Psychometric analysis of the Psychiatric Diagnostic Screening Questionnaire (PDSQ) and determinants of psychopathologyin two outpatient clinics in Navarre (Spain) / Estudio psicométrico del Psychiatric Diagnostic Screening Questionnaire (PDSQ) y determinantes de psicopatología en dos centros ambulatoriosde Navarra (España)

Backgroun: The selfreport Psychiatric Diagnostic Screening Questionnaire PDSQ is designed to screen Axis I psychiatric disorders. We aim to determine its psychometric properties in Spanish outpatients and assess its relationship with two interviews (for psychopathology and for personality disorders) and clinical/demographic variables. Methodology: We administered the study questionnaire, the Mini International Neuropsychiatric Interview Plus (MINIPlus), the Standardised Assessment of Personality Abbreviated Scale (SAPAS), and the List of Threatening Experiences Questionnaire (LTEQ) to 375 patients at two public outpatient centres. Reliability of the study questionnaire was evaluated (Cronbach’s alpha, a) and knowngroup validity measured by comparing groups based on demographic and clinical variables (binary logistic regression analysis) and MINIPlus diagnoses (MannWhitney U). The diagnostic accuracy of the study questionnaire score was analysed taking the MINIPlus diagnoses as the gold standard (ROC analysis). Results: Internal consistency was adequate across all PDSQ scales (a>0.7; mean a=0.85). Knowngroup comparisons were satisfactory. Female and male patients showed higher prevalence of internalizing and externalizing diagnoses, respectively. Younger age, more life events and limitations, higher SAPAS scores, and lower economic levels were linked to a greater number of PDSQ diagnoses. Intergroup differences were found for all PDSQ scales based on the corresponding MINIPlus diagnoses. Mean values of sensitivity, AUC, and negative predictive value were 88.7, 0.82, and 96.7, respectively. Conclusions: When applied to a sample of Spanish outpatients, the PDSQ exhibits satisfactory psychometric properties and adequate relationships with the psychopathology and personality interviews, and clinical and demographic variables. The study questionnaire is suitable for assessing comorbidity and psychopathology dimensions.(AU)

Fundamento: El PDSQ (Psychiatric Diagnostic Screening Questionnaire) es un cuestionario autoadministrado para el cribado de diagnósticos psiquiátricos del eje I. El objetivo es estudiar sus propiedades psicométricas en pacientes ambulatorios españoles y analizar su relación con dos entrevistas (de psicopatología y de trastornos de personalidad), y con variables clínicas y demográficas. Material y métodos: Se administraron los instrumentos PDSQ, MINIPlus, SAPAS, y LTE-Q a 375 pacientes en dos centros ambulatorios públicos. Se estudió la fiabilidad del PDSQ (α de Cronbach). La validez de grupos conocidos se analizó comparando subgrupos organizados por variables demográficas y clínicas (regresión logística binaria) y por diagnósticos MINI Plus (U de Mann-Whitney). Se estudió el desempeño diagnóstico del PDSQ considerando los diagnósticos MINI Plus como gold standard (análisis ROC). Resultados: La consistencia interna del PDSQ fue adecuada en todas las escalas (α >0,7; media=0,85). Las comparaciones entre grupos conocidos fueron satisfactorias. Mujeres y hombres mostraron prevalencias mayores de trastornos internalizantes y externalizantes, respectivamente. Una menor edad, más sucesos vitales y limitaciones, puntuaciones mayores en SAPAS y niveles económicos más bajos se relacionaron con mayor número de diagnósticos PDSQ. Los grupos basados en los correspondientes diagnósticos MINIPlus difirieron en todas las escalas del PDSQ. Los valores medios de sensibilidad, AUC y valor predictivo negativo fueron 88,7; 0,82 y 96,7, respectivamente. Conclusiones: En su aplicación a pacientes españoles ambulatorios, el PDSQ muestra, propiedades psicométricas satisfactorias y relaciones adecuadas con entrevistas de psicopatología y personalidad, así como con variables clínicas y demográficas. El PDSQ es adecuado para evaluar comorbilidad y dimensiones de psicopatología.(AU)

Rationale and validation of a novel mobile application probing motor inhibition: Proof of concept of CALM-IT.

