Steven G. LoBello

Depression and life satisfaction in patients with traumatic brain injury: a longitudinal study

Primary objective: To assess the relationship between depression and life satisfaction among survivors of traumatic brain injury (TBI) over a 3-year period after injury. It was hypothesized that survivors of TBI with depression would have decreased life satisfaction. Research design: Two groups (depression vs no depression) longitudinal design. Methods and procedures: Interviewed survivors of TBI (n ¼ 324) by telephone at 24, 48 and 60 months after hospitalization. At the 24-month interview, 90 (27.8%) respondents reported a post-injury diagnosis of depression and 234 (72.2%) reported no diagnosis. Respondents then completed the Life Satisfaction Index I-A, which was repeated at the 48- and 60-month interviews. Main outcomes and results: The depression group had significantly lower life satisfaction than the no depression group at 24-, 48- and 60-month interviews. Conclusions: Depression and diminished life satisfaction among survivors of TBI are persistent problems that require the close attention of medical and rehabilitation professionals.

The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.

A short form of the Wechsler preschool and primary scale of intelligence-revised

Abstract Data from the standardization sample of the Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) were used to develop a table that gives Full Scale IQs for a four-subtest abbreviated form of the scale. The short-form is composed of the Comprehension and Arithmetic subsets from the Verbal scale and the Picture Completion and Block Design subtests from the Performance scale. Reliability and validity coefficients and standard error of estimates for the abbreviated WPPSI-R IQs are reported, and guidelines for appropriate use of this scale are also discussed.

WISC-III Administration, Clerical, and Scoring Errors Made by Student Examiners

The purpose of this study was to examine the most frequent administration, clerical, and scoring errors made by graduate student examiners who administer the WIS-III. An additional goal was to document the effect of these errors on the IQ values and Index Scores. The graduate students test protocols contained numerous administration, clerical, and scoring errors that influenced Full Scale IQs on two thirds of the protocols (average change was .83 points). When failure to record errors (failing to record responses on the test protocol) were omitted from the analysis, the subtests found most prone to error were Comprehension, Vocabulary and Similarities. Additionally, no improvement in test administration occurred over the course of several test administrations. Findings of this study have implications for the education and training of psychology graduate students enrolled in intelligence testing courses.

The six most essential questions in psychiatric diagnosis: a pluralogue part 3: issues of utility and alternative approaches in psychiatric diagnosis.

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.

The six most essential questions in psychiatric diagnosis: A pluralogue part 2: Issues of conservatism and pragmatism in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM – whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article took up the first two questions. Part II will take up the second two questions. Question 3 deals with the question as to whether DSM-V should assume a conservative or assertive posture in making changes from DSM-IV. That question in turn breaks down into discussion of diagnoses that depend on, and aim toward, empirical, scientific validation, and diagnoses that are more value-laden and less amenable to scientific validation. Question 4 takes up the role of pragmatic consideration in a psychiatric nosology, whether the purely empirical considerations need to be tempered by considerations of practical consequence. As in Part 1 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.

Social integration and life and family satisfaction in survivors of injury at 5 years postinjury.

This study assessed the relationship of social integration (SI) to life satisfaction and family satisfaction among survivors 5 years after injury. Thirty-four matched pairs of injured patients were interviewed by telephone 60 months after initial discharge from the acute care setting. Respondents were matched according to sex, race, education, injury severity, and employment status before comparing high and low socially integrated persons on measures of family and life satisfaction. High and low SI groups were formed based on the Craig Handicap Assessment and Reporting Technique (CHART) SI Scale. The former consisted of patients scoring 100; the latter consisted of patients scoring 50 or less. Analyses of covariance, with age and injury type as covariates, were used to test for group differences. The high and low SI groups differed on both the life and the family satisfaction measures, with the high SI group reporting greater life and family satisfaction.

Estimated prevalence of antenatal depression in the US population

The purpose of this study is to determine the prevalence of minor and major depression among pregnant women in the USA. Also, we compare prevalence of depression among pregnant and non-pregnant women while controlling for relevant covariates. A population-representative sample of pregnant women (nu2009=u20093010) surveyed for the 2006 Behavioral Risk Factor Surveillance System was compared to a sample of women who were not pregnant (nu2009=u200968,620). Binary logistic regression was used to determine prevalence ratios of depression for pregnant and non-pregnant women while controlling for the effects of age, race, annual income, employment status, educational level, marital status, general health, and availability of emotional support. Depression was measured by the Patient Health Questionnaire-8 (PHQ-8). The prevalence of major depression was no greater among pregnant women (6.1xa0%) compared to non-pregnant women (7xa0%; adjusted prevalence ratio (PR)u2009=u20091.1, 95xa0% confidence interval (CI) .8 and 1.5). The prevalence of minor depression was greater among pregnant women (16.6xa0%) compared to non-pregnant women (11.4xa0%; adjusted PRu2009=u20091.5, 95xa0% CI 1.2 and 1.9). Prevalence ratios are adjusted for the effects of covariates noted above. Prevalence of major depression is not associated with pregnancy, but minor depression is more likely among women who are pregnant.

The reliability and validity of the Life Satisfaction Index-A with survivors of traumatic brain injury

Primary objective: To investigate the internal consistency, long-term stability and validity of the Life Satisfaction Index-A (LSI-A) in a sample of survivors of traumatic brain injury (TBI). Research design: Cohort study. Methods and procedures: LSI-A was administered to survivors of TBI at 12, 24, 48 and 60 months post-injury during telephone interviews. Participants rated their quality of life, independence and participation in activities as well as health status at 24 months. Internal consistency was evaluated with Coefficient α. Pearsons r was used to investigate score stability. Test validity was explored with Pearsons r and Analysis of Covariance with age and sex as covariates. Experimental interventions: None. Main outcomes and results: Coefficient αs ranged from 0.85–0.92. Test–re-test coefficients ranged from 0.42–0.77. The LSI-A was positively correlated with self-reported quality of life, independence, activity level and health status. Conclusions: The LSI-A is a reliable and valid measure of the construct of life satisfaction among survivors of TBI.

Reliability and validity of the Family Satisfaction Scale with survivors of traumatic brain injury.

For this study, we investigated the reliability and validity of the FSS (Family Satisfaction Scale) in survivors of traumatic brain injury (TBI). The FSS was administered during the 12- and 60-month follow-up interviews. Data analyses included Cronbachs Alpha to determine internal consistency and analysis of variance to determine the relationship of FSS total score to Life Satisfaction Index-A (LSI-A) total scores, marital status, living arrangement, and number of family contacts outside the home. Cronbachs Alphas were 0.94 (12 months, N = 541) and 0.95 (60 months, N = 340). FSS total score and marital status were significantly related at both 12 months (F(3, 534) = 6.04, p < 0.001) and 60 months postdischarge (F(3, 335) = 4.52, p < 0.005). FSS total scores are correlated with the number of family contacts (r(342) = 0.12, p < 0.03) and with LSI-A total scores (r(337) = 0.43, p < 0.001). The FSS has excellent internal consistency with survivors of TBI. We also demonstrated the evidence of convergent validity.