Reliability of the Impulsive-Premeditated Aggression Scale (IPAS) in treated opiate-dependent individuals

The purpose of the study was to evaluate the internal consistency and test-retest reliability of the Impulsive Aggression (IA) and Premeditated Aggression (PM) scales of the Impulsive-Premeditated Aggression Scale (IPAS) in male and female substance-dependent patients, and to compare the findings to those obtained on widely used, validated measures of aggression. Using a sample of 121 patients (61 women) in methadone maintenance treatment, 69 (35 women) of which were re-evaluated after a minimum of 2weeks, the IPAS scales showed acceptable internal consistency (alpha>.72) and test-retest reliability (ICC>.54). These results were comparable to the other aggression measures, and results among women were comparable to men. This was the first study to examine the IPAS scales in a substance use population, to contain a sufficient sample of women for sub-analyses, and to examine the stability of the measure. Findings support the internal consistency and test-retest reliability of the IPAS in male and female opiate-dependent individuals.

African American children's depressive symptoms: the prospective effects of neighborhood disorder, stressful life events, and parenting

The prospective effects of observed neighborhood disorder, stressful life events, and parents' engagement in inductive reasoning on adolescents' depressive symptoms were examined using data collected from 777 African American families. Multilevel analyses revealed that stressful life events experienced at age 11 predicted depressive symptoms at age 13. Furthermore, a significant interaction between neighborhood disorder and parents' engagement in inductive reasoning was found, indicating that parental use of inductive reasoning was a protective factor for depressive symptoms particularly for youths living in highly disordered neighborhoods. The importance of examining correlates of depressive symptoms from a contextual framework, focusing on individuals, families, and neighborhood contexts, is emphasized.

A Training Program to Improve the Ability of Periodontal Residents to Estimate Patients' Pain Experience

BACKGROUND

The purpose of this study was to determine whether periodontal residents could enhance their ability to assess the pain levels experienced by their patients from probing, using visual analog scale (VAS) to record pain. We hypothesized that with increasing experience by repeated comparisons of the patients' VAS pain ratings with independent ratings by the residents, they would improve their ability to assess their patients' pain experiences.

METHODS

For each of three periodontal residents, 40 consecutive patients with periodontal disease were asked to express the degree of pain they experienced during the probing. Independently, the residents rated the pain levels they perceived that the patients experienced. Subsequently, the residents compared the two VAS ratings and discussed differences in ratings with the patients. Descriptive statistics and intraclass correlation coefficients were used to analyze the findings.

RESULTS

Differences between patients' and residents' VAS scores gradually became smaller over time for two of the residents. Results for the third resident were less compelling.

CONCLUSIONS

This study indicated that the training program improved the residents' ability to estimate the pain experiences of their patients, at least for two of the three participating residents. This training program, using periodontal probing as a model, could serve as an educational tool for students and practitioners who want to improve their sensitivity to their patients' pain experiences.

The operationalized psychodynamic diagnostics system: clinical relevance, reliability and validity

In this paper, we present a multiaxial system for psychodynamic diagnosis, which has attained wide usage in Germany in the last 10 years. First we will discuss the 4 operationalized psychodynamic diagnostics (OPD) axes: illness experience and treatment assumptions, relationships, mental conflicts, and structure, then clinical applications will be outlined. Focus psychodynamic formulations can be employed both with inpatients and with outpatients. Studies show good reliability in a research context and acceptable reliability for clinical purposes. Validity will be separately summarized as content, criterion, and construct validity. Validity studies indicate good validity for the individual axes. Numerous studies on the OPD indicate areas of possible improvement, for example for clinical purposes the OPD should be more practically formulated.

Relationship satisfaction and psychological distress among concerned significant others of pathological gamblers

This study explores correlates of psychological distress and relationship satisfaction among concerned significant others (CSOs) of pathological gamblers. CSOs often seek help in dealing with the gambling problem and are influential in recovery, but little is known about the sources of their distress. A sample of 186 CSOs responded to media announcements offering telephone and bibliotherapy support. In multivariate models, CSOs who were spouses and who were younger reported more personal distress, and higher distress was associated with a greater number of CSO emotional and behavioral consequences. Lower relationship satisfaction was associated with more CSO emotional consequences, fewer gambler consequences, and greater severity of gambling problem. Implications for treatment are discussed.

Evaluating a method of assessing competence in Motivational Interviewing: a study using simulated patients in the United Kingdom

In this evaluation of a method of assessing competence in Motivational Interviewing (MI), participants were asked to interview an actor simulating a substance abuser who was ambivalent about an important issue. The interviews were videotaped and subsequently rated for competence in MI using the Motivational Interviewing Treatment Integrity code (MITI). Ratings of 43 interviews made independently by trained judges found high levels of inter-rater agreement. Ratings of 11 pairs of interviews carried out by the same interviewer with different simulated patients, a mean of 26days apart, resembled each other closely. Participants who had been trained in MI were significantly more competent than others. There was a significant association between researchers' and patients' ratings of the extent to which the interviewer demonstrated the spirit of MI. These findings imply that the assessment method produces reasonably reliable and valid ratings of competence in MI and can be used for both clinical and research purposes.

