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Smith MJ, Smith JD, Fleming MF, Jordan N, Oulvey EA, Bell MD, Mueser KT, McGurk SR, Spencer ES, Mailey K, Razzano LA. Enhancing individual placement and support (IPS) - Supported employment: A Type 1 hybrid design randomized controlled trial to evaluate virtual reality job interview training among adults with severe mental illness. Contemp Clin Trials 2019; 77:86-97. [PMID: 30576841 PMCID: PMC6396298 DOI: 10.1016/j.cct.2018.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 12/03/2018] [Accepted: 12/16/2018] [Indexed: 10/27/2022]
Abstract
Individual Placement and Support (IPS) is the evidence-based model of supported employment that increases employment rates in adults with severe mental illness (SMI). Although IPS is largely successful, over 80% of adults with SMI remain unemployed. An enhancement to high fidelity IPS could be an evidence-based job interview training component. To meet this training need, our group recently completed a series of randomized controlled efficacy trials funded by the National Institute of Mental Health to develop and test virtual reality job interview training (VR-JIT) in a lab setting. The results demonstrated that the intervention was efficacious at helping trainees improve their job interview skills and receive job offers within six months of completing VR-JIT compared to non-trainees. The overarching goal of this study is to evaluate the effectiveness of VR-JIT as an enhancement to IPS when delivered in a large community-based mental health service provider via a randomized controlled trial and initial process evaluation. Our aims are to: evaluate whether IPS services-as-usual in combination with VR-JIT, compared to IPS services-as-usual alone, enhances IPS outcomes for adults with SMI; evaluate mechanisms of employment outcomes and psychological distress; and conduct a multilevel, multidisciplinary, and mixed-method process evaluation of VR-JIT adoption and implementation to assess the acceptability, scalability, generalizability, and affordability of VR-JIT.
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Affiliation(s)
| | - Justin D Smith
- Department of Psychiatry and Behavioral Sciences, Northwestern University, USA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, USA
| | - Michael F Fleming
- Department of Psychiatry and Behavioral Sciences, Northwestern University, USA
| | - Neil Jordan
- Department of Psychiatry and Behavioral Sciences, Northwestern University, USA
| | - Eugene A Oulvey
- Illinois Department of Human Services, Division of Rehabilitation Services, USA
| | - Morris D Bell
- Department of Psychiatry, Yale School of Medicine, USA
| | | | | | | | | | - Lisa A Razzano
- Thresholds Inc, USA; Chicago Department of Psychiatry, University of Illinois, USA
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Wang YY, Shi HS, Liu WH, Yan C, Wang Y, Chiu CD, So SH, Lui SSY, Cheung EFC, Chan RCK. Invariance of factor structure of the 21-item Peters et al. Delusions Inventory (PDI-21) over time and across samples. Psychiatry Res 2017; 254:190-197. [PMID: 28463717 DOI: 10.1016/j.psychres.2017.04.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 04/17/2017] [Accepted: 04/23/2017] [Indexed: 11/26/2022]
Abstract
The present study aimed to explore the latent structure of the 21-item Peters et al. Delusions Inventory (PDI-21) and to test the invariance of its factor structure over time and across samples. The PDI-21 was administered in two samples; one consisting of 1655 undergraduate students investigated in three waves, each separated by six months; and another consisting of 196 outpatients with schizophrenia. Exploratory factor analysis was performed to explore the internal structure of the PDI-21 based on number of beliefs and the grand total scores separately. The number of factors was determined by optimal implementation of parallel analysis. Confirmatory factor analysis, cross-time and cross-sample invariance analyses were carried out with Mplus. Both exploratory factor analysis and the optimal implementation of parallel analysis (based on the number of beliefs and the total score of the PDI-21) suggested a one-factor solution. However, the confirmatory factor analysis revealed a single-dimension structure based on number of beliefs only, which exhibited goodness of fit and stability across time and samples. Our study demonstrated a single-dimension structure of the PDI-21, which can be widely used in screening the number of delusional ideations both in clinical and non-clinical populations.
