Validation of a Measure of Alliance for an Adolescent Inpatient Setting

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/112270/1/cpp1901.pd

Longitudinal stability of Social Cognition and Object Relations Scale—Global Rating Method dimensional ratings, score ranges and narrative ‘blandness’ in a clinical sample

While understanding how internalized representations of others (i.e., object relations) change over the course of treatment is essential for treatment planning and evaluation of progress, few studies have examined the nature of these changes through repeated psychological assessments. In this study, we applied the SCORS‐G to Thematic Apperception Test narratives for 61 adult patients with complex psychiatric problems undergoing residential treatment over an 18‐month period. Over the course of treatment, patient representations of self and others became more complex, indicating improvements in mentalization. Further, an analysis of default ratings (i.e., an aspect of story ‘blandness’) suggested that certain shifts in SCORS‐G dimensional scores over time were accounted for by greater degree of scorable content across time points, rather than changes specific to the dimensions themselves. Findings from novel exploratory analyses aimed at evaluating the test–retest reliability of both default rating proportion and several emerging alternative scoring approaches (including changes in minimum, maximum and range of scores on individual dimensions) are reported. While the magnitude of change across mean dimensional scores was found to be lower compared to those previously found in outpatient populations, our results suggest that the SCORS‐G remains capable of detecting changes in mentalization capacities in individuals contending with longstanding, severe psychiatric impairment and personality‐based psychopathology. Implications for treatment, assessment and future research are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/174772/1/cpp2729.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/174772/2/cpp2729_am.pd

Development of a short form for the DSM–5 Levels of Personality Functioning Questionnaire

© 2019, © 2019 Taylor & Francis Group, LLC. The Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM–5]; American Psychiatric Association, 2013) introduced the Alternative DSM–5 Model for Personality Disorders (AMPD). Criterion A of the AMPD conceptualizes level of personality functioning (LOPF) in terms of self- and interpersonal functioning. This article describes the development of a short form for the DSM–5 Level of Personality Functioning Questionnaire (DLOPFQ). A sample of 1,279 participants was drawn from community, clinical, and college settings. All participants completed the DLOPFQ full form. The sample was split into a derivation sample (n = 640) and a validation sample (n = 639). Exploratory factor analysis of the derivation sample data was used to select short-form items. Using the validation sample, confirmatory factor analyses (CFAs) were used to assess fit for proposed item-to-subscale assignments. Short-form subscales had good internal consistency estimates, correlated strongly with full-form subscales, correlated with one another, and were associated with relevant constructs. CFA supported a second-order factor model (i.e., four factors loading onto a higher order LOPF factor). Overall, the DLOPFQ Short Form provides a brief assessment of the constructs measured by the full form. Limitations of the study are reviewed, speculations for improving the measure are discussed, and suggestions for future directions are provided

Card pull effects of the Thematic Apperception Test using the Social Cognition and Object Relations‐Global Rating Method on complex psychiatric sample

In recent years, there has been growing interest in examining the stimulus pull effects on respondent narratives to the Thematic Apperception Test (Murray, 1943) using standardized coding methods such as the Social Cognition and Object Relations Scale–Global Rating Method (SCORS‐G; Stein, Hilsenroth, Slavin‐Mulford, & Pinsker, 2011; Westen, 1995). The present study expands on prior work by examining sources of variance in SCORS‐G dimensions and card pull effect patterns in an adult clinical sample characterized by high psychiatric comorbidity and clinical severity. A sample of 158 adult psychiatric patients in long‐term residential treatment provided narratives to 10 TAT cards (five of which have not previously been studied for pull effects). Cards 2 and 7BM pulled for significantly more adaptive narratives (positive pull), whereas Card 13MF pulled for more pathological stories (negative pull). Like prior studies, variance in cognitive dimensions of the SCORS‐G was most explained by person effects, whereas the largest source of variance for all other dimensions was best explained by a combination of the card and the person effects on the narrative. Finally, exploratory analyses of card pull effects within different gender groups were conducted. The implications of these findings for performance‐based future studies and possible clinical applications of card pull findings are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/170851/1/cpp2554_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/170851/2/cpp2554.pd

Profile of Mental Functioning. M Axis

This chapter describes 12 categories of basic mental functions that can help clinicians capture the complexity and individuality of each patient. The authors provide descriptions of different levels of psychological functioning and adaptation, ranging from more compromised to more functional, along with descriptors that allow a clinician to rate a patient in each capacity. Clinical utility demands that both adaptive and maladaptive functioning be taken into account in order to plan the most effective and well-rounded therapeutic interventions, anticipate challenges that may arise during treatment, delineate therapeutic goals, and evaluate treatment progress

Dimensional measure of self and interpersonal functioning: Comparisons with treatment alliance and readiness for inpatient psychotherapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145252/1/cpp2193_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145252/2/cpp2193.pd

Convergent and discriminant validity and utility of the DSM–5 Levels of Personality Functioning Questionnaire (DLOPFQ): Associations with medical health care provider ratings and measures of physical health

The ability to evaluate patients’ level of personality functioning in assessing personality disorders has become increasingly important since the DSM–5 Section III hybrid system of personality disorder assessment was released. One measure developed to assess this criterion is the DSM–5 Levels of Personality Functioning Questionnaire (DLOPFQ; Huprich et al., 2017), which assesses individuals’ self and other representations in four domains—self-direction, identity, empathy, and intimacy—across two contexts—work or school and relationships. A sample of 140 psychiatric and internal medicine outpatients were administered several questionnaires, including the DLOPFQ. Provider ratings also were obtained for level of functioning and DSM–5 pathological personality traits. Several of the DLOPFQ scales were significantly correlated with self-reported and provider-reported measures of DSM–5 trait domains and levels of functioning, along with self-reported measures of effortful control, overall physical and mental health, and well-being. Certain DLOPFQ scales and subscales were associated with provider ratings of likeability and patient contact with the providers. However, relatively modest validity coefficients, as well as poor discriminant validity of domain scales, indicate further research and measure refinement might be needed. It is concluded that, although further research is necessary, the DLOPFQ could be useful for understanding patients’ personality pathology in clinical settings

Introduction of the DSM-5 levels of personality functioning questionnaire

With the introduction in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) of a hybrid system of personality disorder assessment, the ability to assess patients\u27 traits, as well as their level of personality functioning, has become increasingly important. To assess this criterion, the DSM-5 Levels of Personality Functioning Questionnaire (DLOPFQ) was developed. The DLOPFQ assesses individuals\u27 self-impairments and other impairments in several domains (self-direction, identity, empathy, and intimacy) and across 2 contexts (work/school and relationships). A sample of 140 psychiatric and medical outpatients was administered the DLOPFQ and several other measures to assess its reliability and construct, incremental, and discriminant validity. The internal consistency and convergence with validation measures yielded generally meaningful and expected results. Several DLOPFQ scales and subscales were significantly correlated with measures of DSM-5 trait domains and levels of personality functioning. DLOPFQ scales also correlated with self-reported ratings of overdependence, detachment, healthy dependency, and overall mental health and well-being. The DLOPFQ also predicted interpersonal and general functioning beyond DSM-5 trait domains. These results support the reliability and validity of the DLOPFQ, which appears to be suitable for clinical use and warrants ongoing study