The aim of this pilot project was to describe maternal responsiveness during child feeding in mothers with eating disorder histories through the combined use of observational, self-report, and physiologic methods. For this non-randomized cohort pilot study, 25 mothers with histories of eating disorders and 25 mothers with no history of an eating disorder with children ages 6–36 months were selected such that the groups were similar based on child age group (within 6 months) and child sex. Maternal behavioral responsiveness to child cues was assessed by video-recording and behavioral coding of both a free-play and feeding episode. Physiologic engagement was assessed through measurement of respiratory sinus arrhythmia (RSA) reactivity during free-play and feeding episodes. No differences were detected in observed behavioral responsiveness during feeding or free-play in mothers with eating disorder histories compared with controls. Mothers with eating disorder histories did report more parenting stress, increased anxiety, and exhibited a blunted physiologic stress response (less RSA reactivity) during both feeding and free-play interactions with their children. These results support future larger-scale investigations of RSA reactivity in mothers with eating disorders.
eating disorders; mothers; feeding behavior; maternal responsiveness; RSA reactivity; infant feeding
A review of the literature suggests that higher levels of psychopathy may be linked to less effective behavioral control. However, several commentators have urged caution in making statements of this type in the absence of direct evidence. In two studies (total N = 142), moment-to-moment accuracy in a motor control task was examined as a function of dimensional variations in psychopathy in an undergraduate population. As hypothesized, motor control was distinctively worse at higher levels of psychopathy relative to lower levels, both as a function of primary and secondary psychopathy and particularly their shared variance. These novel findings provide support for the idea that motor control systematically varies by psychopathy, in a basic manner, consistent with views of psychopathy emphasizing lesser control.
Psychopathy; Behavior; Control; Self-Control; Motor; Executive
Although DSM-IV-TR diagnostic criteria for posttraumatic stress disorder (PTSD) include three primary symptom clusters, recent evidence from confirmatory factor analyses suggest that the latent structure of PTSD is better represented by four factors, which will likely be reflected in the upcoming DSM-5. Given this likely transition from three to four clusters, the present study sought to examine specific and non-specific aspects of dysphoria in the factor structure of PTSD symptoms in a sample of OEF/OIF combat veterans presenting to a Veterans Affairs primary care clinic. PTSD symptoms were assessed using the PCL-M (Weathers et al. 1993). Results from confirmatory factor analyses suggested that a dysphoria factor involving a number of non-specific distress symptoms may be an important part of the PTSD symptom profile. After controlling for variance due to general psychological distress, we further found that factor loadings on the dysphoria factor were attenuated but continued to significantly load onto the factor, suggesting that dysphoria may be a specific part of the PTSD symptom constellation.
Posttraumatic stress disorder; OEF/OIF veterans; Confirmatory factor analysis; Dysphoria
We examined a new structured interview of parent–child conflict that assesses parent and child perceptions of behavioral conflict about daily life topics (e.g., doing chores, homework), and whether discrepancies exist on beliefs about these topics. In a sample of 100 parents and children ages 10 to 17 years (M=13.5 years, 52 males, 57 % African-American), informants could reliably distinguish between perceived behavioral conflicts and perceived discrepant beliefs about topics. These scores were also significantly related to questionnaire reports of parent–child conflict. Parent and child questionnaire reports did not significantly differ, yet on the structured interview, parents reported significantly greater levels of perceived conflict and discrepant beliefs relative to child reports. Additionally, structured interview reports of conflict demonstrated incremental validity by relating to child self-reports of delinquent behaviors, when accounting for questionnaire conflict reports. The findings have implications for increasing understanding of the links between parent–child conflict and psychosocial outcomes.
Parent–child conflict; Multiple informants; Informant discrepancies; Informant disagreement; Structured interview; To(may)to-To(mah)to Interview
The present study aimed to examine the relevance of age of onset to the psychopathology of social phobia using a large clinical sample of 210 patients with social phobia. The two most common periods of onset were during adolescence (ages 14–17) and early childhood (prior to age 10). Structural regression modeling was used to test predictions that early onset social phobia would be associated with greater severity of the disorder, stronger current symptoms of depression and anxiety, greater functional impairment, and more pronounced levels of emotional disorder vulnerabilities (e.g., neuroticism/behavioral inhibition, extraversion, perceptions of control). Logistic regression was used to evaluate relationships between age of onset and the presence of acute and chronic stress at the time of onset. Results showed that earlier age of social phobia onset was associated with stronger current psychopathology, functional impairment, and emotional disorder vulnerabilities, and that later age of onset predicted the presence of an acutely stressful event around the time of disorder emergence. These results are discussed in regard to their clinical implications and congruence with prominent etiological models of the emotional disorders.
