Clinical cut‐off point for the Distrust dimension of the Dimensional Clinical Personality Inventory 2 (IDCP‐2)

The Clinical Dimensional Personality Inventory 2 (IDCP ‐2) is a 206‐item self‐report tool developed for the assessment of 12 dimensions (divided into 47 factors) of personality pathology. One of the scales comprising the instrument, the Distrust scale, is intended to provide psychometric information on traits closely related to the Paranoid Personality Disorder (PPD ). In the present research, we used the Item Response Theory and the Receiver Operating Characteristic curve analysis to establish a clinical meaningful cutoff for the Distrust scale. Participants were 1,679 adults, among outpatients diagnosed with PPD , outpatients diagnosed with other PD s, and adults from the community. The Wright map revealed that outpatients were located at the very high levels on the latent continuum of the Distrust scale, with a very large effect size for the mean difference between patients and non‐patients. The ROC curve supported a cutoff at −1.00 score in theta standardization which yielded 0.87 of sensitivity and 0.54 of specificity. Findings from the present investigation suggest the IDCP ‐2 Distrust scale is useful as a screening tool of the core features of the PPD . We address potential clinical applications for the instrument and discuss limitations from the present study.     

Thought-shape fusion in anorexia nervosa: an experimental investigation

Cognitive biases and cognitive distortions have been implicated as important factors in the development and maintenance of many disorders. The concept of thought-shape fusion (TSF) in eating disorders was developed by Shafran, Teachman, Kerry, and Rachman (British Journal of Clinical Psychology 38 (1999) 167) as a variant of thought-action fusion, described by Shafran, Thordarson and Rachman (Journal of Anxiety Disorders 10 (1996) 379). TSF occurs when thinking about eating certain types of food increases a person's estimate of their shape and/or weight, elicits a perception of moral wrongdoing, and/or makes the person feel fat. Shafran et al. (1999) examined both the psychometric and experimental properties of TSF in an undergraduate sample. This paper reports an extension of this work to a clinical group (N=20) of patients with anorexia nervosa. After completing a set of relevant questionnaires, participants were asked to think about a food which they considered extremely fattening. They were then asked to write out the sentence, "I am eating--.", inserting the name of the fattening food in the blank. After being asked to rate their anxiety, guilt, feelings about their weight, morality, etc., participants were given the opportunity to neutralize their statement in any way they chose. The majority of the participants neutralized in ways consistent with the findings of Shafran et al. (1999). The results are discussed in terms of cognitive-behavioural formulations of eating disorders, and of the influence of cognitive biases and cognitive distortions on the processing of information relevant to food, weight and shape in anorexia nervosa.     

No evidence for overgeneral memories in borderline personality disorder

The hypothesis that borderline personality disorder (BPD) is related to overgeneral memories was tested in a mixed sample of 39 patients. A memory test with emotional cue words and the instruction to produce specific autobiographical memories was used. Specificity was judged by an independent rater. Regression analyses indicated that age and major depressive disorder were related to the production of less specific memories, whereas educational level and presence of personality disorder were positivily related to number of specific memories. Borderline personality disorder, anxiety disorders and childhood traumas were not related to number of specific memories.     

Use of the Beck Scale for suicide ideation with psychiatric inpatients diagnosed with schizophrenia,schizoaffective, or bipolar disorders

To ascertain how useful the Beck Scale for Suicide Ideation (BSI; Beck & Steer, Manual for Beck Scale for Suicide Ideation (1991)) would be for assessing the severity of suicidal ideation in patients who were diagnosed with schizophrenia, schizoaffective, or bipolar disorders, 142 inpatients were asked to complete the BSI. Eight (6%) patients refused, and four patients (3%) were unable to complete the BSI because they were unable to concentrate. Of the 130 patients who completed the BSI, 53 (41%) had schizoaffective, 37 (28%) had paranoid schizophrenia, 30 (23%) had manic bipolar, and 10 (8%) had depressed bipolar disorders. The coefficient alpha for the BSI was .96, and its one-week test-retest reliability for a subsample of 15 inpatients was 0.88, p < 0.001. The BSI total scores were positively correlated with having ever attempted suicide, r = 0.46, p < 0.001. According to the BSI, 36 (28%) patients were classified as current suicide ideators. The results were discussed as supporting the use of the BSI with inpatients who are diagnosed with schizophrenia, schizoaffective, or bipolar disorders.     