Identification of behavioral mechanisms underlying psychopathology is essential for the development of novel targeted therapeutics. However, this work relies on rigorous, time-intensive, clinic-based laboratory research, making it difficult to translate research paradigms into tools that can be used by clinicians in the community. The broad adoption of smartphone technology provides a promising opportunity to bridge the gap between the mechanisms identified in the laboratory and the clinical interventions targeting them in the community. The goal of the current study is to develop a developmentally appropriate, engaging, novel mobile application called CALM-IT that probes a narrow biologically informed process, inhibitory control. We aim to leverage the rigorous and robust methods traditionally used in laboratory settings to validate this novel mechanism-driven but easily disseminatable tool that can be used by clinicians to probe inhibitory control in the community. The development of CALM-IT has significant implications for the ability to screen for inhibitory control deficits in the community by both clinicians and researchers. By facilitating assessment of inhibitory control outside of the laboratory setting, researchers could have access to larger and more diverse samples. Additionally, in the clinical setting, CALM-IT represents a novel clinical screening measure that could be used to determine personalized courses of treatment based on the presence of inhibitory control deficits.

Impact of adolescent complex regional pain syndrome on the psychopathology of young men ahead of military service: a retrospective cohort analysis of Korean conscription data.

BACKGROUND: The relationship between physical and psychopathological features in complex regional pain syndrome (CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service. METHODS: We retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory (MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS (19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at < 15 months (n = 30) versus ≥15 months (n = 33). Binary MPI results (normal-abnormal) were also compared between the two groups. RESULTS: In multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio (OR) at 1.05 for every 1-month increase (95% confidence interval (CI) 1.02-1.08; P = 0.002). Subjects with pain duration at ≥15 months have lower faking good response score (P < 0.001 vs. those with pain duration at < 15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores (P < 0.05). Pain duration was significantly associated with the MPI variables. CONCLUSIONS: Pain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.

Nonverbal Communication and Psychopathology in Kidney Transplant Recipients.

Transplant recipients have difficulty expressing, identifying, and describing their emotional experiences. The Machover human figure test allows us to bring out the deepest contents of a patient's personality, which are normally hidden and not explained to structured quantitative tests. The study analyzed possible situations of distress and possible symptoms of psychopathology in kidney transplant recipients, emerged from the projective test of the human figure and not easily verbalized to the common standardized tests. The sample included 80 kidney transplant patients (51 men and 29 women; mean age, 47.74 [SD, 12.39] years) during follow-up visits at 12 months after transplant. The Machover test was used to evaluate body image, affective aspects, and personality variables by projective method; the Symptom Checklist-90-R was used for the evaluation of possible psychopathology, and the 36-Item Short Form Health Survey was used for the assessment of perceived quality of life. RESULTS: showed that the more anxiety there is in the human figure test, the less somatization dimensions (ANX/SOM R = -331, P < .05), depression (ANX/DEP R = -326, P < .05), and the global index of psychic symptomatology (ANX/GSI R = -367, P < .05) of the Symptom Checklist-90-R are present. This research has confirmed the hypothesis that the spontaneous graphic production of the recipients, through the projective methods, allows them to identify and deepen their psychological contents and to activate and maintain a good psychophysical balance post transplant.

Parsing the Hypomanic Personality: Explicating the Nature of Specific Dimensions Defining Mania Risk.

Considerable research has used the Hypomanic Personality Scale (HPS) to assess traits conferring risk for hypomanic and manic episodes. Although the HPS has been shown to be defined by several distinct sets of content, most research has continued to rely exclusively on HPS total scores, due to (a) little research having examined its structure and (b) the discrepant structural results obtained in the few available studies. Therefore, we examined the structure and relations of the HPS in a large sample of community adults ( N = 737) receiving psychiatric treatment. Our structural results indicated a five-factor structure of Activation, Charisma, Intellectual Confidence, Lability, and Modesty. Subscales modeling these emergent factors showed divergent patterns of relations with personality and other forms of psychopathology. These findings underscore the importance of examining HPS subscale relations in addition to HPS total scores in future research.

