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The purpose of this project was to identify distinct profiles of circumplex interpersonal problems, cross-validate the profiles, and examine construct validity through associations with adult attachment, basic psychological needs frustration, and psychological outcomes. Undergraduates at two universities provided survey data. In Study 1 (N = 469), latent profile analysis identified three distinct profiles of interpersonal problems. We labeled these: Flexible-Adaptive, Exploitable-Subservient, and Hostile-Avoidant. Construct validity analyses suggested the Flexible-Adaptive profile was distinguished from the other two by lower attachment anxiety, whereas the Hostile-Avoidant profile was distinguished from the other two by higher attachment avoidance. In Study 2 (N = 423), we conducted profile similarity analyses to cross-validate Study 1 results, following the multistep procedure proposed by Morin et al. (Organizational Research Methods, 2016, 19, p. 231). Results suggested that when the data from Study 2 were constrained to fit the profile model derived from Study 1, with respect to means, variance, and latent profile membership, the model fit was equivalent. In Study 2, further evidence of construct validity suggested that the Flexible-Adaptive profile was distinguished from the other two by lower relatedness frustration and by lower competence frustration. Additionally, the Hostile-Avoidant profile was distinguished from the Exploitable-Subservient profile by higher relatedness need frustration. Validity evidence for these profiles indicated that those with the Hostile-Avoidant profile reported the most negative psychological outcomes, followed by those with the Exploitable-Subservient profile, while those with the Flexible-Adaptive profile reported the best psychological outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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OBJECTIVE: We differentiated two hypothesized client subtypes: (a) Pseudosecure clients have high Client Attachment to Therapist Scale (CATS) Secure and high CATS Preoccupied scores, tend to idealize their therapist, and exhibit maladaptive dependency; (b) Individuated-secure clients combine high Secure with low Preoccupied scores and function more autonomously. Clients who, despite insecure attachment to others, "earn" individuated-secure attachment to their therapist benefit most from therapy. METHOD: We examined regression suppressor effects by reanalyzing raw data from four published studies. If pseudosecure attachment is present, when covariance between CATS Secure and Preoccupied scores is removed, residual Secure scores should be significantly better predictors of process/outcome indicators than raw Secure scores. RESULTS: Suppressor effects were observed in eight of nine analyses. Two were statistically significant. Earned individuated-secure attachment predicted improvement in interpersonal relationship symptoms, but only for clients with Avoidant pre-therapy attachment patterns. Finally, significant meta-analytic effect size estimates were obtained for CATS subscales, Secure r = .274 (95% CI = .177, .366), Avoidant, r = -.296 (95% CI = -.392, -193), and Preoccupied, r = -.192 (95% CI = -.289, -.092). CONCLUSIONS: Clients with pre-therapy Avoidant attachment who nevertheless "earn" individuated-secure attachment to their therapist appear to benefit more from therapy.

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All groups can be considered multicultural, and group members often present with issues that stem from contextual factors related to cultural identities, including experiences with oppression. Therefore, group leaders must be able to effectively facilitate deep intercultural dialogues in psychotherapy groups, and we suggest that an understanding of attachment theory can help leaders engage group members in these dialogues. In order to demonstrate how attachment theory can be applied to the exploration of diversity in groups, we provide a case example from an intergroup dialogue group bringing together religious minorities, secular individuals, and Christians over the course of eight weeks. In this example, we focus on the two group members who scored the lowest (Jill) and highest (Sarah) on a measure of attachment anxiety and avoidance to illustrate the experiences of one member with more secure attachment and one with more preoccupied attachment. Specifically, we present data from their weekly reflective journals to explore their different experiences of the group over time. Finally, we discuss the case in terms of attachment theory and highlight implications for group leaders.

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OBJECTIVE: The Working Alliance Inventory (WAI) has made great contributions to psychotherapy research. However, studies suggest the 7-point response format and 3-factor structure of the client version may have psychometric problems. This study used Rasch item response theory (IRT) to (a) improve WAI response format, (b) compare two brief 12-item versions (WAI-sr; WAI-s), and (c) develop a new 16-item Brief Alliance Inventory (BAI). METHOD: Archival data from 1786 counseling center and community clients were analyzed. RESULTS: IRT findings suggested problems with crossed category thresholds. A rescoring scheme that combines neighboring responses to create 5- and 4-point scales sharply reduced these problems. Although subscale variance was reduced by 11-26%, rescoring yielded improved reliability and generally higher correlations with therapy process (session depth and smoothness) and outcome measures (residual gain symptom improvement). The 16-item BAI was designed to maximize "bandwidth" of item difficulty and preserve a broader range of WAI sensitivity than WAI-s or WAI-sr. CONCLUSIONS: Comparisons suggest the BAI performed better in several respects than the WAI-s or WAI-sr and equivalent to the full WAI on several performance indicators.

