Logistic Regression With Machine Learning Sheds Light on the Problematic Sexual Behavior Phenotype.

OBJECTIVES: There has been a longstanding debate about whether the mechanisms involved in problematic sexual behavior (PSB) are similar to those observed in addictive disorders, or related to impulse control or to compulsivity. The aim of this report was to contribute to this debate by investigating the association between PSB, addictive disorders (internet addiction, compulsive buying), measures associated with the construct known as reward deficiency (RDS), and obsessive-compulsive disorder (OCD). METHODS: A Canadian university Office of the Registrar invited 68,846 eligible students and postdoctoral fellows. Of 4710 expressing interest in participating, 3359 completed online questionnaires, and 1801 completed the Mini-International Neuropsychiatric Interview. PSB was measured by combining those screening positive (score at least 6) on the Sexual Addiction Screening Test-Revised Core with those self-reporting PSB. Current mental health condition(s) and childhood trauma were measured by self-report. OCD was assessed by a combination of self-report and Mini-International Neuropsychiatric Interview data. RESULTS: Of 3341 participants, 407 (12.18%) screened positive on the Sexual Addiction Screening Test-Revised Core. On logistic regression, OCD, attention deficit, internet addiction, a family history of PSB, childhood trauma, compulsive buying, and male gender were associated with PSB. On multiple correspondence analysis, OCD appeared to cluster separately from the other measures, and the pattern of data differed by gender. CONCLUSIONS: In our sample, factors that have previously been associated with RDS and OCD are both associated with increased odds of PSB. The factors associated with RDS appear to contribute to a separate data cluster from OCD and to lie closer to PSB.

Personality Assessment and Psychotherapy Preferences: Congruence between Client Personality and Therapist Personality Preferences.

Consideration of client preferences has been emphasized as important to therapeutic outcomes, such as treatment engagement and retention. Although studies have investigated several client and therapist characteristics associated with client preferences, few have considered whether people have preferences regarding a potential therapist's personality. The current study extended prior research on client preferences by examining the influence of participants' Big Five personality traits on preferences for therapist personality characteristics utilizing latent profile analysis. We expected congruence between client personality traits and preferred psychotherapist personality traits. In both undergraduate and community samples, results indicated that participants generally prefer a psychotherapist with personality characteristics similar to their own. Our findings establish the presence of preferences based on personality factors and have implications for future research directions and the role of personality assessment in routine clinical practice.

Examining Configural, Metric, and Scalar Invariance of the Pain Catastrophizing Scale in Native American and Non-Hispanic White Adults in the Oklahoma Study of Native American Pain Risk (OK-SNAP).

INTRODUCTION: Native Americans (NAs) have a higher prevalence of chronic pain than other US racial/ethnic groups, but the mechanisms contributing to this pain disparity are under-researched. Pain catastrophizing is one of the most important psychosocial predictors of negative pain outcomes, and the Pain Catastrophizing Scale (PCS) has been established as a reliable and valid measure of the pain catastrophizing construct. However, before the PCS can be used to study pain risk in NAs, it is prudent to first determine whether the established 3-factor structure of the PCS also holds true for NAs. METHODS: The current study examined the measurement (configural, metric, and scalar) invariance of the PCS in a healthy, pain-free sample of 138 NA and 144 non-Hispanic white (NHW) participants. RESULTS: Results suggest that the previously established 3-factor solution fits for both groups (configural invariance) and that the factor loadings were equivalent across groups (metric invariance). Scalar invariance was also established, except for 1 minor scalar difference in a single threshold for item 3 (suggesting NHWs were more likely to respond with a 4 on that item than NAs). DISCUSSION: Results provide additional evidence for the psychometric properties of the PCS and suggest it can be used to study pain catastrophizing in healthy, pain-free NA samples.

Psychopathic Personality Traits in the Military: An Examination of the Levenson Self-Report Psychopathy Scales in a Novel Sample.

The Levenson Self-Report Psychopathy Scale is a short, self-report measure initially developed to assess psychopathic traits in noninstitutionalized samples. The present study aimed to explore factor structure and convergent and discriminant validity of the Levenson Self-Report Psychopathy Scale in a large U.S. military sample (90.7% Army National Guard). Factor analytic data, regression, and correlational analyses point to the superiority of Brinkley, Diamond, Magaletta, and Heigel's three-factor model in this sample. Implications for theory and the study of psychopathic personality traits in a military sample are discussed.

Effects of a Brief Mindfulness Induction on Death-Related Anxiety.

