Adapting Clinical Services To Accommodate Needs of Refugee Populations

The diversity of the refugee population in the United States requires practicing psychologists to respond by adapting clinical services to meet their mental health needs. However, the available literature on culturally adapted treatments is only a first step in guiding the process for adapting clinical services. This paper describes our experiences with designing and adapting a variety of clinical services for youth and families with refugee status. Guided by Sue\u27s (2006) tenets for culturally competent service delivery, we discuss a therapeutic model of tiered service delivery used to deliver preventative services and treatment to refugee youth and adults. We discuss how we adapted treatments to help overcome access barriers to mental health treatment, and we provide specific examples of how existing treatments were used with refugee populations. In addition, we discuss information and approaches for how practicing psychologists can develop additional skills for working with refugee populations. We conclude by focusing on the need for our field to work toward improving access to mental health treatment for refugee youth and families and developing evidence-based treatments for this population

Self-Reported ADHD symptoms among college students: Item positioning affects symptom endorsement rates

Objective: The effect of manipulating item positioning on self-reported ADHD symptoms was examined. We assessed whether listing DSM-IV ADHD symptoms serially or interspersed affected (a) the correlation between ADHD symptoms and (b) the rate of symptom endorsement. Method: In Study 1, an undergraduate sample (n = 102) completed a measure that listed DSM-IV ADHD symptoms serially and a measure that interspersed DSM-IV ADHD items among non-ADHD symptoms. In Study 2, a separate undergraduate sample (n = 240) completed a measure that listed DSM-IV ADHD symptoms serially and another ADHD measure that interspersed DSM-IV ADHD items among non-DSM-IV ADHD items. Results: Item positioning did not affect the correlation between symptoms, but did reveal a significant bias in the rate of symptom endorsements. Conclusion: These findings suggest that there is significant variability in ADHD symptom endorsements resulting from item positioning. This effect has implications for clinical assessment and epidemiological research of ADHD among college students

Emotion dysregulation and emotional impulsivity among adults with attention-deficit/hyperactivity disorder: Results of a preliminary study.

Recent reviews argue that emotion dysregulation is an important feature of attention-deficit/hyperactivity disorder (ADHD) and involves a failure to inhibit negative emotions that leads to negative affectively-driven impulsive behavior (i.e., emotional impulsivity). The goal of the current study was to assess (a) whether emotion dysregulation and emotional impulsivity was higher in a group of adults diagnosed with ADHD and (b) if the relationship between core ADHD symptoms (i.e., inattention and hyperactivity-impulsivity) and emotional impulsivity is mediated by emotion dysregulation symptoms. A group of adults with (n?=?18) and without (n?=?23) ADHD completed measures of core ADHD symptoms, emotion dysregulation, and emotional impulsivity. A series of one-way analyses of covariance indicated significant between-group differences in emotion dysregulation and emotional impulsivity when current depression and oppositional defiant disorder ratings were covaried. In addition, the relationship between ADHD symptoms and emotional impulsivity was mediated by emotion dysregulation symptoms. These findings suggest that emotion dysregulation and emotional impulsivity are higher in adults diagnosed with ADHD and that emotion dysregulation symptoms have predictive value beyond core ADHD symptoms

Anxiety and depression symptoms in psychometrically identified schizotypy

The neurodevelopmental vulnerability for schizophrenia appears to be expressed across a dynamic continuum of adjustment referred to as schizotypy. This model suggests that nonpsychotic schizotypic individuals should exhibit mild and transient forms of symptoms seen in full-blown schizophrenia. Given that depression and anxiety are reported to be comorbid with schizophrenia, the present study examined the relationship of psychometrically defined schizotypy with symptoms of depression and anxiety in a college student sample (n = 1258). A series of confirmatory factor analyses indicated that a three-factor solution of positive schizotypy, negative schizotypy, and negative affect provided the best solution for self-report measures of schizotypy, anxiety, and depression. As hypothesized, the model indicated that symptoms of depression and anxiety are more strongly associated with the positive-symptom dimension of schizotypy than with the negative-symptom dimension. This is consistent with studies of schizophrenic patients and longitudinal findings that positive-symptom schizotypes are at risk for both mood and non-mood psychotic disorders, while negative-symptom schizotypes appear more specifically at risk for schizophrenia-spectrum disorders

The Relationship of Asperger’s Characteristics and Schizotypal Personality Traits in a Non-clinical Adult Sample

The study examines the relationship between Asperger’s Disorder (AD) and Schizotypal Personality Disorder (SPD), mutually exclusive but similar diagnoses [DSM-IV-TR; American Psychiatric Association (2000).Diagnostic and statistical manual of mental disorders. Washington, DC: Author]. The literature and comparison of diagnostic criteria suggest that the two disorders may overlap: AD social impairment with SPD interpersonal problems and AD communication deficits with SPD disorganized features. Questionnaire measures of AD and SPD were administered to a large non-clinical adult sample. Consistent with expectations, the Asperger’s and Schizotypal questionnaires were positively correlated. Further, the social-interpersonal and communication-disorganized areas were positively correlated, though the relationship between social-interpersonal areas is particularly strong. Future research should continue to explore the relationship between AD and schizotypy to confirm current findings and improve understanding of distinctions between the disorders

Examination of the reliability and factor structure of the Autism Spectrum Quotient (AQ) in a non-clinical sample

A self-report screening measure for high functioning autism spectrum disorders is needed for diagnostic screening and research purposes. The Autism Spectrum Quotient (AQ) has been developed for these reasons, although a comprehensive assessment of the psychometric properties of the AQ has not been completed. The purpose of the current study was to assess the distribution, internal consistency, and factor structure of the AQ in a non-clinical sample (n = 1005). The current findings demonstrate the normal distribution of autistic traits and support a three-factor structure of the AQ. Additionally, a three-factor version of the AQ yielded somewhat improved internal consistency. Implications of these findings and suggestions for further development of the AQ as a measure of the autism spectrum are offered

Adapting clinical services to accommodate needs of refugee populations.

