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Psychological distress, attitudes toward seeking help, and utilization of college counseling at a predominantly minority college

Glickman, Kim L; Smith, Scott W; Woods, Ericka C
OBJECTIVE/UNASSIGNED:This study examined psychological distress among students at a predominantly-minority college, attitudes toward seeking help, and utilization of college counseling services. Demographic variables and associations between 8 problem areas (depression, generalized anxiety, social anxiety, academic stress, eating concerns, family distress, hostility, substance use) were explored. PARTICIPANTS/UNASSIGNED:Participants were 347 students at a large public university. METHODS/UNASSIGNED:In 2016-2017, students completed a Web-based questionnaire providing information about their mental health, attitudes toward seeking help, and utilization of counseling services. RESULTS/UNASSIGNED:Psychological distress was significantly higher for LGBQT, Muslim and female students and lower for Christian affiliated and religious students. LGBQT students were less likely to seek psychological help than other students. Utilization of college counseling did not differ by race or gender. CONCLUSIONS/UNASSIGNED:Administrators at PMCs must increase their efforts to disseminate information about mental health services and reduce barriers to seeking help, particularly for LGBQT, female and Muslim students.
PMID: 33891513
ISSN: 1940-3208
CID: 5187692

Relationship Between Patient SWAP-200 Personality Characteristics and Therapist-Rated Therapeutic Alliance Early in Treatment

Smith, Scott W; Levy, Saryn R; Hilsenroth, Mark J; Fiori, Katherine; Bornstein, Robert F
In the present study, we assess the extent to which patient personality features and prototypes are associated with early treatment therapist-rated alliance. The study sample consisted of 94 patients receiving psychodynamic psychotherapy at an outpatient clinic. Clinicians completed the Working Alliance Inventory (J Couns Psychol 36:223-233; Psychother Res 9:405-423) to assess their views of early alliance and the Shedler-Westen Assessment Procedure 200 (SWAP-200; Assessment 5:333-353, Am J Psychiatry 161:1350-1365, 1743-1754; Am J Psychiatry 156:258-272, 273-285) to assess patient personality. The SWAP-200 Narcissistic Clinical Prototype, Dysphoric Q-Factor, and Dysphoric/High-Functioning Neurotic Q-Subfactor significantly correlated with early therapist-rated alliance. Correlations that trended toward significance were also found. Also identified were specific SWAP-200 items that were found to relate to high early therapist-rated alliance scores. These results demonstrate some relationship, albeit small, between patient personality characteristics and therapists' views of the alliance that may serve to further a conceptual understanding of the alliance, specific personality syndromes, and the associated impact on the therapeutic interaction.
PMID: 27176789
ISSN: 1539-736x
CID: 5230052

Clinical validity of prototype personality disorder ratings in adolescents

Defife, Jared A; Haggerty, Greg; Smith, Scott W; Betancourt, Luis; Ahmed, Zain; Ditkowsky, Keith
A growing body of research shows that personality pathology in adolescents is clinically distinctive and frequently stable into adulthood. A reliable and useful method for rating personality pathology in adolescent patients has the potential to enhance conceptualization, dissemination, and treatment effectiveness. The aim of this study is to examine the clinical validity of a prototype matching approach (derived from the Shedler Westen Assessment Procedure-Adolescent Version) for quantifying personality pathology in an adolescent inpatient sample. Sixty-six adolescent inpatients and their parents or legal guardians completed forms of the Child Behavior Checklist (CBCL) assessing emotional and behavioral problems. Clinical criterion variables including suicide history, substance use, and fights with peers were also assessed. Patients' individual and group therapists on the inpatient unit completed personality prototype ratings. Prototype diagnoses demonstrated substantial reliability (median intraclass correlation coefficient =.75) across independent ratings from individual and group therapists. Personality prototype ratings correlated with the CBCL scales and clinical criterion variables in anticipated and meaningful ways. As seen in prior research with adult samples, prototype personality ratings show clinical validity across independent clinician raters previously unfamiliar with the approach, and they are meaningfully related to clinical symptoms, behavioral problems, and adaptive functioning.
PMCID:4682668
PMID: 25457971
ISSN: 1532-7752
CID: 5187682

Relationship between SWAP-200 patient personality characteristics and patient-rated alliance early in treatment

Smith, Scott W; Hilsenroth, Mark J; Fiori, Katherine L; Bornstein, Robert F
Research on the therapeutic alliance suggests patient personality characteristics to be plausible correlates of alliance formation. To date, research has largely focused on the relationship between the alliance and facets of patient personality measured via patient self-report, versus personality syndromes.In the present study, we assess patient personality using a clinician-rated measure-the Shedler-Westen Assessment Procedure-200 (SWAP-200; Shedler and Westen [Assessment 5:335-355, 1998; Am J Psychiatry 161:1350-1365, 2004; Am J Psychiatry 161:1743-1754, 2004]; Westen and Shedler [Am J Psychiatry 156:258-272, 1999; Am J Psychiatry 156:273-285, 1999])-and investigate the extent to which empirically derived personality configurations correlate with patient-rated alliance. The study sample consisted of 94 patients receiving psychodynamic psychotherapy at an outpatient clinic.The SWAP-200 Dependent Clinical Prototype and Dysphoric: Dependent-Masochistic Q-Factors were found to significantly correlate with early alliance. Also identified were specific SWAP-200 items that independently correlated with early alliance scores.The results of the present study demonstrate a relation between patient personality characteristics and therapeutic alliance that may serve to further a conceptual understanding of the alliance.
PMID: 24727718
ISSN: 1539-736x
CID: 5187672

Convergent validity of the SWAP-200 dependency scales

Smith, Scott W; Hilsenroth, Mark J; Bornstein, Robert F
The present study examined the convergent validity of the Shedler-Westen Assessment Procedure Q-Sort (SWAP-200; ) dependency scales (Dependent Personality Disorder [DPD] Clinical Prototype and DPD composite description) by examining links between these variables with Inventory of Interpersonal Problems Circumplex Scales (IIP-C; Alden et al., 1990; Horowitz et al., 2000; Horowitz et al., 1988), and DSM-IV diagnoses of DPD in a clinical sample (N = 85). Results showed that SWAP-200 DPD Clinical Prototype was significantly related to a DSM-IV diagnosis of DPD, higher scores on the IIP-C Affiliative/Submissive Quadrant summary scale, and elevations on Nonassertive and Overly-accommodating Octant Scales. Additional analyses revealed significant positive relationships between the DPD composite description with DSM-IV diagnosis of DPD, the Affiliative/Submissive Quadrant summary scale, and the Overly Accommodating and Self-Sacrificing Octant Scales. We discuss the implications of these findings with regard to theoretical, empirical, and clinical aspects of interpersonal dependency.
PMID: 19684499
ISSN: 1539-736x
CID: 5187662