Margarita B. Marshall

Autonomous motivation for therapy: A new common factor in brief treatments for depression

Abstract The authors propose a new common treatment factor, autonomous motivation (Deci & Ryan, 2000), defined as the extent to which patients experience participation in treatment as a freely made choice emanating from themselves. Ninety-five depressed outpatients were randomly assigned to receive 16 sessions of manualized interpersonal therapy, cognitive–behavior therapy, or pharmacotherapy with clinical management. Self-report and interviewer-based measures of depressive severity were collected at pretreatment and posttreatment. Autonomous motivation, therapeutic alliance, and perceived therapist autonomy support were assessed at Session 3. Autonomous motivation was a stronger predictor of outcome than therapeutic alliance, predicting higher probability of achieving remission and lower posttreatment depression severity across all three treatments. Patients who perceived their therapists as more autonomy supportive reported higher autonomous motivation.

DSM‐IV personality disorders and the Five‐Factor Model of personality: a multi‐method examination of domain‐ and facet‐level predictions

The personality disorder classification system (Axis II) in the various versions of the Diagnostic and Statistical Manuals of Mental Disorders (DSM) has been the target of repeated criticism, with conceptual analysis and empirical evidence documenting its flaws. In response, many have proposed alternative approaches for the assessment of personality psychopathology, including the application of the Five‐Factor Model of personality (FFM). Many remain sceptical, however, as to whether domain and facet traits from a model of general personality functioning can be successfully applied to clinical patients with personality disorders (PDs). In this study, with a sample of psychiatric patients (n = 115), personality disorder symptoms corresponding to each of the 10 PDs were successfully predicted by the facet and domain traits of the FFM, as measured by a semi‐structured interview, the Structured Interview for the Five Factor Model (SIFFM; Trull & Widiger, 1997) and a self‐report questionnaire, the Revised NEO Personality Inventory (NEO PI‐R; Costa and McCrae, 1992). These results provide support for the perspective that personality psychopathology can be captured by general personality dimensions. The FFM has the potential to provide a valid and scientifically sound framework from which to assess personality psychopathology, in a way that covers most of the domains conceptualized in DSM while transcending the limitations of the current categorical approach to these disorders. Copyright

Socially Desirable Responding and the Factorial Stability of the NEO PI-R.

The goal of the present investigation is to compare the factor structure of the revised NEO Personality Inventory (NEO PI-R; P. T. Costa & R. R. McCrae, 1992) in samples of respondents differentially motivated to respond in a socially desirable manner. In the French sample, the authors compared the NEO PI-R structure of job applicants (N=12,631) subgrouped by relative degree of socially desirable responding with that of a normative sample (N=801). In the Belgian sample, the authors compared the NEO PI-R structure in naturally occurring groups, including job applicants (N=3,028), individuals receiving career counseling (N=221), and a normative sample (N=549). Results indicate that the NEO PI-R factor structure remained stable across all samples.

Distinguishing Bipolar Depression, Major Depression, and Schizophrenia With the MMPI-2 Clinical and Content Scales

Clinical and content scales from the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) were used to examine the capacity of these scales to assist in the differential diagnosis of a sample of 212 psychiatric patients-137 with major depression; 43 with schizophrenia; and 32 with bipolar disorder, depressed state. Consistent with the previous literature, the clinical scales Depression (D), and Schizophrenia (Sc), and the content scales Depression (DEP), and Low Self-Esteem (LSE) best distinguished major depression from schizophrenia; the content scale DEP proved to be the most powerful predictor in distinguishing bipolar depression from schizophrenia. No clinical or content scale proved to be effective in distinguishing patients with bipolar depression from patients with major depression. In general, the content scales outperformed the clinical scales.

The incremental validity and clinical utility of the MMPI-2 infrequency posttraumatic stress disorder scale.

The incremental validity and clinical utility of the recently developed Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Infrequency Posttraumatic Stress Disorder Scale (Fptsd) was examined in relation to the family of MMPI-2 F scales in distinguishing feigned post-traumatic stress disorder (PTSD) from disability claimants with PTSD. Research participants instructed to feign PTSD when completing the MMPI-2 scored significantly higher on the MMPI-2 family of F scales and the Fptsd scale compared with their responses when completing the MMPI-2 under standard instructions and the sample of claimants with PTSD. Although comparable in magnitude, effect sizes derived from mean group differences and hierarchical logistic regressions for the Fptsd scale never exceeded those for F B , and F P , F, F B , and F P added incrementally to Fptsd in the prediction of feigned PTSD. These results suggest that the Fptsd scale does not afford any incremental predictive utility for detecting feigned PTSD relative to the complement of the existing family of F scales.

Assessing underreporting response bias on the MMPI-2.

The authors assess the replicability of the two-factor model of underreporting response style. They then examine the relative performance of scales measuring these styles in analog (ARD) and differential prevalence group (DPG) designs. Principal components analysis produced a two-factor structure corresponding to self-deceptive (SD) and impression management (IM) response styles. The IM factor scale and related individual validity scales were elevated among research participants instructed to fake good on the MMPI-2 as compared with participants who completed the MMPI-2 under standard instructions (ARD) and among individuals evaluated in real-life assessment contexts where underreporting is expected (DPG). Participants in DPG samples produced significantly higher SD factor and related individual scale scores than did the ARD participants instructed to fake good. These findings confirm that the MMPI-2 validity scales measure two types of underreporting styles and that these styles may operate differently in ARD versus DPG designs.

The validity and clinical utility of the MMPI-2 Malingering Depression scale.

In this study, we examined the validity and clinical utility of the MMPI–2 (Butcher, Graham, Tellegen, Dahlstrom, & Kaemmer, 2001) Malingering Depression scale (Md) in relation to the MMPI–2 F scales (F, FB, FP) to detect feigned depression. Overall, the FB scale and the F/FP scale combination were the best single predictors, although the Md scale did discriminate successfully cases of feigned depression from patients with bona fide depression. The Md scale added predictive capacity over the F scales, and the FB scale and the F/FP scale combination added predictive capacity over the Md scale; however, the actual increase in the number of cases predicted was minimal in each instance. In sum, although the Md scale is able to detect accurately feigned depression on the MMPI–2 (predictive validity), it does not confer a distinct advantage (incremental validity) over the existing standard validity scales—F, FB, and FP.