A Greek-Language Inventory of Fears: Psychometric Properties and Factor Structure of Self-Reports of Fears on the Hellenic Fear Survey Schedule

The structure of fearfulness and the psychometric properties of a Greek-language version of the Fear Survey Schedule were studied in a sample of normal Greek adults. Overall summary scores were higher for women than for men, had satisfactory temporal stability and internal consistency, and were useful in discriminating levels of phobic anxiety independent of levels of depression as assessed by a concurrent self-report measure. However, the temporal stabilities of responses for many items were inadequate for the reliable identification of levels of fear of specific events and objects. A factor analysis yielded five components that were conceptually similar to those obtained abroad. Subscales based on component items were psychometrically reliable. In comparison with American subjects, Greek subjects rated similar items as most fearful, but reported higher levels of fears of these items, reflecting either higher levels of fears, greater disclosure, or cultural differences in the meaning of fear ratings.     

Disorders of Eating in the Elderly

The most common eating disorder in the elderly in both community and hospital settings is food refusal. This may lead to weight loss and malnutrition with all the adverse consequences on independence and function. The management of disorders of eating in the elderly is a diagnostic and therapeutic challenge, requiring the combined skills of the medical and nursing staff. The causes are often multifactorial and require careful and repeated assessment of the patient's social, psychological, and medical history. Approach to treatment involves these factors, as well as ethical and cultural considerations. Eating is the most basic biological drive for survival in nature. In human societies there are additional cultural and social aspects that may override this instinct, as in the case of hunger strikes for political motives. In the elderly, food is one of the major sources of possible pleasure and it is the challenge for health providers to try and give this enjoyment to their patients for as long as possible.     

Psychological characteristics of women with eating disorders: Permanent or transient features?

The purpose of the study was to make a psychological profile of Danish women with Eating Disorders, who were not currently hospitalized. 75 women between the ages of 19 and 46 years participated. 22 participants suffered from a clinical eating disorder (ED). 20 women had previously suffered from a clinical ED, and 33 women had never suffered from ED. The study included sociodemographic data, problems in relation to eating and weight, exposure to stressful life events, and the following questionnaires: The Eating Disorder Inventory, the Rosenberg Self-Esteem Scale, the Coping Styles Questionnaire, the Perceived Stress Scale, the Defense Style Questionnaire, and the Trauma Symptom Checklist. Psychologically, women with ED differed significantly from women without ED by using a more primitive defense style, perceiving themselves as being more exposed to stress, using more inefficient methods of coping and having lower self-esteem. Unexpectedly, the study also showed that recovery from an ED was resulting in normalisation of both behavioral and psychological characteristics. The implications of these findings are discussed.     

Correlates of Mental Disorders in the Quebec General Population of 6 to 14-Year Olds

Previous epidemiological studies of correlates of child and adolescent mental disorders in the general population have focused more on child/adolescent and socioeconomic/sociodemographic characteristics than on family characteristics. Moreover, there are no generally accepted methods to analyze and interpret correlates. The purpose of the Quebec Child Mental Health Survey in this regard was twofold: (1) to identify correlates of DSM-III-R internalizing and externalizing disorders according to informant (youth, parent, teacher), for three age groups (6–8, 9–11, and 12–14 years), including relevant family characteristics not considered in previous studies; and (2) to interpret the relative importance of risk indicators by ranking correlates according to strength and consistency of association across age groups. Logistic regression models suggest the inconsistency of correlates across informants. The ranking of correlates reveals that individual and family characteristics make a more important contribution than do socioeconomic characteristics, thereby supporting the relevance of proximal variables in the development of psychopathology.     

