Psychological and psychobiological responses to immediate early intervention in the emergency department: Case report of one-session exposure therapy for the prevention of PTSD.

Research suggests that exposure therapy provided in the hours immediately following trauma exposure may prevent PTSD development. This case report presents data on an at-risk for PTSD participant involved in a motor-vehicle crash that caused her severe distress. She received one session of exposure therapy in the emergency department (ED) as part of an ongoing randomized controlled study examining the optimal dose of exposure therapy in the immediate aftermath of trauma. PTSD and depression measures were collected at pre-treatment assessment and one- and three-month follow-up. Potential PTSD biomarkers were also examined. Psychophysiological reactions were measured using skin conductance data measured on an iPad during the exposure therapy session and the follow-up assessments. A fear-potentiated startle paradigm and an functional magnetic resonance imaging (fMRI) behavioral inhibition task were used at follow-up. The participant demonstrated subjective and psychophysiological extinction from pre- to post-imaginal exposure. At follow-up, she did not meet DSM-IV criteria for PTSD or demonstrate hyperarousal to trauma reminders and showed robust fear extinction and the ability to inhibit responses in an fMRI behavioral inhibition task. In line with previous early intervention for the prevention of PTSD studies, this case report supports the need for ongoing empirical research investigating the possibility that one session of exposure therapy in the ED may attenuate risk for PTSD. Furthermore, the current findings demonstrate psychophysiological extinction serving as a prognostic indicator of treatment response for PTSD early intervention to be an exciting avenue to explore in future systematic research.

The Downsides of Extreme Conscientiousness for Psychological Well-being: The Role of Obsessive Compulsive Tendencies.

Although conscientiousness exhibits positive relations with psychological well-being, theoretical and empirical work suggests individuals can be too conscientious, resulting in obsessive-compulsiveness, and therein less positive individual outcomes. However, the potential for curvilinearity between conscientiousness and well-being has been underexplored. We measured 912 subjects on facets of conscientiousness, obsessive-compulsive personality, and well-being variables (life satisfaction, job satisfaction, self-esteem, positive affect, negative affect, work stress). Methods of scoring included traditional sum-scoring, traditional item response theory (IRT), and a relatively new IRT approach. Structural models were estimated to evaluate curvilinearity. Results confirmed the curvilinear relationship between conscientiousness and well-being, and demonstrated that differential facet-level relationships underlie weaker curvilinearity at the general trait level. Consistency was found in the strength of relation between conscientiousness facets with their obsessive-compulsive variants and their contribution to decreased well-being. The most common association was that higher standing on conscientiousness facets was positively related to negative affect. Findings support the idea that extreme standing on facets of conscientiousness more strongly linked to their obsessive-compulsive variants contributed to lower well-being, highlighting the importance of considering alternative functional representations of the relationship between personality and other constructs. Future work should seek to further clarify the link between conscientiousness and negative affect.

Narcissism and United States' culture: The view from home and around the world.

The issue of Americans' levels of narcissism is subject to lively debate. The focus of the present research is on the perception of national character (PNC) of Americans as a group. In Study 1, American adults (N = 100) rated Americans as significantly more narcissistic than they perceived themselves and acquaintances. In Study 2, this finding was replicated with American college students (N = 322). PNC ratings of personality traits and externalizing behaviors revealed that Americans were perceived as disagreeable and antisocial as well. In Study 3, we examined the broader characteristics associated with PNC ratings (N = 183). Americans rated the typical American as average on a variety of characteristics (e.g., wealth, education, health, likability) and PNC ratings of narcissism were largely unrelated to these ratings. In Study 4 (N = 1,202) Americans rated PNCs for different prespecified groups of Americans; as expected, PNC ratings of narcissism differed by gender, age, and occupational status such that American males, younger Americans, and Americans working in high-visibility and status occupations were seen as more narcissistic. In Study 5 (N = 733), citizens of 4 other world regions (Basque Country, China, England, Turkey) rated members of their own region as more narcissistic than they perceived themselves, but the effect sizes were smaller than those found in the case of Americans' perceptions of Americans. Additionally, members of these other regions rated Americans as more narcissistic than members of their own region. Finally, in Study 6, participants from around the world (N = 377) rated Americans as more narcissistic, extraverted, and antagonistic than members of their own countries. We discuss the role that America's position as a global economic and military power, paired with a culture that creates and reifies celebrity figures, may play in leading to perceptions of Americans as considerably narcissistic.

