Psychological assessment relies on accurate and forthright reporting to determine valid clinical presentations. However, it has long been recognized that examinees may be motivated to present a "better picture" through Positive Impression Management (PIM). Within the PIM domain, two distinct motivations (i.e., defensiveness and social desirability) emerge that have not been clearly differentiated in empirical literature. This thesis addressed the research gap for detecting PIM distortion of personality pathology, utilizing the Personality Inventory for DSM-5 (PID-5). In this investigation, 106 psychiatric inpatients were recruited from the adult Co-Occurring Disorders and Trauma Programs at University Behavioral Health. Using a mixed within- and between-subjects design, participants engaged in simulation via scenarios to be considered for a highly valued rehabilitation program (defensiveness) or employment (social desirability). As expected, inpatients showed elevated levels of problematic personality traits when reporting genuinely, but suppressed them under PIM conditions. These findings highlight that the PID-5, like all multiscale inventories, is highly vulnerable to intentional PIM distortion. Interestingly, respondents in the social desirability condition generally engaged in more total denial than those in the defensiveness condition. Empirically- and theoretically-based validity scales were developed to identify simulators and differentiate between conditions. Besides PIM, higher levels of experienced stigma were associated with more personality pathology, particularly the domain of Detachment. In addition, ancillary analyses showed strong convergence of the PID-5 with its hierarchical trait model to the DSM-IV categorical model. Continued research to detect PIM distortion, and more importantly to differentiate between PIM motivations, is essential for accurate clinical assessment of personality disorder traits and effective treatment planning.

Contexte théorique : Au Canada, la prévalence du trouble de stress post-traumatique (TSPT) serait de 9,2%. Plusieurs questionnaires ont été développés pour mesurer les symptômes du TSPT dont le PTSD Checklist For DSM-5 (PCL-5). Ce questionnaire autorapporté a été validé à plusieurs reprises avec des échantillons non-cliniques ou militaires. Toutefois, le PCL-5 n’a jamais été validé avec un échantillon clinique et civil. Aussi, le nombre idéal de facteur du PCL-5 reste toujours à être démontré. Objectif : Cette étude vise à établir la validité de construit du PCL-5 d’un échantillon clinique et civil de 132 participants aux prises avec un TSPT. Les 3 principales structures factorielles seront analysées de façon à retenir celle qui présente les meilleurs résultats. Méthodologie : Les structures factorielles ont été mesurées avec des analyses factorielles confirmatoires et des analyses bifactorielles. La consistance interne a été mesurée à partir du coefficient Oméga de McDonald. La validité convergente et divergente a été mesurée par des corrélations de Pearson avec d’autres construits. Résultats : Au niveau des indices d’ajustement, le modèle à 7 facteurs a obtenu les meilleurs résultats. Sur le plan de la fidélité et sur celui de la validité convergente et divergente, le modèle à 4 facteurs possède les résultats les plus optimaux. Discussion : Globalement, le modèle à 4 facteurs est le plus approprié pour le PCL-5. De plus, les modèles à 6 et 7 facteurs présentent quelques lacunes sur le plan méthodologique et statistique. Finalement, le PCL-5 est un questionnaire valide et fidèle pour une population clinique et civile. / Background: In Canada, the prevalence of post-traumatic stress disorder (PTSD) is estimated to be 9.2%. Several questionnaires have been developed to measure the symptoms of PTSD including the PTSD Checklist For DSM-5 (PCL-5). This questionnaire has been validated several times with non-clinical or military samples. However, PCL-5 has never been validated with a clinical and civilian sample. Also, the ideal factor number of PCL-5 has yet to be demonstrated. Objective: This study aims to establish the construct validity of PCL-5 in a clinical and civilian sample of 132 participants with PTSD. The 3 main factor structures will be analyzed in order to retain the one that presents the best results. Methodology: Factor structures were measured with confirmatory factor analyzes and bifactor analyzes. Internal consistency was measured from McDonald's Omega coefficient. Convergent and discriminant validity was measured by Pearson correlations with other constructs. Results: In terms of fit statistics, the 7-factor model obtained the best results. In terms of reliability and convergent and divergent validity, the 4-factor model has the most optimal results. Discussion: Overall, the 4-factor model is the most appropriate for the PCL-5. In addition, the 6 and 7 factor models have some methodological and statistical limitations. Finally, the PCL-5 is a valid and reliable questionnaire for a clinical and civilian population.

