Caleb J. Siefert

Psychometric Evaluation and Normative Data for the Depression, Anxiety, and Stress Scales-21 (DASS-21) in a Nonclinical Sample of U.S. Adults

Health care professionals are coming under increased pressure to empirically monitor patient outcomes across settings as a means of improving clinical practice. Within the psychiatric and primary care communities, many have begun utilizing brief psychometric measures of psychological functioning to accomplish these goals. The purpose of this study was to evaluate the psychometric properties and clinical utility of the Depression, Anxiety, and Stress Scales—21-item version (DASS-21), and contribute normative data to facilitate interpretation using a sample of U.S. adults (N = 503). Item-scale convergence was generally supported, although assumptions of item-scale divergence were not met. Only 86%, 50%, and 43% of Depression, Anxiety, and Stress items, respectively, correlated significantly greater with their hypothesized scales than other scales. Internal consistency reliability was acceptable for all scales and comparable to existing research (αs = .91, .80, and .84 for Depression, Anxiety, and Stress, respectively). Scale-level correlations were greater than what has been reported elsewhere (range of rs = .68 to .73), and principal components analysis supported the extraction of only one component accounting for 47% of the item-level variance. However, confirmatory factor analysis (CFA) favored a three-factor structure when compared to a one-factor model. The implications for the health care professions are discussed.

Deceptiveness on the PAI: A Study of Naïve Faking With Psychiatric Inpatients

Abstract In this study, we sought to explore the diagnostic accuracy of the Personality Assessment Inventory (PAI; Morey, 1991) Validity scales (Negative Impression Management [NIM] and Positive Impression Management [PIM]) and indexes (Malingering index, Defensiveness index [DEF]; Morey, 1993, 1996; Cashel Discriminant Function; Cashel, Rogers, Sewell, & Martin–Cannici, 1995; and Rogers Discriminant Function [RDF]; Rogers, Sewell, Morey, & Ustad, 1996) to identify differences in profiles completed by psychiatric inpatients under standardized instructions (Time 1) and after random assignment (Time 2) to a fake good (n = 21), fake bad (n = 20), or retest (n = 21) scenario. Repeated measures analysis of variance revealed a significant interaction effect. Whereas the retest group did not show any significant changes on the PAI variables from Time 1 to Time 2, both faking groups showed changes in expected directions. Discriminant function analyses revealed that NIM, RDF, and lower scores on DEF best differentiated between the faking bad and retest groups. PIM was the only nonredundant significant score discriminating the faking good and retest groups. Cutoffs for these scales and indexes established in prior research were supported using diagnostic efficiency statistics. Results suggest that NIM and RDF in faking bad scenarios and PIM in faking good scenarios are most sensitive to unsophisticated attempts to dissimulate by inpatient psychiatric patients.

Exploring the Construct Validity of the Social Cognition and Object Relations Scale in a Clinical Sample

The Social Cognition and Object Relations Scale–Global rating method (SCORS–G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995) measures the quality of object relations in narrative material. This study employed a multimethod approach to explore the structure and construct validity of the SCORS–G. The Thematic Apperception Test (TAT; Murray, 1943) was administered to 59 patients referred for psychological assessment at a large Northeastern U.S. hospital. The resulting 301 TAT narratives were rated using the SCORS–G method. The 8 SCORS variables were found to have high interrater reliability and good internal consistency. Principal components analysis revealed a 3-component solution with components tapping emotions/affect regulation in relationships, self-image, and aspects of cognition. Next, the construct validity of the SCORS–G components was explored using measures of intellectual and executive functioning, psychopathology, and normal personality. The 3 SCORS–G components showed unique and theoretically meaningful relationships across these broad and diverse psychological measures. This study demonstrates the value of using a standardized scoring method, like the SCORS–G, to reveal the rich and complex nature of narrative material.

A double-blind, placebo-controlled study of the impact of galantamine on anterograde memory impairment during electroconvulsive therapy.

