Lilienfeld Honorary Webinar

Buros Center for Testing Author

03/22/2021 Added

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March 2 webinar - Honoring the professional career of Dr. Scott Lilienfeld

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[00:00:00.000]Hello, and welcome to this webinar honoring Scott Lilienfeld.
[00:00:04.500]I am Kurt Geisinger, the director of the Buros Center for Testing,
[00:00:07.920]which has now been at the University of Nebraska-Lincoln for the past 41 years
[00:00:12.450]after having been founded by Oscar Buros.
[00:00:15.510]I am very pleased to welcome the speakers and attendees to our webinar in honor
[00:00:19.500]of the life and work of Professor Scott Lilienfeld.
[00:00:23.520]They honor professor Lilienfeld today as does Scott's wife Candice Basterfield.
[00:00:28.230]Since 1980
[00:00:30.810]when the center came to the University of Nebraska-Lincoln, Buros has had a
[00:00:34.740]National Advisory Council and its history of members includes many,
[00:00:38.910]many of the luminaries of educational and psychological testing and
[00:00:43.530]measurement. Traditional membership on the council has been two
[00:00:48.030]educational measurement scholars and one in either school or counseling
[00:00:51.960]psychology, an industrial psychologist, and a university librarian.
[00:00:57.120]However, because the biggest area,
[00:00:59.160]historically within the Mental Measurements Yearbooks,
[00:01:01.500]our flagship publication, is in the realm of personality and clinical psychology,
[00:01:06.510]we decided that we needed to add a clinical psychologist with a specialty in
[00:01:10.260]clinical testing to our advisory council. I asked
[00:01:14.460]Dr. Janet Carlson,
[00:01:15.840]our resident clinical psychologist and Buros associate director to provide me
[00:01:19.740]with names of the most appropriate clinicians in the country.
[00:01:23.400]It should surprise no one on this committee or to hear today
[00:01:28.320]that Scott Lilienfeld was the top name on the list. To abstract
[00:01:33.270]the rest of the story I called him, asked him to join our group and he said, "Yes".
[00:01:38.370]He spent four years on our National Advisory Council and he was incredibly
[00:01:42.840]participatory
[00:01:44.250]and well-informed. Whether with PhDs,
[00:01:47.880]graduate students or staff, all would report
[00:01:50.730]he was warm and remarkably friendly, and as all of you know,
[00:01:55.950]he was also unbelievably smart and knowledgeable.
[00:01:59.550]He shared his knowledge with all of us generously. In some cases,
[00:02:03.570]and speaking for myself,
[00:02:06.000]he became our friend both personally and professionally.
[00:02:09.990]We miss him. Because Scott shared our commitment to the science and practice
[00:02:14.940]of testing and measurement,
[00:02:16.560]we thought it was fitting to acknowledge his contributions to our work in the
[00:02:21.390]preface of the 21st Mental Measurements Yearbook just out this month.
[00:02:26.130]I would encourage those who are in attendance today to learn about this
[00:02:29.370]cornerstone resource,
[00:02:31.020]as well as the many other resources Buros provides for researchers,
[00:02:34.890]practitioners, and educators.
[00:02:37.080]But today is to honor Professor Lilienfeld who was
[00:02:42.000]taken from us far too early. So again,
[00:02:45.300]welcome to our webinar and with no further ado, Dr. Jonson.
[00:02:50.600]Hello.
[00:02:51.170]and I'd also like to welcome you to the Buros Center for Testing's Honorary
[00:02:54.890]Webinar for Dr. Scott Lilienfeld.
[00:02:57.440]We appreciate you joining us and this distinguished panel of presenters who are
[00:03:01.390]helping us recognize the eminent career contributions of Dr. Lilienfeld
[00:03:05.380]and we're pleased and honored to start our program today with an
[00:03:09.520]introduction from Ms. Candice Basterfield. The presentation,
[00:03:13.960]so the four panelists will follow her introduction and as time allows each
[00:03:18.460]presenter will answer one to two questions after the presentation.
[00:03:22.660]We do ask you submit those questions by clicking the Q and A icon at the bottom
[00:03:27.130]of the screen. We've shared several links in the chat.
[00:03:30.940]One is a link of listing of Dr. Lilienfeld's
[00:03:33.640]most important scholarly work that was put together by a committee for the
[00:03:37.240]Society for the Science of Clinical Psychology.
[00:03:41.230]A second link will provide you access to a web page where you can enter your own
[00:03:45.460]tributes and testimonies about Dr Lilienfeld and his work,
[00:03:49.570]and we will publish and share that along with the recording of this
[00:03:53.530]webinar. We've also included links to articles about Dr. Lilienfeld's
[00:03:57.520]life and career from Emory University and the New York Times.
[00:04:02.560]So we thank you again for your interest in this program.
[00:04:05.590]and I now will turn it over to Ms. Basterfield.
[00:04:15.840]Hi,
[00:04:17.040]I want to thank Buros for inviting me to talk about my late husband, Scott Lilienfeld
[00:04:24.270]who passed away on September 30th, 2020.
[00:04:28.140]He was 59 years old.
[00:04:31.410]Scott fought a battle against a virulent form of cancer for several months,
[00:04:37.050]with courage and dignity and continued working up until his very last days.
[00:04:43.470]The field of clinical psychology and psychology more broadly lost a
[00:04:48.060]pioneer, a brilliant scholar, original and independent thinker,
[00:04:53.850]beloved mentor, colleague and friend.
[00:04:57.570]More than anything else though,
[00:04:59.490]Scott was a kind, caring and thoughtful person.
[00:05:05.010]Scott was born in Queens, New York Thelma and Ralph Lilienfeld.
[00:05:10.260]His mother was a homemaker and his father,
[00:05:12.690]a radiologist. Scott's interest in science was developed
[00:05:17.550]from an early age when his father would frequently take him to the American
[00:05:22.350]Museum of Natural History in New York City.
[00:05:26.400]Scott succeeded in school and was the valedictorian of his high school.
[00:05:31.320]In his youth,
[00:05:33.870]he was an excellent chess player and would compete in chess competitions.
[00:05:39.510]Scott obtained his bachelor's degree from Cornell University in
[00:05:43.740]1982, where he initially was enrolled to study astronomy,
[00:05:48.930]but later changed to psychology.
[00:05:52.470]One of Scott's intellectual heroes was the astronomer Carl Sagan who
[00:05:57.410]happened to be teaching at Cornell when Scott was a student.
[00:06:02.060]Scott was lucky enough to get a brief encounter with him at Cornell and later
[00:06:05.990]actually met him formally and was able to attend his lectures
[00:06:11.390]After Cornell University,
[00:06:13.160]Scott enrolled for his PhD in Clinical Psychology at the University of Minnesota,
[00:06:17.540]and studied under the supervision of David Lykken.
[00:06:23.960]His dissertation developed and validated a measure of psychopathic personality,
[00:06:27.830]called the Psychopathic Personality Inventory
[00:06:33.110]which has become the most widely cited self-report measure of psychopathy
[00:06:38.660]Paul Meehl,
[00:06:39.950]another one of Scott's intellectual heroes served as a committee member
[00:06:44.120]on Scott's doctoral dissertation.
[00:06:46.700]Scott kept a letter from Paul Meehl on his office desk saying,
[00:06:50.450]in sum that Scott's thesis was excellent.
[00:06:55.130]Scott's first academic position was as an assistant professor at the State
[00:06:59.600]University of New York at Albany. In 1994,
[00:07:04.100]he moved to Emory University where he was a Samuel Candler Dobbs
[00:07:07.680]professor. Scott authored, co-authored and co-edited
[00:07:12.680]more than 350 articles and book chapters and 20 books,
[00:07:17.630]including a popular psychology textbook currently on the market.
[00:07:22.640]He published on wide ranging topics, including personality disorders,
[00:07:27.260]dissociative disorders, anxiety disorders, psychiatric classification,
[00:07:32.240]pseudoscience and psychology, intellectual humility,
[00:07:35.480]and evidence-based practice. Considering his broad range of interests,
[00:07:40.340]Scott was a generalist.
[00:07:43.430]This is incredibly rare in today's hyper specialist academy.
[00:07:48.380]Scott was especially interested in the application of scientific thinking to
[00:07:52.100]clinical psychology,
[00:07:53.750]and he played a major role in distinguishing evidence-based from
[00:07:57.560]pseudo-scientific practices,
[00:07:59.810]as well as writing about poorly validated psychotherapeutic and assessment
[00:08:04.250]methods, such as pseudo-scientific autism therapies,
[00:08:08.870]projective tests, recovered memory therapy, lie detectors,
[00:08:13.580]and facilitated communication.
[00:08:17.180]Scott pursued some of the thorniest questions in psychology,
[00:08:21.410]and he did so with intellectual humility and courage.
[00:08:26.030]His work was considered controversial in many corners of academia
[00:08:30.500]and at times he was criticized. Nevertheless,
[00:08:34.250]Scott was very much committed to improving psychological science.
[00:08:40.550]Scott was also deeply committed to disseminating psychological science to the
[00:08:44.780]general public and his work was featured in USA Today,
[00:08:49.880]The Washington Post, Los Angeles Times, Chronicle of Higher Education
[00:08:55.860]and the New York Times to name just a handful of outlets.
[00:09:00.840]From 2006 to 2015,
[00:09:03.420]he was also a regular contributor to the Scientific American Mind where
[00:09:08.400]he had a column on facts and fictions and mental health.
[00:09:12.630]This was later turned into a popular book under the same name.
[00:09:17.580]In addition,
[00:09:18.780]he co-authored another popular psychology book called the 50 Grit Myths of
[00:09:23.460]Popular Psychology, which was translated into 20 languages.
[00:09:28.890]On a personal note,
[00:09:30.600]I was lucky enough to have met Scott in Australia when he was giving a talk on
[00:09:35.310]evidence-based practice, and I was taken aback by his sharp wit,
[00:09:39.600]his warmth, his kindness, and his intelligence.
[00:09:44.040]I will always be honored to be Scott's wife
[00:09:48.240]His extra ordinary intellectual accomplishments, both humble and inspire me.
[00:09:52.140]and I'm sure many of you watching this try to emulate the clear thinking that
[00:09:56.970]he embodied. Thank you.
[00:10:11.870]Okay, good morning everyone.
[00:10:15.530]My name is Martin Sellbom.
[00:10:17.210]I'm a professor of psychology at the University of Otago in
[00:10:21.740]Dunedin, New Zealand. It's morning here in New Zealand.
[00:10:25.070]Good afternoon to those of you in North America.
[00:10:28.610]I just want to start out with saying just how honored I am to be part of this
[00:10:32.540]webinar and,
[00:10:33.770]it's quite the humbling experience to be reflecting on Scott Lilienfeld's
[00:10:38.510]legacy. And I'm going to do my best to
[00:10:42.350]present this in a correct manner as possible.
[00:10:46.300]I want to start out with just a quick personal note.
[00:10:49.160]So, I first started communicating with Scott in
[00:10:52.970]2002.
[00:10:55.040]I was a graduate student at Kent State University
[00:10:59.270]under supervision of a Yossef Ben-Porath
[00:11:02.870]who's listed here on this article that I'm showing you. Now
[00:11:06.230]one of the things that I was doing was trying to find out a measure of
[00:11:10.850]psychopathy that I could use for a new study that I was designing on assessing
[00:11:15.410]psychopathic personality traits with the MMPI-2,
[00:11:19.580]and I found the PPI that Candace just mentioned
[00:11:24.920]and Yossef had gone to graduate school with Scott at the University of Minnesota,
[00:11:29.720]and he recommended
[00:11:30.620]I send Scott an email and ask him the various questions that I have. So I did,
[00:11:35.690]I had absolutely no
[00:11:37.610]thinking that he would get back with me anytime soon,
[00:11:41.300]But to all of those who know Scott,
[00:11:43.480]you would not be surprised to hear that within an hour, I had an email reply
[00:11:48.110]multiple paragraphs and went well beyond the answering the questions that I
[00:11:52.700]had, and that really started my communication with Scott.
[00:11:58.870]Shortly after that I met Scott and we've pretty much have collaborated ever
[00:12:03.790]since. He's very much served as a psychopathy
[00:12:07.890]research mentor to me. And along with some important others, you see,
[00:12:12.940]for instance, Chris Patrick on this one as well, and
[00:12:16.330]there's some others as well, but,
[00:12:17.960]Scott has pretty much always been there since day one.
[00:12:23.830]I also had the fortune to continue to collaborate with Scott over the years.
[00:12:28.510]For instance, when I was an independent academic, we
[00:12:33.400]published papers, some led by my students like Becca Kastner here, Bryan Neo,
[00:12:38.200]others by his students like Joanna Berg, Shauna Bowes,
[00:12:42.370]just to mention a few examples. We also
[00:12:46.090]collaborated on various projects regarding
[00:12:49.600]big issues and topics in the psychopathy field.
[00:12:53.410]And I was quite fortunate to revise his original chapter
[00:12:58.180]on the self-report assessment of psychopathy
[00:13:01.300]for the second edition of Chris Patrick's Handbook of Psychopathy
[00:13:06.160]along with his original coauthor Katie Fowler as well. So,
[00:13:11.170]we pretty much worked together
[00:13:15.340]until his passing. So this presentation,
[00:13:20.260]has essentially two loosely connected parts.
[00:13:24.850]They might perhaps appear a little bit disjointed,
[00:13:27.790]but there is some logic behind here. The first part is that
[00:13:31.640]I want to share some of Scott's contributions to psychopathy assessment,
[00:13:36.340]as well as some of his thinking with respect to psychopathy.
[00:13:40.270]And I'll say personality disorder construct. But the second part
[00:13:44.920]which represents some work, I was doing was Scott
[00:13:49.510]concerns
[00:13:50.050]the addressing misconceptions and fallacies about psychopathy
[00:13:54.820]assessment, something that I know Scott cared deeply about.
[00:13:59.710]So, you know,
[00:14:00.340]for those of you who are less familiar with the construct of psychopathy understand
[00:14:04.630]it's a pretty wide audience.
[00:14:06.610]Some might wonder what is psychopathy or at least
[00:14:09.820]what is the definition of psychopathy?
[00:14:11.920]And I wish I could tell you because there's a significant debate in the field,
[00:14:15.910]really debates have been going on for the past couple of centuries in terms of
[00:14:19.870]how to exactly define this disorder. Now, of course, there's some consensus,
[00:14:24.630]I think most experts in psychopathy would argue that
[00:14:27.850]there's at least characteristics that fall into broad domains of affective,
[00:14:31.660]interpersonal and behavioral functioning,
[00:14:33.550]like individuals who score high in psychopathy measures tend to be lacking in
[00:14:38.200]remorse, empathy, tend to be callous,
[00:14:41.590]Interpersonally, they're deceitful, manipulative, grandiose,
[00:14:45.580]but also potentially, superficially charming.
