Biomedical subjects

Steven K Huprich

Publications and source records attributed to Steven K Huprich.

16 recordsLinked to original sources

PubMed2006

Disentangling depressive personality disorder from avoidant, borderline, and obsessive-compulsive personality disorders.

Several studies have found that 3 personality disorders (PDs) tend to share moderate rates of comorbidity with depressive PD: avoidant, borderline, and obsessive-compulsive. This study sought to evaluate the diagnostic criteria of each disorder in an effort to understand where areas of overlap may occur and to modify criteria sets where reasonable to reduce any degree of overlap. One thousand two hundred psychiatric outpatients were interviewed with the Structured Interview for DSM-IV Personality Disorders. The highest degree of comorbidity was observed between avoidant PD and depressive PD. Logistic regression analyses indicated that 2 criteria-avoidant criterion 5 and depressive criterion 2-could be removed from the diagnostic criteria sets and reduce the rates of overlap by as much as 15%. A factor analysis of the criteria of all 4 PDs indicated that there is a common clustering of many of the symptoms of avoidant, borderline, depressive, and obsessive-compulsive PDs and that borderline symptoms tend to cluster together most consistently. Avoidant and obsessive-compulsive personality symptoms clustered in ways that may reflect a problem of how to engage with others, suggestive of an approach-avoidance conflict. Depressive PD symptoms clustered in a way suggestive of problems with anger that is directed toward oneself and others. The factor analysis results suggest that an organization of symptoms around themes of conflict may provide useful ways of understanding the personality patterns of these 4 disorders.

Adult↗

PubMed2006

Object representations and their relationship to psychopathology and physical health status in African-American women in primary care.

Object relations theories hypothesize a relationship between self/other representations and level of psychopathology. Research has lent support to this hypothesis. This study was conducted to examine the link between object representation and psychopathology, stress, physical health status, and alcohol abuse in 110 African-American women in primary care. Object representations were assessed through spontaneous descriptions of parents. Psychopathology and physical health status were assessed with the Patient Health Questionnaire and the Medical Outcomes Study Short-Form Health Survey, both of which were designed for medical settings. The results support the link between dimensions of object representations (developmental level, benevolence, punitiveness) and psychopathology and between object representations and aspects of health status. Punitive maternal and paternal representations were most robustly associated with psychopathology and health status and were the only representational variables associated with alcohol abuse. The findings provide additional support for the object representations-psychopathology link and extend the research by demonstrating associations among object representations, alcohol abuse, and health status.

Adult↗

PubMed2006

Construct validity of the relationship profile test: three-year retest reliability and links with core personality traits, object relations, and interpersonal problems.

The Relationship Profile Test (RPT; Bornstein & Languirand, 2003) is a 30-item self-report measure of destructive overdependence, dysfunctional detachment, and healthy dependency. Previous research has shown that the 3 RPT subscales have adequate internal consistency, good retest reliability over 23 and 85 weeks, and good convergent and discriminant validity with respect to measures of attachment style, relatedness, gender role, self-concept, alexithymia, locus of control, need for approval, and life satisfaction. In this investigation, we assessed the 3-year retest reliability of RPT scores in a northeastern liberal arts college student sample (Study 1) and evaluated the convergent and discriminant validity of RPT scores in a southern university sample (Study 2). Results generally supported the long-term stability and convergent and discriminant validity of RPT scores but also pointed to some limitations of the measure. We discuss implications of these results and describe future research directions.

Adolescent↗

PubMed2006

Should self-defeating personality disorder be revisited in the DSM?

