Development and validation of the Neuropsychology Behavior and Affect Profile.

This series of 4 studies describes the psychometric properties of the Neuropsychology Behavior and Affect Profile, which consists of 5 peer-rated scales (106 items) designed to measure personality change in brain-impaired individuals. Study 1 pertains to item derivation. Study 2 used relatives of 61 Ss identified as demented to determine the test's internal consistency. Results showed moderate levels of internal consistency across the 5 scales, with slightly higher coefficients (.68–.82) obtained for present (vs. premorbid) emotional status. High test–retest reliability was demonstrated in Study 3 (intraclass correlation coefficients ranged from .92 to .99). Study 4 established discriminant validity; the instrument differentiated 61 demented Ss from 88 normal elderly controls on the basis of present behavioral affective style. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validation of a new self-report measure of parental attributions.

Attributional theory and empirical evidence suggest that a tendency to make stable, global self-causal attributions for undesirable events is associated with negative outcomes. However, existing self-report measures of parental attributions do not account for the possibility that dysfunctional parent-causal attributions for child misbehavior might be important predictors of poor family functioning. To address these concerns, the authors developed and tested a new measure of both parent-causal and child-responsible attributions for child misbehavior in a sample of 453 community couples. Structural validity, convergent validity, discriminant validity, internal consistency, and temporal stability of the new measure were examined. As expected, confirmatory factor analysis resulted in 2 factors, Child-Responsible (9 items) and Parent-Causal (7 items); the final model was cross-validated in a holdout sample. The final scale demonstrated adequate internal consistency (αs = .81–.90), test–retest reliability (rs = .55–.76), and convergent and discriminant validity. Dysfunctional parent-causal and child-responsible attributions significantly predicted parental emotional problems, ineffective discipline, parent–child physical aggression, and low parenting satisfaction. Associations with parent–child aggression and parenting satisfaction were generally larger than with partner aggression and relationship satisfaction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Premorbid adjustment as predictor of outcome in schizophrenia: results of a prospective study

The present prospective follow-up study of 163 schizophrenic patients admitted to hospital for the first time examined the relationship between premorbid adjustment and different measures of the 3-year course and outcome. The same instruments had been used in all phases of the study. The Premorbid Adjustment Scale was used to assess premorbid social functioning. Outcome measures were positive symptoms, negative symptoms, social disability and number of rehospitalizations. The results of the multiple regression analyses showed that premorbid adjustment was the strongest overall predictor of outcome. Premorbid adjustment was significantly associated with negative symptoms and social disability over the 3-year course of illness. In a further step, we examined the relationship between good, moderate and poor premorbid adjustment and the course of positive symptoms, negative symptoms and social disability within the first 3 years after index admission. The most important finding was that premorbid functioning showed a stronger correlation with the course of negative symptoms and social disability than with the course of positive symptoms. Poor premorbid social functioning implies a poor social course of the illness. Female subjects showed better premorbid functioning than male subjects. Good premorbid adjustment was strongly associated with an acute onset of the illness, and poor premorbid adjustment with an insidious onset.     

Deficits in emotional and social cognition in amyotrophic lateral sclerosis.

Objective: These studies investigated whether non-demented ALS patients display impairments on tests of emotional decision making and social and emotional cognition, sensitive to frontal variant Frontotemporal Dementia (fvFTD). Previous studies have shown predominant executive dysfunction and dorsolateral prefrontal involvement in ALS, but evidence of other prefrontal dysfunction implicated in fvFTD is sparse. Method: In Study A, 19 ALS patients and 20 healthy controls undertook a test of affective decision making, modified Iowa Gambling Task (IGT). Behavioral measures included the Frontal Systems Behavior Scale. In Study B, 14 ALS patients and 20 controls undertook tests of social and emotional cognition (Judgment of Preference based on eye gaze, the Mind in the Eyes, recognition of Facial Expressions of Emotion). Results: In Study A, ALS patients demonstrated a significantly different performance profile from healthy controls on the IGT and did not learn to avoid the disadvantageous stimuli (Block 3, d = 0.60, Block 4 days = 0.68). Behavior ratings showed increased apathy from premorbid levels. In Study B, ALS patients were impaired on attentionally demanding (d = 3.12) and undemanding (d = 7.52) conditions of the Judgment of Preference task, despite many showing intact executive functions. A smaller subset showed impaired emotion recognition. Behavior change was also evident. Conclusions: The findings reveal a Theory of Mind deficit on a simple test that was dissociated from the presence of executive dysfunction and suggests a profile of cognitive and behavioral dysfunction indicative of a subclinical fvFTD syndrome. The relative contribution of prefrontal pathways to the cognitive profile in ALS is considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological predictors of adaptive kitchen behavior in geriatric psychiatry inpatients