Measuring performance directly using the veterans health administration electronic medical record: a comparison with external peer review

BACKGROUND

Electronic medical records systems (EMR) contain many directly analyzable data fields that may reduce the need for extensive chart review, thus allowing for performance measures to be assessed on a larger proportion of patients in care.

OBJECTIVE

This study sought to determine the extent to which selected chart review-based clinical performance measures could be accurately replicated using readily available and directly analyzable EMR data.

METHODS

A cross-sectional study using full chart review results from the Veterans Health Administration's External Peer Review Program (EPRP) was merged to EMR data.

RESULTS

Over 80% of the data on these selected measures found in chart review was available in a directly analyzable form in the EMR. The extent of missing EMR data varied by site of care (P<0.01). Among patients on whom both sources of data were available, we found a high degree of correlation between the 2 sources in the measures assessed (correlations of 0.89-0.98) and in the concordance between the measures using performance cut points (kappa: 0.86-0.99). Furthermore, there was little evidence of bias; the differences in values were not clinically meaningful (difference of 0.9 mg/dL for low-density lipoprotein cholesterol, 1.2 mm Hg for systolic blood pressure, 0.3 mm Hg for diastolic, and no difference for HgbA1c).

CONCLUSIONS

Directly analyzable data fields in the EMR can accurately reproduce selected EPRP measures on most patients. We found no evidence of systematic differences in performance values among these with and without directly analyzable data in the EMR.

Cognition checklist for mania-revised

The Cognitive Checklist for Mania-Revised (CCL-M-R), which measures the severity of maladaptive beliefs and cognitions associated with mania, was administered to 35 inpatients with a major depressive disorder, 20 inpatients with a schizoaffective disorder, and 45 inpatients with a bipolar I disorder to determine whether cognitions associated with mania differentiate patients who have most recently experienced either manic, mixed, or depressive episodes. The CCL-M-R is composed of four subscales assessing (a) exaggerated beliefs about self-worth (Myself), (b) grandiose beliefs about interpersonal relationships (Relationships), (c) erroneous beliefs about needing excitement from engaging in high risk situations (Pleasure/Excitement), and (d) unrealistic beliefs about having high energy levels for undertaking goal-driven activities (Activity). As hypothesized, the mean CCL-M-R total, Myself, Relationships, and Activity scores of the 26 patients with manic episodes were higher than those for either the 17 patients with mixed episodes or the 57 with depressive episodes. The CCL-M-R was discussed as a reliable and valid instrument for measuring the severity of maladaptive cognitions associated with mania in psychiatric patients.

Using motivational interviewing with smokers: Do therapist behaviors relate to engagement and therapeutic alliance?

This study examined whether therapist behaviors consistent with motivational interviewing (MI) were associated with within-session working alliance and client engagement. Forty-six audiotaped counseling sessions were drawn from a group-randomized comparison-controlled smoking cessation trial for public housing residents. Separate raters coded therapist behaviors and client behaviors. Therapist behaviors were coded using the Motivational Interviewing Skill Code. Results indicated that an MI-consistent style (average of the global ratings of collaboration, egalitarianism, and empathy) was positively associated with alliance and engagement, whereas confrontation was negatively related to alliance. Small to moderate effect sizes were found for affirming, asking open-ended questions, confronting, reflecting, and summarizing. Significant covariates include treatment condition, session sequence, and session date. Findings empirically support Miller and Rollnick's [Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford Press] emphasis on the importance of MI spirit for enhancing alliance and engagement and their findings that any tears/ruptures in the alliance through the use of confrontation could significantly relate to poor outcomes.

Interrater and Test–Retest Reliability of a Fixed Condition Design Fluency Test

Despite its potential as a unique neuropsychological test, the emergence of a psychometrically sound research foundation for Jones-Gotman and Milner's (1977) Design Fluency Test (DFT) has been constrained by the lack of consistent administration and scoring practices and limited information about its reliability. Here we describe an approach to administering and scoring the fixed condition DFT that is modeled on Jones-Gotman and Milner's original method and that clarifies procedural ambiguities. Results include interrater and long-term test-retest reliability analyses using this approach. First, based on five raters who scored 50 DFT protocols, good to excellent intra-class correlation coefficients were obtained for all DFT scores. Second, in a broadly representative sample of 87 healthy adults who were tested twice over an average of 5 1/2 years, the test-retest reliabilities for total and novel design scores ranged from good to excellent. This study demonstrates that the fixed condition DFT can be scored reliably using these procedures and that the reliability coefficients for DFT total and novel designs scores are comparable to those of other commonly used neuropsychological tests.