Self-defeating personality disorder (SDPD) was proposed for consideration in the DSM-III-R, but was eventually removed from the manual because of the lack of evidence to support its validity. Yet, after DSM-IV was published, some studies suggested that SDPD may be a viable diagnosis. The purpose of this study was to evaluate SDPD's viability as a diagnostic category. Consequently, SDPD's internal consistency, comorbidity with other Axis I and II disorders, association with psychosocial impairment, and its ability to predict overall impairment in past, current, and global levels of functioning beyond other personality disorder symptomatology was assessed in 1,200 psychiatric evaluated with the Structured Clinical Interview for DSM-IV Personality (Pfohl, Blum, & Zimmerman, 1997). Cronbach's alpha for SDPD criteria was 0.61, and item-total correlations ranged between 0.22-0.38. There was substantial comorbidity of SDPD with depressive, avoidant, and borderline personality disorders, as well as major depression and anxiety disorders. The SDPD group did not significantly differ from psychiatric controls on multiple measures of psychosocial impairment, global functioning, and suicidality. SDPD did not meaningfully add to the prediction of impairment above and beyond other measures of Axis II pathology. It is concluded that the data do not support the reliability, validity, and utility of the SDPD diagnosis.

Adult↗

PubMed2005

Functional health status and its relationship to depressive personality disorder, dysthymia, and major depression: preliminary findings.

Controversy continues on the extent to which depressive personality disorder (DPD) and dysthymic disorder (DYST) may be differentiated. Although affective disorders often are accompanied by changes in functional health status, to date no study has examined how functional health associated with affective disorders may assist in differentiating the two disorders. In this study, we hypothesized that measures of DPD would have fewer correlations with functional health status than would measures of DYST and major depressive disorder (MDD). African American women (n=110) completed questionnaires that assessed for depressive disorders, somatic concerns, and physical health. Measures of DPD, DYST, and MDD were all significantly correlated with functional health status. When symptoms of MDD were controlled, DYST was more associated with functional health status than was a DSM-IV measure of DPD, although a self-report measure of DPD--the Depressive Personality Disorder Inventory [DPDI; Huprich et al., 1996: J Clin Psychol 52:152-159]--remained significantly correlated with functional health status. When symptoms of DYST were controlled, DSM-IV symptoms of DPD were not strongly associated with functional health status, although measures of MDD and the DPDI were correlated with functional health status. We concluded that despite the overlap in depressive symptoms and functional health status, DPD may be less associated with functional health status in a primary care population than DYST and MDD. Implications for the assessment of DPD are provided.

Adult↗

PubMed2005

Differentiating avoidant and depressive personality disorders.

The purpose of this study was to test a priori predictions about the way in which avoidant personality disorder (APD) can be differentiated from depressive personality disorder (DPD) in a clinical population. Psychiatric outpatients were administered two measures of DPD, including the SCID-II for other DSM-IV Axis II personality disorders, along with criterion measures upon which the two disorders would be differentiated. APD was found to be most strongly associated with state and trait measures of anxiety, while DPD was most strongly associated with state and trait measures of hostility. Individuals with DPD had higher mean scores on measures of hostility than those without DPD, and individuals with APD had higher mean scores on measures of anxiety than those without APD. However, DPD measures were also significantly correlated with state and trait measures of anxiety and APD with measures of depressive symptoms. Furthermore, anxiety was found to be higher in some groups of individuals with DPD than those with APD. It is concluded that the level of hostility in this DPD population appears to be an important symptom by which to differentiate the two disorders and that a reconsideration of including DPD criterion #4 -- prone to brooding and worrying -- may be justified. Furthermore, the SCID-II interview may be better at differentiating DPD and APD than a self-report measure of DPD.

Adult↗

PubMed2004

Rorschach oral dependency in psychopaths, sexual homicide perpetrators, and nonviolent pedophiles.

Rorschach Oral Dependency scores (Masling, Rabie, & Blondheim, 1967) were compared among nonsexually offending psychopaths (NSOPs, n = 32), sexual homicide perpetrators (SHPs, n = 38), and non-violent pedophiles (NVPs, n = 39) as initially reported by Gacono, Meloy, and Bridges (2000). The aggressive special scores of Gacono and Meloy (1994; Gacono, unpublished doctoral dissertation, 1998) were also scored and compared with ROD scores. Consistent with theory and predictions, NVPs were found to have significantly higher levels of oral dependency scores than NSOPs or SHPs. Additionally, there was a high degree of association between oral dependency and aggression in the SHP and NSOP groups. These Rorschach differences support the validity of the ROD as an implicit measure of dependency and add to the understanding of the dynamics that fuel sexually deviant violence.

