Improving content validity evaluation of assessment instruments through formal content validity analysis.

Content validity is defined as the degree to which elements of an assessment instrument are relevant to and representative of the target construct. The available methods for content validity evaluation typically focus on the extent to which a set of items are relevant to the target construct, but do not afford precise evaluation of items' behavior, nor their exhaustiveness with respect to the elements of the target construct. Formal content validity analysis (FCVA) is a new procedure combining methods and techniques from various areas of psychological assessment, such as (a) constructing Boolean classification matrices to formalize relationships among an assessment instrument's items and target construct elements, and (b) computing interrater agreement indices. We discuss how FCVA can be extended through the implementation of a Bayesian procedure to improve the interrater agreement indices' accuracy (Bayesian formal content validity analysis [B-FCVA]). With respect to extant methods, FCVA and B-FCVA can provide a great amount of information about content validity while not demanding much more work for authors and experts. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Is the Dissociative Experiences Scale able to identify detachment and compartmentalization symptoms? Factor structure of the Dissociative Experiences Scale in a large sample of psychiatric and nonpsychiatric subjects.

BACKGROUND: In this study, we explored the ability of the Dissociative Experiences Scale (DES) to catch detachment and compartmentalization symptoms. PARTICIPANTS AND METHODS: The DES factor structure was evaluated in 768 psychiatric patients (546 women and 222 men) and in 2,403 subjects enrolled in nonpsychiatric settings (1,857 women and 546 men). All participants were administered the Italian version of DES. Twenty senior psychiatric experts in the treatment of dissociative symptoms independently assessed the DES items and categorized each of them as follows: "C" for compartmentalization, "D" for detachment, and "NC" for noncongruence with either C or D. RESULTS: Confirmatory factor analysis supported the three-factor structure of DES in both clinical and nonclinical samples and its invariance across the two groups. Moreover, factor analyses results overlapped with those from the expert classification procedure. CONCLUSION: Our results showed that DES can be used as a valid instrument for clinicians to assess the frequency of different types of dissociative experiences including detachment and compartmentalization.

Time perception in anxious and depressed patients: A comparison between time reproduction and time production tasks.

Several studies reported temporal dysfunctions in anxious and depressed patients. In particular, compared to controls, anxious patients report that time is passing fast whereas depressed patients report that time passes slowly. However, in some studies, no differences between patients and controls are reported. Direct comparison between studies may be complex because of methodological differences, including the fact of conducting investigations with different temporal ranges. In the present study, we tested a group of anxious patients, a group of depressed patients, and a control group with two temporal tasks (time reproduction and time production) with the same temporal intervals (500, 1000 and 1500ms) to further investigate the presence and cause of patients' temporal dysfunctions. Results showed that, compared to controls, anxious patients under-reproduced temporal intervals and depressed patients over-produced temporal intervals. The results suggest that time dysfunction in anxious patients would be mainly due to an attentional dysfunction whereas temporal dysfunction in depressed patients would be mainly due to variations in the pulses' emission rate of the pacemaker.

Anger rumination and aggressive behaviour in borderline personality disorder.

BACKGROUND: Emotional instability and dyscontrolled behaviours are central features in borderline personality disorder (BPD). Recently, some cognitive dysfunctional mechanisms, such as anger rumination, have been found to increase negative emotions and promote dyscontrolled behaviours. Even though rumination has consistently been linked to BPD traits in non-clinical samples, its relationship with problematic behaviour has yet to be established in a clinical population. AIM: The purpose of the study was to explore the relationships between emotional dysregulation, anger rumination and aggression proneness in a clinical sample of patients with BPD. METHODS: Enrolled patients with personality disorders (93 with BPD) completed a comprehensive assessment for personality disorder symptoms, anger rumination, emotional dysregulation and aggression proneness. RESULTS: Anger rumination was found to significantly predict aggression proneness, over and above emotional dysregulation. Furthermore, both BPD diagnosis and anger rumination were significant predictors of aggression proneness. CONCLUSION: Future research should examine whether clinical techniques aimed at reducing rumination are helpful for reducing aggressive and other dyscontrolled behaviours in treating patients with BPD.

Three-week inpatient Cognitive Evolutionary Therapy (CET) for patients with personality disorders: evidence of effectiveness in symptoms reduction and improved treatment adherence.

OBJECTIVES: The aim of this study was to evaluate the efficacy of Cognitive Evolutionary Therapy (CET) in an intensive short residential treatment of a wide range of severe personality disorders (PDs) that resulted in a reduction of social functioning and significant personal distress. DESIGN: Each patient was assessed at admission, discharge, and 3 months later in order to determine if there was a reduction in symptoms and an improved adherence to former outpatient programs and to check if patients were undergoing new treatment after discharge. METHOD: Fifty-one patients participated in this study. The 20-hr weekly program consisted of two individual sessions and various group modules. Outcome measures included: self-reported measures of depression, anxiety, general symptoms, number and duration of inpatient admissions after the programme, and continuation in an outpatient treatment programme. RESULTS: The results show an overall improvement in general psychopathology after the release and in follow-up sessions, a decrease in the number of further hospital admissions, and an increased level of attendance of outpatient therapy. CONCLUSIONS: This study shows that intensive short residential treatment is an effective treatment for patients with a wide range of PDs.

Attachment disorganization and borderline patients' metacognitive responses to therapists' expressed understanding of their states of mind: A pilot study.

This study explores the relationship between psychotherapists' validation interventions and patients' metacognitive responses at the beginning of treatment of borderline personality disorder (BPD). A model of BPD based on disorganized attachment provides the hypothesis that, before patients' internal working model of attachment has been corrected within the therapeutic relationship, therapist interventions that are likely to activate patients' attachment system are also likely to induce temporary disorganization of patients' metacognitive functions. Any validation intervention implies that therapists openly display an understanding and accepting attitude when they comment on patients' reported experiences and is, therefore, likely to activate the patients' attachment system. Linehan's (1993) manual of dialectic-behavioral therapy (DBT) was used as a guideline to assess validation interventions adopted by therapists. The transcripts of the second individual session in the psychotherapy of 19 consecutive patients were analyzed. Checklists based on the DBT manual were used to identify therapists' validating, supportive, and neutral interventions. The Metacognitive Assessment Scale was used to assess changes in specific aspects of patients' metacognitive processes during therapeutic dialogues. Following validation interventions, patients' responses revealed significantly higher rates of temporary metacognitive failure in comparison to the responses solicited by neutral intervention.

Obsessions and compulsions and intolerance for uncertainty in a non-clinical sample.

It has been hypothesized that decision-making difficulties in patients with obsessive-compulsive disorder may arise from intolerance for uncertainty. We investigated the relationship between obsessivity and intolerance for uncertainty (defined in terms of need for cognitive closure), controlling for state and trait anxiety and depression. We tested nonclinical subjects through the Need for Closure Scale (NFCS), the Padua Inventory Revised (PI-R), the Beck Depression Inventory (BDI), and the State-Trait Anxiety Inventory (Form-Y; STAI-Y). A principal component analysis showed a lack of correlation between the PI-R and the NFCS subscales. A set of multiple regression analyses performed on PI-R subscales showed that the need for cognitive closure cannot be considered as a strong predictor of obsessions and compulsions. These results speak against the hypothesis that people with high obsessivity have difficulties in taking decisions because of a cognitive need for certainty. We instead argue that difficulties in taking decisions may be related to other specific cognitive beliefs or meta-beliefs.