This study examined effects of a mindfulness induction on proximal and distal defense responses to mortality salience and negative affect. Three experimental conditions were included: mindfulness, mind-wandering, and worrying. Participants in the mindfulness condition underwent a mindfulness induction at the experiment's outset, while participants in the other two conditions underwent a mind-wandering or worry induction. Inductions involved following guided audio instructions presented via headphones. All conditions (N = 77) underwent a mortality salience induction after experimental manipulation, involving a written exercise pertaining to one's death. Results indicated fewer proximal responses in the mindfulness and mind-wandering groups, compared with the worrying group, but no differences in distal responses. Negative affect was lower in the mindfulness group than in the worrying group following mortality salience. Results suggest that mindfulness exercises effectively buffer against negative affect and some responses to mortality salience, although these effects are not different from those of mind-wandering.

Development and Validation of the Pediatric Diabetes Routines Questionnaire for Adolescents.

This study describes the development and psychometric evaluation of an adolescent self-report version of the Pediatric Diabetes Routines Questionnaire (PDRQ:A), a measure of diabetes-specific routines for youth with type 1 diabetes, and further validation of the parent-version (PDRQ:P) in an adolescent sample. Participants included 120 parent-adolescent dyads (ages 12-17) and an additional 24 parents who completed measures of diabetes-specific adolescent routines, general adolescent routines, diabetes self-care, and family support of youth diabetes care. The PDRQ:P/A demonstrated good internal consistency, test-retest reliability, and parent-child agreement, and adequate validity coefficients. Confirmatory factor analysis supported a one-factor model. Promising results were obtained. The PDRQ:P/A is a clinically feasible parent- and self-report measure that can provide valuable information regarding how frequently adolescents engage in their diabetes management tasks in a consistent manner. Addition of an adolescent report format will enhance the utility of the measure for clinical and research use.

Burdensomeness, Belongingness, and Capability: Assessing the Interpersonal-Psychological Theory of Suicide With MMPI-2-RF Scales.

Given the emerging body of literature demonstrating the validity of the interpersonal-psychological theory of suicide (IPTS), and the importance of increasing our understanding of the development of risk factors associated with suicidal behavior, it seems worthwhile both to expand IPTS research via Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) correlates and to expand the availability of methods by which to assess the constructs of the IPTS. The present study attempted to do so in a large adult outpatient mental health sample by (a) inspecting associations between the IPTS constructs and the substantive scales of the MMPI-2-RF and (b) exploring the utility of MMPI-2-RF scale-based algorithms of the IPTS constructs. Correlates between the IPTS constructs and the MMPI-2-RF scales scores largely followed a pattern consistent with theory-based predictions, and we provide preliminary evidence that the IPTS constructs can be reasonably approximated using theoretically based MMPI-2-RF substantive scales. Implications of these findings are discussed.

Self-esteem instability and humor styles: does the stability of self-esteem influence how people use humor?

The purpose of the present study was to examine whether self-esteem instability moderated the association between self-esteem level and the use of humor. This was accomplished by examining the associations that humor styles had with self-esteem level and self-esteem instability among 499 undergraduates. The results of the present study show that self-esteem instability moderated the association between self-esteem level and humor styles such that individuals with stable high self-esteem reported the highest levels of affiliative humor as well as the lowest levels of aggressive and self-defeating humor. These results suggest that individuals with stable and unstable forms of self-esteem employ different styles of humor.

Hope and the interpersonal-psychological theory of suicidal behavior: replication and extension of prior findings.

The interpersonal-psychological theory of suicidal behavior (IPTS; Joiner, 2005) posits that suicidal behavior occurs when an individual has a desire for death (due to the combination of perceived burdensomeness and thwarted belongingness) in addition to an acquired capacity for suicide, which is present when the individual has a low fear of death and high pain tolerance. Previous research has demonstrated an expected negative relation between trait hope and perceived burdensomeness and thwarted belongingness, as well as a more perplexing finding that hope is positively associated with the acquired capability. In a sample of 230 college students, measures of the three components of the IPTS were administered, along with measures of hope, depression, and painful and/or provocative events. Hierarchical regression analyses replicated the previously found associations between hope and burdensomeness and belongingness while controlling for depression and demographic variables. The positive association between hope and acquired capacity was also replicated, but a mediation analysis demonstrated that the effect was statistically accounted for by distress tolerance. The results further support the incremental validity of hope as a consideration in suicide risk assessments and suggest that hope may serve as a protective factor with respect to suicidal desire.

Development and psychometric evaluation of the Revised Protective Behavioral Strategies Scale.