Measures of fidelity in motivational enhancement: a systematic review

The movement to use empirically supported treatments has increased the need for researchers and clinical supervisors to evaluate therapists' adherence to and competence in particular empirically supported interventions. Motivational interviewing (MI) is an empirically supported intervention for substance abuse and other behavioral problems. However, for this intervention to work, it must be provided with fidelity and skill. This article provides a systematic review of MI adherence and competence measures that have been developed and described independently elsewhere. Recommendations for refinement of the measures and future research are also discussed.

An examination of the Motivational Interviewing Treatment Integrity code

This study examines the reliability of the Motivational Interviewing Treatment Integrity (MITI) code, a brief scale designed to evaluate the integrity of the use of motivational interviewing (MI). Interactions between substance abuse counselors with one person role-playing a client were audiotaped and scored by trained teams of graduate and undergraduate students. Segments of 10 minutes and 20 minutes were compared and found to yield the same reliability and integrity results. Interrater reliability showed good-to-excellent results for each MITI item even with undergraduate raters. Correlations between items showed a coherent pattern of interitem correlations. The MITI is a good measure of treatment integrity for MI and seems superior to existing measures when indicators of client behavior are not needed.

A Rorschach Stability Study in a Nonpatient Adult Sample

The objective of this study was to provide new primary data on Rorschach Comprehensive System stability levels. To achieve this, we tested 75 French nonpatient adults twice on the Rorschach with a 3-month interval between the tests. Interrater reliability was in the excellent range for most of the variables studied. The overall stability level in a selected set of previously studied variables was below expectations (median r = .53). Personality, cognitive or self/relational variables yielded higher test-retest correlations than emotional and coping variables. Moderators of stability could be identified: (a) overall level of Task Engagement (TE) in F, m, FM + m, a, FC, Sum C', Sum V, Sum Shd, Fr + rF, INC + FAB, COP, es, Adj es, EGO, and Blends; (b) variations in TE in F, FM, and p; (c) state distress in Zd, m, FM + m, a, C, CF + C, WSumC, FD, and es; (d) variables derived from the number of responses impacted stability in P, Zf, m, FC, CF + C, Sum C', Sum V, MOR, EA, es, and Blends. These results provide further support for the reliability of several measures. Examiner effects as an influence on productivity and TE were identified as an important area for future research.

Psychometric evaluation of the quality of life interview, brief version, in injection drug users

The authors investigated the psychometric characteristics of the Quality of Life Interview, Brief Version (QOLI-BV; A. F. Lehman, 1995) in 126 injection drug users recruited for a clinical trial. The QOLI-BV assesses global and domain-specific quality of life. Participants completed the instrument at baseline and 3 and 6 months later. Most scales showed acceptable internal consistency. Convergent and discriminant validity were demonstrated through correlations with the SF-36, the Beck Depression Inventory, and demographic variables. Scale means rose over time, suggesting that the QOLI-BV is sensitive to change. Unexpectedly, lower baseline QOLI-BV scores predicted opiate abstinence at follow-up. The QOLI-BV appears to be an acceptable quality-of-life measure for use in clinical trials of opioid dependence treatments.

Insight and cognitive impairment: effects on quality-of-life reports from mild cognitive impairment and Alzheimer's disease patients

This study follows previous work to determine the effect of patient insight and cognitive impairment on the reliability and validity of self-reported quality of life (QOL) from patients diagnosed with Alzheimer's disease (AD) and mild cognitive impairment (MCI). AD and MCI patients (N = 68) and their caregivers participated. Patients with impaired insight provided QOL ratings that were less reliable than those provided by patients with better insight. Patient-caregiver agreement for. QOL reports was used as an index of validity. Neither better insight nor lesser cognitive impairment suggested better agreement. Thus, even when patient insight is intact, patient reports are unlikely to agree with caregiver reports. Patient and caregiver reports about patient QOL may represent 2 unique, yet potentially valid, perspectives.

The "Big Dog" effect: variability assessing the causes of error in diagnoses of patients with lung cancer

PURPOSE

The frequency of diagnostic error in patients who have a lung mass and a pathology specimen is as high as 15%. This study examined the role of inter-pathologist agreement in identifying the cause of error in these patients.

METHODS

Pathologists from six institutions reviewed the slides of 40 patients who had a pulmonary specimen false-negative diagnosis. The initial assessment of error cause arose from cytologic-histologic correlation slide review of discrepant diagnostic samples in patients who had both a bronchial brushing cytologic and surgical specimen. The cause of error was attributed either to clinical sampling (diagnostic material obtained in one but not the other sample) or interpretation (pathologist failed to identify the salient diagnostic features). The pairwise kappa (kappa) statistic was used to calculate interobserver agreement between the review and original diagnoses and between the separate review diagnoses.

