The treatment of schizophrenia today consists of a multi-component system of services. Mental health professionals generally agree that anti-psychotic medications are an essential treatment for schizophrenia. However, adherence to medication regimens by patients with schizophrenia is notoriously poor. To identify correlates and predictors of medication compliance, the Schedule for Affective Disorders and Schizophrenia (SADS), a semi-structured diagnostic interview, was administered to 90 outpatients with schizophrenia. The results suggest that there are specific variables (i.e., mood symptoms, psychotic symptoms, and socio-demographic variables) that predict medication compliance. In addition, the confirmation of these variables was effective (90.0%) at identifying non-compliant patients. The results suggest that schizophrenia is a complex disorder composed of heterogeneous symptoms. However, a specific group of symptoms is proposed which may provide a screening measure for predicting patients who are likely to be non-compliant with their medications.

The phenomenon of seasonality of birth in schizophrenia is important in the study of the etiology of this mental disorder because it helps to give directions for further research. Patients' hospital files from 1981 to 1991 of two of the largest hospitals with psychiatric wards in Taiwan were reviewed, and dates of birth collected on 3346 patients diagnosed with schizophrenia. After adjusting for the variations of the total monthly births in the population, an Auto-Regressive Integrated Moving Average (ARIMA) model was applied. Results support a seasonality phenomenon and indicate a disproportional excess of births in schizophrenia in the cold months (Nov. to Feb.) compared to the hot months (May to Aug.). These findings are compatible with many other studies in other countries and climates. Further investigations of season-related environmental factors in the etiology of schizophrenia are recommended.

This study concerns audiometric evaluation and prediction of hearing loss in the autistic child based on information derived from acoustic reflex thresholds. Two groups (autistic males and normal children) of five subjects each were utilized. Results indicated that the acoustic reflex method consistently predicted significantly higher hearing thresholds for autistic subjects than operant pure-tone audiometric procedures. Furthermore, the acoustic reflex thresholds were significantly less sensitive in the autistic group than in the normal group, suggesting that the acoustic reflex response is somehow altered in autistic individuals. These findings are consistent with earlier work which hypothesized that autistics, manifest an organic brain lesion which interferes with the propagation of auditory information.

Cognitive impairment is common in multiple sclerosis (MS), with as many as 70% of patients with MS affected. Individuals with MS who experience cognitive deficits are less likely to be employed, and may have more difficulty performing independent activities of daily living. Most commonly, deficits are observed in processing speed, complex attention, and memory. Because lesion location varies widely among individuals, no clear pattern of cognitive dysfunction in MS has emerged. However, a number of risk and protective factors may influence the likelihood of individuals to develop and/or express dysfunction, though the contribution of each to specific domains of cognition has not been fully explored. Recently, support for the cognitive reserve hypothesis (i.e., enriching life experiences protect against cognitive decline despite disease burden) has emerged in the MS literature. The current study investigated the contributions of cognitive reserve to learning and memory functioning in MS and the interaction of cognitive reserve variables and risk factors known to impact cognitive functioning in individuals with MS. Finding revealed cognitive reserve protects against decline in the domains of processing speed and complex attention. Furthermore, indirect protective effects of cognitive reserve through these domains were observed for verbal learning and memory. Finally, in line …

Compromised validity of test data due to exaggeration or fabrication of cognitive deficits inhibits the capacity to establish appropriate conclusions and recommendations in neuropsychological examinations. Detection of feigned neurocognitive impairment presents a formidable challenge, particularly for evaluations involving possibilities of significant secondary gain. Among specific populations examined in this domain, litigating mild traumatic brain injury (mTBI) samples are among the most researched. One subpopulation with potential to contribute significantly to this body of literature is that of retired athletes undergoing fixed-battery neuropsychological evaluations within an assessment program. Given the considerable prevalence of concussions sustained by athletes in this sport and the substantial monetary incentives within this program, a unique opportunity exists to establish rates of feigning within this population to be compared to similar forensic mTBI samples. Further, a fixed battery with multiple validity tests (VT) offers a chance to evaluate the classification accuracy of an aggregated VT failure paradigm, as uncertainty abounds regarding the optimal approach to the recommended use of multiple VTs for effort assessment. The current study seeks to examine rates of feigned neurocognitive impairment in this population, demonstrate prediction accuracy equivalence between models based on aggregated VT failures and logistic regression, and compare classification performance of …

