Factor invariance of the Millon Clinical Multiaxial Inventory

Several factor analyses of the Millon Clinical Multiaxial Inventory (MCMI) have resulted in very similar solutions. Interpretation of this consistency is hampered by the fact that the 20 scales of the inventory share items. Overlapping items cause the scales to be linearly dependent and may create structure in the interscale correlation matrix which is separate from the subject response patterns. A factor analysis was performed on the matrix of item-overlap coefficients which describes the underlying artifactual structure of the instrument. Data from two new subject samples were factor analyzed and compared to previously published studies. Similarity coefficients among factors across studies were calculated.     

Ear asymmetries in dichotic listening tasks which increase in difficulty

Accuracy and laterality of ear preference in repeating 2, 3 and 4 word pairs (WP) of dichotic stimuli in English and French were determined in 80 right-handed subjects (anglophone/francophone, male/female), who were tested in both their native language (L1) and nonnative language (L2). Relative performance accuracy decreased as a function of word pairs per trial (from 2 to 4) as well as language (from L1 to L2). Right-lateral preference in turn increased as a function of WP (from 2 to 4) as well as language (L1 to L2). Right-ear advantage (REA) in L2 decreased as a function of language proficiency (low to high). REA was observed in over 90% of subjects. A rationale for greater lateralization of L2 performance is offered.     

Millon Clinical Multiaxial Inventory (MCMI) computer-generated diagnoses: How do they compare to clinician judgment?

During the past several decades, computers have achieved increasing prominence in psychological assessment procedures. This is particularly true for computer-based test interpretation and diagnosis. This study reports on a study designed to compare the accuracy of computer-based diagnoses with clinician-generated diagnoses. The Millon Clinical Multiaxial Inventory (MCMI) was administered to 151 consecutively admitted inpatients at a large private psychiatric hospital. The computer-generated diagnoses were compared with those generated by admitting psychiatrists. The results indicated that the MCMI diagnostic impressions underestimated the severity of depressive disorders when compared with clinician diagnoses on Axis I. Specifically, clinicians diagnosed major depression much more frequently than did the MCMI. In addition, clinicians diagnosed anxiety disorders much less frequently than did the MCMI.     

Why using “consciousness” in psychotherapy? Insight,metacognition and self-consciousness

Since its early development, clinical psychology has questioned the impact of “consciousness” on the determination of human responsibility across psychiatric disorders. In recent years, specific clinical approaches have focused on “consciousness” work that could play a key role in psychotherapy. We focused our research on clinical psychology's consciousness-related concepts of insight, self-consciousness, and metacognition. Insight and metacognition, for example, have prompted increased interest in schizophrenia (SZ), bipolar disorder (BD), and, more recently, borderline personality disorder (BPD) treatments as representative of the latest advances in the cognitive and behavioral therapy field. Here we review cognitive, social, and clinical psychology research measuring “consciousness” in BPD, SZ, and BD, exploring the implications of different conceptualizations of consciousness-like concepts for treatment adherence, symptom evolution, and related aspects of psychotherapy. Our results show the overall relevance of using measures of clinical and cognitive insight, emphasizing the more central role of cognitive insight and metacognition in psychotherapy, as it appears that consciousness can remain useful if understood as a cognitive skill. The inclusion of a conceptualization of self-consciousness is important in order to address the social component of psychotherapy, as it does in biopsychosocial approaches. We discuss the implications of such results for global efficacy, for the relevance of the “consciousness” concept to clinical psychology, and for the potential need to keep operationalizing different conceptualizations of it in psychotherapy. We open the debate on the definition of consciousness to motivational aspects of change and to general considerations of both legal and ethical aspects.     

临床经验对诊断的双重作用及改造

文中用辩证唯物主义的观点,阐述了临床经验的定义、来源及指导实践过程中的意义,指出其具有促进诊断和引起误诊的双重作用,并用临床病历例子详细说明其双重作用的形式、导致结果及产生的原因。指出临床经验的双重作用在临床工作中的重要性及局限性,提出对经验的改造完善途径,以能充分表现出其促进诊断的作用,而最大限度降低其导致误诊的程度,发挥在临床工作中的良性作用。     

The response of day and night wetting children and children who wet only at night to retention control training and the enuresis alarm

Forty-five children with night wetting only (NW) and 30 children with day and night wetting (DNW) were randomly assigned to 2 treatment groups: alarm only and alarm preceded by 4 weeks of retention control training (R.C.T.). Fewer children became dry at night in the DNW group than the NW group and DNW children relapsed earlier following treatment. The enuresis alarm was far superior to R.C.T. in reducing night wetting in both enuretic groups. It also reduced day wetting in some of the DNW children. Children who became dry in the NW group did not show significant changes in functional bladder capacity. Although changes in functional bladder capacity were seen in the DNW children who became dry, changes were only noticeable once dryness had been achieved.     

Treatment of obsessive-compulsive patients: The contribution of self-instructional training to the effectiveness of exposure

Fifteen obsessive-compulsive patients were given treatment consisting of ten sessions of gradual exposure in vivo. For half of the patients gradual exposure in vivo was preceded by self-instructional training.Treatment resulted in significant improvement on anxiety and avoidance scales, Leyton Obsessional Inventory, Self-rating Depression Scale and on ratings for anxious mood and depression. Neither the post-test nor the follow-ups 1 month and 6 months later indicated a difference between the effects of the two conditions. Self-instructional training did not enhance the effectiveness of gradual exposure in vivo.