[Personality Assessment as Contribution to Diagnostic Differentiation Between ADHD and RAD in Middle Childhood]. / Persönlichkeitserfassung als Beitrag zur Differentialdiagnostik zwischen Patienten mit ADHS und Bindungsstörung in der mittleren Kindheit.

Personality Assessment as Contribution to Diagnostic Differentiation Between ADHD and RAD in Middle Childhood Early and prolonged social and emotional deprivation can result in symptoms of both ADHD and attachment disorder (RAD). The present study compares children between 7 and 13 years of age diagnosed with either ADHD or RAD, regarding their disorder specific behavior by using the Conners Rating Scale, a RAD screening scale, the overall psychopathology in the CASCAP-D, and the children's personality using the California Child-Q-sort (CCQ). The RAD group showed an increased overall psychopathology score and both increased ADHD and RAD symptomatology. In addition, they also were characterized as lower in self-regulatory personality characteristics (e. g. ego-resiliency). The results suggest that children with a RAD diagnosis do not show two comorbid disorders (RAD plus ADHD) but are characterized by an even more intense deficit of self-regulation in social and emotional contexts, compared to the children of the pure ADHD group. This should be considered in diagnosis and treatment.

Attachment in young children with incarcerated fathers.

The present study examined young children's attachment behaviors during paternal incarceration and reported on initial validity of a new measure used to rate children's attachment-related behaviors and emotions during visits in a corrections setting. Seventy-seven children, age 2 to 6 years, and their jailed fathers and current caregivers participated in the home visit portion of the study, whereas 28 of these children participated in the jail visit. The results indicated that 27% of children witnessed the father's crime and 22% of children witnessed the father's arrest, with most children who witnessed these events exhibiting extreme distress; children who witnessed these events were more likely to have insecure attachments to their caregivers. Consistent with attachment theory and research, caregivers who exhibited more sensitivity and responsivity during interactions with children and those who provided more stimulating, responsive, learning-oriented home environments had children who were more likely to have secure attachments (measured with the Attachment Q-Sort). We also found preliminary evidence for the validity of our new measure, the Jail Prison Observation Checklist, in that children's attachment-related behaviors and emotions during the jail visit correlated with their attachment security observed in the home. Our observations indicate that, in certain contexts, noncontact visits with incarcerated parents can be stressful for children and that children's caregivers may play a significant role during these visits.

Assessing Anaclitic and Introjective Characteristics Using the SWAP-200 Q-Sort: Concurrent Validity with the Inventory of Interpersonal Problems Circumplex Scales.

This investigation's goal was to assess the concurrent validity of the four scales of the Anaclitic and Introjective Depression Assessment (AIDA), a newly developed clinician-rated measure, and the Inventory of Interpersonal Problems Circumplex Scales (IIP-64). The AIDA is composed of Shedler-Westen Assessment Procedure items and is comprised of two primitive and two more mature scales of introjective and anaclitic personality types. Specific predictions of relationships were made and are discussed further in this paper. The participants in this study were 106 outpatients engaged in psychodynamic psychotherapy. Patients completed the IIP-64 upon assessment and were rated by their therapist on the Shedler-Westen Assessment Procedure 200 (SWAP-200). The present findings demonstrated several expected relationships between the SWAP-derived AIDA and the IIP-64. Primitive levels of Anaclitic and Introjective characteristics on the AIDA were related to more difficulties involving Affiliation and Dominance on the IIP. The primitive Introjective-Dismissive (Dismissive Depression) scale was related to difficulties involving high Dominance and low Affiliation. The more adaptive Introjective-Self-Critical (Self-Critical Depression) scale was not related to any interpersonal problem. The more adaptive Anaclitic-Needy (Needy Depression) scale was related to difficulties involving high Affiliation, and the primitive Anaclitic-Submissive (Submissive Depression) scale was associated with difficulties related to high Affiliation, as well as problems related to low Dominance in one of two domains. Our results bolster the concurrent validity of the four AIDA scales and add to current knowledge of the differential interpersonal patterns of individuals with more mature and primitive levels of anaclitic and introjective personality types. Copyright © 2016 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Clinicians can utilize the Anaclitic and Introjective Depression Assessment (AIDA; Rost, Fonagy, & Luyten, 2014), derived from Shedler-Westen Assessment Procedure (SWAP) items, to assess if their patients possess Anaclitic or Introjective characteristics. This measure can also be used to assess if the Anaclitic and Introjective characteristics are of a more primitive or mature nature. Clinicians should be aware that individuals with more primitive levels of Anaclitic and Introjective characteristics experience more difficulties involving Affiliation and Dominance than individuals with more mature levels of personality development. Specifically, the more primitive Introjective individual will likely encounter difficulties involving high Dominance and low Affiliation. The more adaptive Introjective individual will likely not demonstrate difficulties in these areas. The more primitive Anaclitic individual will likely encounter more difficulties related to high Affiliation, as well as problems related to low Dominance. The more adaptive Anaclitic individual also likely will encounter difficulties involving high Affiliation.