RESULTS

The pairwise kappa statistic ranged widely from -0.154 to 1.0, and the pairwise kappa statistic of the slides from one institution was undetermined because that institutional pathologist never made the assessment that error was secondary to interpretation. Agreement for observers within the same institution was better than agreement between observers from different institutions.

CONCLUSION

Pathologists exhibit poor agreement in determining the cause of error for pulmonary specimens sent for cancer diagnosis. We developed a psychosocial hypothesis (the "Big Dog" Effect) that partially explains biases in error assessment. This lack of agreement precludes confident targeting of these errors for quality improvement interventions with prospects of success across a variety of institutions.

Examining clinical judgment in an adaptive intervention design: The fast track program

Although clinical judgment is often used in assessment and treatment planning, rarely has research examined its reliability, validity, or impact in practice settings. This study tailored the frequency of home visits in a prevention program for aggressive- disruptive children (n = 410; 56% minority) on the basis of 2 kinds of clinical judgment: ratings of parental functioning using a standardized multi-item scale and global assessments of family need for services. Stronger reliability and better concurrent and predictive validity emerged for the 1st kind of clinical judgment than for the 2nd. Exploratory analyses suggested that using ratings of parental functioning to tailor treatment recommendations improved the impact of the intervention by the end of 3rd grade but using more global assessments of family need did not.

The NEO-FFI is a reliable measure of premorbid personality in patients with probable Alzheimer's disease

AIM

To assess the inter-informant reliability, intra-informant reliability and internal consistency of the NEO-FFI as a measure of premorbid personality in patients with Alzheimer's Disease (AD).

SUBJECTS

One hundred and five persons with NINCDS-ADRDA probable AD for the assessment of inter-informant reliability and internal consistency, and 30 for the assessment of intra-informant reliability.

METHODS

Premorbid personality was rated retrospectively by close relatives remembering the patient as he/she had been when aged in his/her forties. One hundred and five AD patients were rated by two separate informants. Thirty AD patients were rated by the same informant on separate occasions one year apart.

RESULTS

Inter-informant reliability for the five domain scores of the NEO-FFI was shown to range from fair to good when measured using the single measure Intraclass Correlation Co-efficient (ICC) (0.52-0.64), and to range from good to excellent when measured using the average ICC (0.68-0.78). Intra-informant reliability for four out of the five domains was shown to be excellent when measured using the single ICC (0.81-0.92), and good for the remaining domain (0.72). Intra-informant reliability was found to be excellent for all five domains when measured using the average ICC (0.84-0.96). Internal consistency of the five domains was good.

CONCLUSIONS

The NEO-FFI can be used reliably to measure premorbid personality in patients with probable AD. It may be useful to maximise reliability by using a mean domain score based on questionnaires completed by two or more informants who knew the patient well earlier in life.

Exploring the alcohol expectancy memory network: the utility of free associates

Alcohol expectancies are theorized to operate through associative memory networks. These networks are thought to differ on the basis of individual experience (direct and vicarious) with alcohol. Free-associate probabilities have been used in cognitive psychology as a metric of the associative strength of words to other words; this method has been used to establish the relationships within a semantic memory network. Participants from a large college sample were asked to free associate to the phrase "Alcohol makes me ______" They were also asked about their quantity of alcohol consumption. Results showed that specific responses were given with different probabilities by individuals who drank at different levels. The heaviest drinkers tended to have more positive and arousing responses than did lighter drinkers, who tended to have more negative and sedating responses. These results underscore the need to take into account relevant individual differences in behavior and experience when characterizing semantic networks.

The impact of behaviour problems on caregiver stress in young people with autism spectrum disorders

BACKGROUND

The purpose of this study was to examine the correlates of caregiver stress in a large sample of young people with autism spectrum disorders (ASDs). Two main objectives were to: (1) disentangle the effects of behaviour problems and level of functioning on caregiver stress; and (2) measure the stability of behaviour problems and caregiver stress.

METHODS

Parents or teachers of 293 young people with ASDs completed measures of stress, behaviour problems and social competence. Parents also completed an adaptive behaviour scale. Eighty-one young people were rated twice at a 1-year interval.

RESULTS

Parents and teachers did not perfectly agree on the nature and severity of behaviour problems. However, both sets of ratings indicated that behaviour problems were strongly associated with stress. Conduct problems in particular were significant predictors of stress. Adaptive skills were not significantly associated with caregiver stress. Parental reports of behaviour problems and stress were quite stable over the 1-year interval, much more so than teacher reports. Parent ratings suggested that behaviour problems and stress exacerbated each other over time. This transactional model did not fit the teacher data.

