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.     

A systematic review of training programs for parents of children with autism spectrum disorders: Single subject contributions

Aim: The purpose of this systematic review was to examine research utilizing single subject research designs (SSRD) to explore the effectiveness of interventions designed to increase parents' ability to support communication and social development in children with autism spectrum disorders (ASDs). Method: Included studies were systematically assessed for methodological quality (Logan et al., 2008; Smith et al., 2007) and intervention effects. Data examining participant characteristics, study methodology, outcomes, and analysis were systematically extracted. Results: Eleven SSRD parent-training intervention studies examining 44 participants with ASD were included. Overall, the studies were of moderate quality and reported increases in parent skills and child language and communication outcomes. Interpretation: The results supported by improvement rate difference (IRD) analysis indicated several interventions demonstrated positive effects for both parent and child outcomes. However, limited generalization and follow-up data suggested only one intervention demonstrated parents' accurate and ongoing intervention implementation beyond training.     

Spiritual Integration Predicts Self-Reported Mental and Physical Health

Data from 167 participants were used to establish the psychometric properties of the Reidhead spiritual integration scale, 31-item version (SI-31). Structural equation modeling was used to empirically evaluate influences on perceived health functioning, while accounting for possible confounds. The analyses showed that SI-31 predicted perceived mental and physical health while controlling for life satisfaction, religious variables, mood patterns, depression symptoms, and demographics. The importance of SI as a predictor of health-related outcomes is supported, as is the usefulness of the SI-31 in predicting these outcomes.     

Person and environmental factors associated with well-being in medical students

Medical students are exposed to demanding academic workloads and are often under considerable psychological strain. This study examined important person and environmental variables that might predict their psychological well-being. Participants were 755 students in years 2-6 from 11 Australian medical schools. A web-based survey assessed well-being, personality, professional expectations, lifestyle expectations, barriers, academic stress, and debt. A hierarchical regression analysis demonstrated that extraversion, conscientiousness, professional expectations, and lifestyle expectations were positively associated with well-being, while academic stress, which was the strongest predictor, neuroticism, and concern about debt were negatively associated. Medical students who displayed a disposition that was outgoing, conscientious, and stable, who were less stressed about their academic workload and their level of debt, and who held higher expectations for their future professional career, and expectations of a balanced lifestyle, had better well-being. Medical educators should be aware of these factors and provide support and strategies that promote well-being to students during medical training.     

A generalized least squares regression approach for computing effect sizes in single-case research: application examples

A new method for deriving effect sizes from single-case designs is proposed. The strategy is applicable to small-sample time-series data with autoregressive errors. The method uses Generalized Least Squares (GLS) to model the autocorrelation of the data and estimate regression parameters to produce an effect size that represents the magnitude of treatment effect from baseline to treatment phases in standard deviation units. In this paper, the method is applied to two published examples using common single case designs (i.e., withdrawal and multiple-baseline). The results from these studies are described, and the method is compared to ten desirable criteria for single-case effect sizes. Based on the results of this application, we conclude with observations about the use of GLS as a support to visual analysis, provide recommendations for future research, and describe implications for practice.     

Bergmann’s dilemma: exit strategies for internalists

Michael Bergmann claims that all versions of epistemic internalism face an irresolvable dilemma. We show that there are many plausible versions of internalism that falsify this claim. First, we demonstrate that there are versions of “weak awareness internalism” that, contra Bergmann, do not succumb to the “Subject’s Perspective Objection” horn of the dilemma. Second, we show that there are versions of “strong awareness internalism” that do not fall prey to the dilemma’s “vicious regress” horn. We note along the way that these versions of internalism do not, in avoiding one horn of the dilemma, succumb to the dilemma’s other horn. The upshot is that internalists have many available strategies for avoiding dilemmatic defeat.     

The Bidimensional Impression Management Index (BIMI): Measuring Agentic and Communal Forms of Impression Management

Measures of impression management have yet to incorporate two-factor models of person perception. The 2 primary factors are often labeled agency and communion. In Study 1, we assembled a new measure of impression management—the Bidimensional Impression Management Index (BIMI): It comprises 2 subscales designed specifically to tap agentic and communal content. Both subscales showed adequate alpha reliabilities under both honest and faking conditions. In Study 2, the BIMI was cross-validated in a new sample: The subscales remained relatively independent, and their reliabilities remained solid. A coherent pattern of personality correlates also supported the validities of both subscales. In Study 3, the differential sensitivity of the 2 subscales was demonstrated by manipulating the job type in simulated job applications. Implications and applications of the BIMI are discussed.     

Traces of Reduction: Marion and Heidegger on the Phenomenon of Religion

In his work, Being Given, Jean‐Luc Marion calls for a phenomenological investigation of the givenness (donation) of the phenomenon. As a phenomenologist of religion, Marion aims to give a philosophical account of the possibility of revelation, something which by definition is unconditionally given. In Being Given, he contends that his phenomenological reduction to unconditional givenness (in the figure of the saturated phenomenon) can account for religious phenomena in a way that respects the subject matter, all the while remaining philosophically neutral. In this paper I argue that Marion's aim to maintain strict philosophical neutrality interferes with his attempt to respect the subject matter of his own investigation, i.e., the givenness of revelation, since revelation is recognizably given, even as possibility, only in the non‐neutral context of an interpretive tradition. I establish the latter claim with recourse to Heidegger's early hermeneutic sketches of ‘primordial Christian religiosity.’ In turn, I call for a phenomenological Destruktion of Marion's work in order to release its potential as a non‐neutral investigation of a distinctively Catholic religiosity.     

What Can Feminist Epistemology Do for Surgery?

Surgery is an important part of contemporary health care, but currently much of surgery lacks a strong evidence base. Uptake of evidence‐based medicine (EBM) methods within surgical research and among practitioners has been slow compared with other areas of medicine. Although this is often viewed as arising from practical and cultural barriers, it also reflects a lack of epistemic fit between EBM research methods and surgical practice. In this paper we discuss some epistemic challenges in surgery relating to this lack of fit, and investigate how resources from feminist epistemology can help to characterize them. We point to ways in which these epistemic challenges may be addressed by gathering and disseminating evidence about what works in surgery using methods that are contextual, pluralistic, and sensitive to hierarchies.