A modified DBT skills training program for oppositional defiant adolescents: promising preliminary findings

A modified skills training component of dialectical behavior therapy (DBT) was implemented in a group therapy format for non-suicidal outpatient young adolescents who met criteria for oppositional defiant disorder (ODD). Thirty-two youths completed the 16-week program, as well as pre- and post-treatment measures. The treatment was effective not only in decreasing negative behaviors, but also in increasing positive behaviors, per caregiver report. The youths reported a significant reduction in externalizing and internalizing symptoms and in depression. Reliable change indices indicated that far more participants were in the improved category than in the deteriorated category on the measures of interest. Despite the absence of control groups but consistent with the treatment outcome research literature for DBT-based treatments for other disorders, this study demonstrated that DBT skills training is feasible and shows promise in improving the behavior of ODD young adolescents.     

PTSD and substance-related problems: the mediating roles of disconstraint and negative emotionality

The authors examined competing hypotheses regarding the role of 2 personality dimensions, disconstraint and negative emotionality, in mediating the relationship between posttraumatic stress disorder (PTSD) severity and substance-related problems. Data were drawn from a large sample of male Vietnam veterans. The best-fitting structural model included significant indirect paths from PTSD to both alcohol- and drug-related outcomes through disconstraint, and a significant indirect path from PTSD to alcohol-related problems through negative emotionality. There were no direct effects of PTSD on either substance-related outcome. These findings indicate distinct pathways to different forms of substance-related problems in PTSD and underscore the role of personality in mediating these relationships.     

The latent structure of posttraumatic stress disorder: a taxometric investigation of reactions to extreme stress

Mental health professionals have debated whether posttraumatic stress disorder (PTSD) can be qualitatively distinguished from normal reactions to traumatic events. This debate has been fueled by indications that many trauma-exposed individuals evidence partial presentations of PTSD that are associated with significant impairment and help-seeking behavior. The authors examined the latent structure of PTSD in a large sample of male combat veterans. Three taxometric procedures-MAMBAC, MAXEIG, and L-Mode-were performed with 3 indicator sets drawn from a clinical interview and a self-report measure of PTSD. Results across procedures, consistency tests, and analysis of simulated comparison data all converged on a dimensional solution, suggesting that PTSD reflects the upper end of a stress-response continuum rather than a discrete clinical syndrome.     

The role of contextual variables in maternal reactions to children's compliance and noncompliance

The present study was designed to assess whether certain contexts influenced material reactions to children's compliant and noncompliant behavior. Study 1 examined the following contextual variables: chronic negative conditions of the child (physical illness and psychological disturbance) and recent life events experienced by the child (both positive and negative). Study 2 examined maternal mood states as another contextual variable. Results indicated that these contexts relate to differential choices of discipline techniques, based on maternal self-report. These data are examined in light of the literature on treatment acceptability and are discussed in terms of a signal-detection model. Clinical applications are addressed, and suggestions for future research are offered.Portions of this paper were presented at the meeting of the Association for Advancement of Behavior Therapy, Philadelphia, November 1984.We express gratitude to the Research Council of the University of North Carolina at Greensboro for Research Council Grant 2110 218 00000 7719 and to the following for their assistance: James Herbert, Nancy Quinn, Carol Roberson, Ira Turkat, and Marilyn Williams.     

Comorbidity In Post-Traumatic Stress Disorder An Analysis of Community and Clinical Studies1

Post-traumatic stress disorder (PTSD) is alleged to be associated with high rates of concurrent psychological disorders. This paper considers the available literature regarding comorbidity in PTSD and reviews in detail the findings to date. This critical evaluation includes studies of clinical samples, veterans community surveys, and population surveys. It also presents new data drawn from 50 PTSD cases assessed at the Boston PTSD Center using a comprehensive, multidimensional diagnostic procedure. The data firmly support the notion that PTSD, regardless of the nature of the trauma, is associated with high rates of other major psychological disorders including substance abuse, major depression, and personality disorders. Despite these findings the issue of cause and effect surrounding comorbidity remains open at this time. More research is needed to determine if exposure to extreme stressors in fact produces the broad spectrum of psychopathology suggested by individuals with PTSD or whether individuals with intrinsic vulnerability are more likely to develop PTSD when exposed to extreme stressors. Implications of the findings from this review are discussed with respect to concepts in diagnosis and comorbidity.     

