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
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
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
The Youth Psychopathic Traits Inventory-Short Version (YPI-S; van Baardewijk et al., 2010) is a self-report measure to assess psychopathic-like traits in adolescents. The aim of the present study is to investigate the factor structure, the internal consistency, and the criterion validity of the YPI-S in 768 Belgian community adolescents (45.4 % males). In general, our study supported the YPI three factor structure while relevant indices showed that the instrument is internally consistent. In addition, relations between the YPI-S total score and dimension scores on the one hand and external criterion measures (e.g. conduct problems and self-reported offending) on the other hand were generally in line with predictions. The present study replicated and substantially extended previous findings of the YPI-S in a sample of community youth. Future studies are needed to test whether findings from community samples can be replicated in clinical-referred and justice-involved boys and adolescents.
Antisocial; Assessment; Self-report; Psychopathy
The Child Behavior Checklist (CBCL) is a widely used questionnaire to assess behavioral and emotional problems. It is often used as a diagnostic screener, but autism spectrum disorders (ASD) are not included in the CBCL for school-aged children. This study investigated patterns of CBCL scores in 108 children with high-functioning ASD from two independent samples, and 67 IQ- and age-matched controls. Scores on the CBCL Thought and Social Problems scales significantly differentiated children with ASD from controls. Both independent ASD samples had the same pattern of elevations, with mean scores over two standard deviations above the mean for Social, Thought, and Attention Problems. The Withdrawn/Depressed scale was elevated to at least the borderline clinical range for half of the ASD sample. This pattern of elevations is consistent with two prior studies of the CBCL with school-aged children with ASD, and therefore may warrant follow-up assessment to rule out an ASD.
Child behavior checklist; Autism; Asperger's disorder; Diagnostic screening
The purpose was to test the reliability of short samples of parent/child interaction for use in single-subject research. Four variable pairs of mother/child behaviour were coded for seven mother/child play sessions. Each session lasted 20 min and 18 min of the session was behaviourally coded using frame-by-frame analysis. The co-occurrence of the mother/child behaviours within a given time window was computed and an odds ratio was calculated for the co-occurrence of the targeted behaviours. The play session was divided into shorter segments (3, 6 and 9 min) and odds ratios of the variable pairs from the shorter segments were compared to the odds ratios from the entire session. Segments of 3 and 6 min did not yield the same pattern of results as the entire session. In single-subject research, evidence of the reliability of the time segment for behavioural coding should be reported in the methods section of original research manuscripts.
Video; Mother child interaction; Microanalysis; Contingency; Sequential Analysis; Thin slice sampling
Childhood characteristics are associated with life-course-persistent antisocial behavior in epidemiological studies in general population samples. The present study examines this association in an inpatient sample. The purpose is to identify easily measurable childhood characteristics that may guide choice of treatment for adolescent psychiatric inpatients with severe disruptive behavior. Patients (N = 203) were divided into two groups with either early-onset (EO) or adolescent-onset (AO) disruptive behavior, based on ages at which professional care was used for disruptive behavior, referral to special education, and criminal offences. Both groups differed on several childhood characteristics. No gender differences in these characteristics were found. Logistic regression analysis indicated that individuals with grade retention in primary school, childhood impulsive behavior, and a history of physical abuse, had the highest probability of being member of the EO group. These characteristics are reasonably easy to identify, likely apply to other clinical samples as well, and may help clinicians to target their treatment.
Adolescents; Antisocial behavior; Psychiatric inpatients; Childhood characteristics
Rating scales are often used to measure behavioral constructs. Yet, different informants’ ratings may not necessarily agree. The situational specificity (SS) perspective postulates that discrepancies between ratings by different informants are primarily attributable to contextual behavior of the people being rated. The multitrait-multimethod (MTMM) perspective, however, attributes discrepancies between informants to rater bias, i.e., each informant provides a systematically distorted picture of the person being rated. Similarly, the Attribution-Bias-Context (ABC) perspective also attributes informant discrepancies to systematic biases. Within the context of measuring hierarchical constructs, we proposed a hybrid perspective that takes account of variance attributable to the behavior of the person being rated in a particular context from the perspective of a specific informant. We then provided a parametric representation of this perspective and analyses of mother, teacher, and self-ratings of Rule-Breaking and Aggressive Behavior to illustrate features of the model. Strengths and limitations of the SS, MTMM, and hybrid perspectives are discussed.
