Diagnosing posttraumatic stress disorder with the MMPI clinical scales: A review of the literature

A review of the literature resulted in 21 published studies that reported mean MMPI profile patterns for PTSD patients. Of these, six (29%) reported that the mean 8-2 profile pattern significantly differentiated PTSD patients from non-PTSD patients. The majority of studies found additional PTSD profile patterns reflecting nearly all of the MMPI clinical scales. The data indicate some common group profile patterns for inpatient veterans, prisoner's of war, and inpatient veteran substance abusers. The results also support the hypothesis that there is a continuum from inpatient to outpatient and veteran to civilian populations that corresponds with both symptom and stressor severity. It is concluded that although there is some typicality in similar populations, clinicians should expect heterogeneous MMPI profiles from PTSD patients representing a diversity of clinical symptoms and styles.     

Teaching peer reinforcement and grocery words: An investigation of observational learning and instructive feedback

A multiple probe across behaviors design, replicated across participants, assessed the effectiveness of constant time delay in teaching appropriate peer reinforcement and grocery words to 3 elementary students with moderate intellectual disabilities. Additionally, pretests and posttests assessed the acquisition of the participants' observational learning (acquisition of peers' grocery words) and instructive feedback (related information supplied by the teacher in the consequent event). Results indicate that the participants learned (a) how to appropriately reinforce peers, (b) to read their grocery words, (c) some of the targeted stimuli of their peers, and (d) much of the instructive feedback that was associated with each of the grocery words. Maintenance data indicate that the participants maintained their target grocery words at high levels of accuracy.     

Effects of training students to identify the semantic base of prose materials

Feedback and feedback plus points toward a course grade were applied to the attentional behaviors (defined as the ability to identify the semantic base of text passages) of 30 undergraduate students participating in a reading comprehension development program. Correct underlining was increased, extraneous underlining was decreased, and postreading comprehension test scores improved as a result of the procedures. Scores on a standardized test of reading comprehension also increased significantly.     

Psychopathy and structure of primary mental abilities

The Comprehensive Ability Battery (CAB) was used to assess 18 primary mental abilities in 53 white, male prison inmates for whom highly reliable ratings of psychopathy were available. None of the correlations between ratings of psychopathy and scores on the CAB tests was significant, and the overall pattern or structure of abilities was the same for inmates with low and high ratings of psychopathy. The possibility is raised that the personality characteristics of psychopaths make them appear to be brighter and more creative than they actually are. Compared with norms for male high school students, the inmates as a group generally performed well, falling near the 50th percentile on 11 of the tests. The inmates performed significantly better than the normative sample on tests of verbal ability, esthetic judgment, aiming, and representational drawing, and significantly worse on tests of ideational fluency, spontaneous flexibility, and word fluency.This research was supported by Grant MT-4511 from the Medical Research Council of Canada.     

Personality diagnostic questionnaire-revised (PDQ-R) personality disorder scores and negative life events independently predict changes in hopkins symptom checklist (SCL-90) Psychopathology Scores

The present study employed a prospective design to investigate whether Personality Diagnostic Questionnaire—Revised (PDQ-R) scores and/or Hassles Scale—Revised (HS-R) scores predict changes in Axis I psychopathology levels over 1 month, in a nonclinical sample of young adults. The PDQ-R, HS-R, and Hopkins Symptom Checklist (SCL-90) were administered to a mixed-sex sample of 100 undergraduate students on two occasions separated by 1 month. Hierarchical multiple regression analyses indicated that (1) time 1 PDQ-R composite scores predicted changes in scores on 11 SLC-90 scales; (2) time 1 PDQ-R impairment/distress index scores predicted changes in SCL-90 general symptom index scores; (3) only one of the individual PDQ-R personality disorder subscales—the schizotypal personality disorder subscale—predicted changes in SCL-90 general symptom index scores; (4) HS-R scores predicted changes in scores on 9 SCL-90 scales; and (5) in only 3 of the 27 analyses conducted did the statistical interaction between PDQ-R and HS-R scores predict changes in SCL-90 scores. These findings indicate that personality disorder symptomatology and negative life events may independently predict changes in Axis I psychopathology levels and, thus, support the continued inclusion of Axis II and Axis IV in future versions of the Diagnostic and Statistical Manual of Mental Disorders.     

Are Individuals Always Aware of Their Trauma-Related Intrusive Thoughts? A Study of Meta-Awareness

Individuals are not always aware of their mental content. We tested whether lack of awareness occurs in those who have experienced trauma, with and without posttraumatic stress disorder (PTSD). We also examined the role of proposed cognitive mechanisms (working memory and inhibition) in explaining unnoticed intrusions. Individuals with PTSD (n = 44), and varying levels of symptoms (high posttraumatic stress [PTS]: n = 24; low PTS: n = 37) reported on intrusive thoughts throughout a reading task. Intermittently, participants responded to probes about whether their thoughts were trauma related. Participants were “caught” engaging in unreported trauma-related thoughts (unnoticed intrusions) for between 24 and 27% of the probes in the PTSD and high PTS groups, compared with 15% of occasions in the low PTS group. For trauma-related intrusions only, participants lacked meta-awareness for almost 40% of probes in the PTSD group, which was significantly less than that observed in the other groups (～60%). Contrary to predictions, working memory and response inhibition did not predict unnoticed intrusions. The results suggest that individuals who have experienced significant trauma can lack awareness about the frequency of their trauma-related thoughts. Further research is warranted to identify the mechanisms underpinning the occurrence of unnoticed intrusions.     

