Avoidance and depression: the construction of the cognitive-behavioral avoidance scale

Previous research has demonstrated a relationship between avoidance and depression, although the nature of this relationship has been confused by inconsistent definitions of avoidance. Following a review of the construct of avoidance and an examination of past research, a new multidimensional measure of avoidance was developed and validated using an undergraduate student sample (245 females and 146 males). Four reliable factors reflecting combinations of cognitive/behavioral and social/nonsocial dimensions of avoidance were obtained from the factor analysis of the new scale, entitled the "Cognitive-Behavioral Avoidance Scale" (CBAS). The scale showed the predicted relationships with convergent and divergent measures used for construct validation. As predicted, subscales of the CBAS, as well as the overall scale score, were significantly related to the depression and anxiety criterion measures. The findings from this study suggest that avoidance may be an important construct in the psychosocial conceptualization of depression. In addition, this integrated measure of avoidance has potential utility for depression researchers. Suggestions for further scale development and research are provided.     

The Göteborg discothèque fire, 1998

Findings from a study of 563 adolescents’ reactions following a discotheque fire that killed 63 young people in Göteborg in October 1998 are presented. The group answered a questionnaire seven months following the disaster. The questionnaire included the Impact of Event Scale (IES) and the Birleson Depression Self‐Rating Scale (DSRS). The level of trauma was found to be very high, while depression scores were less elevated. A little under a third of the students scored above a clinical cut‐off point (> 35) on the IES, indicating high posttraumatic stress levels. Girls evidenced more depression and traumatic stress reactions than boys. Levels of reactions increased with more closeness (knowing victims personally) and if the adolescents were of non‐Swedish origin.     

The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison

This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas.

Educational objectives: The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.     

Effectiveness of the Hamilton Anxiety Rating Scale with Older Generalized Anxiety Disorder Patients

To expand the collection of instruments available for assessment of anxiety in the elderly, this report examined the original and revised Hamilton anxiety scales in a sample of 50 older adults diagnosed with Generalized Anxiety Disorder (GAD) and 93 normal community participants (ages 55–82). Although the revised anxiety scale had better discriminant validity (lower correlation with the revised Hamilton depression scale) than the original anxiety and depression scales, a considerable amount of shared variance still existed (41% shared variance, GAD sample alone; 17% control sample alone; 74% shared variance, both samples combined). Near-perfect group classification was possible using 7 items from the original anxiety scale and 10 items from the revised anxiety scale. Results are discussed in light of their implications for use of the Hamilton anxiety rating scale with older anxiety-disordered patients.     

Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.     

Clinical Guidelines for Working With Stepfamilies: What Family,Couple, Individual,and Child Therapists Need to Know

This article draws on four decades of research and clinical practice to delineate guidelines for evidence‐informed, clinically sound work with stepfamilies for couple, family, individual adult, and child therapists. Few clinicians receive adequate training in working with the intense and often complex dynamics created by stepfamily structure and history. This is despite the fact that stepfamilies are a fundamentally different family form that occurs world‐wide. As a result many clinicians rely on their training in first‐time family models. This is not only often unhelpful, but all too often inadvertently destructive. The article integrates a large body of increasingly sophisticated research about stepfamilies with the author's four decades of clinical practice with stepfamily relationships. It describes the ways in which stepfamilies are different from first‐time families. It delineates the dynamics of five major challenges stepfamily structure creates: (1) Insider/outsider positions are intense and they are fixed. (2) Children struggle with losses, loyalty binds, and change. (3) Issues of parenting, stepparenting, and discipline often divide the couple. (4) Stepcouples must build a new family culture while navigating previously established family cultures. (5) Ex‐spouses (other parents outside the household) are part of the family. Some available data are shared on the impact of cultural and legal differences on these challenges. A three‐level model of clinical intervention is presented: Psychoeducational, Interpersonal, and Intrapsychic/Intergenerational Family‐of‐Origin. The article describes some “easy wrong turns” for well‐meaning therapists and lists some general clinical guidelines for working with stepfamily relationships.     

Evaluating the Factor Structure of the MIDI Personality Scale Using Exploratory Structural Equation Modeling

This study investigated the factor structure of the 26‐item Midlife Development Inventory (MIDI) Personality Scale in a sample of 2,720 Americans. It was found that whereas confirmatory factor analysis (CFA) did not provide an acceptable fit to the data, exploratory structural equation modeling (ESEM) provided an acceptable fit. The results of ESEM revealed that the a priori five‐factor structure of personality was generally consistent with the data, and all items had salient loadings on their target factors. ESEM also revealed that some of the items contributed significantly to more than one personality factor. The results are in line with previous research, and indicate that ESEM is more suitable than CFA for the study of personality traits.     

Couple‐based Intervention for Depression: An Effectiveness Study in the National Health Service in England

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple‐based treatment for depression (BCT‐D) provided in London services that are part of the “Improving Access to Psychological Therapies” (IAPT) program in England. Twenty‐three therapists in community clinics were trained in BCT‐D during a 5‐day workshop, followed by monthly group supervision for 1 year. The BCT‐D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT‐D. Eighty‐five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT‐D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT‐D, although they were not the focus of treatment. BCT‐D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT‐D in routine clinical settings.     

Confirmatory Factor Analyses of the Full and Short Versions of the Marlowe-Crowne Social Desirability Scale

Abstract

Over the years, researchers have developed various short versions of the Marlowe-Crowne Social Desirability Scale (D. P. Crowne & D. Marlowe, 1960). The authors used confirmatory factor analyses (J. L. Arbuckle, 1997) as well as item and scale analyses to evaluate the adequacy of the full version and various short versions. Overall, the results from 232 Canadian undergraduates showed (a) that all the short versions in the present study are a significant improvement in fit over the 33-item full scale and (b) that W. M. Reynolds's (1982) Forms A and B are the best fitting short versions. No gender differences were found for the full scale or any of the short versions. The results show that the full scale could be improved psychometrically and that the psychometrically sound short versions should be available because they require less administration time than the full scale.     

The multi-factor structure of the Brief Self-Control Scale: Discriminant validity of restraint and impulsivity

The Brief Self-Control Scale (BSCS; Tangney, Baumeister, & Boone, 2004) was developed to assess dispositional self-control as it is conceptualized by contemporary theoretical perspectives; however, concerns regarding its unidimensionality and validity remain. This article addresses these concerns using three samples to define, confirm and test a multi-factor version of the BSCS. Results of Study 1 (n = 909) identified two factors of the BSCS: restraint and impulsivity. Results of Study 2 (n = 364) confirmed that the 2-factor structure fit the data well and performed better than 1-factor structures. Finally, results from Study 3 (n = 175) demonstrated the utility of the multi-factor BSCS in predicting self-reported affective and behavioral outcomes. Implications for research and theoretical development are discussed.