Biomedical subjects
S O Lilienfeld
Publications and source records attributed to S O Lilienfeld.
Coming to grips with negative evidence for the Comprehensive System for the Rorschach: a comment on Gacono, Loving, and Bodholdt; Ganellen; and Bornstein.
The Comprehensive System (CS; Exner, 1991, 1993) for the Rorschach is currently engulfed in controversy. This comment article responds to 3 articles by Rorschach proponents in this issue of the Journal of Personality Assessment. Contrary to the claims of Gacono, Loving, and Bodholdt (this issue), CS scores do not bear a well-demonstrated relationship to psychopathy, antisocial personality disorder, or conduct disorder. Contrary to the claims of Ganellen (this issue), both the original and the revised CS Depression Index (Exner, 1993) bear little or no relationship to depression diagnoses. Furthermore, the scoring reliability of some CS scores is problematic. Although we agree with Bornstein (this issue) that Rorschach scores generally bear little or no relation to psychiatric diagnoses or self-report questionnaires, we believe this lack of relationship tends to disconfirm hypotheses concerning the validity of the Rorschach. In the spirit of the philosopher Sir Karl Popper, the Rorschach community should not minimize negative evidence or engage in post hoc arguments to immunize the CS against falsification.
The Rorschach Inkblot Test: a debate. The Rorschach Test is scientifically questionable.
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The Rorschach test in clinical diagnosis: a critical review, with a backward look at Garfield (1947).
The present article comments on a classic study by Garfield (1947) then reviews research on the Rorschach and psychiatric diagnoses. Despite a few positive findings, the Rorschach has demonstrated little validity as a diagnostic tool. Deviant verbalizations and bad form on the Rorschach, and indices based on these variables, are related to Schizophrenia and perhaps to Bipolar Disorder and Schizotypal Personality Disorder. Patients with Borderline Personality Disorder also seem to give an above-average number of deviant verbalizations. Otherwise the Rorschach has not shown a well-demonstrated relationship to these disorders or to Major Depressive Disorder, Posttraumatic Stress Disorder (PTSD), anxiety disorders other than PTSD, Dissociative Identity Disorder, Dependent, Narcissistic, or Antisocial Personality Disorders, Conduct Disorder, or psychopathy.
Limitations of the Rorschach as a diagnostic tool: A reply to Garfield (2000), Lerner (2000), and Weiner (2000)
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A meta-analytic review of the relation between antisocial behavior and neuropsychological measures of executive function.
Previous narrative reviews of the relation between antisocial behavior (ASB) and neuropsychological tests of executive functioning (EF) have raised numerous methodological concerns and produced equivocal conclusions. By using meta-analytic procedures, this study attempts to remedy many of these concerns and quantifies the relation between ASB and performance on six reasonably well validated measures of EF. Thirty-nine studies yielding a total of 4,589 participants were included in the analysis. Overall, antisocial groups performed .62 standard deviations worse on EF tests than comparison groups; this effect size is in the medium to large range. Significant variation within this effect size estimate was found, some of which was accounted for by differences in the operationalizations of ASB (e.g., psychopathy vs. criminality) and measures of EF. Evidence for the specificity of EF deficits relative to deficits on other neuropsychological tasks was inconsistent. Unresolved conceptual problems regarding the association between ASB and EF tests, including the problem of localizing EF tests to specific brain regions, are discussed.
Science and pseudoscience in the development of eye movement desensitization and reprocessing: implications for clinical psychology.
The enormous popularity recently achieved by Eye Movement Desensitization and Reprocessing (EMDR) as a treatment for anxiety disorders appears to have greatly outstripped the evidence for its efficacy from controlled research studies. The disparity raises disturbing questions concerning EMDR's aggressive commercial promotion and its rapid acceptance among practitioners. In this article, we: (1) summarize the evidence concerning EMDR's efficacy; (2) describe the dissemination and promotion of EMDR; (3) delineate the features of pseudoscience and explicate their relevance to EMDR; (4) describe the pseudoscientific marketing practices used to promote EMDR; (5) analyze factors contributing to the acceptance of EMDR by professional psychologists; and (6) discuss practical considerations for professional psychologists regarding the adoption of EMDR into professional practice. We argue that EMDR provides an excellent vehicle for illustrating the differences between scientific and pseudoscientific therapeutic techniques. Such distinctions are of critical importance for clinical psychologists who intend to base their practice on the best available research.
The relation of the MMPI-2 Pd Harris-Lingoes subscales to psychopathy, psychopathy facets, and antisocial behavior: implications for clinical practice.