The World at 7:00: Comparing the Experience of Situations Across 20 Countries.

The purpose of this research is to quantitatively compare everyday situational experience around the world. Local collaborators recruited 5,447 members of college communities in 20 countries, who provided data via a Web site in 14 languages. Using the 89 items of the Riverside Situational Q-sort (RSQ), participants described the situation they experienced the previous evening at 7:00 p.m. Correlations among the average situational profiles of each country ranged from r = .73 to r = .95; the typical situation was described as largely pleasant. Most similar were the United States/Canada; least similar were South Korea/Denmark. Japan had the most homogenous situational experience; South Korea, the least. The 15 RSQ items varying the most across countries described relatively negative aspects of situational experience; the 15 least varying items were more positive. Further analyses correlated RSQ items with national scores on six value dimensions, the Big Five traits, economic output, and population. Individualism, Neuroticism, Openness, and Gross Domestic Product yielded more significant correlations than expected by chance. Psychological research traditionally has paid more attention to the assessment of persons than of situations, a discrepancy that extends to cross-cultural psychology. The present study demonstrates how cultures vary in situational experience in psychologically meaningful ways.

Attitudes towards establishing a daily supervised school-based toothbrushing programme--determined by Q-sort methodology.

OBJECTIVES: This study used Q-sort methodology to determine the views of staff involved in a national school-based daily toothbrushing programme. METHODS: Q-methodology is a mixed-method approach in which participants are asked to sort a collection of statements according to degree of agreement with them. Factor analysis identified subgroups of like-minded participants and revealed areas of consensus and disagreement. 24 Community Dental Service staff managing or delivering the toothbrushing programme were asked to rank 49 statements derived from previous qualitative interviews. RESULTS: Varimax rotation produced a three-factor solution with five/six participants loading significantly into each group. Groups divided largely according to staff role: Factor 1, mainly support workers (assistants with no oral-health background); Factor 2, managers; and factor 3, oral health educators (dental nurses with teaching qualifications). As staff new to the area of oral-health, the views of support workers were of particular interest. Unlike others, this group saw Designed to Smile as a unique health promotion scheme and wanted to involve as many children as possible, regardless of oral-disease risk. Managers' perceptions of issues affecting the establishment of the programme differed from those staff in day-to-day contact with the 515 schools in which the toothbrushing took place. CONCLUSIONS: This study used a long established but little used technique to ascertain the commonality of views of staff These data may be of value not only in managing the current programme, but for anyone who may be considering developing such a toothbrushing scheme.

Women entering clinical psychology: Q-sort narratives of career attraction of female clinical psychology trainees in the UK.

The great majority of the UK clinical psychology workforce are women, and this fact prompted an examination of the various ways clinical psychology might be seen as attractive to women--a neglected research topic. Female clinical psychology trainees from a variety of training programmes Q-sorted statements of potential job attractors. The process of analysis is outlined before most of the article is devoted to explicating the five narratives of attraction generated: making a difference, waiting for what I want, idealising challenge, identifying with distress and acknowledging power and privilege. Two super-ordinate 'stories' spanning the narratives are suggested--an over-riding attraction to the profession and a rebuttal of the suggestion that this attraction may be based on any overtly gendered grounds. In the absence of previous empirical data of women's attraction to clinical psychology, the small but significant contribution to understanding the profession made by the analysis is acknowledged--as is the need for further research to confirm and develop the findings.

Measuring infant attachment security in rhesus macaques (Macaca mulatta): adaptation of the attachment Q-set.

John Bowlby defined offspring-parent attachment as a relationship in which an infant or child uses one or a few preferred adults as a secure base from which to explore and as a haven of safety. He defined attachment security in terms of confidence in the adult's availability and responsiveness and the smooth organization of exploration and proximity seeking. Developmental psychologists have found this perspective productive in both observational and laboratory research. At the same time, they emphasize that such a construct cannot be operationalized in terms of one or a few behaviors. Instead, naturalistic observations of human infant attachment typically employ the Q-sort method to develop the Attachment q-set (AQS), 90 behaviorally descriptive items sorted in terms of how characteristic each item is of the infant's typical behavior. Meta-analyses of research using the AQS attest to its reliability and validity. This article reports an adaptation of the AQS to the task of assessing infant attachment security in nonhuman primates and illustrates its use. The availability of comparable measures of attachment security will contribute to an expanded understanding of patterns of attachment behavior in nonhuman primate societies and will facilitate interaction between comparative and developmental psychologists.

