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Lena C Quilty - Top 30 Publications

Nabiximols combined with motivational enhancement/cognitive behavioral therapy for the treatment of cannabis dependence: A pilot randomized clinical trial.

The current lack of pharmacological treatments for cannabis use disorder (CUD) warrants novel approaches and further investigation of promising pharmacotherapy. We previously showed that nabiximols (27 mg/ml Δ9-tetrahydrocannabinol (THC)/ 25 mg/ml cannabidiol (CBD), Sativex®) can decrease cannabis withdrawal symptoms. Here, we assessed in a pilot study the tolerability and safety of self-titrated nabiximols vs. placebo among 40 treatment-seeking cannabis-dependent participants.

Depression symptoms and reasons for gambling sequentially mediate the associations between insecure attachment styles and problem gambling.

One of the central pathways to problem gambling (PG) is gambling to cope with negative moods, which is a cardinal feature of depression. Insecure attachment styles are also etiologically related to depression; and, therefore, by extension, those who are insecurely attached may engage in excessive gambling behaviors to cope with depression. In this study, we aimed to evaluate this and to this end predicted that depression severity and coping motives for gambling would conjointly mediate the relations between insecure attachment styles and PG. Data came from a larger investigation of PG within mood disorders. Participants exhibited a lifetime depressive or bipolar disorder and endorsed a mood episode within the past ten years. Participants (N=275) completed self-report measures during a two-day assessment. Path analysis supported two main indirect effects. First, anxious attachment predicted elevated depression, which in turn predicted increased coping motives for gambling, which subsequently predicted greater PG severity. Second, this double mediational pathway was also observed for avoidant attachment. Results suggest that insecure attachment relates to PG via depressive symptoms and coping-related gambling motives. Mood symptoms and associated gambling motives are malleable and are promising targets of gambling interventions for insecurely attached individuals.

Big Five aspects of personality interact to predict depression.

Research has shown that three personality traits-Neuroticism, Extraversion, and Conscientiousness-moderate one another in a three-way interaction that predicts depressive symptoms in healthy populations. We test the hypothesis that this effect is driven by three lower-order traits: withdrawal, industriousness, and enthusiasm. We then replicate this interaction within a clinical population for the first time.

Relationships among alexithymia, therapeutic alliance, and psychotherapy outcome in major depressive disorder.

Previous studies have found that alexithymia predicts process and outcome of psychodynamic psychotherapy across a range of psychiatric disorders. There is preliminary evidence that alexithymia may exert its effects on outcome through the therapist. Other studies have found that alexithymia does not influence outcome of cognitive-behavioral therapy (CBT). The aim of the current study was to investigate the capacity of alexithymia to predict therapist- and patient-rated therapeutic alliance and response to CBT and interpersonal psychotherapy (IPT) for major depressive disorder. A total of 75 adults with major depressive disorder were randomized to receive weekly sessions of manualized individual CBT or IPT for a period of 16 weeks. Pre-treatment alexithymia exhibited a positive direct effect on depression change, and a negative indirect effect on depression change via patient-rated alliance at week 13. There was no mediating role of therapist-rated alliance. Although these findings are preliminary, they suggest that pre-treatment alexithymia has meaningful links to psychotherapy process and outcome, and that nuanced analyses incorporating intervening variables are necessary to elucidate the nature of these links.

The structure, correlates, and treatment related changes of mindfulness facets across the anxiety disorders and obsessive compulsive disorder.

