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Biomedical subjects

D Cicchetti

Publications and source records attributed to D Cicchetti.

At least 19 recordsLinked to original sources
PubMed1992

The Positive and Negative Syndrome Scale and the Brief Psychiatric Rating Scale. Reliability, comparability, and predictive validity.

In a psychiatric rehabilitation study, 154 concurrent ratings were performed using the 30-item Positive and Negative Syndrome Scale (PANSS) and the 18-item Brief Psychiatric Rating Scale (BPRS). Although both instruments had excellent interrater reliability, the PANSS was consistently better: on the 18 symptom items the two instruments share, the PANSS had higher intraclass r's on 14; for the syndromes, the PANSS was higher than the BPRS on positive, negative, and total. Weighted Kappas comparing shared items revealed that most were not interchangeable, with only three coefficients in the excellent range. However, syndrome scale scores were very highly correlated and resulted in similar classification for negative schizophrenia. Ten of the 12 items of the PANSS not included in the BPRS had low zero-order correlations with BPRS items, which suggests that they measure symptoms distinct from those measured by the BPRS and should add to clinical predictive power. This proved true in our study of rehabilitation of patients with schizophrenia. PANSS symptom ratings explained up to 55% of the variance on seven measures of work performance, whereas the BPRS had lower predictive power on six of the seven measures. We concluded that the PANSS may be superior to the BPRS in clinical research on schizophrenia and that most BPRS items are not interchangeable with identically named PANSS items.

Adult↗
PubMed1991

Detection of dissociative disorders in psychiatric patients by a screening instrument and a structured diagnostic interview.

OBJECTIVE AND METHOD: Diagnosis and treatment of the dissociative disorders may be delayed for many years because of difficulties in detecting patients at high risk for dissociative disorders. This study investigates the utility of the Dissociative Experiences Scale (DES), a self-report instrument for dissociative experiences, in detecting patients at high risk for dissociative disorders. The clinician-administered Structured Clinical Interview for DSM-III-R Dissociative Disorders (SCID-D) was used as the diagnostic standard, and 36 outpatients with mixed diagnoses and nine normal subjects were evaluated for the presence and absence of a dissociative disorder. DES scores were then compared. RESULTS: Results indicate that a DES cutoff score of 15-20 yields good to excellent sensitivity and specificity as a screening instrument. However, for higher cutoff points the sensitivity can be much lower. CONCLUSIONS: Thus, although the DES can be used to identify some high-risk patients, they should be further evaluated with such diagnostic instruments as the SCID-D or by in-depth clinical follow-up.

Adult↗
PubMed1991

The child-psychoanalytic play interview: a technique for studying thematic content.

Child psychoanalysts have long viewed play as a reflection of children's inner lives and have used the themes children represent in play for diagnostic and therapeutic work. Given the central role children's play has for clinical work, few studies have addressed play empirically. This paper presents a technique for studying the thematic content of children's play as it emerges during a play session with a child analyst. We report the steps involved in developing this investigative technique and describe the interobserver agreement among four rates using the technique with videotaped play sessions. Implications for future research using such an approach are discussed.

Fantasy↗
PubMed1990

Self-concept, motivation, and competence among preschoolers from maltreating and comparison families.

Maltreated children are at risk for impaired cognitive and school functioning. In this study, the role that home environment, self-concept, and mastery motivation play in this relation was investigated. Thirty-six preschool children and their mothers, representing three family backgrounds (12 low-income maltreating, 12 low-income comparison, 12 middle-income comparison), were assessed in a preschool/home study. Children from maltreating families scored lower than their peers on several measures of cognitive and physical competence and on ratings of motivation. At the same time, these children significantly overrated their physical competence, and self-ratings of competence and acceptance tended to be higher (and less realistic) than those of their low-income peers. An overall difference in developmental quality of the home environment of maltreating families was largely accounted for by socioeconomic status (SES), but the tendency of these homes to be less clean and safe remained significant even after SES was controlled. Various aspects of the home environment were associated with superior task performance, but not with motivation or self-perceptions. Whereas the general home environment may affect competence, relationship factors implicated in maltreatment may be more important in shaping self-concept and motivation.

Achievement↗
PubMed1989

Childhood comorbidity of anxiety/affective disorders and behavior disorders.

