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APA Journal of Abnormal Psychology

The real mental illnesses: Susan Nolen-Hoeksema (1959–2013) in memoriam.Open in a New Window

Susan Nolen-Hoeksema’s life work concerned rumination, gender differences in depression, and the “transdiagnostic” processes in mental illness. The articles in this special section expand on these themes. Her work on transdiagnostic processes leads us to consider that the real mental illnesses are not the congeries of symptoms in the Diagnostic and Statistical Manual of Mental Disorders, but these processes themselves. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Positive activities as protective factors against mental health conditions.Open in a New Window

Applying Nolen-Hoeksema and Watkins’s (2011) transdiagnostic risk factor heuristic to our work on positive activities (i.e., practices that characterize naturally happy people, like expressing gratitude and practicing generosity), we propose that such activities may serve as protective factors that mitigate proximal risk factors both directly and by intervening with the mechanisms that give rise to them. First, we discuss theoretical and empirical support for the importance of well-being and the mechanisms that explain how positive activities promote well-being (by boosting positive emotions, positive thoughts, positive behaviors, and need satisfaction; Lyubomirsky & Layous, 2013). Second, we outline examples of how positive activities can mitigate two particular proximal risk factors (rumination and loneliness) and counteract environmental triggers (i.e., moderators) that might amplify them (e.g., through adaptive coping). Third, we argue that positive activities can be taught to youth to instill positive patterns of emotions, thoughts, and behaviors that may serve as protective factors over the course of their lifetimes. Lastly, we propose that certain positive activities might be particularly well-suited to certain individuals and to specific risk factors. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Rumination as a transdiagnostic factor underlying transitions between internalizing symptoms and aggressive behavior in early adolescents.Open in a New Window

The high degree of comorbidity among mental disorders has generated interest in identifying transdiagnostic processes associated with multiple types of psychopathology. Susan Nolen-Hoeksema conceptualized rumination as one such transdiagnostic process associated with depression, anxiety, substance abuse, binge eating, and self-injurious behavior. The degree to which rumination accounts for the co-occurrence of internalizing and externalizing psychopathology, however, has never been tested. We used a sample of early adolescents (N = 1,065) assessed at 3 time points spanning 7 months to examine (a) the reciprocal prospective associations between rumination and aggressive behavior in adolescents, (b) whether rumination explained the longitudinal associations of aggressive behavior with depression and anxiety symptoms, and (c) gender differences in these associations. Rumination predicted increases over time in aggressive behavior, and aggression was associated with increases in rumination over time only for boys. Rumination fully mediated the longitudinal association of aggression with subsequent anxiety symptoms and of both depression and anxiety symptoms with subsequent aggression in boys but not girls. Rumination did not explain the association between aggression and subsequent depressive symptoms for either boys or girls. These findings provide novel evidence for the role of rumination as a transdiagnostic factor underlying transitions between internalizing and externalizing symptoms among males during early adolescence. Interventions aimed at reducing rumination may have beneficial influences on multiple forms of psychopathology and on the development of comorbidity. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


A habit-goal framework of depressive rumination.Open in a New Window

Rumination has been robustly implicated in the onset and maintenance of depression. However, despite empirically well-supported theories of the consequences of trait rumination (response styles theory; Nolen-Hoeksema, 1991), and of the processes underlying state episodes of goal-oriented repetitive thought (control theory; Martin & Tesser, 1989, 1996), the relationship between these theories remains unresolved. Further, less theoretical and clinical attention has been paid to the maintenance and treatment of trait depressive rumination. We propose that conceptualizing rumination as a mental habit (Hertel, 2004) helps to address these issues. Elaborating on this account, we propose a framework linking the response styles and control theories via a theoretical approach to the relationship between habits and goals (Wood & Neal, 2007). In this model, with repetition in the same context, episodes of self-focused repetitive thought triggered by goal discrepancies can become habitual, through a process of automatic association between the behavioral response (i.e., repetitive thinking) and any context that occurs repeatedly with performance of the behavior (e.g., physical location, mood), and in which the repetitive thought is contingent on the stimulus context. When the contingent response involves a passive focus on negative content and abstract construal, the habit of depressive rumination is acquired. Such habitual rumination is cued by context independent of goals and is resistant to change. This habit framework has clear treatment implications and generates novel testable predictions. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Neural substrates of trait ruminations in depression.Open in a New Window