Situational specificity; Method effect; Psychometric modeling; Child psychopathology; Externalizing problems
This study evaluated a five-item screening measure of Callous Unemotional (CU) traits using items drawn from the Preschool Form of the Achenbach System of Empirically Based Assessment (ASEBA). Using data from the Durham Child Health and Development study (N=178), confirmatory factor analyses demonstrated that CU items could be distinguished from Attention Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant (ODD) items. The two-year stability (N=137) of CU (ϕ=.84) was comparable to that of ADHD (ϕ=.79) and ODD (ϕ=.69). Three groups of children were selected based on parent-rated ODD and CU behaviors at the 36-month assessment (N=37; ODD+CU, N=7; ODD-only, N=12; non-ODD, N=18). Multiple measures of infant temperament predicted group membership with 84% accuracy. Consistent with Frick and Morris’ (Journal of Clinical Child and Adolescent Psychology 33(1):54–68, 2004) hypotheses, ODD+CU and ODD-only children exhibited temperamental profiles in infancy that were consistent with low fear and emotionally dysregulated pathways into conduct problems, respectively.
Callous Unemotional; Screening measure; Early childhood
Adult psychopathy has proven to be an important clinical and forensic construct, but much less is known about juvenile psychopathy. In the present study, we examined the construct validity of the self report modified Child Psychopathy Scale mCPS; Lynam (Psychological Bulletin 120:(2), 209–234, 1997) in a sample of 57 adolescents residing in a Dutch juvenile justice center, aged between 13 and 22 years. The mCPS total score was reliably related to high externalizing problems, low empathy, high anger and aggression, high impulsivity, high (violent) delinquency, and high alcohol/drug use. Unique relations were found for the antisocial-impulsive (mCPS Factor 2), but not the callous-unemotional facet of psychopathy (mCPS Factor 1). Our findings support the validity of the mCPS in that it encompasses the antisocial-impulsive facet of psychopathy, but it is less clear whether the mCPS sufficiently captures the affective-interpersonal facet of psychopathy.
Psychopathy; Child psychopathy scale; Antisocial; Impulsivity; Aggression; Psychology; Clinical Psychology; Personality and Social Psychology
Cluster A personality disorders (PD), including schizotypal personality disorder (SPD), paranoid personality disorder (PPD), and schizoid PD, are marked by odd and eccentric behaviors, and are grouped together because of common patterns in symptomatology as well as shared genetic and environmental risk factors. The DSM-IV-TR describes personality disorders as representing stable and enduring patterns of maladaptive traits, and much of what is understood about Cluster A personality disorders in particular stems from research with adult populations. Less in known about these disorders in children and adolescents, and controversy remains regarding diagnosis of personality disorders in general in youth. The current paper reviews the available research on Cluster A personality disorders in childhood and adolescence; specifically, we discuss differentiating between the three disorders and distinguishing them from other syndromes, measuring Cluster A disorders in youth, and the nature and course of these disorders throughout childhood and adolescence. We also present recent longitudinal data from a sample of adolescents diagnosed with Cluster A personality disorders from our research laboratory, and suggest directions for future research in this important but understudied area.
Schizotypal personality disorder; Schizoid personality disorder; Paranoid personality disorder; Personality disorders; Cluster A
The present investigation examined the incremental associations between distress tolerance, or the perceived capacity to tolerate emotional distress, and global posttraumatic stress symptom severity as well as symptom cluster severity, beyond the variance accounted for by number of trauma exposure types and negative affectivity. The sample consisted of 140 adults (72 women; Mage=25.9, SD=11.1) who endorsed exposure to traumatic life events, as defined by posttraumatic stress disorder diagnostic criterion A (American Psychiatric Association 2000). Participants did not meet diagnostic criteria for current axis I psychopathology. Distress tolerance demonstrated significant incremental associations with global posttraumatic stress symptom severity (p<.01) as well as re-experiencing (p<.05), avoidance (p=.05), and hyperarousal (p<.001) symptom cluster severity. Given the cross-sectional study design, causation cannot be inferred. Theoretical implications and future directions for better understanding associations between distress tolerance and posttraumatic stress are discussed.