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Racial/ethnic discrimination has been identified as a risk factor in the development of posttraumatic stress disorder (PTSD) symptoms in persons of color (Carter, 2007). Many persons, regardless of race/ethnicity, with PTSD symptoms resulting from combat, violent crimes, sexual assault, or natural disasters use alcohol in an attempt to cope. This longitudinal study surveyed 203 Hispanic/Latino students twice at approximately a 1-year interval, and used a cross-lagged design to compare Time 1 links from alcohol use and experiences of discrimination with the same variables at Time 2, plus symptoms of PTSD. Each survey included the General Ethnic Discrimination scale and the Alcohol Use Disorders Identification Test. Only Time 2 packets contained the Posttraumatic Stress Disorder Checklist-Civilian. Cross-lagged analyses conducted by comparing nested structural equation models found that fixing the causal paths to zero from Time 1 experiences of discrimination to Time 2 alcohol problems and PTSD resulted in a significantly worse fit of the data. However, fixing the paths to zero from Time 1 maladaptive alcohol use to Time 2 PTSD and experiences of discrimination resulted in no significant difference in model fit. Thus, this pattern of findings is consistent with an inference that Hispanic/Latino college students who experience racial/ethnic discrimination are at risk for developing symptoms of posttraumatic stress and increased maladaptive alcohol use; conversely, maladaptive alcohol use does not appear to be a risk factor for later experiences of discrimination or PTSD symptoms.

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A review was conducted of 14 studies published from 1995 to 2013 and 2 thus far unpublished studies that have used the Client Attachment to Therapist Scale (CATS) in research with help-seeking clients. Of these, meta-analyses were conducted for studies that examined the CATS subscales (Secure, Avoidant, Preoccupied) as correlates of client-rated working alliance, client pretherapy general adult attachment, or both (Total k = 13; k = 9 for each specific analysis). With regard to pretherapy adult attachment, CATS Secure was negatively associated with client Anxiety and Avoidance. For CATS Avoidant, clients' attachment avoidance and anxiety were positively associated. For CATS Preoccupied, client adult attachment Anxiety was significantly positively associated. CATS Secure was strongly positively correlated with total working alliance, CATS Avoidant was negatively correlated with total working alliance, and CATS Preoccupied was not significantly associated with working alliance. Implications for models of therapeutic change based on client gains in social competencies and capacity for secure attachment are discussed.

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OBJECTIVES: The Therapeutic Distance Scale (TDS) was developed in this project to assesse clients' experiences of distance versus engagement with their therapist. METHOD: In a survey study of 47 university clients at the "mid-stage" and 34 of these clients at termination, four TDS subscales were identified: Too Close, Too Distant, Growing Autonomy, and Growing Engagement. RESULTS: TDS subscales were correlated as expected with working alliance and Client Attachment to Therapist. As hypothesized, (i) pre-therapy attachment Avoidance was significantly correlated with perceptions of therapists as Too Close (but not Too Distant), (ii) pre-therapy Anxiety was significantly correlated with Too Distant (but not Too Close); furthermore, among clients who developed a secure attachment to their therapist, (iii) pretherapy Avoidance was significantly correlated with Growing Engagement; however, (iv) contrary to expectations, pre-therapy anxiety was not significantly associated with Growing Autonomy. CONCLUSIONS: The TDS is a promising measure for assessing the in-therapy corrective emotional experiences of clients with hyperactivating attachment (i.e. increasing autonomy) and deactivating attachment (i.e. increasing engagement).