The diversity of the refugee population in the United States requires practicing psychologists to respond by adapting clinical services to meet their mental health needs. However, the available literature on culturally adapted treatments is only a first step in guiding the process for adapting clinical services. This paper describes our experiences with designing and adapting a variety of clinical services for youth and families with refugee status. Guided by Sue's (2006) tenets for culturally competent service delivery, we discuss a therapeutic model of tiered service delivery used to deliver preventative services and treatment to refugee youth and adults. We discuss how we adapted treatments to help overcome access barriers to mental health treatment, and we provide specific examples of how existing treatments were used with refugee populations. In addition, we discuss information and approaches for how practicing psychologists can develop additional skills for working with refugee populations. We conclude by focusing on the need for our field to work toward improving access to mental health treatment for refugee youth and families and developing evidence-based treatments for this population

The interaction of reinforcement sensitivity and life events in the prediction of anhedonic depression and mixed anxiety-depression symptoms

This study examined the relationship between reinforcement sensitivity theory (RST), life stress, and internalizing symptoms. Generally, low sensitivity of the behavioral approach system (BAS) predicts depression whereas high sensitivity of the behavioral inhibition system (BIS) predicts anxiety and depression. However, few studies have examined how RST variables interact with life stress to predict these symptoms. It was hypothesized that higher BIS sensitivity would predict greater anxious arousal; lower BAS sensitivity and higher BIS sensitivity would predict greater anhedonic depression as predicted by the joint subsystems hypothesis (JSH); and low BAS, high BIS, and high life stress would interact to predict anhedonic depression symptoms whereas high BIS with high life stress would predict anxious symptoms. A sample of 285 undergraduates completed measures of RST, life stress, and internalizing symptoms. Greater BIS sensitivity predicted mixed anxiety–depression and anhedonic depressed symptoms, lower BAS predicted anhedonic depression symptoms, and life events predicted mixed anxiety–depression. Three-way interactions indicated that for high life stress, BIS predicted both types of symptoms. For low life stress, low BAS and high BIS predicted anhedonic depression whereas high BIS and high BAS predicted mixed anxiety–depression. The implications of these findings are discussed in terms of the JSH

Borderline personality disorder traits and sexual compliance: a fear of abandonment manipulation

Borderline personality disorder (BPD) traits are primarily characterized by frantic efforts to avoid abandonment and unstable interpersonal relationships. Sexual coercion and consequently sexual compliance are overrepresented in the romantic relationships of those with BPD traits. The present study examined whether this association is altered after inducing fear of abandonment with a novel false feedback manipulation. After receiving an accurate personality assessment, 130 undergraduate women were randomly told how well they match with their current romantic partner—either in 11th percentile or the 89th. Our manipulation decreased mood and relationship expectations in the poorly matched condition; these effects were positive in the highly matched condition. We found that this fear of abandonment manipulation moderated the association between BPD traits and hypothetical sexual compliance. In the poorly matched condition, participants predicted that they would be more likely to engage in unwanted sexual activity the more BPD traits they endorsed (ß = 0.498, p < 0.001, ηp2 = 0.257); this association was not present in the highly matched condition (ß = 0.209, p = 0.102, ηp2 = 0.045). Knowing that the relationship between BPD traits and sexual compliance may be situational increases our understanding of the relationships of people with BPD traits

Are infidelity tolerance and rape myth acceptance related constructs? An association moderated by psychopathy and narcissism

Infidelity and rape are sexual transgressions that embody self-centeredness and disregard for others. The attitudinal frameworks related to each of these sexual malfeasances—infidelity tolerance and rape myth acceptance (RMA), respectively—may both result from sexual scripts that lack empathy. We proposed that infidelity tolerance and RMA are associated constructs and that their relationship is moderated by psychopathy and narcissism, both of which are characterized by a lack of empathy. In our cross-sectional study of 262 undergraduates, the relationship between infidelity tolerance and RMA was significantly moderated by both psychopathy (β = 0.125, p = 0.029) and narcissism (β = 0.133, p = 0.025). Specifically, the positive relationship between infidelity tolerance and RMA was strengthened as psychopathic or narcissistic traits increased. Further, in an exploratory set of analyses, we found that the self-centered impulsivity factor of psychopathy and the exhibitionism/entitlement factor of narcissism were driving their respective interactions with RMA. Infidelity tolerance and RMA are associated, especially in people that are more likely to lack empathy. The sexual scripts of people with psychopathic and narcissistic traits should be further examined. Other sexual scripts (e.g., hostile masculinity) may also result in a positive relationship between infidelity tolerance and RMA