Psychometrically sound measures of the use of protective behavioral strategies are only in a development stage at this point. One such measure, the Protective Behavioral Strategies Scale (PBSS), has shown particular promise in this area. This study aimed to build on the PBSS by (a) evaluating revisions to the measure intended to yield more reliable scores from the serious harm reduction (SHR) subscale and (b) evaluating the factor structure of the revised measure and the stability of the factor structure across White non-Hispanics and African Americans and between women and men using multigroup confirmatory factor analysis. Three additional items were added to the SHR subscale, which improved its functioning. A 2-factor model best fit the data, and the factor structure of the measure was invariant across White non-Hispanic and African American men and women. Suggestions for further refinement of the measure and future research are provided.

Trouble ahead, trouble behind: Narcissism and early maladaptive schemas.

Narcissism is a multifaceted construct that is inconsistently defined and assessed between clinical psychology and social-personality psychology. The purpose of the present study was to examine the similarities and differences in the cognitive schemas underlying various forms of narcissism. This was accomplished by examining the associations of normal and pathological forms of narcissism with the early maladaptive schemas. The results showed important similarities in these associations (e.g., all of the narcissism scales were positively associated with the entitlement schema) as well as differences (e.g., vulnerable narcissism was the only form of narcissism that was positively associated with subjugation). Discussion focuses on the implications of these results for the ways in which individuals with these forms of narcissism perceive and navigate their social environments.

The Anxiety Sensitivity Index--Revised: confirmatory factor analyses, structural invariance in Caucasian and African American samples, and score reliability and validity.

The most commonly used measure of anxiety sensitivity is the 36-item Anxiety Sensitivity Index-Revised (ASI-R). Exploratory factor analyses have produced several different factors structures for the ASI-R, but an acceptable fit using confirmatory factor analytic approaches has only been found for a 21-item version of the instrument. We evaluated the fit of all published factor models for the 36- and 21-item ASI-R, modified the hierarchical model using an approach that does not eliminate items, evaluated the invariance of the modified model across Caucasian and African-American subsamples, and compared the reliability and validity of the 36-item and 21-item versions. The 21-item version of the ASI-R fit a four factor model, as did the 36-item version after several meaningful model modifications. The modified 36-item model was replicable in independent cases and its structural properties were generally invariant across race. Scores from the 36-item version exhibited superior reliability and criterion-related validity.

Taxometric analysis of biceps femoris EMG following electrocutaneous stimulation over the sural nerve: determining the latent structure of the nociceptive flexion reflex (NFR).

The nociceptive flexion reflex (NFR) is a polysynaptic withdrawal reflex typically assessed from biceps femoris electromyogram (EMG) following noxious stimulation of the ipsilateral sural nerve. Electrophysiological evidence suggests the reflex is elicited following the activation of small diameter A-delta afferents. As a result, the NFR is assumed to be a categorically distinct construct that emerges from EMG activity only following nociceptor activation. Despite the widespread use of the NFR in pain research, there has been little attempt to verify the latent structure of the NFR. The present study used "coherent cut kinetics" taxometric analyses to examine whether the latent structure of biceps femoris EMG reflects the taxonic structure that would be predicted from electrophysiological evidence. To achieve this end, preliminary analyses first compared different methods of scoring NFR magnitude. Results suggested the presence of a taxon in the covariance of biceps femoris EMG and stimulus intensity that is likely to be the NFR. Furthermore, preliminary analyses suggested the best method of scoring NFR magnitude was using Cohen's d. Implications of these results are discussed.

Health anxiety, rumination, and negative affect: a mediational analysis.

OBJECTIVE: A ruminative cognitive style has been associated with a variety of mood and anxiety disorders. This study examined whether a ruminative cognitive style is associated with health anxiety, even when controlling for negative affect. METHOD: College students (N=198) completed measures of health anxiety, rumination, and negative affect and estimated the likelihood that ambiguous symptoms were indicative of catastrophic illnesses. These data were analyzed using structural equation modeling. RESULTS: A ruminative cognitive style was both indirectly associated with health anxiety via its strong relationship with negative affect and was also directly associated with health anxiety. Furthermore, catastrophizing ambiguous symptoms was also directly related to health anxiety. CONCLUSION: High health anxiety individuals not only hold dysfunctional beliefs about health and illness but they also think about their distress in a ruminative manner. A more complete cognitive-behavioral model of health anxiety should include not only cognitive contents ("what") but also cognitive style ("how").

The latent structure of anxiety sensitivity--revisited.

