Depression, anxiety, and the MCMI-III: construct validity and diagnostic efficiency

This study aimed to enhance knowledge of the construct validity and diagnostic efficiency of the depression- and anxiety-related scales of the MCMI-III (Millon, 1994). The MCMI-III, various concurrent depression and anxiety measures, and an Axis I structured diagnostic interview were administered in a total sample of 696 outpatients with depressive disorders, anxiety disorders, or both. Sound construct validity was found for the Dysthymia and Major Depression clinical syndrome scales and the Avoidant and Depressive personality disorder scales. The validity of the Anxiety scale was poor, showing moderate convergence with panic and worry-related anxiety measures, but problems discriminating from depression. Operating characteristics for discriminating depressed patients from anxious patients were fair for the Major Depression scale, but poor for the Anxiety and Dysthymia scales.     

What You Feel Influences What You See: The Role of Affective Feelings in Resolving Binocular Rivalry

It seems obvious that what you see influences what you feel, but what if the opposite were also true? What if how you feel can shape your visual experience? In this experiment, we demonstrate that the affective state of a perceiver influences the contents of visual awareness. Participants received positive, negative, and neutral affect inductions and then completed a series of binocular rivalry trials in which a face (smiling, scowling, or neutral) was presented to one eye and a house to the other. The percepts “competed” for dominance in visual consciousness. We found, as predicted, that all faces (smiling, scowling, and neutral) were dominant for longer when perceivers experienced unpleasant affect compared to when they were in a neutral state (a social vigilance effect), although scowling faces increased their dominance when perceivers felt unpleasant (a relative negative congruence effect). Relatively speaking, smiling faces increased their dominance more when perceivers were experiencing pleasant affect (a positive congruence effect). These findings illustrate that the affective state of a perceiver serves as a context that influences the contents of consciousness.     

Seeing failure in your life: Imagery perspective determines whether self-esteem shapes reactions to recalled and imagined failure

The present research reveals that when it comes to recalling and imagining failure in one's life, changing how one looks at the event can change its impact on well-being; however, the nature of the effect depends on an aspect of one's self-concept, namely, self-esteem. Five studies measured or manipulated the visual perspective (internal first-person vs. external third-person) individuals used to mentally image recalled or imagined personal failures. It has been proposed that imagery perspective determines whether people's reactions to an event are shaped bottom-up by concrete features of the event (first-person) or top-down by their self-concept (third-person; L. K. Libby & R. P. Eibach, 2011b). Evidence suggests that differences in the self-concepts of individuals with low and high self-esteem (LSEs and HSEs) are responsible for self-esteem differences in reaction to failure, leading LSEs to have more negative thoughts and feelings about themselves (e.g., M. H. Kernis, J. Brockner, & B. S. Frankel, 1989). Thus, the authors predicted, and found, that low self-esteem was associated with greater overgeneralization--operationalized as negativity in accessible self-knowledge and feelings of shame--only when participants had pictured failure from the third-person perspective and not from the first-person. Further, picturing failure from the third-person, rather than first-person, perspective, increased shame and the negativity of accessible knowledge among LSEs, whereas it decreased shame among HSEs. Results help to distinguish between different theoretical accounts of how imagery perspective functions and have implications for the study of top-down and bottom-up influences on self-judgment and emotion, as well as for the role of perspective and abstraction in coping.     

Behavioral Health Services ��Don��t Work for Us��: Cultural Incongruities in Human Service Systems for Alaska Native Communities

Community psychology emphasizes the importance of context in the study of people's lives, and culture influences this in profound ways. To develop programs that effectively address diverse communities' problems, it is essential to recognize how Euro-American human service systems are understood and responded to by the many different people being served by them. The article describes how some broadly defined social services-conceptualized and implemented within a Euro-American framework-are ill suited for the everyday realities of Alaska Native villages. The cultural discontinuities are illustrated through ethnographic vignettes. The article concludes with suggestions for developing more culturally-responsive ways to conceive of and do programming for Alaska Native and possibly other Indigenous and minority communities.     

