Psychometric properties of the mobility inventory for agoraphobia: convergent, discriminant, and criterion-related validity

Aims of this study were (a) to summarize the psychometric literature on the Mobility Inventory for Agoraphobia (MIA), (b) to examine the convergent and discriminant validity of the MIA's Avoidance Alone and Avoidance Accompanied rating scales relative to clinical severity ratings of anxiety disorders from the Anxiety Disorders Interview Schedule (ADIS), and (c) to establish a cutoff score indicative of interviewers’ diagnosis of agoraphobia for the Avoidance Alone scale. A meta-analytic synthesis of 10 published studies yielded positive evidence for internal consistency and convergent and discriminant validity of the scales. Participants in the present study were 129 people with a diagnosis of panic disorder. Internal consistency was excellent for this sample, α = .95 for AAC and .96 for AAL. When the MIA scales were correlated with interviewer ratings, evidence for convergent and discriminant validity for AAL was strong (convergent r with agoraphobia severity ratings = .63 vs. discriminant rs of .10–.29 for other anxiety disorders) and more modest but still positive for AAC (.54 vs. .01–.37). Receiver operating curve analysis indicated that the optimal operating point for AAL as an indicator of ADIS agoraphobia diagnosis was 1.61, which yielded sensitivity of .87 and specificity of .73.     

Prevention of depression among Icelandic adolescents: a 12-month follow-up

This paper reports the 12-month follow-up results regarding a program designed to prevent the initial episode of depression and/or dysthymia among Icelandic adolescents. This indicated prevention program was implemented in school settings for 14–15 year-old students judged to be “at risk” for depression because of the presence of some depressive symptoms and/or a negative attributional style. We previously reported (Arnarson & Craighead, 2009) that this program, when compared to treatment-as-usual, was effective in preventing the first episode of depression and/or dysthymia at 6-months following completion of the program. Survival analyses of the 12-month follow-up data indicated that the preventive effects were sustained at the end of 1 year following the completion of the prevention program with only 2 of the prevention program participants reporting an initial episode of MDD/DYS versus 13 of the TAU participants (χ² = 5.02, p = .025). Using logistic regression, we also found that initial level of depressive symptoms significantly (p = .0330) predicted the first episode of depression and/or dysthymia among TAU subjects. The limitations of the study were noted, and future directions of research regarding prevention of depression were discussed.     

A test of written emotional disclosure as an intervention for posttraumatic stress disorder

This study examined the efficacy of the written emotional disclosure (WED) procedure with a sample of young adults who met diagnostic criteria for posttraumatic stress disorder (PTSD). Participants were randomly assigned to either WED or a control writing condition and were assessed at baseline and one month following the writing sessions. During each writing session, participants’ heart rate was recorded; participants also provided self-report ratings of emotional responding. Findings indicated no significant group differences for PTSD and depression symptom severity at follow-up assessment. Relative to control participants, WED participants displayed significantly greater heart rate activity and reported greater emotional responding during the first writing session; however, no reduction in emotional responding occurred for either condition from the first to the last writing session. Taken together, these findings indicate that WED may not be an efficacious intervention for PTSD. Suggestions are made for future work in this area.     

Emotion dysregulation and adolescent psychopathology: a prospective study

Background

Emotion regulation deficits have been consistently linked to psychopathology in cross-sectional studies. However, the direction of the relationship between emotion regulation and psychopathology is unclear. This study examined the longitudinal and reciprocal relationships between emotion regulation deficits and psychopathology in adolescents.

Methods

Emotion dysregulation and symptomatology (depression, anxiety, aggressive behavior, and eating pathology) were assessed in a large, diverse sample of adolescents (N = 1065) at two time points separated by seven months. Structural equation modeling was used to examine the longitudinal and reciprocal relationships between emotion dysregulation and symptoms of psychopathology.

Results

The three distinct emotion processes examined here (emotional understanding, dysregulated expression of sadness and anger, and ruminative responses to distress) formed a unitary latent emotion dysregulation factor. Emotion dysregulation predicted increases in anxiety symptoms, aggressive behavior, and eating pathology after controlling for baseline symptoms but did not predict depressive symptoms. In contrast, none of the four types of psychopathology predicted increases in emotion dysregulation after controlling for baseline emotion dysregulation.

Conclusions

Emotion dysregulation appears to be an important transdiagnostic factor that increases risk for a wide range of psychopathology outcomes in adolescence. These results suggest targets for preventive interventions during this developmental period of risk.     

A feasibility study of Acceptance and Commitment Therapy for emotional dysfunction following psychosis

The experience of psychosis can lead to depression, anxiety and fear. Acceptance and Commitment Therapy (ACT) facilitates individuals to accept difficult mental experiences and behave in ways that are consistent with personally held values. This study was a single (rater) blind pilot randomised controlled trial of ACT for emotional dysfunction following psychosis. Twenty-seven participants with psychosis were randomised to either: ten sessions of ACT plus treatment as usual (TAU) or TAU alone. The Hospital Anxiety and Depression Scale, Positive and Negative Syndrome Scale, Acceptance and Action Questionnaire, Kentucky Inventory of Mindfulness Skills and Working Alliance Inventory were used. Individuals were assessed at baseline and 3 months post-baseline. The individuals randomised to receive ACT found the intervention acceptable. A significantly greater proportion of the ACT group changed from being depressed at time of entry into the study to not being depressed at follow-up. The ACT group showed a significantly greater increase in mindfulness skills and reduction in negative symptoms. Results indicated that individuals randomised to ACT had significantly fewer crisis contacts over the study. Changes in mindfulness skills correlated positively with changes in depression. ACT appears to offer promise in reducing negative symptoms, depression and crisis contacts in psychosis.     