This study examined the degree to which demographic variables, psychiatric diagnosis, depression rating, and neuropsychological test performance predict adaptive kitchen behavior in geriatric psychiatry patients and normal elderly volunteers. Amixed group of 27 participants including 8 normal volunteers and 19 geriatric psychiatry inpatients underwent psychiatric evaluation, neuropsychological testing, and a kitchen skills assessment conducted in a natural setting. Both depression and dementia were prevalent among patients. The kitchen skills assessment was abnormal in 69% of patients, compared to none of the normal volunteers. Estimated premorbid IQs, psychiatric diagnosis, and neuropsychological test scores significantly predicted the pass/fail status on the kitchen skills assessment, but there was no effect for age, education, gender, or depression. The discriminant function analysis classified 92% of cases, and the canonical correlation coefficient was .84. Of the neuropsychological tests employed in the study, two tests involving visuospatial processing and attention were retained in the discriminant function analysis. The results are consistent with previous studies that suggest that visuospatial tasks are more predictive of instrumental activities of daily living than are cognitive tasks emphasizing verbal and memory abilities. In addition, we conclude that neuropsychological test data are useful and valid for the purpose of guiding clinical judgments regarding activities of daily living in geriatric psychiatry patients.     

Assessing irrational beliefs and emotional distress: Evidence and implications of limited discriminant validity.

In the present study of adult mental health center outpatients, we examined the discriminant validity of measures of irrational beliefs. The Irrational Beliefs Test (IBT; Jones, 1968) and the Rational Behavior Inventory (RBI; Shorkey & Whiteman, 1977) were highly correlated but were equally highly correlated with self-report measures of depression and anxiety. Thus, rather than assessing beliefs that are in turn correlated with emotional distress, the IBT and RBI may themselves actually assess general dysphoria or neuroticism. Further analyses suggested that contamination with neuroticism may account for correlations between beliefs and dysfunctional emotions. Some specific beliefs, however, demonstrated associations with depression and anger that could not be accounted for by contamination with neuroticism. Results are discussed in terms of empirical support for the rational–emotive model and our ability to test its basic assumptions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinical samples of children with below-average IQs are not "nonimpaired" and other troubles: Comment on Klesges and Sanchez.

R. C. Klesges and V. C. Sanchez (see record 1981-09257-001) investigated the validity of an index of premorbid intellectual functioning for children that was derived from demographic data. However, the use of clinical samples without knowledge of actual premorbid IQs belies the logic of the investigation. Specific factual errors are also noted. Contrary to their interpretations, the Klesges and Sanchez results can make no statement regarding the validity of the index. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The mere exposure effect in patients with Alzheimer's disease.

The mere exposure effect was examined in patients with mild to moderate Alzheimer's disease (AD). Twenty patients and 20 elderly controls judged the physical characteristics of faces. Implicit memory was tested later by presenting pairs of faces (old and new) and asking participants which faces they liked better. Patients and controls exhibited above chance preference for previously exposed faces. Experiment 2 evaluated whether the preserved implicit memory of patients was mediated by explicit memory. Patients and controls again judged faces but then later chose which faces they had seen before. Patients exhibited impaired recognition memory compared to controls. These findings suggest that a mere exposure affect for unfamiliar faces is present in mild to moderate AD. The results are discussed in terms of perceptual and conceptual priming and relatively spared occipital lobe functioning in early AD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Observed emotional involvement and overinvolvement in families of patients with bipolar disorder.

Many studies have examined the construct validity of the criticism component of expressed emotion, but little work has been done on clarifying the emotional overinvolvement (EOI) construct. In a sample of 115 recently episodic patients with bipolar disorder, the authors of the present study examined the construct validity of an observational coding system for both appropriate and inappropriate emotional involvement that permitted separate ratings for relatives' intrusiveness, self-sacrificing behaviors, and distress related to the patient's well-being. Findings support the measure's reliability and convergent validity and are moderately supportive of the measure's discriminant validity. Results also suggest that Camberwell Family Interview (C. E. Vaughn & J. P. Leff, 1976) EOI ratings do not discriminate among the different dimensions of the emotional involvement construct (or their appropriateness or inappropriateness) as revealed in laboratory-based interactions. The findings suggest that clinicians working with such families might consider differentiating among the various ways in which family members are involved with the patient and helping them learn to judge under what circumstances such involvement is appropriate and inappropriate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Behavioral activation and inhibition systems and the severity and course of depression.

Theorists have proposed that depression is associated with abnormalities in the behavioral activation (BAS) and behavioral inhibition (BIS) systems. In particular, depressed individuals are hypothesized to exhibit deficient BAS and overactive BIS functioning. Self-reported levels of BAS and BIS were examined in 62 depressed participants and 27 nondepressed controls. Clinical functioning was assessed at intake and at 8-month follow-up. Relative to nondepressed controls, depressed participants reported lower BAS levels and higher BIS levels. Within the depressed group, lower BAS levels were associated with greater concurrent depression severity and predicted worse 8-month outcome. Levels of both BIS and BAS showed considerable stability over time and clinical state. Overall, results suggest that BAS dysregulation exacerbates the presentation and course of depressive illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Estimation of WAIS—R premorbid intelligence: Current ability and demographic data used in a best-performance fashion.