Distress tolerance; Posttraumatic stress; PTSD; Emotion regulation; Trauma
The Thought Suppression Inventory (TSI; Rassin, European Journal of Personality 17: 285-298, 2003) was designed to measure thought intrusion, thought suppression and successful thought suppression. Given the importance to distinguish between these three aspects of thought control, the aim of this study was to scrutinize the dimensionality of the TSI. In a sample of 333 Dutch senior citizins, we examined (1) the dimensionality of the TSI using various procedures such as PAF, Mokken scale analysis (MSA) and CFA, and (2) the scale properties of the TSI. PAF favored a two factor solution, however, MSA and CFA suggested that three dimensions most adequately capture the structure of the TSI. Although all scales obtained at least medium scalability coefficients, several items were identified that are psychometrically unsound and may benefit from rewording or replacement. The findings suggest that the TSI is a three-dimensional questionnaire as originally proposed by Rassin (European Journal of Personality 17: 285-298, 2003) measuring thought intrusion, thought suppression, and successful thought suppression.
Thought suppression; Thought intrusion; Dimensionality; Mokken scale analysis; Confirmatory factor analysis
To explain fear of blushing, it has been proposed that individuals with fear of blushing overestimate the social costs of their blushing. Current information-processing models emphasize the relevance of differentiating between more automatic and more explicit cognitions, as both types of cognitions may independently influence behavior. The present study tested whether individuals with fear of blushing expect blushing to have more negative social consequences than controls, both on an explicit level and on a more automatic level. Automatic associations between blushing and social costs were assessed in a treatment-seeking sample of individuals with fear of blushing who met DSM-IV criteria for social anxiety disorder (n = 49) and a non-anxious control group (n = 27) using a single-target Implicit Association Test (stIAT). In addition, participants’ explicit expectations about the social costs of their blushing were assessed. Individuals with fear of blushing showed stronger associations between blushing and negative outcomes, as indicated by both stIAT and self-report. The findings support the view that automatic and explicit associations between blushing and social costs may both help to enhance our understanding of the cognitive processes that underlie fear of blushing.
Fear of blushing; Automatic associations; Single-target implicit association test
We explored cross-sectionally the roles in bipolar spectrum symptomatology of two broad motivational systems that are thought to control levels of responsiveness to cues of threat and reward, the Behavioral Inhibition System (BIS) and the Behavioral Activation System (BAS). Undergraduate students (n = 357) completed questionnaires regarding (a) bipolar spectrum disorders [the General Behavior Inventory (GBI), a well-established clinical screening measure], (b) current depression and mania symptoms (the Internal State Scale; ISS), and (c) BIS/BAS sensitivities (the BIS/BAS scales). Validated cutoff scores on the GBI were used to identify individuals at risk for a mood disorder. It was hypothesized that, among at-risk respondents, high BAS and low BIS levels would be associated with high current mania ratings, whereas low BAS and high BIS would be associated with high current depression ratings. Multiple regression analyses indicated that, among at-risk individuals (n = 63), BAS accounted for 27% of current mania symptoms but BIS did not contribute. For these individuals, BAS and BIS were both significant and together accounted for 44% of current depressive symptoms.
bipolar disorder; behavioral activation; behavioral inhibition; BIS/BAS scales
Over the past 10 years, theorists have suggested that bipolar disorder symptoms result from increases and decreases in the activity of the Behavioral Activation or Facilitation System (BAS or BFS) and the Behavioral Inhibition System (BIS). These neurobehavioral systems are thought to determine the intensity of affective and behavioral responses to incentives and threats. This study examined cross-sectional and prospective associations of self-reported BIS and BAS with mania and depression in a sample of 59 individuals diagnosed with Bipolar I disorder. Depression was tied to BIS, pointing to the importance of sensitivity to threats in depression. However, links between BIS and depression appeared state-dependent. BAS subscales did not correlate with manic symptoms in a state-dependent manner; however, BAS (total scale and reward responsiveness subscale) predicted relative intensification of manic symptoms over time. Thus, evidence suggests that BAS sensitivity may constitute a vulnerability to mania among persons diagnosed with bipolar disorder. Discussion focuses on the integrative potential of the BIS/BAS constructs for linking psychosocial and biological research on bipolar disorder.