Considerable data have been reported concerning comorbidity of various individual psychiatric disorders in children within the diagnostic supradomains of affect/anxiety disorders and behavior disorders as well as between these supradomains. To further examine such comorbidity, 35 psychiatrically hospitalized children were studied in terms of the prevalence of comorbidity, demographic and cognitive characteristics, adaptive functioning and maladaptive behaviors. The prevalence of comorbid behavior + affect/anxiety disorders exceeded 50% of the samples. Children with such comorbidity were similar to children with Behavior only diagnoses in terms of demographic and cognitive characteristics but differed in terms of adaptive functioning and maladaptive behaviors.

Anxiety Disorders↗
PubMed1988

Do object relations deficits distinguish BPD from other diagnostic groups?

Two independent samples that met DSM-III criteria for borderline personality disorder (BPD) were found to have similar patterns of object relations deficits as measured by group means and percentage of high scoring subjects on the four subscales of the Bell Objects Relation (OR) Inventory. Statistical comparison of the composite BPD group with affective, schizoaffective, and schizophrenic groups revealed that the pattern of OR deficits in BPD was significantly different from each of the other diagnostic groups. On the basis of scores from the Alienation subscale alone, BPD subjects could be distinguished from the other diagnostic groups with 77-82% predictive accuracy. The role of object relations deficits in BPD is discussed, along with potential contributions of the Bell OR Inventory to diagnostic efficiency.

Adult↗
PubMed1979

Reliability of a schedule for rating personality disorders.

The inter-situational, inter-rater and temporal reliability of a schedule for rating personality disorders is described. In an initial study with a simplified form of the schedule in patients from different wards of a psychiatric hospital inter-situational reliability between raters was higher for patients with personality disorders than with no personality disorder. Using the full schedule, inter-rater reliability, using audiotaped and separate interviews, and temporal reliability at interviews conducted a mean of 12.5 months apart all reached a satisfactory level, suggesting that the schedule may be a useful instrument for measuring deviant personality traits. The interview may be used with a subject or an informant but agreement between ratings made with informants and psychiatric patients during illness was low, and the schedule is not recommended for use with patients alone during acute episodes of illness.

Humans↗
PubMed1978

Visual calibration of posture in normal and motor retarded Down's syndrome infants.

Infants with Down's syndrome are delayed in achieving motor milestones. When they first sit unsupported a discrepancy between visual and mechanical-vestibular indices of postural stability is less disruptive of their balance than in normal infants. Yet when they first stand unsupported, the same discrepancy disrupts balance more in these infants than in the normal infants. The effect of discrepant visual feedback also differs systematically as a function of the infants' experience of the posture. Monitoring posture in relation to a stable visual surround appears to be fundamental to the normal development of motor control.

Child Development↗
PubMed1978

Mirrow reactions of Down's syndrome infants and toddlers: cognitive underpinnings of self-recognition.

To examine the developmental significance of mirrow self-recognition in early childhood, a cross-sectional study with 55 Down's syndrome children was conducted. When their image is altered by rouge on the nose, normal infants by 22 months indicate self-recognition by touching their noses while looking in the mirror. Only a small percentage of Down's syndrome children touched their noses by this age, confirming the expected lag in this development. However, those young Down's syndrome infants with near-normal development quotient did manifest the reaction. In general, when developmental age was equated, the Down's syndrome children showed parallel development to normal children.

Body Image↗
PubMed1976

The relationship between affective and cognitive development in Down's Syndrome infants.

A close association between affective expression and cognitive development was demonstrated in a longitudinal study of 14 Down's syndrome infants. It was found that the Down's syndrome infants laughed to groups of stimulus items in the same order as did previous samples of normal infants. Although the process was delayed by several months, the retarded babies too laughed first at physically intrusive items and only later to items calling for greater cognitive sophistication. In addition, cognitive developmental status, assessed by the Bayley and Uzgiris-Hunt scales, paralleled and was predicted by the level of affective development. Predictive and concurrent correlations between Bayley mental scores and various indices of affectivity ranged from .68 to .92. There was striking individual consistency across affective, mental, and motor measures, suggesting the organized nature of retarded development. Finally, since Down's syndrome infants frequently smiled under conditions when normal babies would laugh, a role for tension production, in addition to cognitive factors, was suggested in accounting for the behavior of these infants.

Affect↗