Natural course of cannabis use disorders.

BACKGROUND: Despite its importance as a public health concern, relatively little is known about the natural course of cannabis use disorders (CUDs). The primary objective of this research was to provide descriptive data on the onset, recovery and recurrence functions of CUDs during the high-risk periods of adolescence, emerging adulthood and young adulthood based on data from a large prospective community sample. METHOD: Probands (n = 816) from the Oregon Adolescent Depression Project (OADP) participated in four diagnostic assessments (T1-T4) between the ages of 16 and 30 years, during which current and past CUDs were assessed. RESULTS: The weighted lifetime prevalence of CUDs was 19.1% with an average onset age of 18.6 years. Although gender was not significantly related to the age of initial CUD onset, men were more likely to be diagnosed with a lifetime CUD. Of those diagnosed with a CUD episode, 81.8% eventually achieved recovery during the study period. Women achieved recovery significantly more quickly than men. The recurrence rate (27.7%) was relatively modest, and most likely to occur within the first 36 months following the offset of the first CUD episode. CUD recurrence was uncommon after 72 months of remission and recovery. CONCLUSIONS: CUDs are relatively common, affecting about one out of five persons in the OADP sample prior to the age of 30 years. Eventual recovery from index CUD episodes is the norm, although about 30% of those with a CUD exhibit a generally persistent pattern of problematic use extending 7 years or longer.

Disordered eating behaviors and reward sensitivity.

This research evaluated the extent to which reward sensitivity demonstrated associations with binge and purge behavior frequency. A verbal operant conditioning task designed to assess conditionability to reward cues was administered to a sample of 34 women who exhibited disordered eating patterns for at least I month prior to study participation. Reward sensitivity significantly correlated with the average weekly frequency of purge (r = 0.44) but not binge behaviors. These findings suggest that reward sensitivity has some associations with aspects of disordered eating and therefore may have relevance for theories on the maintenance of some forms of eating disorder-related behavior.

Issues in the assessment and conceptualization of personality disorders.

This article reviews several current issues associated with the definition and assessment of personality disorders (PDs) as defined in the third and fourth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Specifically reviewed are issues associated with classification, PD conceptualizations, and the assessment of these disorders. DSM PD categories are also reviewed in terms of their psychometric properties. A review of the PD assessment literature suggests that DSM conceptualizations and definitions of PDs are problematic at both conceptual and quantitative levels. This article concludes with suggestions for possible alternative approaches to and modifications of DSM PD assessment.

Construct validity of repression: a dimensional analysis.

This study explored the construct validity of repression through an examination of the interrelations among indicators identified in previous research as being associated with the construct. Three behavioral tasks, i.e., dichotic listening task, recall of past events task, and Stroop task, modified in accordance with previous research to tap into repressive tendencies, and one questionnaire (Byrne Repression-Sensitization Scale) were administered to a sample of 62 university undergraduates. A series of correlational analyses provided weak to moderate support for the construct validity of repression.

Behavioral assessment of personality disorders.

This article examines the definition of personality disorders (PDs) from a functional analytical framework and discusses the potential utility of such a framework to account for behavioral tendencies associated with PD pathology. Also reviewed are specific behavioral assessment methods that can be employed in the assessment of PDs, and how information derived from these assessments may be linked to specific intervention strategies.

Functional analysis and response covariation in the assessment of personality disorders: a reply to Staats and to Bissett and Hayes.

In this reply to Bissett and Hayes (this issue) and Staats (this issue) we address critical comments in response to our initial proposal and highlight points of agreement. The overall thesis of our reply is that classification schemes based on nomothetic response covariation, such as DSM, complement, but do not substitute for, an idiographically-based functional analysis and behavioral assessment. In the context of our reply, we address the following primary concerns raised by Bissett, Hayes, and Staats: (a) we are essentially proposing the melding of two theoretically incongruent approaches, and that such a melding is inherently not viable or useful; (b) the behavior analytic approach cannot account for personality or psychological constructs; and (c) that categories based on topography do not have demonstrated treatment utility. We also discuss points of agreement with our respondents: (d) a theoretically-based descriptive classification system is required to ultimately advance clinical science, (e) the DSM personality disorder classification system, to remain viable, needs a stronger empirical base; and (f) that alternatives to DSM classification that more strongly emphasize behavioral principles are in need of development.

Depressive symptoms as a function of trait anxiety and impulsivity.

This research examined differences in depressive symptomatology as assessed by the Beck Depression Inventory (BDI) in a large sample (n = 267) of young adults who scored in the upper ranges on trait anxiety and/or impulsivity measures. Given previous research which has identified anxiety and impulsivity as important organizing dimensions for personality, personality pathology, and behavior, a goal of this present research was to identify specific depressive symptoms that were uniquely associated with either anxiety or impulsivity. Results indicated that the presence of impulsivity without coexisting anxiety was associated with the endorsement of fewer depressive symptoms and lower BDI scores. An examination of specific depressive symptoms as a function of anxiety and impulsivity revealed three general response patterns across 20 of the 21 BDI items.