[00:14:49.660]They hate really the impulsive, risk taking, irresponsible.
[00:14:54.830]But there is some significant debate about what sorts of characteristics really
[00:14:58.910]constitutes the core of psychopathy,
[00:15:01.370]as well as which characteristics are truly part of psychopathy versus others
[00:15:06.380]might be potentially, peripheral. Now,
[00:15:09.930]in terms of the assessments of psychopathy,
[00:15:12.290]I would say this started with Bob Hare's Psychopathy Checklist. This
[00:15:16.520]was a monumental contribution to the field.
[00:15:20.600]Bob Hare developed
[00:15:22.250]the Psychopathy Checklist essentially as a research tool at first to
[00:15:26.780]unify the operationalization of this construct,
[00:15:30.470]which was pretty much in shambles at the time.
[00:15:33.860]The Psychopathy Checklist was revised in 1991 for clinical use
[00:15:39.230]and essentially constitutes
[00:15:42.710]20 items that reflect different features of psychopathy that was meant to
[00:15:47.540]capture Harvey Cleckley's original conceptualization of
[00:15:52.370]psychopathy that he wrote about in the 1940s after studying their
[00:15:57.260]psychiatric patients, who he believed were psychopathic.
[00:16:02.060]And it's a clinical rating scale.
[00:16:04.310]One makes ratings on these items after interview and review of file information
[00:16:08.780]and in an institutional context.
[00:16:13.610]There's a score ranging from 0 to 40,
[00:16:16.250]where 30 has been denoted as potentially
[00:16:20.030]reflecting a diagnosis of psychopathy. Factor analysis of the PCL-R,
[00:16:25.100]initially revealed two broad factors of
[00:16:28.880]affective interpersonal traits versus more behavioral proclivities,
[00:16:33.470]but later worked as focused on four factors underlying these items that
[00:16:37.760]represent affective, interpersonal lifestyle and antisocial
[00:16:40.310]characteristics. Now there's been some concerns expressed about the
[00:16:45.080]PCL-R. I should mentioned that these concerns are certainly not
[00:16:49.890]held by everyone, and
[00:16:52.460]there's some significant debate about these topics,
[00:16:55.250]but I think these are concerns that Scott would have shared.
[00:16:59.330]One of them being that the PCL-R had migrated away from Cleckley's
[00:17:03.860]classical description in the sense that there were certain
[00:17:07.160]characteristics and traits that were,
[00:17:09.020]that are not well embedded within the PCL-R like fearlessness and stress immunity
[00:17:14.960]Aspects I know Scott felt were important to the conceptualization of psychopathy.
[00:17:19.820]Others have also complained that there's an excessive emphasis on criminal
[00:17:23.690]and antisocial behaviors within the PCL-R, and
[00:17:28.610]that you're essentially merging outcomes and
[00:17:36.020]also consequences of a personality disorder with
[00:17:40.700]the personality trait structure in itself.
[00:17:45.680]There's again some significant debate there. Candace mentioned that
[00:17:49.740]one of Scott's initial major contributions to the field was a Psychopathic
[00:17:54.540]Personality Inventory,
[00:17:55.950]which was part of his doctoral dissertation and was later published in the Journal of
[00:17:59.700]Personality Assessment and revise for clinical use in 2005.
[00:18:04.440]And originally out 187 items
[00:18:07.120]it was later shortened to 154 items.
[00:18:10.140]And this test was meant to capture the personality traits associated with
[00:18:13.980]psychopathy, the emphasizing some of the more behavioral outcomes,
[00:18:18.480]but also that it could be used in institutional contexts.
[00:18:23.100]He also canvassed the literature and
[00:18:25.680]tried to capture all important aspects of psychopathy
[00:18:29.050]including some traits that go back to Harvey
[00:18:32.370]Cleckley like fearlessness and stress immunity. For instance,
[00:18:36.150]as I mentioned earlier,
[00:18:37.980]and a lot of work with a PPI that's really been on elaborating on its high order
[00:18:42.330]structure.
[00:18:42.990]So essentially you're subjecting these eight scales to factor
[00:18:47.850]analyses that have yielded, generally three
[00:18:52.050]broad factors or really two broad factors of fearless dominance
[00:18:56.400]that has been also referred to as boldness
[00:19:00.360]in the psychopathy literature that capture some of these classic,
[00:19:04.590]Clecklien characteristics like stress immunity, fearlessness,
[00:19:08.940]social influence and dominance.
[00:19:12.180]One broad factor called in a self-centered impulsivity
[00:19:15.690]which has some of the more classic
[00:19:19.170]psychopathy traits that are perhaps less debated.
[00:19:23.040]And then cold hardiness always ended up on its own factor. Now,
[00:19:27.660]even this structure has been somewhat debated with some finding that it doesn't
[00:19:32.640]quite replicate in every single sample, but now most of the work
[00:19:37.650]on the PPI is really focused on the two factors from that
[00:19:42.660]high order structure, fearless dominance, and self-centered impulsivity.
[00:19:47.700]And a lot of this work has informed
[00:19:50.310]Scott's theoretical thinking about psychopathy.
[00:19:53.880]He viewed psychopathy as not being a classical syndrome in which all of the
[00:19:58.650]symptoms and traits would converge to
[00:20:02.580]show the phenotype.
[00:20:04.320]But rather, he argued that it was a constellation of a range of personality
[00:20:08.880]traits from multiple higher order domains,
[00:20:11.370]some of which are not highly correlated with one another. And he believed that
[00:20:15.660]these individual personality traits from common trait models can be quite
[00:20:20.280]useful in understanding differences in both psychopathy theories and their
[00:20:25.200]various operationalizations, including different manifestations of psychopathy.
[00:20:30.360]There's been a lot of literature to suggest there's not just one psychopathy
[00:20:34.590]manifestation but rather research on subtypes have suggested that there
[00:20:39.570]was at least two as some of which I've been called primary versus secondary
[00:20:43.680]psychopathy although there's been other names published as well.
[00:20:47.590]And different trait constellations can be used to understand
[00:20:52.090]these different manifestations. Now,
[00:20:55.630]Scott believed that the fearless dominance or boldness is a key aspect of
[00:21:00.280]psychopathy.
[00:21:01.960]And this has been under some significant debates. Scholars like Don Lynam,
[00:21:06.010]Josh Miller, Stephen Hart, among others,
[00:21:08.570]tend to disagree with this perspective and have certainly published some
[00:21:12.130]empirical data to support their
[00:21:15.550]perspective and disagreement with the stance.
[00:21:18.820]But in representing Scout's thinking, it's important to highlight the fact that
[00:21:23.980]he strongly believed that this was an important part of psychopathy.
[00:21:28.900]And interestingly boldness as I'll just refer to it from here out is generally
[00:21:33.670]modestly correlated with other psychopathy domains
[00:21:36.430]which of course would be inconsistent with a psychopathy syndrome,
[00:21:39.850]but he argue that boldness would interact with other personality or sorry
[00:21:43.300]psychopathy domains to form a particularly impactful trade constellation.
[00:21:48.460]But he also argued that boldness in itself in isolation would be unlikely to
[00:21:53.080]reflect psychopathy. It really needs to interact with other psychopathy
[00:21:56.800]traits for psychopathic manifestation. And in fact,
[00:22:00.850]some individuals are high in boldness,
[00:22:03.040]but not those psychopathy traits might actually be,
[00:22:07.570]excuse me generally successful in adaptive
[00:22:11.740]in some domains of their lives. Now
[00:22:16.270]Scott argued that psychopathy represents a particular personality trait
[00:22:20.710]configuration that is especially interpersonally impactful.
[00:22:24.590]And what he meant by this was that, you know,
[00:22:27.400]a lot of scholars in personality disorder field more generally,
[00:22:32.140]have talked about personality disorders being defined as extreme
[00:22:36.400]manifestations of normal individual personality traits
[00:22:40.060]where this could essentially create thousands of potential
[00:22:43.270]constellations of traits that would reflect personality disorder.
[00:22:47.290]But why have not all of these different constellations been observed
[00:22:52.180]in clinical practice, in other areas.
[00:22:56.230]And Scott argued that that's because there's some particular constellations that
[00:23:00.850]are particularly interpersonally impactful.
[00:23:04.390]And he wrote about this general perspective quite recently,
[00:23:08.110]representing it does an emergent interpersonal syndrome.
[00:23:12.490]And he argued that this
[00:23:14.920]trait constellation that includes boldness would essentially
[00:23:19.420]generate a manifestation that can be adaptive on the surface.
[00:23:23.720]Certainly look like they're leading generally good lives
[00:23:28.390]are superficially successful, are free of mental illness and
[00:23:33.160]other problems, but in the long term very much
[00:23:37.690]show maladaptive nature and the harm to others
[00:23:42.410]in society.
[00:23:45.760]And some of this perspective certainly inspired
[00:23:49.520]research into both adaptive and successful psychopathy. For instance,
[00:23:54.530]one study looking at psychopathy in former U.S. presidents.
[00:23:58.880]Or Waldman is a part of that study. Maybe he will mention it in his talk
[00:24:03.650]later on. But essentially in
[00:24:06.860]the short amount of time that I have hopefully
[00:24:11.420]that does some of Scott's thinking about this
[00:24:14.870]very interesting construct justice. Now the second part that I want to
[00:24:19.880]share with you is
[00:24:22.410]addressing misconceptions and fallacies.
[00:24:25.430]I think Scott was the ultimate mythbuster in psychology. He
[00:24:29.570]clearly enjoyed writing on this topic, not just on psychopathy,
[00:24:33.740]but in psychology in general and Candace spoke to this earlier.
[00:24:39.050]And, it was also represented in
[00:24:43.100]the last work that I authored with Scott
[00:24:46.400]along with two other important colleagues, Rob Latzman and Dustin Wygant.
[00:24:52.180]And this was truly a team effort and we very much enjoyed working on this
[00:24:56.270]chapter that is about to come out in psychopathy,
[00:24:59.540]its uses, validity and status.
[00:25:02.210]I believe the whole volume is being dedicated to Scott.
[00:25:06.080]And within here we addressed some myths, misconceptions and fallacies.
[00:25:10.040]I do not have time to talk about everything
[00:25:13.230]that we included in this chapter, but I will
[00:25:16.430]talk about some things I know Scott in particular
[00:25:20.360]felt strongly about.
[00:25:22.190]And these were posed as questions and we'll just dive into certain measures,
[00:25:26.330]and standards for assessing
[00:25:29.660]psychopathy, this major pet peeve of Scott's especially since
[00:25:34.520]frequently people would talk about certain measures
[00:25:37.700]being the gold standards for detecting psychopathy with the PCL-R being the most
[00:25:42.680]frequently heralded in this way.
[00:25:44.960]For instance, Evans and Tully wrote PCL-R as the sole tool of choice
[00:25:49.910]for psychopathy measurement. If you go to Google scholar,
[00:25:53.180]you'll find plenty of hits referring to PCL-R as a gold
[00:25:58.010]standard. But also the PPI, Scott's own measure,
[00:26:02.870]had been referred to as the gold standard self-report psychopathy measure
[00:26:07.250]something that they also strongly disagreed with.
[00:26:10.190]And part of the reason for this is because there are no genuine gold standards
[00:26:14.390]for any construct in psychology
[00:26:17.660]because psychological constructs by definition are latent entities that we
[00:26:21.710]can't directly observe. So any approximation
[00:26:25.280]of psychological construct are by definition fallible.
[00:26:29.390]So there's no perfect inventory. And
[00:26:32.600]this would also violate the principles of construct validity that were
[00:26:36.650]articulated by Lee Cronbach and Paul Meehl for instance.
[00:26:40.460]Paul Meehl as Candace mentioned, certainly being one of
[00:26:43.920]Scott's heroes in many respects in terms of intellectual and
[00:26:48.690]scholarly thinking. And also when we think about construct validation,
[00:26:53.250]it's an inherently ongoing and self-correcting process,
[00:26:57.000]meaning that we continuously learn new things about our measures,
[00:27:00.780]and it can never really be regarded as final. It's not an absolute property.
[00:27:05.460]And another important thing is that construct validation is also directly linked
[00:27:09.120]to theoretical frameworks.
[00:27:11.210]So you can essentially have two scholars who have different theoretical
[00:27:15.480]perspectives, look at the same data for a measure,
[00:27:18.750]and actually come to different conclusions about construct validity.
[00:27:23.220]And I think we see a fair bit of that in the field of psychopathy assessments.
[00:27:28.050]And there's also no meta analytic evidence of the PCL-R for instance,
[00:27:31.530]consistently outperforms other widely used psychopathy measures with respect to
[00:27:35.430]convergent and discriminant validity
[00:27:37.890]with relevant external criteria.
[00:27:41.310]A second question is antisocial personality disorder an
[00:27:44.640]adequate operationalization of psychopathy. For instance,
[00:27:48.420]Ben Karpman who wrote about psychopathy early on wrote "It's about time that
[00:27:53.370]we cease making psychopathy, criminal and antisocial behavior identical and
[00:27:57.900]interchangeable".
[00:27:59.370]which very much would have implications for the States today. Now,
[00:28:04.230]psychopathy of course
[00:28:05.220]was always the target construct for the criteria underlying antisocial
[00:28:08.790]personality disorder. If you look in DSM I and DSM II, for instance,
[00:28:13.600]it's very much reflected the core psychopathic personality traits. In fact,
[00:28:17.430]it was referred to as sociopathic personality disorders,
[00:28:21.570]but it was really with the DSM-III and onwards that things changed.
[00:28:25.920]A sociologist by the name of Lee Robins had a lot of influence in the
[00:28:30.420]shaping of the diagnostic criteria of antisocial personality disorder,
[00:28:34.560]and it dramatically shifted towards a more behavioral operationalization.
[00:28:39.330]In parts, they argued for inter-rater reliability,
[00:28:43.950]but also in part, because these were deemed the most predictive
[00:28:48.300]traits associated with a disorder in terms of
[00:28:52.830]outcomes. Now,
[00:28:54.810]most experts in the psychopathy field would likely argue that the DSM III
[00:28:59.580]through DSM V criteria for antisocial personality disorder are
[00:29:03.780]certainly inadequate with respect to operationalization of psychopathy,
[00:29:08.910]at least in so far as the most dominant psychopathy theory go.
[00:29:12.780]I suppose if you adhere to Lee Robin's perspective
[00:29:16.890]on this disorder, you would argue that the ASPD might
[00:29:20.400]be associated with a good construct validity.