Subjects Without a World? An Husserlian Analysis of Solitary Confinement

Psychiatrist Stuart Grassian has proposed the term “SHU syndrome” to name the cluster of cognitive, perceptual and affective symptoms that commonly arise for inmates held in the Special Housing Units (SHU) of supermax prisons. In this paper, I analyze the harm of solitary confinement from a phenomenological perspective by drawing on Husserl’s account of the essential relation between consciousness, the experience of an alter ego and the sense of a real, Objective world. While Husserl’s prioritization of transcendental subjectivity over transcendental intersubjectivity underestimates the degree to which first-person consciousness is constitutively intertwined with the embodied consciousness of others, Husserl’s phenomenology nevertheless provides a fruitful starting-point for a philosophical engagement with the psychiatric research on solitary confinement.     

Examining the Use of Sex to Cope in a Forensic Sample

The authors examined differences between sexual and mentally disordered offenders on the Coping Using Sex Inventory. Sexual offenders were more likely to use sex to cope with negative life events but did not use all forms of deviant sexual activity.     

Longitudinal Interviews of Couples Diagnosed with Diminished Ovarian Reserve Undergoing Fragile X Premutation Testing

About 10 % of infertile/subfertile women are diagnosed with diminished ovarian reserve (DOR), of which?<?5 % will become pregnant spontaneously. Fragile X (FMR1) genetic testing may provide a reason for her early ovarian aging and/or have reproductive implications. Seven women with DOR (genetic study subset) and the male partners of six of these women were separately interviewed about the experience of being asked to undergo this unanticipated genetic test. Three interviews were conducted (before, within 1 week after, and 3 months after learning the test results). None of the participants carried the FMR1 premutation (largest FMR1 allele 27–50 CGG repeats). For women, their pregnancy-seeking journey was long and exhausting. Women understood the reproductive implications of carrying the FMR1 premutation, and hoped for a negative result. Being offered a genetic test caused women to pause and re-think their future reproductive plans. Husbands viewed the infertility journey as filled with unknowns, of which the genetic test results would be one more puzzle piece. The expense of fertility testing/treatment was mentioned by both spouses, though more notably by husbands. The introduction of a possible genetic cause of infertility, with additional potential health consequences for future biological children, caused women to re-think their quest for pregnancy. In contrast, the genetic test was viewed as an additional source of information for their husbands as opposed to raising concern regarding potential reproductive ramifications.     

Perceived Risk Following Melanoma Genetic Testing: A 2-Year Prospective Study Distinguishing Subjective Estimates from Recall

A major goal of predictive genetic testing is to alert people to their risk before illness onset; however, little is known about how risk perceptions change following genetic testing and whether information is recalled accurately over time. In the United States, a CDKN2A/p16 mutation confers 76 % lifetime risk of melanoma. Following genetic counseling and test reporting, subjective risk estimates and recall of counselor-provided risk estimates were assessed 5 times over the next 2 years among 60 adult members of 2 extended CDKN2A/p16 kindreds. No sustained changes from baseline in risk perceptions were reported. Unaffected carriers (n?=?15) consistently reported significantly lower subjective risk estimates (46 %) than they were actually given (76 %, p?<?0.001) or recalled having been given (60 %, p?<?0.001). Noncarriers’ (n?=?27) risk estimates decreased following results disclosure, but rebounded, with both subjective and recalled estimates subsequently exceeding what they were told by the counselor (both ps?<?0.001). Affected carriers’ (n?=?18) risk estimates for developing a new melanoma corresponded well to counselor-provided information (p?=?0.362). For all 3 patient groups, results were consistent across multiple risk measures and remained similar when demographic, phenotypic, and baseline behavioral contributors to melanoma risk were statistically controlled. These findings are consistent with other studies of risk perception, but additional studies of more diverse populations are needed to understand the reasons behind both the persistence of initial risk estimates and their divergence from information provided by the counselor during genetic counseling. Additionally, determining whether holding subjective risk perceptions that differ from counselor-provided information ultimately affects adherence to management recommendations will help guide the presentation of risk information in genetic counseling practice.