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The authors of this commentary aim to expand on particular points covered in the chapter by Evans, Williams and Simms, and discuss other issues that were not covered there. First, they discuss future research directions for, and the potential utility of, multisource assessments of personality pathology. Second, they emphasize the need for aspects of clinical utility within some of the reviewed measures (e.g., norms, validity scales). Third, they discuss the need for further examinations into the feasibility and utility of longitudinal assessments of personality pathology (e.g., dynamics in the context of treatment). Fourth, they describe two recent measures of personality pathology that warrant further validation. Lastly, they emphasize the need for a conceptual and measurement-based consensus regarding the multidimensional nature of personality pathology as a whole.
Psychological assessment and report writing are arguably two of the more important tasks of clinical psychologists. The overall purpose of this chapter is to provide some recommendations and guidelines on how to write a psychological report using evidence-based assessment methods. Principles on psychological report writing derived from seminal papers in the field of psychological assessment were adapted and used as an organizing tool to create a template on how to write all varieties of psychological reports that incorporate evidence-based assessment methods. Report writers who share similar approaches to evidence-based assessment methods may find this template helpful when formatting their psychological reports.
Although cognitive-behavioural therapy (CBT) is a well-established treatment for adult depression, its efficacy and efficiency may be enhanced by better understanding its mechanism(s) of action. According to the theoretical model of CBT, symptom improvement occurs via reductions in maladaptive cognition. However, previous research has not established clear evidence for this cognitive mediation model.
The present study investigated the cognitive mediation model of CBT in the context of a randomized controlled trial of CBT v. antidepressant medication (ADM) for adult depression. Participants with major depressive disorder were randomized to receive 16 weeks of CBT (n = 54) or ADM (n = 50). Depression symptoms and three candidate cognitive mediators (dysfunctional attitudes, cognitive distortions and negative automatic thoughts) were assessed at week 0 (pre-treatment), week 4, week 8 and week 16 (post-treatment). Longitudinal associations between cognition and depression symptoms, and mediation of treatment outcome, were evaluated in structural equation models.
Both CBT and ADM produced significant reductions in maladaptive cognition and depression symptoms. Cognitive content and depression symptoms were moderately correlated within measurement waves, but cross-lagged associations between the variables and indirect (i.e. mediated) treatment effects were non-significant.
The results provide support for concurrent relationships between cognitive and symptom change, but not the longitudinal relationships hypothesized by the cognitive mediation model. Results may be indicative of an incongruence between the timing of measurement and the dynamics of cognitive and symptom change.
Alexithymia is a personality trait characterised by difficulty identifying and describing subjective emotional feelings, a restricted imagination, and an externally oriented style of thinking. Individuals with high levels of this trait are at risk of developing several common psychiatric disorders. The concept of alexithymia has evolved considerably over the past twenty years, and this important new work responds to the need for a definitive book on the subject. The research, theory and clinical issues surrounding alexithymia are discussed in depth, examining the psychological, biological and social aspects of the construct and their related outcomes. Featuring contributions from researchers and clinicians in the field of emotion processing and regulation, chapters include methods for assessing and reducing alexithymia, and research findings from diverse fields of scientific enquiry including genetics, neuroimaging studies, emotion regulation, attachment and trauma research, and comorbidities with a number of psychiatric and medical disorders.