In the present study, we compare factor analytic models of post-traumatic stress disorder (PTSD) in terms of their fit and predictive utility with regard to external correlates such as comorbid diagnoses and other psychosocial outcomes. Competing models were compared and validated in an epidemiological dataset (N = 23,936). Confirmatory factor analyses (CFA) using models from prior literature with four through seven factor solutions were conducted. The seven factor Hybrid model, the six-factor Anhedonia model, and the six-factor Externalizing Behaviors model were the first, second, and third best-fitting models, respectively; however, the inconsistency of associations with external correlates and high factor intercorrelations suggested that higher-factor solutions may sacrifice parsimony for minimal gains in utility. The Anhedonia and Hybrid models’ separate Anhedonia and Negative Affect factors (a core difference from other models) demonstrated limited utility in differentially associating with distinct constructs under the internalizing umbrella. Anhedonia and Negative Affect also correlated highly with each other and nearly perfectly with the factors composed of their combined symptoms (e.g. the Externalizing Behaviors model’s Numbing factor), suggesting a "lumped" factor would be more parsimonious. The Externalizing Behaviors model showed predictive utility in accounting for externalizing comorbidities as well as differentiating among constructs within the internalizing spectrum; however, it lacked robust associations with externalizing behavioral outcomes such as frequency and quantity of drinking. These results give reason for concern that predominant structural models of PTSD may not be adequate for discriminating among or predicting functional outcomes related to PTSD symptomatology in trauma-exposed populations.<br>

The DSM-IV-TR diagnosis Gender Identity Disorder Not Otherwise Specified (GID NOS) is used to describe individuals who have gender issues but do not meet the current criteria for GID. As part of a consensus process conducted by the World Professional Association for Transgender Health, the authors make the following recommendations for DSM 5: removal from the chapter on sexual disorders, more specific diagnostic criteria, retention of clinical significance criteria, and removal of exclusionary criteria of Intersex/Disorders of Sex Development. Changes to the existing clinical examples were also recommended, suggesting additional clinical examples that encompass a broader range of gender-variance and more commonly found transgender presentations. The diagnosis must reflect the severity of the clinical issues that represent legitimate identity experiences and possible need for gender-confirming treatments.

No description available.

Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2022. / Mental illness is a high burden of disease especially in Low- and Medium-Income Countries (LMICs) like South Africa. In many LMICs, there is a paucity of Mental Health Professionals (MHCPs). As a result, people with mental illness call their faith healers or religious/spiritual leaders (pastors in this study) when experiencing mental health problems. Pastors are more accessible, share the same religious/spiritual beliefs about mental illness with their congregants and often provide religious/spiritual solutions to those who consult with them. Thus, they are often preferred over MHCPs. However, pastors are rarely involved as partners in community based mental health programs. While mental illness is mainly clinically diagnosed and recognised by MHCPs using the DSM-5 and ICD-10 codes, less is known in South Africa with regards to the views of pastors with regards to their notions of what mental illness is. Thus, it may be complex for Pentecostal pastors to clearly distinguish between spirit possession and mental illness as much as it is complex for MHCPs who struggle with accommodating their patients’ religious/spiritual beliefs. Religious/spiritual beliefs are significant in many Africans seeking mental health recovery. However, less has been explored in South Africa in the area of religion/spirituality and its relevance in the practice of clinical psychology. Western based psychotherapeutic methods of intervention which exclude the religious/spiritual domain of African clients continue to dominate the practise of psychology in Africa. Given the above, this study aimed to explore and understand selected Pentecostal pastors’ perception and treatment of mental illness. The research objectives were, namely: (1) to establish the notions held by Pentecostal pastors’ regarding what mental illness is (2) to establish Pentecostal pastors’ perception of what causes mental illness; (3) to determine Pentecostal pastors’ perceptions of how and by whom mental illness can be recognised, diagnosed, treated and managed; (4) To determine Pentecostal pastors’ views regarding their own roles in the management of mental illness; and (5) To canvass and describe Pentecostal pastors’ perceptions about collaboration for purposes of an intervention programme aimed at providing a holistic care and treatment of religious/spiritual patients. The study was qualitative, and the exploratory research approach was adopted. The research was informed by the Bio-Psycho-Social-Spiritual (BPSS) model. Purposive sampling was used to select nineteen (19) participants. In-depth semi-structured interviews were conducted. Data were analysed using Thematic Analysis (TA). The following six major themes emerged from the analysed data: (i) Notions of mental illness; (ii) Causes of mental illness;(iii) Recognition and diagnosis of mental illness (iv) Notions on the treatment and management of mental illness; (v) Perceived roles in the treatment and management of mental illness; (vi) Views regarding collaboration with MHCPs. The participants held a multifactorial view of mental illness. They were limited in their understanding of mental illness and perceived it mainly to be madness (psychosis). The participants’ perception of mental illness was influenced by their theological (Pentecostal) as well as their cultural backgrounds (Black Africans). The participants indicated that they lacked training in mental health issues. As such, they were not opposed to collaborating with MHCPs. They mentioned that their roles included counselling, prayer, support, and referral. This study also discovered that Pentecostal pastors upheld three treatment approaches of mental illness namely: The Full-Collaborative Approach; The Partial-Collaborative Approach and the Non-Collaborative Approach. Findings of the study were discussed, and recommendations were made including the proposed intervention programme between pastors and MHCPs with the aim of facilitating a referral process and collaboration between the two professions. / National Institute for the Humanities and Social Sciences (NIHSS), and South African Humanities Deans Association (SAHUDA)