CONCLUSION

Results of this study suggested that it is a specific group of externalized behaviours that are the most strongly associated with both parent and teacher stress. Results were discussed from methodological and conceptual perspectives.

Matters of conscience and conscientiousness: the place of ego development in the Five-factor model

The Five-factor model (FFM; Digman, 1990; Goldberg, 1990) and Loevinger's (1994) theory of ego development are two active research traditions that are often construed as incompatible approaches to the study of personality. For example, each theory proposes a different view of the concept of conscientiousness. Loevinger argued that FFM conscientiousness, which emphasizes attributes such as order, self-discipline, and achievement striving, lacks a moral component and is more similar to the conformist stage in her theory. To investigate these claims, we administered the Revised NEO-Personality Inventory (NEO-PI-R; Costa & McCrae, 1992) and the Washington University Sentence Completion Test (WUSCT; Hy & Loevinger, 1996) to 120 university students on 2 separate occasions. Together, the five traits of the FFM significantly predicted item sum scores from the WUSCT (multiple R = .54). Unique linear relationships of Openness to Experience and Agreeableness with ego level demonstrated that the two theories proposed similar constructs. We argue that these two FFM dimensions have conceptual relevance to the cognitive and interpersonal aspects of the ego development construct. We draw further connections between these FFM dimensions, ego development, and human values.

Comparability and reliability of paper- and computer-based measures of psychosocial constructs for adolescent fruit and vegetable and dietary fat intake

BACKGROUND

This study investigated the comparability and reliability of computer- and paper-based measures of psychosocial constructs related to fruit and vegetable and dietary fat intake among adolescents.

METHODS

An ethnically diverse sample of 76 adolescents was studied (mean age 13 years). Scales measured use of change strategies, self-efficacy, decisional balance, family influences, and peer influences separately for the two dietary outcomes.

RESULTS

Comparability analyses indicated that responses for each of the 12 diet-related scales were not significantly different between the computer- and paper-based surveys. Internal consistencies were generally high (alpha from .61 to .97) with slightly better reliability on the computer- vs paper-based surveys. Test-retest reliabilities were adequate to good for most multiple-item scales (interclass correlation coefficients from .43 to .85 and .48 to .90 for paper and computer formats, respectively).

CONCLUSIONS

Computer- and paper-based measures of psychosocial constructs are appropriate and ready for use in either format for studies of dietary behaviors in young people.

ALQOL 9 FOR MEASURING QUALITY OF LIFE IN ALCOHOL DEPENDENCE

AIMS

Quality of life (QoL) is an important factor of outcome tracking and treatment in alcohol misuse. A 9-item QoL scale, AlQoL 9, obtained from the generic SF 36, is proposed as a measure that characterizes the QoL of alcohol-dependent patients. Our objective was to study the psychometric properties of this subscale.

METHODS

AlQoL 9 was evaluated in two study groups of patients with DSM-IV diagnosis of dependence: 104 inpatients, and 114 outpatients. Severity of dependence, alcohol consumption, psychiatric, and somatic comorbidities were assessed. We studied the global properties of AlQoL 9 and its structure.

RESULTS

Cronbach alpha-coefficients in both populations indicated good internal consistency (0.71 and 0.85). Test-retest intraclass coefficients for a 2-day interval in hospital were in the range 0.57-0.78. Principal component analysis found a unidimensional scale. This subscale has properties that are consistent with the concept of QoL in alcohol dependence, i.e. lowered QoL compared with the general population, influenced by gender, and depression.

CONCLUSIONS

AlQoL 9 epitomizes QoL in alcohol-dependence. It gives a global measurement with good psychometric properties. It could be used in clinical practice as a diagnosis and management support instrument and may also be useful in research for evaluating treatment efficacy.

Validity of the sleep subscale of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II)

Currently there are no available sleep disorder measures for individuals with severe and profound intellectual disability. We, therefore, attempted to establish the external validity of the Diagnostic Assessment for the Severely Handicapped-II (DASH-II) sleep subscale by comparing daily observational sleep data with the responses of direct care staff to the sleep subscale of the DASH-II. Participants included 25 individuals with severe intellectual disability and 25 individuals with profound intellectual disability who reside in a large developmental center in central Louisiana. Four of the five items of the DASH-II were shown to have external validity. Implications of these findings for future research and practice are discussed.

