Latent class analysis of eating disorders: relationship to mortality

The current diagnostic nomenclature for eating disorders has shortcomings. Empirical attempts to identify a new nomenclature have found numerous latent structures, but validation of this work has been largely cross-sectional, and nothing is known yet about the relationship of derived latent classes to mortality. This study examined latent diagnostic structure in 1,885 participants seeking outpatient eating disorder treatment over an 18-year period. Eating disorder symptoms were used as indicators, and the main validator was mortality as assessed using computerized linkage to the National Death Index. Six latent classes were derived; three of the six had significantly elevated standardized mortality ratios. It appeared that the latent class structure yielded better delineation of mortality risk than the existing classifications in the Diagnostic and Statistical Manual of Mental Disorders. These results provide support for an alternative, empirically derived diagnostic structure.     

EARLY RESPONSE DISTRIBUTION AND OUTCOMES OF RESPONSE-RESTRICTION ANALYSES

We examined whether the results of a response‐restriction analysis (RRA) could be predicted on the basis of response distribution in early sessions, when these sessions indicated interaction with multiple items. Four preschool‐aged children participated. For 3 of the 4 participants, the results from sessions conducted prior to restriction of the first item corresponded closely with results of the full RRA.     

Pathogenesis: Freud’s Paul and the question of historical truth

Continental Philosophy Review - This article retrieves Freud’s Paul as a forgotten predecessor and untapped critic of the “return to Paul” in contemporary political theology and...     

The Development of Global and Local Processing: A Comparison of Children to Adults

In light of the adult model of a hemispheric asymmetry of global and local processing, we compared children (M _age = 8.4 years) to adults in a global-local reaction time (RT) paradigm. Hierarchical designs (large shapes made of small shapes) were presented randomly to each visual field, and participants were instructed to identify either the global or the local level in each of two blocks. We obtained evidence of a global-local processing asymmetry, with stronger effects for children than for adults. In both children and adults, responses were faster and more accurate for global identification in the right hemisphere and for local identification in the left hemisphere. Similarly, a significant asymmetry of global and local interference was obtained in children but not in adults. Interference reflects the RT cost of conflicting information at the nonattended level. For example, local interference indicates the degree to which inconsistency at the local level slows global identification. Stronger evidence for lateralized processing in children is discussed within the framework of increasing interhemispheric transfer. That is, as interhemispheric transfer increases, cost of presentation to the nonpreferred hemisphere (e.g., local identification in the right hemisphere) is reduced.     

Describing suicidality: an investigation of qualitative SSF responses

Given the incidence and seriousness of suicidality in clinical practice, the need for new and better ways to assess suicide risk is clear. While there are many published assessment instruments in the literature, survey data suggest that these measure are not widely used. One possible explanation is that current quantitatively developed assessment instruments may fail to capture something essential about the suicidal patient's experience. The current exploratory study examined a range of open ended qualitative written responses made by suicidal outpatients to five assessment prompts from the Suicide Status Form (SSF)--psychological pain, press, perturbation, hopelessness, and self-hate. Two different samples of suicidal outpatients seeking treatment, including suicidal college students (n = 119) and active duty U.S. Air Force personnel (n = 33), provided a wide range of written responses to the five SSF prompts. A qualitative coding manual was developed through a step-by-step methodology; two naive coders were trained to use the coding system and were able to sort all the patients' written responses into the content categories with very high interrater reliability (Kappa > .80). Certain written qualitative responses of the patients were more frequent than others, both within and across the five SSF constructs. Among a range of specific exploratory findings, one general finding was that two thirds of the 636 obtained written responses could be reliably categorized under four major content headings: relational (22%), role responsibilities (20%), self (15%), and unpleasant internal states (10%). Theoretical, research, and clinical implications of the methodology and data are discussed.     

Children and cigarettes: The effect of a model who quits

Twenty-six previous studies were reviewed which demonstrated a consistent link between children's smoking uptake and exposure at home to an actively smoking older family member. The present study included another variable: the family model of smoking cessation. The smoking practices, intentions, and attitudes of 344 children aged 10–14 in Western Australia were anonymously assessed. Those with ex-smokers but no active smokers at home resembled children who had never been exposed to a smoking family model in being less likely to smoke now or intend to in the future, having fewer smoking chums, and believing that cigarettes had more personal and social disadvantages than their peers who shared households with active smokers. This suggested that any pro-smoking modeling while the ex-smoker was active had been counteracted by modeling of quitting. Implications for intervention were discussed.