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Affiliation(s)
- Yan-Yu Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, Weifang Medical University, Shandong Province, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hai-Song Shi
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; North China Electric Power University, Beijing, China
| | - Wen-Hua Liu
- Faculty of Health Management, Guangzhou Medical University, Guangzhou, China
| | - Chao Yan
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), School of Psychology, and Cognitive Science, East China Normal University, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Chui-de Chiu
- Department of Psychology, the Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Suzanne H So
- Department of Psychology, the Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Simon S Y Lui
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Jahn DR, DeVylder JE, Drapalski AL, Medoff D, Dixon LB. Personal Recovery as a Protective Factor Against Suicide Ideation in Individuals With Schizophrenia. J Nerv Ment Dis 2016; 204:827-831. [PMID: 27105456 PMCID: PMC5075268 DOI: 10.1097/nmd.0000000000000521] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Suicide rates are elevated in individuals with schizophrenia, yet evidence is mixed regarding the roles of positive and negative symptoms as risk factors for suicide in this population, suggesting that there may be other influential variables. One such variable may be personal recovery. Therefore, the purpose of this study was to test the hypothesis that personal recovery would moderate the relationship between symptoms of schizophrenia and suicide ideation. This hypothesis was tested in a sample of 169 individuals diagnosed with schizophrenia or schizoaffective disorder using a Poisson regression model. Results suggested that there was no significant interaction between recovery and symptoms of schizophrenia. However, recovery was a significant predictor of suicide ideation after controlling for psychiatric symptoms. These findings indicate that recovery is associated with lower suicide ideation and thus may protect against it. Thus, recovery should be assessed, and potentially intervened upon, to reduce suicide risk in individuals with schizophrenia.
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Affiliation(s)
- Danielle R. Jahn
- Department of Psychiatry, University of Maryland School of Medicine
- VA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center; VA Maryland Health Care System
| | | | - Amy L. Drapalski
- VA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center; VA Maryland Health Care System
| | - Deborah Medoff
- Department of Psychiatry, University of Maryland School of Medicine
- VA Capitol Health Care Network (VISN 5) Mental Illness Research, Education, and Clinical Center; VA Maryland Health Care System
| | - Lisa B. Dixon
- Department of Psychiatry, Columbia University
- New York State Psychiatric Institute
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Ohannessian CM, Laird R, De Los Reyes A. Discrepancies in Adolescents' and Mothers' Perceptions of the Family and Mothers' Psychological Symptomatology. J Youth Adolesc 2016; 45:2011-21. [PMID: 27048418 DOI: 10.1007/s10964-016-0477-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 03/23/2016] [Indexed: 11/27/2022]
Abstract
Research has shown that discrepancies in adolescents' and their parents' perceptions of the family are linked to adolescent adjustment. Of note, the majority of studies to date have focused on differences in perceptions between adolescents and their parents. However, recent research has suggested that convergence in adolescents' and their parents' perceptions of the family may be linked to adolescent psychological outcomes as well. To date, research examining adolescents' and parents' perceptions of the family in relation to outcomes has focused only on adolescent outcomes. Therefore, the goal of this study was to examine the relationship between adolescents' and their mothers' perceptions of the family and mothers' psychological symptomatology. Surveys were administered to 141 adolescents (56 % girls) and their mothers during the spring of 2007. The results indicated that adolescents viewed the family more negatively in comparison to their mothers. In addition, interactions between adolescents' and mothers' reports of open communication, communication problems, and family satisfaction predicted mothers' psychological symptoms. These interactions indicated that mothers reported the most psychological symptoms when adolescents and mothers agreed that family functioning was poor (e.g., low open communication, high communication problems, low family satisfaction). The findings from this study underscore the need to consider adolescents' and parents' perceptions of the family in tandem when considering parental psychological adjustment.
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Affiliation(s)
- Christine McCauley Ohannessian
- Connecticut Children's Medical Center, University of Connecticut School of Medicine, 282 Washington Street, Hartford, CT, 06106, USA.