中国创伤后应激反应量表在大学生群体中的应用

采用以中国文化为背景编制的“中国自然灾难幸存者创伤后应激反应量表(CPI)”, 对芦山地震灾区某大学1057名学生进行测试, 考察CPI在地震后大学生人群的应用, 并探讨PTSD的影响因素。结果发现, 性别、主观害怕体验和D型人格等因素能够预测PTSD症状的发生。CPI在地震受灾的大学生群体中具有良好的信效度, 可用于PTSD症状严重程度的评估。     

Parents' description of conduct problems in their children - a test of the Eyberg Child Behavior Inventory (ECBI) in a Swedish sample aged 3-10

The Eyberg Child Behavior Inventory (ECBI) is a widely used 36-item uni-dimensional parent rating scale constructed to measure disruptive behavior problems in children. However, in an American sample a 22-item version, including three subscales, has been suggested in order to increase the usefulness of the ECBI. Two studies were conducted to test the ECBI in a Swedish sample (N = 841). The aims of Study I were (a) examine the psychometric properties of the ECBI (b) to investigate the correspondence between mothers' and fathers' ratings, and (c) to obtain Swedish norms. The aim of Study II was to test the suggested three-factor solution in the Swedish sample using a confirmatory factor analysis (CFA). The ECBI showed good psychometric properties also in the present study, and Swedish normative data is presented. The best-fitting CFA-model was identical to the previously suggested three-factor model, which thus might be a useful alternative to the 36-item version.     

Academic Achievement Over 8 Years Among Children Who Met Modified Criteria for Attention-deficit/Hyperactivity Disorder at 4–6 Years of Age

The predictive validity of symptom criteria for different subtypes of ADHD among children who were impaired in at least one setting in early childhood was examined. Academic achievement was assessed seven times over 8 years in 125 children who met symptom criteria for ADHD at 4–6 years of age and in 130 demographically-matched non-referred comparison children. When intelligence and other confounds were controlled, children who met modified criteria for the predominantly inattentive subtype of ADHD in wave 1 had lower reading, spelling, and mathematics scores over time than both comparison children and children who met modified criteria for the other subtypes of ADHD. In some analyses, children who met modified criteria for the combined type had somewhat lower mathematics scores than comparison children. The robust academic deficits relative to intelligence in the inattentive group in this age range suggest either that inattention results in academic underachievement or that some children in the inattentive group have learning disabilities that cause secondary symptoms of inattention. Unexpectedly, wave 1 internalizing (anxiety and depression) symptoms independently predicted deficits in academic achievement controlling ADHD, intelligence, and other predictors.     

Implicit depression and hopelessness in remitted depressed individuals

Cognitive theories of depression posit that automatically activated cognitive schemas, including negative thoughts about the self and the future, predispose individuals to develop depressive disorders. However, prior research has largely examined these constructs using explicit tests in currently depressed individuals. Using the Implicit Association Test (IAT), the present study examined automatic associations between the self and mood state ("depression IAT") and between the future and mood state ("hopelessness IAT") before and after a negative mood induction in 19 remitted depressed individuals and 23 healthy controls. In the depression IAT, remitted depressed participants exhibited an overall lower tendency to associate themselves with happiness relative to the healthy controls before the mood induction. Control, but not remitted depressed, participants' automatic associations between the self and happiness diminished following the mood induction. Contrary to our hypotheses, no significant findings emerged when considering the hopelessness IAT. Consistent with prior studies, no significant correlations emerged between implicit and explicit biases, suggesting that these measures probe different processes. Results extend prior IAT research by documenting the presence of a reduced tendency to associate the self with happiness in a sample at increased risk for depression.     

Prospective and positive mental imagery deficits in dysphoria

We know less about positive mental imagery than we do about negative mental imagery in depression. This study examined the relationship between depressed mood and the subjective experience of emotion in imagined events; specifically, prospective imagery, and imagery in response to emotionally ambiguous stimuli. One hundred and twenty-six undergraduates completed measures of depression, imagery vividness for future events, and a homograph interpretation task in which they generated images and subsequently rated image pleasantness and vividness. As predicted, compared to low dysphoria, high dysphoria was associated with poorer ability to vividly imagine positive (but not negative) future events. These findings were augmented by the observation that high dysphorics provided lower pleasantness ratings of images generated in response to homographs they interpreted as positive. We suggest that an imbalance in the inability to vividly imagine positive but not negative future events may curtail the ability of high dysphorics to be optimistic. High dysphoric individuals are further disadvantaged: even when they interpret ambiguity positively, the resulting images they generate are associated with less positive affect. Therapeutic strategies that address both such positive-specific imagery biases hold promise for depression treatment innovation.