Social phobia; age of onset; vulnerability-stress; impairment; structural equation modeling
Five personality traits that dispose individuals to rash or ill-advised action (i.e., sensation seeking, negative urgency, positive urgency, lack of planning, and lack of perseverance), can be reliably and validly assessed in children. This paper reports on the first test of parental reports of these traits. In a sample of 94 children (ages 7–13, mean age 10.6), the authors found the following. First, parental reports of the five traits in their children appeared to be reliable. Second, there was moderate convergent validity: parent and child reports of the same traits had a median correlation of r = .30. Third, there was adequate discriminant validity: within-parent reports on different traits had a median correlation of r = .11. Fourth, concurrent prediction of child behavior from parental reports generally was inconsistent with prior findings. Fifth, discrepancies between the two reporters did predict dysfunctional child behavior. There are advantages to securing both child self-report and parental report of personality dispositions to rash action, although there is limited evidence for the concurrent validity of parental reports.
impulsivity; children; parent; personality; traits; risky behavior
Discrepancies between observers are common in studies of child behavior problems that rely on behavior ratings. Although modest concordance between informants is well-documented, little is known about characteristics that predict discrepancies. In 477 children aged 5 to 12 years, maternal age and indicators of socioeconomic status (SES; maternal education, family income) were evaluated in relation to score discrepancies between the Child Behavior Checklist and Teacher Report Form for Total, Externalizing and Internalizing Problems. Family income <$35,000 was independently associated with discrepancies in which mothers rated more clinically significant child behavior problems than teachers for Total, Externalizing and Internalizing Problems [odds ratio (OR) = 3.26, 95% confidence interval (CI ), 1.19-8.96, OR = 2.76, 95% CI 1.03-7.34 and OR = 3.07, 95% CI 1.30-7.26, respectively]. Maternal education was not associated with discrepancies, but younger mothers were less likely to rate child's behavior in the clinical range for Externalizing Problems than teachers (OR per year of age = 0.88, 95% CI 0.81-0.96). These results suggest that studies that utilize only maternal or teacher report of child behavior may have misclassification of outcomes that is dependent on SES and could produce biased results.
Informant discrepancy; child behavior ratings; CBCL; TRF; AESBA; socioeconomic status
This report is concerned with the prevalence of symptoms of specific personality disorders in a representative community sample and draws attention to the importance of different sources of diagnostic information. We recruited a sample of 1,630 people between the ages of 55 and 64 to participate in a study regarding personality and health. Using careful recruitment methods, our participation rate was 43 %. Participants completed the SIDP-IV interview as well as a questionnaire (self-report MAPP). Informants completed the same questionnaire (informant MAPP), describing the participant’s maladaptive personality characteristics. According to the diagnostic interview, 7 % of participants met criteria for exactly one PD, 1 % met criteria for 2 or 3 PDs, and 2 % met criteria for PD NOS (defined as 10 or more miscellaneous criteria). Avoidant and obsessive compulsive PDs were the most common types. Correlations between the three sources of information indicated significant agreement among these measurement methods, but they are not redundant. In comparison to interview and self-report data, informants reported more symptoms of personality pathology (except for avoidant PD). Symptoms of personality pathology are continuously distributed, and subthreshold features may have an important impact on health and social adjustment. In this community sample, rates of co-morbidity among PDs and the proportion of PDNOS diagnoses are substantially lower than reported from clinical samples. Future research must evaluate the validity of diagnostic thresholds and competing sources of diagnostic information in relation to important life outcomes.