[00:29:23.850]But nevertheless, research has shown that
[00:29:26.160]if you look at prevalence rates in prison
[00:29:28.020]samples of offenders for instance, about 50 to 80% meet criteria for
[00:29:32.130]anti social personality disorder. If you use the PCL-R,
[00:29:35.520]which as we have established before is a certainly well-supported measure for
[00:29:40.170]psychopathy and use that cut score of 30 that we'll get to in a minute,
[00:29:44.680]about 15 to 25% would meet criteria for the same
[00:29:49.270]putative disorder. There's also been some neurological differences shown
[00:29:53.770]when you use
[00:29:55.000]antisocial personality disorders versus other psychopathy measures.
[00:29:58.840]For instance, works by Luke Hyde and colleagues have shown this.
[00:30:02.920]Is it scientifically acceptable to rely on psychopathy total scores? Certainly,
[00:30:07.990]numerous research do this. There was
[00:30:10.510]a meta analysis by Poeppl and colleagues that looked at fMRI correlates of
[00:30:14.290]psychopathy without looking at the self-dimensions.
[00:30:18.850]There are also the brief measures of psychopathy like the Dark Triad measures,
[00:30:23.360]and the sort that don't provide information about the sub dimensions of
[00:30:27.700]psychopathy.
[00:30:28.810]But this is problematic because using total scores can obscure and dilute
[00:30:32.920]potential important associations among the sub dimensions.
[00:30:37.660]And we can look at the PCL-R for instance,and trait anxiety,
[00:30:41.320]where the old factor, the more behavioral factors tend to positively
[00:30:45.070]correlated trait anxiety whereas affective interpersonal factor was
[00:30:49.090]a weekly negatively correlated with trait anxiety. And in fact,
[00:30:53.020]in many cases,
[00:30:53.740]a sub dimension psychopathy measures do fractionate opposing directions in
[00:30:58.240]terms of associations with external criteria. And
[00:31:02.030]this would of course,
[00:31:02.830]result in near zero associations for a total score and also potentially
[00:31:07.720]theoretically important reciprocal suppressor effects cannot be observed if you
[00:31:12.340]rely on total scores.
[00:31:15.130]Is it scientifically acceptable to rely on psychopathy cutoff scores?
[00:31:18.820]Certainly some manuals like the PCL-R manual suggests a score of 30 out of
[00:31:23.350]40 to suggest psychopathy. Now the manual itself does
[00:31:28.400]provide some caution about this.
[00:31:31.360]But it's still potentially problematic to use a score like this
[00:31:35.880]to diagnose psychopathy cause it does happen in clinical practice.
[00:31:39.880]Some other authors use lower cut scores for women or Europeans for instance,
[00:31:44.020]and researchers
[00:31:45.490]would often distinguish between psychopaths and non- psychopaths using this
[00:31:50.260]sort of cutoff score.
[00:31:52.900]Now there's little empirical justification
[00:31:56.140]for this sort of practice. The PCL-R for instance,
[00:32:00.940]the original score was based on one standard deviation from the mean
[00:32:03.910]on an offender population.
[00:32:05.620]Nothing magical happens at a cut score of 30 and there's no taxonomic
[00:32:10.120]analysis that would look for taxons or qualitative,
[00:32:14.920]categorical constructs that would support this idea that there is a
[00:32:19.870]clear, qualitative psychopathy
[00:32:23.620]disorder underlying these measures.
[00:32:26.230]And there's a number of issues with dichotomization from a statistical
[00:32:29.980]perspective that I'm listing here, but because I'm quickly running out of time,
[00:32:34.780]I'm going to move on to some other things.
[00:32:38.740]And the final thing I want to talk about are the PCL-R and allied measures
[00:32:42.650]unparalleled predictors of violence?
[00:32:45.860]Many assume that the PCL-R and its variants are distinctively
[00:32:48.920]if not uniquely suited for this sort of prediction. One writer,
[00:32:53.090]for instance,
[00:32:53.630]recently described the PCL-R's ability to predict violence as quote "unprecedented
[00:32:58.040]and unparalleled". Now,
[00:33:01.520]in saying that, the PCL-R is indeed the consistent,
[00:33:04.640]robust predictor of criminal violence and recidivism.
[00:33:07.250]We're not trying to argue otherwise,
[00:33:09.140]but the evidence is uniquely talented in this regard.
[00:33:12.620]It's essentially non-existent. And in fact,
[00:33:15.080]Singh and colleagues showed in the meta analysis that the PCL-R ranked among the
[00:33:19.190]lowest at predicting risk for general offending and fell below a number of other
[00:33:23.510]widely used measures and variables for this purpose.
[00:33:26.630]It's also been a recent statement of concern. Experts have questioned the utility
[00:33:30.680]of using the PCL-R for risk assessment in death penalty cases because of the
[00:33:35.360]prediction of institutional violence and aggression. Though,
[00:33:38.570]there's certainly been some debate about this issue as well
[00:33:41.760]that that needs to be highlighted.
[00:33:44.120]The most predictive utility of the PCL-R for instance
[00:33:46.700]resides with the anti-social facets
[00:33:48.890]which is the most debated facet among the PCL-R facets to begin with.
[00:33:53.870]And might really just represent Meehl's maxim that the best predictor of
[00:33:57.980]future behavior tends to be past behavior with other traits being less
[00:34:02.000]predictive. So, in summary
[00:34:05.090]there's many more myths about psychopathy, some that were described, and
[00:34:09.620]others that have been described in the past.
[00:34:12.320]I really encourage others to just rely on psychopathy assessment measures that
[00:34:16.880]exhibit
[00:34:17.790]robust construct validity for the purposes and populations with which
[00:34:22.730]they should be used.
[00:34:23.630]And this recommendation is really no different for any other psychological
[00:34:27.620]tests.
[00:34:28.250]And I think the field really needs to move beyond the idea that one measurement
[00:34:32.180]modality is inherently superior to others,
[00:34:34.790]and really focus on which measure best maps onto the theoretical
[00:34:40.100]perspective to which one prescribes.
[00:34:42.830]Sorry for the rush there towards the end,
[00:34:45.530]but hopefully this gives you some ideas into a Scott's
[00:34:50.720]thoughts about psychopathy and some of the
[00:34:53.150]concerns that he had expressed about this literature. It's time for questions.
[00:34:57.880]Thank you, Dr. Sellbom.
[00:34:59.080]I don't have a lot of time for questions and I'm not sure if we have anything
[00:35:02.950]that's come in yet. I'll just ask,
[00:35:05.950]is there anything in particular that you see as important next steps
[00:35:10.600]worth the research on this,
[00:35:12.130]in terms of what measures do you use and how to use those measures?
[00:35:16.570]Well, I think that Scott's ideas of thinking about
[00:35:21.400]psychopathy and any personality disorder as a reflecting a
[00:35:25.810]constellation of personality traits, is really
[00:35:30.550]the way to move forward. Personality disorder and
[00:35:34.090]science more generally, in this assessment,
[00:35:37.260]they're all certainly moving in that direction.
[00:35:39.930]There's lots of important scholars, not just Scott who think this way and have,
[00:35:44.760]certainly published a lot of important literature
[00:35:48.900]that would guide us in this direction.
[00:35:51.090]But I do think that we need to move away from psychopathy as some
[00:35:56.070]unitary umbrella construct
[00:35:58.560]and instead just focus on the underlying components and understanding those
[00:36:02.460]components,
[00:36:03.360]some of which are relevant to other personality disorders that we have
[00:36:08.340]labeled and not just psychopathy. If we look at disinhibition, for instance,
[00:36:13.370]which is a broad trait domain, it's relevant
[00:36:16.600]to understanding psychopathy,
[00:36:18.150]but it's also relevant to understanding other manifestations of personality
[00:36:22.020]disorder like I say, borderline personality disorder.
[00:36:25.740]So I think we need to kind of move away from, from some of these labels.
[00:36:29.640]And instead of trying to understand
[00:36:32.220]maladaptive expressions of these personality domains much more so than
[00:36:37.020]holding on to what I think are becoming agent constructs.
[00:36:41.970]Very good. Thank you. All right. Well, we have a full program for you,
[00:36:46.830]so we're gonna move on to our next presentation. Thank you, Dr. Sellbom and
[00:36:51.510]Dr. Clark, you are up now.
[00:37:00.320]See if I can get this going properly.
[00:37:13.160]Did I do it right this time? It looks good. All right, thanks.
[00:37:18.470]Well, first I want to thank the Buros Center for testing for inviting me to
[00:37:21.740]contribute to this webinar honoring my late friend,
[00:37:25.040]Scott Lilienfeld. I'm humbled and honored to be able to
[00:37:29.270]participate. Given that one area to which Scott contributed
[00:37:33.770]significantly, particularly with regard to assessment,
[00:37:36.740]as has already been made very clear, was psychopathic personality,
[00:37:40.880]I chose for my talk today to present information regarding assessing
[00:37:45.080]psychopathic personality traits and behaviors using the SNAP-2, the Schedule for
[00:37:50.060]Non Adaptive and Adaptive Personality, second edition.
[00:37:53.630]This is partly because I am far from a psychopathy expert as some of
[00:37:58.640]those who are speaking today are so I wanted to speak about something that
[00:38:03.860]I at least had some knowledge rather than going out in a whim and
[00:38:08.630]hoisting myself by my own.
[00:38:13.460]First, a conflict of interest disclosure. I'm the author,
[00:38:16.100]copyright holder of the SNAP family of measures.
[00:38:21.110]The various measures in the SNAP family are all freely available for unfunded,
[00:38:25.400]non-commercial research and non-profit clinical work.
[00:38:30.170]In all other cases,
[00:38:31.250]I negotiate a mutually acceptable fee with the user and use the funds to support
[00:38:35.620]student research and in all cases that require a user
[00:38:40.300]license. So,
[00:38:42.580]first I want to take a minute to mention my relationship with Scott.
[00:38:45.880]He and I have a number of connections that suggest some similarities between us.
[00:38:50.470]You heard from Candace, Scott obtained his degrees from Cornell and
[00:38:55.450]the University of Minnesota and coincidentally,
[00:38:58.690]I also obtained my bachelor's degree from Cornell and my PhD from the University
[00:39:03.370]of Minnesota.
[00:39:04.120]We also both worked some with [inaudible] and of course we were both interested
[00:39:08.200]in personality pathology. However,
[00:39:10.780]we never overlapped at either institution.
[00:39:15.280]Related to our common interest,
[00:39:16.960]The first article of Scott's that I ever read was the relationship of
[00:39:21.580]histrionic personality disorder to anti-social personality and somatization
[00:39:26.290]disorders.
[00:39:29.670]The comorbidity of histrionic personality disorder, often abbreviated PD,
[00:39:34.380]and anti-social PD is now well documented as is the association between
[00:39:39.240]what used to be called hysteria, now histrionic PD and somatization disorder.
[00:39:44.820]Although neither relation was established when this paper was published,
[00:39:49.020]this paper posited
[00:39:50.100]the intriguing hypothesis that in individuals with histrionic PD/hysteria
[00:39:54.900]males were more likely to have comorbid anti social PD
[00:40:00.300]and females co-morbid somatization disorder,
[00:40:04.110]a hypothesis is that continues to be of some interest to this day. Of note,
[00:40:08.460]the senior author of the paper was Hagop Akiskal,
[00:40:11.670]a well-known psychiatrist and longtime editor of the Journal of Affective
[00:40:15.570]Disorders.
[00:40:17.520]When Scott published this paper in a premier journal,
[00:40:20.790]the American Journal of Psychiatry with well-known researchers as co-authors,
[00:40:25.800]he was a graduate student.
[00:40:28.710]I was an assistant professor whose only first authored publication was a chapter
[00:40:33.450]in my advisor's book.
[00:40:37.050]Despite my lack of credentials at the time,
[00:40:40.110]I guess I was smart enough to recognize Scott as someone who would rise to
[00:40:44.190]eminence and perhaps needless to say, I've followed Scott's work ever since.
[00:40:50.820]So I'm going to transition here to the main substance of my talk,
[00:40:53.820]the Schedule for Non Adaptive and Adaptive Personality,
[00:40:56.970]second edition or SNAP-2,
[00:40:59.490]and its relationship with psychopathic personality traits, including of course
[00:41:04.260]those assessed by Scott's Psychopathic Personality Inventory,
[00:41:07.950]as well as behaviors in the psychopathy domain. First,
[00:41:12.780]a quick introduction to the SNAP.
[00:41:14.370]It assesses 15 traits relevant to personality pathology,
[00:41:18.150]including for example, mistrust.
[00:41:21.210]The sample item is "I'm sure I'm being talked about". Exhibitionism,
[00:41:25.530]"I love to have my picture taken" and impulsivity,
[00:41:28.830]"I often act without thinking". The scales were developed by combined content and
[00:41:33.770]factor analysis. Factor analytically derived measures have the advantage over
[00:41:37.850]scales that were developed using empirical keying
[00:41:41.180]or that were rationally derived. Now their items
[00:41:44.360]generally cohere better and form single-factor scales,
[00:41:47.420]or have a hierarchical structure as when a broad domain scale encompasses
[00:41:52.010]narrower facets.
[00:41:54.470]The full version of the SNAP has 390 items that were developed based on both
[00:41:59.060]DSM and other PD criteria. There are also short, brief
[00:42:03.560]and very brief forms of the SNAP as well as informant versions of all lengths.
[00:42:09.500]In addition to the 15 traits,
[00:42:11.870]the full version only has six validity scales to detect various forms of
[00:42:16.490]invalid responding and 10 diagnostic scales keep to the DSM IV
[00:42:20.930]PDs, or if you will
[00:42:22.910]the DSM-V section two PDs whose criteria are identical.
[00:42:27.830]The SNAP's 15 traits form three broad temperament domains.
[00:42:31.790]The first being negative affectivity (AKA neuroticism and negative emotionality)
[00:42:37.280]with negative temperament being the name of the scale in the SNAP that assesses
[00:42:41.030]the affective core of this broad domain. Second,
[00:42:44.540]just positive affectivity (AKA extroversion and positive emotionality)
[00:42:49.580]with positive temperament being the name of the scale that assesses the
[00:42:52.730]affective core of this broad domain.
[00:42:54.890]And third is disinhibition versus constraint called psychoticism by Eysenck
[00:43:00.110]and assessing both conscientiousness and agreeableness at the opposite end
[00:43:05.030]of the five factor model of personality. Now,
[00:43:08.500]many of you will recognize this as Eysenck's three factor model with negative
[00:43:12.650]affectivity being neuroticism and positive affectivity being extroversion and disinhibition,
[00:43:16.730]psychoticism.
