Robert Plutchik

A Self-report Borderline Scale: Discriminative Validity and Preliminary Norms

On the basis of a selected review of some important theoretical discussions and empirical investigations of patients characterized as borderline, a self-report questionnaire, the Borderline Syndrome Index (BSI), was constructed. Its purpose was to provide an assessment of the borderline syndrome that would increase the amount of information rapidly available to the clinician. The items reflect criteria cited in the literature as important characteristics of borderline patients and also incorporate the criteria for the borderline personality organization as listed in the DSM-III draft. The BSI was completed by 50 normal individuals, 36 nonpsychotic depressed outpatients, 35 patients diagnosed as borderline, and 20 inpatients diagnosed as schizophrenic. The internal consistency of the 52-item BSI was .92. It significantly discriminated the borderline patients from the normal individuals, from the depressed outpatients, and from the schizophrenic inpatients, thereby providing a measure of discriminative validity. An item analysis indicated that the most discriminating items were concerned with impaired object relations, impulsivity, emptiness and depression, depersonalization, and lack of self-identity. Cross-validation of the BSI was carried out on independent samples of borderline and nonborderline patients, and it was found to discriminate significantly between the two. Preliminary percentile norms are presented in order to provide clinicians with additional information to assist them in their diagnostic assessments.

Toward a rationale for the seclusion process.

The present paper summarizes three studies focusing on different aspects of seclusion room practices. The first study involved chart reviews to collect empirical data on reasons for seclusion, length of seclusion, and characteristics of secluded patients. The second study focused on staff attitudes toward seclusion; the third dealt with the attitudes of both secluded and nonsecluded patients. The average time of seclusion was approximately 4 hours and in most cases aggressive behaviors of various types were cited as the precipitating event. In addition, patient and staff attitudes implied that a major function of the seclusion process was to isolate patients from disturbing interactions and to maintain the smooth functioning of the ward minisociety. Two models of seclusion, an ethological model and a behavioristic “time out” model, were developed in order to integrate the results of these studies. Implications of the findings and models are presented for changes in seclusion room procedures.

A comparison of psychopathology in child psychiatric inpatients, outpatients, and nonpatients implications for treatment planning

A total of 308 preadolescents who were either psychiatric inpatients, psychiatric outpatients, or nonpatients were studied with semistructured interview research instruments that have been described previously. The three groups of children included 106 children consecutively admitted to a voluntary hospital psychiatric inpatient unit, 101 consecutively admitted children to the same voluntary hospital center psychiatric outpatient clinic, and 101 randomly selected nonpatients. The research instruments included a Spectrum of Suicidal Behavior Scale, a Spectrum of Assaultive Behavior Scale, a Precipitating Events Scale, General Psychopathology (recent and past) Scales, a Family Background Scale, a Childs Concept of Death Scale, an Ego- Functioning Scale, an Ego-Defense Scale, and a Medical-Neurological Assessment Scale. The results of the study indicated that the presence of recent depression and recent and past aggression, the use of such ego defenses as projection, displacement, and regression, and the experience of parental separation were significantly different for the three groups of children. Impulse control and reality testing were best in the nonpatients and poorest in the inpatients. The variables that best predicted the need for psychiatric hospitalization were suicidal behavior, recent depression, recent aggression, poor reality testing, and such ego defenses as projection and regression. Implications of these findings are discussed.

Measurement Implications of a Psychoevolutionary Theory of Emotions

Most people usually think of emotion as a subjective feeling of a certain kind, the kind for which labels like happy, sad, and frightened are appropriate. However, there is much evidence to suggest that this is too narrow a way to define emotion, that the facts available to us and the current uses of the term imply the need for a different and broader conceptualization.