Psychopathy in a Multiethnic World: Investigating Multiple Measures of Psychopathy in Hispanic, African American, and Caucasian Offenders.

Despite the forensic relevance of psychopathy and the overrepresentation of Hispanics in the United States' criminal justice system, these two issues remain underexplored, particularly with self-report measures of psychopathy. We investigated the criterion validity of three psychopathy measures among African Americans, Caucasians, and Hispanics in a sample of 1,742 offenders. More similarity than dissimilarity emerged across groups. The factor structures of psychopathy measures among Hispanic offenders were consistent with previous findings. Few significant differences emerged between Hispanic and Caucasian offenders, with most differences emerging between African Americans and the other ethnic groups. In such instances, the correlates of psychopathy were typically weaker for African Americans. The Psychopathy Checklist-Revised yielded fewer psychopathy × ethnicity interactions than the Psychopathic Personality Inventory and Levenson Primary and Secondary Psychopathy Scales. Overall, these psychopathy measures showed reasonable validity across these cultural groups.

Identifying Careless Responding With the Psychopathic Personality Inventory-Revised Validity Scales.

The Psychopathic Personality Inventory-Revised (PPI-R) includes validity scales that assess Deviant Responding (DR), Virtuous Responding, and Inconsistent Responding. We examined the utility of these scales for identifying careless responding using data from two online studies that examined correlates of psychopathy in college students (Sample 1: N = 583; Sample 2: N = 454). Compared with those below the cut scores, those above the cut on the DR scale yielded consistently lower validity coefficients when PPI-R scores were correlated with corresponding scales from the Triarchic Psychopathy Measure. The other three PPI-R validity scales yielded weaker and less consistent results. Participants who completed the studies in an inordinately brief amount of time scored significantly higher on the DR and Virtuous Responding scales than other participants. Based on the findings from the current studies, researchers collecting PPI-R data online should consider identifying and perhaps screening out respondents with elevated scores on the DR scale.

Development and Initial Validation of an Inconsistent Responding Scale for the Youth Psychopathic Traits Inventory.

The Youth Psychopathic Traits Inventory (YPI) is widely used in research, but there currently exist no means to identify potentially invalid protocols resulting from careless or random responding. We describe the development of an inconsistent responding scale for the YPI using three archival samples of youths, including two from the United States (juvenile justice and middle school) and one from Germany (vocational training school). We first identified pairs of correlated YPI items and then created a total score based on the sum of the absolute value of the differences for each item pair. The resulting scale strongly differentiated between genuine protocols and randomly generated YPI data (n = 1,000) across samples (AUC values = .88-.92). It also differentiated between genuine protocols and those same protocols after 50% of the original YPI items were replaced with random data (AUCs = .77-.84). Scores on this scale also demonstrated fairly consistent patterns of association with theoretically relevant correlates.

Análisis de redes: ¿una nueva forma de comprender la psicopatología? / Network analysis: a new way of understanding psychopathology?

Los sistemas taxonómicos actuales se basan en un enfoque categorial, de corte descriptivo, donde los síntomas y signos psicopatológicos son causados por un hipotético trastorno mental subyacente. Con la finalidad de soslayar las limitaciones de los sistemas clasificatorios, se hace necesario incorporar nuevos modelos conceptuales y psicométricos que permitan comprender, analizar e intervenir en los fenómenos psicopatológicos desde otra perspectiva. El objetivo general de este trabajo fue presentar un nuevo enfoque denominado análisis de redes (network analysis) para su aplicación al campo de la psicopatología. En primer lugar se lleva a cabo una breve introducción al análisis de redes, donde se conciben los trastornos psicopatológicos como sistemas complejos dinámicos. A continuación se comentan conceptos clave, los diferentes tipos de redes y los procedimientos para su estimación. Seguidamente se abordan las medidas de centralidad importantes para comprender la estructura de la red así como para examinar la relevancia de las variables dentro de la misma. Posteriormente se ejemplifica todo lo anterior mediante la estimación de una red de síntomas psicopatológicos autoinformados en una muestra representativa de adolescentes. Finalmente, a modo de conclusión, se realiza una breve recapitulación y se comentan posibles líneas de investigación futuras (AU)