Rumination in depression is a risk factor for longer, more intense, and harder-to-treat depressions. But there appear to be multiple types of depressive rumination—whether they all share these vulnerability mechanisms, and thus would benefit from the same types of clinical attention is unclear. In the current study, we examined neural correlates of empirically derived dimensions of trait rumination in 35 depressed participants. These individuals and 29 never-depressed controls completed 17 self-report measures of rumination and an alternating emotion-processing/executive-control task during functional MRI (fMRI) assessment. We examined associations of regions of interest—the amygdala and other cortical regions subserving a potential role in deficient cognitive control and elaborative emotion-processing—with trait rumination. Rumination of all types was generally associated with increased sustained amygdala reactivity. When controlling for amygdala reactivity, distinct activity patterns in hippocampus were also associated with specific dimensions of rumination. We discuss the possibly utility of targeting more basic biological substrates of emotional reactivity in depressed patients who frequently ruminate. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Transdiagnostic processes in psychopathology: In memory of Susan Nolen-Hoeksema.Open in a New Window

This special section honors Dr. Susan Nolen-Hoeksema’s influential work dedicated to improving our understanding of psychopathology. Dr. Nolen-Hoeksema adopted a transdiagnostic perspective to identify mechanisms that underlie many emotional disorders such as cognitive processes and emotion regulation. Her work on the role of rumination and the role of gender differences in psychopathology not only advanced our understanding of important risk factors that cut across disorders but also inspired the development of improved prevention and intervention efforts. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Autobiographical episodic memory in major depressive disorder.Open in a New Window

Autobiographical memory in major depression has been characterized as overgeneralized, with patients recalling few episodic details, prioritizing general schematic events. However, whether this effect reflects impaired episodic or semantic memory, or domain-general cognitive processes, is unknown. We used the Autobiographical Interview (Levine, Svoboda, Hay, Winocur, & Moscovitch, 2002) to derive episodic and semantic contributions to autobiographical memory in patients with severe major depression. We also assessed memory for public events and famous people. Depressed patients were impaired on episodic, but not semantic, autobiographical memory from 2 weeks to 10 years before testing. They were also impaired on memory for public events, possibly because they followed the news less than controls. Patients’ memory for famous names was not impaired, although this was strongly associated with non-episodic memories to a greater degree than in controls. The findings suggest a specific impairment of episodic autobiographical memory in depression that is not fully accounted for by domain-general processes involved in strategic retrieval. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Brooding rumination and heart rate variability in women at high and low risk for depression: Group differences and moderation by COMT genotype.Open in a New Window

There is growing evidence that rumination, perhaps specifically brooding rumination, is a core feature of depression and that it contributes to the development and maintenance of the disorder. A separate line of research has highlighted the role played by heart rate variability (HRV). Both brooding rumination and HRV appear to be driven by disruption in the same neural circuit, heightened amygdala reactivity combined with decreased prefrontal control, and both are highlighted in different units of analysis as reflecting the Research Domain Criteria (RDoC) construct of Loss. However, little is known about the relation among these variables. In the current study, we predicted that higher levels of brooding rumination would be associated with lower levels of HRV and that women at high risk for future depression (i.e., those with a history of past major depressive disorder [MDD]) would exhibit higher levels of brooding and lower levels of HRV. We also examined genetic influences on the variables in this model. We predicted that COMT Val158Met genotype, which has been linked to heightened amygdala reactivity and deficits in prefrontal functioning, would be associated with brooding rumination and HRV, particularly among women with a history of past MDD. The results largely supported our hypotheses, providing additional support for relations among the different units of analysis for the Loss construct. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Abnormal proactive and reactive cognitive control during conflict processing in major depression.Open in a New Window