Le présent projet doctoral vise à considérer les lacunes dans la documentation scientifique sur le Trouble Paraphilique Coercitif (TPC) en mettant l’accent sur la validité des critères diagnostiques proposés pour inclusion dans le DSM-5 et les marqueurs comportementaux. À ce fait, les données archivées d’individus ayant sexuellement agressé des femmes adultes ont été étudiées. La thèse est constituée de trois articles empiriques. Le premier article présente des résultats clés découlant des analyses, élaborés dans les articles subséquents. Le second (N = 47) évalue les fréquences observées du TPC, la validité et l’impact du recours au nombre minimal de victimes comme critère diagnostique, ainsi que les indices prédisant la récidive sexuelle. Le troisième article (N = 52) compare les groupes diagnostiques sur une série de comportements délictuels, tels que les gestes sexuels et les comportements violents, dans le but d’identifier les marqueurs comportementaux associés avec la propension au viol qui pourraient assister dans le processus diagnostique. Dans le même ordre d’idées, nous avons créé des typologies de violeurs à partir des gestes sexuels commis, d’un côté, et des comportements violents, de l’autre côté. Conséquemment, les caractéristiques des typologies ainsi obtenues et leur association avec le TPC furent examinées. Dans l’ensemble, nos résultats ne soutiennent pas le recours au nombre de victimes. Nos données suggèrent que, globalement, les violeurs avec le TPC utilisent un niveau de gestes sexuels plus envahissant et un niveau de violence moindre que les violeurs n’ayant pas ce diagnostic, et que l’exhibitionnisme et l’attouchement pourraient servir de marqueurs comportementaux pour le TPC. En outre, les violeurs avec le TPC sont caractérisés davantage par demande indécente, exhibitionnisme, attouchement, masturbation, tentative de pénétration et pénétration digitale que par pénétration vaginale et sodomie. De plus, ces derniers font moins recours à l’utilisation d’armes, semblent ne pas frapper/donner des coups à la victime et sont caractérisés par la manipulation plutôt que par le recours aux menaces de mort, force excessive et utilisation d’armes. En somme, nos données soulignent la nécessité de s’appuyer sur une combinaison de méthodes d’évaluation afin d’améliorer la validité diagnostique et discriminante du TPC. / The present dissertation aims to address the shortcomings in the current literature on Paraphilic Coercive Disorder (PCD) by focusing on two main objectives: assessing the validity of the diagnostic criteria proposed for inclusion in the DSM-5 and investigating behavioral markers. To this end, archival files of rapists who offended against adult women were studied. The thesis consists of three empirical articles. The first article presents a succinct account of some of the key results emanating from the analyses. The second article (N = 47) examines the observed frequencies of PCD and assesses the validity and impact of relying on minimum number of victims as a diagnostic criterion. Furthermore, a number of variables of interest are examined to determine predictors of sexual recidivism. The third article (N = 52) compares diagnostic groups on a number of offense conduct characteristics – specifically sexual acts and violent behaviors – in an attempt to identify behavioral markers associated with rape-proneness that could aid with the diagnosis of PCD. Similarly, rapist typologies were created by classifying the sample into groups of sex offenders based on their sexual acts, on one hand, and violent behaviors, on the other hand. Consequently, their characteristics and association with PCD were examined. Our results do not support the reliance on number of victims. Our findings suggest that rapists with PCD are more sexually intrusive and resort to less violence overall than sex offenders without such a diagnosis and that exhibitionism and fondling could serve as behavioral markers for PCD. Moreover, rapists with PCD are characterised more by indecent request, exhibitionism, fondling, masturbation, attempted intercourse and digital penetration rather than by intercourse and sodomy. In terms of violent behaviors, rapists with PCD resort less to the use of weapons, seem not to hit their victims, and are likely characterised more by manipulation rather than by the use of death threats, excessive force and weapons. In sum, the present study highlights the necessity of relying on a combination of assessment methods in order to improve diagnostic and discriminant validity of PCD.

No description available.