Personality disorders; Sample recruitment; Prevalence; Informant report
This study explores longitudinally a four-factor structure of pathological personality trait dimensions (PPTDs) to examine both its structural stability and intra-individual changes among PPTDs over time. Personality Disorder (PD) scales of the Millon Clinical Multiaxial Inventory-III were administered to 361 low-income women with various psychiatric conditions (drug dependence, depression), who were followed in a two-wave study over 5-years. Cross-sectional and longitudinal factor analyses outlined a robust factorial structure of PPTDs, extrinsically invariant over time, representing Negative Emotionality, Introversion, Antagonism and Impulsivity. Despite moderate rank-order stability in the PPTDs, results also indicated substantial intra-individual variability in the degree and direction of change, consistent with trajectories of change in participants’ clinical diagnoses. Results are discussed in light of current debates on the structure and dynamic of pathological personality.
Pathological Personality; Personality Disorders; MCMI; Longitudinal Factor Analysis
The present study examined rates of trauma exposure, clinical characteristics associated with trauma exposure, and the effect of trauma exposure on treatment outcome in a large sample of primary care patients without posttraumatic stress disorder (PTSD). Individuals without PTSD (N = 1263) treated as part of the CALM program (Roy-Byrne et al., 2010) were assessed for presence of trauma exposure. Those with and without trauma exposure were compared on baseline demographic and diagnostic information, symptom severity, and responder status six months after beginning treatment. Trauma-exposed individuals (N = 662, 53%) were more likely to meet diagnostic criteria for Obsessive Compulsive Disorder and had higher levels of somatic symptoms at baseline. Individuals with and without trauma exposure did not differ significantly on severity of anxiety, depression, or mental health functioning at baseline. Trauma exposure did not significantly impact treatment response. Findings suggest that adverse effects of trauma exposure in those without PTSD may include OCD and somatic anxiety symptoms. Treatment did not appear to be adversely impacted by trauma exposure. Thus, although trauma exposure is prevalent in primary care samples, results suggest that treatment of the presenting anxiety disorder is effective irrespective of trauma history.
anxiety; treatment; primary care; trauma
Little attention has been paid to the examination and measurement of self-stigma in substance misuse. This paper aims to fill this gap by reporting on the development of a new scale to measure self-stigma experienced by people who are misusing substances, the Substance Abuse Self-Stigma Scale. Content validity and item refinement occurred through an iterative process involving a literature search, focus groups, and expert judges. Psychometric properties were examined in a cross-sectional study of individuals (n = 352) receiving treatment for substance misuse. Factor analyses resulted in a 40-item measure with self devaluation, fear of enacted stigma, stigma avoidance, and values disengagement subscales. The measure showed a strong factor structure and good reliability and validity overall, though the values disengagement subscale showed a mixed pattern. Results are discussed in terms of their implications for studies of stigma impact and intervention.
stigma; substance misuse; psychometric; measure development
In two studies (N = 416; N = 118) examining responses from undergraduates, we developed the Social Exercise and Anxiety Measure (SEAM) and tested its factorial, convergent, and divergent validity. Our results demonstrate that the SEAM exhibits an excellent three factor structure consisting of the following subscales: Social Exercise Self-efficacy, Gym Avoidance, and Exercise Importance. In both studies, Social Exercise Self-efficacy correlated negatively and Gym Avoidance correlated positively with social interaction anxiety, fear of scrutiny, and fear of negative evaluation. Exercise Importance correlated positively with frequency of exercise and frequency of public exercise. Implications for the mental and physical health of individuals with high levels of social anxiety are discussed.
social anxiety; exercise; self-efficacy; assessment; anxiety
Dissatisfaction with the DSM-IV model of personality disorders has led to the development of alternative conceptualizations, including pathological trait models and models linked to particular theoretical approaches, such as Beck and Freeman’s (1990) cognitive framework. An important issue involves the potential to interweave such models into a single, parsimonious system that combines their distinct advantages. In this study, pathological trait and dysfunctional belief data from 616 individuals in a non-clinical sample were evaluated for commensurability using structural equation modeling. These models can be integrated via five higher-order factors, and that specific dimensions of dysfunctional beliefs can be differentiated based on features of the DSM-5 trait model. Overall, these results suggest that traits provide scaffolding for individual differences in pathological personality, within which dysfunctional beliefs offer specific vectors for clinical intervention in a cognitive framework. Implications of the empirical commensurability of trait and cognitive models are discussed.