Four different patterns of fatigue in rheumatoid arthritis patients: results of a Q-sort study.

OBJECTIVES: Many patients with RA complain about fatigue. Whereas qualitative studies have covered the meaning of fatigue for RA patients, it was still unknown whether subgroups of patients could be distinguished. This study aimed to describe different perspectives on the experience of fatigue. METHODS: Participants were 30 outpatients with established controlled RA of the Medical Spectrum Twente, with a mean fatigue severity score of 4.67 (visual analogue scale 0-10). They evaluated 57 statements about fatigue according to Q-methodology. Data were analysed with PCQ for Windows (Portland, OR, USA), using centroid factor analysis with varimax rotation (i.e. the participants but not the items of a scale are the variables). Factor scores of statements on the different dimensions were calculated to investigate which items are relevant when describing and distinguishing fatigue experiences. Demographic and clinical patient characteristics were collected to describe each of the dimensions that resulted from centroid factor analysis. RESULTS: After statistical and theoretical considerations, a four-factor structure of the data was obtained. Each factor represented a perspective on the experience of fatigue, shared by a certain group of patients. Physical, psychological and social patient characteristics seemed to be associated with those experiences. The factors were labelled as: 'Little impact of fatigue'; 'Good coping and bad sleep'; 'Search for balance'; and 'High distress'. CONCLUSIONS: Results indicated that fatigue experience is a complex phenomenon. Existing questionnaires to measure fatigue do not meet this complexity. Extensive research is warranted and new efforts to develop instruments that take into account all aspects of fatigue are indicated.

Convergence of internal and external structure for the California Child Q-set.

The language of personality traits includes single-word trait descriptors, and longer phrases or sentences. Evidence has accumulated that abstract, semantic relationships among single words have the same underlying structure as the empirical relationships when words are applied to individuals. The present study examines whether these two kinds of structure are also isomorphic for longer trait descriptors. Empirical descriptions and judgements of semantic similarity were collected among the descriptors comprising the California Child Q-set, or CCQ, and analysed with multidimensional scaling. Canonical correlation showed the solutions to be closely related to one another, and to independent sets of ratings available for the CCQ items. Informants' similarity judgements were not affected by the context in which they were made. The dominant dimensions of the solutions reproduce dimensions found previously for the single-word personality lexicon, indicating the two trait-descriptive languages to be closely parallel.

Convergent validity of the SWAP-200 dependency scales.

The present study examined the convergent validity of the Shedler-Westen Assessment Procedure Q-Sort (SWAP-200; ) dependency scales (Dependent Personality Disorder [DPD] Clinical Prototype and DPD composite description) by examining links between these variables with Inventory of Interpersonal Problems Circumplex Scales (IIP-C; Alden et al., 1990; Horowitz et al., 2000; Horowitz et al., 1988), and DSM-IV diagnoses of DPD in a clinical sample (N = 85). Results showed that SWAP-200 DPD Clinical Prototype was significantly related to a DSM-IV diagnosis of DPD, higher scores on the IIP-C Affiliative/Submissive Quadrant summary scale, and elevations on Nonassertive and Overly-accommodating Octant Scales. Additional analyses revealed significant positive relationships between the DPD composite description with DSM-IV diagnosis of DPD, the Affiliative/Submissive Quadrant summary scale, and the Overly Accommodating and Self-Sacrificing Octant Scales. We discuss the implications of these findings with regard to theoretical, empirical, and clinical aspects of interpersonal dependency.

Personality subtypes of suicidal adults.

Research into personality factors related to suicidality suggests substantial variability among suicide attempters. A potentially useful approach that accounts for this complexity is personality subtyping. As part of a large sample looking at personality pathology, this study used Q-factor analysis to identify subtypes of 311 adult suicide attempters using Shedler-Westen Assessment Procedure-II personality profiles. Identified subtypes included internalizing, emotionally dysregulated, dependent, hostile-isolated, psychopathic, and anxious somatizing. Subtypes differed in hypothesized ways on criterion variables that address their construct validity, including adaptive functioning, Axis I and II comorbidity, and etiology-related variables (e.g., history of abuse). Furthermore, dimensional ratings of the subtypes predicted adaptive functioning above DSM-based diagnoses and symptoms.

Questioning the coherence of histrionic personality disorder: borderline and hysterical personality subtypes in adults and adolescents.