According to the Dual Mechanisms of Control framework, cognitive control consists of two complementary components: proactive control refers to anticipatory maintenance of goal-relevant information, whereas reactive control acts as a correction mechanism that is activated when a conflict occurs. Possibly, the well-known diminished inhibitory control in response to negative stimuli in Major Depressive Disorder (MDD) patients stems from a breakdown in proactive control, and/or anomalies in reactive cognitive control. In our study, MDD patients specifically showed increased response latencies when actively inhibiting a dominant response to a sad compared with a happy face. This condition was associated with a longer duration of a dominant ERP topography (800–900 ms poststimulus onset) and a stronger activity in the bilateral dorsal anterior cingulate cortex, reflecting abnormal reactive control when inhibiting attention to a negative stimulus. Moreover, MDD patients showed abnormalities in proactive cognitive control when preparing for the upcoming imperative stimulus (abnormal modulation of the contingent negative variation component), accompanied by more activity in brain regions belonging to the default mode network. All together, deficits to inhibit attention to negative information in MDD might originate from an abnormal use of both proactive resources and reactive control processes. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Over-reporting bias and the modified Stroop effect in Operation Enduring and Iraqi Freedom veterans with and without PTSD.Open in a New Window

The current study investigated in a sample of Operation Enduring and Iraqi Freedom (OEF/OIF) veterans how a symptom overreporting response style might influence the association between PTSD diagnostic status and color-naming response latency for trauma-related stimuli during the Modified Stroop Task (i.e., the Modified Stroop Task effect, MST effect). It was hypothesized that, if an overreporting response style reflected feigning or exaggerating PTSD symptoms, an attenuated MST effect would be expected in overreporters with PTSD as compared with PTSD−diagnosed veterans without an overreporting style. If, however, overreporting stemmed from high levels of distress, the MST effect might be greater in overreporters compared with those with a neutral response style. The results showed that veterans with PTSD and an overreporting response style demonstrated an augmented MST effect in comparison with those with a more neutral style of response. Overreporters also reported greater levels of psychopathology, including markedly elevated reports of dissociative experiences. We suggest that dissociation-prone overreporters may misattribute emotional distress to combat experiences leading to the enhanced MST effect. Other possible explanations for these results are also discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Neural markers of positive reappraisal and their associations with trait reappraisal and worry.Open in a New Window

Positively reinterpreting negative experiences is important for psychological well-being and represents a key mechanism of cognitive–behavioral therapies for emotional problems. Yet, little is known about the neural mechanisms that underlie this process and how they relate to clinically relevant individual differences. Here we demonstrate using event-related potentials (ERPs) that positively reappraising distress-inducing images is associated with early increases in frontal control activity and later decreases in parietal arousal-related activity. Moreover, we show that people’s chronic tendencies to reappraise versus worry modulate neural activity in opposing directions—trait reappraisal predicts decreases in parietal arousal-related activity during positive reappraisal implementation whereas worry predicts increases in the same waveform. These findings provide novel insights into the neural time course of positive reappraisal. They also speak to the potential clinical utility of neurophysiological measures as relatively inexpensive, noninvasive biomarkers that could serve as risk indicators and treatment mediators. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Child temperament and parental depression predict cortisol reactivity to stress in middle childhood.Open in a New Window

