Clinical Utility of the Personality Assessment Inventory in Predicting Symptom Change and Clinical Outcome in an Inpatient Chemical Dependency Rehabilitation Unit.

Newly admitted inpatients in a 28-day chemical dependency rehabilitation unit completed the Personality Assessment Inventory (PAI) at admission and measures of clinical symptomatology (Symptom Checklist-90-Revised) and clinical outcome (Schwartz Outcome Scale-10) at admission and discharge. PAI drug and alcohol scale scores were clinically elevated in this inpatient sample. Modest elevations were found on scales measuring stress, depression, and antisocial and borderline features. Lower scores on most PAI clinical scales were associated with greater symptom reduction and improved psychological well-being, while controlling for pretreatment levels. Multivariate analysis controlling for contributions of clinical scales measuring borderline, depressive, and antisocial traits, as well as pretreatment outcome measures, demonstrated that the PAI Suicidal Ideation and Treatment Rejection scales were significant individual predictors of symptom reduction and improved psychological well-being, respectively, although the treatment scales as a group failed to incrementally contribute to prediction. Overall, the results support the clinical utility of using the PAI to predict clinical improvement among inpatients treated for substance use disorders.

Personality profiles of patients with alcohol use disorder and opioid use disorder in an inpatient treatment setting.

The present study aimed to compare personality profiles of alcohol use disorder and opioid use disorder patients in an inpatient chemical dependency rehabilitation unit using a multidimensional personality inventory, the Personality Assessment Inventory (PAI). Ninety-six patients meeting DSM-IV-TR diagnoses for alcohol use or opioid use disorders completed the PAI at admission. Results revealed largely normative patterns across most PAI scales, though alcohol use disorder patients showed clinically elevated scores on Alcohol Problems and Drug Problems, and opioid use disorder patients showed clinical elevations on Antisocial Features, Borderline Features, and Drug Problems. Opioid use disorder patients showed, on average, significantly higher scores than alcohol use disorder patients on Borderline Features, Antisocial Features, Drug Problems, and Suicidal Ideation. Alcohol use disorder patients showed significantly higher scores than opioid use disorder patients only on Alcohol Problems. Discriminant function analysis (DFA) showed discriminability between patient groups using the PAI clinical scales and treatment scales, highlighting higher levels of disturbed functioning among opioid use disorder patients with respect to clinical syndromes, especially borderline features, antisocial features, suicidal ideation, and anxiety. These findings underscore the need to tailor treatment recommendations to distinctive patterns of personality pathology, especially among opioid use disorder patients.

The Role of Gender as a Moderator of the Alliance-Outcome Link in Acute Inpatient Treatment of Severely Disturbed Youth.

Research is needed to further examine the role of treatment alliance or engagement among child and adolescent patients in inpatient psychiatric settings. In this study, 72 newly admitted patients on an inpatient adolescent psychiatric unit completed measures of symptom severity and treatment alliance. Female patients showed greater symptom severity at both admission and discharge. Residualized gain score analysis showed that male gender predicted greater symptom reduction. Treatment alliance also predicted greater symptom reduction, but only among women. These results suggest that alliance or engagement with acute inpatient psychiatric services may play a more important role among women than men in predicting symptomatic change in severely disturbed adolescents. Copyright © 2016 John Wiley & Sons, Ltd.

Alcohol consumption in relation to residence status and ethnicity in college students.

The present study examined the roles of gender, ethnicity, and residence status in an ethnically diverse sample of undergraduate students who completed the Core Alcohol and Drug Survey. Gender, ethnicity, and residential status were associated with likelihood of binge drinking among students who reported consuming alcohol (non-Hispanic). White students were more likely to report using alcohol than Black students and Asian students. Ethnicity moderated the effects of both residence status and gender on alcohol consumption. Living with one's parents was associated with a lower likelihood of reported alcohol use among Hispanic students, but not among (non-Hispanic) White students. Hispanic women were more likely to report using alcohol than were Hispanic men, but no gender difference in likelihood of alcohol consumption was found among (non-Hispanic) White students.

Acculturation, enculturation, and perceptions of mental disorders in Asian Indian immigrants.