[00:43:19.280]And some of you will also know that Eysenck's psychoticism scale would be better
[00:43:23.570]named psychopathy. Alternatively,
[00:43:27.650]the SNAP can be thought of as measuring four of the five scale domains of the
[00:43:31.610]consensual five factor model with disinhibition
[00:43:34.280]combining agreeableness and conscientiousness. In a later
[00:43:38.690]development, scales keyed more directly to positively appraised (inaudible) would
[00:43:43.190]develop, except for openness, because SNAP doesn't have the relevant item content.
[00:43:48.860]However,
[00:43:49.190]some researchers have argued that psychoticism is a pathological form of
[00:43:52.940]openness. And if you buy into that theory,
[00:43:57.890]you can assess that content using SNAP's eccentric perception
[00:44:02.210]scale. Besides negative temperament, other scales in the negative affectivity
[00:44:06.710]domain are mistrust, manipulativeness, aggression,
[00:44:10.070]self-harm, eccentric
[00:44:11.750]perceptions and dependency. Besides positive temperament,
[00:44:15.740]other scales in the positive affect domain are exhibitionism and
[00:44:20.540]entitlement with detachment on the other end.
[00:44:24.590]And besides disinhibition, other scales in the domain are impulsivity with the
[00:44:29.330]constraint being propriety and workaholism.
[00:44:33.990]Very quickly, some basic psychometric data.
[00:44:37.080]The SNAP scales are internally consistent with average alphas in the low to
[00:44:40.740]mid eighties from mid to high seventies at the low end and high eighties to
[00:44:45.150]nineties at the high end. Interestingly,
[00:44:47.670]a different scale was the lowest in each of these samples
[00:44:50.430]so there's no one scale that is generally less internally consistent than the
[00:44:55.410]others
[00:44:56.370]whether that appears to be sample specific. In the short to medium term,
[00:45:01.170]scales are temporarily stable.
[00:45:03.270]And even in a sample of patients in treatment for three to six months,
[00:45:06.870]they're reasonably stable.
[00:45:09.570]A key property of the SNAP is that despite having a higher order structure,
[00:45:13.950]it's lower order scales are generally independent with an average inner
[00:45:18.750]scale correlation of around 0.2 and the highest correlations topping out around
[00:45:23.730]0.6. Thus,
[00:45:25.290]the measure truly gives you 15 relatively independent pieces of information
[00:45:29.400]about individual's personality traits. Finally,
[00:45:32.790]regarding the SNAP's factor structure,
[00:45:34.740]most of the negative affectivity factor scales load on the first factor with
[00:45:38.370]some cross loadings onto the other two,
[00:45:41.550]especially the disinhibition factors. By the way, C A T P here
[00:45:46.440]stand for college, adult, teens, and patients.
[00:45:49.650]These data are from the same samples that was showing earlier. Similarly,
[00:45:54.450]the positive affectivity factor scales load on the second factor with a few
[00:45:58.590]cross loadings,
[00:46:00.210]and finally, the disinhibition scales load on the third factor with the strongest
[00:46:04.560]cross loadings on negative affectivity in patient samples,
[00:46:08.250]in which there's a stronger representation of the higher order dimension
[00:46:11.550]originally termed simply alpha more often now called stability,
[00:46:16.560]which is composed of neuroticism, low agreeableness, antagonism,
[00:46:20.610]and low conscientiousness,
[00:46:22.470]or in terms of the SNAP, negative affectivity and disinhibition versus
[00:46:26.010]constraint.
[00:46:28.320]Now on to relations between the SNAP and Scott's
[00:46:33.060]Psychopathic Personality Inventory.
[00:46:36.630]Two large samples of undergraduates completed the SNAP-2
[00:46:39.840]or GTS, a form of the SNAP that contains only the three core temperament scales,
[00:46:45.120]the PPI,
[00:46:46.590]and one or more other measures. I've been asked to contribute a chapter to a
[00:46:50.760]festschrift volume dedicated to Scott,
[00:46:52.890]and I plan to use these data in that chapter. Today, however,
[00:46:56.580]given our time constraints,
[00:46:58.230]I'm going to present data mostly from the first sample.
[00:47:01.230]I'm going to critique the popular two factor scoring of the PPI
[00:47:06.090]that Martin Sellbom introduced in his talk in a way that I like to think Scott
[00:47:10.830]would appreciate,
[00:47:12.270]and I'm not going to discuss the other measures that we collected.
[00:47:16.650]We wanted to find a structural level between the two factor higher order level
[00:47:20.970]most commonly used, the one that Martin introduced, and the original eight
[00:47:25.680]scale structure. So we conducted an item level factor analysis.
[00:47:30.880]First, we replicated the two factors, scale level structure using items,
[00:47:35.770]convergent validity correlations were 0.93
[00:47:38.710]and 0.95 respectively in the two samples and discriminate correlations
[00:47:43.330]were similar to the 0.15 correlation between the two level factor scales.
[00:47:47.760]So we felt that we had a replicated the two factor level and then continued to
[00:47:52.570]extract factors and found the four-factor level to be optimal.
[00:47:57.940]Two factor fearless dominance split into fearless non-conformity
[00:48:03.460]and social dominance.
[00:48:05.590]Whereas self-centered impulsivity split into irritable
[00:48:10.270]disinhibition and thoughtful dependability with fearless
[00:48:14.470]nonconformity having a secondary cross loading on self-centered impulsivity.
[00:48:20.320]We hypothesized that what was happening at the four-factor level is that the
[00:48:24.430]more pathological range and the more normal range content in each of the higher
[00:48:28.480]order scales was splitting into two scales.
[00:48:32.470]Incidentally, using absolute values, the
[00:48:36.490]inter scale correlations on the four mid-level factor scales ranged from
[00:48:40.990]0.07 to 0.31 so they're reasonably independent.
[00:48:46.390]Next, we examined relations of the two higher order and four mid-level factor
[00:48:51.350]scales with the SNAP or GTS temperament scales.
[00:48:56.260]S(1) is the smaller of the two samples I mentioned earlier,
[00:48:59.830]and S(2) is the larger. For clarity, only correlations of at least
[00:49:04.780]0.3 are shown.
[00:49:06.910]You can see here that of the four mid-level scales,
[00:49:10.930]negative temperament correlates only with irritable disinhibition,
[00:49:15.400]whereas it correlates with both of the higher order scales,
[00:49:18.550]at least in one of the samples.
[00:49:21.490]Conversely, positive temperament correlates most strongly and positively
[00:49:26.350]with social dominance at the four factor level with moderate positive
[00:49:30.760]correlations with thoughtful dependability,
[00:49:33.910]and only with fearless dominance at the higher order level.
[00:49:39.010]These results may then some support to our hypothesis that social
[00:49:43.360]dominance at least, reflects more adaptive pro-social traits
[00:49:48.280]than does fearless non-conformity,
[00:49:51.040]which I think Martin was alluding to in his talk.
[00:49:55.360]It's less clear whether either irritable,
[00:49:57.220]disinhibition or low thoughtful dependability are more pro-social.
[00:50:02.170]Turning to disinhibition versus constraint,
[00:50:04.840]which we would expect to be more strongly correlated with psychopathic
[00:50:08.860]personality traits than either negative or positive temperament,
[00:50:12.640]we can see that it correlates with everything,
[00:50:15.100]but social dominance and relates more strongly to fearless non-conformity
[00:50:20.320]and negatively to thoughtless dependability
[00:50:26.500]than with irritable disinhibition,
[00:50:28.400]which you'll recall was related strongly to negative temperament. At the higher
[00:50:33.230]order level,
[00:50:33.980]it also correlates more strongly with self-centered impulsivity than with
[00:50:37.640]fearless dominant,
[00:50:39.050]suggesting that of those two factors self-centered impulsivity,
[00:50:43.880]maybe the more maladaptive.
[00:50:47.750]Just for comparison sake,
[00:50:49.760]there are correlations with five factor model agreeableness and
[00:50:53.600]conscientiousness in sample two,
[00:50:55.970]showing that both of them are related to both irritable disinhibition
[00:51:00.680]negatively and thoughtful dependability positively at the four-factor level.
[00:51:05.780]And only with self-centered impulsivity negatively at the higher order level.
[00:51:11.570]So these data also suggests social dominance per se
[00:51:15.560]maybe best conceptualized is not particularly strongly reflecting a
[00:51:19.910]psychopathic personality trait.
[00:51:22.070]Perhaps it does need to be combined with other traits to reflect psychopathy.
[00:51:27.680]Taken together,
[00:51:28.370]these data show the advantage of separating the two higher order factors,
[00:51:33.830]fearless dominance in particular, into two subtraits with fearless,
[00:51:38.720]non-conformity more pathological than social dominance,
[00:51:43.340]and the jury is still out regarding irritable disinhibition and low thoughtful
[00:51:48.110]dependability. As I said earlier,
[00:51:51.890]I plan to follow up on these analysis in a chapter in a forthcoming festschrift
[00:51:55.890]volume,
[00:51:57.020]examining their relations with the additional measures and including behavioral
[00:52:01.910]assessments.
[00:52:02.690]I hope you'll have the opportunity to read that volume when it is published
[00:52:06.740]so I'm sure it will contain a number of chapters that will be worth
[00:52:11.720]perusing. In some two factor,
[00:52:15.170]fearless dominance can be split into fearless nonconformity and social
[00:52:19.100]dominance,
[00:52:20.030]which correlate respectively with disinhibition positive temperament or
[00:52:24.560]agentic extroversion, if you will.
[00:52:27.920]Whereas self-centered impulsivity can be split into irritable disinhibition
[00:52:32.630]versus thoughtful dependability,
[00:52:34.820]which correlate respectively with negative temperament and constraint.
[00:52:42.020]I want to end my talk today by illustrating how the SNAP scales
[00:52:46.970]relate to behaviors that are relevant to psychopathic personality
[00:52:51.440]traits using three different samples.
[00:52:55.700]First is a sample of 170 college students who prospectively
[00:53:00.050]recorded on a daily basis
[00:53:02.390]whether they had exhibited a set of behaviors relevant to three trait domains
[00:53:07.430]over a period of 10 to 14 days.
[00:53:11.240]The domains we assessed were aggression.
[00:53:14.150]Sample items include "yelled, cursed, snap, or shouted at someone",
[00:53:18.290]"got into an argument".
[00:53:23.120]Impulsiveness. Sample items included "skipped class on a whim"
[00:53:29.070]"made.a list of things to do", reversed scored of course,
[00:53:34.530]and exhibitionism. Sample items included "work clothes that drew attention"
[00:53:39.240],"flirted with someone".
[00:53:42.480]We then calculated the average number of each set of behaviors
[00:53:47.460]that participants had exhibited daily over the sampling period and
[00:53:52.230]correlated those with the corresponding scales from the SNAP and other
[00:53:56.790]measures that were assessed at the beginning of the 10 day behavioral assessment
[00:54:00.690]period.
[00:54:03.960]You can readily see that the aggressive behaviors correlated with SNAP
[00:54:09.000]trait aggression, and also the Buss-Perry aggression questionnaire.
[00:54:13.380]The impulsive behaviors correlated with SNAP trait
[00:54:17.400]impulsivity and the Barrett Impulsivity scale.
[00:54:21.210]And the exhibitionistic behaviors correlated with SNAP and
[00:54:25.650]Narcissistic Personality Inventory exhibitionism demonstrating that
[00:54:30.300]self-reported personality traits reflect corresponding real life daily
[00:54:35.220]behavior. In the second study,
[00:54:41.220]366 adolescents completed the SNAPY,
[00:54:45.600]the SNAP for youth, and their parents rated their teens using an
[00:54:50.280]informant version of the SNAP.
[00:54:53.250]We also gathered both academic data and behavioral problem data from
[00:54:58.200]their school charts.
[00:55:01.620]Here are the correlates with the academic data. Parent rated workaholism
[00:55:07.350]correlated with students' grades as did propriety, a scale assessing adherence to
[00:55:12.300]traditional social rules as rated by both parents and teens.
[00:55:18.360]Grades also related negatively to teen rated disinhibition,
[00:55:22.830]impulsivity and aggression. Interestingly,
[00:55:27.240]other than the two parent rated scales,
[00:55:30.510]these personality traits were not related to standardized test scores.
[00:55:35.280]And even the parent ratings correlated more weekly than with grades.
[00:55:40.620]This indicates that grades largely reflect the role of personality
[00:55:45.960]in academic achievement,
[00:55:48.180]whereas standardized tests for the most part do not.
[00:55:54.630]As for the problem behaviors, the correlates were moderate
[00:55:58.080]especially for the number of suspensions, which were very low in frequency,
[00:56:03.090]but higher for the number of times that the school bus driver wrote up the
[00:56:07.050]student for misbehaving on the bus with aggression being the strongest
[00:56:11.340]correlate.
[00:56:12.840]These results indicate that maladaptive behaviors can in fact be self-reported
[00:56:16.860]by adolescents as well as discerned by school bus drivers.
[00:56:21.900]Also know by the way,
[00:56:22.800]the good agreement between parents and teens on these relations was just
[00:56:26.860]unusual. Finally,
[00:56:30.880]in the third study,
[00:56:33.010]561 community adults completed what we call the demographic questionnaire.
[00:56:38.770]Besides actual demographics,
[00:56:41.440]the questionnaire asked whether they were currently in treatment for mental
[00:56:44.530]health issues, whether they had a history of arrest or not,
[00:56:49.360]and a number of questions regarding frequency and quantity of alcohol and drug
[00:56:53.440]use, including whether they had ever been treated for drug or alcohol problems.
[00:56:59.290]From the substance use questions, we created a total score,
[00:57:02.590]and for our purposes today,
[00:57:04.450]I dichotimized that measure and we examined the relations between the three
[00:57:09.220]core temperament scales of the SNAP and these three behavioral domains.
[00:57:15.880]Regarding mental health treatment,
[00:57:18.130]we see the expected difference in negative temperament with those who are in
[00:57:21.730]treatment higher in negative temperament than those who are not.
[00:57:26.260]A similar but smaller, and of course
[00:57:28.780]opposite effect for positive temperament was found,
[00:57:33.040]but there was no significant difference on disinhibition.
[00:57:38.620]Severity of alcohol and drug use however,
[00:57:41.680]shows a different pattern with no significant difference on either negative
[00:57:46.030]temperament or positive temperament,
[00:57:50.890]but a significant difference on disinhibition.
[00:57:55.900]Likewise, a history of criminal arrest.
[00:57:58.810]There was no significant difference on negative temperament or positive
[00:58:03.310]temperament, but a significant difference on disinhibition.