Promoting imitative play through generalized observational learning in autisticlike children

Three autisticlike boys with deficits in imitative and appropriate play behaviors were taught to play with an unfamiliar toy by observing a peer model demonstrate appropriate play with the toy. Generalization was assessed across toys and models, and temporal maintenance was assessed at 1 and 3 weeks following generalization. Following training each child demonstrated increases in imitative play concomitant with decreases in the frequency of nonmanipulated selfstimulatory behavior. Results are discussed in terms of their implications for the amelioration of social isolation and self-stimulatory behavior.The authors wish to acknowledge the help and cooperation of the Henry Wiseman Kendall Center and the Highpoint Preschool Enrichment Program.     

On Adaptation in Analogy: Tests of Pragmatic Importance and Adaptability in Analogical Problem Solving

When people use analogies to solve problems, they form an analogical mapping between two domains of knowledge. This mapping may support inferences by analogy that suggest a novel solution to a problem. Several factors have been proposed to be important in selecting this mapping from among several alternative mappings: structural factors (systematicity and structural consistency) and pragmatic factors (the exploitation of higher-order planning categories). We suggest another set of factors plays a role in selecting mappings: adaptability. Specifically, if a mapped solution can be adapted easily to a problem, then it will be preferred over an alternative mapping that is less adaptable. Two experiments are reported which test the effects of pragmatic and adaptation factors, using a novel technique in which the story analogue has two alternative plans, either of which can be used to solve an insight problem. In Experiment 1, these plans were varied in terms of their pragmatic importance (success or failure) and their adaptability. In Experiment 2, the relative adaptability of plans was manipulated. The results suggest that there is little evidence for these specific pragmatic factors, but that adaptability plays a definite role in selecting an analogous plan. The findings suggest that most models need to be extended to include adaptation constraints.     

Predictive and concurrent validity of the Suicidal Ideation Questionnaire among American Indian adolescents

Suicide is currently the second leading cause of death for ages 15–24 years; reports indicate that 6–8% of American teens have attempted suicide. Rates of suicide and suicide attempts are at least as high, if not higher, for American Indian adolescents and young adults. The Suicidal Ideation Questionnaire (Junior High School Version) (SIQ-JR) could be used to identify young people who may be at risk for attempting suicide, since this questionnaire focuses on suicidal ideation, a major risk factor for suicide attempt. However, little is known about the predictive validity of the SIQ-JR, particularly in American Indian adolescent populations. A suicide attempt cluster at an American Indian boarding school provided the unique opportunity to examine the performance of the SIQ-JR in a group of American Indian high school students who had taken the SIQ-JR approximately 2 months prior to the outbreak of attempts. The SIQ-JR proved to be an excellent predictor of future suicide attempts when compared to other measures of distress: anxiety, depression, and alcohol use. The SIQ-JR is an effective screener for suicide risk in this American Indian adolescent population.     

Category knowledge in Alzheimer's disease: normal organization and a general retrieval deficit.

Three hypotheses that could account for deficits in the retrieval of category information in Alzheimer's disease (AD) were evaluated: abnormal organization, class- or category-specific vulnerability, and limitation by general factors, such as decreased processing speed. Relative to 18 elderly control subjects, 18 patients with AD produced fewer items in a category fluency task and had longer reaction times in a category decision task. The pattern of performance across categories on both tasks was normal in the AD group: The same categories elicited the most (or fastest) responses in both the control group and the AD group. AD patients showed normal performance in ranking of category exemplars by typicality. There was no evidence for differential accessibility by category or by class of information (animate vs. inanimate). The authors conclude that a general factor or factors limit(s) retrievability equally across all categories.