Children’s cortisol reactivity to stress is an important mediator of depression risk, making the search for predictors of such reactivity an important goal for psychopathologists. Multiple studies have linked maternal depression and childhood behavioral inhibition (BI) independently to child cortisol reactivity, yet few have tested multivariate models of these risks. Further, paternal depression and other child temperament traits, such as positive emotionality (PE), have been largely ignored despite their potential relevance. We therefore examined longitudinal associations between child fear/BI and PE and parental depression, and children’s cortisol stress reactivity, in 205 7-year-olds. Paternal depression and child fear/BI predicted greater cortisol stress reactivity at a follow-up of 164 9-year-olds, and maternal depression and child PE interacted to predict children’s cortisol reactivity, such that higher child PE predicted lower cortisol reactivity in the context of maternal depression. Results highlight the importance of both parents’ depression, as well as multiple facets of child temperament, in developing more comprehensive models of childhood cortisol reactivity to stress. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Characterizing subjective responses to alcohol among adolescent problem drinkers.Open in a New Window

Theoretical models of alcoholism emphasize the acute reinforcing properties of alcohol as chief determinants of drinking, and animal research suggests adolescents are uniquely sensitive to these effects. Human studies of these phenomena, however, are virtually nonexistent. We used ecological momentary assessment methods to capture adolescents’ subjective responses to alcohol in real time in their natural environments. Adolescent participants were 22 problem drinkers, ages 15 to 19 years (M = 18.3, SD = 0.09; 55% female; 55% alcohol dependent). Participants consumed alcohol on 38% of days during a 1-week monitoring period, with an average of 5 drinks per occasion. Momentary data revealed that adolescents experience decreased stimulation and increased sedation and “high” across the ascending limb of the blood alcohol curve. Notably, greater craving predicted higher volumes of subsequent alcohol consumption during the episode, whereas greater “high” attenuated use. To test for developmental differences in these effects, we pooled these data with data from a similarly ascertained sample of 36 adult heavy drinkers, ages 24 to 64 years (M = 38.1, SD = 11.8; 50% female; 61% alcohol dependent). Adolescents were more sensitive to the stimulant effects of alcohol than adults. This study provides novel data on how adolescent problem drinkers experience alcohol in their natural contexts and illustrates how these effects, which appear to differ from adult problem drinkers, confer liability for future drinking. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Effects of ALDH2∗2 on alcohol problem trajectories of Asian American college students.Open in a New Window

The variant aldehyde dehydrogenase allele, ALDH2∗2, consistently has been associated with protection against alcohol dependence, but the mechanism underlying this process is not known. This study examined growth trajectories of alcohol consumption (frequency, average quantity, binge drinking, maximum drinks) and problems over the college years and then tested whether the ALDH2 genotype mediated or moderated the relationship between alcohol consumption and problems. Asian American college students (N = 433) reported on their drinking behavior in their first year of college and then annually for 3 consecutive years. Alcohol consumption and problems increased over the college years for both those with and without ALDH2∗2, but having an ALDH2∗2 allele was associated with less of an increase in problems over time. A mediation model was supported, with ALDH2∗2 group differences in problems fully accounted for by differences in frequency of binge drinking. Findings also supported a moderation hypothesis: All four alcohol consumption variables were significant predictors of subsequent alcohol problems, but these relationships were not as strong in those with ALDH2∗2 as in those without ALDH2∗2. Our findings suggest that the interplay between ALDH2∗2 and drinking-related problems is complex, involving both mediation and moderation processes that reduce the likelihood of developing problems via reduction of heavy drinking as well as by altering the relationship between alcohol consumption and problems. Results of this longitudinal study provide evidence that what seems like a relatively straightforward effect of a diminished ability to metabolize alcohol on drinking behavior is actually dependent on behavior and developmental stage. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Longitudinal test of a developmental model of the transition to early drinking.Open in a New Window

This article reports on a longitudinal test of a developmental model of early drinking that specifies transactions among personality, learning, and behavior in the risk process. The model was tested on 1,906 children making the transition from elementary school to middle school across 3 time points: the spring of 5th grade, the fall of 6th grade, and the spring of 6th grade. In a transaction that has been referred to as acquired preparedness, individual differences in the trait positive urgency at the end of 5th grade were associated with increases in expectancies for social facilitation from alcohol at the start of 6th grade, which then predicted drinker status at the end of 6th grade. In addition, the alcohol expectancy and drinker status predicted each other reciprocally across time. Multiple factors appear to transact to predict early drinking behavior. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Give me just a little more time: Effects of alcohol on the failure and recovery of cognitive control.Open in a New Window

