Managing Alzheimer's Dementia with Homecare in an African American Family During the COVID Pandemic.

In the US, over 95 million people have been infected with COVID and over 1 million have died. 10% of Californians are infected with COVID with higher rates reported among Latinx, Pacific Islanders, and low-income people. Higher death rates have been reported among African Americans. People living with Alzheimer's Disease (AD) are also more likely to be infected with COVID. African Americans with AD have three times the COVID rate of Whites. Homecare workers who care for moderate to severe AD in home and community settings are frontline essential workers who manage complex AD-related problems like incontinence. Little is known about communication and problem-solving processes between homecare workers and families of people with AD to manage continence at home. This report describes the challenges facing homecare workers illustrated by an African American family caring for a relative with advanced AD during pandemic.

Interpersonal Decentering and Interpersonal Problems: Testing the Multi-Method Utility of Person-Situation Interactions in Thematic Apperception Tests.

Mature interpersonal decentering is a form of social cognitive role-taking involving reflective thought about one's interpersonal relationships. Previous research examining main effects for persons, card situation content, story content, and person-card interactions found more mature decentering in stories about heterosexual romantic-pull Thematic Apperception Test (TAT) cards (HRC) as compared with stories about nonromantic cards (NRC). To see whether differences in means corresponded to differential criterion validity, this multi-method study examined Inventory of Interpersonal Problems circumplex (IIP-C) scores associated with young adults' decentering maturity and deficits, comparing correlations with IIP-C scores of decentering scores calculated from HRC versus NRC. Similarly, to test the effect of story content, IIP-C scores were correlated with decentering scores calculated from stories having romantic versus nonromantic story content. Using circumplex statistical tests, decentering deficits were associated with domineering/vindictive interpersonal problems, and mature decentering with nonassertive/exploitable problems. Men who reported more exploitable problems decentered more maturely across all situations. Women who decentered more maturely in response to HRC reported more socially avoidant problems, whereas those who decentered more maturely to NRC reported more exploitable problems. Results for romantic versus nonromantic story content were largely uninterpretable (did not meet circumplexity assumption). Findings might assist clinicians' card selection.

Object relations assessment predicts outpatients' attrition, early working alliance and psychotherapy process.

This study investigated the predictive utility of assessing clients' object relations functioning to prognosticate therapy dropout, quality of the early working alliance and psychotherapy process events reported by clients after their first five sessions. Clients accepting a recruitment invitation were administered the thematic apperception test (TAT) shortly after intake, and those still in treatment three to four sessions later rated the working alliance and psychotherapy process events. Participants were 47 clients beginning psychotherapy with advanced doctoral practicum students at a university-based community-serving training clinic. The Social Cognition and Object Relations Scales (SCORS), an object relations scoring system for TAT stories, was used to assess object relations functioning. The California Psychotherapy Alliance Scales-Patient form measured four dimensions of the alliance. The Therapy Orientation Process Scales, created from the Psychotherapy Process Q-set, measured clients' perceptions of therapy process events as involving relatively more psychodynamic or cognitive behavioural techniques. The SCORS significantly predicted remaining in therapy, client ratings of stronger working alliance and typical therapy process as more psychodynamic than cognitive behavioural. SCORS complexity of representations and capacity for emotional investment in relationships scales were the strongest predictors, especially of the patient commitment facet of the alliance. The findings suggest that (1) beginning psychotherapy with object relations assessment can be useful for treatment planning and (2) the relationship between clients' object relations functioning, working alliance and greater sensitivity to psychodynamic than to cognitive behavioural interventions depends on the aspect of object relations that is being assessed.

Acculturation processes and mental health of Asian Indian women in the United States: A mixed-methods study.