bipolar disorder; behavioral activation; behavioral inhibition; mania; depression
This study examined the classification accuracy of the UPPS Impulsive Behavior Scale (UPPS) in discriminating several attention deficit/hyperactivity disorder (ADHD) subtypes, including predominantly inattentive type (ADHD/I), combined type (ADHD/C), and combined type with behavioral problems (ADHD/ODD), between each other and a non-ADHD control group using logistic regression analyses. The sample consisted of 88 children ranging in age from 9.0 years to 12.8 years, with a mean of 10.9 years. Children were predominantly male (74%) and Caucasian (86%) and in grades 3–7. Results indicated that the UPPS performed well in classifying ADHD subtypes relative to traditional diagnostic measures. In addition, analyses indicated that differences in symptoms between subtypes can be explained by specific pathways to impulsivity. Implications for the assessment of ADHD and conceptual issues are discussed.
ADHD; Impulsivity; UPPS; ADHD subtypes
Growing research has examined parental accommodation among the families of children with obsessive-compulsive disorder (OCD). However, these studies have utilized a parent-report (PR) version of a measure, the Family Accommodation Scale (FAS) that has never received proper psychometric validation. In turn, previously derived subscales have been developed via clinical rather than empirical evidence. This study aims to conduct a comprehensive psychometric analysis of the FAS-PR utilizing data collected from 96 youths with OCD. Exploratory factors analysis was conducted and revealed a 12-item scale yielding two separate, yet related subscales, Avoidance of Triggers (AT) and Involvement in Compulsions (IC). Subsequent analyses revealed good internal consistency and convergent and discriminant validity. These findings suggest that future research should seek to examine factors that may impact various facets to accommodation as well as the role these facets plays in predicting treatment outcome. Limitations are discussed.
OCD; Accommodation; Assessment; Psychometrics
We investigated measurement equivalence in two antisocial behavior scales (i.e., one scale for adolescents and a second scale for young adults) by examining differential item functioning (DIF) for respondents from single-parent (n = 109) and two-parent families (n = 447). Even though one item in the scale for adolescents and two items in the scale for young adults showed significant DIF, the two scales exhibited non-significant differential test functioning (DTF). Two types of DIF (e.g., uniform and nonuniform DIF) were investigated and examples of each type were identified. Specifically, uniform DIF was exhibited in the adolescent scale whereas nonuniform DIF was shown in the young adult scale. Implications of our DIF results for assessment of antisocial behavior, along with strengths and limitations of the study, are discussed.
A depressogenic attributional style, i.e., internal, stable and global causal interpretations of negative events, is a stable vulnerability factor for depression. Current measures of pessimistic attributional style can be time-consuming to complete, and some are designed for specific use with student populations. We developed and validated a new short questionnaire suitable for the measurement of depressogenic attributions in clinical settings, the Depressive Attributions Questionnaire (DAQ). The 16-item DAQ, and measures of depression and related cognitive concepts were completed by three samples of depressed patients and matched controls, or depressed and non-depressed participants who had been exposed to a recent uncontrollable stressful life event (total N = 375). The DAQ had high (i) internal reliability, (ii) test-retest reliability, (iii) convergent, discriminant and construct validity. It predicted a diagnosis of major depression at 6 months after an uncontrollable stressor, over and above what could be predicted from initial depression severity. Depressed patients rated the scale as acceptable. The DAQ may be a useful short measure of depressogenic attributions, which is easy to administer, and predicts concurrent and future depression. It has possible applications as a screening measure for risk of depression, or as a treatment process measure.
Depression; Attribution; Cognition; Questionnaire; Assessment
Studies have shown that, on average, Parent Management Training combined with cognitive-behavioral therapy decreases children’s externalizing behavior, but some children do not improve through treatment. The current study aimed to examine the role of maternal depression in understanding this variability in treatment outcome. Children with externalizing behavioral problems and their parents were recruited from combined Parent Management Training and Cognitive-Behavioral programs in “real-world” clinical settings. At pre- and post treatment, maternal depression and children’s externalizing behavior were assessed. Results showed that treatment was less effective for children of depressed mothers compared to non-depressed mothers and that improvements in maternal depression were associated with improvements in children’s externalizing behavior. These findings suggest that treatment programs for children with externalizing problems may be able to improve outcomes if maternal depression is a target of intervention.
Maternal depression; Externalizing behaviour problems; Childhood; Combined treatment