Computer scoring of the Levels of Emotional Awareness Scale

The Levels of Emotional Awareness Scale (LEAS; Lane, Quinlan, Schwartz, Walker, & Zeitlan, 1990) is the most commonly used measure of differentiation and complexity in the use of emotion words and is associated with important clinical outcomes. Hand scoring the LEAS is time consuming. Existing programs for scoring open-ended responses cannot mimic LEAS hand scoring. Therefore, Leaf and Barchard (2006) developed the Program for Open-Ended Scoring (POES) to score the LEAS. In this article, we report a study in which the reliability and validity of POES scoring were examined. In the study, we used three participant types (adult community members, university students, children), three LEAS versions (paper based, computer based, and the LEAS for children), and a diverse set of criterion variables. Across this variety of conditions, the four POES scoring methods had internal consistencies and validities that were comparable to hand scoring, indicating that POES scoring can be used in clinical practice and other applied settings in which hand scoring is impractical.     

Referral Source Differences in Functional Impairment Levels for Children Served in the Comprehensive Community Mental Health Services for Children and Their Families Program

We report one of the first multi-site investigations into referral source variation in functional impairment for children with serious emotional disturbance served in systems of care settings. Baseline data collected as part of the national evaluation for the Comprehensive Community Mental Health Services for Children and Their Families Program was used to assess the comparability of functional status for children referred from traditional mental health versus non-mental health agencies. Results indicate that children referred from child welfare and family groups have significantly lower levels of overall dysfunction than those referred from mental health, while children referred from school and juvenile justice agencies have comparable levels. Clinical and research implications are discussed.     

Comparison of million personality profiles of chronic residential substance abusers and a general outpatient population.

Several theories and studies have suggested that particular personality disorders or psychiatric symptoms should be associated with substance abuse. The current study was done to clarify these relationships by comparing scale profiles on the Millon Clinical Multiaxial Inventory obtained by 144 inpatient residentially treated substance-abuse clients and 1000 general clinical outpatient clients in psychotherapy. A surprisingly large number of significant differences were noted. Substance-abuse clients displayed relative elevations on scales for Alcohol and Drug Abuse, Hypomania, Antisocialism, Narcissism, Schizoidism, Paranoia, Psychotic Thinking, and Psychotic Delusions. General clinical outpatients showed relative elevations on Anxiety, Somatoform, Dysthymia, Borderline, and Compulsive scales. Some possible meanings of these findings were explored and suggestions for research given.     

The endorsement of irrational beliefs in a general clinical population

Burgess' Attitude and Belief Scale, a measure of Ellis' irrational beliefs, was administered to a large sample of outpatients. All 13 subscales demonstrate very adequate internal consistency. A factor analysis yielded one factor accounting for 83% of the variance, which was labeled irrationality. Clients endorsed focused items more than overgeneralized items, self-referential items more than non-self-referential items, and preferential items more than irrational items. Clients also received higher scores on the irrational process of demandingness than they did on the irrational process of awfulizing, self-worth and low frustration tolerance. The results were consistent with new formulations in Rational-Emotive theory. Suggestions were made for the construction of measures of irrational beliefs.     

Countering perfectionism in research on clinical practice II: Retrospective analysis of treatment progress

A simple correlational study is described which has methodological advantages, when compared with an equivalent manipulative (i.e., quasiexperimental) research design, for examining exploratory questions about treatment outcome. These advantages stem from the fact that retrospective designs, when compared with prospective ones, are much less likely to involve ethical problems due to offering relatively ineffective or unnecessary treatment, and less likely to involve confounds from newly hypothesized differential expectations about treatment. Based on Millon Clinical Multiaxial Inventory (MCMI) scale scores, clients with high levels of histrionic or narcissistic (and possibly also those with antisocial, compulsive and paranoid) personality traits seemed to profit more from RET than those without such traits. Clients with high levels of schizoid, avoidant, and schizotypal traits (and probably also clients with strong passive-aggressive traits, and possibly also clients with strong dependent and borderline traits) seemed to profit less from RET than those without such marked traits. We have previously shown that the relatively healthy personality traits and disorders are associated with global self-upping and the relatively sick ones with global self-downing, as well as contrasting patterns of positive and negative reactions to stressful events. Our findings here support the concept that clients who consistently handle life situations well will tend to progress most rapidly in therapy, and those who generally handle life situations badly will tend to progress slowly. Personality traits may be especially significant markers for therapeutic attention to problems stemming from global self-rating. Expectations based on the severity of global self-upping and/or self-downing may be good predictors of therapeutic progress. In contrast, expectations about RET outcomes based on severity of distress or neediness will probably be less accurate.Dr. Russell C. Leaf is Associate Professor of Psychology at Rutgers. He also directs a research project at the Institute for Rational-Emotive Therapy, in collaboration with the four other authors of this article, on the relationships between intake personality and mental health. He is an Institute Fellow and Supervisor, and previously served as a staff therapist and as the Institute's Director of Clinical Evaluation.Albert Ellis is President of the Institute for Rational-Emotive Therapy.Roslyn Mass is Professor at Middlesex County College. She is in charge of data processing and analysis for the collaborative research of this authorial team, and is a Fellow of and previously served as Administrative Director of the Institute for Rational-Emotive Therapy.Raymond DiGiuseppe is Associate Professor of Psychology at St. Johns and Director of Research and Director of Training at the Institute for Rational-Emotive Therapy.Diane Alington is Assistant Director and a member of the core faculty of the Institute for Health, Health Care Policy and Aging Research at Rutgers, where she conducts a research program on sex differences in adult development.     

Concordance Between Parent Reports of Children's Mental Health Services and Service Records: The Services Assessment for Children and Adolescents (SACA)

The concordance between parent reports of children's mental health services and medical and administrative service records were assessed in a field test of the Services Assessment for Children and Adolescents (SACA) interview instrument. Service use reports from primary caregivers, usually mothers, for their child's emotional or behavioral problems were compared against inpatient, outpatient, and school records in St. Louis, one of the pilot sites for the Multi-Site Study of Service Use, Need, Outcomes and Costs in Child and Adolescent Populations (UNOCCAP). A global any use service variable, comprised of inpatient, outpatient, and school reports, yielded an overall service use concordance kappa of .76 between parent reports and records. Parent reports of inpatient hospitalization services using the SACA yielded the highest agreement with medical records, with kappa statistics of 1.00 for use of any inpatient hospital care and for medication use. Parent reports of specific inpatient services concurred with medical records more moderately, yielding kappas from .50 to .66. Reports of any outpatient mental health services yielded variable rates of agreement, with kappas ranging from .67 for any use of outpatient care, to .66 for medication use, to negligible kappas for specific treatments. Parent reports of school services were weakly related to records for most services, except for moderate agreement (.48) on placement in special classrooms for emotional or behavioral problems. Family burden or impact discriminated more powerfully than other variables between respondents who concurred with records and those who did not.