Showing papers by "Daniel L. Segal published in 2013"

Issues regarding the proposed DSM-5 personality disorders in geriatric psychology and psychiatry.

Abstract: The official introduction of the psychiatric diagnosis of personality disorders (PDs) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) began in 1952 with the publication of the first edition (American Psychiatric Association, 1952). DSM-I contained 12 main types of PDs with a total description for all types in only two paragraphs. In the following DSM-II (American Psychiatric Association, 1968), just 10 specific types of PDs were described, including a very brief general definition of PDs. The DSM-III (American Psychiatric Association, 1980) included a significant paradigm shift from the medical model by incorporating the design of a multi-axial approach, in which the combinations of symptoms of more than five primary axes were used to describe the pathological state and formulate the diagnosis. Notably, the PDs were placed on a separate axis (Axis II) to distinguish their long-standing nature from the more episodic clinical disorders placed on Axis I. PDs were recognized as important formal diagnoses and included a more comprehensive listing of polythetic diagnostic criteria for each specific PD.

Persian version of the geriatric anxiety scale: Translation and preliminary psychometric properties among Iranian older adults

Abstract: Objective: The Geriatric Anxiety Scale (GAS) is a new self-report screening measure designed for older adults. Due to the burgeoning Iranian population of older adults and the need for validated, culturally-appropriate screening measures for anxiety in Iran, the purposes of the present study were to translate the GAS into Persian and to explore its preliminary psychometric properties. Method: Iranian older adults (N = 295; M age = 67.0 years) completed the GAS and the Iranian version of the Geriatric Depression Scale (GDS-15). Results: Cronbach's alpha for the GAS total score and the GAS subscales were excellent (Total score α = .92; Cognitive α = .81; Somatic α = .84; Affective α = .80). As expected, each subscale was significantly positively correlated (all p's < .01) with the other subscales. The subscales share common variance ranging from 42% to 56%. The GAS total score and GAS subscale scores were significantly positively correlated with the GDS-15, with medium effect sizes (GAS Total r = .55; Cogni...

Methylations of tryptophan-modified naphthoquinone affect its inhibitory potential toward Aβ aggregation.

Abstract: Aggregation of amyloid beta (Aβ) is the hallmark of Alzheimer's disease (AD). Small molecules inhibiting Aβ can be valuable therapeutics for AD. We have previously reported that 1,4-naphthoquinon-2-yl-l-tryptophan (NQTrp), reduces aggregation and oligomerization of Aβ in vitro and in vivo. In silico analysis further showed that certain functional groups of NQTrp, not in the aromatic rings, are also involved in binding and inhibiting Aβ. To better understand the exact mode of action and identify the groups crucial for NQTrp inhibitory activity, we conducted structure-activity analysis. Four derivatives of NQTrp were studied in silico: a D-isomer, two single-methylated and one double-methylated derivative. In silico results showed that the NQTrp groups involved in hydrogen bonds are the anilinic NH (i.e., the NH linker between the quinone and tryptophan moieties), the quinonic carbonyls, and the carboxylic acid. These predictions were supported by in vitro results. Our results should aid in designing improved small-molecule inhibitors of Aβ aggregation for treating AD.

The Angular Interval between the Direction of Progression and Body Orientation in Normal, Alcohol- and Cocaine Treated Fruit Flies

Abstract: In this study we characterize the coordination between the direction a fruit-fly walks and the direction it faces, as well as offer a methodology for isolating and validating key variables with which we phenotype fly locomotor behavior. Our fundamental finding is that the angular interval between the direction a fly walks and the direction it faces is actively managed in intact animals and modulated in a patterned way with drugs. This interval is small in intact flies, larger with alcohol and much larger with cocaine. The dynamics of this interval generates six coordinative modes that flow smoothly into each other. Under alcohol and much more so under cocaine, straight path modes dwindle and modes involving rotation proliferate. To obtain these results we perform high content analysis of video-tracked open field locomotor behavior. Presently there is a gap between the quality of descriptions of insect behaviors that unfold in circumscribed situations, and descriptions that unfold in extended time and space. While the first describe the coordination between low-level kinematic variables, the second quantify cumulative measures and subjectively defined behavior patterns. Here we reduce this gap by phenotyping extended locomotor behavior in terms of the coordination between low-level kinematic variables, which we quantify, combining into a single field two disparate fields, that of high content phenotyping and that of locomotor coordination. This will allow the study of the genes/brain/locomotor coordination interface in genetically engineered and pharmacologically manipulated animal models of human diseases.