Current taxonomic systems are based on a descriptive and categorical approach where psychopathological symptoms and signs are caused by a hypothetical underlying mental disorder. In order to circumvent the limitations of classification systems, it is necessary to incorporate new conceptual and psychometric models that allow to understand, analyze and intervene in psychopathological phenomena from another perspective. The main goal was to present a new approach called network analysis for its application in the field of psychopathology. First of all, a brief introduction where psychopathological disorders are conceived as complex dynamic systems was carried out. Key concepts, as well as the different types of networks and the procedures for their estimation, are discussed. Following this, centrality measures, important for the understanding of the network as well as to examine the relevance of the variables within the network were addressed. These factors were then exemplified by estimating a network of self-reported psychopathological symptoms in a representative sample of adolescents. Finally, a brief recapitulation is made and future lines of research are discussed (AU)

Utilización de tecnologías móviles en pacientes con psicosis: una revisión sistemática / Use of mobile technologies in patients with psychosis: a systematic review

Hay un creciente interés en las intervenciones mobile Health (m-Health) en pacientes con psicosis. El objetivo de este estudio es realizar una revisión sistemática para analizar el estado actual de la investigación en este ámbito. La búsqueda de publicaciones se llevó a cabo siguiendo los criterios PRISMA, centrándose en aquellos estudios que utilizan tecnologías móviles en pacientes con psicosis durante el periodo de 1990 a 2016. Se seleccionó un total de 20 artículos de los 431 estudios que se encontraron. Se diferencian 3 tipos de intervenciones: 1) análisis de calidad y usabilidad; 2) mejora de la adherencia, síntomas y reducción de hospitalizaciones, y 3) análisis de la sintomatología del paciente. Conclusión: Las intervenciones m-Health son viables y resultan fáciles de utilizar para los pacientes con psicosis. Evalúan de forma más eficiente la evolución de los síntomas psicóticos y mejoran la adherencia al tratamiento, los síntomas y las hospitalizaciones. No se puede destacar una estrategia sobre las demás debido a que las diferencias en la metodología las hace difícilmente comparables (AU)

There is a growing interest in mobile Health interventions (m-Health) in patients with psychosis. The aim of this study is to conduct a systematic review in order to analysethe current state of research in this area. The search of articles was carried out following the PRISMA criteria, focusing on those studies that used mobile technologies in patients with psychosis during the period from 1990 to 2016. A total of 20 articles were selected from the 431 studies found. Three types of studies are distinguished: 1) Analysis of quality and usability, 2) Improving treatment adherence and reducing hospital admissions, and 3) Analysisof patient symptoms. Conclusions: m-Health interventions are feasible, and are easy to use for patients with psychosis. They evaluate the evolution of psychotic symptoms more efficiently, and improve adherence to treatment, as well as symptoms and hospital admissions. However, a particular strategy does not stand out over the rest, because differences in methodology make them difficult to compare (AU)

Initial development of the Psychopathic Processing and Personality Assessment (PAPA) across populations.

Three studies describe development of the Psychopathic Processing and Personality Assessment (PAPA). Study one outlines a literature review and Expert Delphi (n=32) to develop the initial PAPA. Study two validates the PAPA with 431 participants (121 male prisoners and 310 university students: 154 men, 156 women), also using the Levenson Self Report Psychopathy scale and a measure of cognitive schema and affect. Study three refined the PAPA, employing it with 50 male students and 40 male forensic psychiatric patients using clinical (interview) assessments of psychopathy: the Psychopathy Checklist - Screening Version and the Affect, Cognitive and Lifestyle assessment. The PAPA comprised four factors; dissocial tendencies; emotional detachment; disregard for others; and lack of sensitivity to emotion. It positively correlated with existing psychopathy measures. Variations across PAPA subscales were noted across samples when associated with clinical measures of psychopathy. Support for the validity of the PAPA was indicated across samples. Directions for research and application are outlined.

The Youth Psychopathic Traits Inventory: A Bifactor Model, Dimensionality, and Measurement Invariance.