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Abbass A, Bernier D, Kisely S, Town J, Johansson R. Sustained reduction in health care costs after adjunctive treatment of graded intensive short-term dynamic psychotherapy in patients with psychotic disorders. Psychiatry Res 2015; 228:538-43. [PMID: 26106054 DOI: 10.1016/j.psychres.2015.05.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 04/02/2015] [Accepted: 05/17/2015] [Indexed: 11/26/2022]
Abstract
The aim of this pilot study was to evaluate the changes in symptom severity and long-term health care cost after intensive short-term dynamic psychotherapy (ISTDP) individually tailored and administered to patients with psychotic disorders undergoing standard psychiatric care. Eleven therapists with different levels of expertise delivered an average of 13 one-hour sessions of graded ISTDP to 38 patients with psychotic disorders. Costs for health care services were compiled for a one-year period prior to the start of ISTDP (baseline) along with four one-year periods after termination. Two validated self-report scales, the Brief Symptom Inventory and the Inventory of Interpersonal Problems, were administered at intake and termination of ISTDP. Results revealed that health care cost reductions were significant for the one-year post-treatment period relative to baseline year, for both physician costs and hospital costs, and the reductions were sustained for the follow-up period of four post-treatment years. Furthermore, at treatment termination self-reported symptoms and interpersonal problems were significantly reduced. These preliminary findings suggest that this brief adjunctive psychotherapy may be beneficial and reduce costs in selected patients with psychotic disorders, and that gains are sustained in long-term follow-up. Future research directions are discussed.
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Affiliation(s)
- Allan Abbass
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Denise Bernier
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Steve Kisely
- School of Medicine, The University of Queensland, Australia
| | - Joel Town
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robert Johansson
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Behavioural Sciences and Learning, Linköping University, Sweden
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Stratton KJ, Aggen SH, Richardson LK, Berenz EC, Tran TL, Trung LT, Tam NT, Tuan T, Buoi LT, Ha TT, Thach TD, Amstadter AB. Using the SRQ-20 factor structure to examine changes in mental distress following typhoon exposure. Psychol Assess 2014; 26:528-38. [PMID: 24512425 DOI: 10.1037/a0035871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Empirical research is limited regarding postdisaster assessment of distress in developing nations. This study aimed to evaluate the factor structure of the 20-item Self-Reporting Questionnaire (SRQ-20) before and after an acute trauma, Typhoon Xangsane, in order to examine changes in mental health symptoms in an epidemiologic sample of Vietnamese adults. The study examined a model estimating individual item factor loadings, thresholds, and a latent change factor for the SRQ-20's single "general distress" common factor. The covariates of sex, age, and severity of typhoon exposure were used to evaluate the disaster-induced changes in SRQ-20 scores while accounting for possible differences in the relationship between individual measurement scale items and the latent mental health construct. Evidence for measurement noninvariance was found. However, allowing sex and age effects on the pre-typhoon and post-typhoon factors accounted for much of the noninvariance in the SRQ-20 measurement structure. A test of no latent change failed, indicating that the SRQ-20 detected significant individual differences in distress between pre- and post-typhoon assessment. Conditioning on age and sex, several typhoon exposure variables differentially predicted levels of distress change, including evacuation, personal injury, and peri-event fear. On average, females and older individuals reported higher levels of distress than males and younger individuals, respectively. The SRQ-20 is a valid and reasonably stable instrument that may be used in postdisaster contexts to assess emotional distress and individual changes in mental health symptoms.