Anxiety sensitivity has been implicated as a risk factor for the development and maintenance of panic and other anxiety disorders. Although researchers have generally assumed that anxiety sensitivity is a dimensional, rather than categorical, variable, recent taxometric research has raised questions concerning the accuracy of this assumption. The present study examined the latent structure of anxiety sensitivity by applying four taxometric procedures (MAXEIG, MAXCOV, MAMBAC, and L-Mode) to data collected from two large nonclinical samples (n = 1,025 and n = 744) using two distinct measures of anxiety sensitivity (Anxiety Sensitivity Profile and Anxiety Sensitivity Index-Revised). In contrast to previous taxometric analyses of anxiety sensitivity, results of the present research provided convergent evidence for a latent anxiety sensitivity dimension. Several potential explanations for the discrepancy between these findings and those of previous research are discussed, as well as the implications of these findings for the conceptualization and measurement of anxiety sensitivity.

Longitudinal effects of hope on depression and anxiety: a latent variable analysis.

This study tested the prospective effects of hope on depression and anxiety using a longitudinal design. A sample of 522 college students completed self-report measures of hope, depression, and anxiety at three time points, with 1-month delays between administrations. Structural equation modeling was employed to test two cross-lagged panel models of the reciprocal effects of the Agency and Pathways components of hope on depression and anxiety. Results indicated statistically significant negative effects for the Agency component of hope on later depression but no unique effect of the Pathways component of hope on depression. Likewise, Agency showed a statistically significant negative effect on later anxiety, but again Pathways had no significant influence on anxiety. In both cases, neither depression nor anxiety demonstrated any longitudinal effects on either the Agency or Pathways components of hope. Implications of these findings are discussed, along with potential directions for future research.

An evaluation of the MMPI-2 and MMPI-a true response inconsistency (TRIN) scales.

The Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) True Response Inconsistency (TRIN) scales are measures of acquiescence and non-acquiescence included among the standard validity scales on these instruments. The goals of this study were to evaluate the effectiveness of these scales in detecting varying degrees of acquiescence and non-acquiescence and to evaluate cutoff scores for clinical use. After the removal of invalid protocols from the MMPI-2 and MMPI-A normative samples, each normative sample was randomly divided in half. For each measure, one half of the normative sample served as a comparison group and the other half was modified with increasing degrees (10%, 20%, 30%, 40%, and 50%) of randomly inserted true or false responses. The results for a 9.1% base rate of acquiescence or non-acquiescence provide support for TRIN cutoff scores at or near those presented in the MMPI-A and MMPI-2 manuals.

An efficient method of identifying major depression and panic disorder in primary care.

The research literature is replete with evidence of and concerns about the prevalence and undertreatment of mental disorders in primary care. Although screening, on its own, may not directly affect clinical outcomes, it is still the most efficient and effective way to identify psychologically distressed patients for either research purposes or to provide patients with or refer patients to appropriate care. The current study sought to establish the utility of the MHI-5 for the detection of patients suffering from major depression or panic disorder, two of the most common psychiatric conditions seen in primary care settings. This study was conducted in a family medicine clinic and 246 adult outpatients participated. Patients completed the Mental Health Index-5 (MHI-5) as the screening measure and the PRIME-MD Patient Health Questionnaire (PHQ) as the diagnostic instrument. ROC analyses indicated that a cut-off score of 23 on the MHI-5 yielded a sensitivity of 91% and a specificity of 58% for predicting provisional diagnoses of major depression or panic disorder from the PHQ. Using a single item to screen for a PHQ diagnosis of major depression yielded a sensitivity of 88% and a specificity of 62% and a second question had a sensitivity of 100% and specificity of 63% for PHQ diagnosis of panic disorder. These results indicate that it is possible to use a small number of items to efficiently and effectively screen for mental disorders affecting a significant portion of primary care patients.

Principal components analyses of the MMPI-2 PSY-5 scales: identification of facet subscales.

The Personality Psychopathology Five (PSY-5) is a five-factor personality trait model designed for assessing personality pathology using quantitative dimensions. Harkness, McNulty, and Ben-Porath developed Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scales based on the PSY-5 model, and these scales were recently added to the standard MMPI-2 profile. Although the PSY-5 constructs are multidimensional in definition, explicit subscales for the broader PSY-5 scales have not been developed. The primary goals of this study were to empirically derive subscales for the MMPI-2 PSY-5 scales using principal components analysis (PCA) and to replicate these subscales with an independent sample. Individual PSY-5 scales were analyzed using PCA with an initial sample of 4,325 MMPI-2 protocols, and the component structure was replicated with a second sample of 4,277 MMPI-2 protocols. A third sample of 4,327 protocols was used to further evaluate the internal consistency reliabilities of the resulting facet subscales. Overall, replicable facet subscales were identified with content areas that are largely congruent with Harkness and McNulty's model.