Research with non-clinical and clinical samples has examined how mindfulness concepts relate to psychological symptom presentations. However, there is less clarity when examining treatment-seeking patients who experience DSM-diagnosed anxiety and obsessional disorders - both cross-sectionally, and following empirically-supported treatments. The Five Facet Mindfulness Questionnaire (FFMQ; Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006) conceptualizes mindfulness as consisting of five facets: Observing, Describing, Acting with Awareness, Nonreactivity, and Nonjudging. The current study examines the factor structure and predictive validity of the FFMQ in a large sample of treatment-seeking individuals with obsessive compulsive disorder (OCD), panic disorder with or without agoraphobia (PD/A), social anxiety disorder (SAD), and generalized anxiety disorder (GAD). Confirmatory factor analyses (CFA) established that both four and five-factor models (i.e., with and without inclusion of the Observing factor) provided an acceptable representation of the underlying FFMQ structure, but did not support a one-factor solution. For each of these diagnostic groups, hierarchical regression analyses clarified the association between specific FFMQ facets and diagnosis specific symptom change during CBT treatment. These findings are discussed in the context of the possible transdiagnostic relevance of specific mindfulness facets, and how these facets are differentially associated with diagnosis specific symptom alleviation during CBT.

Response Bias and the Personality Inventory for DSM-5: Contrasting Self- and Informant-Report.

Previous research has raised concerns that scores derived from the Personality Inventory for DSM-5 (PID-5; American Psychiatric Association, 2013; Krueger, Derringer, Markon, Watson, & Skodol, 2012) may be compromised by response styles such as underreporting or overreporting. The informant-report form of the PID-5 (PID-5-IRF; Markon, Quilty, Bagby, & Krueger, 2013) has been recommended for use when response bias is an assessment concern. The purpose of the current investigation was to evaluate PID-5 and PID-5-IRF scale score elevations across participants exhibiting signs of overreporting or underreporting. A total of 245 adults completed the PID-5 and the Revised NEO Personality Inventory (NEO PI-R; Costa & McCrae, 1992). A family member or friend of at least 1 year's acquaintance completed the PID-5-IRF for 216 of these. A total of 211 target-informant pairs were available for analysis. Participants were categorized as overreporting and underreporting according to NEO PI-R validity scale cutoffs. The majority of PID-5 scale scores were elevated in those identified as overreporting; more than half of the PID-5-IRF scale scores were similarly elevated. The majority of PID-5 scale scores were lower in those scoring above underreporting cut-offs; however, PID-5-IRF scales were not as consistently or strongly impacted. PID-5 scales were strongly impacted by response bias, whereas PID-5-IRF scores were less strongly impacted overall, and more so by overreporting bias. Caution when using these instruments in the assessment of personality disorders prone to over- or underreporting may be warranted. (PsycINFO Database Record

Childhood Abuse History in Depression Predicts Better Response to Antidepressants with Higher Serotonin Transporter Affinity: A Pilot Investigation.

Childhood abuse is a powerful prognostic indicator in adults with major depressive disorder (MDD) and is associated with numerous biological risk factors for depression. The purpose of this investigation was to explore if antidepressant medication affinity for the serotonin transporter moderates the association between childhood abuse and treatment response.

Fun Seeking and Reward Responsiveness Moderate the Effect of the Behavioural Inhibition System on Coping-Motivated Problem Gambling.

Gray's Reinforcement Sensitivity Theory (RST) predicts that the Behavioral Inhibition System (BIS) may relate to coping-motivated problem gambling, given its central role in anxiety. Studies examining the BIS-problem gambling association, however, are mixed. The revised RST posits that the Behavioral Approach System (BAS) may moderate the effect of the BIS on coping-motivated problem gambling. A concurrently strong BAS may highlight the negatively reinforcing effects of gambling, which may strengthen coping motives and increase gambling-related harms. We examined these interactive effects to clarify the moderators and mediators of the negative reinforcement pathway to problem gambling. Data came from a larger investigation of problem gambling among individuals with mood disorders. All participants (N = 275) met criteria for a lifetime depressive or bipolar disorder. During a two-day assessment, participants completed a diagnostic assessment and self-reports. Mediated moderation path analysis showed positive indirect effects from the BIS to problem gambling via coping motives at high, but not at low, levels of BAS-Reward Responsiveness and BAS-Fun Seeking. Enhancement motives were also found to mediate the associations of BAS-Fun Seeking and BAS-Drive with problem gambling. Reward Responsiveness and Fun Seeking facets of the BAS may strengthen coping gambling motives within the mood disorders.

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 2. Psychological Treatments.