Numerous externalizing behaviors, from aggression to risk taking to drug abuse, stem from impaired cognitive control, including that brought about by the acute effects of alcohol. Although research generally indicates that alcohol impairs cognitive abilities, a close examination of the literature suggests that alcohol’s effects are quite variable and likely depend on a number of contextual factors. The purpose of the current study was to characterize the effects of alcohol on cognitive control in terms of neural and behavioral responses to successful and unsuccessful control attempts. Participants were randomly assigned to consume an alcohol (0.80g/kg ETOH), placebo, or nonalcoholic control beverage prior to completing a cognitive control (flanker) task while event-related brain potentials were recorded. Alcohol reduced the amplitude of the error-related negativity on error trials and increased the posterror compatibility effect in response time. Of particular interest, neural indices of conflict monitoring and performance adjustment (frontal slow wave) were attenuated by alcohol, but only on trials following errors. These functions had recovered, however, by 2 trials after an error. These findings suggest that alcohol’s effects on cognitive control are best characterized as impaired (or delayed) recovery following control failures. Implications of these findings for understanding alcohol’s effects on behavioral undercontrol are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


An intact threat superiority effect for nonsocial but not social stimuli in schizophrenia.Open in a New Window

Studies examining the processing of threat-related information in schizophrenia suggest that patients may show intact abilities to detect nonsocial threats despite impaired processing of social threat. The present study examined potential differences between social and nonsocial threat detection abilities in schizophrenia via two analogous threat perception tasks: one that used nonsocial threat (i.e., snakes) and one that used social threat (i.e., angry faces). Both tasks have reliably demonstrated a threat superiority effect (TSE) among healthy individuals in which threat-related stimuli are detected more accurately and efficiently than non–threat-related stimuli. Results from 30 healthy controls and 35 individuals with schizophrenia indicated that control participants showed a normative TSE on both the nonsocial and social tasks. In contrast, patients showed a TSE on only the nonsocial task, demonstrating intact detection abilities for nonsocial threat but impaired detection of social threats. The discrepant performance across nonsocial and social threat detection tasks within the patient group is consistent with evidence indicating that social and nonsocial information processing can be differentially affected in schizophrenia. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Event-related theta synchronization predicts deficit in facial affect recognition in schizophrenia.Open in a New Window

Growing evidence suggests that abnormalities in the synchronized oscillatory activity of neurons in schizophrenia may lead to impaired neural activation and temporal coding and thus lead to neurocognitive dysfunctions, such as deficits in facial affect recognition. To gain an insight into the neurobiological processes linked to facial affect recognition, we investigated both induced and evoked oscillatory activity by calculating the Event Related Spectral Perturbation (ERSP) and the Inter Trial Coherence (ITC) during facial affect recognition. Fearful and neutral faces as well as nonface patches were presented to 24 patients with schizophrenia and 24 matched healthy controls while EEG was recorded. The participants’ task was to recognize facial expressions. Because previous findings with healthy controls showed that facial feature decoding was associated primarily with oscillatory activity in the theta band, we analyzed ERSP and ITC in this frequency band in the time interval of 140–200 ms, which corresponds to the N170 component. Event-related theta activity and phase-locking to facial expressions, but not to nonface patches, predicted emotion recognition performance in both controls and patients. Event-related changes in theta amplitude and phase-locking were found to be significantly weaker in patients compared with healthy controls, which is in line with previous investigations showing decreased neural synchronization in the low frequency bands in patients with schizophrenia. Neural synchrony is thought to underlie distributed information processing. Our results indicate a less effective functioning in the recognition process of facial features, which may contribute to a less effective social cognition in schizophrenia. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Neural activity to positive expressions predicts daily experience of schizophrenia-spectrum symptoms in adults with high social anhedonia.Open in a New Window

