Normative studies with the Scale for Interpersonal Behaviour (SIB): II. US students. A cross-cultural comparison with Dutch data

Impaired Emotion Processing and Panic Disorder After Left Anterior Temporal Lobectomy: A Case Report of Successful Psychotherapeutic Intervention

Background

Over the last decades, brain surgery became a more frequently applied treatment for temporal lobe epilepsy (TLE). Despite its success, several studies found de-novo post-operative psychiatric symptoms in TLE surgery patients. Cognitive behavioural therapy is effective to treat brain healthy psychiatric patients but might not be translatable to patients with resections in emotion regulating networks as these areas seem to be essentially involved in successful psychotherapeutic treatment.

Methods

Here we report the case of a female patient with medically refractory medial temporal lobe epilepsy resulting in left anterior temporal lobectomy at age 35. Post operation she did not show adequate fearful response but at the same time manifested symptoms of a severe panic disorder. We investigated if this patient, despite lesions in emotion-behaviour brain circuits, can benefit from cognitive behavioural therapy.

Results

The intervention, customized to the specific resources and difficulties of the patient, was effective in stopping panic attacks and improving social functioning.

Conclusions

This case shows that MTL brain surgery patients may benefit from CBT and demonstrates the important and if yet still somewhat mysterious role of the amygdala in emotion regulation processes.

Social Management Training in Males With 47,XXY (Klinefelter Syndrome): A Pilot Study of a Neurocognitive-Behavioral Treatment Targeting Social, Emotional, and Behavioral Problems

Klinefelter syndrome (47,XXY) is associated with problems in social interaction and behavioral adaptation. Sixteen adolescents and adult men with 47,XXY enrolled in a pilot-study evaluating the effectiveness of Social Management Training (SMT), a novel neurocognitive-behavioral treatment program targeted at improving social, emotional, and behavioral functioning. Participants reported improved emotional stability from pre- to post-test (5 months). Informants reported reductions in internalizing and externalizing symptoms, including improvement in self-regulation. Although informants did not report changes in autism-like symptoms, increased awareness of social challenges was found. SMT may improve emotional stability, self-regulation, and self-reflection in people males with Klinefelter syndrome. This potentially efficacious treatment approach may prove to be a promising psychosocial therapeutic intervention for this population.

The Soft Skills Inventory: Developmental procedures and psychometric analysis

When attending and participating in Higher Education, students face a multitude of personal, social, and work-related challenges, which may increase the risk of developing psychopathological symptomatology. To date, there is no instrument that grasps the non-technical skills that may help prepare students to respond to these challenges. This paper presents the development and psychometric properties of the Soft Skills Inventory (SSI). The inventory was developed based on theoretical and empirical findings on the skills associated with academic and professional success, and on students' perception. The SSI was tested with 2030 Portuguese students (of which 77.1% were female) using a two-stage approach: item calibration and model generation (n = 1033), followed by model validation (n = 997). Item calibration analyses led to retaining 49 items that were organized into six-factors: self-determination, resilience, empathy, assertiveness, social support, and teamwork. This measurement model was further validated and proved to be an invariant, and thus credible, tool to compare male and female students on those relevant skills. All measures attained good internal consistency, with alphas ranging from .76 to .88. Female students scored significantly higher than males on self-determination, empathy, social support and teamwork. On the other hand, male students scored significantly higher on resilience. No significant differences were found between men and women for assertiveness. Psychometric analysis showed that the SSI is a reliable and valid instrument to evaluate students intra and interpersonal skills. The SSI may help identify gaps in soft skills and guide targeted interventions to support a more positive student experience in Higher Education.

Assessing Online and Offline Adolescent Social Skills: Development and Validation of the Real and Electronic Communication Skills Questionnaire

Studies examining the associations between Internet use and social skills are increasingly frequent. However, most of them only evaluate offline social skills and consider them as equivalents to online social skills. So far, no instrument allowed differentiating social skills depending on online versus offline contexts. This study aimed to develop and validate the Real and Electronic Communication Skills questionnaire (RECS), a new measure evaluating several dimensions of social skills in two different contexts (i.e., face-to-face and computer-mediated communication). Results of exploratory and confirmatory factor analyses among a sample of 657 adolescents and young adults (mean age = 17.68 years; 67% female) showed that the best fitting model for each context is a bifactor solution, with one general factor (Social Competence) and four specific factors (Sociability, Emotion Decoding, Disclosure, and Assertiveness). Each specific factor was differentially correlated with theoretically relevant subscales of the Social Skills Inventory, confirming the external validity of the RECS. The RECS is the first instrument allowing not only to assess social competence in online settings but also to quantify the relationships between offline social skills and their online counterpart. Given its ease of use and brevity, the RECS is a useful and promising instrument to capture social skills in both online and offline contexts.

Social cognitive training for adults with Noonan syndrome: a feasibility study

PURPOSE

Noonan syndrome (NS) is a genetic disorder that is associated with social cognitive problems. While treatment aimed at the improvement of social cognition is available for other neuropsychiatric disorders, no such interventions yet exist for NS patients. In this study, the development of the first social cognitive training for NS patients is described and its applicability and feasibility evaluated.