The validity of a technique for estimating premorbid intellectual functioning based on Wechsler Adult Intelligence Scale—Revised (WAIS—R; D. Wechsler, 1981) subtest performance and demographic information used in a best-performance fashion was investigated. Premorbid IQ scores were predicted using the highest score from (a) all 11 R. D. Vanderploeg and J. A. Schinka (see record 1996-13380-001) regression equations (BEST-11) and (b) the 3 most robust regression equations (BEST-3). These results were compared with premorbid estimates based solely on demographic information. In the WAIS—R standardization sample the BEST methods were more highly correlated with actual WAIS—R IQ than were A. Barona et al (see record 1985-04035-001) estimates. The BEST-11 and BEST-3 approaches resulted in overestimates of about 9 points and 5 points, respectively. In matched samples of neurologic patients and normal controls, Pearson correlations between actual and estimated IQ scores were significantly higher for the BEST-3 than the Barona et al method. The BEST-3 method also was superior at predicting group membership (normal vs brain-damaged). These studies support the use of the BEST-3 approach to premorbid estimation of cognitive abilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Revised Dimensions of Temperament Survey (DOTS—R): Simultaneous group confirmatory factor analysis for adolescent gender groups.

Confirmatory factor analyses supported the plausibility of a 10-factor model of the DOTS—R (M. Windle and R. M. Lerner, 1986) with a sample of 975 teenagers. Simultaneous group models across gender indicated an invariant pattern for factor loadings and factor intercorrelations. Internal consistency estimates and test–retest stability were moderately high for the 10 temperament attributes, and consensual validity was indicated by convergent/discriminant correlations between adolescent and primary caregiver agreement indexes. A 2nd-order factor analysis revealed 3 factors: Adaptability/Positive Affect, Attentional Focus, and General Rhythmicity. In terms of levels of temperament, girls reported more adaptability/positive affect, whereas boys reported more attentional focus and general rhythmicity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment style and emotion regulation in dementia patients and their relation to caregiver burden

One hundred and sixty-eight patients with mid- to late-stage dementia and their caregivers participated in a study of the relation between patient emotional characteristics, dementia symptomatology, and caregiver burden. Measures included premorbid attachment style, premorbid emotion regulation style, and behavioral symptoms of dementia. The attachment patterns (secure, avoidant, ambivalent) of these elderly patients resembled those obtained in samples of younger individuals in terms of emotion regulation characteristics; however, the distribution of attachment styles was significantly different, with a lower proportion of ambivalently attached individuals in the present sample. In terms of the behavioral symptoms of dementia, ambivalent patients had more depression and anxiety than secure and avoidant patients; the latter patients experienced more activity disturbance than ambivalently attached individuals and were higher on paranoid symptomatology than securely attached persons. Caregivers of securely attached individuals experienced less total burden than did caregivers of both insecure groups. In regression analysis, attachment style accounted for the largest proportion of unique variance in the prediction of caregiver burden (8%); only 1 of 7 patient symptoms contributed a significant independent effect, namely depressed affect, which accounted for 4% of the variance.     

Gastro-oesophageal reflux disease

Using emerging international guidelines, stringent procedures were used to develop and evaluate Canadian-French, German and UK translations/adaptions of the 50 item, parent-completed Child Health Questionnaire (CHQ-PF50). Multitrait analysis was used to evaluate the convergent and discriminant validity of the hypothesized item sets across countries relative to the results obtained for a representative sample of children in the US. Cronbach's alpha coefficient was used to estimate the internal consistency reliability for each of the health scales. Floor and ceiling effects were also examined. Seventy-nine percent of all the item-scale correlations achieved acceptable internal consistency (0.40 or higher). The tests of the item convergent and discriminant validity were successful at least 87% of the time across all scales and countries. Equal item variance was observed 90% of the time across all countries. The reliability coefficients ranged from a low of 0.43 (parental time impact, Canadian English) to a high of 0.97 (physical functioning index, Canadian French) across all scales (median 0.80). Negligible floor effects were observed across countries. Noteworthy ceiling effects were observed, as expected, for the hypothesized physical scales (mean effect 73%). Conversely, fewer ceiling effects were observed for the psychosocial scales (range 3-17% behaviour-parental emotional impact). The item-scaling results obtained in these pilot studies support the psychometric properties of the American-English CHQ-PF50 and its respective translations.     

Emotional sequelae of stroke.