The Body Influence Assessment Inventory (BIAI): Development and initial validation

This manuscript describes the development and preliminary psychometric properties of a 28-item self-report instrument, the Body Influence Assessment Inventory (BIAI). The BIAI taps four dimensions of bodily experiences in the eating disorders area that are linked with suicide-related behaviors. Following the four phases of instrument development, four studies were conducted to examine the psychometric properties of the BIAI. In Study 1 (n = 510 nonclinical participants), exploratory factor analysis identified four factors with item-factor compositions ranging from .30 to .88. In Study 2 (n = 490 nonclinical participants), the four-factor oblique solution provided the best fit to the sample data: Comparative fit index of .95, Tucker-Lewis Index of .93, and root-mean-square error of approximation value of .05. In Study 3 (psychiatric inpatients), estimates of test-retest reliability across a four-week interval (n = 46) ranged from .80 to .89, and estimates of criterion-related validity were strong. In Study 4, Cronbach alpha estimates ranged from .81 to .90 for the BIAI scales. Results provided additional evidence of known-groups and concurrent validity estimates for the BIAI scales. The results suggest that the BIAI has good preliminary psychometric properties.

Evaluation of the subjects' response to antipsychotics questionnaire

The present study reports on the development of a new self-administered instrument to assess patients' responses to antipsychotic medication. The Subjects' Response to Antipsychotics (SRA) Questionnaire is a 74-item instrument with eight scales (Recovery, Weight Gain, Sexual Anhedonia, Sedation, Affective Flattening, Extrapyramidal Side-Effects, Diminished Sociability and Increased Sleep), and a total adverse responses score including additional items. Psychometric aspects were examined in a study of 320 inpatients and outpatients showing good internal consistency, reproducibility and external validity. Concordance with other instruments claiming to measure the subjective response is low, suggesting that the instruments measure different concepts. The SRA Questionnaire appears to be a reliable and efficient way of measuring patients' subjective responses to antipsychotic medication.

A comparison of selected Rorschach variables of violent female offenders and female non-offenders

A national sample of incarcerated violent female offenders (N = 45) and a sample of female non-offenders (N = 30) were compared on nine selected Rorschach CS (Exner, 2003) variables and three of the aggression variables of Gacono and Meloy (1994). The results indicate that an avoidant and inconsistent coping style was more characteristic of the offenders than the non-offenders. The offenders were characterized by social immaturity and limited capacities to cope with stress as compared with the non-offenders. No significant differences were found between the two groups in handling intense emotions. Although the aggressive scores revealed no discrimination between the groups, significant correlations were found between the aggressive content score and childhood victimization. An inverse relation was found between the aggressive past score and the emotional intensity of the violent offense. The study indicates that the selected RCS variables related to adaptive resources for coping discriminate between violent offenders and non-offenders, but that the variables related to affective features need further examination.

Children with Prader-Willi syndrome vs. Williams syndrome: indirect effects on parents during a jigsaw puzzle task

BACKGROUND

Genetic disorders predispose individuals to exhibit characteristic behaviours, which in turn elicit particular behaviours from others. In response to the strength of Prader-Willi syndrome (PWS) and weakness of Williams syndrome (WS) in visual-spatial tasks such as jigsaw puzzles, parents' behaviours can be affected by their child's level of puzzle ability or syndrome diagnosis.

METHODS

Children were asked to complete two jigsaw puzzles (one with the experimenter and the other with the parent) for 5 min each. Frequencies of parental helping and reinforcement behaviours, along with ratings of parental directiveness, were examined as parents interacted with their children on a jigsaw puzzle task. Within each aetiological group, correlates of parental behaviours with child characteristics were also examined.

RESULTS

Compared to parents of children with PWS, parents of children with WS engaged in a more directive style of interaction, and provided more help and reinforcement. Relative to parents of children with higher puzzle abilities (from both aetiologies), parents of children with lower abilities also showed the same pattern. Both the child's aetiology and puzzle abilities were important in predicting parents' directiveness and helping and reinforcement behaviours. Within the PWS group, parents' behaviours correlated negatively with the child's puzzle abilities and general cognitive functioning; no such relations occurred in the WS group.

CONCLUSIONS

Parents' behaviours were affected by both the child's diagnosis and actual puzzle abilities, suggesting important implications for understanding and intervening with parents and children with different genetic syndromes.

An Evaluation of the Gilliam Autism Rating Scale

The Gilliam Autism Rating Scale was developed to identify individuals with autism in research and clinical settings. It has benefited from wide use and acceptance but has received little empirical attention. The purpose of this study was to evaluate the construct and diagnostic validity, interrater reliability, and effects of participant characteristics of the GARS in a large and heterogeneous sample of children and adolescents with autism spectrum disorders. 360 parent and teacher ratings were submitted to factor analysis. A three-factor solution explaining 38% of the variance was obtained. Almost half of all items loaded on a Repetitive and Stereotyped Behavior factor. The Developmental Disturbance subscale did not contribute to the Autism Quotient (AQ) and was poorly related to other subscales. Internal consistency for the three behavioral subscales was good but low for the Developmental Disturbance subscale. The average AQ was significantly lower than what was reported in the test manual, suggesting low sensitivity with the current cutoff criteria. Interrater reliability was also much lower than originally reported by the instrument's developer. No significant age or gender effects were found. Level of impairment, as measured by adaptive behavior, was negatively related to total and subscale scores. The implications of these findings were discussed, as was the use of diagnostic instruments in the field in general.

