Evaluation of the PAI–A Anxiety and Depression Scales: Evidence of Construct Validity

Against the background of a dearth of studies examining the properties of the scale scores of the Personality Assessment Inventory–Adolescent (PAI–A; Morey, 2007), this study was conducted to evaluate evidence of construct validity for the Anxiety (ANX) and Depression (DEP) scales of the PAI–A. Convergent and discriminant validity of the ANX and DEP scale scores were investigated using a sample of adolescents admitted to the adolescent program of a private tertiary care inpatient treatment facility. Multiple methods assessing anxious and depressive symptomology and diagnoses were included. Construct validity of the ANX and DEP scales was mostly supported. Advantages of using the PAI–A for the assessment of anxiety and depression were discussed.     

Methodological considerations in developing measures of HIV risk-relevant behaviors and attitudes: An empirical illustration

Abstract

This paper describes the pilot testing of a survey designed to assess the prevalence of HIV exposure risk-relevant behaviors and associated attitudes, beliefs and knowledge in a heterogeneous, ethnically diverse, sexually active population (the US Army). The specific objectives for the pilot test were to: (1) define optimal survey question formats for behavioral and attitude items; (2) identify questions that were poorly worded or that would not contribute to the overall objectives of the survey; (3) assess the extent to which respondents could accurately follow instructions; (4) identify appropriate and culturally relevant terminology for sensitive items; (5) determine the appropriate timeframe for recall of simple and complex sexual behaviors; (6) assess the degree of respondent honesty and belief in the anonymity of the survey results.     

A systematic review of activities at a high-volume ethics consultation service

We describe the ethics consultation service (ECS) at the Cleveland Clinic and report on its activities over a 24-month period in which 478 consultations were performed.To our knowledge, this is the largest case series of ethics consultations reported to date. Established more than 25 years ago, the ECS at the Cleveland Clinic is staffed by multiple consultants with advanced training in bioethics. Several of these ethicists work closely with specialized clinical units and research departments, where they participate in multidisciplinary meetings and provide specialized assistance. This combination of historical experience, large numbers of consultation requests, and specialized clinical ethicists suggests that the experience at the Cleveland Clinic may be helpful to ethicists and others who may be considering how to structure and sustain a vibrant ECS. Our results highlight the diversity of activities performed by a high-volume ECS at a tertiary care facility. Our hope in sharing the inner workings of the ECS at the Cleveland Clinic is to promote dialogue on common practices and approaches across medical institutions that support ethics consultation.     

Predicting substance use behavior among South African adolescents: The role of leisure experiences across time

Using seven waves of data, collected twice a year from the 8th through the 11th grades in a low-resource community in Cape Town, South Africa, we aimed to describe the developmental trends in three specific leisure experiences (leisure boredom, new leisure interests, and healthy leisure) and substance use (cigarettes, alcohol, and marijuana) behaviors and to investigate the ways in which changes in leisure experiences predict changes in substance use behaviors over time. Results indicated that adolescents' substance use increased significantly across adolescence, but that leisure experiences remained fairly stable over time. We also found that adolescent leisure experiences predicted baseline substance use and that changes in leisure experiences predicted changes in substance use behaviors over time, with leisure boredom emerging as the most consistent and strongest predictor of alcohol, cigarette, and marijuana use. Implications for interventions that target time use and leisure experiences are discussed.     

The Difficulties in Emotion Regulation Scale: Factor Structure and Association with Nonsuicidal Self-Injury in Adolescent Inpatients

Research suggests that difficulties in emotion regulation are an important correlate of nonsuicidal self-injury (NSSI) in adults. Research examining this link in adolescents is limited by the lack of comprehensive instruments to assess difficulties in emotion regulation. Against this background, the aims of the current study were to (a) confirm the six-factor structure of the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, Journal of Psychopathology and Behavioral Assessment, 23(4), 253?C263, 2004) in a sample of adolescent inpatients (N?=?218); (b) explore the relation between different aspects of emotion dysregulation and lifetime NSSI while controlling for psychopathology and sex; and (c) assess the clinical utility of the DERS in detecting lifetime NSSI status. Fit indices obtained through Confirmatory Factor Analysis indicated that the six-factor structure of the DERS fit the data adequately and that most items loaded strongly on their respective latent factor. All six latent factors were significantly correlated with each other, with the exception of lack of emotional awareness and difficulties engaging in goal-directed behavioral when distressed. Regression analyses revealed that only the limited access to emotion regulation strategies subscale accounted for a significant portion of the variance in NSSI when controlling for other aspects of emotion dysregulation, sex, and psychopathology. Receiver Operating Characteristic analysis indicated that the DERS limited access to emotion regulation strategies subscale score has moderate diagnostic accuracy in detecting the presence of NSSI. The optimal cut-off score was 21.5 when detecting NSSI among inpatient adolescents. Results provide further support for the relation between emotion regulation difficulties and NSSI. The DERS appears to be a useful measure of detecting NSSI in clinical samples of adolescents.     

Social Discounting and Externalizing Behavior Problems in Boys

Social discounting refers to the fact that most people assign more value to the welfare of close affiliates than they do to the welfare of distant affiliates—they discount the latter compared to the former. We report the first study to apply a social discounting paradigm to boys. We were particularly interested in investigating the relations between social discounting, age, and externalizing behavior problems (antisocial behavior). Results showed that (1) preadolescent boys were more likely than adolescent boys to show atypical response patterns in allocating rewards to affiliates; (2) task behavior was well represented as social discounting once boys with atypical response patterns were deleted from the sample, and (3) boys functioning in the clinical range on indices of externalizing behavior problems demonstrated steeper social discounting compared to controls. We conclude that social discounting as a measure of perceived social closeness is feasible for use in adolescent samples. Social discounting may operate similarly to other forms of discounting in impulsive individuals. Copyright © 2011 John Wiley & Sons, Ltd.     

Working within an Individual Zone of Optimal Functioning (IZOF) framework: Consultant practice and athlete reflections on refining emotion regulation skills

Objective

To examine how working within Hanin’s (2000a) Individual Zone of Optimal Functioning theoretical model (IZOF) informs intervention development for enhancing athletes’ emotion regulation skills.

Design

A single case study design was adopted to examine the applied process of facilitating a female university cross-country runner’s emotion regulation skills.

Method

Consultant reflections followed Boud’s (2001) reflective learning model for immediate and delayed reflection that informed an action research narrative organized round Kellmann and Beckmann’s (2003) action research cycle. A social validation interview was conducted following program completion to examine the athlete’s responses to the emotion regulation intervention.

Results

Consultant’s professional practice decisions and action taken to support the intervention are highlighted. Specifically, the employment and extension of Hanin’s (2000c) IZOF profiling process to inform the development of athlete skills in emotion regulation are described. Moreover, how the content and intensity of performance related subjective emotion, physiological symptom, and cognitive zone profiles for optimal performance guided the identification and enhancement of techniques contributing to effective emotion regulation is illustrated. Athlete interview responses support the overall efficacy of the intervention program.

Conclusion

The present case study supports the efficacy of working within an IZOF framework from a consultant perspective. Furthermore, athlete reflections suggest enhanced skills in emotion regulation were perceived to result from the intervention.