Joye C. Anestis

Equine-Related Treatments For Mental Disorders Lack Empirical Support: A Systematic Review of Empirical Investigations

CONTEXTnEquine-related treatments (ERT) for mental disorders are becoming increasingly popular for a variety of diagnoses; however, they have been subjected only to limited systematic investigation.nnnOBJECTIVEnTo examine the quality of and results from peer-reviewed research on ERT for mental disorders and related outcomes.nnnMETHODnPeer-reviewed studies (k = 14) examining treatments for mental disorders or closely related outcomes were identified from databases and article reference sections.nnnRESULTSnAll studies were compromised by a substantial number of threats to validity, calling into question the meaning and clinical significance of their findings. Additionally, studies failed to provide consistent evidence that ERT is superior to the mere passage of time in the treatment of any mental disorder.nnnCONCLUSIONnThe current evidence base does not justify the marketing and utilization of ERT for mental disorders. Such services should not be offered to the public unless and until well-designed studies provide evidence that justify different conclusions.

Measuring Moral Injury Psychometric Properties of the Moral Injury Events Scale in Two Military Samples

As the construct of moral injury has gained increased conceptual and empirical attention among military personnel and veterans, preliminary attempts to operationalize and measure the construct have emerged. One such measure is the Moral Injury Event Scale (MIES). The aim of the current study was to further evaluate the MIES’s psychometric properties in two military samples: a clinical sample of Air Force personnel and a nonclinical sample of Army National Guard personnel. Exploratory and confirmatory factor analyses across both samples supported a three-factor solution: transgressions by others, transgressions by self, and betrayal. Transgressions-Others was most strongly associated with posttraumatic stress; Transgressions-Self was most strongly associated with hopelessness, pessimism, and anger; and Betrayal was most strongly associated with posttraumatic stress and anger. Results support the construct validity of the MIES, although areas for improvement are indicated and discussed.

Examination of MMPI-2-RF Substantive Scales as Indicators of Acute Suicidal Affective Disturbance Components.

ABSTRACT A new suicide-specific diagnostic entity, acute suicidal affective disturbance (ASAD), was recently proposed to fill a void in the nomenclature. Although several studies have examined the reliability, validity, and potential clinical utility of ASAD, no studies have examined personality indicators of ASAD. This study sought to examine the association between personality and psychopathology factors, as assessed by the Minnesota Multiphasic Personality Inventory–2–Revised Form (MMPI–2–RF), and constructs that comprise ASAD in a sample of 554 psychiatric outpatients who completed all measures prior to their intake appointments. A smaller subset of patients (N = 58) also completed a measure designed to assess lifetime ASAD symptoms. Results indicated that ASAD symptoms were associated with traits characterized by emotional turmoil and atypical cognitive processes. Further, suicide-related criteria that comprise ASAD were related to low positive emotionality and hopelessness, whereas the overarousal criteria were associated with somatic symptoms and an inability to tolerate frustration and stress. These findings expand on previous research that examines the convergent and discriminant validity of ASAD and could inform clinical treatment by providing insight into personality traits that might be associated with acute suicide risk.

Reading the Road Signs: The Utility of the MMPI-2 Restructured Form Validity Scales in Prediction of Premature Termination

This study examined the utility of the Minnesota Multiphasic Personality Inventory–2 Restructured Form (MMPI-2-RF) Validity Scales in prediction of premature termination in a sample of 511 individuals seeking services from a university-based psychology clinic. Higher scores on True Response Inconsistency–Revised and Infrequent Psychopathology Responses increased the risk of premature termination, whereas higher scores on Adjustment Validity lowered the risk of premature termination. Additionally, when compared with individuals who did not prematurely terminate, individuals who prematurely terminated treatment had lower Global Assessment of Functioning scores at both intake and termination and made fewer improvements. Implications of these findings for the use of the MMPI-2-RF Validity Scales in promoting treatment compliance are discussed.

Differentiating suicide decedents who died using firearms from those who died using other methods

Studies have documented a link between gun ownership and suicide, but little is known about characteristics of those most likely to use a gun in a suicide attempt rather than alternative methods. We examined which factors differentiate suicide decedents who died using a gun from those who died by other methods. We further examined whether such findings are consistent within the subcomponent of our larger sample comprised entirely of gun owning suicide decedents. Data reflect 267 suicide decedents, with data provided by individuals who identified as having lost someone to suicide (loss survivors). Within the full sample, a higher proportion of gun-owning and male suicide decedents died by firearm. Further, individuals who had previously discussed suicide or engaged in one or more non-lethal suicide attempts were less likely to die by suicide using a gun. Within the subsample of gun owning suicide decedents, a greater proportion of decedents who stored guns at home and in unsecure locations died from self-inflected gunshot wounds. These findings add clarity to the relationship between firearm ownership and death by suicide at the individual level. Furthermore, these findings are consistent with the notion that means safety implementation may represent a vital suicide prevention tool.

