Dimensionality of the Beck Youth Inventories With Child Psychiatric Outpatients

The Anxiety, Depression, Anger, Disruptive Behavior, and Self-Concept Inventories of the Beck Youth Inventories of Emotional and Social Impairment (J. S. Beck, A. S. Beck, & J. Jolly, 2001) were administered to 150 female and 150 male outpatients who were 7–12 years old and matched by sex as to whether they were diagnosed with anxiety, mood, adjustment, or attention-deficit and disruptive behavior disorders to determine whether each inventory represented distinct symptom dimensions. Horns parallel analyses (J. L. Horn, 1965) found that the Anxiety, Depression, and Disruptive Behavior Inventories were unidimensional, but that the Anger and Self-Concept Inventories were each composed of two underlying dimensions. Iterated principal-factor analyses indicated that the Anger Inventory represented Affective and Cognitive dimensions, whereas the Self-concept Inventory reflected Self-Esteem and Competency dimensions. However, the overall pattern of results was discussed as supporting the current practice of scoring each inventory as a summative scale for clinical assessment purposes.     

The Beck Anxiety Inventory in Older Adults With Generalized Anxiety Disorder

The authors investigated the psychometric properties of the Beck Anxiety Inventory (BAI) in a sample of 75 older generalized anxiety disorder (GAD) patients and a comparison group of 32 older adults without significant psychopathology. Internal consistency was above .80, and the BAI showed evidence of convergent validity in both groups. Evidence for discriminant validity with respect to measures of depression was weaker. Two items, fearing the worst and nervousness, correctly distinguished 86.5% of patients with GAD and 93.8% of the normal controls. Medical comorbidity was associated with somatic but not cognitive anxiety symptoms in the normal older sample. Overall, results indicate the limitations of the BAI in assessing anxiety symptoms in older adults and suggest the need for use of an instrument focusing on cognitive aspects of anxiety.     

Racial Differences in Responses to the Caregiver Strain Questionnaire

The aim of this study was to examine differences in responses to the Caregiver Strain Questionnaire (CGSQ) between African American and White caregivers of children with emotional and behavioral challenges. Significant item- and scale-level differences were detected across groups with African Americans consistently reporting less strain. We examined whether these differences were more likely due to nonequivalent measurement than to real differences in the experience of caregiver strain. Confirmatory factor analysis showed that the model fit the data well for both racial groups, but there were some differences in structural components. Internal consistency was equivalent across the groups. In an examination of criterion validity, regression analyses showed that African American caregivers experienced a slower rate of increase in objective caregiver strain at a given increase in child internalizing problems. No other race differences were found in the regression analyses. In general, we conclude that the CGSQ can be useful for detecting caregiver strain and identifying family support needs for both White and African American caregivers. Differences across groups in reports of caregiver strain, however, call for more research on racial differences in the impact on the family of caring for a child with emotional and behavioral disorders.     

School Mobility and Students with Emotional Disturbance

We examined the school mobility of a cross-sectional sample of 70 secondary-age youth with emotional disturbance (ED). Data were collected through an archival review of school records. Students’ school mobility histories were examined in terms of the overall number of schools attended in the elementary school years, as well as the timing of the moves that were made. Findings indicate that sample students experienced high rates of school mobility with 66% having changed schools at least once by the end of 2nd grade and 89% having changed schools at least once by the end of 5th grade. Strategies for minimizing school mobility and the impact of high rates of school mobility are reviewed.     

The Family Impact of Pain Scale: Preliminary Validation

A new questionnaire, the Family Impact of Pain Scale (FIPS), was designed in order to assess the effects of chronic pain on the significant other and family of the chronic pain patient. The FIPS is a 10-item self-report questionnaire examining the effect of pain on domestic duties, social functioning and communication within the family. It was administered to 177 chronic pain patients in two different samples to investigate its psychometric properties. Internal reliability (α = .94) and test–retest reliability (r = 0.79) were high. Exploratory factor analysis suggested a two-factor solution, relating to physical limitations and difficulties with communication. Construct validity was confirmed by significant Pearson correlations with pain intensity, pain distress, mood and the use of pain coping skills (r = −0.22–0.74, all at p < .05). Outcome data also showed that the measure is sensitive to the effects of a cognitive behavioural pain management intervention.     

The norms and stability of new measures of the multidimensional body image construct

The measurement of the body image construct has become increasingly multidimensional. New assessments are available to measure various facets of body image functioning: The Body Image Disturbance Questionnaire, Appearance Schemas Inventory-Revised, Body Image Coping Strategies Inventory, and Body Image Quality of Life Inventory. The present article reports normative data and acceptable internal reliabilities across seven completed investigations using these measures with female and male college students. Sex differences were examined and found, as expected, for most of the measures. In addition, a study evaluated an undetermined but essential psychometric property of these facets of the construct—their test–retest reliability. In a sample of 107 college students, the 2-week stability of these measures was found to be acceptable. Several directions for future research with these assessments are identified.     

