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Empirical and logical evidence is presented to refute the Truax rejoinder to an earlier critique by the authors. It is argued that the construct accurate empathy is markedly confused. The accurate empathy scale is shown to lack discriminant validity, and its relationship to therapeutic outcome is considered. The meaning of ratings of empathy in the absence of client responses is questioned. Finally, the use of repeated measurement of the same therapist is shown to be faulty on both statistical and design grounds and to yield spuriously inflated reliability coefficients.

A study of 301 college undergraduates is employed to test a causal model which proposes that dissociation and depression act as mediator variables that develop from child abuse and lead to various negative outcomes. As predicted, child maltreatment was found to be related to negative life experiences, with depression and dissociation differentially mediating the various outcomes.