The Canadian Network for Mood and Anxiety Treatments (CANMAT) has revised its 2009 guidelines for the management of major depressive disorder (MDD) in adults by updating the evidence and recommendations. The target audiences for these 2016 guidelines are psychiatrists and other mental health professionals.

Impulsivity, working memory, and impaired control over alcohol: A latent variable analysis.

Impaired control over alcohol is an important risk factor for heavy drinking among young adults and may mediate, in part, the association between personality risk and alcohol problems. Research suggests that trait impulsivity is associated with impaired control over alcohol; however, few studies of this association have included a range of impulsivity facets. The purpose of this study was to examine specific pathways from higher order impulsivity factors to alcohol problems mediated via impaired control over alcohol. We also examined the moderating role of working memory in these associations. Young heavy drinkers (N = 300) completed 2 multidimensional impulsivity measures along with self-report measures of impaired control over alcohol, alcohol use, and alcohol problems. Working memory was assessed using a computerized digit span task. Results showed that the impulsivity facets loaded onto 2 higher order factors that were labeled Response and Reflection Impulsivity. Response impulsivity predicted unique variance in self-reported impaired control and alcohol problems, whereas reflection impulsivity predicted unique variance in heavy drinking frequency only. Further, significant indirect associations were observed from response and reflection impulsivity to alcohol problems mediated via impaired control and heavy drinking frequency, respectively. Working memory and sensation seeking were not uniquely associated with the alcohol variables, and no support was found for the moderating role of working memory. The results help to clarify associations among impulsivity, impaired control, and alcohol problems, suggesting that impaired control may play a specific role in the pathway to alcohol problems from response impulsivity but not from reflection impulsivity. (PsycINFO Database Record

A Prospective Investigation of Affect, the Desire to Gamble, Gambling Motivations and Gambling Behavior in the Mood Disorders.

Time-sampling methodology was implemented to examine the prospective associations between affect, desire to gamble, and gambling behavior in individuals diagnosed with a mood disorder. Thirty (9 male, 21 female) adults with a lifetime diagnosis of a depressive or bipolar disorder diagnosis who endorsed current gambling and lifetime gambling harm participated in the present study. Participants completed electronic diary entries of their current affective state, desire to gamble, and gambling behavior for 30 consecutive days. Hierarchical linear modelling revealed that affect was not a predictor of gambling behavior. Instead, affect predicted the desire to gamble, with high levels of sadness and arousal independently predicting an increased desire to gamble. Desire to gamble predicted actual gambling behavior. There were no differences across diagnostic groups in terms of gambling motivations at baseline; however, during the 30-day period, participants with bipolar disorder endorsed gambling to cope with negative affect more often than did participants with depressive disorder, whereas those with depressive disorder more often endorsed gambling for social reasons or enhancement of positive affect. The present findings provide evidence that negative affect is not directly related to actual gambling behavior, and suggest that affective states rather impact the desire to gamble.

Therapeutic alliance mediates the association between personality and treatment outcome in patients with major depressive disorder.

Patient personality traits have been shown to influence treatment outcome in those with major depressive disorder (MDD). The trait agreeableness, which reflects an interpersonal orientation, may affect treatment outcome via its role in the formation of therapeutic alliance. No published studies have tested this hypothesis in patients with MDD.

An Examination of the Topology and Measurement of the Alexithymia Construct Using Network Analysis.

There is some ongoing controversy surrounding the definition and measurement of the alexithymia construct. Whereas most researchers describe 4 components comprising the construct (difficulty identifying feelings, difficulty describing feelings, restricted fantasizing, and externally oriented thinking), some include a 5th component, which is defined as "reduced experiencing of emotional feelings." This study examined the topology and measurement of alexithymia using the method of network analysis with data from a heterogeneous multilanguage sample (N = 1,696) that had completed the Bermond-Vorst Alexithymia Questionnaire (BVAQ; Vorst & Bermond, 2001 ). The BVAQ includes an Emotionalizing subscale for assessing the purported 5th component; we compared the network analyses conducted both with and without the Emotionalizing items. The results revealed strong associations between Emotionalizing and Analyzing (externally oriented thinking) items, but Emotionalizing items had almost as many negative as positive connections with items assessing the other components of the construct. A comparison of communities identified by modularity analyses of the 2 networks failed to support emotionalizing as a distinct component of the construct. In addition, network metrics revealed that Fantasizing items were particularly weak within both networks, suggesting that reduced fantasizing might be a peripheral component of the alexithymia construct. Implications for the measurement and treatment of alexithymia are discussed.

