Detection of Feigned Posttraumatic Stress Disorder: A Comparison of the MMPI-2 and PAI

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Personality Assessment Inventory (PAI) were compared for detecting feigned posttraumatic stress disorder (PTSD) in a simulation research design. Participants were 85 undergraduates in one of three groups: PTSDs (n = 23), Fakers (n = 31), and Controls (n = 31). As expected, both the MMPI-2 and PAI discriminated PTSDs and Controls, with PTSDs scoring significantly higher on fake-bad validity scales and PTSD-relevant clinical scales. However, only the MMPI-2 discriminated Fakers and PTSDs, with Fakers scoring significantly higher on all MMPI-2 scales considered, but on only one PAI scale. Further, in logistic regression analyses the MMPI-2 demonstrated higher overall correct classification of PTSDs and Fakers than did the PAI. Although the MMPI-2 outperformed the PAI in detecting feigned PTSD, a substantial proportion of Fakers avoided detection by MMPI-2 fake-bad validity scales, suggesting that both tests are vulnerable to feigning of PTSD by motivated respondents with relatively limited coaching.     

Generalized Anxiety Disorder in Hispanics: Symptom Characteristics and Prediction of Severity

Literature suggests that an increasing number of Hispanic people suffer with GAD, and possible associated problems include high costs for treatment and elevated risk of severe impairment. The current study examined components of anxiety, as measured by currently available assessment instruments in both English and Spanish languages, among bilingual Hispanic individuals with GAD. Participants completed all instruments in both languages. Relations between these self-report measures and clinician-rated GAD severity were also studied. In factor analyses, the Spanish measures yielded two factors, the first of which included all instruments assessing physiological components of anxiety and one content specific measure of worry. The second factor included one worry scale and one trait anxiety scale. The English measures yielded a single factor solution. Regression analyses revealed that for the English measures, the BAI and PSWQ were statistically significant predictors of GAD severity. For the Spanish measures, the BAI was the only statistically significant predictor.     

Dialectical Behavior Therapy: An Emotion-Focused Treatment for Borderline Personality Disorder

Dialectical Behavior Therapy (DBT) is a cognitive-behavioral treatment for borderline personality disorder (BPD) that is based on the theory that emotion dysregulation is the core feature of BPD. This article focuses on aspects of DBT theory and techniques that specifically address emotion. The dialectical and biosocial theories that underlie DBT are reviewed with an emphasis on how each relates to emotional experiencing in BPD. Selected treatment strategies that address emotion dysregulation and their hypothesized mechanisms of change are also described. Relevant research findings are incorporated throughout to provide an empirical foundation for the DBT theories and strategies that are discussed.     

躯体形式障碍的优化诊治

躯体形式障碍是精神科常见的一种神经症,该病具有较高的发病率,占用了大量的医疗资源,但临床识别率和有效治疗率却相当低。围绕躯体形式障碍的特点及其优化诊治作一些探讨,利于提高社会和非精神科医生对该病的认识,减少医疗资源的过度消耗,使疾病得到早期有效治疗。     

Working memory and behavioral inhibition in children with attention-deficit/hyperactivity disorder (ADHD): an examination of varied central executive demands,construct overlap,and task impurity

The stop-signal paradigm is the premier metric of behavioral inhibition in contemporary attention-deficit/hyperactivity disorder (ADHD) research. The stop-signal paradigm’s choice-reaction time component, however, arguably places greater demands on working memory processes (e.g., controlled-focused attention) relative to alternative inhibition metrics (i.e., go/no-go (GNG) tasks), and consequently obscures conclusions about inhibition and working memory deficits in affected children. The current study, therefore, aimed to determine whether shared variance between stop-signal behavioral inhibition and working memory performance in children with ADHD reflects overlap between the working memory and inhibition constructs or insufficient specificity of the stop-signal paradigm. Fifty-five children (8–12 years) with and without ADHD were administered established phonological (PH) and visuospatial (VS) working memory measures, as well as stop-signal and GNG tasks that vary with respect to demands on controlled-focused attention. Although working memory and GNG performance each uniquely predicted children’s inattention, stop-signal task performance was not a significant predictor of unique variance in inattention, above and beyond variance associated with working memory. Collectively, these findings suggest that performance on the stop-signal task, compared to the GNG task, is confounded by greater demands associated with working memory and consequently reflects an impure estimate of the inhibition construct.     