This study is the first to use reporting sources close to the S to examine mood and personality changes in patients with left- (LH) and right-hemisphere (RH) stroke lesions. Ss (29 with RH lesions, 27 with LH lesions, and 14 with bilateral lesions) together with their significant others, were assessed approximately 2 wks poststroke. Depression was one of the major types of emotional change regardless of lesion site. Other emotional concomitants included increased indifference, inappropriate behavior, and pragnosia (defective social communication style). A significant 3-way interaction indicated that, during the acute stroke phase, the syndrome of depression and other mood and personality changes in LH patients significantly differentiated them from their RH counterparts. Specific patterns of changes from premorbid to poststroke status are discussed in terms of their theoretical, clinical, and research implications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differential recovery of intellectual, associational, and psychophysiological functioning in withdrawn and active schizophrenics.

Recent research indicates that activity level in schizophrenics is related to probability of cerebral damage, neurophysiological functioning, severity of the schizophrenic episode, and level of premorbid adjustment. Withdrawn patients consistently appear more disturbed than active patients on these variables. The present study examined 15 withdrawn chronic schizophrenics (mean age 37.8 yrs) and 15 active chronic schizophrenics (mean age 40.2 yrs) who were evaluated on the Venables Activity–Withdrawal Scale within their 1st wk of hospitalization. Withdrawns recovered more slowly than actives across the 1st 5 wks of hospitalization in terms of intellectual, associational, and psychophysiological measures. The interaction of these various areas of functioning and their implications for clinical practice are discussed. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Severity Indices of Personality Problems (SIPP-118): Development, factor structure, reliability, and validity.

This article describes a series of studies involving 2,730 participants on the development and validity testing of the Severity Indices of Personality Problems (SIPP), a self-report questionnaire covering important core components of (mal)adaptive personality functioning. Results show that the 16 facets constituted homogeneous item clusters (i.e., unidimensional and internally consistent parcels) that fit well into 5 clinically interpretable, higher order domains: self-control, identity integration, relational capacities, social concordance, and responsibility. These domains appeared to have good concurrent validity across various populations, good convergent validity in terms of associations with interview ratings of the severity of personality pathology, and good discriminant validity in terms of associations with trait-based personality disorder dimensions. Furthermore, results suggest that the domain scores are stable over a time interval of 14-21 days in a student sample but are sensitive to change over a 2-year follow-up interval in a treated patient population. Taken together, the final instrument, the SIPP-118, provides a set of 5 reliable, valid, and efficient indices of the core components of (mal)adaptive personality functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive decline from estimated premorbid status predicts neurodegeneration in Alzheimer's disease.

This study investigated the relationship between premorbid and current cognitive function with respect to the clinical features of patients with various types of neurodegeneration in the form of Alzheimer's disease (AD), mild cognitive impairment (MCI), and subjective cognitive impairment (SCI), as compared with a healthy control group (C). Clinical features (MMSE, cognitive and depressive symptoms), genetics (apolipoprotein E; APOE) and measures of neurodegeneration (Aβ42, t-tau, and p-tau) were examined, as well as present cognitive function. Various methods of assessing premorbid cognitive function were compared, including a Swedish NART-analogous test (Irregularly Spelled Words; ISW), a Swedish lexical decision test (SLDT), a Hold test (Information in WAIS-R), Best current performance test, and combined demographic characteristics. Results showed that cognitive decline (premorbid minus current cognitive function) based on SLDT and ISW was a significant predictor for MMSE and Aβ42, whereas corresponding associations for present cognitive function and decline measures based on other methods were less powerful. Results also showed that specific verbal abilities (e.g., SLDT and ISW) were insensitive to AD and that these abilities indicated premorbid cognitive function in retrospect. In conclusion, cognitive decline from premorbid status reflects the disease processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Proprioception and schizophrenia: a replication study with nonschizophrenic patient controls

In 3 experiments, weight discrimination, arm flexion discrimination, and a test of kinesthetic figural aftereffects were used to evaluate the proprioceptive functioning of 40 schizophrenic patients, 30 nonschizophrenic (psychotic and nonpsychotic) patients, and 10 normals. The additional variables of premorbid functioning and paranoia were also examined. Previous findings of a subtle proprioceptive deficit for schizophrenics in comparison with normals were replicated for nonparanoid schizophrenics of a weight-discrimination procedure and poor premorbid schizophrenics on an arm-flexion task. The kinesthetic-figural-aftereffects schizophrenic deficit previously reported by the author and E. Ebner (see record 1974-23243-001) was not replicated. Deficits in proprioception also were found for all nonschizophrenic patient groups on the weight-discrimination procedure and for poor premorbid nonschizophrenic psychotics and neurotics on the arm-flexion task. It is concluded that a deficit in proprioception is not unique to schizophrenia but appears to be related to chronicity and severity of pathology in both schizophrenic and nonschizophrenic hospitalized patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)