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Affiliation(s)
| | - Steven H Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University
| | | | - Erin C Berenz
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University
| | | | | | | | - Tran Tuan
- Research and Training Center for Community Development
| | - La Thi Buoi
- Research and Training Center for Community Development
| | - Tran Thu Ha
- Research and Training Center for Community Development
| | | | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University
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Hart T, Benn EKT, Bagiella E, Arenth P, Dikmen S, Hesdorffer DC, Novack TA, Ricker JH, Zafonte R. Early trajectory of psychiatric symptoms after traumatic brain injury: relationship to patient and injury characteristics. J Neurotrauma 2014; 31:610-7. [PMID: 24237113 DOI: 10.1089/neu.2013.3041] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Psychiatric disturbance is common and disabling after traumatic brain injury (TBI). Few studies have investigated the trajectory of psychiatric symptoms in the first 6 months postinjury, when monitoring and early treatment might prevent persistent difficulties. The aim of this study was to examine the trajectory of psychiatric symptoms 1-6 months post-TBI, the patient/injury characteristics associated with changes, and characteristics predictive of persisting symptoms. A secondary analysis was performed on data from a clinical trial with three data collection points. Across eight centers, 872 participants with complicated mild to severe TBI were administered the Brief Symptom Inventory (BSI) at 30, 90, and 180 days postinjury. Mixed-effects models were used to assess longitudinal changes in the BSI Global Severity Index (GSI). Multi-variate logistic regression was used to assess predictors of clinically significant GSI elevations persisting to 6 months post-TBI. In general, GSI scores improved over time. Women improved faster than men; race/ethnicity was also significantly associated with rate of change, with Hispanics showing the most and African Americans the least improvement. Clinically significant psychiatric symptoms (caseness) occurred in 42% of the sample at 6 months, and more than one type of symptom was common. Significant predictors of caseness included African American race, age from 30 to 60 years, longer post-traumatic amnesia (PTA) duration, pre-TBI unemployment, and pre-TBI risky alcohol use. Findings indicate that psychiatric symptoms are common in the first 6 months post-TBI and frequently extend beyond the depression and anxiety symptoms that may be most commonly screened. Patients with longer PTA and preinjury alcohol misuse may need more intensive monitoring for symptom persistence.
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Affiliation(s)
- Tessa Hart
- 1 Moss Rehabilitation Research Institute , Elkins Park, Pennsylvania
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Assessing suitability for short-term cognitive-behavioral therapy in psychiatric outpatients with psychosis: a comparison with depressed and anxious outpatients. J Psychiatr Pract 2013; 19:29-41. [PMID: 23334677 DOI: 10.1097/01.pra.0000426325.49396.4c] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The Suitability for Short-Term Cognitive Therapy (SSCT) rating procedure has predicted outcome in depressed and anxious patients. This study examines its relevance in assessing patients with psychosis. METHOD Outpatients with psychosis (n=56), depression (n=93), and anxiety (n=264) received cognitive- behavioral therapy in a university hospital teaching unit (mean number of sessions=16, SD=11). Demographic, clinical, and suitability variables were assessed as potential predictors of dropout and success as measured by the Reliable Change Index. RESULTS Despite lower suitability scores in the psychosis group, dropout and success rates were similar across groups, although the magnitude of symptom reduction was less in the psychosis group. Across diagnoses, dropout was predicted by unemployment and by reluctance to take personal responsibility for change. In the psychosis group only, dropout was predicted by hostility. Success of completed therapy was predicted by higher baseline agoraphobic anxiety and "responsibility for change" scores. CONCLUSION Attention to hostility early in therapy may reduce dropout in psychotic patients. Fostering acceptance of responsibility for change may improve both treatment retention and success across diagnoses. Agoraphobic fear is associated with success, possibly reflecting the effectiveness of behavioral interventions in psychosis and anxiety alike.
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Meyer PS, Johnson DP, Parks A, Iwanski C, Penn DL. Positive living: A pilot study of group positive psychotherapy for people with schizophrenia. JOURNAL OF POSITIVE PSYCHOLOGY 2012. [DOI: 10.1080/17439760.2012.677467] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Fagnani C, Bellani M, Tansella M, Balestrieri M, Toccaceli V, Patriarca V, Stazi MA, Brambilla P. Investigation of shared genetic effects for psychotic and obsessive symptoms in young adult twins. Psychiatry Res 2011; 188:276-82. [PMID: 21215460 DOI: 10.1016/j.psychres.2010.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 11/29/2010] [Accepted: 12/01/2010] [Indexed: 11/29/2022]
Abstract
Genetic and environmental architecture of psychotic and obsessive symptoms are not completely elucidated. This study estimated for these symptoms (i) the genetic and environmental components, (ii) the within-individual association, and (iii) the extent to which this association originates from common genetic and environmental factors. Young adult twins (N=701) from the population-based Italian Twin Register were assessed for psychotic and obsessive-compulsive symptoms by using the Symptom Check List (SCL-90). Multivariate Cholesky models were fitted by the Mx statistical program. No previous study used this design to examine the same dimensions. The best-fitting model included additive genetic and nonshared environmental components, each accounting for about half of total variance in the symptoms. Genetic influences on the different symptoms overlapped considerably (r(g)=0.81 to 0.99). Phenotypic correlations of psychotic symptoms and of psychotic with obsessive symptoms were high (r=0.61 to 0.76), with 53% to 69% explained by shared genetic effects. This study shows substantial genetic influence on psychotic and obsessive symptoms, and indicates that their co-occurrence may be due to genetic factors to a greater extent than to environmental effects. These results encourage the search for genetic and environmental factors underlying the covariance between different psychotic traits as well as between psychotic and obsessive traits.