A study was conducted in which a computerized battery of information processing tasks (called the COGLAB) was administered to three subject groups: patients with schizophrenia, patients with bipolar disorder, and normal controls. The tasks included Mueller-Lyer illusion, reaction time, size estimation, Wisconsin Card Sort, backward masking. and Asarnow Continuous Performance.

Research indicates that some college students may be strongly motivated to feign AHDD symptoms for desired external incentives, such as stimulant medication or academic accommodations. To date, literature examining feigned ADHD has been primarily focused on ADHD specific self-report measures (e.g., CAARS) and continuous performance tests (e.g., CPTs); however, little attention has been devoted to the use of multi-scale inventories in detecting feigned ADHD. For CPT measures, virtually no literature exists on the effectiveness of the TOVA to identify feigned ADHD, despite its frequent clinical use for establishing this diagnosis. The current study utilized a between-subjects simulation design to validate feigning cut scores on ADHD-specific measures using 66 feigners and 51 confirmed ADHD cases. As prior literature suggested, the results convincingly demonstrated that face-valid ADHD assessment measures were easily faked. Across both TOVA modalities (e.g., Auditory and Visual), the ADHD simulators performed significantly poorer than those diagnosed with ADHD. As an innovative approach, a Dissimulation-ADHD (Ds-ADHD) scale was developed and initially validated. The Ds-ADHD is composed of ten MMPI-2-RF items mistakenly believed to be clinical characteristics associated with ADHD. Requiring cross-validation, Ds-ADHD optimized cut scores and classification of ADHD feigners appears promising. They were clearly distinguishable from ADHD client, as …

The current study examined 236 undergraduate students in a week long twice-per-day ecological momentary assessment exploring the influence of baseline reward sensitivity and interactions between circadian variables (i.e., total sleep time, sleep quality) and daily measures of reward. Though primary study findings did not support reward sensitivity related moderation of sleep-reward pathways, a number of notable findings emerged. We found evidence of specific domains of reward sensitivity (anticipatory reward and reward responsiveness) which are uniquely related to daily experiences of reward. In addition, bidirectional circadian-reward pathways were found between sleep quality and daily rewards which suggests pathways towards reward-related engagement. Evidence also supported interactions between sleep quality and total sleep time on experience of daily reward, further highlighting the complexity of sleep-reward pathways and their relevance to mood symptoms.

Nonsuicidal self-injury (NSSI) is a form of direct self-harm that involves willful damage to bodily tissue without suicidal intent; it includes behaviors such as cutting, burning, carving, biting, scraping, and scratching of the skin, as well as hitting and skin and scab picking. Engagement in NSSI has been shown to relate to a host of maladaptive states and outcomes, including depression, anxiety, poor emotion regulation, and suicidal ideation and attempts. Socially sanctioned forms of body modification (e.g. tattoos and piercings) have received less attention as potential self-harm outlets, but have been posited to represent similar physical outlets of emotional pain. Indirect self-harm, in contrast, can include behaviors such as substance abuse, disordered eating, participation in abusive relationships, and sexual risk-taking. Extant literature suggests that self-harm in either form is associated with higher levels of self-criticism than healthy adults endorse. However, few studies have examined self-criticism in each of these self-harming subgroups. Female participants were recruited online using Amazon's Mechanical Turk. Results from the present study indicate that 1) direct self-harming individuals are considerably more self-critical than indirect self-harmers and control subjects, 2) those who engage in multiple forms of self-harm are more self-critical than those engaging in only one form, …

