Effects of Tibiofibular and Ankle Joint Manipulation on Hip Strength and Muscle Activation.

OBJECTIVES: The purpose of this study was to determine whether high-velocity, low-amplitude ankle region manipulations could increase force output and muscle activation of hip musculature in individuals with a history of ankle sprain and unilateral tensor fascia latae (TFL) weakness during muscle testing. METHODS: This investigation used a single-arm repeated measures design. Twenty-five participants' force outputs were tested at three time points (before manipulation, immediately after manipulation, and 48 hours after manipulation), and muscle activation of the rectus femoris, gluteus medius, and TFL was measured before and immediately after manipulation. Manipulations were applied to the talocrural, subtalar, proximal, and distal tibiofibular joints of the weaker limb. No contralateral manipulations were applied. Two-way repeated measures analysis of variance was used to compare maximal and average force production for each limb. In addition, paired t tests were used to compare muscle activation before and after manipulations. RESULTS: There was a significant limb × time interaction. The involved limb average force increased from before manipulation (65.7 N) to 48 hours after manipulation (77.8 N; P = .014), maximal force increased (76.9 N) 48 hours after manipulation (87.8 N; P = .030), and gluteus medius activation increased (9.8% maximum, 12.2% average) immediately after manipulation. No significant differences were found in the uninvolved limb. CONCLUSION: The results of this study suggest that high-velocity, low-amplitude ankle region manipulations might improve hip abductor strength in individuals with a history of ankle sprain and unilateral weakness during a TFL muscle test.

Emotion regulation deficits in intermittent explosive disorder.

Intermittent explosive disorder (IED) is a psychiatric disorder characterized by repeated acts of affective aggression. Despite the diagnostic emphasis on the failure to control aggressive impulses, there is little research on affective processes and emotion regulation in IED; however, this research suggests possible dysfunctions in experiences of emotional intensity and lability. The hypothesis in the present study was that compared to individuals with other psychiatric disorders, and psychologically healthy individuals, individuals with IED experience greater negative affect intensity and emotional lability. Participants (N = 373) consisted of 202 individuals diagnosed with IED, 68 non-IED psychiatric controls (PC), and 103 healthy volunteers (HV). Emotion regulation was assessed using the General Behavior Inventory, the Affective Lability Scale, and the Affect Intensity Measure. Results showed that IED participants reported greater negative affect intensity and greater emotional lability across several emotion domains (e.g., anger, anxiety, depression) than PC and HV participants. These findings suggest that IED is characterized by more global emotion regulation deficits than those associated with anger alone. Aggr. Behav. 41:25-33 2015. © 2014 Wiley Periodicals, Inc.

Psychometric properties of a short form of the Affective Lability Scale (ALS-18).

Psychometric properties of a short form of the Affective Lability Scale (ALS) that was developed in a nonclinical sample (i.e., undergraduate students) were examined in a sample of people diagnosed with Cluster B DSM-IV Axis II personality disorders (n=236), other personality disorders (n=180), and healthy comparison participants (n=164). The total score of the ALS-18 score correlated strongly with the original 54-item scale (r = .97) and aspects of convergent and discriminant validity of the ALS-18 subscales (Anxiety/Depression, Depression/Elation, and Anger) were evaluated using self-report measures of affective and psychosocial functioning in the domains of affect intensity, anxiety, anger, and minimization/denial. Clinical utility of the scale was also demonstrated; participants diagnosed with Cluster B personality disorders reported higher affective lability scores, and healthy control participants reported lower scores, relative to individuals with Cluster A or Cluster C personality disorders (p's < .001). Confirmatory factor analyses were conducted and demonstrated reasonably good fit to the data but future research is needed to test the three factor substructure of the ALS-18 against alternative factor models in samples that include clinical and non-clinical participants.

Verbal versus physical aggression in Intermittent Explosive Disorder.

Intermittent Explosive Disorder (IED) is the only adult psychiatric diagnosis for which pathological aggression is primary. DSM-IV criteria focused on physical aggression, but Diagnostic and Statistical Manual of Mental Disorders (DSM-5) allows for an IED diagnosis in the presence of frequent verbal aggression with or without concurrent physical aggression. It remains unclear how individuals with verbal aggression differ from those with physical aggression with respect to cognitive-affective deficits and psychosocial functioning. The current study compared individuals who met IED criteria with either frequent verbal aggression without physical aggression (IED-V), physical aggression without frequent verbal aggression (IED-P), or both frequent verbal aggression and physical aggression (IED-B) as well as a non-aggressive personality-disordered (PD) comparison group using behavioral and self-report measures of aggression, anger, impulsivity, and affective lability, and psychosocial impairment. Results indicate all IED groups showed increased anger/aggression, psychosocial impairment, and affective lability relative to the PD group. The IED-B group showed greater trait anger, anger dyscontrol, and aggression compared to the IED-V and IED-P groups. Overall, the IED-V and IED-P groups reported comparable deficits and impairment. These results support the inclusion of verbal aggression within the IED criteria and suggest a more severe profile for individuals who engage in both frequent verbal arguments and repeated physical aggression.