One hundred eighteen Asian Indian immigrants completed questionnaires assessing behavioral acculturation, values enculturation, and perceptions of the psychological and medical determinants of case descriptions of major depression and schizophrenia, as well as treatment-seeking recommendations and stigma associated with treatment seeking. Case vignettes depicted symptoms meeting the Diagnostic and Statistical Manual for Mental Disorders (4th ed., text revision, American Psychiatric Association, 2000) criteria for major depression and schizophrenia. Results revealed that responses to male case vignettes elicited lower levels of endorsement of psychological determinants and higher levels of endorsement of biological determinants in comparison to female case vignettes. Moreover, vignette gender moderated the relationship between behavioral acculturation and perceptions of the psychological basis of the disorders depicted in the vignettes. Both vignette gender and type of disorder moderated the relationship between years in the United States and perceptions of biological determinants. The study findings were consistent with traditional gender ideals among Asian Indians. Moreover, behavioral acculturation appeared to moderate traditional conceptions of masculinity toward greater recognition of the psychological bases of mental disorders.

Kant, cognitive psychotherapy, and the hardening of the categories.

Contemporary models of psychotherapy owe a considerable intellectual debt to philosophy, even though the contributions of philosophers to contemporary practice in the field often go unrecognized. A case in point is Kant's epistemology, which is foundational to cognitive approaches to psychotherapy. Here, it is argued that the rigid use of certain judgments represented in Kant's conceptual scheme underlies patterns of distorted or dysfunctional thinking associated with emotional disorders. Kantian judgments of necessity, disjunction, particularity and universality have counterpoints in contemporary conceptions of cognitive distortions. Moreover, Kantian epistemology has important therapeutic implications with respect to helping people with emotional disorders recognize and challenge rigidly held judgments or categories of understanding. The Kantian perspective also leads us to consider the cognitive frameworks or thought structures that underlie dysfunctional thinking patterns.

Risk factors associated with posttraumatic stress disorder symptomatology in HIV-infected women.

This study examined risk factors for posttraumatic stress disorder (PTSD) symptomatology in a sample of 102 HIV-positive women. The magnitude of HIV-related PTSD symptoms was associated with a greater number of HIV-related physical symptoms, more extensive history of pre-HIV trauma, less perceived availability of social support, greater degree of perceived stigma, and greater degree of negative life events. Hierarchical multiple regression analysis revealed three individual predictors of PTSD symptomatology: total impact of negative life events, total stigma score, and total number of present symptoms. Stigma emerged as the strongest individual predictor. Social support failed to moderate relationships between PTSD symptomatology and HIV-related physical symptoms and negative life events. These findings may inform helping professionals about risk factors associated with PTSD symptomatology in HIV-positive women.

Social constraints and distress among women at familial risk for breast cancer.

BACKGROUND: Despite literature finding support for the social cognitive processing model, which suggests that social constraints are related to distress, few studies have examined possible mediators of this effect; none have examined this relation among women with family histories of breast cancer (FH+). PURPOSE: This study was designed to examine possible effects of social constraints on psychological distress among FH+ women. METHODS: Six FH+ women (M age = 39.2 years) completed self-report measures of social constraints, avoidance, and general and cancer-specific distress. RESULTS: Multiple regression analyses revealed that social constraints were significantly related to both cancer-specific and general distress and that avoidance partially mediated the relation between social constraints and both types of distress. CONCLUSIONS: Theoretical and clinical implications of these findings are discussed.

The specificity of maternal disclosure of HIV/AIDS in relation to children's adjustment.

Disclosure experience of 58 HIV-seropositive women was examined as a multi-faceted process comprising eight variables: level, seriousness, breadth, frequency, source, secrecy, age at first disclosure, and time since disclosure. The majority of children (57%) were told that their mothers had HIV/AIDS and were given additional information about mothers' health (64%) including prognosis of potential death (68%). Most were disclosed to by their mothers (75%) and were not asked to keep disclosures secret (66%). For most (68%) discussion regarding mother's health was infrequent. Children, on average, were first disclosed information at age 7 and had been aware of information for 3 years. Disclosure characteristics were related to demographics of mothers and children. Hierarchical multiple regression analyses showed that children asked to keep disclosures secret tended to display more behavior problems than children not asked to keep secrets. However, the specificity of disclosure did not otherwise predict children's adaptive functioning.