Psychology Commons^™

Ethnicity And Mental Health Treatment Utilization By Patients With Personality Disorders, Donna S. Bender, Andrew E. Skodol, Ingrid R. Dyck, John C. Markowitz, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Anthony Pinto, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson, Maria T. Daversa, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

The authors examined the relationship between ethnicity and treatment utilization by individuals with personality disorders (PDs). Lifetime and prospectively determined rates and amounts of mental health treatments received were compared in over 500 White, African American, and Hispanic participants with PDs in a naturalistic longitudinal study. Minority, especially Hispanic, participants were significantly less likely than White participants to receive a range of outpatient and inpatient psychosocial treatments and psychotropic medications. This pattern was especially pronounced for minority participants with more severe PDs. A positive support alliance factor significantly predicted the amount of individual psychotherapy used by African American and Hispanic …

The Sensitivity And Psychometric Properties Of A Brief Computer-Based Cognitive Screening Battery In A Depression Clinic, S A. Langenecker, A Caveney, B Giordani, E A. Young, Kristy Nielson, L J. Rapport, L A. Bieliauskas, M J. Mordhorst, S Marcus, N Yodkovik, K Kerber, S Berent, J K. Zubieta

Kristy Nielson

At present, there is poor accuracy in assessing cognitive and vegetative symptoms in depression using clinician or self-rated measures, suggesting the need for development of standardized tasks to assess these functions. The current study assessed the psychometric properties and diagnostic specificity of a brief neuropsychological screening battery designed to assess core signs of depression; psychomotor retardation, attention and executive functioning difficulties, and impaired emotion perception within an outpatient psychiatry setting. Three hundred eighty-four patients with mood disorders and 77 healthy volunteers participated. A large percentage of patients met diagnostic criteria for Major Depressive Disorder alone (49%) or with another comorbid …

Temporally Graded Activation Of Neocortical Regions In Response To Memories Of Different Ages, J Woodard, M Seidenberg, Kristy Nielson, S Miller, M Franczak, P Antuono, K Douville, S Rao

Kristy Nielson

The temporally graded memory impairment seen in many neurobehavioral disorders implies different neuroanatomical pathways and/or cognitive mechanisms involved in storage and retrieval of memories of different ages. A dynamic interaction between medial-temporal and neocortical brain regions has been proposed to account for memory’s greater permanence with time. Despite considerable debate concerning its time-dependent role in memory retrieval, medial-temporal lobe activity has been well studied. However, the relative participation of neocortical regions in recent and remote memory retrieval has received much less attention. Using functional magnetic resonance imaging, we demonstrate robust, temporally graded signal differences in posterior cingulate, right middle frontal, …

Comparison Of Alternative Models For Personality Disorders, Leslie C. Morey, Christopher J. Hopwood, John G. Gunderson, Andrew E. Skodol, M. Tracie Shea, Shirley Yen, Robert L. Stout, Mary C. Zanarini, Carlos M. Grilo, Charles A. Sanislow, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

BACKGROUND: The categorical classification system for personality disorder (PD) has been frequently criticized and several alternative dimensional models have been proposed.

METHOD: Antecedent, concurrent and predictive markers of construct validity were examined for three models of PDs: the Five-Factor Model (FFM), the Schedule for Nonadaptive and Adaptive Personality (SNAP) model and the DSM-IV in the Collaborative Study of Personality Disorders (CLPS) sample.

RESULTS: All models showed substantial validity across a variety of marker variables over time. Dimensional models (including dimensionalized DSM-IV) consistently outperformed the conventional categorical diagnosis in predicting external variables, such as subsequent suicidal gestures and hospitalizations. FFM facets …

Positive Childhood Experiences: Resilience And Recovery From Personality Disorder In Early Adulthood, Andrew E. Skodol, Donna S. Bender, Maria E. Pagano, M. Tracie Shea, Shirley Yen, Charles A. Sanislow, Carlos M. Grilo, Maria T. Daversa, Robert L. Stout, Mary C. Zanarini, Thomas H. Mcglashan, John G. Gunderson

Charles A. Sanislow, Ph.D.

OBJECTIVE: Recent follow-along studies of personality disorders have shown significant improvement in psychopathology over time. The purpose of this study was to prospectively investigate the association between positive childhood experiences related to resiliency and remission from personality disorder.