Testing whether the DSM-5 personality disorder trait model can be measured with a reduced set of items: An item response theory investigation of the Personality Inventory for DSM-5.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes an alternative model of personality disorders (PDs) in Section III, consisting in part of a pathological personality trait model. To date, the 220-item Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) is the only extant self-report instrument explicitly developed to measure this pathological trait model. The present study used item response theory-based analyses in a large sample (n = 1,417) to investigate whether a reduced set of 100 items could be identified from the PID-5 that could measure the 25 traits and 5 domains. This reduced set of PID-5 items was then tested in a community sample of adults currently receiving psychological treatment (n = 109). Across a wide range of criterion variables including NEO PI-R domains and facets, DSM-5 Section II PD scores, and externalizing and internalizing outcomes, the correlational profiles of the original and reduced versions of the PID-5 were nearly identical (rICC = .995). These results provide strong support for the hypothesis that an abbreviated set of PID-5 items can be used to reliably, validly, and efficiently assess these personality disorder traits. The ability to assess the DSM-5 Section III traits using only 100 items has important implications in that it suggests these traits could still be measured in settings in which assessment-related resources (e.g., time, compensation) are limited.

An investigation of outcome expectancies as a predictor of treatment response for combat veterans with PTSD: comparison of clinician, self-report, and biological measures.

BACKGROUND: Outcome expectancy, or the degree to which a client believes that therapy will result in improvement, is related to improved treatment outcomes for multiple disorders. There is a paucity of research investigating this relation in regards to posttraumatic stress disorder (PTSD). Additionally, the bulk of the research on outcome expectancy and treatment outcomes has relied mostly on self-report outcome measures. METHODS: The relation between outcome expectancy on self-report measures, clinician-rated measures, and two biological indices (fear-potentiated startle and cortisol reactivity) of PTSD symptoms was explored. The sample included combat veterans (N = 116) treated with virtual reality exposure therapy for PTSD. RESULTS: Results supported a negative association between outcome expectancy and both self-report and clinician-rated symptoms at the conclusion of treatment, but outcome expectancy was related to the magnitude of change during treatment for self-report measures only. Outcome expectancy was unrelated to biological measures of treatment response. CONCLUSIONS: These findings suggest that outcome expectancy may be related to patient and clinician perceptions of outcomes, but not biological indices of outcome for PTSD.

Comparing the utility of DSM-5 Section II and III antisocial personality disorder diagnostic approaches for capturing psychopathic traits.

The current study compares the 2 diagnostic approaches (Section II vs. Section III) included in the Diagnostic and Statistical Manual for Mental Disorders-5 (DSM-5; American Psychiatric Association, 2013) for diagnosis of antisocial personality disorder (ASPD) in terms of their relations with psychopathic traits and externalizing behaviors (EBs). The Section III approach to ASPD, which is more explicitly trait-based than the Section II approach, also includes a psychopathy specifier (PS) that was created with the goal of making the diagnosis of ASPD more congruent with psychopathy. In a community sample of individuals currently receiving mental health treatment (N = 106), ratings of the 2 DSM-5 diagnostic approaches were compared in relation to measures of psychopathy, as well as indices of EBs. Both DSM-5 ASPD approaches were significantly related to the psychopathy scores, although the Section III approach accounted for almost twice the amount of variance when compared with the Section II approach. Relatively little of this predictive advantage, however, was due to the PS, as these traits manifested little evidence of incremental validity in relation to existing psychopathy measures and EBs, with the exception of a measure of fearless dominance. Overall, the DSM-5 Section III diagnostic approach for ASPD is more convergent with the construct of psychopathy, from which ASPD was originally derived. These improvements, however, are due primarily to the new trait-based focus in the Section III ASPD diagnosis rather than the assessment of personality dysfunction or the inclusion of additional "psychopathy-specific" traits.

A test of the International Personality Item Pool representation of the Revised NEO Personality Inventory and development of a 120-item IPIP-based measure of the five-factor model.