Little is known concerning the correlates of the MMPI-2 Psychopathic deviate (Pd) Harris-Lingoes subscales. In four studies with undergraduates, Pd2 (Authority Problems) emerged as the most consistent marker of psychopathy and antisocial behavior and was the only Pd subscale to assess the callousness traditionally associated with psychopathy. Pd3 (Social Imperturbability) correlated highly with social potency and was the only Pd subscale to consistently assess low anxiety proneness. Pd1, Pd4, and Pd5 (Familial Discord, Social Alienation, and Self-Alienation, respectively) correlated highly with externalization of blame but exhibited few differential correlates. Pd2 exhibited statistically significant levels of incremental validity above and beyond all other Pd subscales in the prediction of global psychopathy and antisocial behavior. These findings indicate that several Pd subscales assess markedly different facets of psychopathy and suggest that consideration of different Pd subscale elevations may hold important implications for clinical practice and assessment.
Identifying inmates at risk for disciplinary infractions: a comparison of two measures of psychopathy.
Poythress, Edens, and Lilienfeld (1998) recently reported a moderately strong correlation between Hare's (1991) Psychopathy Checklist-Revised (PCL-R) and a newly developed self-report measure of psychopathy, the Psychopathic Personality Inventory (PPI) of Lilienfeld and Andrews (1996), in an ethnically diverse sample of 50 inmates from a youthful offender prison. The present study reports follow-up data regarding disciplinary infractions in this sample and examines the utility of the PCL-R and PPI for identifying those at risk for institutional misbehavior. Generally modest, but statistically significant, correlations were obtained between both measures and indices of aggressive institutional behavior. Multiple regression analyses revealed that both measures accounted for common variance in the criterion but that neither accounted for significant unique variance. Results are discussed in terms of the clinical utility of these measures in populations of young offenders.
The association between anxiety and psychopathy dimensions in children.
Although several theoretical models posit that low levels of anxiety are a risk factor for psychopathy and antisocial behavior, a number of studies have reported elevated levels of anxiety among antisocial individuals. Nevertheless, most investigators in this literature have not distinguished between fearfulness and trait anxiety or attempted to separate the antisocial lifestyle dimension from the callous and unemotional dimension of psychopathy. In a study of clinically referred children (N = 143), we found that (a) measures of trait anxiety and fearlessness (low fearfulness) exhibited low correlations; (b) conduct problems tended to be positively correlated with trait anxiety, whereas callous and unemotional traits tended to be negatively correlated with trait anxiety; and (c) controlling statistically for the effects of one dimension increased the divergent correlations of the other dimension with both trait anxiety and fearful inhibition. These findings bear potentially important implications for the diagnosis and etiology of psychopathy and antisocial behavior and suggest that distinctions between trait anxiety and fearful inhibition, as well as between the two dimensions of psychopathy, may help to clarify longstanding confusion in this literature.
Essentialism revisited: evolutionary theory and the concept of mental disorder.
J. C. Wakefield's (1999) elaboration of his harmful dysfunction analysis (HDA) of mental disorder does little to address previous criticisms (S. O. Lilienfeld & L. Marino, 1995) and instead reveals further conceptual weaknesses in his position. The authors demonstrate that (a) a Roschian analysis can account for the results of all of Wakefield's conceptual experiments and predicts a number of judgments of disorder not predicted by the HDA, (b) the HDA is incapable in many cases of providing a scientifically nonarbitrary distinction between disorder and nondisorder, and (c) the HDA cannot account for failures of cultural ex adaptations, mismatches between evolutionary design and novel environments, or defenses against threat. The authors argue that the HDA has been convincingly falsified and discuss the failure of essentialistic concepts to resolve controversies in other domains of biological science.
Dissociative identity disorder and the sociocognitive model: recalling the lessons of the past.
In a recent article in this journal, D. H. Gleaves (1996) criticized the sociocognitive model (SCM; N. P. Spanos, 1994) of dissociative identity disorder (DID) and argued in favor of a posttraumatic model (PTM) in which DID is conceptualized as a consequence of childhood abuse and other traumatic events. The present authors demonstrate that (a) many of Gleaves's arguments were predicated on misunderstandings of the SCM, (b) scrutiny of the evidence regarding the psychopathology and assessment of DID raises questions concerning the PTM's conceptual and empirical underpinnings, (c) the treatment literature suggests that iatrogenic factors play an important role in the etiology of DID, and (d) the evidence linking child abuse to DID is more problematic than implied by Gleaves. The present authors conclude that Gleaves's analysis underemphasized the cultural manifestations of multiple role enactments and that the history of DID imparts a valuable lesson to contemporary psychotherapists.
A preliminary investigation of the construct of psychopathic personality (psychopathy) in chimpanzees (Pan troglodytes).