Burdensomeness, Belongingness, and Capability Assessing the Interpersonal–Psychological Theory of Suicide With MMPI-2-RF Scales

Given the emerging body of literature demonstrating the validity of the interpersonal–psychological theory of suicide (IPTS), and the importance of increasing our understanding of the development of risk factors associated with suicidal behavior, it seems worthwhile both to expand IPTS research via Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF) correlates and to expand the availability of methods by which to assess the constructs of the IPTS. The present study attempted to do so in a large adult outpatient mental health sample by (a) inspecting associations between the IPTS constructs and the substantive scales of the MMPI-2-RF and (b) exploring the utility of MMPI-2-RF scale–based algorithms of the IPTS constructs. Correlates between the IPTS constructs and the MMPI-2-RF scales scores largely followed a pattern consistent with theory-based predictions, and we provide preliminary evidence that the IPTS constructs can be reasonably approximated using theoretically based MMPI-2-RF substantive scales. Implications of these findings are discussed.

Dark traits and suicide: Associations between psychopathy, narcissism, and components of the interpersonal–psychological theory of suicide.

Studies have identified independent relationships between psychopathy, narcissism, and suicidality. The current study expands upon the extant literature by exploring psychopathic and narcissistic personality traits and components of the interpersonal–psychological theory of suicide, utilizing a 3-factor model of psychopathy and 2-factor model of pathological narcissism in community, undergraduate, and military individuals. We hypothesized that the impulsive–antisocial facets of psychopathy would be related to suicidal desire, whereas all facets of psychopathy would relate to the capability for suicide. We anticipated an association between pathological narcissism, thwarted belongingness, and capability for suicide, but not perceived burdensomeness. We further hypothesized a relationship between physical pain tolerance and persistence and the affective (i.e., callousness) facet of psychopathy. Results partially supported these hypotheses and underscore the need for further examination of these associations utilizing contemporary models of psychopathy and narcissism.

The Utility of MMPI-2-RF Substantive Scales in Prediction of Negative Treatment Outcomes in a Community Mental Health Center:

This study examined the utility of the Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF) substantive scales in the prediction of premature termination and therapy no-shows while controlling for other relevant predictors in a university-based community mental health center, a sample at high risk of both premature termination and no-show appointments. Participants included 457 individuals seeking services from a university-based psychology clinic. Results indicated that Juvenile Conduct Problems (JCP) predicted premature termination and Behavioral/Externalizing Dysfunction and JCP predicted number of no-shows, when accounting for initial severity of illness, personality disorder diagnosis, therapist experience, and other related MMPI-2-RF scales. The MMPI-2-RF Aesthetic-Literary Interests scale also predicted number of no-shows. Recommendations for applying these findings in clinical practice are discussed.

Investigating the Relationship Between Social and Economic Policy Views, Firearm Ownership, and Death by Firearm in a Sample of Suicide Decedents

Extant literature provides evidence for the frequent use and lethality of firearms in suicide and the ability of means safety measures to prevent suicides; however, little evidence exists to provide an understanding of the characteristics that differentiate suicide decedents who die by firearm from those who die by other methods. In this study, we build on prior findings regarding the characteristics of those who die by firearms by examining the relationship between social and economic policy views and both firearm ownership and death by firearm in a sample of 160 American suicide decedents. We hypothesized that individuals with more conservative social and economic policy views would have higher rates of firearm ownership and would be more likely to die by firearm than would individuals with more liberal social and economic policy views. Furthermore, we hypothesized that differences in the likelihood of dying by a firearm would be accounted for by firearm ownership, providing preliminary evidence for a specific mechanism through which risk for death by firearm is conferred. As expected, suicide decedents with conservative social and economic policy views owned firearms at higher rates than did decedents with moderate or liberal views. The use of a firearm, the most common method across all decedents, was higher in individuals with conservative policy views. These results represent a novel angle from which to consider the importance of means safety efforts focused on firearm ownership and storage and limit concerns that firearm specific suicide research has relied too heavily on samples that are not representative of typical American suicide decedents.

The Associations Between the Minnesota Multiphasic Personality Inventory-2-Restructured Form and Self-Reported Physical and Sexual Abuse and Posttraumatic Symptoms in a Sample of Incarcerated Women

ABSTRACT This study examined the impact of posttraumatic symptoms and self-reported abuse on the MMPI-2-RF among female inmates (N = 212). Posttraumatic symptoms were related to demoralization and internalizing dysfunction. MMPI-2-RF scales related to behavioral and externalizing problems, conduct problems, anxiety, anger, fear, guilt, unusual beliefs, somatic complaints, ineffectiveness, stress, family problems, and social isolation were associated with posttraumatic symptoms and abuse. Findings indicate that the MMPI-2-RF has utility for examining the impact of abuse and posttraumatic symptoms in incarcerated women. Using a standardized instrument to examine the effects of trauma provides useful information for treatment management and planning.