Development and validation of a brief instrument for routine outcome monitoring in opioid maintenance pharmacotherapy services: the brief treatment outcome measure (BTOM)

AIM

To develop a brief, multi-dimensional instrument for routine, on-going treatment outcome monitoring in alcohol and other drug (AOD) services in Australia and examine the underlying psychometric properties. This study focuses on opioid maintenance pharmacotherapy (OMP) services.

DESIGN

Researcher-administered test-retest interviews and clinician administered interviews.

SETTING

The test-retest interviews took place in two private and two public OMP clinics in Sydney, Australia. The clinician-administered interviews took place in 37 metropolitan, rural and prison OMP services in New South Wales, Australia.

PARTICIPANTS

One hundred and sixty current OMP clients for the test-retest interviews and 2004 clients commencing OMP treatment for the clinician-administered interviews.

MEASURES

Thirty-two items across the domains of dependence, blood-borne virus exposure risk, drug use, health/psychological functioning and social functioning.

FINDINGS

The internal reliability of the brief treatment outcome measure (BTOM) is satisfactory. Retest reliabilities for the scales and drug use scores are good to excellent indicating their consistency with multiple measurements across time and different interviewers and concurrent validation of BTOM scales with analogous scales from similar instruments yielded acceptable agreement. Average completion times of the BTOM were 14.5 min, when administered in a research context and 21 min in a clinical context.

CONCLUSIONS

A brief, valid and reliable questionnaire has been developed for monitoring treatment outcome over the range of OMP services. The BTOM contains a core set of outcome measures, which can be easily adapted for integration into routine clinical practice across the range of AOD services.

The video assessment of simulated encounters (VASE): Development and validation of a group-administered method for evaluating clinician skills in motivational interviewing

The authors developed and evaluated a group-administered method for measuring motivational interviewing (MI) skills. The video assessment of simulated encounters (VASE) consists of three videotaped vignettes of actors playing substance abusers. Each vignette is followed by eight questions asking examinees to generate written responses consistent with MI principles. Twenty-two clinicians completed the VASE questionnaire and two other measures of MI skill: a paper-and-pencil measure that elicited responses to written scenarios and an audiotaped interaction with a standardized patient (SP), subsequently scored for MI skill by independent tape raters. Psychometric analyses of this original VASE scale evaluated: (1) scoring reliability of the 24 VASE items; (2) internal reliability of the VASE full-scale score, seven subscale scores and the three vignettes; and (3) concurrent validity with aforementioned indices of MI skill. Analyses informed the removal of two subscales, redesign of a third and revisions to a fourth. The resulting 18-item VASE-R scale retains its three-vignette format, and assesses overall MI skill as well as the following five MI "microskills": reflective listening, responding to resistance, summarizing, eliciting change talk and developing discrepancy. The VASE-R requires further analysis to evaluate these revisions, but shows promise as a cost-effective alternative for use in MI skill assessment in a variety of training and research contexts.

Predicting return to work after low back injury using the Psychosocial Risk for Occupational Disability Instrument: a validation study

INTRODUCTION

This paper reports on the predictive validity of a Psychosocial Risk for Occupational Disability Scale in the workers' compensation environment using a paper and pencil version of a previously validated multimethod instrument on a new, subacute sample of workers with low back pain.

METHODS

A cohort longitudinal study design with a randomly selected cohort off work for 4-6 weeks was applied. The questionnaire was completed by 111 eligible workers at 4-6 weeks following injury. Return to work status data at three months was obtained from 100 workers. Sixty-four workers had returned to work (RTW) and 36 had not (NRTW).

RESULTS

Stepwise backward elimination resulted in a model with these predictors: Expectations of Recovery, SF-36 Vitality, SF-36 Mental Health, and Waddell Symptoms. The correct classification of RTW/NRTW was 79%, with sensitivity (NRTW) of 61% and specificity (RTW) of 89%. The area under the ROC curve was 84%.

CONCLUSIONS

New evidence for predictive validity for the Psychosocial Risk-for-Disability Instrument was provided.

IMPLICATIONS

The instrument can be useful and practical for prediction of return to work outcomes in the subacute stage after low back injury in the workers' compensation context.