METHOD: Five hundred twenty patients with DSM-IV-based semistructured interview diagnoses of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders were evaluated 6 times over 4 years between September 1996 and June 2002. Positive childhood experiences, including achievements, positive interpersonal relationships with others, and caretaker competencies, were measured using the Childhood Experiences Questionnaire-Revised. The effects of positive childhood experiences on clinically significant remission from …

Psychosocial Impairment And Treatment Utilization By Patients With Borderline Personality Disorder, Other Personality Disorders, Mood And Anxiety Disorders, And A Healthy Comparison Group, Emily B. Ansell, Charles A. Sanislow, Thomas H. Mcglashan, Carlos M. Grilo

Charles A. Sanislow, Ph.D.

This study compared psychosocial functioning and treatment utilization in 130 participants who were diagnosed with a borderline personality disorder (BPD), a non-BPD personality disorder (OPD), a mood and/or anxiety disorder (MAD), or had no current psychiatric diagnosis and served as a healthy comparison group. Diagnostic and Statistical Manual of Mental Disorders (4th Edition) diagnoses, psychosocial functioning, and treatment utilization were determined by using well-established semistructured research interviews conducted by trained doctoral-level clinicians. Analysis of variance revealed the most severe deficits in functioning characterized the BPD group across areas of global functioning with more moderate impairments in functioning occurring in OPD …

Longitudinal Diagnostic Efficiency Of Dsm-Iv Criteria For Borderline Personality Disorder: A 2-Year Prospective Study, Carlos M. Grilo, Charles A. Sanislow, Andrew E. Skodol, John G. Gunderson, Robert L. Stout, Donna S. Bender, Shirley Yen, M. Tracie Shea, Leslie C. Morey, Mary C. Zanarini, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine the longitudinal diagnostic efficiency of the DSM-IV criteria for borderline personality disorder (BPD). METHODS: At baseline, we used semistructured diagnostic interviews to determine criteria and diagnoses; blinded assessments were performed 24 months later with 550 participants. Diagnostic efficiency indices (specifically, conditional probabilities, total predictive power, and kappa) were calculated for each criterion determined at baseline, with the independent BPD diagnosis at follow-up used as the standard. RESULTS: Longitudinal diagnostic efficiencies for the BPD criteria varied, with the criteria of suicidality or self-injury and unstable relationships demonstrating the most predictive utility. CONCLUSIONS: BPD criteria differ in their predictive …

Natural Course Of Bulimia Nervosa And Of Eating Disorder Not Otherwise Specified: 5-Year Prospective Study Of Remissions, Relapses, And The Effects Of Personality Disorder Psychopathology, Carlos M. Grilo, Maria E. Pagano, Andrew E. Skodol, Charles A. Sanislow, Thomas H. Mcglashan, John G. Gunderson, Robert L. Stout

Charles A. Sanislow, Ph.D.

OBJECTIVE: To examine prospectively the natural course of bulimia nervosa and eating disorder not otherwise specified (EDNOS) and to test for the effects of personality disorder psychopathology on remission and relapse.

METHOD: Subjects were 92 female patients with current bulimia nervosa (N = 23) or EDNOS (N = 69) at baseline enrollment in the Collaborative Longitudinal Personality Disorders Study. Axis I psychiatric disorders (including eating disorders) were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Version, and personality disorders were assessed with the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). The course of eating disorders was assessed …

An Evaluation Of Distinct Volumetric And Functional Mri Contributions Toward Understanding Age And Task Performance: A Study In The Basal Ganglia, S Langenecker, E Briceno, N Hamid, Kristy Nielson

Kristy Nielson

Prior work by our group and others has implicated the basal ganglia as important in age-related differences in tasks involving motor response control. The present study used structural and functional MRI approaches to analyze this region of interest (ROI) toward better understanding the contributions of structural and functional MRI measures to understanding age-related and task performance-related cognitive differences. Eleven healthy elders were compared with 11 healthy younger adults while they completed the “go” portion of a complex Go/No-go task. Separate ROI's in the bilateral caudate (C) and putamen/globus pallidus (PGp) were studied based upon previous findings of age-related functional MRI …

Personality Traits Predict Current And Future Functioning Comparably For Individuals With Major Depressive And Personality Disorders, Christopher J. Hopwood, Leslie C. Morey, M. Tracie Shea, Thomas H. Mcglashan, Charles A. Sanislow, Carlos M. Grilo, John G. Gunderson, Mary C. Zanarini, Andrew E. Skodol

Charles A. Sanislow, Ph.D.

