Psychometric evaluation of trauma and posttraumatic stress disorder assessments in persons with severe mental illness

Interrater reliability, internal consistency, test-retest reliability, and convergent validity were examined for the Trauma History Questionnaire (THQ), the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (CAPS), and the PTSD Checklist (PCL) in 30 clients with severe mental illnesses. Interrater reliability for the THQ and CAPS was high, as was internal consistency of CAPS and PCL subscales. The test-retest reliability of the THQ was moderate to high for different traumas. PTSD diagnoses on the CAPS and PCL showed moderate test-retest reliability. Lower levels of test-retest reliability for PTSD diagnoses were related to psychosis diagnoses and symptoms. However, when more stringent criteria for PTSD were used on the CAPS, it had excellent test-retest reliability across all clients. CAPS and PCL diagnoses of PTSD showed moderate convergent validity. The results support the reliability of trauma and PTSD assessments in clients with severe mental illness.     

A generalized signal detection model to predict rational variation in base rate use

The predominant models of rational behavior currently used to analyze a large class of experiments imply that subjects neglect or place insufficient weight on base rates when making probabilistic judgments. We argue that the evidence is inadequate for this conclusion because the models make needlessly restrictive assumptions about how base rates should be used. The restrictive assumptions stem from a misuse of Bayes' rule that ignores specific aspects of how the proportions arose. We develop a model of rational behavior that generalizes signal detection theory to reflect the environment subjects routinely face and we reexamine the relevant experimental literature. Variation observed in subjects' responses to base rate information is explained by the present rational model more fully than by extant models.     

Physical Attractiveness and Psychological Adjustment Among Substance Abuse Inpatients: A Longitudinal Study1

Relations between psychological adjustment and physical attractiveness were examined longitudinally in substance abuse inpatients, controlling for the effects of length of drug abuse, length of inpatient stay, age, and socioeconomic status. Measures of adjustment and attractiveness were obtained during the first week of admission and six weeks later (within two weeks of discharge). Regression analyses indicated that initial attractiveness did not predict later adjustment, and initial adjustment did not predict later attractiveness. Partial correlation analyses revealed a positive association between attractiveness and adjustment at the first time point, but not at the later time point. These results suggest that physical attractiveness exerts only a temporary effect on judgments of adjustment in an inpatient setting. Attractiveness may affect decisions made when screening patients at mental health facilities, but may not affect decisions made over the full course of inpatient treatment.     

Trauma and posttraumatic stress disorder in people with schizophrenia

This study evaluated the hypothesis that trauma and posttraumatic stress disorder (PTSD) severity would be positively associated with schizophrenia symptoms. Forty-seven clients with schizophrenia were assessed for schizophrenia severity and for lifetime trauma history and PTSD symptoms in 2 independent symptom interviews; 35 (74%) participants reported at least 1 event in which there was threat of harm or life threat and subjective distress, and 6 (13%) had current PTSD. Trauma across the life span was associated with greater severity of PTSD. Within the total sample, PTSD symptoms were associated with greater emotional distress, but not with schizophrenia-specific symptoms. Distress among clients with schizophrenia and PTSD suggests the need for routine assessment of PTSD and development of PTSD interventions in this population.