personality disorders; traits; schema; dysfunctional beliefs; DSM-5
Despite the growing recognition for multidimensional assessments of cue-elicited craving, few studies have attempted to measure multiple response domains associated with craving. The present study evaluated the Ambivalence Model of Craving (Breiner et al., 1999; Stritzke et al., 2007) using a unique cue reactivity methodology designed to capture both the desire to use (approach inclination) and desire to not consume (avoidance inclination) in a clinical sample of incarcerated female substance abusers. Participants were 155 incarcerated women who were participating in or waiting to begin participation in a nine-month drug treatment program. Results indicated that all four substance cue-types (alcohol, cigarette, marijuana, and crack cocaine) had good reliability and showed high specificity. Also, the validity of measuring approach and avoidance as separate dimensions was supported, as demonstrated by meaningful clinical distinctions between groups evincing different reactivity patterns and incremental prediction of avoidance inclinations on measures of stages of change readiness. Taken together, results continue to highlight the importance of measuring both approach and avoidance inclinations in the study of cue-elicited craving.
approach; avoidance; craving; cue reactivity; incarcerated females
Callous-unemotional (CU) traits have been shown to delineate a subgroup of individuals at high risk for exhibiting severe and persistent criminal behavior. The Inventory of Callous-Unemotional Traits (ICU; Frick 2004) was recently developed as a comprehensive rating scale designed to measure multiple facets of CU traits. However, validation of this measure has been limited to youth in adolescence and emerging adulthood (age range=12–20), leaving questions about the utility of this measure in early adulthood unanswered. The current study evaluated the factor structure of the ICU within a racially diverse and well characterized community sample of adult males (n=425) using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). While results found the best fitting model to be the three-bifactor structure that has been previously reported in adolescent samples, the fit indices were only marginally acceptable and suggest the need for scale refinement. Total and subscales scores demonstrated significant and distinct associations with relevant external criteria (e.g., delinquency, psychopathy, psychopathology, psychosocial functioning). Implications and directions for future research are discussed.
Callous-unemotional traits; Psychopathy; Validation; Young adulthood; Delinquency; Psychopathology; Psychosocial functioning
The present investigation evaluated the main and interactive effects of distress tolerance and negative affect intensity in relation to posttraumatic stress disorder (PTSD) symptom severity and symptom cluster severity. Participants were 190 trauma-exposed adults (52.6 % women; Mage=25.3 years, SD=11.4) recruited from the community. Distress tolerance (i.e., perceived ability to withstand distressing emotional states) demonstrated significant incremental associations with global PTSD symptom severity as well as Re-Experiencing, Emotional Numbing, and Hyperarousal symptom cluster severity. Negative affect intensity (i.e., perceived intensity of negative emotional responses) demonstrated significant incremental associations with each of the PTSD symptom outcomes. Moreover, the incremental interactive effect of distress tolerance and negative affect intensity was significantly associated with PTSD symptom severity as well as PTSD—Emotional Numbing symptom cluster severity. These incremental effects were evident after accounting for the variance explained by anxiety sensitivity (i.e., fear of anxiety-related sensations). Post hoc probing analyses supported the moderating role of negative affect intensity in the association between distress tolerance and PTSD symptom severity, such that low levels of distress tolerance, in the context of elevated levels of negative affect intensity, were associated with the greatest levels of PTSD symptoms.
Distress tolerance; Affect intensity; PTSD; Trauma
The present study examines a simple model for the relationship between temperament, anxiety and maladaptive metacognition. A clinical sample of patients diagnosed with anxiety disorders (n = 216) completed a set of self-reported questionnaires measuring temperament dimensions, state anxiety and metacognitions. Three temperament traits were included in the hypothesized model: emotional reactivity, perseveration and briskness. A structural equation modeling analysis supported a model in which the relationship between the three temperament traits and anxiety were fully mediated by metacognition. Dissimilar models were identified for the male and female subgroups, and also with reference to individual categories of maladaptive metacognition. The findings support the significance of metacognition as a factor influencing the temperament-anxiety relationship. Moreover, they confirm the roles both of emotional reactivity and of perseveration, being major traits related to anxiety which also turned out to be strongly associated with metacognition. In case of the models for the categories of metacognition, emotional reactivity was associated with negative beliefs, perseveration with negative and positive beliefs, while briskness predicted anxiety independently of metacognition. These results suggest the existence of more specific associations between temperament traits, anxiety, and various types of metacognition.
