The role of mindfulness and emotion regulation in dialectical behavioral therapy for borderline personality disorder.

Despite nearly 30 years of research demonstrating its effectiveness in the treatment of borderline personality disorder (BPD) and related problems, few studies have investigated mechanisms of change for dialectical behavior therapy (DBT; Linehan, 1993a). Improvements in mindfulness and emotion regulation have been highlighted as key potential mechanisms of change in DBT (Lynch et al., 2006). The present study examined the time course of and associations between mindfulness, emotion regulation, and BPD symptoms during DBT. Participants were 240 repeatedly and recently self-harming adults (Mage = 27.75) with BPD who were randomly assigned to receive either 6 or 12 months of standard DBT. Primary hypotheses were that: (a) changes in mindfulness would occur before changes in emotion regulation, and (b) changes in emotion regulation would mediate the association of changes in mindfulness with changes in BPD symptoms. Results from changepoint analysis illuminated the proportion of participants for whom first changes occurred in emotion regulation (40.7%), mindfulness (32.4%), or both (26.9%). Contrary to hypotheses, five-wave, cross-lagged analyses did not indicate mediational effects of either mindfulness or emotion regulation on the association of either variable with change in BPD symptoms. Supplemental analyses, however, suggested that changes in emotion regulation mediated the inverse association of changes in mindfulness with changes in BPD symptoms. Findings highlight patterns of change in key, proposed mechanisms of change in DBT and suggest important future research directions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Support for Economic Inequality Scale: Development and adjudication.

Past research has documented myriad pernicious psychological effects of high economic inequality, prompting interest into how people perceive, evaluate, and react to inequality. Here we propose, refine, and validate the Support for Economic Inequality Scale (SEIS)-a novel measure of attitudes towards economic inequality. In Study 1, we distill eighteen items down to five, providing evidence for unidimensionality and reliability. In Study 2, we replicate the scale's unidimensionality and reliability and demonstrate its validity. In Study 3, we evaluate a United States version of the SEIS. Finally, in Studies 4-5, we demonstrate the SEIS's convergent and predictive validity, as well as evidence for the SEIS being distinct from other conceptually similar measures. The SEIS is a valid and reliable instrument for assessing perceptions of and reactions to economic inequality and provides a useful tool for researchers investigating the psychological underpinnings of economic inequality.

Predictors and prognostic impact of silent coronary artery disease in asymptomatic high-risk patients with diabetes mellitus.

AIMS: Evaluation of predictors of silent coronary artery disease (SCAD) in high-risk asymptomatic diabetic patients and to evaluate their two-year outcome. METHODS AND RESULTS: Four hundred diabetic patients without prior CAD but at high CAD risk underwent myocardial perfusion scintigraphy (MPS) in this prospective multicentre outcome trial. MPS were abnormal in 22% of patients. Male sex (OR 2.223, 1.152-4.290; p=0.017), diabetes duration (OR 1.049,1.015-1.085; p=0·005), peripheral artery disease (OR 2.134, 1·150-3.961; p=0.016), smoking (OR 2.064, 1.109-3.839; p=0·022), systolic blood pressure (OR 1.014, 1.00-1.03, p=0·056), brain natriuretic peptide (OR 1.002, 1.001-1.004, p=0·005) independently predicted an abnormal MPS: if <2 and >3 predictors were present, 3.2% and 47% patients had an abnormal MPS, respectively (p<0·001). Two-year major adverse cardiac event rates increased from 2·9% to 14·6%, cardiac death rates from 0·6% to 4·1% in patients with summed stress scores ≤10 and >10%, respectively (each p<0.045). CONCLUSIONS: Male sex, diabetes duration, peripheral artery disease, smoking, elevated systolic blood pressure and increased brain-natriuretic peptides independently predicted SCAD. In presence of >3 predictors, almost 50% of patients had an abnormal MPS. They may benefit from screening by MPS since the extent of the MPS abnormality discriminated clearly between a favourable compared to a bad 2-year outcome. However, even highest risk patients without objective evidence of CAD had a benign prognosis without need for specific evaluation or therapy. TRIAL REGISTRATION NUMBER: ISRCTN87953632.

The Taxonic Latent Structure and Taxometrics in Forensic Mental Health.