Social anhedonia (SA), the diminished pleasure from social relationships, is a prominent characteristic of the vulnerability and manifestation of schizophrenia disorder. However, SA can develop for multiple reasons and little is known about its neural basis; these 2 issues hinder the utility and sensitivity of SA as a marker of schizophrenia pathology. This study investigated whether lateral prefrontal cortex (LPFC) deficits in social reward processing are associated with both SA and other schizophrenia-spectrum symptoms. During functional MRI (fMRI), a community sample of healthy adults (N = 30) with high and low SA viewed positive, negative, and neutral facial expressions. Afterward, participants completed an online daily diary in which they rated schizophrenia-spectrum symptoms and occurrence of interpersonal conflict each day for 21 days. Compared with low SA, high SA participants had less ventral (V)LPFC activity to positive versus neutral expressions. In addition, participants with a combination of high SA and low VLPFC activity to positive versus neutral expressions had worse daily diary ratings of schizophrenia-spectrum symptoms, including worse cognition, paranoia, motivation/productivity, and vigor/positive affect (i.e., psychomotor activation). Finally, among high SA participants, VLPFC activity predicted the daily relationship between distress from interpersonal conflict and symptom-severity; specifically, high SA participants with low VLPFC activity had worse paranoia on days of high conflict distress. These findings indicate that VLPFC deficits in positive emotion are associated with both SA and other schizophrenia-spectrum symptoms and that understanding the interaction of SA, VLPFC function, and social stress could facilitate the use of SA in the prevention and treatment of schizophrenia. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Examining the relations among pain tolerance, psychopathic traits, and violent and nonviolent antisocial behavior.Open in a New Window

Psychopathic traits are typically associated with an array of externalizing behaviors including violent and nonviolent crime and recidivism, substance use, aggression, and sexual coercion. In the current study, we test the hypothesis that psychopathic traits are related to an increased tolerance for physical pain, which may partially account for the relations between psychopathy and antisocial behavior (ASB). Using community participants oversampled for psychopathic traits (N = 104), we found that psychopathic traits, measured using self- and informant reports, manifested small correlations with some measures of physical pain tolerance (tolerance of pressure and electric shock) but not others (tolerance of cold temperature). In addition, pain tolerance, particularly tolerance of pressure, manifested small correlations with a history of antisocial and aggressive behavior. However, there was little evidence that pain tolerance serves as a mediator of the relations between psychopathy and violent or nonviolent ASB. Conversely, there was evidence that the relations between pain tolerance and ASB were mediated by the presence of certain psychopathic traits. The implications of these findings are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Amygdala reactivity and negative emotionality: Divergent correlates of antisocial personality and psychopathy traits in a community sample.Open in a New Window

Previous studies have emphasized that antisocial personality disorder (APD) and psychopathy overlap highly but differ critically in several features, notably negative emotionality (NEM) and possibly amygdala reactivity to social signals of threat and distress. Here we examined whether dimensions of psychopathy and APD correlate differentially with NEM and amygdala reactivity to emotional faces. Testing these relationships among healthy individuals, dimensions of psychopathy and APD were generated by the profile matching technique of Lynam and Widiger (2001), using facet scales of the NEO Personality Inventory-Revised, and amygdala reactivity was measured using a well-established emotional faces task, in a community sample of 103 men and women. Higher psychopathy scores were associated with lower NEM and lower amygdala reactivity, whereas higher APD scores were related to greater NEM and greater amygdala reactivity, but only after overlapping variance in APD and psychopathy was adjusted for in the statistical model. Amygdala reactivity did not mediate the relationship of APD and psychopathy scores to NEM. Supplemental analyses also compared other measures of factors within psychopathy in predicting NEM and amygdala reactivity and found that Factor 2 psychopathy was positively related to NEM and amygdala reactivity across measures of psychopathy. The overall findings replicate seminal observations on NEM in psychopathy by Hicks and Patrick (2006) and extend this work to neuroimaging in a normative population. They also suggest that one critical way in which APD and psychopathy dimensions may differ in their etiology is through their opposing levels of NEM and amygdala reactivity to threat. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