Temperament; Metacognition; Anxiety; Self-regulatory executive function model; Structural equation modeling
Understanding the development of psychopathic personality from childhood to adulthood is crucial for understanding the development and stability of severe and long-lasting conduct problems and criminal behavior. This paper describes the development of a new teacher rated instrument to assess psychopathic personality from age three to 12, the Child Problematic Traits Inventory (CPTI). The reliability and validity of the CPTI was tested in a Swedish general population sample of 2,056 3- to 5-year-olds (mean age = 3.86; SD = .86; 53 % boys). The CPTI items loaded distinctively on three theoretically proposed factors: a Grandiose-Deceitful Factor, a Callous-Unemotional factor, and an Impulsive-Need for Stimulation factor. The three CPTI factors showed reliability in internal consistency and external validity, in terms of expected correlations with theoretically relevant constructs (e.g., fearlessness). The interaction between the three CPTI factors was a stronger predictor of concurrent conduct problems than any of the three individual CPTI factors, showing that it is important to assess all three factors of the psychopathic personality construct in early childhood. In conclusion, the CPTI seems to reliably and validly assess a constellation of traits that is similar to psychopathic personality as manifested in adolescence and adulthood.
Assessment; Child problematic traits inventory (CPTI); Children; Conduct problems; Psychopathic personality
Coping reactions to stressful events are important links between difficult experiences and the emergence of psychopathology. In this study we compared youths' negative coping with stress in general to their negative coping with violence in particular, and utilized a person-centered analytic approach to examine how patterns of coping relate to various mental health outcomes. We utilized survey interview measures to collect data from a sample of 131 youth (ages 11–14, 100% ethnic minority) residing in an economically distressed metropolitan area of the northeast. We observed significant relations between youths' tendencies to cope with stress and violence via externalized-internalized strategies (e.g., yelling to let off steam, crying) and their mental health symptoms. However, we generally did not observe relations between engagement in distancing coping strategies (e.g., making believe nothing happened) and any problematic outcomes. Negative coping does not appear be a monolithic construct uniformly associated with negative outcomes for youth. Distancing coping might represent an especially useful short-term coping response for youth living in socioeconomically distressed conditions from the standpoint of inhibiting symptom development.
coping; mental health; violence; PTSD
The present investigation evaluated the factor structure of the Distress Tolerance Scale (DTS; Simons and Gaher 2005) among a sample of 173 (54.9% males) daily cigarette smokers (M=16.64 cigarettes per day, SD=7.83). Comparison of a single higher-order model and a hierarchical multidimensional model was conducted using confirmatory factor analyses (CFA). In addition, evaluation of the internal consistency and convergent and discriminant validity of the better-fitting model was completed. CFA of the DTS indicated a single second-order factor of distress tolerance, and four lower-order factors including Tolerance, Appraisal, Absorption, and Regulation; each factor demonstrated acceptable levels of internal consistency. In addition, the DTS displayed good convergent and discriminant validity with theoretically relevant smoking and affect variables. Results are discussed in terms of explicating the latent structure of distress tolerance, as measured by the DTS, within the context of smoking research.
Distress tolerance; Distress intolerance; Emotion regulation; Cigarette smokers; Nicotine; Substance use; Confirmatory factor analysis
Antisocial individuals have problems recognizing negative emotions (e.g. Marsh & Blair in Neuroscience and Biobehavioral Reviews 32:454–465, 2009); however, due to issues with sampling and different methods used, previous findings have been varied. Sixty-three male young offenders and 37 age-, IQ- and socio-economic status-matched male controls completed a facial emotion recognition task, which measures recognition of happiness, sadness, fear, anger, disgust, and surprise and neutral expressions across 4 emotional intensities. Conduct disorder (YSR), and psychopathic and callous/unemotional traits (YPI) were measured, and offenders’ offense data were taken from the Youth Offending Service’s case files. Relative to controls, offenders were significantly worse at identifying sadness, low intensity disgust and high intensity fear. A significant interaction for anger was also observed, with offenders showing reduced low- but increased high-intensity anger recognition in comparison with controls. Within the young offenders levels of conduct disorder and psychopathic traits explained variation in sadness and disgust recognition, whereas offense severity explained variation in anger recognition. These results suggest that antisocial youths show specific problems in recognizing negative emotions and support the use of targeted emotion recognition interventions for problematic behavior.