Discovering biomarkers for antidepressant response: protocol from the Canadian biomarker integration network in depression (CAN-BIND) and clinical characteristics of the first patient cohort.

Major Depressive Disorder (MDD) is among the most prevalent and disabling medical conditions worldwide. Identification of clinical and biological markers ("biomarkers") of treatment response could personalize clinical decisions and lead to better outcomes. This paper describes the aims, design, and methods of a discovery study of biomarkers in antidepressant treatment response, conducted by the Canadian Biomarker Integration Network in Depression (CAN-BIND). The CAN-BIND research program investigates and identifies biomarkers that help to predict outcomes in patients with MDD treated with antidepressant medication. The primary objective of this initial study (known as CAN-BIND-1) is to identify individual and integrated neuroimaging, electrophysiological, molecular, and clinical predictors of response to sequential antidepressant monotherapy and adjunctive therapy in MDD.

Interpersonal impacts mediate the association between personality and treatment response in major depression.

Personality, as characterized by the Five-Factor Model, predicts response to psychotherapy for depression. To explain how personality impacts treatment response, the present study investigated patient and therapist interpersonal processes in treatment sessions as an explanatory pathway. A clinical trial was conducted in which 103 outpatients (mean age: 41.17 years, 65% female) with primary major depressive disorder completed 16-20 weeks of cognitive-behavioral or interpersonal therapy. Before treatment, patients completed the Revised NEO Personality Inventory to assess personality domains (neuroticism, extraversion, openness-to-experience, agreeableness, and conscientiousness). After 3 and 13 weeks, patient interpersonal behavior was rated by the therapist and vice versa to determine levels of patient and therapist communal and agentic behaviors. Depression levels were measured before and after treatment. Structural equation modeling supported that patients' interpersonal behavior during therapy mediated the associations between pretreatment personality and depression treatment outcome. Specifically, extraversion, conscientiousness, and neuroticism (inverse) predicted higher levels of patient communion throughout treatment, which was in turn associated with improved treatment outcomes. Furthermore, patient agreeableness was inversely associated with agency throughout treatment, which was linked to poorer treatment response. Therapist interpersonal behavior was not a significant mediator. Results suggest that patient interpersonal behavior during treatment may be one way that patient personality impacts clinical outcomes in depression. Results underscore the clinical utility of Five-Factor Model domains in treatment process and outcome. (PsycINFO Database Record

Individual factors predicted to influence outcome in group CBT for psychosis (CBTp) and related therapies.

Development and validation of the Dimensional Anhedonia Rating Scale (DARS) in a community sample and individuals with major depression.

Anhedonia, a core symptom of Major Depressive Disorder (MDD), is predictive of antidepressant non-response. In contrast to the definition of anhedonia as a "loss of pleasure", neuropsychological studies provide evidence for multiple facets of hedonic function. The aim of the current study was to develop and validate the Dimensional Anhedonia Rating Scale (DARS), a dynamic scale that measures desire, motivation, effort and consummatory pleasure across hedonic domains. Following item selection procedures and reliability testing using data from community participants (N=229) (Study 1), the 17-item scale was validated in an online study with community participants (N=150) (Study 2). The DARS was also validated in unipolar or bipolar depressed patients (n=52) and controls (n=50) (Study 3). Principal components analysis of the 17-item DARS revealed a 4-component structure mapping onto the domains of anhedonia: hobbies, food/drink, social activities, and sensory experience. Reliability of the DARS subscales was high across studies (Cronbach's α=0.75-0.92). The DARS also demonstrated good convergent and divergent validity. Hierarchical regression analysis revealed the DARS showed additional utility over the Snaith-Hamilton Pleasure Scale (SHAPS) in predicting reward function and distinguishing MDD subgroups. These studies provide support for the reliability and validity of the DARS.

