We examined relationships between the Personality Assessment Inventory (PAI) clinical scales (e.g., Somatic Complaints [SOM]) and subscales (e.g., Conversion [SOM-C]) with patient- and therapist-rated alliance early in treatment (third or fourth session). We also replicated and extended findings from a previous study examining PAI treatment scales (Treatment Rejection, Treatment Process Index) and early session therapist-rated alliance. We used PAI protocols from a clinical outpatient sample ( N = 84). Data were analyzed using stepwise linear regressions. Results suggest that patients who report lower early session alliance also report more antisocial features (β = −.219, p = .050, f2 = 0.05) specifically more antisocial behaviors (β = −.315, p = .004, f2 = 0.11). Additionally, therapists report higher early session alliance with patients who report more anxiety-related disorders (β = .274, p = .012, f2 = 0.08), specifically traumatic stress (β = .325, p = .003, f2 = 0.12). No significant relationships were found between patient- or therapist-rated alliance and Treatment Rejection and Treatment Process Index, consistent with prior findings. Clinical implications are discussed.

Background: The Montreal Cognitive Assessment (MoCA) is quickly becoming the most common clinical screen for cognitive impairment. Cognitive impairment is a frequent symptom of multiple sclerosis (MS) and can be difficult to detect in routine evaluation. Although specific screening measures have been studied and established for use in MS, MS cognitive screening tools may not be implemented in a general neurology setting.

We explored the relationship between severity of personality pathology, cluster type and therapeutic interventions (psychodynamic–interpersonal [PI] and cognitive–behavioural [CB]) in 76 outpatients across two early sessions (3rd and 9th) of psychodynamic psychotherapy, while accounting for patients' baseline global symptom severity. Pretreatment personality pathology severity was assessed using the Personality Disorder Index (PDI), where DSM‐IV Axis II PD was assigned a value of 2, subclinical traits and features were assigned a 1 and absence of Axis II psychopathology was assigned a 0. Interrater reliability of personality pathology severity was excellent (ICC [1, 1]: 0.85). Interrater agreement for Cluster A (κ = 0.75), Cluster B (κ = 0.92) and Cluster C (κ = 0.70) was high. Interventions were coded with Comparative Psychotherapy Process Scale (CPPS) from videotapes, and reliability was excellent (CPPS‐PI = 0.86; CPPS‐CB = 0.78). Stepwise linear regressions indicated that therapists' focus on mood shift/topic avoidance (B = 0.29, p = .009) and future events (B = −0.26, p = .020) predicted Axis II severity. Overall use of PI techniques and Cluster A personality disorder (CLA) were positively correlated (r = .312, p = .006). Stepwise binomial logistic regressions indicated that therapists' focus on uncomfortable feelings (B = 1.915, p = .008) and explaining rationale behind approach (B = 1.276, p =. 038) predicted CLA. All results remained significant when controlling for patients' baseline general symptomatology (Brief Symptom Inventory‐Global Severity Index [BSI‐GSI]), except for the relation between explaining rationale and CLA. Discussion highlights how using psychodynamic treatment model, therapists' focus on patient's in‐session affect expression and explaining rationale behind approach are highly relevant when working with CLA patients.

Based on the results of prior research, we examined relationships between Personality Assessment Inventory (PAI) items on clinical scales of antisocial features (ANT) and anxiety‐related disorders (ARD) with patient‐ and therapist‐rated alliance early in treatment (third or fourth session). We also explored the relationship between the PAI treatment rejection scale (RXR) and early session therapist‐rated alliance, despite null findings in previous work. We used PAI protocols from a clinical outpatient sample (N = 80). Data were analysed using backwards linear regressions. Results indicated that a group of ANT items from different ANT subscales predicted patient‐rated therapeutic alliance, F(8,59) = 5.182, p = .000, R2 of .413, f2 = 0.70. Additionally, a group of ARD items from different ARD subscales significantly predicted therapist‐rated alliance, F(6,62) = 3.007, p = .012, R2 of .225, f2 = 0.29. No significant relationships were found for RXR items and therapist‐rated alliance, consistent with prior findings. Clinical implications are discussed.

The emotional and behavioral problems associated with pediatric multiple sclerosis (MS) remain unclear. Participants with pediatric MS or clinically isolated syndrome (n=140; ages 5 to 18 years) completed self- and parent-ratings using the Behavioral Assessment System for Children, Second Edition, neurological exam, the Fatigue Severity Scale, and neuropsychological assessment. Mean self- and parent-ratings on the BASC-2 were in the typical range across all scales. However, 33.1% indicated a clinically significant problem on a least one scale. While the type of clinical problems varied across participants, attention problems, somatization and anxiety were found most common. Disease features including duration, age of onset, neurologic disability and fatigue did not distinguish those with and without clinical problems. However, cognitive functioning significantly predicted the presence of a clinical problem (p=0.02). Pediatric MS is associated with a range of nonspecific emotional and behavioral clinical problems, occurring more frequently in those patients with cognitive involvement.