Borderline pathology and the Personality Assessment Inventory (PAI): an evaluation of criterion and concurrent validity

In this study, we examined how patients diagnosed with borderline pathology (BP) would respond on the Personality Assessment Inventory (PAI; Morey, 1991) Borderline (BOR) scales in relation to patients without BP pathology. In addition, we examined whether the PAI BOR scales would be related to variables on the Social Cognition and Object Relations Scale (SCORS; Hilsenroth, Stein, & Pinsker, 2004; Westen, 1995) derived from early memory narratives. Results indicate that outpatients with a Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) diagnosis of BP scored significantly higher on the PAI BOR Total (BOR-Total) score, Identity Problems, and Self- Harm scales in comparison to a Non-BP clinical sample. The overall correct classification rate for the presence or absence of BP using the BOR Total scale (T >or= 70) was 73%. In addition, there were several significant relationships between dimensional PAI BOR scales and the presence versus absence of DSM-IV BP. Moreover, both the BOR-Total and Affect Instability scales were significantly related to the SCORS variable Complexity of Representations. We provide clinical examples to illustrate these research findings in an applied manner.     

Concurrent validity of the Personality Assessment Inventory Borderline scales in patients seeking dialectical behavior therapy

The purpose of this study was to explore the usefulness of the Personality Assessment Inventory (PAI; Morey, 1991) Borderline full scale (BOR) and subscales in the assessment of patients being evaluated for dialectical behavior therapy (DBT; Linehan, 1993).We administered 67 patients both the PAI and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) Structured Clinical Interview for Axis II disorders (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1997). Point biserial correlations showed a significant relationship between the presence of borderline personality disorder (BPD) and scores on the BOR and Schizophrenia (SCZ) scales. A regression analysis showed that among the BOR subscales, those measuring identity disturbance, self-harming behavior, and negative relationships were significantly related to the total number of SCID-II BPD criteria. Diagnostic efficiency statistics between the BOR scale and the number of SCID-II BPD criteria indicated that a T score cutoff of 65 optimally differentiates patients who do and do not meet criteria for BPD. The relationship between BOR and SCID-II BPD demonstrates the concurrent validity of the PAI and shows its usefulness in this setting.     

The role of multiple-exemplar training and naming in establishing derived equivalence in an infant

The conditions under which symmetry and equivalence relations develop are still controversial. This paper reports three experiments that attempt to analyze the impact of multiple-exemplar training (MET) in receptive symmetry on the emergence of visual-visual equivalence relations with a very young child, Gloria. At the age of 15 months 24 days (15m24d), Gloria was tested for receptive symmetry and naming and showed no evidence of either repertoire. In the first experiment, MET in immediate and delayed receptive symmetrical responding or listener behavior (from object-sound to immediate and delayed sound-object selection) proceeded for one month with 10 different objects. This was followed, at 16m25d, by a second test conducted with six new objects. Gloria showed generalized receptive symmetry with a 3-hr delay; however no evidence of naming with new objects was found. Experiment 2 began at 17m with the aim of establishing derived visual-visual equivalence relations using a matching-to-sample format with two comparisons. Visual-visual equivalence responding emerged at 19m, although Gloria still had not shown evidence of naming. Experiment 3 (22m to 23m25d) used a three-comparison matching-to-sample procedure to establish visual-visual equivalence. Equivalence responding emerged as in Experiment 2, and naming emerged by the end of Experiment 3. Results are discussed in terms of the history of training in bidirectional relations responsible for the emergence of visual-visual equivalence relations and of their implications for current theories of stimulus equivalence.     

Trunk posture affects upper extremity function of adults

This study examined the effects of various seated trunk postures on upper extremity function. 59 adults were tested using the Jebsen Taylor Hand Function Test while in three different trunk postures. Significant mean differences between the neutral versus the flexed and laterally flexed trunk postures were noted during selected tasks. Specifically, dominant hand performance during the tasks of feeding and lifting heavy cans was significantly slower while the trunk was flexed and laterally flexed than when performed in the neutral trunk position. Performance of the nondomi nant hand during the tasks of picking up small objects, page turning, as well as the total score was slower while the trunk was flexed compared to performance in the neutral trunk position. These findings support the assumption that neutral trunk posture improves upper extremity performance during daily activities although the effect is not consistent across tasks. Findings are discussed along with limitations and recommendations for research.     

