Individuals with Borderline Personality Disorder show larger preferred social distance in live dyadic interactions.

Personal space regulation is a key component of effective social engagement. Personal space varies among individuals and with some mental health conditions. Simulated personal space intrusions in Borderline Personality Disorder (BPD) reveal larger preferred interpersonal distance in that setting. These findings led us to conduct the first test of live interpersonal distance preferences in symptoms in BPD. With direct observation of subjects' personal space behavior in the stop-distance paradigm, we found a 2-fold larger preferred interpersonal distance in BPD than control (n = 30, n = 23). We discuss this result in context of known biology and etiology of BPD. Future work is needed to identify neural circuits underlying personal space regulation in BPD, individual differences in preferred interpersonal distance in relation to specific symptoms and relationship to recovery status.

Psychometrics of social cognitive measures for psychosis treatment research.

Social cognition represents an important treatment target, closely linked to everyday social function. While a number of social cognitive interventions have recently been developed, measures used to evaluate these treatments are only beginning to receive psychometric scrutiny. Study goals were to replicate recently-published psychometrics for several social cognitive measures, and to provide information for additional social cognitive measures not included in recent reports. Forty-eight outpatients with psychotic-spectrum disorders completed measures of emotion perception, theory of mind, and attributional bias on two occasions, one month apart. Measures were tested for distributional characteristics, test-retest reliability, utility as a repeated measure, and relationship to symptoms and functioning. For a subgroup of participants, information about sensitivity to social cognitive treatment was also available. We replicated aspects of prior work, including largely favorable psychometric characteristics for the Bell-Lysaker Emotion Recognition Task, and promising but weaker characteristics for The Awareness of Social Inferences Test subscales and Reading the Mind in the Eyes Task. The Hinting Task had adequate test-retest statistics but a more pronounced ceiling effect. Ambiguous Intentions and Hostility Questionnaire data showed evidence of validity but were limited by inconsistency over time. Our results strongly support the Davos Assessment of Cognitive Biases Scale for future evaluation as a social cognitive treatment outcome measure. Its scores were adequately distributed, consistent over time, related to symptoms and functioning, and sensitive to treatment effects. Other relatively novel assessments of attributional bias and theory of mind showed some promise, although more work is needed.

A midwifery-led in-hospital birth center within an academic medical center: successes and challenges.

The University of California San Diego Community Women's Health Program (CWHP) has emerged as a successful and sustainable coexistence model of women's healthcare. The cornerstone of this midwifery practice is California's only in-hospital birth center. Located within the medical center, this unique and physically separate birth center has been the site for more than 4000 births. With 10% cesarean delivery and 98% breast-feeding rates, it is an exceptional example of low-intervention care. Integrating this previously freestanding birth center into an academic center has brought trials of mistrust and ineffectual communication. Education, consistent leadership, and development of multidisciplinary guidelines aided in overcoming these challenges. This collaborative model provides a structure in which residents learn to be respectful consultants and appreciate differences in medical practice. The CWHP and its Birth Center illustrates that through persistence and flexibility a collaborative model of maternity services can flourish and not only positively influence new families but also future generations of providers.