[00:58:11.050]In summary,
[00:58:11.560]I've shown that the factors measured with Scott Lilienfeld's PPI can be assessed
[00:58:15.550]with a measure developed in the three factor tradition of Eysenck,
[00:58:20.140]and also Scott's and my common mentor,
[00:58:23.020]Auke Tellegen who held to a three factor model and that these scales do
[00:58:27.790]indeed correlate with a variety of behaviors in the domain of psychopathy.
[00:58:33.430]I think Scott would have been pleased to see how
[00:58:37.660]broadly his Psychopathic Personality Inventory reaches
[00:58:42.490]into other measures of maladaptive personality.
[00:58:47.830]At least I hope so. Thank you for attending today,
[00:58:51.730]and I guess we'll take questions now.
[00:58:53.940]All right. Very good. Thank you, Dr. Clark,
[00:58:57.360]and we do not have any questions I believe at this
[00:59:01.590]time. And let me,
[00:59:05.340]I was just double checking the time to make sure we have some time.
[00:59:11.130]So you mentioned early on that
[00:59:14.940]Scott had mentioned some differences,
[00:59:16.530]gender differences on such. Is that also been some areas that you've explored
[00:59:21.530]with the SNAP
[00:59:22.310]or how it associates and aligns with other measures such
[00:59:26.180]demographic differences?
[00:59:28.660]I have done some of that certainly, and the biggest demographic
[00:59:33.670]the biggest gender differences are on negative temperament with females
[00:59:38.650]typically scoring higher and disinhibition
[00:59:42.760]with males scoring higher.
[00:59:46.390]That's not been a major emphasis of mine, but
[00:59:51.100]yeah, those data certainly are there and there's
[00:59:53.600]surprisingly little difference on positive temperament.
[00:59:57.220]Very good. Very interesting. Yeah. It's interesting to see how that plays out.
[01:00:03.700]Let's assume that if there are no questions,
[01:00:05.560]that means that I was crystal clear.
[01:00:09.610]I thought it came across pretty clear,
[01:00:15.670]so we thank you for your time. All right. So Dr. Waldman,
[01:00:20.470]you are up.
[01:00:44.050]Thanks very much and thanks very much for having me speak today.
[01:00:49.060]So I'm going to be talking about some work that I've done
[01:00:53.560]in my lab recently with my senior grad student Holly Poore on
[01:00:58.240]mapping the externalizing spectrum and youth from an assessment perspective.
[01:01:04.450]So I had the great good fortune to be friends with Scott,
[01:01:08.980]close friends with Scott for 40 years since we were undergrads together at
[01:01:13.030]Cornell, and in fact,
[01:01:14.740]I could give a whole separate much longer talk about that,
[01:01:18.550]but we don't have time for that today,
[01:01:21.100]and I've been lucky to be a colleague of his for 30 of those years.
[01:01:26.110]And, I went back and after just a little bit of digging,
[01:01:29.150]found a couple of papers that are relevant to
[01:01:32.470]the topic of my talk today that we published near the start of our careers.
[01:01:38.140]Both here looking at the relation of childhood ADHD to
[01:01:42.760]oppositional defiant disorder
[01:01:45.310]on the one hand and adult antisocial behavior on the other.
[01:01:49.480]And then also
[01:01:51.760]looking at more conceptual and statistical or methodological issues,
[01:01:56.740]in this domain, and the first paper on the left
[01:02:00.880]in which we took on the concept of comorbidity in psychopathology research and
[01:02:05.620]on the right, we
[01:02:07.030]talked about statistical methods on how they might be
[01:02:11.140]better use to examine construct validity of externalizing in childhood.
[01:02:17.950]Aside from my collaboration with Scott,
[01:02:22.110]my own motivations for this study is that I've been involved in research on
[01:02:26.580]hierarchical structural models of psychopathology for quite some time,
[01:02:30.870]particularly of child psychopathology. And most recently,
[01:02:34.410]the past five years through an organization,
[01:02:36.930]a consortium called HiToP that LeeAnna and Martin are also part of
[01:02:42.390]and more broadly, this project fits with research approaches
[01:02:47.370]that have sought to reconceptualize
[01:02:50.130]psychopathology moving from categorical diagnoses
[01:02:54.030]into the use of continuous symptom dimensions.
[01:02:56.760]And the way I think about this is it represents a move from
[01:03:01.530]commonly called transdiagnostic approaches to more transdimensional
[01:03:06.330]approaches.
[01:03:08.310]I've also more recently been involved in genome-wide studies of childhood
[01:03:12.630]psychiatric disorders, ADHD, ODD, and conduct disorder,
[01:03:17.640]and more recently
[01:03:20.970]an externalizing GWAS consortium. And this raises the question in my mind of
[01:03:25.980]whether an externalizing higher-order dimension might represent a better
[01:03:30.000]phenotype for such studies in the sense that it might increase statistical
[01:03:33.990]power by increasing effect sizes.
[01:03:37.170]So this work brings together my two major interests in the classification and
[01:03:41.790]causes of psychopathology, particularly
[01:03:43.880]in child samples. So there are
[01:03:47.630]a couple of specific questions we sought to answer in this work. So first,
[01:03:52.610]what is the evidence for an Externalizing spectrum in kids?
[01:03:56.360]I think we have come to know
[01:03:58.250]quite a bit about this in adults and late adolescence,
[01:04:01.700]but the literature in youth is lagging behind.
[01:04:05.300]Can we distinguish a higher order from a bifactor representation of
[01:04:08.690]externalizing in structural modeling and external validity analyses?
[01:04:14.030]And rather than putting these in competition,
[01:04:17.450]might there be advantages of each of those approaches to externalize it?
[01:04:22.310]Another issue is whether the factor structure for Externalizing
[01:04:26.450]replicates
[01:04:28.340]across clinically referred and non-referred populations and what the
[01:04:32.390]incremental value of these approaches over a simple externalizing composite
[01:04:37.700]which is still what's mainly used in the literature that or factor scores to
[01:04:42.470]represent externalizing,
[01:04:44.390]what the incremental value of those approaches might be? And in general,
[01:04:48.530]how helpful a more granular approach starting with specific symptoms
[01:04:53.450]at the item level, rather than symptom, dimensions or diagnoses might be?
[01:04:59.570]So after
[01:05:00.380]a little bit of background,
[01:05:01.400]I'll go into the alternative models that we contrasted and then the model
[01:05:06.050]fitting results for those,
[01:05:07.730]and then present some results from external validity analyses
[01:05:10.850]comparing the various models, and then finish up with some
[01:05:15.680]item response theory
[01:05:17.320]results that have more to do with the measurement of externalizing across the
[01:05:21.970]various symptom domains. So by way of background,
[01:05:26.830]most people are familiar with Tom Achenbach's seminal contribution in
[01:05:31.150]1966,
[01:05:32.740]in which he used factor analysis of behavior problems that he gleaned from
[01:05:36.970]review of clinic case files,
[01:05:39.580]and in which he identified broad externalizing and internalizing dimensions.
[01:05:44.800]In adult late adolescent samples,
[01:05:46.930]a lot of progress has been made over the past 20 years
[01:05:51.280]mostly I suppose by Bob Krueger's group at Minnesota and Susan Young and her
[01:05:55.540]colleagues at Boulder in which they identified a broad externalizing dimension
[01:06:00.160]that includes antisocial behavior,
[01:06:01.870]substance use and personality traits, in particular behavioral disinhibition.
[01:06:07.660]In child samples, along with Ben Lahey,
[01:06:10.360]we identified an externalizing dimension using symptoms of
[01:06:14.440]DSM-IV ADHD, ODD and conduct disorder,
[01:06:18.310]but there are limitations in my view of extant literature in youth,
[01:06:22.570]and these include limited tests of alternative conceptualizations of
[01:06:26.410]externalizing. So what's the best model for representing it?
[01:06:31.330]Assessing fit relative to a simpler model
[01:06:35.800]which consists of correlated lower order symptom dimensions rather
[01:06:40.600]than any higher order factor.
[01:06:43.660]Rudimentary measurement of externalizing dimension
[01:06:48.220]using composites as I already mentioned.
[01:06:51.970]And a failure to contrast external validity results across alternative models.
[01:06:56.620]And in this work we're seeking to address these limitations.
[01:07:01.240]So I'm not going to spend a lot of time on this slide. This is just capturing
[01:07:05.020]some of the
[01:07:07.360]results of previous relevant recent studies in this domain.
[01:07:11.860]And the main point to take away from this slide is that across these studies,
[01:07:16.120]not many have represented symptoms of ADHD,
[01:07:20.800]ODD, conduct disorder together, or even symptom dimensions representing them,
[01:07:25.150]and not many have started at the item level.
[01:07:29.410]So I'm going to be presenting today on two samples, a non-referred sample that
[01:07:34.000]comprises of 2,229 unselected twins and siblings from Georgia,
[01:07:39.580]and a clinic referred sample consisting of 640 cases or control
[01:07:44.510]children born in Georgia or Arizona. Across both studies,
[01:07:49.360]the participants ranged in age from 4 to 19 years.
[01:07:53.890]About 50% were male in the twin sample, about
[01:07:57.900]70% in the clinic referred sample and across both samples,
[01:08:02.410]about 70% were European ancestry and 24% African ancestry.
[01:08:07.810]As I said earlier, we assessed symptoms of ADHD, ODD and conduct disorder,
[01:08:12.910]and these were assessed by a parent report on a questionnaire that we've
[01:08:16.520]developed in my lab.
[01:08:19.150]So we conducted
[01:08:20.380]analyses of competing structural models using confirmatory factor analysis and
[01:08:25.210]did our external validity analyses using structural equation models that
[01:08:29.140]extended them, and then used item response theory methods to examine
[01:08:34.060]the measurement properties of individual items.
[01:08:36.370]So just to give a feel
[01:08:39.910]for the nature of these symptoms, for those who don't work in the child
[01:08:44.140]psychopathology realm, ADHD
[01:08:48.070]has three symptom domains,
[01:08:50.920]inattention, involving being easily distracted, impulsivity,
[01:08:56.050]blurting out answers before questions have been finished, hyperactivity,
[01:09:00.910]involving fidgeting or trouble staying seated when the child's required to.
[01:09:06.280]Within ODD,
[01:09:07.750]we follow recent trends that we've contributed to where we distinguish
[01:09:12.760]the what I'm going to call negative affect symptoms,
[01:09:16.720]but it's really a bit narrower than that in the literature having to do with the
[01:09:20.650]irritability component of negative affect involving
[01:09:24.910]losing one's temper,
[01:09:25.990]being touchy or easily annoyed from the defiant behavior aspects.
[01:09:31.120]And then within conduct disorder distinguishing the aggressive symptoms from the
[01:09:35.110]rule-breaking symptoms that involve things like destroying property or running
[01:09:39.220]away from home.
[01:09:42.370]Unfortunately,
[01:09:43.900]as is common with many studies,
[01:09:46.060]we had to exclude a number of conduct disorder symptoms due to low endorsement.
[01:09:50.830]So in both samples, we had to exclude "setting fires",
[01:09:55.630]"breaking and entering", "mugging" and "forced sex", and in the clinic sample in addition,
[01:10:00.700]we had to exclude "running away from home overnight", "using a weapon in a fight"
[01:10:04.780]and "being cruel to people".
[01:10:06.310]So I guess I would summarize this by saying bad for science,
[01:10:09.100]but good for society that there are so rare.
[01:10:13.750]So what are the models that we
[01:10:15.220]contrasted? So first is this correlated factors model. Here
[01:10:19.990]you see the seven symptom dimensions that I referred to and all the
[01:10:24.250]correlations among them. And then
[01:10:28.420]two models that represented externalizing.
[01:10:31.990]The first being a very commonly used bi-factor model where all those
[01:10:35.980]correlations among the seven symptom dimensions are captured by this general
[01:10:40.750]externalizing factor. Now, in this work,
[01:10:43.690]we realized that that's a pretty tall order that general externalizing
[01:10:48.160]factor may not be sufficient to capture the entirety of the correlations among
[01:10:53.140]the symptom dimensions.
[01:10:54.670]So we tested a modified version that also had residual correlations
[01:10:59.920]among the symptom dimensions within each disorder
[01:11:04.210]as shown here. And then the alternative model is a higher order
[01:11:09.190]externalizing model
[01:11:10.810]where the externalizing factor influences seven symptom dimensions rather than
[01:11:15.780]the symptoms directly. And as with the bi-factor model,
[01:11:20.010]we tested the modified version as well.
[01:11:22.250]So what did we find?
[01:11:26.150]Before I go on to the structural models, the results for those,
[01:11:31.070]this is the correlation matrix for the clinic sample in red and the non-preferred
[01:11:34.670]sample in blue.
[01:11:35.990]And what you could see is that all the correlations among the seven symptom
[01:11:39.470]dimensions are moderate
[01:11:41.330]except for the correlation between the two ODD dimensions of negative affect
[01:11:46.580]and deviant behavior which is quite high 0.96 in both
[01:11:50.630]samples.
[01:11:53.630]In the clinic referred sample first, we found that
[01:11:58.520]the two models for externalizing shown at the bottom
[01:12:03.230]but including the modification of the domain specific correlations among the
[01:12:07.820]residuals
[01:12:09.500]fit as well as the seven correlated factors model
[01:12:13.490]which is noteworthy because they're more parsimonious representations
[01:12:18.530]of the relations among the symptom dimensions.
[01:12:23.540]You could also see though, if you look at the bottom two lines that are bolded,
[01:12:27.830]that the fit between these two models is totally interchangeable and
[01:12:32.810]indistinguishable. And in fact,
[01:12:35.000]one of the only things that distinguishes these two models from each other is
[01:12:38.750]that as often is the case,
[01:12:40.940]there were some concerns with the bi-factor model. In this case,
[01:12:44.660]there were some non-significant or nearly so loadings. The same is true
[01:12:49.610]in the non-referred sample. Again,
[01:12:51.800]indistinguishable fit of the two externalizing
[01:12:56.780]models from each other
[01:12:58.850]as well as from the seven correlated factors model. Here again,
[01:13:02.780]there was a concern with the bi-factor model
[01:13:05.450]in that as you'll see in a few slides,
[01:13:08.330]the correlation between the aggressive and rule-breaking symptoms
[01:13:14.210]is non-significant.
[01:13:14.630]This is what the results look like. This is for the clinical sample.
[01:13:18.140]You could see that all seven symptom dimensions have moderate to high loadings
[01:13:22.310]on the externalizing factor,
[01:13:24.410]and there are moderate residual correlations among the ADHD,
[01:13:28.790]ODD, and conduct disorder symptom dimensions.