Although the construct of psychopathy has received considerable attention in humans, its relevance to other animals is largely unknown. We developed a measure of psychopathy for use in chimpanzees (Pan troglodytes), the Chimpanzee Psychopathy Measure (CPM), and asked 6 raters to complete this index on 34 chimpanzees. The CPM (a) demonstrated satisfactory interrater reliability and internal consistency; (b) exhibited marginally significant sex differences (males > females); (c) correlated positively with measures of extraversion, agreeableness, and observational ratings of agonism, sexual activity, daring behaviors, teasing, silent bluff displays, and temper tantrums, and negatively with observational ratings of generosity; and (d) demonstrated incremental validity above and beyond a measure of dominance. Although further validation of the CPM is needed, these findings suggest that the psychopathy construct may be relevant to chimpanzees.
The Rorschach Inkblot Test: a case of overstatement?
In the 1940s, inflated claims were often made regarding the Rorschach Inkblot Test. Over half a century later, overstatements regarding the test are still common. The present article identifies problems with the Rorschach regarding norms, cultural sensitivity, interrater reliability, test-retest reliability, validity, factor structure, and accessibility of supporting studies. Contrary to overstated claims made on behalf of the Rorschach, the test continues to be a highly problematic instrument from a psychometric standpoint.
Methodological advances and developments in the assessment of psychopathy.
The last decade has witnessed a number of significant methodological advances and developments in the assessment of psychopathy. The Psychopathy Checklist-Revised and the two-factor model of psychopathy have facilitated the assessment of psychopathy and clarified the differential correlates of the personality- and behavior-based operationalizations of this syndrome. Although preliminary evidence suggests that certain features of psychopathy may be underpinned by a latent taxon, the categorical versus dimensional status of psychopathy requires clarification. Researchers have accorded increasing attention to the assessment of psychopathy in non-criminal samples, although the construct of subclinical psychopathy remains controversial. Other recent methodological developments include: (a) the extension of the Five-Factor Model and other higher-order personality taxonomies to psychopathy; (b) development of a Q-sort methodology to permit the assessment of psychopathy by observers; (c) standardized assessment of psychopaths' interpersonal behaviors; (d) assessment of psychopathy in children; and (e) examination of gender, ethnic, and cross-cultural differences in psychopathy.
The relation of anxiety sensitivity to higher and lower order personality dimensions: implications for the etiology of panic attacks.
The relation of anxiety sensitivity (AS) to personality dimensions has received little attention. In this study, 4 AS indexes were administered along with measures of personality, fears, and panic attacks to 220 undergraduates. At the higher order level, AS was positively correlated with negative emotionality (NE) but was largely unrelated to either positive emotionality or constraint. At the lower order level, AS was positively correlated with absorption and NE indexes. Most of these correlations were significant even among participants with no panic attack history. AS exhibited incremental validity above and beyond a number of personality variables, including absorption and trait anxiety, in the prediction of fears and panic attack history. These findings are consistent with the hypothesis that a propensity toward immersion in sensory experiences is a diathesis for panic attacks.
Development and preliminary validation of a self-report measure of psychopathic personality traits in noncriminal populations.
Research on psychopathology has been hindered by persisting difficulties and controversies regarding its assessment. The primary goals of this set of studies were to (a) develop, and initiate the construct validation of, a self-report measure that assesses the major personality traits of psychopathy in noncriminal populations and (b) clarify the nature of these traits via an exploratory approach to test construction. This measure, the Psychopathic Personality Inventory (PPI), was developed by writing items to assess a large number of personality domains relevant to psychopathy and performing successive item-level factor analyses and revisions on three undergraduate samples. The PPI total score and its eight subscales were found to possess satisfactory internal consistency and test-retest reliability. In four studies with undergraduates, the PPI and its subscales exhibited a promising pattern of convergent and discriminant validity with self-report, psychiatric interview, observer rating, and family history data. In addition, the PPI total score demonstrated incremental validity relative to several commonly used self-report psychopathy-related measures. Future construct validation studies, unresolved conceptual issues regarding the assessment of psychopathy, and potential research uses of the PPI are outlined.
Mental disorder as a Roschian concept: a critique of Wakefield's "harmful dysfunction" analysis.
J. C. Wakefield (1992a, 1992b, 1993) recently proposed that mental disorder is best conceptualized as a "harmful dysfunction," whereby "harm" is a value judgment regarding the undesirability of a condition, and "dysfunction" is the failure of a system to function as designed by natural selection. The authors maintain, however, that (a) many mental functions are not direct evolutionary adaptations, but rather adaptively neutral by-products of adaptations, (b) Wakefield's concept of the evolutionarily designed response neglects the fact that natural selection almost invariably results in substantial variability across individuals, and (c) many consensual disorders represent evolutionarily adaptive reactions to danger or loss. The authors propose that mental disorder is a Roschian concept characterized by instrinsically fuzzy boundaries and that Wakefield's analysis may only prolong scientific debate on a fundamentally nonscientific issue.