Are complex psychotherapies more effective than biofeedback, progressive muscle relaxation, or both? A meta-analysis

A meta-analysis of 26 studies was conducted to assess whether more complex forms of psychotherapy would be superior to control treatments of either biofeedback, progressive muscle relaxation, or both. Consistent with hypotheses, more complex treatments provided a small, significant improvement over biofeedback and progressive muscle relaxation (r = .09). A subset of the more complex behavioral treatments accounted for most of this small incremental effectiveness of more complex treatments (r = .15). Possible sources of this incremental effectiveness are discussed.     

Research without Consent: Exception from and Waiver of Informed Consent in Resuscitation Research

The ethical concept of Informed Consent provides individuals with the right and the opportunity to approve of events that will occur regarding his or her own person. In medicine, informed consent is obtained for treatment and for research participation. However, under some circumstances, prospective informed consent cannot be obtained because of the devastating clinical condition of the patient. In emergency circumstances, treatment is never withheld if obtaining informed consent from a critically ill person is not possible or if a delay while seeking surrogates would further endanger life. In emergency research circumstances, waiving informed consent for study participation is fraught with additional ethical considerations. This article will review a presentation given at the June 2, 2006 conference entitled “The Ethics of Research in Emergency Medicine”. An earlier version of this paper was presented at: The 7th International Conference on Bioethics on “The Ethics of Research in Emergency Medicine”, held on June 2, 2006, Warsaw, Poland.     

Work-family climate, organizational commitment, and turnover: Multilevel contagion effects of leaders

This paper presents empirical research analyzing the relationship between work-family climate (operationalized in terms of three work-family climate sub-scales), organizational leadership (i.e., senior manager) characteristics, organizational commitment and turnover intent among 526 employees from 37 different hotels across the US. Using multilevel modeling, we found significant associations between work-family climate, and both organizational commitment and turnover intent, both within and between hotels. Findings underscored the importance of managerial support for employee work-family balance, the relevance of senior managers’ own work-family circumstances in relation to employees’ work outcomes, and the existence of possible contagion effects of leaders in relation to work-family climate.     

Change in emotional processing during a dialectical behavior therapy-based skills group for major depressive disorder

Across studies, paying attention to and analyzing one's emotions has been found to be both positively and negatively correlated with depression symptoms. One way of reconciling these seemingly contradictory findings is the possibility that attending to emotions in a skillful manner may help to reduce depression whereas attending to emotions with limited skill may be counterproductive. Dialectical behavior therapy (DBT) is a clinical intervention designed to foster adaptive awareness, expression, regulation, tolerance, and acceptance of emotions. Results of the present report come from a pilot study of a 16-week DBT-based skills training group for treatment-resistant major depressive disorder (MDD) as an adjunctive treatment to pharmacotherapy. Patients were randomized to treatment or a waitlist control group. A significant interaction revealed that increases in emotional processing were associated with decreases in depression symptoms in the DBT-based skills group; however, increases in emotional processing in the waitlist condition were associated with increases in depression. Results offer preliminary support for the idea that participating in DBT-based skills training may help individuals with treatment-resistant MDD to develop skills that facilitate processing emotions in a way that helps to reduce rather than exacerbate depression symptoms.     

The relationship between career adaptability, person and situation variables, and career concerns in young adults

We surveyed 245 first-year university students using measures of career concerns, career adaptability (career planning, career exploration, self-exploration, decision-making, self-regulation), goal-orientation (learning, performance-prove, performance-avoid) and social support (family, friends, significant others), and tested: (a) whether the career adaptability variables could be represented by a second-order factor of career adaptability; (b) whether career adaptability, goal-orientation and social support were associated with fewer career concerns; and (c) whether career adaptability mediated the relationship between goal-orientation and social support and career concerns. The study demonstrated that the career adaptability variables were inter-related and could be represented by a higher-order factor. Decision-making and self-exploration were negatively associated with career concerns, and decision-making mediated the relationship between goal-orientation and career concerns. Having more of a learning orientation was associated with more decision-making and fewer career concerns, whereas holding a performance-prove orientation was associated with poorer decision-making and more career concerns.