The current study examines a bifactor model for the Youth Psychopathic Traits Inventory (YPI) in a Dutch community sample of adolescents ( N = 2,874). The primary goal was to examine the latent structure of the YPI with a bifactor modeling approach. Furthermore, the study examines the dimensionality and measurement invariance of the YPI. Results show that a bifactor model at subscale level fits the YPI best. The general psychopathy factor influences the 10 subscales of the YPI strongly, indicating that the YPI seems to be rather unidimensional than multidimensional. Nevertheless, the dimensions still explain nearly one third of the variance found. Findings imply that the bifactor model of the YPI should be used when examining relations with outcome variables, with a focus on the total score of the YPI, while factor scores should be reported with caution. Furthermore, the bifactor model appears invariant for gender, age, and ethnic background.

Convergence of Self-Reports and Informant Reports on the Personality Assessment Screener.

The present study is the first to investigate the Personality Assessment Screener, a brief self-report measure of risk for emotional and behavioral dysfunction, in relation to the informant report version of this instrument, the Personality Assessment Screener-Other. Among a sample of undergraduate roommate dyads ( N = 174), self-report and informant report total scores on the Personality Assessment Screener/Personality Assessment Screener-Other moderately converged ( r = 0.45), with generally greater agreement between perspectives observed for externalizing behaviors compared with internalizing distress. In addition, selves tended to report more psychological difficulties relative to informant ratings ( d = 0.45) with an average absolute discrepancy between sources of 6.31 ( SD = 4.96) out of a possible range of 66. Discrepancies between self-report and informant report were significantly associated with characteristics of the dyadic relationship (e.g., length of acquaintanceship) as well as the severity of self-reported psychological difficulties and positive impression management.

Evaluating the Construct Validity of the Levenson Self-Report Psychopathy Scale in China.

The Levenson Self-Report Psychopathy (LSRP) scale is an efficient measure of psychopathy with promising psychometric properties. However, the cross-cultural utility of the LSRP has not been well documented, and no study has explored measurement invariance of the LSRP across East Asian and North American samples. We translated the LSRP into Chinese (Study 1) and investigated the validity and reliability of the Chinese LSRP using a sample of 226 university students in China (Study 2). Confirmatory factor analyses supported Brinkley, Diamond, Magaletta, and Heigel's (2008) three-factor model (Egocentricity, Callousness, and Antisocial). Evidence for configural and partial metric (but not scalar) invariance of the factor structure was observed when comparing Chinese and U.S. university samples. However, response thresholds were significantly different between the two samples. The Chinese LSRP scores also demonstrated encouraging convergent and discriminate validity in terms of their associations with external criteria. We discuss the implications for cross-cultural assessment of psychopathy.

Examining the Factor Structure of the Self-Report of Psychopathy Short-Form Across Four Young Adult Samples.

Psychopathy refers to a range of complex behaviors and personality traits, including callousness and antisocial behavior, typically studied in criminal populations. Recent studies have used self-reports to examine psychopathic traits among noncriminal samples. The goal of the current study was to examine the underlying factor structure of the Self-Report of Psychopathy Scale-Short Form (SRP-SF) across complementary samples and examine the impact of gender on factor structure. We examined the structure of the SRP-SF among 2,554 young adults from three undergraduate samples and a high-risk young adult sample. Using confirmatory factor analysis, a four-correlated factor model and a four-bifactor model showed good fit to the data. Evidence of weak invariance was found for both models across gender. These findings highlight that the SRP-SF is a useful measure of low-level psychopathic traits in noncriminal samples, although the underlying factor structure may not fully translate across men and women.

Socially Desirable Responding in Web-Based Questionnaires: A Meta-Analytic Review of the Candor Hypothesis.