Excessive Object Attachment in Hoarding Disorder: Examining the Role of Interpersonal Functioning

Excessive attachment towards possessions can be maladaptive because it can lead individuals to excessively acquire and save objects. Little is known about how attachment to objects develops and changes over time; however, interpersonal factors have been theorized to play a role. The current study examined whether interpersonal factors, specifically interpersonal attachment style and empathy, moderate changes in object attachment over time. A total of 145 participants with excessive acquiring and discarding difficulties rated their level of attachment to a novel object just after receiving it, and 1 week later. Participants also completed measures of interpersonal anxious attachment and interpersonal functioning. We found that changes in object attachment over time were moderated by interpersonal anxious attachment. Also, our findings suggested that individuals with hoarding problems are likely not impaired in their ability to empathize with others, but rather have difficulty displaying empathy in tense social situations and also have more empathy for fictional characters. Further, greater discomfort in tense social situations and greater empathy for fictional characters interacted to predict greater object attachment. Taken together, these findings indicate that individuals with an interpersonal anxious attachment style may be those at risk of forming greater attachments to objects over time. A learning history that includes inconsistent support from caregivers may result in individuals experiencing more empathy for fictional characters and discomfort in tense social situations, which may produce a vulnerability for becoming excessively attached to objects. Our results are in line with theories of hoarding which propose that individuals use objects to compensate for unmet interpersonal needs and suggest that treatment may need to target interpersonal functioning to reduce hoarding symptoms.     

Treating Childhood Social Anxiety Disorder With Virtual Environments and Serious Games: A Randomized Trial

Disseminating efficacious psychological treatments remains a challenge for researchers and clinicians. In the case of social anxiety disorder (SAD), Social Effectiveness Therapy for Children (SET-C) has been demonstrated as an efficacious intervention, but elements of the protocol, such as peer generalization sessions, remain challenging to conduct in typical clinical settings. To address this need, we developed an artificially intelligent, web-based application, Pegasys-VR™, designed to replace peer generalization sessions and enhance homework compliance. The feasibility of Pegasys-VR™ was tested in a randomized controlled trial in comparison to SET-C. The results indicated that both programs were equally efficacious in decreasing anxiety and improving social skill in social encounters. Sixty-three percent (63%) of children treated with SET-C and 60% treated with Pegasys-VR™ did not meet diagnostic criteria for SAD at posttreatment. Pegasys-VR™ is a feasible, efficacious, and dissemination-friendly element of a comprehensive treatment program for social anxiety disorder in children.     

La psychothérapie assistée par la MDMA dans la prise en charge du syndrome de stress post-traumatique

Posttraumatic stress disorder (PTSD) is estimated to remain chronic and severe for 25–50% of patients despite psychotherapeutic treatment. Part of the reasons is that patients with PTSD can have difficulties in establishing a good therapeutical alliance with the therapist. Moreover, they often fail to re-think the content of the trauma without being overwhelmed by negative emotions and tend to rely on avoidance strategies and/or to abandon the therapy. MDMA (“ecstasy”) is a drug classified as an entactogen (en “within”, tactus “touch”, and gen “produce”), an amphetamine with psychedelic properties that possesses psychopharmacological properties to overcome these issues. Indeed, MDMA triggers the release of oxytocin, which favors the establishment of interpersonal relationship based on kindness and trust. Moreover, MDMA diminishes the activity of the amygdale, allowing patients to work on challenging memories with less fear and anxiety. Finally, MDMA may also provide access to meaningful spiritual experiences, release of tensions and a sense of healing on a non-verbal level that are not completely understood. But are viewed as important by patients. Today, there is no evidence that the use of MDMA in a clinical setting has bad neurologic, psychological or cognitive consequences. Results of phase II trials in the United States and Europe confirm that MDMA favors psychotherapy's outcome without severe adverse effects. Phase III trials are underway. The Multidisciplinary Association for Psychedelic Studies (MAPS) has published online a method proposal and trains therapists in MDMA-assisted psychotherapy.ConclusionFood and Drug Administration (FDA) and European Medicines Agency (EMA) could approve this therapeutic tool in the coming years.     

Single-Stage Prediction Models Do Not Explain the Magnitude of Syntactic Disambiguation Difficulty

The disambiguation of a syntactically ambiguous sentence in favor of a less preferred parse can lead to slower reading at the disambiguation point. This phenomenon, referred to as a garden-path effect, has motivated models in which readers initially maintain only a subset of the possible parses of the sentence, and subsequently require time-consuming reanalysis to reconstruct a discarded parse. A more recent proposal argues that the garden-path effect can be reduced to surprisal arising in a fully parallel parser: words consistent with the initially dispreferred but ultimately correct parse are simply less predictable than those consistent with the incorrect parse. Since predictability has pervasive effects in reading far beyond garden-path sentences, this account, which dispenses with reanalysis mechanisms, is more parsimonious. Crucially, it predicts a linear effect of surprisal: the garden-path effect is expected to be proportional to the difference in word surprisal between the ultimately correct and ultimately incorrect interpretations. To test this prediction, we used recurrent neural network language models to estimate word-by-word surprisal for three temporarily ambiguous constructions. We then estimated the slowdown attributed to each bit of surprisal from human self-paced reading times, and used that quantity to predict syntactic disambiguation difficulty. Surprisal successfully predicted the existence of garden-path effects, but drastically underpredicted their magnitude, and failed to predict their relative severity across constructions. We conclude that a full explanation of syntactic disambiguation difficulty may require recovery mechanisms beyond predictability.