Recently, researchers in the field of forensic mental health have attempted to address the technical, empirical question of whether important clinical problems, such as psychopathy or malingering, constitute taxa (i.e., discrete conditions). In this paper, we provide a detailed elucidation of the foundational logic of the quantitative methods employed to answer this question, focusing on the taxometric procedures developed by Paul Meehl and colleagues. We attempt to demonstrate that research on taxonicity is hampered by (a) researchers' unfamiliarity with or misunderstanding of the logic underlying latent variable technologies and (b) the fundamental incapacity of Meehlian procedures to provide a test of taxonicity. We conclude by discussing the utility of taxometric procedures to research in forensic mental health and, more broadly, in the field of applied psychological measurement.

Optimizing insulin pump therapy: the potential advantages of using a structured diabetes management program.

Use of continuous subcutaneous insulin infusion (CSII) therapy improves glycemic control, reduces hypoglycemia and increases treatment satisfaction in individuals with diabetes. As a number of patient- and clinician-related factors can hinder the effectiveness and optimal usage of CSII therapy, new approaches are needed to address these obstacles. Ceriello and colleagues recently proposed a model of care that incorporates the collaborative use of structured SMBG into a formal approach to personalized diabetes management within all diabetes populations. We adapted this model for use in CSII-treated patients in order to enable the implementation of a workflow structure that enhances patient-physician communication and supports patients' diabetes self-management skills. We recognize that time constraints and current reimbursement policies pose significant challenges to healthcare providers integrating the Personalised Diabetes Management (PDM) process into clinical practice. We believe, however, that the time invested in modifying practice workflow and learning to apply the various steps of the PDM process will be offset by improved workflow and more effective patient consultations. This article describes how to implement PDM into clinical practice as a systematic, standardized process that can optimize CSII therapy.

Progression to overt or silent CAD in asymptomatic patients with diabetes mellitus at high coronary risk: main findings of the prospective multicenter BARDOT trial with a pilot randomized treatment substudy.

OBJECTIVES: The purpose of this study was to evaluate prevalence, progression, treatment, and outcome of silent coronary artery disease (CAD) in asymptomatic patients with diabetes (DM) at high coronary risk. BACKGROUND: Despite the close association of diabetes and CAD, general CAD screening in asymptomatic patients with DM is discouraged even though outcome data in patients at high coronary risk are lacking. METHODS: Prospective multicenter outcome study-with a pilot randomized treatment substudy. The study comprised 400 asymptomatic patients with DM (type 2) without history or symptoms of CAD at high CAD risk. They underwent clinical evaluation and myocardial perfusion single-photon emission computed tomography (MPS) at baseline and after 2 years. Patients with normal MPS received usual care; those with abnormal MPS received medical or combined invasive and medical management. RESULTS: An abnormal MPS was found in 87 of 400 patients (22%). In patients with normal MPS, MACE occurred in 2.9% and ischemia or new scar in 3.2%. Patients with abnormal MPS had more MACE (9.8%; hazard ratio: 3.44; 95% confidence interval [CI]: 1.32 to 8.95; p = 0.011) and ischemia or new scar (34.2%; odds ratio: 15.91; 95% CI: 7.24 to 38.03; p < 0.001) despite therapy, resulting in "overt or silent CAD progression" of 35.6% versus 4.6% (odds ratio: 11.53; 95% CI: 5.63 to 24.70; p < 0.001). Patients with abnormal MPS randomized to medical versus invasive-medical strategies had similar event rates (p = 0.215), but more ischemic or new scar findings (54.3% vs. 15.8%; p < 0.001). CONCLUSIONS: High-risk asymptomatic patients with DM and normal MPS (78%) have a low rate of first manifestations of CAD. Patients with abnormal MPS at baseline (22%) have a 7-fold higher rate of progression to "overt or silent CAD," despite therapy. Randomized patients' outcomes suggest that a combined invasive and medical strategy for silent CAD may reduce scintigraphic but not symptomatic CAD progression versus medical therapy alone. (Trial of Invasive versus Medical therapy of Early coronary artery disease in Diabetes Mellitus ISRCTN87953632).

Killeen's (2005) p rep coefficient: logical and mathematical problems.

In his article, "An alternative to null-hypothesis significance tests," Killeen (2005) urged the discipline to abandon the practice of p obs-based null hypothesis testing and to quantify the signal-to-noise characteristics of experimental outcomes with replication probabilities. He described the coefficient that he invented, prep, as the probability of obtaining "an effect of the same sign as that found in an original experiment" (Killeen, 2005, p. 346). The journal Psychological Science quickly came to encourage researchers to employ prep, rather than p obs, in the reporting of their experimental findings. In the current article, we (a) establish that Killeen's derivation of prep contains an error, the result of which is that prep is not, in fact, the probability that Killeen set out to derive; (b) establish that prep is not a replication probability of any kind but, rather, is a quasi-power coefficient; and (c) suggest that Killeen has mischaracterized both the relationship between replication probabilities and statistical inference, and the kinds of claims that are licensed by knowledge of the value assumed by the replication probability that he attempted to derive.