Motivational pathways from reward sensitivity and punishment sensitivity to gambling frequency and gambling-related problems.

Motives for gambling have been shown to have an important role in gambling behavior, consistent with the literature on motives for substance use. While studies have demonstrated that traits related to sensitivity to reward (SR) and sensitivity to punishment (SP) are predictive of substance use motives, little research has examined the role of these traits in gambling motives. This study investigated motivational pathways from SR and SP to gambling frequency and gambling problems via specific gambling motives, while also taking into account history of substance use disorder (SUD). A community sample of gamblers (N = 248) completed self-report questionnaires assessing SR, SP, gambling frequency, gambling-related problems, and motives for gambling (social, negative affect, and enhancement/winning motives). Lifetime SUD was also assessed with a structured clinical interview. The results of a path analysis showed that SR was uniquely associated with all 3 types of gambling motives, whereas SP and SUD were associated with negative affect and enhancement/winning motives but not social motives. Also, both negative affect and enhancement/winning motives were associated with gambling problems, but only enhancement/winning motives were significantly related to gambling frequency. Analyses of indirect associations revealed significant indirect associations from SR, SP, and SUD to gambling frequency mediated through enhancement/winning motives and to gambling problems mediated through both negative affect and enhancement/winning motives. The findings highlight the importance of SR and SP as independent predictors of gambling motives and suggest that specific motivational pathways underlie their associations with gambling outcomes.

Associations between DSM-5 section III personality traits and the Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scales in a psychiatric patient sample.

Our aim in the current study was to evaluate the convergence between Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) Section III dimensional personality traits, as operationalized via the Personality Inventory for DSM-5 (PID-5), and Minnesota Multiphasic Personality Inventory 2-Restructured Form (MMPI-2-RF) scale scores in a psychiatric patient sample. We used a sample of 346 (171 men, 175 women) patients who were recruited through a university-affiliated psychiatric facility in Toronto, Canada. We estimated zero-order correlations between the PID-5 and MMPI-2-RF substantive scale scores, as well as a series of exploratory structural equation modeling (ESEM) analyses to examine how these scales converged in multivariate latent space. Results generally showed empirical convergence between the scales of these two measures that were thematically meaningful and in accordance with conceptual expectations. Correlation analyses showed significant associations between conceptually expected scales, and the highest associations tended to be between scales that were theoretically related. ESEM analyses generated evidence for distinct internalizing, externalizing, and psychoticism factors across all analyses. These findings indicate convergence between these two measures and help further elucidate the associations between dysfunctional personality traits and general psychopathology.

Alcohol sensitivity moderates the indirect associations between impulsive traits, impaired control over drinking, and drinking outcomes.

The purpose of this study was to examine impaired control over drinking behavior as a mediator of unique pathways from impulsive traits to alcohol outcomes in young adults. We also sought to investigate the moderating influence of self-reported sensitivity to alcohol on these pathways.

Openness to Experience and Intellect Differentially Predict Creative Achievement in the Arts and Sciences.

The Big Five personality dimension Openness/Intellect is the trait most closely associated with creativity and creative achievement. Little is known, however, regarding the discriminant validity of its two aspects-Openness to Experience (reflecting cognitive engagement with perception, fantasy, aesthetics, and emotions) and Intellect (reflecting cognitive engagement with abstract and semantic information, primarily through reasoning)-in relation to creativity. In four demographically diverse samples totaling 1,035 participants, we investigated the independent predictive validity of Openness and Intellect by assessing the relations among cognitive ability, divergent thinking, personality, and creative achievement across the arts and sciences. We confirmed the hypothesis that whereas Openness predicts creative achievement in the arts, Intellect predicts creative achievement in the sciences. Inclusion of performance measures of general cognitive ability and divergent thinking indicated that the relation of Intellect to scientific creativity may be due at least in part to these abilities. Lastly, we found that Extraversion additionally predicted creative achievement in the arts, independently of Openness. Results are discussed in the context of dual-process theory.