Background Electroconvulsive therapy (ECT) continues to be an effective treatment option for patients who fail to respond to pharmacological interventions, are unable to tolerate medications, and show a suboptimal response to behavioral and psychotherapeutic treatments. However, risks for cognitive impairment may contribute to some patients’ refusal of ECT. Methods The present study examined galantamine as a pharmacological intervention to reduce cognitive adverse effects from ECT. Thirty-nine inpatients diagnosed with major depressive disorder; bipolar disorder, depressed type; or schizoaffective disorder, depressed type and admitted for ECT were randomized to galantamine or placebo. Study drugs were initiated 24 to 48 hours before starting ECT and continued throughout the course of ECT. A neuropsychological test battery was administered at baseline and 24 to 48 hours after completing a course of ECT treatments. Depression severity was monitored using the 17-item Hamilton Rating Scale for Depression and Clinical Global Impression Scale at baseline, weekly, and end point. Self-rated adverse effects were monitored weekly. Results Thirty participants (12 patients in the galantamine group, 18 patients in the placebo group) had both pretreatment and posttreatment neuropsychological ratings. Those in the galantamine group scored significantly higher at discharge for delayed memory (t28 = 2.44, P < 0.05). Hierarchical regressions examined if treatment condition predicted changes in delayed memory scores from baseline to discharge. Inclusion of the treatment condition in the final model made a significant incremental improvement in prediction (&Dgr;R2 = 0.12, F1,27 change = 4.65, P < 0.05; &bgr; = 0.37, t = 2.16, P < 0.05). Galantamine was well tolerated with no clinically significant bradycardia or prolonged paralysis when administered with ECT. Conclusions Galantamine may be protective against impairment in retention of new learning. Galantamine exhibited minimal adverse effects and was safe when administered during ECT. The present findings require replication by future researchers using larger samples before broad conclusions can be drawn.

Leveraging Synergy and Emotion In a Multi-Platform World A Neuroscience-Informed Model of Engagement

ABSTRACT The proliferation of media platforms raises questions among marketers about their relative value. This study tests a neuroscience-informed model of immersive-versus-flexible audience engagement and demonstrates televisions heightened ability to sustain nonconscious emotional response over online viewing. Employing biometrics and eye tracking, 251 participants experienced 24 brands on television, online, or both. Findings indicate that brand advertising proved far more emotionally engaging when experienced on television alone or combined with online viewing. This emotional connection using both platforms proved strongest when the television program and Web site content were related. The results support prior research that demonstrates televisions ability to engage and sustain emotional response.

Biometric and eye-tracking insights into the efficiency of information processing of television advertising during fast-forward viewing

Despite increased research focusing on the impact of digital video recorder (DVR) use, there continues to be a notable lack of data on viewers’ direct experience of time-shifted television ads. The current study was designed to increase understanding of information processing among DVR users by directly examining viewers’ biometric responses, eyegaze patterns and memory for ads viewed entirely in fast-forward (FF) mode compared with viewers who watched the same ads in real time. The results indicate that, compared with a control group of viewers of real-time advertising, viewers recalled the same ads viewed in FF at significantly higher rates than expected given the speed with which they were viewed. Notably, prior exposure to an ad increased the likelihood of that ad being recalled in FF mode. Eye-tracking data show that viewers in the DVR group spent significantly more time with their eyes on screen, more time looking at the centre of the screen, and also showed a substantial amount of visual processing activity during FF viewing. Finally, there were significantly higher levels of biometric response, an indicator of emotional processing, suggesting that viewers are in a ‘hyper-alert’ state during FF viewing. The biometric results, when combined with indications of visual processing and increased screen time, help explain the higher than expected next-day recall of ads in the DVR group.

An item-level psychometric analysis of the personality assessment inventory: clinical scales in a psychiatric inpatient unit.