The relative impact of socioeconomic status and childhood trauma on Black-White differences in paranoid personality disorder symptoms.Open in a New Window

The current study examines mechanisms of racial differences in symptoms of paranoid personality disorder (PPD) in a sample of adults ages 55–64 from the St. Louis, MO area. Socioeconomic status (SES) and childhood trauma were tested as intervening variables in the association between race and PPD symptoms using structural equation modeling. PPD symptoms were modeled as a latent variable composed of items from the PPD scales of the Multi-Source Assessment of Personality Pathology self and informant reports and the Structured Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM–IV) Personality. Childhood trauma was measured using the Traumatic Life Events Questionnaire, and SES was a composite of parent education, participant education, and annual household income. Blacks exhibited higher levels of PPD symptoms across the 3 personality measures, reported significantly lower SES, and reported greater childhood trauma. The proposed model was a good fit to the data, and the effect of race on PPD symptoms operated mainly through SES. The indirect effect through SES was stronger for males. Findings suggest that racial differences in PPD symptoms are partly explained by problems more commonly experienced by Black individuals. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


An investigation of differential item functioning across gender of BPD criteria.Open in a New Window

Gender differences in prevalence rates of Borderline Personality Disorder (BPD) may reflect true differences between groups or may reflect some form of gender bias in diagnostic criteria. The detection of differential item functioning (DIF) using item response theory methods provides a powerful method of evaluating whether gender differences in prevalence rates of BPD reflect true mean differences or criterion bias. The aim of the current study was to evaluate gender-based DIF in DSM BPD criteria. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM–IV) Axis II Personality Disorders (SCID-II: First, Spitzer, Gibbon, Williams, & Benjamin, 1994) was administered to 747 adult inpatients. Results indicated DIF for 2 BPD criteria (impulsivity and uncontrolled anger), such that it was easier for these items to be endorsed for men compared with women at the same level of latent trait. At the level of the test, men were expected to be rated slightly higher than women on the SCID-II at the same level of latent BPD liability. Implications of these results for research and clinical assessment are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Drinking motives moderate daily relationships between PTSD symptoms and alcohol use.Open in a New Window

Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) frequently co-occur, although results of both cross-sectional and longitudinal studies evaluating the nature of their relationship have been mixed. There has been varied support for competing models explaining how these conditions influence one another. To assess both the self-medication and mutual maintenance models, as well as examine the potential moderating role of drinking motives, the current study used Generalized Estimating Equations to evaluate daily associations for an average of 7.3 days between PTSD symptoms and alcohol use in a mixed-gender sample of individuals who met criteria for both PTSD and AD. Results generally supported a self-medication model with elevated PTSD symptoms predictive of greater alcohol use on that same day and on the following day. Contrary to a mutual maintenance model prediction, drinking did not predict next-day PTSD symptoms. Results also indicated that both coping and enhancement drinking motives were significant moderators of the PTSD and drinking relationships, suggesting that these relationships may be more or less salient depending on an individual’s particular drinking motivations. For example, among those higher on coping drinking motives, a 1-unit increase in PTSD symptom severity was associated with a 35% increase in amount of alcohol consumed the same day, while among those low on coping drinking motives, a 1-unit PTSD increase was associated with only a 10% increase in alcohol consumption. We discuss implications of these findings for the larger literature on the associations between PTSD and alcohol use as well as for clinical interventions. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Spatial working memory in children with high-functioning autism: Intact configural processing but impaired capacity.Open in a New Window