Currently, neuropsychologists rely on assessment instruments rooted in century old theory and technology to make evaluations of military personnel’s readiness to return-to-duty or return to their community. The present study sought to explore an alternative by evaluating the validity of a neuropsychological assessment presented within a virtual reality platform. The integration of a neuropsychological assessment into a cognitively and emotionally demanding virtual environment – reminiscent of a combat experience in Iraq – offers a more ecologically valid manner in which to evaluate the cognitive skills required in theater. U.S. military veterans’ (N = 50) performance on the Virtual Reality Stroop Task (VRST) was compared with performance on a paper-and-pencil, a computer adapted version of the Stroop task, and the subtests included in the Automated Neuropsychological Assessment Metrics-4 (ANAM4) TBI-MIL test battery. Results supported the validity of the VRST, indicating it demonstrates the typical Stroop effect pattern. The emotional salience of the VRST resulted in slowed reaction time compared to the ANAM Stroop. Further, the complex interference condition of the VRST offers opportunities for evaluation of exogenous and endogenous attentional processing. In the evaluation of threat, participants were noted to perform more accurately and more quickly in low threat versus high …

The present study compared the responses of a group of simulating malingerers who were offered a monetary incentive to feign symptoms of a head injury, with the responses of head injured groups both with and without litigation, a forensic parole group, and an honest-responding control group. The following six neuropsychological measures were utilized: Rey 15-Item Memory Test, Controlled Oral Word Association Test, Finger Oscillation Test, WAIS-R Neuropsychological Instrument (Vocabulary, Information, and Similarities subtests), Booklet Category Test, and Wisconsin Card Sorting Test. The statistical concepts of floor effect, performance curve, and magnitude of error were examined. Additionally, the statistical differences in the responses of the five groups were analyzed to determine cutting scores for use in distinguishing malingerers from nonmalingerers.

Traumatic brain injury (TBI) is the leading cause of death and disability among children and adolescents in the US. Children and adolescents who sustain moderate and severe head injuries are much more likely to evidence significant deficits in neuropsychological functioning when compared with children with mild head injuries. Information about the recovery process and functional sequelae associated with moderate and severe head injuries remains limited, despite clear indications that children who experience such injuries typically exhibit notable deficits in intellectual functioning, particularly during the acute phase of recovery. Thus, the present study was conducted to augment research on intellectual functioning in children with moderate or severe head injuries. To accomplish this, the study first examined the proposed factor model of the WISC-III in children with moderate and severe TBI. Given high prevalence rates and similar trends in cognitive impairment, particularly within the frontal lobe structures (e.g., disrupted cognitive flexibility and divided attention), the study also examined this same factor model for a group of children with attention-deficit/hyperactivity disorder (ADHD) and compared it with the model fit from the TBI group. In the second phase of the study, both the TBI and AHDH groups were evaluated to determine if distinct WISC-III …

The Diagnostic and Statistical Manual of Mental Disorders arranges co-occurring clusters of symptoms into distinct disorder categories, which theoretically have specific etiologies, pathologies, and treatments. However, researchers and clinicians alike have consistently found DSM diagnoses to have high rates of comorbidity, low diagnostic specificity, and no disorder has proven to be a discrete category. There is mounting evidence that dimensional taxonomies more accurately capture the underlying structure of mental illness and clinical presentations. The recently proposed hierarchical taxonomy of psychopathology presumes to address the issues of categorical nosologies using a data driven approach to create a dimensional model of psychopathology. However, heretofore there are no empirical examinations of HiTOP's ability to predict psychotherapy treatment outcomes. This study compared the predictive validity DSM, RDoC, and HiTOP criteria using natural language processing on free text narrative notes. Of the three GMM run, only the model using DSM criteria as predictors had adequate model fit. Additionally, none of the nosologies significantly predicted treatment course. Implications for the application of RDoC and HiTOP are discussed.

Although the suicide literature is replete with studies approaching risk assessment from the standpoint of the external observer, research into the intrapsychic mechanisms involved is rare. This study investigated the importance of hope, threat, competence, succorance, helplessness, and control among inpatients hospitalized for suicidal behavior.