METHODS

Eleven adult patients with NS participated in this controlled proof-of-principle study. Six patients were included in the treatment group and five in the control group. Neuropsychological testing was performed in both groups at baseline and posttreatment. Social cognition was a primary outcome measure and nonsocial cognition and psychopathology secondary outcome measures. Differences between pre- and posttest were investigated with Wilcoxon signed-rank tests, and a process evaluation was performed to aid interpretation of the results.

RESULTS

Both groups were comparable with regard to age, estimated intelligence, and baseline performance. Although no significant differences were found between pre- and posttest scores on primary and secondary outcome measures in either group, a medium-large effect size was found on emotion recognition in the treatment group. Also, the process evaluation demonstrated the feasibility of the training.

CONCLUSION

This first social cognitive training for adult patients with NS has proven to be feasible for this population and showed some encouraging results regarding emotion recognition, although the training protocol could be optimized. Further investigation is required using a randomized controlled design in a larger sample, in order to substantiate the overall effectiveness of the training.

Social Attention in 47,XXY (Klinefelter Syndrome): Visual Scanning of Facial Expressions Using Eyetracking

Boys and men with an extra X chromosome (47,XXY, Klinefelter syndrome) are at risk for problems in social functioning and have an increased vulnerability for autism spectrum disorders (ASD). In the search for underlying mechanisms driving this increased risk, this study focused on social attention, that is, spontaneous orientation toward facial expressions. Seventeen adults with 47,XXY and 20 non-clinical controls participated in this study. Social attention was measured using an eyetracking method that quantifies the visual scanning patterns of faces expressing different types of emotions (happy, fearful, angry, neutral) and their varying intensity levels (25%, 50%, 75%, 100%). Overall, the group with Klinefelter syndrome fixated less on the eye region of faces when compared to controls (Cohen's d 1.4), and did not show the typical tendency, as was found in the control group, to first fixate on the eyes when presented with a face (Cohen's d 1.0). There was no significant effect of type or intensity of emotion. Shorter looking times toward eyes showed a borderline significant correlation with self-reports of poorer social functioning, with 29% explained variance. These findings suggest a reduced tendency to rapidly and automatically attend to the eyes of others in individuals with 47,XXY. This may have impact on more complex social-cognitive abilities that build upon this. In addition to studies of behaviorally defined disorders such as ASD, studying individuals with Klinefelter syndrome provide insight into mechanisms underlying various "at risk" pathways of social dysfunction and the factors that mediate this risk.

Long-term effects of oxandrolone treatment in childhood on neurocognition, quality of life and social-emotional functioning in young adults with Turner syndrome

Turner syndrome (TS) is the result of (partial) absence of one X-chromosome. Besides short stature, gonadal dysgenesis and other physical aspects, TS women have typical psychological features. Since psychological effects of androgen exposure in childhood probably are long-lasting, we explored long-term psychological functioning after oxandrolone (Ox) therapy during childhood in adults with TS in terms of neurocognition, quality of life and social-emotional functioning. During the initial study, girls were treated with growth hormone (GH) combined with placebo (Pl), Ox 0.03 mg/kg/day, or Ox 0.06 mg/kg/day from the age of eight, and estrogen from the age of twelve. Sixty-eight women participated in the current double-blinded follow-up study (mean age 24.0 years, mean time since stopping GH/Ox 8.7 years). We found no effects on neurocognition. Concerning quality of life women treated with Ox had higher anxiety levels (STAI 37.4 ± 8.4 vs 31.8 ± 5.0, p=0.002) and higher scores on the depression subscale of the SCL-90-R (25.7 ± 10.7 vs 20.5 ± 4.7, p=0.01). Regarding social-emotional functioning, emotion perception for fearful faces was lower in the Ox-treated patients, without effect on interpersonal behavior. Our exploratory study is the first to suggest that androgen treatment in adolescence possibly has long-term effects on adult quality of life and social-emotional functioning. However, differences are small and clinical implications of our results seem limited. Therefore we would not recommend against the use of Ox in light of psychological consequences.

Alexithymia, emotion perception, and social assertiveness in adult women with Noonan and Turner syndromes

Noonan syndrome (NS) and Turner syndrome (TS) are associated with cognitive problems and difficulties in affective information processing. While both phenotypes include short stature, facial dysmorphisms, and a webbed neck, genetic etiology and neuropsychological phenotype differ significantly. The present study examines putative differences in affective information processing and social assertiveness between adult women with NS and TS. Twenty-six women with NS, 40 women with TS, and 40 female controls were matched on age and intelligence, and subsequently compared on (1) alexithymia, measured by the Bermond-Vorst Alexithymia Questionnaire, (2) emotion perception, evaluated by the Emotion Recognition Task, and (3) social assertiveness and social discomfort, assessed by the Scale for Interpersonal Behavior. Women with TS showed higher levels of alexithymia than women with NS and controls (P-values < 0.001), whereas women with NS had more trouble recognizing angry facial expressions in comparison with controls (P = 0.01). No significant group differences were found for the frequency of social assertiveness and the level of social discomfort. Women with NS and TS demonstrated different patterns of impairment in affective information processing, in terms of alexithymia and emotion perception. The present findings suggest neuropsychological phenotyping to be helpful for the diagnosis of specific cognitive-affective deficits in genetic syndromes, for the enhancement of genetic counseling, and for the development of personalized treatment plans.