Unproctored, web-based assessments supposedly reduce social desirability distortions in self-report questionnaires because of an increased sense of privacy among participants. Three random-effects meta-analyses focusing either on social desirability ( k = 30, total N = 3,746), the Big Five of personality ( k = 66, total N = 2,951), or psychopathology ( k = 96, total N = 16,034) compared social desirability distortions of self-reports across computerized and paper-and-pencil administration modes. Overall, a near-zero effect, Δ = 0.01, was obtained that did not indicate less socially desirable responding in computerized assessments. Moreover, moderator analyses did not identify differential effects for proctored and unproctored procedures. Thus, paper-and-pencil and computerized administrations of self-report scales yield comparable mean scores. Unproctored web-based surveys do not offer an advantage with regard to socially desirable responding in self-report questionnaires.

An Integrative Analysis of the Narcissistic Personality Inventory and the Hypomanic Personality Scale: Implications for Construct Validity.

The primary goal of this study was to explicate the construct validity of the Narcissistic Personality Inventory (NPI) and the Hypomanic Personality Scale (HPS) by examining their relations both to each other and to measures of personality and psychopathology in a community sample ( N = 255). Structural evidence indicates that the NPI is defined by Leadership/Authority, Grandiose Exhibitionism, and Entitlement/Exploitativeness factors, whereas the HPS is characterized by specific dimensions reflecting Social Vitality, Mood Volatility, and Excitement. Our results establish that (a) factor-based subscales from these instruments display divergent patterns of relations that are obscured when relying exclusively on total scores and (b) some NPI and HPS subscales more clearly tap content specifically relevant to narcissism and mania, respectively, than others. In particular, our findings challenge the construct validity of the NPI Leadership/Authority and HPS Social Vitality subscales, which appear to assess overlapping assertiveness content that is largely adaptive in nature.

Isolating Trait and Method Variance in the Measurement of Callous and Unemotional Traits.

To examine hypothesized influence of method variance from negatively keyed items in measurement of callous-unemotional (CU) traits, nine a priori confirmatory factor analysis model comparisons of the Inventory of Callous-Unemotional Traits were evaluated on multiple fit indices and theoretical coherence. Tested models included a unidimensional model, a three-factor model, a three-bifactor model, an item response theory-shortened model, two item-parceled models, and three correlated trait-correlated method minus one models (unidimensional, correlated three-factor, and bifactor). Data were self-reports of 234 adolescents (191 juvenile offenders, 43 high school students; 63% male; ages 11-17 years). Consistent with hypotheses, models accounting for method variance substantially improved fit to the data. Additionally, bifactor models with a general CU factor better fit the data compared with correlated factor models, suggesting a general CU factor is important to understanding the construct of CU traits. Future Inventory of Callous-Unemotional Traits analyses should account for method variance from item keying and response bias to isolate trait variance.

Contingencia y subjetividad en el trasfondo de la clínica psiquiátrica / Contingency and subjectivity in the background of psychiatric clinics

El surgimiento de la psiquiatría pende de la manera de usar el concepto de subjetividad. En tanto que moderno este concepto de subjetividad se despliega para afrontar la contingencia de la realidad en un nuevo modo de saber. Sin embargo, por más que haya sido simplificado, reducido y se haya ocultado la imposibilidad de su determinación, su incorporación a la psiquiatría genera una inestabilidad referencial y una inconsistencia epistemológica que no se puede pasar por alto. Asumir semejante complejidad es aceptar una aporía inherente a la conceptuación de la subjetividad, del mismo modo que supone ver que la contingencia, de la que inevitablemente participa, es la única forma de asumir los límites en los que se desenvuelve y la manera consecuente de adoptar estrategias que permitan afrontar la heterogeneidad y variabilidad de la clínica psiquiátrica, manifestada tanto en la historia de la especialidad como en la práctica cotidiana (AU)

The emergence of psychiatry depends on the way of using the concept of subjectivity. As a modern concept, subjectivity is deployed to deal with the contingency of reality in a new way of knowing. However, even if it has been simplified and reduced and the impossibility of its determination has been concealed, its incorporation to psychiatry generates a referential instability and an epistemological inconsistency that cannot be overlooked. Taking on such complexity means to accept the Aporia inherent to the conceptualization of subjectivity, and it also implies to see the contingency inevitably involved in taking on the limits within which it operates, as well as the consequent way of adopting strategies to address the heterogeneity and variability of clinical psychiatry as it manifests itself both in history and daily practice (AU)