There has been a substantial increase in the use of personality assessment measures constructed using items from the International Personality Item Pool (IPIP) such as the 300-item IPIP-NEO (Goldberg, 1999), a representation of the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992). The IPIP-NEO is free to use and can be modified to accommodate its users' needs. Despite the substantial interest in this measure, there is still a dearth of data demonstrating its convergence with the NEO PI-R. The present study represents an investigation of the reliability and validity of scores on the IPIP-NEO. Additionally, we used item response theory (IRT) methodology to create a 120-item version of the IPIP-NEO. Using an undergraduate sample (n = 359), we examined the reliability, as well as the convergent and criterion validity, of scores from the 300-item IPIP-NEO, a previously constructed 120-item version of the IPIP-NEO (Johnson, 2011), and the newly created IRT-based IPIP-120 in comparison to the NEO PI-R across a range of outcomes. Scores from all 3 IPIP measures demonstrated strong reliability and convergence with the NEO PI-R and a high degree of similarity with regard to their correlational profiles across the criterion variables (rICC = .983, .972, and .976, respectively). The replicability of these findings was then tested in a community sample (n = 757), and the results closely mirrored the findings from Sample 1. These results provide support for the use of the IPIP-NEO and both 120-item IPIP-NEO measures as assessment tools for measurement of the five-factor model.

A test of the construct validity of the elemental psychopathy assessment scores in a community sample of adults.

The Elemental Psychopathy Assessment (EPA) is a relatively new self-report measure of the basic traits associated with psychopathy. Using community participants (N = 104) oversampled for the presence of psychopathic traits, we examined the convergent and criterion validity of the EPA total and factor scores (i.e., Antagonism, Emotional Stability, Disinhibition, and Narcissism) in relation to self- and informant reports of psychopathy and the general personality dimensions of the HEXACO (Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, and Openness to Experience; Ashton & Lee, 2009), as well as self-reported scores on narcissism, Machiavellianism, and externalizing behaviors (EBs) such as antisocial behavior and aggression. The EPA total and factor scores manifested substantial positive correlations with self- and informant-reported psychopathy scores and dimensions from the HEXACO, narcissism, Machiavellianism, and EBs. The patterns of these relations became clearer and more differentiated when examined via regression analyses such that the EPA factors manifested differential relations with various aspects of psychopathy (e.g., EPA Antagonism was the only unique correlate of psychopathy traits related to callousness and manipulation). Overall, the EPA is a promising assessment tool given the breadth of its coverage, the flexibility with which it can be used (total score; 4-factor scores; 18 subscale scores), and its ties to a popular model of basic personality traits.

A test of two brief measures of the dark triad: the dirty dozen and short dark triad.

There has been a substantial increase in the simultaneous study of 3 related constructs--psychopathy, Machiavellianism, and narcissism--since being termed the dark triad (DT; Paulhus & Williams, 2002). Growing interest in the DT has led to the development of 2 short, efficient measures that reduce the number of items typically used from 124 to 12 (Dirty Dozen, or DD; Jonason & Webster, 2010) and 27 (Short Dark Triad, or SD3; Jones & Paulhus, in press), respectively. Using a community sample collected online (N = 287), we examined the convergent, discriminant, incremental, and criterion validity of scores from 2 brief measures of the DT. In general, scores from the SD3 scales manifested stronger convergent and incremental validity in relation to longer, more established measures of the DT constructs. Scores from both brief DT measures evidenced adequate discriminant validity as well as criterion validity in relation to traits from the five-factor model. However, the SD3 Narcissism Scale appears to assess primarily the grandiose aspects of this construct, whereas the DD captures both vulnerable and grandiose features of narcissism. Overall, if a short measure of the DT is required, the SD3 yields data that are more consistent with these constructs as they are measured using more established and validated measures.

An examination of the correlates of fearless dominance and self-centered impulsivity among high-frequency gamblers.

The Psychopathic Personality Inventory (PPI) is a commonly used assessment of psychopathy. Questions have been raised, however, regarding the validity of its Fearless Dominance (FD) factor. In the current study, the correlations manifested by FD and Self-centered Impulsivity (ScI) in relation to external criteria were examined in a sample of gamblers. Two key hypotheses were also tested: (a) does FD perform differently when paired with high scores on ScI, and (b) does FD serve as an index of narcissism. As expected, FD and ScI manifested a divergent pattern of correlations such that only ScI was associated with psychopathology or impairment. FD's relations with the external criteria were not generally moderated by scores on ScI. FD was significantly correlated with narcissism, but the two differed such that only narcissism was associated with any degree of maladaptivity. It remains unclear whether FD should be considered a core component of psychopathy.