Latent classes of nonresponders, rapid responders, and gradual responders in depressed outpatients receiving antidepressant medication and psychotherapy.

We used growth mixture modeling (GMM) to identify subsets of patients with qualitatively distinct symptom trajectories resulting from treatment. Existing studies have focused on 12-week antidepressant trials. We used data from a concurrent antidepressant and psychotherapy trial over a 6-month period.

Distinct profiles of behavioral inhibition and activation system sensitivity in unipolar vs. bipolar mood disorders.

Psychiatric outpatients with mood disorders (n=275) and community controls (n=733) completed a measure of Behavioral Inhibition System (BIS) and Behavioral Activation System (BAS) sensitivity; psychiatric outpatients also completed measures of mood symptom severity. All patients scored higher on BIS compared to controls; patients with bipolar disorders scored higher on BAS scales compared to patients with depressive disorders. BIS and BAS demonstrated unique patterns of association with mood symptoms. Results support the clinical utility of the BIS/BAS.

Extraversion and behavioral activation: integrating the components of approach.

This investigation evaluates the structure and correlates of lower order traits related to approach, specifically, facets of extraversion and behavioral activation system (BAS) sensitivity. A 3-factor structure of approach was derived in community and clinical samples: assertiveness, enthusiasm, and sensation seeking. All factors were positively associated with Openness/Intellect scores. Enthusiasm and assertiveness were both negatively associated with Neuroticism scores, but were distinguished by associations with Agreeableness and Conscientiousness. Sensation seeking was negatively associated with Conscientiousness scores. The 3 factors demonstrated a unique profile of association with components of impulsivity. Enthusiasm and assertiveness were negatively related to psychopathological symptoms, whereas sensation seeking was largely independent of psychopathology. Results suggest that approach is associated with 3 subfactors, which differ in their pattern or magnitude of associations with other variables, thus underscoring the importance of distinguishing among them. Further, results support the construct validity of the Assertiveness and Enthusiasm aspect scales of the Big Five Aspect Scales to assess traits at this level of the personality hierarchy.

The structure of the Montgomery-Åsberg depression rating scale over the course of treatment for depression.

The Montgomery-Åsberg Depression Rating Scale (MADRS) is a widely used clinician-rated measure of depressive severity. Empirical support for the factor structure of the MADRS is mixed; further, the comparison of MADRS scores within and between patients requires the demonstration of consistent instrument properties. The objective of the current investigation was to evaluate MADRS factor structure as well as MADRS factorial invariance across time and gender. The MADRS was administered to 821 depressed outpatients participating in a large-scale effectiveness study of combined pharmacotherapy and psychotherapy for depression. Treatment outcome did not differ across treatment groups. Factor structure and invariance was evaluated via confirmatory factor analysis. A four-factor model consisting of Sadness, Negative Thoughts, Detachment and Neurovegetative symptoms demonstrated a good fit to the data. This four-factor structure was invariant across time and gender. A hierarchical model, in which these four factors served as indicators of a general depression factor, was also supported. A limitation of the current study is the lack of comprehensive characterization of patient clinical features; results need to be replicated in more severely depressed or treatment refractory patients. Overall, evidence supported the use of the MADRS total score as well as subscales focused on affective, cognitive, social and somatic aspects of depression in male and female outpatients.

Exploring the hierarchical structure of the MMPI-2-RF Personality Psychopathology Five in psychiatric patient and university student samples.