Acculturation theories and research find that both new culture acquisition and heritage culture attachment are associated with positive outcomes. However, gender-related analyses are rare. In this mixed-method study of 73 Asian Indian American women who were first- or second-generation immigrants from Kerala, India, those classified as behaviorally bicultural, assimilated, separated, or marginalized did not differ significantly in well-being. Being older and married was related to higher self-esteem; unmarried women reported more Kerala attitudinal marginalization. With age, marital status, immigrant generation, and both cultural behavioral orientations controlled, Kerala attitudinal marginalization (but not Anglo attitudinal marginalization) correlated moderately with both lower self-esteem and more severe depressive symptoms. Content analysis of open-ended question data suggested associations among more intricate and multifaceted acculturation processes and psychological well-being via the rewards and challenges the women described. Attaining the "best of both worlds" that some mentioned meant selective adoption and rejection of facets of each culture: family connectedness and control, freedom and moral decline, opportunity, and discrimination. For these women, status-related characteristics (being younger and single representing lower status), discrimination experiences, and attitudinal rejection of their heritage culture (although it accords women lower status than men) had negative psychological outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Emotional Approach Coping Scales in Chinese: Validation, Psychometric Properties, and Measurement Invariance.

American and Chinese literatures on emotion-focused coping show inconsistent associations with distress, attributable to criterion contamination problems with measures. This problem was remedied by the American Emotional Approach Coping (EAC) scales, which are not confounded with distress; however, there is no Chinese counterpart. The EAC is of theoretical interest for exploring cross-cultural models of psychological and physical health since it allows one to measure emotion processing (theoretically lowering distress) without emotion expression (maintaining collectivist group harmony). In the present study, the EAC scales were translated into Chinese and their factorial, criterion, and discriminant validity as well as measurement invariance of the two versions were examined in 353 Chinese and 491 Americans. Previous validational findings for American EAC scales were replicated and configural and metric invariance demonstrated, supporting the comparable reliability and validity of the Chinese EAC scales. Chinese showed fewer gender differences than Americans.

Validating the Structure of the Depression and Somatic Symptoms Scale.

BACKGROUND: Depressed primary care patients may present with somatic symptoms first, complicating differential diagnosis. Clinicians have few instruments for assessing this comorbidity. OBJECTIVE: To evaluate the psychometrics of the translated Chinese Depression and Somatic Symptoms Scale (DSSS) in Americans. PROCEDURES: A total of 491 nonclinical but symptomatic ethnically-diverse individuals completed the DSSS and Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS: Factor analysis yielded 2 distinct factors: depression and somatic symptoms. DSSS and subscales showed internal consistency, reliability, and convergent validity with CES-D and subscales. CONCLUSIONS: These results support DSSS's trustworthiness for US populations. Using DSSS for patient assessment may assist diagnosis and inform interventions.

The Narrative Arc of TATs: Introduction to the JPA Special Section on Thematic Apperceptive Techniques.

The past decade has seen important developments in thematic apperceptive techniques (TATs), with the creation of new card sets having alternate pictures representing different cultures, new scoring systems becoming available, and increasing international communication of these achievements. However, continuing impediments to the development of a validational literature include lingering mistaken assumptions about the nature of story data, ongoing debates about appropriate psychometric evaluation, and continuing questions about how stimuli and scoring systems should be conceptualized and interpreted. Negotiating the publication system can impede some potential authors. Excellent work on TATs with children is not well known in the adult-focused journals. The labor burden of meeting increasingly sophisticated publication standards might be a barrier to assessors focused on clinical practice. Accumulating a focused evidence base is challenging given the diversity of criterion variables for which TATs have been used. Research on TATs by clinicians can span the science-practice gap, but the narrative arc can be a dramatic one. The articles in this special section on TATs represent important conceptual, methodological, and substantive innovations.

Not Your Same Old Story: New Rules for Thematic Apperceptive Techniques (TATs).

Stories told about pictures have been used for both research and clinical practice since the beginning of modern personality assessment. However, with the growing science-practice gap, these thematic apperceptive techniques (TATs) have been used differently in those 2 venues. Scientific validation is presumptively general, but clinical application is idiographic and situation-specific. A bridge is needed. The manualized human-scored narrative analysis systems discussed here are valuable scientist-practitioner tools, but they require a validation literature to support further research publication, maintain their role in clinical training, and justify clinicians' reimbursement by third-party payers. To facilitate wider understanding of manualized TAT methodologies, this article addresses long-standing criticisms of TAT reliability and proposes some strategic solutions to the measurement error problem for both researchers and clinicians, including analyzing person-situation interactions, purposeful situation sampling for within-storyteller comparisons, and uses of small samples. The new rules for TATs include conceptual and methodological standards that researchers should aim to meet and report, reviewers should apply to manuscripts, and clinical assessors can use to analyze their own data and justify third-party payment.

