotions (e.g. regret) in a private social context, whereas more public self-evaluative emotions (e.g. embarrassment) will be felt in a public social context with negative norms. Consistent with our hypotheses, we show that participants anticipate feeling more private self-evaluative emotions when confronted with the negative consequences of their unhealthy behaviour when alone, and more public self-evaluative emotions when in a group (Study 1). They further anticipate more public self-evaluative emotions in response to a health self-threat when the group norm is negative, and more private self-evaluative emotions when the group norm is lenient (Study 2). Finally, in a cross-sectional study amongst smokers, we show that private but not public negative self-evaluative emotions concerning their own smoking habits are positively correlated with the intent to quit smoking (Study 3). These studies show that a distinction needs to be made between public and private self-evaluative emotions, in terms of their antecedents and effects. Theoretical implications and further lines of research are discussed.     

Walking and talking: dual-task effects on street crossing behavior in older adults

The ability to perform multiple tasks simultaneously has become increasingly important as technologies such as cell phones and portable music players have become more common. In the current study, we examined dual-task costs in older and younger adults using a simulated street crossing task constructed in an immersive virtual environment with an integrated treadmill so that participants could walk as they would in the real world. Participants were asked to cross simulated streets of varying difficulty while either undistracted, listening to music, or conversing on a cell phone. Older adults were more vulnerable to dual-task impairments than younger adults when the crossing task was difficult; dual-task costs were largely absent in the younger adult group. Performance costs in older adults were primarily reflected in timeout rates. When conversing on a cell phone, older adults were less likely to complete their crossing compared with when listening to music or undistracted. Analysis of time spent next to the street prior to each crossing, where participants were presumably analyzing traffic patterns and making decisions regarding when to cross, revealed that older adults took longer than younger adults to initiate their crossing, and that this difference was exacerbated during cell phone conversation, suggesting impairments in cognitive planning processes. Our data suggest that multitasking costs may be particularly dangerous for older adults even during everyday activities such as crossing the street.     

Cognitive antecedents to adolescent health risk: Discriminating between behavioral intention and behavioral willingness

Abstract

A model of adolescent health risk behavior that is both cognitive and social-psychological in orientation is described, and an aspect of the model is tested empirically. The model suggests that health risk behaviors (e.g., smoking or drunk driving), especially among adolescents, are not always intended or premeditated, but instead are often reactions to risk-conducive circumstances. Because they are not entirely premeditated, such behaviors are not accurately predicted by “traditional” behavioral intention measures, but are predicted by a central construct in the model labeled behavioral willingness. Results of two studies indicate that both intention (expectation) and willingness measures predict future risk behaviors, and do so independent of one another. Additional analyses provide further evidence of discriminant validity between the two constructs by indicating that they relate differently to perceptions of personal vulnerability to the health risks associated with these behaviors.     

COMMUNICATING WITH THE COMMUNITY ABOUT GRIEVING: A DESCRIPTION AND REVIEW OF THE FOUNDATIONS OF A BROKEN LEG ANALOGY OF GRIEVING

With loss permeating the lives of all people throughout the entire life span and its potential for serious long-term deleterious effects, providing effective care for those experiencing situations of loss would be an important element of any preventive community-based mental health promotion approach.The low use of mental health services by those confronted with loss, and the lack of such services in many areas, makes it imperative to enhance the competency of the broader community to provide appropriate care during times of loss. Contributory to such care is a sound knowledge of the literature concerning loss and grieving. The broken leg analogy of grief presented in this article integrates the traditional and emerging grief theories and empirical evidence into an analogy of grieving that can be easily communicated to the general community, is relevant to many losses, and yet upholds the differing positions concerning grieving held by various schools of psychiatric thought.     

“Subordination” and Nonverbal Sensitivity: A Study and Synthesis of Findings Based on Trait Measures

We conducted a primary study and a meta-analysis on the relation of trait subordination measures to trait measures of sensitivity to nonverbal cues, in order to test the hypothesis that more subordinate individuals have enhanced ability to decode nonverbal cues. In the primary study, subordination measures included socioeconomic background, two dominance scales, a capacity for status scale, a control by powerful others scale, self-ratings of leadership and social status in high school, and for women, measures of sex role values. Sensitivity to nonverbal cues was measured using three psychometric tests, Results showed little overall support for the subordination hypothesis, and some results were significantly opposite to the prediction. The meta-analysis showed that dominance, capacity for status, socioeconomic status, and women's sex role values all had relations to nonverbal sensitivity that were opposite to the predictions of the subordination hypothesis. Future prospects for the subordination hypothesis with respect to nonverbal sensitivity are discussed.