In this study our goal was to examine the hierarchical structure of personality pathology as conceptualized by Harkness and McNulty's (1994) Personality Psychopathology Five (PSY-5) model, as recently operationalized by the MMPI-2-RF (Ben-Porath & Tellegen, 2011) PSY-5r scales. We used Goldberg's (2006) "bass-ackwards" method to obtain factor structure using PSY-5r item data, successively extracting from 1 to 5 factors in a sample of psychiatric patients (n = 1,000) and a sample of university undergraduate students (n = 1,331). Participants from these samples had completed either the MMPI-2 or the MMPI-2-RF. The results were mostly consistent across the 2 samples, with some differences at the 3-factor level. In the patient sample a factor structure representing 3 broad psychopathology domains (internalizing, externalizing, and psychoticism) emerged; in the student sample the 3-factor level represented what is more commonly observed in "normal-range" personality models (negative emotionality, introversion, and disconstraint). At the 5-factor level the basic structure was similar across the 2 samples and represented well the PSY-5r domains.

Openness to experience, intellect, and cognitive ability.

An instrument designed to separate 2 midlevel traits within each of the Big Five (the Big Five Aspect Scales [BFAS]) was used to clarify the relation of personality to cognitive ability. The BFAS measures Openness to Experience and Intellect as separate (although related) traits, and refers to the broader Big Five trait as Openness/Intellect. In 2 samples (N = 125 and 189), Intellect was independently associated with general intelligence (g) and with verbal and nonverbal intelligence about equally. Openness was independently associated only with verbal intelligence. Implications of these findings are discussed for the empirical and conceptual relations of intelligence to personality and for the mechanisms potentially underlying both Openness/Intellect and cognitive ability.

Interpersonal problems and impacts: further evidence for the role of interpersonal functioning in treatment outcome in major depressive disorder.

Empirical research has converged to support the concurrent association between social difficulties and psychiatric symptoms; yet, longitudinal associations between interpersonal problems and treatment outcome require clarification. The current investigation evaluated the influence of interpersonal problems assessed prior to treatment on interpersonal impacts assessed during treatment as well as on treatment outcome in outpatients with major depressive disorder (MDD).

Identifying indicators of harmful and problem gambling in a Canadian sample through receiver operating characteristic analysis.

Many gamblers would prefer to reduce gambling on their own rather than to adopt an abstinence approach within the context of a gambling treatment program. Yet responsible gambling guidelines lack quantifiable markers to guide gamblers in wagering safely. To address these issues, the current investigation implemented receiver operating characteristic (ROC) analysis to identify behavioral indicators of harmful and problem gambling. Gambling involvement was assessed in 503 participants (275 psychiatric outpatients and 228 community gamblers) with the Canadian Problem Gambling Index. Overall gambling frequency, duration, and expenditure were able to distinguish harmful and problematic gambling at a moderate level. Indicators of harmful gambling were generated for engagement in specific gambling activities: frequency of tickets and casino; duration of bingo, casino, and investments; and expenditures on bingo, casino, sports betting, games of skill, and investments. Indicators of problem gambling were similarly produced for frequency of tickets and casino, and expenditures on bingo, casino, games of skill, and investments. Logistic regression analyses revealed that overall gambling frequency uniquely predicted the presence of harmful and problem gambling. Furthermore, frequency indicators for tickets and casino uniquely predicted the presence of both harmful and problem gambling. Together, these findings contribute to the development of an empirically based method enabling the minimization of harmful or problem gambling through self-control rather than abstinence.

The development and psychometric properties of an informant-report form of the personality inventory for DSM-5 (PID-5).

The current article reports on the development, psychometric properties, and external validity of an informant-report form of the Personality Inventory for DSM-5 (the PID-5-IRF). Using data from two nationally representative samples, as well as an elevated-risk community sample, we report on the PID-5-IRF item characteristics, scale properties, superordinate factor structure, and correlations with other measures. The PID-5-IRF replicates the factor structure of the self-report form and has relationships with other measures (including the PID-5 self-report form and a widely used Big Five measure) that are consistent with previous research and theory. We believe that the PID-5-IRF is a useful measure for a number of scenarios, such as when additional sources of information are desired, where informant measures are expected to provide incremental validity over self-report, where relationships or social perception is a focal interest, or when response bias is a salient concern. Areas for future research are also discussed.