Development of a Scale to Measure Death Perspectives: Overcoming and Participating.

Kastenbaum and Aisenberg have suggested that persons can cope with the impact of death and dying by altering their understanding of what each means to them as well as by changing their behavioral responses to such experiences. The present study's purpose was to develop a reliable and valid measure to assess an individual's particular death perspective based on Kastenbaum and Aisenberg's distinctions between overcomers and participators. The Death Perspective Scale developed here assessed the extent to which individuals utilize either an overcoming or participating approach to (a) assigning meaning to dying and death and (b) behaviorally responding to death-related experiences. Based upon the data collected from 168 adults varying by age and gender, findings suggested that both overcoming and participating could be reliably assessed, correlated with measures of death anxiety and death attitudes, and varied reliably (p < .05) by age and gender, wherein such differences were for the most part consistent with predictions by Kastenbaum and Aisenberg espoused over 30 years ago. Findings here suggested that overcomers reported more fear of death and dying and were less accepting in this respect, while participators reported fewer death-related fears and were more accepting. Women and older adults were more participating, while men and younger adults were more overcoming, though such effects varied depending upon whether meaning versus response to death was considered. The consistency between the present findings and the predictions Kastenbaum and Aisenberg suggests that while person's orientations to death and dying seem to transcend sociocultural change, empirically based efforts to better understand how our death system impacts persons need to move forward.

Cross-measure equivalence and communicability in the assessment of depression: a focus on factor-based scales.

All measures of depression yield a global summary scale indicating the severity of depressive symptoms, implicitly conceptualized as a homogeneous construct. However, depression is a heterogeneous construct, with different presentations, subtypes, correlates, and responses to interventions. In response, the National Institute of Mental Health (NIMH) has suggested changes in the way depression is assessed, moving the focus to specific factors, such as cognitive, somatic, or affective symptoms. Still, there is little factor overlap between measures, and shared factors are weighted differently. To help fulfill NIMH's strategic plan, this study used canonical correlation analysis (CCA) to explore shared latent variables and redundancy across the measures. It also analyzed the psychometric properties of factor-based subscales in the Beck Depression Inventory-2nd edition (BDI-II), Center for Epidemiologic Studies Depression scale (CES-D), Inventory for Depression and Anxiety Symptoms (IDAS), and Inventory of Depressive Symptomatology (IDS). Using a diverse sample of 218 students who reported at least mild depressive symptoms, this study found that the IDAS was best aligned with NIMH's strategic plan; it has complete DSM-IV/DSM-5 symptom coverage and content-valid, psychometrically sound subscales. The BDI-II, CES-D, and IDS did not have consistent subscales, nor had incomplete or incongruent coverage of DSM criteria. Furthermore, CCA revealed low redundancy across measures (23% to 41% shared variance). These results suggest that different measures of depression do not measure the same construct. As a partial solution, empirical conversion tables were provided for researchers and clinicians to empirically compare total scores from different measures.

Psychometrics and latent structure of the IDS and QIDS with young adult students.

BACKGROUND: Students and young adults have high rates of suicide and depression, thus are a population of interest. To date, there is no normative psychometric information on the IDS and QIDS in these populations. Furthermore, there is equivocal evidence on the factor structure and subscales of the IDS. METHODS: Two samples of young adult students (ns=475 and 1681) were given multiple measures to test the psychometrics and dimensionality of the IDS and QIDS. RESULTS: The IDS, its subscales, and QIDS had acceptable internal consistencies (αs=.79-90) and favorable convergent and divergent validity correlations. A three-factor structure and two Rasch-derived subscales best fit the IDS. LIMITATIONS: The samples were collected from one university, which may influence generalizability. CONCLUSIONS: The IDS and QIDS are desirable measures of depressive symptoms when studying young adult students.

Verbal expressive personality testing with older adults: 25+ years later.