Data Collection↗

PubMed2004

A national survey of trainee impairment in clinical, counseling, and school psychology doctoral programs and internships.

The purpose of this study was to assess the frequency, type, and management of trainee impairment at a national level across doctoral programs in clinical, counseling, and school psychology and predoctoral internships. A total of 199 surveys were completed, returned, and usable. In general, doctoral programs reported a greater frequency of trainee impairment than internships. However, a greater percentage of internships had a policy and program in place for managing impairments than did doctoral programs. These findings are compared with past studies and reviews of this issue. In light of these findings, specific implications for training programs are discussed, with the recommendation that training programs address more attention to the assessment and management of such problems.

Counseling↗

PubMed2004

Convergent and discriminant validity of three measures of depressive personality disorder.

Sixty-eight outpatients from a veterans' administration psychiatry clinic and community mental health center were assessed with 3 measures of depressive personality disorder (DPD)-the Diagnostic Interview for Depressive Personality Disorder (Gunderson, Phillips, Triebwasser, & Hirschfeld, 1994), the Depressive Personality Disorder Inventory (Huprich, Margrett, Barthelemy, & Fine, 1996), and the Structured Clinical Interview for DSM-IV Axis II Disorders (First, Gibbon, Spitzer, Williams, & Benjamin, 1997a)-to evaluate their convergent and discriminant validity. Evidence supporting the measures' validity was mixed. The rate of convergence of depressive personality diagnoses across 3 measures was less than optimal, but the degree of intercorrelation among the measures was strong. Although depressive personality scores had moderate levels of intercorrelations with other personality disorders, the degree of intercorrelation decreased substantially after controlling for depressive symptoms. I conclude that further work is needed to strengthen the validity of measures of DPD.

Depressive Disorder↗

PubMed2004

The Depressive Personality Disorder Inventory and its relationship to quality of life, hopefulness, and optimism.

The construct validity of the Depressive Personality Disorder Inventory (DPDI; Huprich, Margrett, Barthelemy, & Fine, 1996) was examined through its relationship to the constructs of hope, optimism, and quality of life (QOL). Three hundred thirty-two undergraduate students were administered the DPDI and measures of the aforementioned constructs. As predicted, the DPDI negatively correlated with all measures. Individuals classified with a depressive personality disorder had significantly higher scores on measures of hope, optimism, and QOL compared to a control group. Stepwise regression analysis indicated that optimism, QOL, and one component of hope significantly predicted DPDI scores, although more variance was accounted for in women than men. These findings are explained in light of Carver and Scheier's (2000) explanation of optimism and its relationship to hope. In sum, it appears that the construct validity of the DPDI is supported within an undergraduate sample.

Adult↗

PubMed2003

Advances in the assessment of object relations in the 1990s.

In this paper, we review the empirical publications from the 1990s on the assessment of object relations (OR). Twelve different measures are referenced. Major findings of studies, conclusions, and evaluations of each measure are provided. In general, it was found that the most recent empirical literature has compared OR across diagnostic groups or evaluated therapy process and outcome by the quality of one's OR. Current strengths and limitations of the extant OR literature are provided, along with methodological recommendations to expand the utility and validity of OR assessment.

Humans↗

PubMed2003

Depressive personality and its relationship to depressed mood, interpersonal loss, negative parental perceptions, and perfectionism.

Eighty veteran psychiatric outpatients were evaluated for depressive personality disorder on the Depressive Personality Disorder Inventory (DPDI). It was predicted that those classified with depressive personality would report higher levels of interpersonal loss, negative perceptions of their parents, and higher levels of perfectionism than psychiatric control subjects. Nine of the 12 measures of these variables were significantly greater in those with depressive personality compared with psychiatric control subjects. When statelike depression was controlled for, seven of the nine variables still significantly differed between the two groups. Hierarchical regression analysis and discriminant function analysis found that these variables predicted 9% of the variance in the DPDI above and beyond statelike depression, and that a combination of these variables correctly classified 91% of the depressive personalities and 88% of the psychiatric control subjects. It is concluded that, as hypothesized, depressive personality disorder is associated with loss, negative parental perceptions, and perfectionism, and that these relationships are not accounted for exclusively by a depressed mood.