After the introduction of histrionic personality disorder (HPD), nosologists struggled to reduce its overlap with borderline personality disorder and other PDs. We studied the coherence of HPD in adults and adolescents as part of 2 larger studies. Clinicians described a random patient with personality pathology using rigorous psychometrics, including the SWAP-II (a Q-sort that captures personality and its pathology in adults) in study 1 and the SWAP-II-A (the adolescent version) in study 2. Using DSM-IV-based measures, we identified patients who met HPD criteria with varying degrees of diagnostic confidence. Central tendencies in the SWAP-II and SWAP-II-A profiles revealed that both the most descriptive and most distinctive features of the patients included some features of HPD but also many features of borderline personality disorder. Q-factor analyses of the SWAP data yielded 3 types of patients in each of the 2 samples. The HPD diagnosis may not be sufficiently coherent or valid.

[Validity of mother and observer ratings on infant attachment behavior]. / Validität von Mutter- und Beobachterurteilen über kindliches Bindungsverhalten.

The observer version of the Attachment Q-Set (AQS) is considered to be a valid instrument for the assessment of infant attachment security while it is unclear which variables are measured by its mother version. Since there are only few studies so far who evaluate both versions concerning more than one aspect of validity, this was the aim of the present study. Furthermore it was searched for variables which moderate the correspondence of both versions. In a sample of 64 mother child dyads attachment security was assessed at the childrens' age of 18 months in the Strange Situation Test (SST) and at the age of 30 months via AQS in both the observer and the mother version. Maternal sensitivity which is hypothesised in attachment theory to be related to attachment security was estimated in order to test validity. The mothers' tendency to describe her child in a social desired way was investigated via questionnaire. To summarize validity can be stated for both versions of the AQS since both correlate significantly with maternal sensitivity. However only the observer version of AQS was associated with SST classifications and can therefore be considered to reach validity. Mother and observer version corresponded better in the case of girls respectively when the mothers' social desirability response bias was low.

Aesthetics of streetscapes: influence of fundamental properties on aesthetic judgments of urban space.

This experiment was designed to investigate the relationship between the fundamental visual, spatial properties of existing complex streetscapes and aesthetic judgments. Participants performed aesthetic judgments over 35 photographs of typical spatial situations taken along the Meissner Strasse in Radebeul, Germany. In a modified Q-Sort procedure, the participants assigned the pictures to five categories, including 1 (beautiful) and 5 (not beautiful). Vegetation, Stylistic Uniformity, Homogeneity of Scale, and Symmetry were identified as primary components of aesthetic judgment by using principal component analysis. Stimuli, photographically edited according to these factors, were then tested using the same Q-Sort procedure, which confirmed these determinants. These results are intended to help the development of the theoretical understanding of the link between the influence of selected spatial properties and the aesthetic judgment of the visual quality of urban spaces.

Relationship between clinician assessment and self-assessment of personality disorders using the SWAP-200 and PAI.

The relation between self- and peer-informant reports of personality using psychometric instruments has been the focus of considerable research. The quantified judgments of clinically experienced observers such as treating clinicians have also been studied. The focus of the present article is on the measurement of 3 personality disorders (borderline, antisocial, and obsessive-compulsive) using the Shedler-Westen Assessment Procedure (SWAP-200), an instrument designed to quantify personality ratings made by clinically experienced informants, and the self-report Personality Assessment Inventory (PAI). SWAP-200 personality disorder scales showed small to medium correlations with borderline and antisocial personality disorder scales from the PAI. As predicted, SWAP-200 obsessive-compulsive personality disorder correlated negatively with these scales, suggesting discriminant validity.

A quantitative estimate of schema abnormality in socially anxious and non-anxious individuals.

Although cognitive theories of anxiety suggest that anxious individuals are characterized by abnormal threat-relevant schemas, few empirical studies have estimated the nature of these cognitive structures using quantitative methods that lend themselves to inferential statistical analysis. In the present study, socially anxious (n = 55) and non-anxious (n = 62) participants completed 3 Q-Sort tasks to assess their knowledge of events that commonly occur in social or evaluative scenarios. Participants either sorted events according to how commonly they personally believe the events occur (i.e. "self" condition), or to how commonly they estimate that most people believe they occur (i.e. "other" condition). Participants' individual Q-Sorts were correlated with mean sorts obtained from a normative sample to obtain an estimate of schema abnormality, with lower correlations representing greater levels of abnormality. Relative to non-anxious participants, socially anxious participants' sorts were less strongly associated with sorts of the normative sample, particularly in the "self" condition, although secondary analyses suggest that some significant results might be explained, in part, by depression and experience with the scenarios. These results provide empirical support for the theoretical notion that threat-relevant self-schemas of anxious individuals are characterized by some degree of abnormality.