[01:13:32.510]The same is true for the non-referred sample of twins and sibs with the
[01:13:37.130]exception as I mentioned,
[01:13:38.930]that the correlation between aggression and rule breaking is really quite low
[01:13:42.650]and was non-significant.
[01:13:46.160]So we can go on and ask using the results of the higher order factor
[01:13:50.960]model of externalizing
[01:13:52.790]what percent of the correlations among these seven symptom dimensions is
[01:13:57.230]explained by that higher order factor? And in bold in the off diagonal,
[01:14:02.480]we're showing the relations
[01:14:05.720]across symptom domains, across disorders.
[01:14:08.840]And you could see that they average to 100% percent.
[01:14:12.340]You could also see that some of these go above 100% percent.
[01:14:15.880]That's not a mathematical error.
[01:14:17.440]It's just that these are correlations that are implied by the model rather than
[01:14:22.240]the correlations that we observed.
[01:14:25.150]In the off diagonal elements in italics,
[01:14:28.900]you can see that we did not capture 100% percent of the correlations
[01:14:33.790]for the within disorder symptom dimensions
[01:14:37.810]by the externalizing higher order factor loadings.
[01:14:40.900]And that's why indeed we needed the residual
[01:14:43.380]correlations among them. So looking at
[01:14:47.950]the factor loadings on the higher order factor, we can see a couple of things.
[01:14:52.950]First, the pattern and indeed
[01:14:54.570]even the magnitude of these loadings is very similar across the two
[01:14:59.310]samples,
[01:14:59.880]the clinical and non-referred samples. And the highest loadings are for the
[01:15:04.800]deviant behavior dimension of ODD followed by the negative affect
[01:15:09.150]dimension of ODD and the two conduct disorder
[01:15:12.000]dimensions of aggression and rule breaking.
[01:15:14.850]And then finally the ADHD symptom dimensions at the far left
[01:15:19.680]being
[01:15:20.250]the lowest. So what
[01:15:22.470]about external validity? So these analyses are quite important
[01:15:26.910]not just for the obvious reason that we want to look at
[01:15:30.720]the external validity of these factors structures in predicting
[01:15:35.040]external correlates and outcomes, but because within the context of
[01:15:39.510]the literature on the general factor psychopathology,
[01:15:43.140]what some have argued is that
[01:15:46.830]while one cannot distinguish a general factor from correlated
[01:15:51.480]factors using conventional model fit
[01:15:55.650]indices, one can use external validity
[01:16:00.030]indices such as R squared to distinguish among those models.
[01:16:04.050]So we wanted to see the degree to which that was true with regard to externalizing.
[01:16:07.650]We use a number of measures
[01:16:11.160]in these external validity analysis.
[01:16:14.850]They're listed here and for the sake of time,
[01:16:18.180]and also because we haven't finished all of them yet,
[01:16:20.820]I'm going to limit myself to the first five to the impulsivity,
[01:16:25.290]narcissism, callousness and emotionality scales from
[01:16:29.550]the APSD, the Antisocial Process Screening Device which is
[01:16:34.470]a measure of psychopathic traits in kids and then reactive and proactive
[01:16:38.880]aggression.
[01:16:42.780]In this slide, on the Y axis, I'm showing the R squares
[01:16:46.470]with their 95% confidence intervals for three models.
[01:16:51.960]From left to right,
[01:16:53.550]the hierarchical and the bi-factor models that include an externalizing factor
[01:16:58.410]and then an externalizing composite shown in red.
[01:17:01.950]And as you can see here,
[01:17:03.780]the hierarchical and bi-factor models always explain exactly the same percentage
[01:17:08.220]of variance, completely interchangeable or indistinguishable
[01:17:12.140]whereas the composite is always explaining about 5 to 8% of the variance less.
[01:17:19.130]Here, now I'm comparing the correlated factors model.
[01:17:23.180]The first model in sequence in teal to the hierarchical model in
[01:17:27.860]green and the bi-factor model in red, and what you can [inaudible]
[01:17:48.790]It's about 10% less than the models containing an externalizing factor,
[01:17:53.890]but if you look at the far right with regard to proactive aggression,
[01:17:57.490]you could see that it explains about 10% more of the variance.
[01:18:01.270]So we wanted to drill down on this a bit further to understand it better,
[01:18:05.920]and so we compared the results and the results here are standardized
[01:18:10.540]regression
[01:18:11.110]coefficients, betas that are partialing out externalizing
[01:18:15.970]along with their 95% confidence intervals on the y-axis for
[01:18:20.650]reactive aggression on the left and proactive aggression on the right. And
[01:18:25.030]starting with proactive aggression what you could see is,
[01:18:29.140]the filled in dots here mean that these results are significantly different from
[01:18:32.920]zero is that for proactive aggression,
[01:18:37.270]the strongest predictor were the aggressive symptoms of conduct disorder,
[01:18:41.050]rather unsurprisingly, but more surprisingly,
[01:18:44.020]no other scales were related. And in fact, in the positive direction,
[01:18:49.270]the rule-breaking symptoms of conduct disorder were significantly negatively
[01:18:53.710]related, reflecting suppression effects.
[01:18:57.370]but you see very different results for reactive aggression on the left.
[01:19:01.300]Aggressive CD symptoms again we're a significant predictor,
[01:19:04.510]but nowhere nearly as strongly as for proactive aggression,
[01:19:08.530]but impulsivity in red and the negative affect
[01:19:13.240]symptoms of ODD in dark blue also were significantly positively
[01:19:18.040]related.
[01:19:18.910]And this makes a lot of sense when you think of what reactive aggression is,
[01:19:23.170]which is hot tempered, impulsive aggression,
[01:19:27.370]often in reaction to a perceived threat to the self in contrast to proactive
[01:19:32.290]aggression, which is cold,
[01:19:35.140]planned, premeditated aggression.
[01:19:37.810]And this also highlights the utility of not only limiting our
[01:19:42.400]attention to the higher order dimensions of psychopathology in this case
[01:19:46.450]externalizing,
[01:19:47.800]but looking at the residualized lower order dimensions as well in our
[01:19:51.730]models.
[01:19:53.890]So now I want to finish up by talking about some results from item response
[01:19:57.550]theory analyses of externalizing,
[01:20:00.070]and as is common in the IRT literature,
[01:20:03.760]we were interested in two aspects information,
[01:20:07.500]which captures the precision of measurement at different points along the latent
[01:20:10.950]trait in this case, externalizing and item difficulty,
[01:20:14.760]which captures the probability of endorsing a symptom, a binary symptom at
[01:20:19.410]different points along the latent trait.
[01:20:21.960]The one difference here is that given that many of our symptoms,
[01:20:25.560]the majority of them are polygamous rather than dichotomous,
[01:20:28.890]we present something called Location Index Item Response Function Values,
[01:20:33.810]and these capture the level of the latent trait at which respondents have an
[01:20:38.040]average score that's equal to half the maximum of the
[01:20:41.640]scale. So this
[01:20:43.950]is the total information plot of externalizing symptoms and the twin sample,
[01:20:48.600]and what you could see here is that it was measured fairly precisely
[01:20:53.130]ranging from minus one standard deviation below the mean to
[01:20:57.990]about five standard deviations above the mean,
[01:21:00.720]but with the majority of the precision residing between the mean at zero
[01:21:05.640]and three standard deviations above the mean. Similar results
[01:21:10.470]were found for the clinic sample,
[01:21:12.120]except here the distributions are narrower where the majority of
[01:21:17.850]the information,
[01:21:18.900]the precision of measurement is provided from the mean up to about two
[01:21:23.460]standard deviations above the mean so narrower interval
[01:21:27.780]at which we had precision of measurement in
[01:21:29.640]the clinic sample.
[01:21:32.160]Looking at the partial information plots,
[01:21:36.390]this looks at the contribution of each of the seven symptom domains to the total
[01:21:40.860]precision of measurement. We see that the peak is for
[01:21:44.680]the inattentive symptoms at about two standard deviations above the mean,
[01:21:49.410]and that the ODD symptom dimensions of negative affect and deviant
[01:21:54.000]behavior are a bit below that, about one standard deviation
[01:21:59.550]above the mean, whereas the hyperactive
[01:22:04.620]and impulsive and aggression and rule-breaking especially symptoms
[01:22:09.780]are providing greater precision at the higher level.
[01:22:18.080]Similar results were found for the clinic sample though these were
[01:22:21.600]more of a piece of that inattention again
[01:22:25.810]is at the lowest along now with
[01:22:29.000]negative affect and deviant behavior. And again,
[01:22:32.120]the conduct disorder symptom dimensions along with hyperactivity and impulsivity
[01:22:36.410]now provide more information at the higher levels of the
[01:22:41.210]latent trait.
[01:22:44.720]Looking at the LI-IRF values, we see that
[01:22:49.490]the negative affect symptoms and deviant behavior symptoms
[01:22:54.290]provided the best
[01:22:56.870]aspects of item difficulty at the lower part of
[01:23:01.850]the latent trait at about one standard deviation above the mean. The ADHD
[01:23:06.010]dimensions were next in the middle
[01:23:08.470]followed by the conduct disorder dimensions of aggression and rule-breaking.
[01:23:12.400]And you see that these are flatter
[01:23:14.170]and what that is representing is the fact that these symptom domains seem
[01:23:19.120]to be a bit more heterogeneous than those of ADHD and oppositional defiant
[01:23:24.040]disorder. Similar results
[01:23:26.440]were found in the clinic sample except here,
[01:23:28.960]as you can plainly see the results are a bit more clumped
[01:23:32.800]such that they're a little harder to disentangle but
[01:23:37.840]the inattentive symptoms and the ODD symptoms seem again to be
[01:23:42.550]providing
[01:23:44.290]most of the item difficulty at the lower end followed
[01:23:49.000]by impulsivity and hyperactivity and aggression, and then rule-breaking
[01:23:53.830]at the top.
[01:23:56.080]So I want
[01:23:57.070]to end by saying a couple of conclusions and then future directions.
[01:24:01.240]So in our CFAs and external validity analysis,
[01:24:05.560]the fit of both the hierarchical or higher order and bi-factor models
[01:24:10.360]were
[01:24:11.170]identical to each other in virtually indistinguishable from that of a correlated
[01:24:14.770]factors model.
[01:24:16.510]The pattern and magnitude of the loadings of the seven symptom dimensions were
[01:24:20.350]very similar across the non-referred and clinically referred samples,
[01:24:24.940]such that the deviant behavior
[01:24:28.510]items had the highest loadings on the higher order externalizing factor
[01:24:33.430]followed by the negative affect, aggressive and rule-breaking
[01:24:36.760]symptom dimensions, and then the ADHD dimensions.
[01:24:41.020]And as I showed in the bar graph, the loadings
[01:24:44.830]of these seven symptom dimensions on the higher order
[01:24:47.650]externalizing factor explained 100% of the cross disorder
[01:24:51.700]correlations, but only about 75% of the within-disorder associations.
[01:24:59.010]As in the
[01:24:59.880]structural models and the external validity analyses,
[01:25:03.240]the higher-order or hierarchical,
[01:25:05.040]and bi-factor models showed identical relations with correlates
[01:25:09.940]and outcomes. And this was often,
[01:25:12.420]but not always true for the correlated factors models,
[01:25:15.570]the most notable exception being for proactive aggression.
[01:25:21.210]From the item
[01:25:21.780]response theory analyses,
[01:25:24.300]different symptoms measured externalizing more precisely at different levels,
[01:25:28.500]in the non-referred sample, the ODD symptom
[01:25:32.790]domains captured
[01:25:36.150]externalizing
[01:25:38.580]best at low levels followed by the ADHD symptoms and then the aggressive and
[01:25:43.290]rule-breaking symptoms.
[01:25:45.630]And then a similar finding was in the clinical sample,
[01:25:48.960]but here the inattentive symptoms were best at capturing the lower end.
[01:25:53.700]And the results were really quite similar looking at the average endorsements as
[01:25:58.170]these symptoms relative to externalizing at different levels
[01:26:01.320]so I'll skip over that. And then finally
[01:26:04.790]what came out of these IRT analyses,
[01:26:07.040]but also would come out if you looked at their factor loadings in the CFAs
[01:26:12.000]is that the aggressive and rule-breaking
[01:26:15.260]symptom domains were more heterogeneous.
[01:26:18.350]So what are some of the future directions we intend to conduct
[01:26:22.820]or to examine? So we
[01:26:25.280]are going to go on and conduct formal analyses of measurement and structural
[01:26:28.850]variance across sample type, more formally
[01:26:33.770]contrasting the clinic and non-referred samples,
[01:26:37.220]but also looking at age and sex
[01:26:39.080]since there's such a large age range of our sample.
[01:26:42.890]We're going to finish the external validity analyses,
[01:26:45.800]obviously with the remaining criteria and look at the variance explained by
[01:26:50.570]the higher order externalizing factor versus the lower order dimensions.
[01:26:55.100]And again,
[01:26:55.850]look for instances where we do find interesting suppression effects
[01:27:00.650]with the lower order dimensions once we partial out externalizing.
[01:27:05.540]We've also just launched a followup study of these two samples in which we
[01:27:10.100]intend to examine the relations of externalizing and the lower order
[01:27:14.990]dimensions with adult psychopathology, disordered substance use,
[01:27:19.340]and other outcomes. And, Holly Poore in her dissertation,
[01:27:23.660]which she has her defense scheduled in three weeks I'm happy to say,
[01:27:28.640]and I'm sure she has as well is
[01:27:31.040]we're going to examine extensions of externalizing spectrum in youth using
[01:27:35.810]the relevant personality traits and behavioral characteristics that were the
[01:27:39.890]external validity outcome variables in this study.
[01:27:44.090]And of course we want to replicate our findings in larger samples
[01:27:48.050]for its own sake, but also
[01:27:49.400]so we can retain more of the conduct disorder symptoms
[01:27:53.300]rather than losing them. Okay, thanks.
[01:27:56.300]I'm going to stop there and take any questions.
[01:27:59.710]Thank you, Dr. Waldman, and we do have a few questions,
[01:28:02.800]but unfortunately are a bit short on time. I'll just ask one briefly.
[01:28:07.150]So what extent do you believe
[01:28:08.890]or as research identified healthy or prosocial counterparts to externalizing
[01:28:13.960]behaviors associated with ADHD, ODD or
[01:28:18.430]CD?
[01:28:21.370]We have not looked at that,
[01:28:25.000]but traits relevant to those could be looked at that way. So risk-taking
[01:28:29.710]for example, not always a bad thing.
[01:28:34.330]And of course that goes into some of the symptoms.
