Andrew C. Butler

Assessment of dysfunctional beliefs in borderline personality disorder

This study had two aims: to test the hypothesis that borderline personality disorder (BPD) patients hold numerous dysfunctional beliefs associated with a variety of Axis II disorders, and to construct a BPD belief scale which captures these beliefs. Beliefs were measured using the Personality Belief Questionnaire (PBQ) which is designed to assess beliefs associated with various personality disorders, although not specifically BPD. Eighty-four BPD patients and 204 patients with other personality disorders (OPD) were randomly split into two study samples. Fourteen PBQ items were found to discriminate BPD from OPD patients in both samples. These items came from the PBQ Dependent, Paranoid, Avoidant, and Histrionic scales and reflect themes of dependency, helplessness, distrust, fears of rejection/abandonment/losing emotional control, and extreme attention-seeking behavior. A BPD beliefs scale constructed from these items showed good internal consistency and diagnostic validity among the 288 study patients. The scale may be used to assist in diagnosis and cognitive therapy of BPD.

Cluster analysis of depressed college students' social behaviors.

Measures of interpersonal behaviors exhibited by depressed college students toward their dormitory roommates were cluster analyzed, and this procedure produced 2 relatively distinct subgroups: a dependent, friendly, overgenerous type and an autocratic, competitive, aggressive, mistrustful type. These 2 groups were studied over a 9-month period; findings revealed that behaviors associated with each cluster were relatively stable and unrelated to gender or initial symptom severity. In longitudinal analyses, depressives in one group showed symptom abatement across time, whereas symptoms of the other group remained elevated. The roommates of depressives exhibited relatively high levels of hostility and a progressive decline in social contact and satisfaction with their depressed cohabitant. The results are discussed in relation to other typological approaches to unipolar depression.

The Personality Belief Questionnaire-Short Form: Development and Preliminary Findings

Two studies are reported which document the development and psychometric properties of an abbreviated version of the Personality Belief Questionnaire (PBQ). In the first study, the seven PBQ items with the highest item–total correlations with each PBQ scale were used to construct experimental scales. These scales showed good internal consistency and discriminated five personality disorders as predicted. Items from the experimental scales were then incorporated into a new measure—the PBQ Short Form (SF)—which was administered to an independent sample of psychiatric patients. The PBQ-SF scales showed good reliability and correlated significantly with depression, anxiety, dysfunctional attitudes, neuroticism, self-esteem, and psychosocial functioning. Findings suggest that the overall elevation of a PBQ-SF profile is influenced by a general distress factor, whereas variability of PBQ-SF scales within a profile reveals disorder-specific effects. It is concluded that the PBQ-SF is a practical alternative as a measure of personality disorder beliefs.

Depression and Next-day Spillover of Negative Mood and Depressive Cognitions Following Interpersonal Stress

We hypothesized that individuals high in depression would experience a greater increase in depressive symptoms following daily interpersonal stress, as compared with their symptoms following noninterpersonal stress. Forty-six adult outpatients completed seven consecutive daily assessments of stressful events, appraisals of those events, depressive cognitions, and negative affect at the beginning of treatment. Although there were no same-day differences in reactions to interpersonal and noninterpersonal stressors, there was significant “spillover” of negative thoughts and affect following interpersonal stressors for those high in depression. In other words, for those high in depression, negative thoughts and affect increased to a greater degree on days following an interpersonal stressor, as compared to days following a noninterpersonal stressor. These findings suggest that delayed recovery from daily interpersonal stress might contribute to the maintenance of depressive symptoms.

Beliefs and personality disorders: an overview of the personality beliefs questionnaire

OBJECTIVE This article presents an overview of the Personality Beliefs Questionnaire (PBQ)--a 126-item self-report measure of beliefs associated with 10 personality disorders. DESIGN It consolidates the literature on the PBQ over the last 20 years to provide a summary of the psychometric status, revisions and applications of the PBQ scales. RESULTS The PBQ scales are psychometrically reliable (α = 77-94, test-retest stability r=.57-.93) and discriminate between individuals with and without a specific personality disorder. Two revisions have been made to the measure: A 14-item subscale measuring beliefs central to borderline personality disorder has been identified, and a short form version of the PBQ has been validated. The PBQ has been used to measure cognitive mechanisms of treatment outcomes, and has been found to be sensitive to changes in beliefs. CONCLUSIONS Given the proposed shift in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) to a dimensional conceptualization of psychological components of personality dysfunction, the PBQ is likely to remain relevant and useful for identifying such components in individuals with personality disorders.

Attachment, support seeking, and adaptive inferential feedback: Implications for psychological health

The purpose of this study was to examine differences between attachment groups in support-seeking behavior; ability to benefit from adaptive feedback, a subtype of social support; and identity of preferred supportive figure. Two hundred and sixty-eight undergraduates completed a questionnaire packet containing measures of attachment, depressive symptoms, hopelessness, anxiety, and social support. As expected, securely attached individuals engaged in more support-seeking behavior than people with an avoidant attachment style. Contrary to previous literature, social support benefited people with an avoidant attachment style: adaptive inferential feedback was associated with fewer depressive and anxious symptoms. Furthermore, attachment groups did not differ in the rate at which they turned to primary supporters for guidance. The clinical implications of these findings are discussed.

Preliminary Evidence that Anxiety is Associated with Accelerated Response in Cognitive Therapy for Depression

We conducted two studies that assessed the role of initial anxiety in rate of change (depression reduction) in cognitive therapy for major depression. In both studies, depression and anxiety were assessed at intake, and depression was assessed at every treatment session. Longitudinal growth modeling was used to predict rate of change in treatment from sessions 1–12 controlling for intake depression, with intake anxiety as a moderator of change. In Study 1, high initial anxiety was associated with a faster rate of depression reduction across the course of cognitive therapy, whereas in Study 2, high initial anxiety was associated with a faster rate of depression reduction in the early sessions of treatment. The influence of intake depression on rate of change was controlled, and therefore the results are likely not due to greater symptom severity or distress among those high in anxiety. BAI subscale analyses suggest that the results are likely due to the physiological arousal characteristic of anxiety. These results suggest a potentially beneficial role for initial anxiety in cognitive therapy for depression.