The Psychopathy Q-sort: construct validity evidence in a nonclinical sample.

Scant research has examined the validity of instruments that permit observer ratings of psychopathy. Using a nonclinical (undergraduate) sample, the authors examined the associations between both self-and observer ratings on a psychopathy prototype (Psychopathy Q-Sort, PQS) and widely used measures of psychopathy, antisocial behavior, and negative emotionality. Self- and observer prototype correlations generally displayed predicted patterns of convergent and discriminant validity for the PQS. Future research using the PQS should focus on potential domains of incremental validity of peer-rated psychopathy beyond self-reported psychopathy.

Clinical assessment of pathological personality traits.

OBJECTIVE: Research has raised questions about the ability of clinicians to make reliable diagnostic judgments about personality. The aim of this study was to assess the reliability and validity of the dimensional diagnosis of pathological personality traits with the Shedler-Westen Assessment Procedure-200 (SWAP-200) Q sort. METHOD: Two clinician/judges independently described 24 outpatients using the SWAP-200, based on a systematic clinical interview. Treating clinicians described the patients using the SWAP-200 based on their knowledge of the patients over the course of treatment while they were blind to interview data. RESULTS: Interrater reliability was high. Convergent and discriminant validity between interviewers and clinicians was also strong. A procedure recently developed for providing precise estimates of construct validity with contrast analysis applied to correlational data documented strong evidence of validity. CONCLUSIONS: Clinicians and independent interviewers can reliably assess complex personality traits associated with personality pathology using the SWAP-200.

A prototype approach to personality disorder diagnosis.

OBJECTIVE: Virtually no research has tested alternatives to the diagnostic method used since DSM-III, which requires decisions about the presence/absence of individual diagnostic criteria, followed by counting symptoms and applying cutoffs (the count/cutoff method). This study tested an alternative, prototype matching procedure designed to simplify diagnosis. The procedure was applied to personality disorders. METHOD: A random national sample of psychiatrists and clinical psychologists (N=291) described a randomly selected patient in their care. Clinician-provided diagnostic data were used to generate categorical and dimensional DSM-IV diagnoses (number of symptoms present per disorder). Clinicians also used one of two prototype matching systems to provide a diagnosis for the selected patient. RESULTS: Prototype diagnosis led to reduced comorbidity relative to DSM-IV diagnosis, yielded similar estimates of validity in predicting criterion variables (adaptive functioning, treatment response, and etiology), and outperformed DSM-IV diagnosis in ratings of clinical utility and ease of use. Adding a personality health prototype further increased prediction. CONCLUSIONS: A simple prototype matching procedure provides a viable alternative for improving diagnosis of personality disorders in clinical practice. Prototype diagnosis has multiple advantages, including ease of use, minimization of artifactual comorbidity, compatibility with naturally occurring cognitive processes, and ready translation into both categorical and dimensional diagnosis.

Borderline personality disorder in clinical practice.

OBJECTIVE: Most studies of borderline personality disorder have drawn patients from among hospital inpatients or outpatients. The aims of this study were to examine the nature of borderline personality disorder patients in everyday clinical practice and to use data from a sample of borderline personality disorder patients seen in the community to refine the borderline construct. METHOD: A random national sample of 117 experienced psychiatrists and psychologists from the membership registers of the American Psychiatric Association and American Psychological Association provided data on a randomly selected patient with borderline personality disorder (N=90) or dysthymic disorder (N=27) from their practice. The clinicians provided data on axis I comorbidity, axis II comorbidity, and adaptive functioning, as well as a personality description of the patient using the Shedler-Westen Assessment Procedure-200 (SWAP-200) Q-sort, an instrument designed for assessment and taxonomic purposes. Analyses compared borderline personality disorder and dysthymic disorder groups on variables of interest and aggregated SWAP-200 items across all borderline personality disorder patients to create a composite portrait of borderline personality disorder as seen in the community. RESULTS: The borderline personality disorder sample strongly resembled previously studied borderline personality disorder samples with regard to comorbidity and adaptive functioning. However, the SWAP-200 painted a portrait of borderline personality disorder patients as having more distress and emotion dysregulation, compared to the DSM-IV description. CONCLUSIONS: Borderline personality disorder patients in research samples are highly similar to those seen in a cross-section of clinical practice. However, several studies have now replicated a portrait of borderline personality disorder symptoms that places greater weight than the DSM-IV description on the intense psychological pain of these patients and suggests candidate diagnostic criteria for DSM-V.