Psychometric Properties of a New Measure to Assess Autism Spectrum Disorder in DSM‐5

Abstract: This article presents preliminary psychometric properties of a new 45-item scale, the Coolidge Autistic Symptoms Survey (CASS), designed to differentiate between children within the autism spectrum (including Asperger's Disorder) and purportedly normal children, in anticipation of DSM-5 changes, in which a single diagnostic category is proposed: autism spectrum disorder. The final sample (N = 72) consisted of 19 children diagnosed with Asperger's Disorder, 19 children who were considered loners by their parents (without an autism diagnosis), and 34 purportedly normal children. The CASS and the 200-item, DSM-IV-TR aligned, Coolidge Personality and Neuropsychological Inventory were completed by a parent. The CASS had excellent internal scale reliability (α= .97) and test-retest (r = .91) reliability. ANOVA revealed the CASS was able to discriminate significantly among the 3 groups of children. Further research with the CASS appears warranted.

Writing Up the Intake Interview

Abstract: The ability to write up a clear, comprehensive, and professional intake evaluation report is a top skill for seasoned mental health professionals. However, this task often seems overwhelming to the beginning clinician, who also is facing the challenges of learning other basic interviewing and therapy skills. But imagine a clinician who conducts a whole course of treatment without formally documenting anything about why clients came for services, what problems they initially had, and what treatment recommendations and goals were established. How could this practitioner justify the type of treatment provided and gauge whether or not treatment was successful? Indeed, practices with limited documentation cannot survive in today's climate of managed health care organizations, professional accountability, and client rights. No matter what clinical specialty or type of setting in which therapists work, they most likely will be responsible for writing at least some form of an intake report. Historically, however, many psychology training programs have not provided formalized classroom training in professional report writing. Rather, students learned to write intake reports through informal means: studying old intake reports in their clients' charts or borrowing "model" reports from more experienced students or teachers. This chapter assists therapists in report writing, and offers practical and explicit guidelines to help them prepare well-written and thorough intake reports.

The Barriers to Mental Health Services Scale Revised: Reliability, Validity, and Underlying Structure

Abstract: Introduction: It is understood that older adults underutilize mental health services; however, it is unclear which factors create the biggest barriers. The purpose of this study was to revise the Barriers to Mental Health Services Scale (BMHSS), previously developed and validated by these authors (Pepin, Segal, & Coolidge, 2009). We developed this scale to address a gap in the literature; although barriers had been measured separately no comprehensive measure had been developed. The BMHSS addressed this by concurrently measuring a number of barriers making it possible to examine them in relationship to each other. The BMHSS is a self-report scale comprised of 10 possible barriers to mental health service use, including transportation, finding a psychotherapist, physician referral, psychotherapists’ qualifications, ageism, help seeking, stigma, and insurance/ payment concerns. The BMHSS’s primary strength is providing a comprehensive tool measuring a number of barriers potentially instrumental in preventing geriatric mental health service use. However, the instrument has several limitations. Weaknesses include: a) an inconsistent distribution of items across subscales, with some subscales comprised of 12 items and others only containing 3; b) Cronbach’s alpha values below the acceptable level (.7) for 4 subscales (finding a psychotherapist [.32], belief that depressive symptoms are normal [.48], physician referral [.61], and ageism [.63]); c) a lack of convergent validity analyses; and d) the absence of analyses examining the underlying scale structure. Methods: In the present study, we revised the BMHSS, resulting in the Barriers to Mental Health Services Scale Revised (BMHSS-R). The BMHSS-R is an improved, shorter, and more user-friendly instrument, which was achieved by changing the response format, adding new items, eliminating some existing items, and balancing the number of items on each subscale in the original measure. Younger (n 1⁄4 499, M 1⁄4 22.03 years) and community-dwelling older (n 1⁄4 100, M 1⁄4 72.09 years) adults completed the BMHSS-R. Results: Internal consistency ranged between .55 and .85, with 7 of the 10 subscales’ alphas being over .70. The subscales of stigma and help seeking were moderately correlated with existing measures. The stigma subscale was significantly and positively correlated with The Beliefs Toward Mental Illness Scale (Hirai & Clum, 2000), r(589) 1⁄4 .42 p < .001. The help seeking subscale was significantly and negatively correlated with the Willingness to Seek Help Questionnaire (Cohen, 1999), r(588) 1⁄4 -.44, p < .001. We used principal component analysis to explore the underlying structure of the measure. Ten components with eigenvalues above 1 comprise the underlying structure. These explained the following percent of variance, respectively: 29.14%, 6.60%, 5.25%, 4.13%, 3.37%, 3.09%, 2.77%, 2.55%, 2.43%, and 2.40%. Items for the subscales were all supported through PCA. However, some subscales (i.e., confidence in psychotherapists’ qualifications and ageism; stigma and knowledge and fear of therapy) were not well represented as independent components, instead having one underlying component whereas another subscale (i.e., transportation) was split into two components. Conclusions: Revisions to the BMHSS resulted in improved reliability and validity. This study provides a needed contribution to the field by expanding and improving tools available to assess barriers to mental health services for older adults. Valid measurement of barriers may be helpful in identifying improvements that could lead to improved design and delivery of services, facilitating more appropriate use of services. Also, such a scale could be used in intervention studies to illuminate previously unmeasured variables responsible for participant differences in engagement and intervention use patterns.