[01:28:39.850]Very good. All right. Thank you very much. All right. And Dr. Wood,
[01:28:45.220]we are ready for you now. Thank you, Dr. Waldman.
[01:28:49.690]Thank you. Okay.
[01:28:53.520]Let's see what happens here.
[01:29:05.700]All right. Now, can you see that?
[01:29:10.700]Yes, we can.
[01:29:12.260]You may want to start your slideshow that may provide us a better view.
[01:29:19.220]Okay. Let's see.
[01:29:24.740]Here we go. Let's see if that works. There we go. Looks good.
[01:29:28.850]Thank you. Hi, my name is Jim Wood, and
[01:29:32.720]today I'm going to give a little talk on the current status of the Rorschach
[01:29:36.590]Inkblot Test.
[01:29:37.550]My co-authors for the talk are Theresa Nezworski and Howard
[01:29:42.500]Garb. On behalf of Teresa, Howard, and myself,
[01:29:47.360]I'd like to begin by saying how much the three of us already miss the sage
[01:29:51.860]comments and helpful insights of Scott Lilienfeld our fellow Rorschach
[01:29:56.870]critic and foxhole friend for more than two decades.
[01:30:01.580]My presentation today would surely be better if he were giving us input and
[01:30:06.410]editorial advice as a coauthor. As I learned,
[01:30:11.210]well, preparing dozens of articles and one book with Scott,
[01:30:15.110]he was a great collaborator.
[01:30:16.880]His knowledge of the scientific literature on clinical psychology,
[01:30:20.900]social psychology and assessment was encyclopedic.
[01:30:25.400]He was a fluent writer who explained complex issues with clarity and
[01:30:29.870]grace. He provided excellent editorial suggestions,
[01:30:34.220]always with modesty and a light touch.
[01:30:38.720]But what I admired most about Scott was his
[01:30:43.340]willingness to speak out calmly and courageously on
[01:30:47.930]many,
[01:30:48.440]many occasions regarding ill-conceived, harmful notions about
[01:30:53.000]psychology that have gained widespread acceptance from time to time in our
[01:30:57.620]profession or our society. When multiple personality
[01:31:02.510]disorder and facilitated communication became fads,
[01:31:06.770]he stepped forward to critique the unscientific claims that were being advanced.
[01:31:11.720]When the United States Congress voted to condemn a meta-analysis by Rind and his
[01:31:16.610]associates in Psychological Bulletin and the American Psychological
[01:31:21.050]Association caved to the political pressure,
[01:31:24.500]Scott advocated for scientific integrity and the peer review
[01:31:29.300]process.
[01:31:31.130]I could compile a long list of similar instances in which
[01:31:35.960]Scott was willing to speak out in his distinctively calm,
[01:31:41.000]courteous, and good humored way
[01:31:43.310]when a voice of reason was urgently needed to represent the cause of good
[01:31:47.480]science and depose popular myths and fallacies.
[01:31:52.610]Of course,
[01:31:53.660]I observed Scott's opposition to myths and fallacies most closely and appreciatively
[01:31:58.520]when he joined Teresa, Howard and me
[01:32:03.940]in the Rorschach controversy.
[01:32:07.600]So that brings me to my talk today.
[01:32:10.930]I originally planned to focus on the importance of norms for test validity,
[01:32:15.160]but one of my coauthors suggested that it would be more interesting to give a
[01:32:18.970]little elevator talk on the current status of the Rorschach Inkblot
[01:32:23.800]Test. So I'm gonna hop a bit from topic to topic, and I hope you find it
[01:32:28.450]interesting.
[01:32:29.650]I'll start with one of the most interesting and unanticipated
[01:32:34.180]Rorschach developments of the past 10 years.
[01:32:38.740]Once again,
[01:32:40.390]there are two competing Rorschach systems.
[01:32:44.140]The first is the comprehensive system developed by John Exner,
[01:32:50.080]and the second is the Rorschach Performance Assessment System,
[01:32:54.970]the R-PAS developed by Gregory Meyer, Joni Mihura,
[01:32:58.750]Donald Viglione and Phillip Erdburg.
[01:33:01.870]Now to appreciate the significance of this development,
[01:33:05.020]it will help to give a little history. From the 1940s until the
[01:33:09.910]1970s,
[01:33:11.470]there were several competing Rorschach systems in use by American psychologists,
[01:33:16.060]the most prominent were the system developed by Samuel Beck and a much different
[01:33:20.920]system developed by Bruno Klopfer.
[01:33:23.680]There was considerable controversy,
[01:33:26.320]even hostility between Beck and Klopfer regarding their systems,
[01:33:30.280]but in 1974, after Beck
[01:33:33.700]and Klopfer had both died, John Exner introduced a new system,
[01:33:40.270]the comprehensive system for the Rorshach that combined what he considered the
[01:33:44.680]best features of the Beck and Klopfer systems.
[01:33:48.850]This idea of combining both systems was appealing to many
[01:33:53.680]clinicians. Furthermore, Exner won
[01:33:56.170]the admiration of empirically minded assessment experts
[01:34:01.120]such as Anastasi because he included extensive norms
[01:34:05.860]for American adults and children,
[01:34:08.020]and provided detailed reviews of the scientific literature to support the
[01:34:12.580]validity of the scores in his system.
[01:34:16.150]By the time my colleagues and I began publishing articles on the Rorschach in
[01:34:20.920]1995, Exner's system had become by far the most
[01:34:25.630]popular approach to the Rorschach.
[01:34:28.750]There seemed to be no likelihood that another system could seek to replace it
[01:34:33.130]within the foreseeable future. However,
[01:34:35.620]two events opened the door for a new system. First in the years
[01:34:40.270]between 1995 and 2005,
[01:34:43.750]it became clear that the comprehensive system had serious scientific and
[01:34:48.430]psychometric difficulties. Second,
[01:34:51.610]John Exner passed away in 2006. After
[01:34:56.200]Exner's death,
[01:34:57.560]the group of Rorschach scholars that I've already named established a new
[01:35:02.060]Rorschach system,
[01:35:02.840]which they named the Rorschach Performance Assessment System,
[01:35:07.220]or (R-PAS).
[01:35:09.080]The first technical manual for (R-PAS) was published in 2011.
[01:35:14.600]During the 10 years since then,
[01:35:17.780]the comprehensive system has continued to be the most popular Rorschach system.
[01:35:22.940]However,
[01:35:24.050]R-PAS has steadily gained adherence and may eventually become the most
[01:35:28.820]popular Rorschach system,
[01:35:30.710]particularly because Exner is no longer alive to update and
[01:35:35.690]promote his own system.
[01:35:40.340]Now I've alluded to serious problems with Exner's comprehensive
[01:35:45.230]system that were identified between 1995 and 2005.
[01:35:50.360]And the rest of this talk, I'll briefly describe some of them.
[01:35:54.530]The first problem concerns the inaccurate literature reviews presented
[01:35:59.450]in Exner's books. From 1985 until the present, many
[01:36:04.430]psychologists have been introduced to these books in graduate school.
[01:36:09.380]They are often treated as authoritative textbooks or test
[01:36:13.850]manuals in clinical assessment classes.
[01:36:18.560]However, in 1995 and 96,
[01:36:22.640]my coauthors and I began publishing articles to point out that Exner's
[01:36:27.560]literature reviews on the Rorschach omitted
[01:36:30.230]many important research findings and substantially exaggerated
[01:36:35.360]the empirical evidence favorable to the Rorschach. In these
[01:36:40.370]same articles,
[01:36:41.660]we pointed out that Exeter's claims regarding Rorschach validity were
[01:36:46.370]often based on brief descriptions of unpublished studies that he and his
[01:36:51.050]colleagues had carried out,
[01:36:54.380]but when we wrote to Exner and requested copies of these studies
[01:36:58.610]so we could examine their methodology and analyses in detail,
[01:37:02.960]he had an assistant write back to us that the studies had not been written up in
[01:37:07.730]a form that could be shared with us. For many years,
[01:37:12.590]our criticisms of Exner's literature reviews were more or less
[01:37:17.270]ignored by Rorschach researchers. However, in a new development,
[01:37:21.950]Joni Mihura, a prominent proponent of the Rorschach and coauthor of the (R-PAS)
[01:37:26.910]has recently expressed views very similar to
[01:37:30.190]Here
[01:37:35.080]are some of the comments of Mihura and her colleagues on Exeter's book,
[01:37:39.160]which they refer to as the Comprehensive System (CS) test manual.
[01:37:44.920]The Comprehensive System (CS) test manual contains a notable number of
[01:37:49.840]reporting errors and inaccurate study descriptions.
[01:37:54.460]The degree which the Comprehensive System (CS) manual portrays a more
[01:37:58.770]consistently positive picture of its test variables than the published
[01:38:03.240]literature is due
[01:38:04.560]at least in part to the reporting errors in the Comprehensive System (CS) manual.
[01:38:10.530]The extent of the inaccuracies in the Comprehensive System (CS) manual
[01:38:15.150]make it impossible for test user users to rely on its report of
[01:38:20.130]the validity literature for its test variables,
[01:38:23.700]especially for the test developers' unpublished studies
[01:38:27.240]which are not available for review to correct any errors.
[01:38:36.740]Now I'm often asked, is the Rorschach valid?
[01:38:39.740]And my answer is the Rorschach includes hundreds of different scores.
[01:38:44.480]Some are genuinely valid for limited purposes,
[01:38:47.930]but most have little or no validity for any purpose.
[01:38:53.150]Since 1995, my colleagues and I,
[01:38:55.730]including Scott have been evaluating the validity of Exener's Rorschach's scores
[01:39:00.980]for measuring traits relevant to mental health, including psychiatric diagnoses.
[01:39:05.870]Our conclusions stated in our book,
[01:39:09.770]"What's Wrong with the Rorschach?" are that some comprehensive system scores are
[01:39:14.540]validly related to cognitive ability,
[01:39:17.600]that is to G and to cognitive impairment.
[01:39:21.500]Other scores are validly related to schizophrenia, psychosis, thought
[01:39:26.120]disorder, and personality disorders that involve thought disorders such as
[01:39:31.250]schizotypal personality disorder and borderline personality disorder.
[01:39:36.740]Otherwise, comprehensive system scores
[01:39:40.160]bear little or no demonstrated
[01:39:42.650]relationship to diagnoses of anxiety, depression,
[01:39:46.250]antisocial personality disorder, psychopathy,
[01:39:49.610]or other psychological disorders.
[01:39:54.860]These conclusions have received substantial though
[01:39:58.430]not total support from a massive Psychological Bulletin article published in
[01:40:03.410]2013 by Joni Mihura,
[01:40:06.110]Greg Meyer and their colleagues.
[01:40:09.170]The article included meta analyses of what the authors identified as the
[01:40:14.120]65 most important variables in Exner's Comprehensive System.
[01:40:19.610]I'll quickly summarize what we think can be learned from the Mihura et al. meta
[01:40:24.590]analysis. First, I'd like to discuss the top rows in this table.
[01:40:29.960]This is a summary of the 65 studies. You can see the number of studies there,
[01:40:35.060]and it tells
[01:40:36.890]how they were ranked as far as their evidence of the validity. Mihura
[01:40:42.200]and her colleagues found that 12 of the 65 comprehensive system
[01:40:46.670]variables have no research support at all.
[01:40:50.510]The validity of these variables has simply never examined by researchers.
[01:40:56.200]Another 13 variables have been examined by researchers, but
[01:41:01.420]have validity lower than 0.15.
[01:41:05.050]Ten additional variables have validity between 0.15
[01:41:10.060]and 0.20. So to sum up these numbers,
[01:41:13.600]the Mihura meta analysis or meta analyses actually found that
[01:41:18.520]more than half of the Comprehensive System (CS) variables,
[01:41:21.910]that is 53.8% have no evidence of validity
[01:41:26.890]or validity of 0.20 or smaller. Now,
[01:41:31.360]many of these variables in the past
[01:41:33.280]have been given substantial importance in the Comprehensive System (CS). However,
[01:41:36.850]it's hard to imagine that variables with validity this low could be
[01:41:41.530]clinically useful.
[01:41:44.440]Now, next
[01:41:44.950]I want to call your attention to the group of 13 variables at the bottom of the
[01:41:49.510]table,
[01:41:50.230]that according to Mihura and her colleagues have excellent validity,
[01:41:54.610]that is validity greater than 0.33.
[01:41:58.840]Now this is the group of Rorschach scores that my colleagues and I are
[01:42:03.560]most excited to see. What are the top performers
[01:42:08.410]among Rorschach scores? As you recall,
[01:42:12.790]our book said that some Rorschach scores are validly related to
[01:42:17.290]cognitive ability, cognitive impairment, thought disorder or psychoticism.
[01:42:22.180]It turns out that none of these top performing Rorschach variables are
[01:42:26.980]measures
[01:42:27.900]of that type.
[01:42:30.900]These nine Rorschach variables reflect the number of responses given by the test
[01:42:35.880]taker, the complexity of those responses,
[01:42:39.600]whether the objects described actually fit the shape of the blocks,
[01:42:43.920]whether the test taker shows odd thinking or language,
[01:42:48.180]or there is a combination of psychotic features.
[01:42:53.760]The high validity coefficients for these nine scores confirm our
[01:42:58.230]conclusions from 20 years ago. However,
[01:43:02.340]there are four other Rorschach variables in this group of top performers that we
[01:43:06.960]had not predicted. We published a comment in Psychological Bulletin,
[01:43:12.030]which showed that two of these four variables actually have very low validity
[01:43:17.130]once you include data from unpublished dissertations.
[01:43:21.600]The Mihura et al. meta analyses looked only at the published literature,
[01:43:27.180]but there still remained two Rorschach variables on the list of top performers
[01:43:31.650]that we never expected to see there and
[01:43:35.250]so far their validity coefficients
[01:43:38.580]do not seem to be explained by
[01:43:41.730]publication bias.
[01:43:43.950]So it may very well be that there are some Comprehensive System (CS) variables,
[01:43:49.200]maybe two that were not named in our book,
[01:43:52.280]but have a useful level of validity.
[01:43:59.410]As I said earlier, many people have asked me is the Rorschach valid?
[01:44:03.520]But no one has ever asked the really important question to
[01:44:08.290]me, does the Rorschach have good norms?
[01:44:11.230]But if clinicians want to be accurate and avoid errors
[01:44:14.500]when using test scores to assess patients,
[01:44:17.440]then it's important to pay at least as much attention to norms as to validity
[01:44:22.420]coefficients.
[01:44:23.740]Using a test with low validity will lead to serious clinical
[01:44:28.300]errors.
[01:44:29.320]But using a test with inaccurate norms can lead to errors that are much more
[01:44:33.400]severe and render interpretations meaningless.