Multi-item multiscale self-report measures are increasingly used in inpatient assessments. When considering a measure for this setting, it is important to evaluate the psychometric properties of the clinical scales and items to ensure that they are functioning as intended in a highly distressed clinical population. The present study examines scale properties for a self-report measure frequently employed in inpatient assessments, the Personality Assessment Inventory (PAI). In addition to examining internal consistency statistics, this study extends prior PAI research by considering key issues related to inpatient assessment (e.g., scale distinctiveness, ceiling effects). Coefficient alphas, interitem correlations, and item— scale relationships suggest that the PAI clinical scales and subscales are internally consistent. Items for respective clinical scales generally showed significantly higher item—scale correlations with their intended scale (as compared with their item—scale correlation with scales they were not intended to measure). In addition, scales’ coefficient alpha scores were higher than their interscale correlations. Taken as a whole, these results support the hypothesis that PAI scales were measuring relatively distinct constructs in this inpatient sample. Findings are discussed with regard to the implications for scale interpretation in inpatient assessment, functioning of individual scales and subscales, and functioning of specific items. Limitations of the present study and directions for future research are discussed.

What you cannot see can help you: the effect of exposure to unreportable stimuli on approach behavior.

We examined effects of exposure to unreportable images of spiders on approach towards a tarantula. Pretests revealed awareness of the stimuli was at chance. Participants high or low (top and bottom 15%) on fear of spiders were randomly assigned to receive computer-generated exposure to unreportable pictures of spiders or outdoor scenes. They then engaged in a Behavioral Approach Task (BAT) with a live tarantula. Non-fearful participants completed more BAT items than spider-fearful individuals. Additionally, as predicted, a significant interaction (F(1,48)=5.12, p<.03) between fear of spiders and stimulus demonstrated that spider-fearful participants exposed to spiders completed more BAT items than spider-fearful participants exposed to control stimuli (but not as many as non-fearful participants). The findings support the hypothesis that exposure to unreportable feared stimuli promotes approach towards the feared object. Future research and clinical implications were discussed.

Convergent and divergent validity of the relationship profile test: investigating the relationship with attachment, interpersonal distress and psychological health†

The present study looked to illustrate the convergent and divergent validity of the Relationship Profile Test (RPT), which is a 30-item self-report measuring destructive overdependence, dysfunctional detachment, and healthy dependence. The RPT items are written to draw upon Bornsteins (19921993) 4-component model as well as other essential components of the dimension in question (Bornstein et al., 2003). The results reveal that the subscales of the RPT are related in predictable ways to scores on measures of adult attachment, interpersonal distress, and psychological health and well-being. The clinical implications of the results and the assessment of dependency in the clinical setting are discussed.

Relationship between the Social Cognition and Object Relations Scale (SCORS) and attachment style in a clinical sample

This present study examined the relationship between the Social Cognition and Object Relations Scale (SCORS) and two measures of adult attachment: the Relationship Questionnaire (RQ) and the Experiences in Close Relationships Questionnaire-Revised (ECR-R). Forty-five patients (76% female) at a university-based outpatient treatment clinic participated in this study. We hypothesized that higher levels of attachment security would be associated with higher, more adaptive ratings on the SCORS variables. Results indicated that the SCORS Self-Esteem (SE) variable was significantly positively related to the RQs Secure Attachment ratings and negatively related with the ECR-Rs Anxious Attachment scale. Additionally, negative trends were noted between SE and the RQs Fearful and Preoccupied Attachment scores. The SCORS Emotional Investments in Relationships and Affective Quality of Representations variables were associated with higher Secure scores and lower, more maladaptive Preoccupied scores on the RQ. It was also associated with greater attachment anxiety as measured by the ECR-R. Using both clinician (SCORS) and participant-rated measures (ECR-R and RQ), this study provides further understanding on how object representations and attachment style relate within a clinical sample. Results are discussed in light of prior research examining relationships between object relations and adult attachments, and clinical implications are also reviewed. Copyright