A Critique of Miller and Rohling's Statistical Interpretive Method for Neuropsychological Test Data

A critical review of the 24-step procedure of Miller and Rohling's (in press) proposed standardization of clinician's use of neuropsychological assessment batteries is presented. Each step is examined for statistical sources of invalidity. It was concluded that parts of the procedure are quite vulnerable to between-battery variability that cannot be easily estimated or controlled, leading to significant errors in analysis and classification. A second fatal flaw is the failure to distinguish in the procedures between standard error measurement and standard error of the estimate in calculations in several steps. The purpose of the process remains viable, however, and is an important contribution toward the improvement of clinical diagnosis.     

Linguistic Analysis of Written Narratives of Caregivers of Children and Adolescents with Chronic Illness: Cognitive and Emotional Processes and Physical and Psychological Health Outcomes

Used linguistic analysis of written narratives of caregivers of hospitalized youth with chronic illness to identify emotional and cognitive processes related to physical and psychological health outcomes following writing. Measures were administered at baseline and 4 months. Experimental group (n = 29) wrote about traumas whereas the control group (n = 24) wrote about summer activities for 20 min on three different days. Compared groups on negative emotion- and cognition-related word use. Tested change in negative emotion- and cognition-related word use as predictors of outcomes in experimental group. Consistent with hypotheses, experimental group used more negative emotion words [F(1, 53) = 77.55, p < .001] and cognition-related words than control group [F(1, 53) = 19.09, p < .001] and an increase in cognition words predicted Physical Health Summary Score on SF-36 (standardized = .37, p < .05). A decrease in negative emotion words was related to Physical Health Summary Score on SF-36 only when entered into regression with change in cognition words (standardized = –.31, p < .05). A decrease in negative emotion together with an increase in cognitive processing facilitated by written emotional disclosure has beneficial effects on physical health-related quality of life.     

Predicting traumatic stress using emotional intelligence

The study investigated whether emotional intelligence (EI) can predict how individuals respond to traumatic experiences. A random sample of 414 participants (181 male, 233 female) were administered a measure of EI along with the Impact of Event Scale--revised [IES-R; Weiss, D. S. & Marmar, C. R. (1997). The Impact of Events Scale--revised. In J.P. Wilson & T.M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford Press], and the monitoring and blunting questionnaire [MBQ, Anxiety Stress Coping 7 (1994) 53]. The results showed that participants with higher NEIS scores report fewer psychological symptoms relating to their traumatic experiences, that monitors are more likely to have higher NEIS scores than blunters. Traumatic events had a greater impact on females than males, and males had higher EI than females. The implications of these findings for using EI as a predictor for individuals who may experience traumatic stress are discussed.     

Identity, narcissism and the emotional core

This paper describes the course of an analysis which demonstrates how borderline and narcissistic functioning can be understood in terms of a struggle with issues of identity. It shows how such functioning can come to exert a profound hold on the individual and why it seems, at times, a matter of life and death to the patient to avoid states of separation from the analyst. The paper suggests that these complex phenomena can be understood, perhaps surprisingly, in the simple terms of the nature of affect itself. The concept of the emotional core is introduced to embody and highlight that which lies beneath both Jungian and Freudian models (offering a potential bridge between the two models)--namely the psyche's essentially affective nature. It is suggested that the emotional core can serve as an organ of perception giving the individual both their primary relation to reality and an emotional attachment to others. This emotional core is understood to function in a narcissistic manner to preference experiences of sameness and in aversion to experiences of difference--a view consonant with Stern's understanding of infant development where the infant is able to distinguish self from other from the beginning of life (as Fordham also held); taking up Stern's terminology, it gives the individual a 'core' sense of being. There is, however, no stable, on-going sense of 'I' associated with this form of functioning as the individual is immersed in the latest affect to enter consciousness (as in the borderline state of mind) and consequently the individual comes to rely intensely on the other to determine their sense of being (the other becomes a self-regulating other in Stern's terms). The development of ego-functioning gives a more stable and on-going sense of 'I' to the individual, giving contact with the broader personality, allowing the individual to be less reliant on the other and orientating them to reality in a way more fitting to their overall needs. The paper describes how consciousness, which is not seen as identical with the ego, moves between the mode of functioning of the ego and that of the emotional core, i.e., shifting in and out of states where projective identification predominates. It elaborates the range of self-experience encompassing spiritual experience and states of disintegration (which are understood to have a similar structure) on one side, to ego-based experience (which can itself be defensive and rigid at times) on the other. It explores the consequences of such a view for analytic technique and relates it to the Jungian view of the self and the Freudian unconscious.