How does motivational interviewing work? Therapist interpersonal skill predicts client involvement within motivational interviewing sessions

Although many studies have shown that motivational interviewing (MI) is effective in reducing problem behaviors, few have investigated purported causal mechanisms. Therapist interpersonal skills have been proposed as an influence on client involvement during MI sessions and as a necessary precursor to client commitment language. Using the Motivational Interviewing Skills Code (MISC; Version 1.0) rating system, the authors investigated 103 unique MI sessions for substance abuse and found that therapist interpersonal skills were positively associated with client involvement as defined by cooperation, disclosure and expression of affect. An unexpected finding indicated that behaviors inconsistent with MI enhanced the impact of therapist interpersonal skills upon client involvement. Drawbacks to the study include a potential sampling bias and uneven reliability of the variables measured.

Evidence-Based Assessment of Child and Adolescent Disorders: Issues and Challenges

The main purpose of this article and this special section is to encourage greater attention to evidence-based assessment (EBA) in the development of a scientifically supported clinical child and adolescent psychology. This increased attention is especially important in light of (a) the omission of assessment considerations in recent efforts to promote evidence-based treatments for children and (b) ongoing changes in the nature of clinical child assessment. We discuss several key considerations in the development of guidelines for EBA, including the purposes of assessment, the role of disorder or problem specificity, the scope of assessment, assessment process parameters, possible "cross-cutting" assessment issues, psychometric considerations, and issues related to the clinician's integration of assessment data. We conclude the article with suggestions for how current, summary information on EBA can be developed, maintained, and disseminated.

Exploring High School Science Students' Perceptions of Parental Involvement in Their Education

This exploratory study describes high school students' perceptions of their parents' involvement in their education and in relation to school achievement. A new 12-item Parental Involvement Scale was used to measure parents' involvement in curricular and extracurricular activities and using exploratory analyses to estimate the scale's properties. Exploratory analysis resulted in the reduction of the 12 items to 8, with an internal consistency (Cronbach alpha) .82. Grade 12 science students indicated that their less educated parents were involved in activities pertaining to their learning; however, high perceived parental involvement in curricular activities was related to low achievement. It is recommended that further exploratory analyses be undertaken to examine the reported two-dimensional model of the Parental Involvement Scale.

Assessing competence in the use of motivational interviewing

This report presents reliability, validity and sensitivity indices for the Motivational Interviewing Treatment Integrity (MITI) scale. Factor analysis of MI treatment sessions coded with the Motivational Interviewing Skills Code (MISC) was used to derive 10 elements of MI practice, forming the MITI. Canonical correlation revealed that the MITI captured 59% of the variability in the MISC. Reliability estimates for the MITI were derived using three masked, independent coders. Intra-class coefficients ranged from .5 to .9 and were generally in the good to excellent range. Comparison of MITI scores before and after MI workshops indicate good sensitivity for detecting improvement in clinical practice as result of training. Implications for the use of this instrument in research and supervision are discussed.

Executive functions and methylphenidate response in subtypes of attention-deficit/hyperactivity disorder

BACKGROUND

Oculomotor tasks are a well-established means of studying executive functions and frontal-striatal functioning in both nonhuman primates and humans. Attention-deficit/hyperactivity disorder (ADHD) is thought to implicate frontal-striatal circuitry. We used oculomotor tests to investigate executive functions and methylphenidate response in two subtypes of ADHD.

METHODS

Subjects were boys, aged 11.5-14 years, with ADHD-combined (n = 10), ADHD-inattentive (n = 12), and control subjects (n = 10). Executive functions assessed were motor planning (tapped with predictive saccades), response inhibition (antisaccades), and task switching (saccades-antisaccades mixed).

RESULTS

The ADHD-combined boys were impaired relative to control subjects in motor planning (p < .003) and response inhibition (p < .007) but not in task switching (p > .92). They were also significantly impaired relative to ADHD-inattentive boys, making fewer predictive saccades (p < .03) and having more subjects with antisaccade performance in the impaired range (p < .04). Methylphenidate significantly improved motor planning and response inhibition in both subtypes.

CONCLUSIONS

ADHD-combined but not ADHD-inattentive boys showed impairments on motor planning and response inhibition. These deficits might be mediated by brain structures implicated specifically in the hyperactive/impulsive symptoms. Methylphenidate improved oculomotor performance in both subtypes; thus, it was effective even when initial performance was not impaired.

Use of the Conners-wells adolescent self-report scale (short form) with children

The short form of the Conners-Wells Adolescent Self-Report Scale (CASS:Short) is administered to 319 children and 844 adolescents to investigate whether the instrument can be used with respondents under the age of 12. Mothers of all respondents are asked to rate each child using a measure designed to assess a parallel set of problem behaviors. The factor structure of the CASS:Short is tested in both samples and is found to have good fit to the data. Mean levels of ADHD symptomatology are also examined for possible sex and age effects, as was the relationship between parent and self-report ratings. The overall results provide empirical support for the use of the CASS:Short with children ages 7 to 11.