The clinician-investigator: unavoidable but manageable tension

The "difference position" holds that clinical research and therapeutic medical practice are sufficiently distinct activities to require different ethical rules and principles. The "similarity position" holds instead that clinical investigators ought to be bound by the same fundamental principles that govern therapeutic medicine--specifically, a duty to provide the optimal therapeutic benefit to each patient or subject. Some defenders of the similarity position defend it because of the overlap between the role of attending physician and the role of investigator in a research trial. This overlap is maximal when the same physician occupies both roles with respect to a particular patient-subject. We address the ethical tensions inherent in that role conflict and argue that the tensions are real but manageable. The difference position provides a sound ethical framework within which to manage those tensions, while the similarity position is unsatisfactory because it seeks to deny the existence of the tensions.     

Validation of the Japanese version of the NEO Five-Factor Inventory in a large community sample

The NEO Five-Factor Inventory is the shortened version of the Revised NEO Personality Inventory. The aim of this study was to examine the reliability and validity of the Japanese version of the shortened version in the general population of Japan. This version was translated into Japanese and then administered to 2,051 adults in a rural town in Akita Prefecture. A total of 1,664 (81.1%) individuals gave valid answers. Internal reliability, assessed by Cronbach alpha for subscales, ranged from .60 to .77. The scales were only weakly correlated both with each other and with age. In a multiple regression analysis, only the Neuroticism scale score was a significant predictor of scores on the General Health Questionnaire. Factor analysis supported the theoretical structure of personality. Overall, the Japanese version showed good reliability and validity in this sample of the general population of Japan.     

Gender Differences in Rape Reporting

This paper compares male and female rapereporting behavior. Participants from National Crime andVictimization Survey data (90% female, 10% male) aremuch like victims of other violent crimes (25%non-white, higher than average unemployment, young, andunmarried). The data indicate that the situationalcharacteristics of rape, and factors that influence arape reporting decision, differ by sex. Whereas men fail to report rape when it jeopardizes theirmasculine self-identity, women fail to report rape whenthe rape does not fit the classic stereotypical rapesituation. Women reported victimization more frequently than did men. It is asserted that furthercomparative research on rape reporting behaviorutilizing qualitative methods is needed in order tofully understand rape victimization for bothsexes.     

Lay Theories Concerning Causes and Treatment of Depression

This study compared perceptions of the causes of, therapies for, and means of coping with, depression between two groups of currently nondepressed adults: one with a history of major depression and one with no history of depression. Currently nondepressed participants were selected so that effects of past experience of depression could be distinguished from those of current mood. Recovered depressed participants (RD) (n = 25) and Never depressed participants (ND) (n = 25) recruited via newspaper advertisements completed self-report measures of (a) the perceived utility of either professional or self-help coping strategies for managing their own experiences of depression; (b) likely effectiveness of several major therapies for depression; and (c) perceived accuracy of several etiological theories of depression. RD participants rated depression as being less amenable to everyday self-help methods of coping and more in need of professional intervention. However, RD and ND subgroups did not differ significantly in their perceptions of the plausibility of etiological theories of depression in general, nor in their ratings of the likely helpfulness of major therapies.     

Does infancy matter? predicting social behavior from infant temperament

In this essay we argue that infant temperament, defined as behavioral styles that appear early in life as a direct result of neurobiological factors, plays a significant role in the development and expression of social behavior. Temperament may be studied using a typological or dimensional approach and the relations between early temperament and later behavior can be examined in terms of homotypic or heterotypic continuity. The implication of each of these approaches for understanding the influence of infant temperament on social development is examined. As well, utilizing data from our laboratory, we suggest that under certain circumstances one can predict social behavior by identifying two temperament types in infancy. These types are high reactive/high negative infants and high reactive/high positive infants. A significant proportion of the high reactive/high negative infants display behavioral inhibition and social reticence through the preschool years, whereas a significant proportion of the high reactive/high positive infants display exuberance and positive social interaction through the preschool period.     

Attachment Versus Differentiation: The Contemporary Couple Therapy Debate

This paper reviews the current debate between differentiation and attachment in treating couples through exploring the tenets of crucible therapy (Schnarch, 1991) and emotionally focused couple therapy (Johnson, 2004). We provide a review of the two theories—as well as the two “pure form” example models—and explore the debate in light of the integrative movement in couple and family therapy (Lebow, 2014). We also examine points of convergence of the two theories and models, and provide clinicians and researchers with an enhanced understanding of their divergent positions. Both differentiation and attachment are developmental theories that highlight the human experience of balancing individuality and connection in adulthood. The two models converge in terms of metaconcepts that pervade their respective theories and approach. Both models capitalize on the depth and importance of the therapeutic relationship, and provide rich case conceptualization and processes of therapy. However, they substantially differ in terms of how they view the fundamental aspects of adult development, have vastly divergent approaches to how a therapist intervenes in the room, and different ideas of how a healthy couple should function. In light of the deep polarization of the two models, points of integration—particularly between the broader theories of attachment and differentiation—are offered for therapists to consider.     

The detection of feigned disabilities: the effectiveness of the Personality Assessment Inventory in a traumatized inpatient sample

Research on feigned mental disorders indicates that severe psychopathology coupled with significant trauma histories often complicate feigning determinations, resulting in inaccuracies on otherwise effective measures. As part of malingering assessments, the Personality Assessment Inventory (PAI) is often used because of its excellent validation and the availability of three feigning indicators (Negative Impression, Malingering Index, and Rogers Discriminant Function), which have evidenced large effect sizes and clinically useful cut scores. The current study examined the effectiveness of the PAI in a traumatized inpatient sample using a between-subjects simulation design. Although Negative Impression appeared affected by trauma--especially in conjunction with dissociative symptoms--very positive results were found for Malingering Index and Rogers Discriminant Function. They remained relatively unelevated under honest conditions, despite posttraumatic stress disorder and extensive comorbidity. Using single-point cut scores provided moderately good classification of feigned and genuine PAI profiles. For purposes of classification, the authors operationally defined small indeterminate groups that were considered too close to classify (i.e., ±5T of the cut scores). With indeterminate cases removed, the overall classification rates improved modestly. However, the more important finding involved the error rates for the indeterminate group, which exceeded 50%. Directions for further research are discussed.     

DIFFERENTIAL RESPONDING ACROSS THERAPISTS IN A FUNCTIONAL ANALYSIS: A CASE STUDY

False negative functional analysis (FA) results may be less likely when caregivers serve as therapists, as problem behavior may be more likely to occur in the presence of a caregiver than with a novel therapist. This case study both replicated and extended prior research on this topic. It provides an example of FA results differing between a caregiver and novel therapist and also showed that FA results may differ across caregivers when they serve as therapists. Copyright © 2012 John Wiley & Sons, Ltd.