This review builds on those conducted over 25 years ago by Panek and Hayslip in examining the literature dealing with the use of verbal expressive techniques with older adults. Such findings based on the Rorschach Ink Blot Test, Holtzman Inkblot Technique, Hand Test, Sentence Completion methods, and the Thematic Apperception Test and kindred thematic apperceptive techniques are presented and evaluated regarding the evidence for age differences, differential diagnosis, extraneous individual differences in performance, and adequacy of normative data. Although available evidence appears to warrant the continued use of verbal expressive techniques with older adults, more adequately designed studies are necessary to fully support the potential of these assessment tools for decision making with this population: assisting in diagnosis, recommending the appropriateness of various living arrangements, facilitating supportive care choices, and aiding in treatment planning.

The counselor's trauma as counseling motivation: vulnerability or stress inoculation?

Should counselors with interpersonal trauma histories work with similarly traumatized clients? How does the work affect them? Current research is inconsistent. This study examines 101 sexual assault and domestic violence counselors' recalled motivations for trauma work, their reported subjective personal changes, and their secondary and vicarious trauma symptoms and burnout. Counselors motivated by interpersonal trauma report both more symptoms and positive changes (including dealing with their own trauma). Those seeking personal meaning report becoming more hypervigilant and self-isolating. Those saying they learned from clients rate symptoms lower, suggesting stress inoculation. Supervisors of trauma counselors should facilitate learning from clients separately from processing the counselor's trauma.

Gender differences in HIV-related coping and depression.

Our study examined differences in HIV-related coping in relation to depression in men and women. Ethnically diverse participants (n = 247, 46% women) were recruited in Dallas/Fort Worth and completed medical and demographic information, the Coping with HIV Scale (CHIV), and the Center for Epidemiological Studies-Depression scale (CES-D). Multiple regression analyses revealed that in men, depression was associated with symptoms, higher use of distraction, blame, expression and lower use of positive growth. In women, depression was associated with symptoms and higher use of blame. These results shed light on the ways in which each gender copes with HIV and may help researchers develop interventions tailored to the needs of the HIV-positive population.

Feeling frugal: socioeconomic status, acculturation, and cultural health beliefs among women of Mexican descent.

Psychosocial and socioeconomic variables are often confounded. The authors combined quantitative with grounded theory analysis to investigate influences of acculturation, socioeconomic status (SES), and cultural health beliefs on Mexican-descent women's preventive health behaviors. In 5 focus group interviews sampling across levels of acculturation and SES, women expressing more traditional Mexican health beliefs about breast cancer screening were of lower SES and were less U.S. acculturated. However, SES and acculturation were uncorrelated with screening behaviors. Qualitative analysis generated hypotheses about joint influences of SES and traditional health beliefs; for example, low-SES women may learn frugal habits as part of their cultural traditions that influence their health care decision making, magnifying SES-imposed structural restrictions on health care access.

Vicarious traumatization, secondary traumatic stress, and burnout in sexual assault and domestic violence agency staff.

This study investigated three occupational hazards of therapy with trauma victims: vicarious trauma and secondary traumatic stress (or "compassion fatigue"), which describe therapists' adverse reactions to clients' traumatic material, and burnout, a stress response experienced in many emotionally demanding "people work" jobs. Among 101 trauma counselors, client exposure workload and being paid as a staff member (vs. volunteer) were related to burnout sub-scales, but not as expected to overall burnout or vicarious trauma, secondary traumatic stress, or general distress. More educated counselors and those seeing more clients reported less vicarious trauma. Younger counselors and those with more trauma counseling experience reported more emotional exhaustion. Findings have implications for training, treatment, and agency support systems.

Secondary traumatic stress and vicarious trauma: a validational study.

Vicarious trauma (VT) and secondary traumatic stress (STS) or compassion fatigue both describe effects of working with traumatized persons on therapists. Despite conceptual similarities, their emphases differ: cognitive schemas vs. posttraumatic symptoms and burnout, respectively. The TSI Belief Scale (TSI-BSL) measures VT; the Compassion Fatigue Self-Test (CFST) for Psychotherapists measures STS. Neither has substantial psychometric evidence yet, nor has their association been studied. Results for 99 sexual assault and domestic violence counselors show concurrent validity between TSI-BSL and CFST, moderate convergence with burnout but useful discrimination, and strong convergence with general distress, but adequate independent shared variance. Counselors with interpersonal trauma histories scored higher on CFST, but not TSI-BSL or burnout, consistent with the CFST's emphasis on trauma symptomatology.