Introduction Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for hypersexual disorder (HD) have been proposed to capture symptoms reported by patients seeking help for out-of-control sexual behavior. The proposed criteria created by the DSM-5 Work Group on Sexual and Gender Identity Disorders require evaluation in a formal field trial. Aim This DSM-5 Field Trial was designed to assess the reliability and validity of the criteria for HD in a sample of patients seeking treatment for hypersexual behavior, a general psychiatric condition, or a substance-related disorder. Method Patients (N = 207) were assessed for psychopathology and HD by blinded raters to determine inter-rater reliability of the HD criteria and following a 2-week interval by a third rater to evaluate the stability of the HD criteria over time. Patients also completed a number of self-report measures to assess the validity of the HD criteria. Main Outcome Measures HD and psychopathology were measured by structured diagnostic interviews, the Hypersexual Behavior Inventory, Sexual Compulsivity Scale, and Hypersexual Behavior Consequences Scale. Emotional dysregulation and stress proneness were measured by facets on the NEO Personality Inventory—Revised. Results Inter-rater reliability was high and the HD criteria showed good stability over time. Sensitivity and specificity indices showed that the criteria for HD accurately reflected the presenting problem among patients. The diagnostic criteria for HD showed good validity with theoretically related measures of hypersexuality, impulsivity, emotional dysregulation, and stress proneness, as well as good internal consistency. Patients assessed for HD also reported a vast array of consequences for hypersexual behavior that were significantly greater than those diagnosed with a general psychiatric condition or substance-related disorder. Conclusions The HD criteria proposed by the DSM-5 Work Group on Sexual and Gender Identity Disorders appear to demonstrate high reliability and validity when applied to patients in a clinical setting among a group of raters with modest training on assessing HD.
Past research on variables affecting hiring decisions has emphasized the role of applicant and interviewer demographics. However, recent studies have questioned the generalizability of findings from laboratory interviews to real interviews. In this article, a model of demographics and interviewing decisions is proposed and tested with actual employment interviews. Industrial interviewers (N = 8) provided demographic data concerning themselves and applicants (N = 171), rated applicants on widely studied attributes, and made two hiring decisions. The data support the model that interview outcomes are directly dependent on the more logically relevant variables, such as skill. Furthermore, the influence of demographics is modest and less important than other variables.
This meta-analytic review sought to answer questions concerning the role of psychosocial treatments in the comprehensive management of patients with schizophrenia. The review focused on the effects of combining psychosocial treatment with somatic treatment. Findings demonstrated the additive and supplementary effects of psychosocial treatments and the durability of these effects. Patients with more chronic illness appeared to be more responsive to psychosocial treatments, as were patients in studies conducted in non-Western countries. Among the Western countries, studies from Scandinavian countries reported the least effectiveness for psychosocial treatments. There was some evidence for differential effect of psychosocial treatments on different dimensions of illness as the measures of disorganized behavior and employment showed little difference in treated and control groups. There was also some evidence for differences between different modalities of treatment as group treatments produced smaller effects. Implications for practice and future research are discussed.Key words: Psychosocial treatment, combination treatment, psychotherapy.Schizophrenia Bulletin, 24(4):569-587,1998.The dramatic success of antipsychotic medication in the treatment of schizophrenia has led most clinicians to believe that medication is the treatment of choice, or at least a major component of treatment, for managing schizophrenia (e.g., Schooler and Keith 1993). However, some clinicians argue that psychosocial intervention, and more specifically psychotherapy, should be considered the treatment of choice. As recently as 1989, Karon stated that "the optimal treatment for a schizophrenic is psychotherapy, from a competent therapist, without medication, if the patient, the therapist, and the setting can tolerate it" (p. 146).Sigmund Freud, the forefather of modern psychotherapy, expressed pessimism about psychoanalytic treatment of schizophrenia (Fenichel 1945). However, in the years that followed, many therapists attempted psychological treatment for these patients (Fromm-Reichmann 1950;Arieti 1955). These treatments were based on psychogenic theories of etiology and sought to cure the illness by addressing its generative mechanisms. The advent of antipsychotic medications and developments in the biological understanding of schizophrenia on the one hand, and lack of supporting evidence for some of the psychogenic theories such as "schizophrenogenic mother" on the other, led to pessimism concerning the effectiveness of the psychological treatments for schizophrenia (Bellack and Mueser 1993).However, better understanding of the limitations of antipsychotic medications and the emergence of interactive etiological models of schizophrenia (e.g., stressdiathesis model) in more recent years have contributed to a renewal of interest in psychological interventions (Schwartz et al. 1993). Beyond the old controversies of psychotherapy versus medication, a new perspective seems to be emerging that psychosocial interventions can be used bene...
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