Emotion recognition; Antisocial behavior; Psychopathy; Conduct disorder; CU traits; Criminal behavior
This study compared adult women with childhood ADHD to adult women without childhood ADHD and to adult men with childhood ADHD. The participants, all from a larger longitudinal study, included 30 women and 30 men (approximately age 23 to 24) with childhood ADHD, and 27 women without ADHD. Women with childhood ADHD were matched to comparison women on age, ethnicity, and parental education, and to men with childhood ADHD on age, ethnicity, and IQ. Self- and parent-reports of internalizing, interpersonal, academic, and job impairment, as well as substance use and delinquency indicated group differences on measures of self-esteem, interpersonal and vocational functioning, as well as substance use. Follow-up planned comparison tests revealed that almost all of these differences emerged by diagnostic status, and not by gender. This study adds to research on the negative adult outcomes of ADHD and demonstrates that the outcomes of men and women with childhood ADHD are relatively similar.
Disasters have been associated with both acute and prolonged distress and significant post-disaster psychiatric symptoms. These outcomes may be further complicated by extended periods without vital services and supplies, such as electricity and drinking water. The present study investigated the relations between post-disaster loss of services and psychiatric symptoms in urban/non-urban disaster victims. Random-digit–dial methodology was used to interview 1,249 victims of Hurricane Ike, a strong storm that hit Galveston, TX in 2008. Findings demonstrated significant relations between loss of services and post-disaster symptoms of posttraumatic stress disorder (PTSD), depression, and worry. These relations varied by urban/non-urban settings; there were significant positive relations between loss of services and symptoms of depression in non-urban settings, but not in urban settings. Similarly, a stronger relation between loss of services and symptoms of PTSD also was demonstrated in non-urban compared to urban settings. Findings highlight the potential importance of pre-disaster preparation, post-disaster restoration of services, and post-disaster community support in post-disaster psychiatric outcomes, with a particular emphasis in non-urban settings.
PTSD; Depression; Worry; Preparedness; Disaster; Urban; Non-urban
Psychological flexibility and mindfulness are two related, but distinct, regulation processes that have been shown to be at the core of psychological wellbeing. The current study investigated whether these two processes independently moderated the association between disordered eating cognitions and psychological distress as well as the relation between disordered eating cognitions and disordered eating behaviors. Non-clinical, ethnically diverse college undergraduates completed a web-based survey. Of 278 participants (nfemale=208; nmale=70) aged 18–24 years old, disordered eating cognitions, mindfulness, and psychological flexibility were related to psychological distress after controlling for gender, ethnicity, and body mass index. Disordered eating cognitions and mindfulness accounted for unique variance in disordered eating behaviors. Finally, mindfulness was found to moderate the association between disordered eating cognitions and disordered eating behaviors.
Disordered eating cognition; Disordered eating symptoms; Psychological distress; General psychological ill-health; Psychological flexibility; Experiential avoidance; Mindfulness
The prevalence of alcohol use disorders in college students necessitates that adequate measures exist to assess students for abuse and dependence. The Alcohol Dependence Scale (ADS) is a continuous measure of the severity of alcohol involvement found to have a unidimensional factor structure in clinical samples. The latent factor structure of the ADS in college drinkers has not been examined and this study sought to replicate unidimensionality. Heavy college drinkers (N=343) completed the ADS. Performance was examined using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). The CFA did not support a single factor solution. Follow-up EFA revealed a two factor structure. The first, termed “Acute Excessive Drinking” consisted of relatively commonly endorsed items relating to loss of behavioral control, blackouts, and obsessive/compulsive drinking. The second, termed “Severe Withdrawal Symptoms,” consisted of relatively infrequently endorsed items relating to withdrawal symptoms. The ADS does not appear to have the same factor structure in college and clinical samples, making it inadvisable as a linear measure of alcohol problems within a college population.
Alcohol; Assessment; Factor Structure; College Students