[01:44:37.960]The Comprehensive System (CS) is a good illustration of the point. As you recall,
[01:44:43.270]when the system first appeared,
[01:44:45.190]it gained approval from some rigorous empiricists because it was
[01:44:49.900]thought to be the first and only Rorschach system ever to have good
[01:44:54.640]norms.
[01:44:56.050]Exner's books were full of normative tables for both adults and children,
[01:45:00.730]and these norms were used for more than 30 years with tens of thousands or
[01:45:05.530]even hundreds of thousands of patients. However,
[01:45:09.460]starting in the late 1990s, study after study began to
[01:45:14.350]show that Exner's
[01:45:16.000]adult and children's norms were seriously in error,
[01:45:20.320]they tended to overpathologize. That is,
[01:45:23.860]they tended to make normal individuals appear psychologically disordered.
[01:45:28.660]I won't catalog the stories here, but they're discussed in depth in our book.
[01:45:33.040]And I'll mention just one as an illustration.
[01:45:38.050]In a 1999 study published in the Journal of Personality Assessment,
[01:45:43.210]Shaffer and his colleagues reported giving the Comprehensive System for the Rorschach
[01:45:47.680]to 123 non-patient community
[01:45:52.390]volunteers.
[01:45:55.690]Their scores on the WAIS and
[01:46:00.460]the MMPI-2 were average,
[01:46:05.770]but on the Rorschach,
[01:46:07.030]17% of participants had scores suggestive of psychoticism
[01:46:12.010]or thought disorder.
[01:46:14.380]And 30% were identified as narcissistic.
[01:46:20.140]Now, as evidence like this mounted,
[01:46:22.060]it became clear that the Comprehensive System (CS) norms were seriously in error
[01:46:26.950]with a tendency to overpathologize. Exner adamantly denied
[01:46:31.630]there was any problem with the norms. However,
[01:46:34.570]his position was seriously eroded when in 2001,
[01:46:39.400]he reported that his adult normative sample,
[01:46:42.610]which supposedly contained 700 individuals and had been used by
[01:46:46.960]psychologists since the 1980s had in fact consisted of
[01:46:51.570]only 479 individuals with the other 221
[01:46:56.460]records consisting of accidental duplications.
[01:47:02.370]The Comprehensive
[01:47:03.180]System (CS) has remained popular since Exner's death in
[01:47:07.290]2006, but psychologists who still use it are running a grave risk,
[01:47:12.420]if they use his norms.
[01:47:14.790]There's a very substantial danger of identifying psychologically normal people
[01:47:19.470]as disturbed.
[01:47:25.880]The problem is with these norms have gradually become clearer even
[01:47:30.380]to some of the most stalwart Rorschach defenders. For example,
[01:47:35.510]in 2001, when evidence of these problems first emerged,
[01:47:39.710]and we pointed them out in a review article, Gregory Meyer, published a
[01:47:44.540]reply,
[01:47:45.290]arguing that it should be clear that the Comprehensive System norms do
[01:47:50.060]not overpathologize.
[01:47:54.410]More recently though,
[01:47:56.000]Meyer has adopted a position similar to what we argued in 2001.
[01:48:01.040]So here's what he has said and we are in agreement.
[01:48:06.770]Clinicians in the United States and
[01:48:08.390]inother countries using the standard Comprehensive System (CS) norms will
[01:48:13.130]incorrectly infer that non-patients are prone to perceptual distortions,
[01:48:18.320]see the world in an atypical and idiosyncratic manner, tend to be
[01:48:22.700]simplistic, lack affect resources,
[01:48:25.190]lack coping resources in general, are prone to affective disturbances and
[01:48:29.660]dysregulation, and misunderstand others and perceive relationships.
[01:48:34.910]Of additional concern,
[01:48:36.380]these inferences will be incorrectly applied in clinical and research settings
[01:48:41.150]as well, where they are likely to have serious ramifications.
[01:48:48.920]Okay.
[01:48:49.130]Yeah, so you've noticed that I've said very little about (R-PAS),
[01:48:53.300]the baby in the Rorschach system. In fact,
[01:48:56.120]there's not a lot to say. There's very little independent research
[01:49:01.280]on basic topics concerning (R-PAS), such as validity,
[01:49:05.060]temporal stability, and the representativeness of norms.
[01:49:09.380]So I'm going to end by providing just six swift observations that
[01:49:14.330]may provide some stimulation to your own thinking about the (R-PAS).
[01:49:21.200]First,
[01:49:21.830]the administration and scoring procedures for (R-PAS) were intentionally
[01:49:25.670]designed to modify the administration scoring and interpreted procedures
[01:49:30.470]of the Exner system.
[01:49:32.270]The two systems differ substantially in these respects.
[01:49:39.290]Two.
[01:49:40.190]One of the most important changes for the (R-PAS) was its introduction of new
[01:49:44.780]scoring rules for form quality.
[01:49:47.350]It is still unclear whether these new scoring rules are effective or yield
[01:49:51.610]results that are as reliable and valid as the comprehensive systems
[01:49:56.080]rules for form quality.
[01:49:59.560]It is sometimes said. This,three.
[01:50:02.290]It is sometimes said that (R-PAS) retained the valid scores in the extra
[01:50:07.240]system and tossed out the invalid ones. This claim is only half true. The
[01:50:12.190](R-PAS) authors did discard many invalid scores from
[01:50:17.050]Exner's system,
[01:50:18.640]but they also incorporated a substantial number of variables of unproven or
[01:50:23.410]limited validity. So when, for instance,
[01:50:26.710]deciding whether to teach this into the assessment class, one cannot assume that
[01:50:31.000]most (R-PAS) scores have good empirical support.
[01:50:38.190]Number four. At present, only a very small number of
[01:50:42.510]studies have examined the validity of (R-PAS) scores.
[01:50:47.160]Most assertions about (R-PAS) validity
[01:50:50.010]rest upon research using the Comprehensive System (CS) for the Rorschach,
[01:50:54.750]which I indicated has substantially different administration and
[01:50:59.490]scoring rules or based on other Rorschach approaches.
[01:51:05.070]Five.
[01:51:06.390]The adult norms of (R-PAS) are highly problematic and have been criticized by
[01:51:11.130]several authors. And, if you would like to references, just let me know.
[01:51:15.660]There are two main problems with these norms. First,
[01:51:20.010]the normative sample is a composite based on combining normative samples
[01:51:24.600]from a fairly large number of different countries, socioeconomic groups,
[01:51:29.100]language groups, and cultures. They were mainly,
[01:51:35.520]they were not selected in any way as a random sample of
[01:51:39.570]the countries they came from or the people that they came from.
[01:51:44.550]Therefore, the
[01:51:45.270]norms do not represent a representative sample from the United States
[01:51:50.370]or from any identifiable population.
[01:51:54.810]Second,
[01:51:55.860]the Rorschach protocols for the (R-PAS) were gathered and initially scored
[01:52:00.540]using the administration and scoring procedures of Comprehensive
[01:52:05.220]System (CS), which as I have said,
[01:52:07.470]are substantially different from the procedures of (R-PAS).
[01:52:11.280]After protocols were gathered,
[01:52:13.410]the (R-PAS) norms were calculated by estimation.
[01:52:16.770]Specifically, the (R-PAS) authors performed what they called a modeling
[01:52:21.540]procedure to estimate what participants Rorschach scores would
[01:52:26.280]have been
[01:52:27.480]if the task had been administered using (R-PAS) administration
[01:52:32.160]rules.
[01:52:36.780]Six.
[01:52:37.710]When the (R-PAS) was developed in or introduced in 2011,
[01:52:42.510]it was widely expected that the (R-PAS) authors would soon gather
[01:52:46.460]representative American norms using (R-PAS) administration and scoring
[01:52:51.260]procedures. Ten years later,
[01:52:54.110]adult norms have still not appeared.
[01:52:58.100]So there I'm done.
[01:53:00.500]And I want to say it's been my pleasure to address you and to join this
[01:53:05.030]very special occasion in honor of Scott.
[01:53:10.030]Great. Thank you, Dr. Wood. And we just have maybe a few moments
[01:53:14.500]for a couple of questions. One question was you mentioned,
[01:53:19.240]and I don't think you referred to it that,
[01:53:23.110]there were two Rorschach indices that had some validity
[01:53:27.340]were non-cognitive?
[01:53:29.740]Yes. One of them is called the suicide constellation.
[01:53:35.710]Okay. And I've forgotten the other one. Okay.
[01:53:40.630]Okay. Very good. Another question that was asked,
[01:53:44.230]and you may have been commenting on this because it came in before your
[01:53:47.560]conclusion, but I wasn't entirely sure if this is what you're referring to,
[01:53:52.360]but the
[01:53:53.620](R-PAS) authors developed a technique to use during the Rorschach
[01:53:57.730]administration to optimize the number of responses offered and in part to
[01:54:01.750]strengthen norms.
[01:54:03.070]So could you offer your perspective on that response optimization?
[01:54:07.360]Well as you said,
[01:54:11.060]they developed basically three procedures. They give
[01:54:14.320]instructions at the beginning that they expect maybe two or four
[01:54:18.580]responses per card. They kind of prime the client.
[01:54:23.410]They then
[01:54:26.620]give the cards to the client and if the client does not respond,
[01:54:30.760]they prompt, if they only get one response,
[01:54:33.040]they prompt for at least one more. And then they also will pull a card.
[01:54:37.000]In other words, if a subject has four responders to a card,
[01:54:41.890]they take it back. Plus, there's a procedure
[01:54:44.320]if someone comes to the end without enough Rorschach responses,
[01:54:47.680]they circle back,
[01:54:49.240]and re-administer the cards a second time and keep all the responses.
[01:54:53.680]This was an attempt to control R,
[01:54:58.360]which
[01:55:02.110]and the question is was it worth it?
[01:55:07.150]And recent studies indicate,
[01:55:10.680]if I understood the findings published by Gregory Meyer,
[01:55:13.810]it was that they have the
[01:55:17.140]result of the (R-PAS) administration slightly reduces the mean level
[01:55:22.120]of R.
[01:55:23.830]And it reduces the standard deviation of R by
[01:55:28.300]about maybe a quarter to one half of the standard deviation,
[01:55:33.220]but that has no impact on other scores in the
[01:55:37.840]system except for one involving complexity.
[01:55:42.730]So surprisingly, the aim was to
[01:55:47.550]keep the R from contaminating all these other responses,
[01:55:51.090]but the results as I read them, indicate that it didn't succeed in that,
[01:55:55.950]it just reduced R
[01:55:58.710]without the desired effects on other variables.
[01:56:09.390]I do want to say one other thing. There was
[01:56:17.010]probably the most amazing Rorschach study of the last 15 years was done by
[01:56:21.390]Phillip Erberg
[01:56:22.830]and his colleagues where they gathered data from all these different countries.
[01:56:27.420]Now, in my talk, I made it clear.
[01:56:29.070]I don't think it was that that data is appropriate for forming norms for
[01:56:32.880]Americans, right. But nevertheless,
[01:56:35.790]it's an amazing study because it began to show us where are the central
[01:56:39.240]tendencies of the Rorschach.
[01:56:40.920]And there's quite a bit of similarity between different nations and even
[01:56:45.900]language groups.
[01:56:48.210]The trouble that I see with the (R-PAS) administration is that we can no longer
[01:56:53.880]compare for instance. Let's go back.
[01:56:59.330]The existence of these many datasets from around the world allowed us to
[01:57:04.140]see very distinctly what we were already suspecting
[01:57:06.780]that Exner's norms were way out of line with
[01:57:11.730]what you would find in any other country or
[01:57:15.330]in other samples within the United States.
[01:57:18.600]But now with the (R-PAS) norms, which I've indicated,
[01:57:22.350]I think may be problematic, we just don't have had a chance to see them.
[01:57:26.670]But now we have no comparison again, since the administration has been changed,
[01:57:31.080]we can't compare them to thousands of Rorschachs
[01:57:34.680]which have been administered with the (R-PAS) and other countries and see if
[01:57:38.340]the (R-PAS) norms are indeed getting at the
[01:57:43.140]central distribution of these variables.
[01:57:46.130]All right. Very good. Well, I want to thank the presenters.
[01:57:50.420]We are running out of time.
[01:57:52.580]But I want to thank the presenters for their informative,
[01:57:54.890]interesting presentations.
[01:57:56.250]I think it was a great sampling of how you spend time carefully
[01:58:01.220]defining your constructs, determining how to best measure those,
[01:58:05.900]and then bringing those
[01:58:07.550]measures and how constructs are defined into question
[01:58:11.330]that represents the kind of work that Scott did.
[01:58:14.960]So thank you the presenters, the panelists.
[01:58:18.050]I really appreciate your time and effort and
[01:58:21.680]joining us in this honorary webinar. And of course,
[01:58:26.090]Ms. Basterfield for sharing more with us about
[01:58:30.500]Dr. Lilenfeld's life and career. Just as logistics,
[01:58:35.360]if you applied for continuing education credit,
[01:58:38.300]you'll receive a follow up email or everyone attending will receive a
[01:58:43.240]follow up email to an online evaluation
[01:58:46.960]that you're required to complete if you want continuing education credit,
[01:58:51.130]but we would like everyone to complete to help us plan and improve our future
[01:58:55.120]programming.
[01:58:57.490]And we appreciate your interest in this program and honoring Dr. Lilienfeld's
[01:59:01.600]professional legacy.
[01:59:04.630]Please don't forget to visit the kudo board link
[01:59:08.440]that's the area where you can put down,
[01:59:10.240]share your own tributes and testimonies about Dr. Lilienfeld.
[01:59:14.290]Any final words from our presenters at all?
[01:59:17.170]Or anything you'd like to say before we say goodbye?
[01:59:22.800]Thanks to everybody for attending.
[01:59:27.030]It really shows how many people have valued
[01:59:31.980]Scott's contributions to the profession. Very good.
[01:59:36.660]Thanks Dr. Clark.
[01:59:37.920]I will just echo those same words.
[01:59:40.260]Thanks everyone so much for attending this webinar today.
[01:59:45.690]Thank you. Yes.
[01:59:48.680]Thanks for attending. And thank you for organizing this, Jessica and
[01:59:53.550]Kurt. It was a real pleasure.
[01:59:58.350]Thank you.
[01:59:59.730]You bet. Well, thank you again. We appreciate your time and effort.
[02:00:02.490]I know you put a lot into your presentation so we appreciate that. So,
[02:00:06.600]all right, well, thank you.
[02:00:09.920]We were glad you were here and
[02:00:12.510]we hope you have a pleasant rest of your day.

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