Measuring depression at the end of life: is the Hamilton Depression Rating Scale a valid instrument?

Depression at the end of life is a common mental health issue with serious implications for quality of life and decision making. This study investigated the reliability and validity of one of the most frequently used measures of depression, the Hamilton Depression Rating Scale (HAM-D) in 422 patients with terminal cancer admitted to a palliative care hospital. The HAM-D demonstrated high reliability and concurrent validity with depression diagnosis, based on Structured Clinical Interview for DSM-IV Axis I Disorders, non-patient research version (SCID-I/NP Depression Module). Receiver Operating Characteristic (ROC) analyses generated an area under the curve of .91, indicating high sensitivity and specificity. The HAM-D strongly correlated with several measures of distress (e.g., hopelessness, desire for hastened death, and suicidal ideation). Factor analysis generated 4 factors (anxiety, depressed mood, insomnia, and somatic symptoms), accounting for 42% of the variance. Implications for assessing depression in this population are discussed.     

The effects of torture-related injuries on long-term psychological distress in a Punjabi Sikh sample

Torture survivors often report chronic debilitating physical and psychological distress. Prior research on the relationship between physical and psychological trauma suggests that the 2 are not independent. Injury sustained during torture may increase the likelihood of subsequent distress as either a moderator or mediator. For long-term psychopathology in a sample of Punjabi Sikh survivors of human rights violations (N = 116), chronic injuries mediated the path between torture and posttraumatic stress disorder, specifically the severity of numbing symptoms. Although injuries were associated with major depression, torture was not, and injuries did not moderate the relationship between major depression and torture. Chronic injuries may represent trauma severity or persistent traumatic cues. These findings emphasize connections between physical and psychological trauma and the importance of an interdisciplinary approach to torture treatment.     

Full Information Maximum Likelihood Estimation for Latent Variable Interactions With Incomplete Indicators

Researchers have developed missing data handling techniques for estimating interaction effects in multiple regression. Extending to latent variable interactions, we investigated full information maximum likelihood (FIML) estimation to handle incompletely observed indicators for product indicator (PI) and latent moderated structural equations (LMS) methods. Drawing on the analytic work on missing data handling techniques in multiple regression with interaction effects, we compared the performance of FIML for PI and LMS analytically. We performed a simulation study to compare FIML for PI and LMS. We recommend using FIML for LMS when the indicators are missing completely at random (MCAR) or missing at random (MAR) and when they are normally distributed. FIML for LMS produces unbiased parameter estimates with small variances, correct Type I error rates, and high statistical power of interaction effects. We illustrated the use of these methods by analyzing the interaction effect between advanced cancer patients’ depression and change of inner peace well-being on future hopelessness levels.     

Do tests of malingering concur? Concordance among malingering measures

Malingering test accuracy is increasingly a major issue in psychology and law. Integrating results across measures might offset limitations of a single test, but the practical benefits of using several tests depend on the extent to which they misclassify the same individuals. Data from 66 evaluatees were used to assess the degree of overlap and consistency of classification among several commonly used malingering instruments. Although correlative data indicated that measures were highly redundant even across symptom domains, classification accuracy analyses revealed that findings based on conjunctions of these scales may not overlap to the degree that the correlations might suggest.     

Expansion of Genetic Services Utilizing a General Genetic Counseling Clinic

We established a general genetic counseling clinic (GCC) to help reduce long wait times for new patient appointments and to enhance services for a subset of patients. Genetic counselors, who are licensed in Tennessee, were the primary providers and MD geneticists served as medical advisors. This article describes the clinic referral sources, reasons for referral and patient dispositions following their GCC visit(s). We obtained patients by triaging referrals made to our medical genetics division. Over 24 months, our GCC provided timely visits for 321 patients, allowing the MD geneticists to focus on patients needing a clinical exam and/or complex medical management. Following their GCC visit(s), over 80 % of patients did not need additional appointments with an MD geneticist. The GCC allowed the genetic counselor to spend more time with patients than is possible in our traditional medical genetics clinic. Patient satisfaction surveys (n?=?30) were very positive overall concerning the care provided. Added benefits for the genetic counselors were increased professional responsibility, autonomy and visibility as health care providers. We conclude that genetic counselors are accepted as health care providers by patients and referring providers for a subset of clinical genetics cases. A GCC can expand genetic services, complement more traditional genetic clinic models and utilize the strengths of the genetic counselor health care provider.     

Do Occupational Performance and Social Support Predict Health and Well-Being Among Mothers of Preterm Infants?

Journal of Child and Family Studies - Giving birth to a preterm infant has significant implications on the mother’s life. The purpose of this study was to compare occupational performance...     

Assessment and treatment of obsessional harassment

Obsessional harassment and stalking have become increasingly recognized as significant social problems, often with dramatic negative repercussions on the lives of victims. As the public awareness of this problematic behavior has grown, the amount of clinical attention and empirical research focused on understanding the perpetrators of harassment has increased accordingly. Nevertheless, relatively little research has addressed the numerous issues involved in the assessment and treatment of obsessional harassment offenders. This article reviews the existing research on obsessional harassment/stalking, and offers a diagnostic typology of these offenders based on the nature of the relationship with the victim and the motivation of the offender. Treatment modalities are then discussed with regard to each of the primary diagnoses that occur among obsessional harassment offenders. Finally, strategies for initiating treatment for unmotivated or unwilling offenders are discussed, along with clinical issues that arise in the evaluation and treatment process.