Thirty-two silicone breast implant patients scored in the mild to moderate range of impairment on the Halstead-Reitan Neuropsychological Battery. An unusual number of patients had positive tests for antinuclear antibody on immunological testing and a high incidence of EEG abnormalities were found. Personality testing revealed an MMPI profile which is typical for neuropsychologically impaired subjects but components were consistent with extreme emotional distress. None of the subjects were near the cutoff score for malingering or faking bad on the F-K index of the MMPI. There was no apparent relationship between length of exposure and the severity of neurological impairment. Also, explanted subjects performance was not improved when compared to subjects whose implants were still in place.

One purpose of this primarily exploratory study was to explore whether differences in beliefs about the etiology of homosexuality exist between homosexuals and nonhomosexuals. Another purpose was to investigate whether differences exist between groups in the extent to which they feel that it is appropriate to manifest homosexual behaviors in public. Finally, this study examined the question of whether a relationship exists between one's perception of the cause of homosexuality and the degree to which that person felt it was appropriate to manifest homosexual behaviors.

This study evaluated the efficacy of a cognitive behavioral treatment for insomnia among inpatients who met the diagnostic criteria for Post Traumatic Stress Disorder. The cognitive behavioral treatment consisted of progressive relaxation, stimulus control, and thought stopping with cognitive restructuring.

Incidents and awareness of sports-related concussion have grown in recent years, attracting attention in both the academic and popular press. These concussions can lead to the rapid onset of neurological dysfunctions, as well as a variety of subjective symptoms. Although concussive sequelae are typically considered transient, debate remains about the persistent effects of repeated traumatic contact during sport participation. Although research has examined the complications of head trauma found in traditionally popular sports (e.g., football, soccer, boxing), little research has focused on the growing sport of mixed-martial-arts (MMA). Research specifically pertaining to MMA is in nascent stages, but to-date studies suggest that concussive injuries for this sport are prevalent and the training regimens of these athletes may place them at a high risk for concussive or subconcussive head traumas—as well as the accompanying neurological difficulties. The current study is the first to assess cognitive profiles of MMA athletes using an objective neuropsychological assessment instrument. Among 56 athletes (28 MMA athletes and 28 athletes not exposed to head traumas), no neuropsychological differences were found between groups of athletes. Additionally, no aspects of MMA training regimen shared a reliable relationship with neuropsychological performance or subjective concussive symptoms. This suggests non-professional participation in …

This study analyzed the relationship between the OF functioning of 100 incarcerated male offenders and their psychopathy symptoms. The study's rejected hypothesis had predicted a significant relationship between measures of OF functioning and the Defective Affective Experience (DAE) and Impulsive and Irresponsible Behavioral Style (IIB) factors of the Cooke and Michie (2001) three-factor model of psychopathy. Regression analysis failed to demonstrate a relationship between OF functioning and the DAE and IIB factors. Group differences on OF functioning were not demonstrated between participants in the upper and lower quartiles of a summed DAE and IIB factor score. A general role for OF functioning in criminal behavior was suggested as two OF measures accounted for 14.9% of the variance of criminal convictions.

The current study investigated the process of change underlying two different evidence-based treatments that yield similar outcome effectiveness in the treatment of depression: Cognitive Therapy (CT) and Interpersonal Therapy (IPT). The phase model of psychotherapeutic change (Howard et al., 1993) change is used to provide both a theoretical and practical framework in which to assess different patterns of change across the treatment modalities. The phase model posits that recovery from distress occurs in three sequential stages: remoralization, remediation and rehabilitation. CT can be conceptualized as a treatment in which the primary focus is on the treatment of symptoms (remediation), whereas IPT can typically be conceptualized as focusing on interpersonal conflicts and functioning (rehabilitation). The study utilized the TDCRP dataset (Elkin et al., 1985). Survival analysis indicated no significant difference in terms of onset or pattern of improvement across treatment orientations. Chi square analyses indicated individuals treated with IPT spend significantly more time engaged in rehabilitation compared to their CT counterparts. Taken together, these findings represent evidence that the process of therapeutic change is similar, if not virtually identical, across therapeutic orientation. The analyses also indicate that the phases of therapy may not necessarily be mutually exclusive and sequential, but may …