Selection Between Linear Factor Models and Latent Profile Models Using Conditional Covariances.

A method for selecting between K-dimensional linear factor models and (K + 1)-class latent profile models is proposed. In particular, it is shown that the conditional covariances of observed variables are constant under factor models but nonlinear functions of the conditioning variable under latent profile models. The performance of a convenient inferential method suggested by the main result is examined via data simulation and is shown to have acceptable error rate control when deciding between the 2 types of models. The proposed test is illustrated using examples from vocational assessment and developmental psychology.

A proposed framework for conducting data-based test analysis.

The authors argue that the current state of applied data-based test analytic practice is unstructured and unmethodical due in large part to the fact that there is no clearly specified, widely accepted test analytic framework for judging the performances of particular tests in particular contexts. Drawing from the extant test theory literature, they propose a rationale that may be used in data-based test analysis. The components of the proposed test analytic framework are outlined in detail, as are examples of the framework as applied to commonly encountered test evaluative scenarios. A number of potential extensions of the framework are discussed.

What does it mean that an issue is conceptual in nature?

McGrath (2005/this issue) argues that "the conceptual complexity [italics added] of the constructs psychologists choose to measure and the scales they use to measure them has played an important role in the failure to develop more accurate measurement systems" (p. 112). Although we agree with this, we argue, in this commentary, that McGrath has misdiagnosed the source of these difficulties and that this misdiagnosis originates with an unresolved articulation of the nature of a conceptual issue and of the relationship between conceptual and empirical issues in science.

Dual scaling for the analysis of categorical data.

Dual scaling is a set of related techniques for the analysis of a wide assortment of categorical data types including contingency tables and multiple-choice, rank order, and paired comparison data. When applied to a contingency table, dual scaling also goes by the name "correspondence analysis," and when applied to multiple-choice data in which there are more than 2 items, "optimal scaling" and "multiple correspondence analysis. " Our aim of this article was to explain in nontechnical terms what dual scaling offers to an analysis of contingency table and multiple-choice data.

An Analysis of Meehl's MAXCOV-HITMAX Procedure for the Case of Continuous Indicators.

MAXCOV-HITMAX was invented by Paul Meehl as a tool for the detection of latent taxonic structures (i.e., structures in which the latent variable, u, is not continuously, but rather Bernoulli, distributed). It involves the examination of the shape of a certain conditional covariance function and is based on Meehl's claims that (R1) Taxonic structures produce single-peaked conditional covariance functions and that (R2) continuous latent structures produce flat, rather than single-peaked, curves. For neither (R1), nor (R2), have formal proofs been provided, Meehl and colleagues instead having provided an argument ("Meehl's Hypothesis") as to why they should be true, and a number of Monte Carlo studies. In an earlier article, Maraun, Slaney, and Goddyn (2003) proved that, for the case of dichotomous indicators, Meehl's Hypothesis is false and, by counterexample, that (R2) is false. In the current article (a) it is proved that, for the case of continuous indicators, Meehl's Hypothesis is false and (b) results are developed analytically on the behaviour of the conditional covariance functions produced by taxonic structures.

An Analysis of Meehl's MAXCOV-HITMAX Procedure for the Case of Dichotomous Indicators.

MAXCOV-HITMAX was invented by Paul Meehl for the detection of latent taxonic structures (i.e., structures in which the latent variable, _, is not continuously, but rather Bernoulli, distributed). It involves the examination of the shape of a certain conditional covariance function, and is based on Meehl's claims that: (R1) Given a latent taxonic structure, this conditional covariance function is single peaked; and that (R2), continuous latent structures produce a flat, rather than single-peaked, curve. While Meehl has recommended that continuous indicators be used as input into MAXCOV-HITMAX, the use of dichotomous indicators has become popular. The current work investigates whether (R1) and (R2) are true for the case of dichotomous indicators. The conclusions will be that, for dichotomous indicators: (a) (R1) is not true; (b) (R1) is made true given that there are a large number of indicators; and (c) (R2) is not true, certain unexceptional Rasch structures, for example, producing single-peaked curves. Implications are briefly discussed of these results for the case of MAXCOV-HITMAX with continuous indicators.