Axes I and II were separated in DSM-III to encourage the consideration of the influence of both personality and psychopathology on patient behavior, on the assumption that an understanding of personality would increment syndromal diagnosis in treatment decisions. However, in practice the distinction between Axis I and Axis II is less clear. The current report investigates one aspect on which Axis I and Axis II might be expected to differ, that being the the significance of normative personality traits as an influence on functional status. In this study, the contribution of normative personality traits to functioning is presented for 2 …

Longitudinal Effects Of Personality Disorders On Psychosocial Functioning Of Patients With Major Depressive Disorder, John C. Markowitz, Andrew E. Skodol, Eva Petkova, Jianfeng Cheng, Charles A. Sanislow, Carlos M. Grilo, John G. Gunderson, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

OBJECTIVE: No previous research has focused on psychosocial functioning in understanding how personality disorders compound the impairment caused by major depressive disorder over time. This report describes the effects of persistent and remitting comorbid personality disorders on the depressive status and functioning of patients with major depressive disorder over the course of 2 years.

METHOD: Longitudinal data on functioning from the first 2 years of the Collaborative Longitudinal Personality Disorders Study were evaluated for 3 groups of subjects with major depressive disorder: subjects with major depressive disorder alone (N = 103), those with persistent comorbid personality disorders (N = 164), …

Bereavement In The Modern Western World, David San Filippo Ph.D.

David San Filippo Ph.D.

Bereavement is the process of suffering that follows the loss of a living being that is significant to someone. When one suffers, she or he has to endure an unpleasant experience, in the case of bereavement, the loss of something special to the person. This loss most often is a loved one but could also include the loss of a pet, relationship, or physical or mental capability. This state of suffering is called grief. In describing his grief, C. S. Lewis stated, after the loss of his wife, “No one ever told me that grief felt so much like fear. …

Models Of Care For Treating Late-Life Depression In Primary Care, Steven D. Vannoy, Diane Powers, JüRgen UnüTzer

Steven D Vannoy

No abstract provided.

Mental Health Parity Laws, Louis Graham, Kisha Braithwaite

Louis F Graham

Brief Report: Impact Of Classroom Presentations About Health And Help Seeking On Rural Australian Adolescents’ Intentions To Consult Health Care Professionals., Coralie J. Wilson

Frank Deane

Building Bridges-GP-Team (Building Bridges-Team; Wilson et al., 2004c) is a variation of the Building Bridges to General Practice: GPs in Schools program (Building Bridges-GP; Wilson et al., 2004a), which promotes consultation with health care professionals who are local and available for rural and regional adolescent’ consultation. The first major component of Building Bridges-GP-Team involves structured health professional training that provides knowledge in three basic areas: (1) adolescents’ help seeking barriers and ways to address barriers in primary health care; (2) developmental issues relevant to adolescent’ help seeking; and (3) classroom management, presentation strategies, and elementary teaching skills. Training is based …

Brief Report: Impact Of Classroom Presentations About Health And Help Seeking On Rural Australian Adolescents’ Intentions To Consult Health Care Professionals., Coralie J. Wilson

Coralie J Wilson

Building Bridges-GP-Team (Building Bridges-Team; Wilson et al., 2004c) is a variation of the Building Bridges to General Practice: GPs in Schools program (Building Bridges-GP; Wilson et al., 2004a), which promotes consultation with health care professionals who are local and available for rural and regional adolescent’ consultation. The first major component of Building Bridges-GP-Team involves structured health professional training that provides knowledge in three basic areas: (1) adolescents’ help seeking barriers and ways to address barriers in primary health care; (2) developmental issues relevant to adolescent’ help seeking; and (3) classroom management, presentation strategies, and elementary teaching skills. Training is based …

Depressive Symptoms And Help-Seeking Intentions In Young People., Coralie J. Wilson

Coralie J Wilson

Whether the help-negation effect as demonstrated for suicidal thoughts was also evident for depressive symptoms was investigated in three studies of young people from diverse urban areas. The studies comprised a large sample of younger high school students (years 7-10), a sample of older high school students (years 8-12), and first year university students. A self-report questionnaire that measured help-seeking intentions, prior help-seeking experiences, and depression was administered. Results revealed the strongest inverse association between level of depressive symptoms was with intentions to seek help from parents across all three samples. There was a consistent trend for students to report …

When And How Do Young People Seek Professional Help For Mental Health Problems?, Coralie J. Wilson

Coralie J Wilson

Despite the high prevalence of mental health problems and disorders that develop in adolescence and early adulthood, young people tend to not seek professional help. Young men and young people from Indigenous and ethnic minority groups tend to be those most reluctant to seek help. Young people are more inclined to seek help for mental health problems if they: have some knowledge about mental health issues and sources of help; feel emotionally competent to express their feelings; and have established and trusted relationships with potential help providers. Young people are less likely to seek help if they: are experiencing suicidal …