Previous research has revealed heterogeneity in outcome trajectories among individuals seeking psychotherapy. However, questions remain as to the number, nature, and predictors of these trajectories. Therefore, the present study had three aims: 1) to identify heterogeneous latent groups among treatment trajectories of 212 clients with major depressive disorder (MDD) seeking psychotherapy at a community mental health training clinic; 2) to identify significant associations between clinical and demographic variables and group membership; and 3) to identify correlations between trajectory shape and positive treatment outcome. Prior to treatment, participants provided demographic information and completed symptom severity ratings. Once in treatment, participants completed a self-report of distress via the Outcome Questionnaire (OQ-45) at every session. Growth mixture modeling was utilized to identify distinct patient subgroups based on outcome trajectories among the sample. Three distinct latent classes of treatment trajectory were identified, providing evidence of heterogeneity in treatment trajectories among individuals with MDD. Baseline distress, pre-treatment work problems, and sleep difficulties were found to be predictive of an individual's membership in a specific trajectory group. Finally, specific shapes of change, namely early response and sudden gains, were associated with positive treatment outcome. Findings from this study can be used to identify patients at risk …

The number of adults in the United States who are age 65 or older is rapidly increasing. With longer lifespan comes an increase in chronic diseases such as dementia, diabetes, and depression. This study used archival data from a larger study conducted at the Memory Clinic at John Peter Smith County Hospital in Ft. Worth, Texas to examine several hypotheses and research questions related to the influence of type of dementia, presence of Type II diabetes, and presence of depression on neuropsychological test performance. First, this study attempted to identify specific patterns of performance on neuropsychological measures for those with Alzheimer's dementia (AD), vascular dementia (VaD), or mild cognitive impairment (MCI). The results indicated that those with MCI perform better than those with AD or VaD on all neuropsychological measures, and that those with VaD perform better than those with AD on a measure of verbal memory. Another purpose of the study was to determine how the presence of Type II diabetes affects this pattern of functioning; the overall finding in this study was that the presence or absence of diabetes did not affect performance on measures of cognitive functioning. Additionally, the study attempted to add to literature examining the …

This longitudinal study examined factors influencing the relationship between sustained partner violence and depression/suicidality among ethnically diverse, low income, community women. The sample at Wave 1 consisted of 303 African American, 273 Euro-American, and 260 Mexican American women in long term relationships with a household income less that twice the poverty threshold. There were no ethnic differences on frequency of partner violence, depression, or suicidality. The moderate relationship between partner violence and women's depression, confirmed previous findings. Frequency, but not recency, of violence predicted depression and suicidal ideation for African Americans and Mexican Americans, even after controlling for earlier depression or ideation. Recent violence did not predict Euro-American's depression or suicidality after controlling for initial scores. Causal and responsibility attributions for partners' violence did not mediate the relationship between violence and depression or suicidality in any ethnic group. However, African American women's attributions of global effects for violence mediated the relationship of violence on depression and suicidal ideation. Poverty level and marital status moderated the relationship between violence and the number of times women seriously considered and actually attempted suicide. Frequent violence was most lethal among the poorest women and marriage provided the least protection for women in the most …

This study predicted that individuals diagnosed as having higher levels of stress, based upon DSM-III-R, Axis IV ratings, would also be diagnosed as having more severe forms of mental illness. Conversely, it predicted that individuals with higher premorbid health ratings, according to DSM-III-R, Axis V, would be diagnosed as having less severe forms of mental illness. Highly significant correlations were found between stress ratings and severity of disorder. Significant inverse relationships were also found between Axis V ratings and disorder severity. Additionally, several other demographic variables were significantly correlated with severity of disorder.