Visual attention and visual working memory exert severe capacity limitations on cognitive processing. Impairments in both functions may exacerbate the social and communication deficits seen in children with an autism spectrum disorder (ASD). This study characterizes spatial working memory and visual attention in school-age children with high-functioning autism. Children with ASD, and age, gender, and IQ-matched typically developing (TD) children performed 2 tasks: a spatial working memory task and an attentive tracking task. Compared with TD children, children with ASD showed a more pronounced deficit in the spatial working memory task than the attentive tracking task, even though the latter placed significant demands on sustained attention, location updating, and distractor inhibition. Because both groups of children were sensitive to configuration mismatches between the sample and test arrays, the spatial working memory deficit was not because of atypical organization of spatial working memory. These findings show that attention and working memory are dissociable, and that children with ASD show a specific deficit in buffering visual information across temporal discontinuity. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Specificity of affective instability in patients with borderline personality disorder compared to posttraumatic stress disorder, bulimia nervosa, and healthy controls.Open in a New Window

Affective instability is a core feature of borderline personality disorder (BPD). The use of advanced assessment methodologies and appropriate statistical analyses has led to consistent findings that indicate a heightened instability in patients with BPD compared with healthy controls. However, few studies have investigated the specificity of affective instability among patients with BPD with regard to relevant clinical control groups. In this study, 43 patients with BPD, 28 patients with posttraumatic stress disorder (PTSD), 20 patients with bulimia nervosa (BN), and 28 healthy controls carried e-diaries for 24 hours and were prompted to rate their momentary affective states approximately every 15 minutes while awake. To quantify instability, we used 3 state-of-the-art indices: multilevel models for squared successive differences (SSDs), multilevel models for probability of acute changes (PACs), and aggregated point-by-point changes (APPCs). Patients with BPD displayed heightened affective instability for emotional valence and distress compared with healthy controls, regardless of the specific instability indices. These results directly replicate earlier studies. However, affective instability did not seem to be specific to patients with BPD. With regard to SSDs, PACs, and APPCs, patients with PTSD or BN showed a similar heightened instability of affect (emotional valence and distress) to that of patients with BPD. Our results give raise to the discussion if affective instability is a transdiagnostic or a disorder-specific mechanism. Current evidence cannot answer this question, but investigating psychopathological mechanisms in everyday life across disorders is a promising approach to enhance validity and specificity of mental health diagnoses. (PsycINFO Database Record (c) 2014 APA, all rights reserved)


Understanding processing speed weaknesses among pedophilic child molesters: Response style vs. Neuropathology.Open in a New Window

Research shows that pedophilic (PED) child molesters exhibit slower performance speed and greater performance accuracy when compared to nonpedophilic (N-PED) child molesters or other criminal and noncriminal controls. The purpose of the present study was to examine whether these differences reflect a slow/deliberate response style among PEDS (as we have previously hypothesized; Eastvold, Suchy, & Strassberg, 2011; Suchy, Whittaker, Strassberg, & Eastvold, 2009a, 2009b), or a fundamental neuropathological weakness in processing speed. Data came from a larger study examining neurocognition among sex offenders. Processing speed in three different domains (motor speed, visual-perceptual speed, and visual-motor integration) was examined in 20 phallometrically identified PEDs, 20 N-PEDs, and 20 nonsexual offenders, using both clinical (Finger Tapping, Symbol Search, Digit Symbol Coding) and experimental measures (Inspection Time Task [ITT]). The ITT assessed speed of visual-perceptual processing independent of response speed. On clinical measures, PEDs exhibited slower visual perception [F(2, 57) = 5.24, p = .008] and visual-motor integration [F(2, 57) = 5.02, p = .010] than the other groups, with no differences for simple motor speed. On the ITT, PEDs performed less accurately than the other groups [F(2, 57) = 3.95, p = .025], clearly indicating that slow processing speed cannot be explained by a deliberate response style. Group differences persisted after controlling for other potential confounds (age, estimate IQ, working memory, ethnicity, and substance use). PEDs’ slower performance is due to a fundamental neurocognitive weakness, rather than a slow/deliberate response style. These results are consistent with Cantor et al.’s (2008) work identifying white matter abnormalities among PEDs and provide further support for a neurodevelopmental etiology of pedophilia. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
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