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 …

The purpose of this study is to examine the structure of neurobehavioral symptoms in service members with physical and/or psychological trauma to determine the diagnostic specificity of these symptoms. Previous literature has demonstrated that orthopedic injured, mild traumatic brain injury (MTBI), and healthy controls shared similar levels of postconcussive symptom complaints, which suggest that postconcussion-like symptoms are not unique to MTBI. To the best of my knowledge, this is the first study examining this phenomenon in a sample of recently redeployed service members. Dimensional analysis of the PCL-C and NSI using SEM did not produce a model that was consistent with previous literature and principle component analyses did not produce a simple solution for posttraumatic stress or neurobehavioral symptoms. Thus, the study does not provide evidence for construct validity for either instrument. Implications for these findings are that clinicians need to be aware that these instruments may not be measuring coherent constructs within this population as purported and should judiciously interpret and report the results of these instruments.

Malingered posttraumatic stress disorder (PTSD) poses a formidable clinical challenge in personal injury and disability cases because of the apparent ease in feigning PTSD and the supposed link (proximate cause) to the claimed damages. The effective assessment of feigned PTSD is particularly challenging because this diagnosis is both easier to fake than other Axis I disorders and more difficult to detect. As an additional confound, some patients with genuine PTSD produce highly variable, elevated profiles on multiscale inventories that are difficult to distinguish from feigned PTSD. The current study examined whether the Personality Assessment Inventory (PAI) can effectively differentiate between genuine and feigned PTSD in 109 inpatients from a trauma unit. The two most effective scales were the MAL and the NDS scales. As a primary focus, the current study was the first empirical investigation of Resnick's model of malingered PTSD that is comprised of three subtypes: pure malingering (pure-M), partial malingering (partial-M), and false imputation (false-I). The primary goal was to evaluate whether each feigning group was able to (a) effectively simulate PTSD symptoms and diagnoses and (b) avoid being classified as feigning. The partial-M group proved to be the best feigning group in achieving these two goals. Furthermore, …

Risk assessments for offenders often combine past records with current clinical findings from observations, interviews, and test data. Conclusions based on these risk assessments are highly consequential, sometimes resulting in increased criminal sentences or prolonged hospitalization. Offenders are therefore motivated to intentionally minimize their risk scores. Intentional minimization is especially likely to occur in offenders with high psychopathic traits because goal-directed deception is reflected in many of the core traits of the disorder, such as manipulativeness, glibness, and superficial charm. However, this connection appears to be based on the conceptual understanding of psychopathy, and it has rarely been examined empirically for either frequency or success. The current study examined the connection between psychopathic traits and the intentional minimization of risk factors using a sentenced jail sample. In general, offenders were able to effectively minimize risk on the HCR-20 and SAQ, while the PICTS, as a measure of cognitive styles, was more resistant to such minimization. Psychopathic traits, especially high interpersonal facet scores, led to greater minimization using a repeated measure, simulation design. Important differences in the willingness and ability to use deception were found based on (a) the content of subscales, and (b) the mode of administration (i.e., interview vs. …

For response styles, malingering describes the deliberate production of feigned symptoms by persons seeking external gain such as financial compensation, exemption from duty, or leniency from the criminal justice system. In contradistinction, defensiveness occurs when patients attempt to downplay their symptoms of psychological impairment. Both of the aforementioned response styles can markedly affect the accuracy of diagnosis, especially on self-reports, such as multiscale inventories. As an important oversight, no studies have been conducted to examine the effect of culturally specific response styles on profile validity and the classification of malingering among Hispanic American clinical populations. The current study investigated whether the Spanish Personality Assessment Inventory (PAI) effectively distinguished between Spanish-speaking outpatient groups randomly assigned to honest, feigning, and defensive experimental conditions. In examining the results, PAI malingering indicators utilizing Rare Symptoms strategies (NIM and MAL) demonstrated moderate to large effect sizes. For defensiveness, Spanish PAI indicators also demonstrated moderate to very large effect sizes (M d = 1.27; range from 0.94 to 1.68). Regarding psychometric properties, Spanish PAI validity scales, provide adequate to good data on reliability and discriminant validity. Clinical utility of the Spanish PAI increases as different cut scores are employed.

Miranda understanding, appreciation, and reasoning abilities are essential to courts' determinations of knowing and intelligent Miranda rights waivers. Despite the remarkable development of Miranda research in recent decades, studies have generally focused on understanding and appreciation of Miranda rights, but have not examined Miranda reasoning and waiver decisions. Therefore, examining the nature of defendants' decisional capacities constitutes a critical step in further developing theoretical and clinical models for competent Miranda waiver decisions. The current study evaluated Miranda waiver decisions for 80 pretrial defendants from two Tulsa-area Oklahoma jails. Previously untested, the current study examined systematically how rational decision abilities affect defendants' personal waiver decisions. Components from general models of legal decision making, such as decisional competence and judgment models, were examined to determine their applicability to Miranda waiver decisions.

Psychopathy has long been lauded as a premier predictor of negative behavioral outcomes because of its demonstrated associations with violence, antisocial conduct, and institutional maladjustment. Traditional conceptualizations of psychopathy highlight the relatively equal importance placed on personality features (i.e., a grandiose, deceitful interpersonal style and deficits in affective experience) and behavioral elements (i.e., an impulsive and irresponsible lifestyle marked by social deviance) of the syndrome. However, little research to date has investigated psychopathy dimensions in female samples, particularly as they relate to maladaptive behaviors beyond forensic settings. The current study comprehensively examined personality (i.e., Axis II Cluster B traits and alexithymia) and behavioral (i.e., suicide-related behavior and aggression) expressions of psychopathy in a sample of female inpatients recruited from trauma and dual-diagnosis units at a psychiatric hospital in Dallas, Texas. Contrary to expectations, the essential components of psychopathy in female psychiatric patients emphasized APD and NPD traits over features of HPD and BPD, which were relatively similar to elements traditionally highlighted in male psychopathy. On this point, two latent dimensions comprehensively addressed female psychopathy in the current sample: impulsive antisociality and narcissistic and histrionic interpersonal style. Interestingly, psychopathy (M r = .01) and Cluster B traits (M r = .05) …