Dysfunctional Cognitions in Children with Social Phobia, Separation Anxiety Disorder, and Generalized Anxiety Disorder

According to cognitive theories of anxiety, anxious adults interpret ambiguous situations in a negative way: They overestimate danger and underestimate their abilities to cope with danger. The present study investigated whether children with social phobia, separation anxiety disorder, and generalized anxiety disorder have such a bias, compared to a clinical and a normal control group. Children were exposed to stories in which ambiguous situations were described, and asked to give their interpretations, using open and closed responses. Results showed that anxious children reported more negative cognitions than control children. However, anxious children did not overestimate danger on the free responses, but they did judge the situations as more dangerous on the closed responses. Anxious children had lower estimations of their own competency to cope with danger than the control groups on both open and closed responses. The results indicate that children with anxiety disorders have dysfunctional cognitions about ambiguous situations.     

Dementia with Lewy bodies: a pure case

A pure case of autopsy-confirmed dementia with Lewy bodies (DLB) is described. The patient presented with distinctive verbal fluency deficits in the context of mild language impairment, intact recognition memory, and impaired paragraph recall. Neuroimaging (CT and SPECT) showed progressive medial temporal lobe atrophy. Neuropathology revealed Lewy bodies, degeneration in the substantia nigra, nucleus basalis of Meynert (Nakano & Hirano, 1984), and locus ceruleus, but no pathology characteristic of Alzheimer's disease. It is in this sense that the case is "pure" DLB. Early neuropsychological diagnosis of DLB is essential (Salmon et al., 1996) given the potentially fatal hazard of neuroleptics (McKeith et al., 1992) and the difficulties associated with clinical neurological diagnoses (Litvan et al., 1998).     

Behavioral testing of anxiety: Issues,diagnosis, and practice

This paper cites certain issues of concern in the area of assessment of anxiety and the anxiety disorders. It attempts to describe, in general terms, the potential of behavioral testing for clarifying these issues and for using these tests to supplement clinical interviews, rating scales, and self-report measures. Moreover, the paper describes a potential compatibility between objective behavioral testing and the most recent (third revision)Diagnostic and Statistical Manual of Mental Disorders.The opinions expressed in this paper are those of the author alone and do not necessarily reflect the position of the National Institute of Mental Health.     

Outcomes in a System of Care for Youths with Emotional and Behavioral Disorders: An Examination of Differential Change Across Clinical Profiles

We assessed the utility of an empirically-derived classification system for youths with emotional and behavioral disorders in a system of care with a strong representation of juvenile delinquents. Eighty-seven youths served in a system of care were categorized by variables related to past history, current behavioral functioning, and current psychological functioning into four clinical clusters. We evaluated preliminary clinical outcomes after six months of interagency involvement for youths within each cluster and across the four clusters. Results indicated that youths in different clusters improved significantly in need-specific areas. Trends in our data indicated differential change in clinical outcomes across clusters. We discuss our findings within the context of emerging outcomes of youths involved in comprehensive community-based programs and consider implications for outcome research, treatment of juvenile delinquents, and mental health policy.     

Assessing the specific psychopathology of binge eating disorder patients: Interview or self-report?

Research addressing the assessment of binge eating and associated eating disorder psychopathology has steadily increased in recent years. Few studies have examined the relationship between the various assessment methods. This study compared an investigator-based interview, the Eating Disorder Examination (EDE), with a self-report version of that interview, the EDE-Q. Fifty-two individuals (six men and 46 women) with binge eating disorder (BED) completed both instruments. Modest-to-good agreement and significant correlations (P < 0.0001) were found between the two methods on all four subscales assessing specific eating disorder psychopathology (i.e., Restraint, Eating Concern, Weight Concern, and Shape Concern subscales). However, higher levels of disturbance were consistently reported on the EDE-Q than the EDE interview. The two methods were not significantly or reliably related to one another when assessing binge eating. This may be due in part to the difficulty inherent in identifying binges in subjects with BED. Examination of individual item scores suggest that it might be possible to improve the performance of the EDE-Q by clarifying the definitions of certain complex features, although this should not be at the expense of compromising the practical utility of its self-report format.