Ambulatory Care↗

PubMed2003

Divergent ethical perspectives on the duty-to-warn principle with HIV patients.

This article presents the case of an HIV-positive client who reported having sexual relations with an unknowing partner. The issue raised is whether the therapist was required to warn the unknowing partner, similar to the Tarasoff mandate that is imposed on therapists. The case is analyzed from an ethical framework similar to that presented by Beauchamp and Childress (1994). Two opinions are presented, each leading to different conclusions about whether the therapist should inform the unknowing partner. It is concluded that although such analysis is valuable in aiding the therapist in his or her decision-making process, no clear professional standard for the management of the problem is evident.

Beneficence↗

PubMed2003

Evaluating NEO Personality Inventory-Revised profiles in veterans with personality disorders.

Fifty-one psychiatric, veteran outpatients were assessed for personality disorders on the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II; First, Gibbon, Spitzer, Williams, & Benjamin, 1997a) and were also administered the NEO Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1992). Results were compared to Trull and Widiger's (1997) hypotheses about the profiles of such patients and similar past studies. Correlations between NEO-PI-R facets and SCID-II personality disorder symptom clusters generally occurred in the expected direction. Facets hypothesized to be associated with a given personality disorder were able to predict variance in their respective SCID-II personality disorder scores for seven of ten personality disorders. In general, results support the facet-level conceptualizations of these disorders, except for Obsessive-Compulsive Personality Disorder.

Diagnostic and Statistical Manual of Mental Disord↗

PubMed2003

Evaluating facet-level predictions and construct validity of depressive personality disorder.

The purpose of this study was to evaluate Widiger, Trull, Clarkin, Sanderson, and Costa's (1994) facet-level predictions about depressive personality disorder, thereby evaluating the validity of the depressive personality disorder construct. A sample of 67 patients was collected from two treatment facilities. Participants completed three different measures of depressive personality disorder and the NEO-PI-R (Costa & McCrae, 1992). All measures of depressive personality disorder were significantly correlated with three of the four predicted facets: Anxiety, Depression, and Self-Consciousness. All three measures were significantly correlated with the Vulnerability, Warmth, Gregariousness, Assertiveness, Positive Emotions, Actions, Trusts, and Achievement Striving facets. A series of regression analyses was performed. Two of the predicted facets--Self-Consciousness and Tendermindedness--were able to uniquely account for variance in all three measures of depressive personality across most analyses. However, there was a lack of specificity across other facets in predicting the depressive personality disorder. A facet-level understanding of depressive personality disorder appears to be empirically justified, and the validity of the depressive personality disorder further supported. Additional work is needed on improving the measurement of depressive personality disorder.

Depressive Disorder↗

PubMed2002

Psychometric evaluation of the depressive personality disorder inventory.

The purpose of this study was to evaluate the psychometric properties of the Depressive Personality Disorder Inventory (DPDI; Huprich, Margrett, Barthelemy, & Fine, 1996). The DPDI was found to have strong internal consistency in both an undergraduate and a veteran, psychiatric outpatient population. The DPDI had significant, positive correlations with other measures of depressive personality, supporting its convergent validity. These relationships remained even after controlling for state-like depression, suggesting that the DPDI has incremental validity. The DPDI also significantly predicted scores on measures of interpersonal loss, even after controlling for state-like depression, suggesting that the DPDI has good construct validity. In support of discriminant validity, the DPDI was more correlated with another measure of depressive personality than it was with measures of other personality disorders. Finally, the DPDI had strong diagnostic efficiency statistics: (a) Sensitivity = .82, (b) Specificity = .80, (c) Positive Predictive Power = .75, (d) Negative Predictive Power = .86, and (e) Overall Diagnostic Power = .81. It appears that the DPDI has good psychometric properties.

Adult↗