Affective functioning and social cognition in Noonan syndrome

BACKGROUND

Noonan syndrome (NS) is a common genetic disorder, characterized by short stature, facial dysmorphia, congenital heart defects and a mildly lowered IQ. Impairments in psychosocial functioning have often been suggested, without, however, systematic investigation in a clinical group. In this study, different aspects of affective processing, social cognition and behaviour, in addition to personal well-being, were assessed in a large group of patients with NS.

METHOD

Forty adult patients with NS were compared with 40 healthy controls, matched with respect to age, sex, intelligence and education level. Facial emotion recognition was measured with the Emotion Recognition Task (ERT), alexithymia with both the 20-item Toronto Alexithymia Scale (TAS-20) and the Bermond-Vorst Alexithymia Questionnaire (BVAQ), and mentalizing with the Theory of Mind (ToM) test. The Symptom Checklist-90 Revised (SCL-90-R) and the Scale for Interpersonal Behaviour (SIB) were used to record aspects of psychological well-being and social interaction.

RESULTS

Patients showed higher levels of cognitive alexithymia than controls. They also experienced more social distress, but the frequency of engaging in social situations did not differ. Facial emotion recognition was only slightly impaired.

CONCLUSIONS

Higher levels of alexithymia and social discomfort are part of the behavioural phenotype of NS. However, patients with NS have relatively intact perception of emotions in others and unimpaired mentalizing. These results provide insight into the underlying mechanisms of social daily life functioning in this patient group.

Cross-cultural validity of the scale for interpersonal behavior

The Scale for Interpersonal Behavior (SIB) is a 50-item multidimensional measure of difficulty and distress in assertiveness. The SIB assesses negative assertion, expression of and dealing with personal limitations, initiating assertiveness and positive assertion. The SIB was originally developed in the Netherlands. The present study attempted to replicate the original factors with an Italian student sample (n = 995). The four distress and four performance factors were replicable across two methods of analysis (the multiple group method of confirmatory analysis and Tucker's coefficient of congruence (phi). The corresponding scales were internally consistent and showed predicted patterns of correlations with a measure of self-efficacy. Sex and age differences in assertiveness were generally negligible. Italian students had higher positive assertion-performance scores than the Dutch and comparable scores on other performance scales; by contrast, the Italian subjects had significantly higher scores on all SIB distress scales than their Dutch equivalents. This was ascribed to the stronger pressure on people in Italian society to behave assertively (Hofstede's National Masculinity score = 70) as opposed to the Dutch society (National Masculinity score = 14).

Parental Attachment, Interparental Conflict, and Young Adults’ Emotional Adjustment

This study extends Engels et al.’s model of emotional adjustment to young adults and includes the constructs of interparental conflict and conflict resolution. Results indicate that parental attachment is better conceived as a two-factor construct of mother and father attachment and that although attachment to both mothers and fathers directly predicts emotional adjustment, the mechanisms that mediate these relationships differ. Attachment to fathers was found to be predictive of better social skills, which in turn promoted greater relational competence, and better emotional adjustment. Attachment to mothers was found to be predictive of better conflict resolution behavior, which in turn promoted greater relational competence, and better emotional adjustment. These results are discussed along with recommendations for practice and future research.

Initial reliability and validity of the Ohio State University TBI Identification Method

OBJECTIVES

Evaluate the psychometric properties of indices of a lifetime history of traumatic brain injury (TBI).

PARTICIPANTS

Convenience samples recruited from 2 treatment programs for persons with substance use disorders: N = 119 (study 1) and N = 103 (study 2)

DESIGN

Test interrater reliability (study 1) and predictive validity (Study 2).

MEASURES

Summary indices of the number, severity, timing, and effects of lifetime TBIs calculated from data elicited via a structured interview.

RESULTS

Interrater reliability was high. Factor analysis showed indices could be characterized by severity weighted counts of the number of injuries, both lifetime and in childhood, number of symptoms persisting, worst injury, time since last TBI with loss of consciousness, and age at first TBI with loss of consciousness. Age at injury and symptoms persisting contributed independently to the prediction of common cognitive and behavioral consequences of TBI.

CONCLUSION

These results provide preliminary support for the reliability and validity of summary indices of lifetime history of TBI elicited via a structured interview.

Tucker's Congruence Coefficient as a Meaningful Index of Factor Similarity

When Tucker's congruence coefficient is used to assess the similarity of factor interpretations, it is desirable to have a critical congruence level less than unity that can be regarded as indicative of identity of the factors. The literature only reports rules of thumb. The present article repeats and broadens the approach used in the study by Haven and ten Berge ( 1977 ). It aims to find a critical congruence level on the basis of judgments of factor similarity by practitioners of factor analysis. Our results suggest that a value in the range .85-.94 corresponds to a fair similarity, while a value higher than .95 implies that the two factors or components compared can be considered equal.