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Affiliation(s)
- Corrado Fagnani
- National Centre for Epidemiology, Surveillance and Health Promotion, Genetic Epidemiology Unit, Istituto Superiore di Sanità, Rome, Italy
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Relationship of maternal negative moods to child emotion regulation during family interaction. Dev Psychopathol 2011; 23:211-23. [PMID: 21262049 DOI: 10.1017/s095457941000074x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The relationship of maternal hostile and depressive moods to children's downregulation of unprovoked anger and sadness/fear was assessed in a community sample of 267 5-year-old boys and girls. The speed of children's downregulation of unprovoked anger and sadness/fear was based on real-time observations during mother-child interaction. The association of downregulation with maternal mood was estimated using Bayesian event history analysis. As mothers reported higher depressive mood, both boys and girls were faster to downregulate anger displays as those displays accumulated during mother child interaction. The speed of boys' downregulation of anger and of sadness/fear was not associated with maternal hostile mood. As mothers reported more hostile mood, girls were faster to downregulate displays of sadness/fear, but the speed of this downregulation slowed as those displays accumulated during ongoing mother-child interaction. These associations of child downregulation and maternal mood were observed after controlling for child adjustment. The data suggest frequent exposure to different negative maternal moods affect children's expression and regulation of emotions in relatively specific ways, conditional on the type of maternal mood, the type of child emotion, and child gender.
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Continuity and cascade in offspring of bipolar parents: A longitudinal study of externalizing, internalizing, and thought problems. Dev Psychopathol 2010; 22:849-66. [DOI: 10.1017/s0954579410000507] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThere is growing evidence that many offspring of bipolar parents will develop moderate to severe forms of psychopathology during childhood and adolescence. The purpose of this study was to apply growth curve models to evaluate developmental progression with regard to continuity and cascades representative within the context of a family risk study of bipolar disorder (BD). Repeated assessments of externalizing, internalizing, and thought problems, spanning more than a decade, were examined in a total of 94 offspring of parents with BD (O-BD), major depressive disorder (O-UNI), or no significant psychiatric or medical problems (O-WELL). Continuity was defined by the growth curve of the O-WELL group who exhibited low levels of problems from early childhood through late adolescence. Discontinuity, as evidenced by greater complexity of growth curves relative to the O-WELL group, was exhibited in the at- risk offspring groups for internalizing problems. Different patterns of developmental cascades were supported for the at-risk group with O-UNI showing a robust cascade from self-regulatory deficits (externalizing problems) to internalizing problems. There was also support for a cascade from self-regulatory deficits to thought problems across the entire group (with some support that this pattern was accounted for primarily by O-BD). This study not only serves to advance our understanding of the risks associated with a family history of BD, but also provides a novel approach to examining developmental cascades.
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Abstract
Item response theory (IRT) and related latent variable models represent modern psychometric theory, the successor to classical test theory in psychological assessment. Although IRT has become prevalent in the measurement of ability and achievement, its contributions to clinical domains have been less extensive. Applications of IRT to clinical assessment are reviewed to appraise its current and potential value. Benefits of IRT include comprehensive analyses and reduction of measurement error, creation of computer adaptive tests, meaningful scaling of latent variables, objective calibration and equating, evaluation of test and item bias, greater accuracy in the assessment of change due to therapeutic intervention, and evaluation of model and person fit. The theory may soon reinvent the manner in which tests are selected, developed, and scored. Although challenges remain to the widespread implementation of IRT, its application to clinical assessment holds great promise. Recommendations for research, test development, and clinical practice are provided.
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Affiliation(s)
- Michael L Thomas
- Department of Psychology, Arizona State University, 950 S. McAllister, Tempe, AZ 85287, USA.
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