The relationship between non-suicidal self-injury and borderline personality disorder symptoms in a college sample.

BACKGROUND: Non-suicidal self-injury (NSSI) is a major concern in both clinical and non-clinical populations. It has been approximated that 65-80% of individuals with borderline personality disorder (BPD) engage in some form of NSSI. Despite such high co-morbidity, much still remains unknown about the relationship between NSSI and BPD symptomatology. The goal of the current study was to identify individual BPD symptoms and higher order BPD factors that increase one's vulnerability of NSSI engagement among a college sample. It was hypothesized that the BPD factor of emotion dysregulation and the BPD symptoms of affect instability and intense anger/aggression would be associated with the presence and frequency of NSSI. METHOD: Seven hundred twenty four undergraduates (61.2% female) completed self-report measures of BPD symptomology and NSSI history. RESULTS: Regression analyses revealed that among the individual BPD symptoms, past suicidality, impulsivity, chronic emptiness, and identity disturbance were each significantly, positively associated with lifetime history of NSSI, whereas unstable relationships were negatively associated with lifetime history of NSSI. The BPD symptom associated with NSSI frequency was dissociation. Among the BPD factors, emotion dysregulation and disturbed relatedness were both associated with NSSI history, but only disturbed relatedness was associated with NSSI frequency. CONCLUSION: Findings show partial support for the importance of emotion dysregulation in the relationship between NSSI and BPD symptomatology, but also suggest that the relationship may be more complex and not solely based on emotion dysregulation.

Vocational functioning in schizotypal and paranoid personality disorders.

Impaired vocational functioning is a hallmark of schizophrenia, but limited research has evaluated the relationships between work and schizophrenia-spectrum personality disorders, including schizotypal (SPD) and paranoid personality disorder (PPD). This study compared employment history and job characteristics of 174 individuals drawn from the community or clinic, based on four personality disorder groups: SPD Only, PPD Only, SPD+PPD, and No SPD or PPD. Symptoms and cognitive functioning were also assessed. Both PPD and/or SPD were associated with lower rates of current employment, and a history of having worked at less cognitively complex jobs than people without these disorders. Participants with PPD were less likely to have a history of competitive work for one year, whereas those with SPD tended to have worked at jobs involving lower levels of social contact, compared with those without these disorders. When the effects of symptoms and cognitive functioning were statistically controlled, PPD remained a significant predictor of work history, and SPD remained a significant predictor of social contact on the job. The findings suggest that impaired vocational functioning is an important characteristic of SPD and PPD.

Nonsuicidal self-injury: relationship to behavioral and self-rating measures of impulsivity and self-aggression.

Previous research using self-report measures has shown an association between nonsuicidal self-injurious behavior (NSSI) and impulsive tendencies. However, self-injurers have not been shown to be different from comparison groups on laboratory tasks putatively assessing impulsive behavior. One explanation for these contradictory findings is that self-report and laboratory measures of impulsive behavior tap into distinct but related constructs. Moreover, performance on laboratory measures of impulsive behavior can be influenced by myriad contextual and affective factors not present during past self-reported NSSI events. Accordingly, a relationship between behavioral tasks of impulsivity and self-injurious behavior could emerge if both are assessed relatively close in time under controlled laboratory conditions. To test this possibility, both self-ratings and laboratory task measures of self-injurious and impulsive behavior were employed in the current study. This multi-modal assessment approach revealed that self-rated impulsivity was associated with both self-report and behavioral measures of self-injurious behavior. Moreover, behavioral measures of impulsivity were associated with self-injurious behavior, but not NSSI history. These results provide support for the notion that a multi-modal approach to assessing self-injurious behavior is important for better understanding the correlates of nonsuicidal self-injury.

Dorso- and ventro-lateral prefrontal volume and spatial working memory in schizotypal personality disorder.

Schizotypal personality disorder (SPD) individuals and borderline personality disorder (BPD) individuals have been reported to show neuropsychological impairments and abnormalities in brain structure. However, relationships between neuropsychological function and brain structure in these groups are not well understood. This study compared visual-spatial working memory (SWM) and its associations with dorsolateral prefrontal cortex (DLPFC) and ventrolateral prefrontal cortex (VLPFC) gray matter volume in 18 unmedicated SPD patients with no BPD traits, 18 unmedicated BPD patients with no SPD traits, and 16 healthy controls (HC). Results showed impaired SWM in SPD but not BPD, compared with HC. Moreover, among the HC group, but not SPD patients, better SWM performance was associated with larger VLPFC (BA44/45) gray matter volume (Fisher's Z p-values <0.05). Findings suggest spatial working memory impairments may be a core neuropsychological deficit specific to SPD patients and highlight the role of VLPFC subcomponents in normal and dysfunctional memory performance.