Faculty Bibliography

OBJECTIVE: To determine lifetime prevalence rates of sleep paralysis. DATA SOURCES: Keyword term searches using "sleep paralysis", "isolated sleep paralysis", or "parasomnia not otherwise specified" were conducted using MEDLINE (1950-present) and PsychINFO (1872-present). English and Spanish language abstracts were reviewed, as were reference lists of identified articles. STUDY SELECTION: Thirty five studies that reported lifetime sleep paralysis rates and described both the assessment procedures and sample utilized were selected. DATA EXTRACTION: Weighted percentages were calculated for each study and, when possible, for each reported subsample. DATA SYNTHESIS: Aggregating across studies (total N=36,533), 7.6% of the general population, 28.3% of students, and 31.9% of psychiatric patients experienced at least one episode of sleep paralysis. Of the psychiatric patients with panic disorder, 34.6% reported lifetime sleep paralysis. Results also suggested that minorities experience lifetime sleep paralysis at higher rates than Caucasians. CONCLUSIONS: Sleep paralysis is relatively common in the general population and more frequent in students and psychiatric patients. Given these prevalence rates, sleep paralysis should be assessed more regularly and uniformly in order to determine its impact on individual functioning and better articulate its relation to psychiatric and other medical conditions.

Aims of this study were (a) to summarize the psychometric literature on the Mobility Inventory for Agoraphobia (MIA), (b) to examine the convergent and discriminant validity of the MIA's Avoidance Alone and Avoidance Accompanied rating scales relative to clinical severity ratings of anxiety disorders from the Anxiety Disorders Interview Schedule (ADIS), and (c) to establish a cutoff score indicative of interviewers' diagnosis of agoraphobia for the Avoidance Alone scale. A meta-analytic synthesis of 10 published studies yielded positive evidence for internal consistency and convergent and discriminant validity of the scales. Participants in the present study were 129 people with a diagnosis of panic disorder. Internal consistency was excellent for this sample, alpha=.95 for AAC and .96 for AAL. When the MIA scales were correlated with interviewer ratings, evidence for convergent and discriminant validity for AAL was strong (convergent r with agoraphobia severity ratings=.63 vs. discriminant rs of .10-.29 for other anxiety disorders) and more modest but still positive for AAC (.54 vs. .01-.37). Receiver operating curve analysis indicated that the optimal operating point for AAL as an indicator of ADIS agoraphobia diagnosis was 1.61, which yielded sensitivity of .87 and specificity of .73.

The field of psychotherapy research has lost one of its founding fathers. Lester Bernard Luborsky, born in Philadelphia on May 15, 1920, to Meyer and Celia Luborsky, immigrants from Eastern Europe, died on October 22, 2009. Lester Luborsky is best known as one of the pioneers of empirical research on psychodynamic psychotherapy. Indeed, he operationalized many of its concepts. His core conflictual relationship theme (CCRT) method was a breakthrough in the formalization of clinical psychodynamic concepts (Luborsky & Crits-Christoph, 1998, Understanding Transference: The Core Conflictual Relationship Theme Method, APA Books). Until the end of his life, Lester was a strong believer that psychotherapy is effective and that different psychotherapies are equally effective (a belief known as the "dodo bird verdict"). On the basis of a qualitative review of about a hundred comparative treatment studies, Luborsky, Singer, and Luborsky (1975, Archives of General Psychiatry, 32, 995-1008) first concluded that all psychotherapies were equally effective. Lester's early contribution to psychosomatic research attempted to delineate the onset conditions for the appearance of both psychological and somatic symptoms. Using his symptom-context method, he compared the content of clients' narratives preceding the appearance of symptoms in psychotherapy to sections of a psychotherapy session preceding a randomly selected control event.

BACKGROUND: In the context of a National Institutes of Mental Health-funded Interventions and Practice Research Infrastructure Programs (IP-RISP) grant for the treatment of depression, a partnership was developed between a community mental health organization and a team of researchers. OBJECTIVES: This paper describes the collaborative process, key challenges, and strategies employed to meet the goals of the first phase of the grant, which included development of a working and sustainable partnership and building capacity for recruitment and research. METHODS: This paper was developed through the use of qualitative interviews and discussion with a variety of IP-RISP partners. LESSONS LEARNED: Communication with multiple stakeholders through varied channels, feedback from stakeholders on research procedures, and employing a research liaison at the clinic have been key strategies in the first phase of the grant. CONCLUSION: The strategies we employed allowed multiple stakeholders to contribute to the larger mission of the IP-RISP and helped to establish an ongoing research program within the mental health organization.

Isolated sleep paralysis (ISP) has received scant attention in clinical populations, and there has been little empirical consideration of the role of fear in ISP episodes. To facilitate research and clinical work in this area, the authors developed a reliable semistructured interview (the Fearful Isolated Sleep Paralysis Interview) to assess ISP and their proposed fearful ISP (FISP) episode criteria in 133 patients presenting for panic disorder treatment. Of these, 29.3% met lifetime ISP episode criteria, 20.3% met the authors' lifetime FISP episode criteria, and 12.8% met their recurrent FISP criteria. Both ISP and FISP were associated with minority status and comorbidity. However, only FISP was significantly associated with posttraumatic stress disorder, body mass, anxiety sensitivity, and mood and anxiety disorder symptomatology.

CONTEXT: In 2004, the American Psychiatric Association's Committee on Research on Psychiatric Treatments appointed a subcommittee to investigate the status of empirical evidence with regard to psychodynamic psychotherapy. OBJECTIVE: As a part of this effort, the committee developed a rating scale designed to assess the quality of randomized controlled trials (RCTs) of psychotherapy. DATA SOURCES: A 25-item RCT of Psychotherapy Quality Rating Scale was generated by expert consensus. Interrater reliability, internal consistency, and validity testing were undertaken using 7 trained raters. STUDY SELECTION: A PubMed search was conducted to locate all RCTs of psychotherapies identified by their authors as being "psychodynamic" or "psychoanalytic" in origin and implementation. DATA EXTRACTION: A total of 69 RCTs were independently rated by 2 raters. DATA SYNTHESIS: The scale was found to have good interrater reliability (total score intraclass correlation = 0.76), internal consistency (Cronbach alpha = .87), and external validity. CONCLUSIONS: This scale establishes a new standard for the design and execution of psychotherapy RCTs and provides a systematic empirical method for evaluating the quality of published RCTs.