Patterns of friendship among girls with and without attention-deficit/hyperactivity disorder

Examined patterns of friendship participation, stability, and quality among previously unfamiliar, ethnically diverse girls with attention-deficit/hyperactivity disorder (ADHD; n = 140) and comparison (n = 88) girls, aged 6–12 years, who attended 5-week naturalistic summer camps. Each girl completed sociometric nominations during Weeks 1, 3, and 5 of the camps; friendships were indexed by examining patterns of reciprocal nominations. At each assessment point, girls with ADHD had fewer mutual friends and were more likely to have no friends. Girls with Combined-type ADHD exhibited difficulties maintaining friendships from the beginning to middle of camp, whereas girls with Inattentive-type ADHD demonstrated poor friendship stability from the middle to end of camp. In general, girls with ADHD had higher levels of negative relationship features—including conflict and relational aggression—than did comparison girls, but levels of positive relationship features did not differ across subgroups. Friendship status predicted positive and negative peer regard, controlling for Verbal IQ and diagnostic status. Overall, although girls with ADHD were able to make friends to some extent, they differed from comparison girls in terms of the likelihood of doing so, the ability to maintain the friendships that they did form, and the levels of negative features found in their friendships.     

Family Unification with Reactive Attachment Disorder Children: A Brief Treatment

This is a case study of a family with a child (age eight) with reactive attachment disorder and the subsequent individual and family therapy. Treatment of choice for the child was Eye Movement Desensitization and Reprocessing (EMDR) and supportive educational counseling for the parents and family. Qualitative evaluation of the process demonstrated that the parents observed an instant change in the child's attitude. The child reported that she felt better about family, school, and truthfulness, and stated about the therapy: It opened a window for me. A 12-month evaluation demonstrated continued positive effects.     

Neurocognitive Functioning in Posttraumatic Stress Disorder

This paper reviews the literature on performance on standard neuropsychological tests among individuals with posttraumatic stress disorder (PTSD). Of 19 studies, 16 reported impairment of attention or immediate memory (or both); however, most of these studies included PTSD patients with significant psychiatric comorbidity, so that the extent to which the observed deficits are specifically attributable to PTSD remains unclear. Other potential confounds, including medical illness, substance abuse, and motivational factors, further preclude definitive conclusions at present. Results of structural and functional neuroimaging studies of PTSD are also summarized. Two studies have reported correlations between hippocampal volume and cognitive findings in PTSD patients; functional studies have indicated specific findings in limbic regions, although the relationship of these results to neuropsychological performance remains to be explored.     

Psychosocial Treatment Strategies in the MTA Study: Rationale, Methods, and Critical Issues in Design and Implementation

The Collaborative Multimodal Treatment Study of Children with Attention Deficit Hyperactivity Disorder (ADHD), the MTA, is the first multisite, cooperative agreement treatment study of children, and the largest psychiatric/psychological treatment trial ever conducted by the National Institute of Mental Health. It examines the effectiveness of Medication vs. Psychosocial treatment vs. their combination for treatment of ADHD and compares these experimental arms to each other and to routine community care. In a parallel group design, 579 (male and female) ADHD children, aged 7–9 years, 11 months, were randomly assigned to one of the four experimental arms, and then received 14 months of prescribed treatment (or community care) with periodic reassessments. After delineating the theoretical and empirical rationales for Psychosocial treatment of ADHD, we describe the MTA's Psychosocial Treatment strategy applied to all children in two of the four experimental arms (Psychosocial treatment alone; Combined treatment). Psychosocial treatment consisted of three major components: a Parent Training component, a two-part School Intervention component, and a child treatment component anchored in an intensive Summer Treatment Program. Components were selected based on evidence of treatment efficacy and because they address comprehensive symptom targets, settings, comorbidities, and functional domains. We delineate key conceptual and logistical issues faced by clinical researchers in design and implementation of Psychosocial research with examples of how these issues were addressed in the MTA study.Deceased