Factors predictive of a fetal alcohol spectrum disorder diagnosis: Parent and teacher ratings

Diagnostic assessment in Fetal Alcohol Spectrum Disorder (FASD) is informed by multidisciplinary assessment incorporating objective (i.e., test measures) and subjective means, such as parent and teacher behavior ratings. The purpose of this study was to extend our previous neuropsychological test findings by identifying parent and teacher ratings of academic achievement, attention, executive functioning, and adaptive functioning as predictors of an FASD diagnosis. The charts of 315 children and adolescents with prenatal alcohol exposure (PAE) who underwent assessment for FASD were retrospectively reviewed. Direct logistic regressions analyzed the contribution of different ratings on the likelihood of an FASD diagnosis. The results suggest that a number of rating measures do contribute toward accurately differentiating those with FASD from within a PAE population, including teacher ratings of learning problems, inattention, and adaptive skills. The classification accuracy for each regression was clinically significant (59.1–70.8%). Children with worse ratings on these variables are approximately 1.5 to 2 times more likely to receive an FASD diagnosis. Only teacher ratings (not parent) significantly contributed to whether a diagnosis was made, suggesting that teacher observational rating scales are a critical component of an FASD assessment. Together with our previous research examining neuropsychological evaluation and FASD diagnostic assessment, this study helps to further guide decisions to streamline care in multidisciplinary assessment and intervention planning.     

Relationships between implicit and explicit uncertainty monitoring and mindreading: Evidence from autism spectrum disorder

We examined performance on implicit (non-verbal) and explicit (verbal) uncertainty-monitoring tasks among neurotypical participants and participants with autism, while also testing mindreading abilities in both groups. We found that: (i) performance of autistic participants was unimpaired on the implicit uncertainty-monitoring task, while being significantly impaired on the explicit task; (ii) performance on the explicit task was correlated with performance on mindreading tasks in both groups, whereas performance on the implicit uncertainty-monitoring task was not; and (iii) performance on implicit and explicit uncertainty-monitoring tasks was not correlated. The results support the view that (a) explicit uncertainty-monitoring draws on the same cognitive faculty as mindreading whereas (b) implicit uncertainty-monitoring only test first-order decision making. These findings support the theory that metacognition and mindreading are underpinned by the same meta-representational faculty/resources, and that the implicit uncertainty-monitoring tasks that are frequently used with non-human animals fail to demonstrate the presence of metacognitive abilities.     

Analyzing conditions for recognizing pictures of family members in a patient with Alzheimer's disease

In the present study, an 89‐year‐old woman with the neurocognitive disorder Alzheimer's disease participated. The purpose was to study recognition of the participant's relatives' faces with the use of sorting tests and matching‐to‐sample (MTS) trainings and tests for emergent relations. The stimuli used were pictures of her relatives, their written names, and their family relationship. The study also focused on how responding to pictures of relatives changed over time. Therefore, the participant was presented with experimental conditions over three time periods. Time Period 1 included only sorting tests. In Time Period 2, which began 9 months after Time Period 1, the participant was presented with both sorting tests and conditional discrimination training and testing. In Time Period 3, which began 1 year after Time Period 2, both sorting tests and conditional discrimination training and testing were again presented. The results from Time Periods 2 and 3 showed that the percentage of stimuli sorted correctly was maintained over time. Additionally, the results from the MTS training and tests were maintained at the second follow‐up periods.     

A component analysis of job interview training for young adults with autism spectrum disorder

The job interview is a vital component to acquire employment. Individuals with autism spectrum disorder may experience difficulties with job interviews due to notable deficits in social and communication skills. We evaluated the relative impact of several components of a job interview training package on six participants' responses to commonly asked interview questions. We used a multiple baseline design across participants to present the following components: written instructions, rehearsal and video self‐feedback with a commercially available training program, and verbal feedback delivered by the experimenter. Results demonstrated that all participants required an additional behavioral skills training session to meet our mastery criterion. However, once training was complete, all participants showed generalized performance when the interview questions were presented in a varied format and by a novel interviewer outside of the training environment. In addition, their performance was maintained at follow‐up.     

Development and evaluation of the evidence‐based practice classroom observation measure (EBP‐COM)

Due to the increased emphasis on evidence‐based practices (EBPs) in recent education initiatives, classroom observers need an objective way to measure teacher use of EBPs. Although some measures for this purpose exist, these measures are limited by their reliance on self‐report. Therefore, we created a direct observation tool titled the Evidence‐Based Practice Classroom Observation Measure (EBP‐COM) for observers to assess the use of EBPs by teachers of students with autism spectrum disorder (ASD). We evaluated reliability and validity of the EBP‐COM, as well as whether the assessment tool could detect change in teacher behavior. A measurement refinement process involving six raters collecting 65 data points revealed the EPB‐COM to have sound psychometric properties. With this tool, researchers can conduct comprehensive and objective assessments of teacher EBP use.