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A barrier to assessing effectiveness of multicultural programming is lack of a relatively brief instrument to measure the wide range of intended outcomes. A frequent goal of programming is to increase cultural empathy, but this is rarely the only intended outcome. We conducted focus groups of campus administrators, student affairs staff, and undergraduate instructors who identified a full range of racial/ethnic multicultural competencies that undergraduates should possess. An 84-item pool generated from these focus groups was combined with the 31-item Scale of Ethnocultural Empathy (SEE; Wang et al., 2003). These 115 items, together with instruments used to gauge concurrent validity, were administered to White undergraduate students in introductory psychology courses at the midpoint (n = 602) and end (n = 676) of fall semester. Exploratory factor analysis suggested 6 subscales for the Everyday Multicultural Competencies/Revised SEE (EMC/RSEE): (a) Cultural Openness and Desire to Learn; (b) Resentment and Cultural Dominance; (c) Anxiety and Lack of Multicultural Self-Efficacy; (d) Empathic Perspective-Taking; (e) Awareness of Contemporary Racism and Privilege; and (f) Empathic Feeling and Acting as an Ally. Item response theory principles guided final selection of subscale items. Analyses suggested good factor stability, reliability, and discriminant validity of the 48-item EMC/RSEE in these undergraduate samples. EMC/RSEE subscales were not strongly correlated with a measure of impression management and were significantly associated with measures of Openness to Diversity Challenge, and Universal-Diverse Orientation.

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This study examined a threshold model that proposes that social support exhibits a curvilinear association with adjustment and distress, such that support in excess of a critical threshold level has decreasing incremental benefits. Women diagnosed with a first occurrence of breast cancer (N = 154) completed survey measures of perceived support (Social Provisions Scale), quality of life (Functional Living Index--Cancer), adjustment (Psychological Adjustment to Illness Scale) and psychological distress (Brief Symptom Inventory) approximately 3 weeks after surgical treatment and 8-16 months later. Consistent with a threshold model, multiple regression analyses suggested a significant curvilinear relationship between social support and distress at Time 1 and Time 2 and between social support and adjustment at Time 2. Consistent with this model, the significant bivariate correlations between social support and outcomes were accounted for almost entirely by women in the lowest quartile of support. Social support among women in the highest 3 quartiles was unrelated or only marginally related to adjustment and distress.

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Archival data (N = 1,048 women, 1,136 men) from a mental health survey of college students were used to investigate incidence of nonsuicidal self-injury (NSSI), including cutting. Significant levels (defined as 4-5 lifetime incidents) were found in 9.3% of women and 5.3% of men. The Counseling Center Assessment for Psychological Symptoms (a global symptom inventory) and an assessment of trauma had been field tested with this sample. We randomly partitioned half of these data into a holdout sample and used the remainder to develop an NSSI screening inventory that included (a) 5 women's screening items, including 1 item to assess trauma experienced; (b) 11 men's screening items; and (c) 12 items common to men and women, including depression, dissociation, anger, unwanted thoughts, nightmares or flashbacks, and having witnessed trauma. Logistic regression and receiver-operating characteristic curve analysis suggested the inventory significantly discriminated NSSI men and women in the holdout sample, p < .001. Cutoff scores were identified to correctly classify about 48% of the true positive male and female NSSI cases, with false positive rates of 13.2% and 8.4% for women and men, respectively.

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INTRODUCTION: Emotional care of the breast cancer patient is not well understood; this lack of understanding results in both a high cost to the patient, as well as the health care system. This study examined the role of problem-solving style as a predictor of emotional distress, adjustment to breast cancer, and physical function immediately post-surgery and 12 months later. METHODS: The sample consisted of 121 women diagnosed with breast cancer and undergoing surgery as a primary treatment. The survivors completed a measure of problem-solving style and three outcome measures immediately post-surgery, as well as at 1 year later. There was a 95.6% retention rate at 1 year. RESULTS: Multiple hierarchical regressions revealed, after controlling for patient demographics and stage of cancer, that problem-solving style (particularly personal control) was associated with emotional distress, adjustment to chronic illness, and physical function immediately following surgical intervention. In addition, a more positive problem-solving style was associated with less emotional distress, but not a better adaptation to a chronic illness or physical functioning 12 months later; the Personal Control again was the best single predictor of the emotional distress, adding 10% of the variance in predicting this outcome. CONCLUSIONS: The utility of post-surgery assessment may help identify those in need for problem-solving training to improve these outcomes at 1 year. Future studies need to determine the impact of interventions tailored to levels of problem-solving styles in cancer survivors over time. IMPLICATIONS FOR CANCER SURVIVORS: Understanding the role of problem solving style in breast cancer survivors deserves attention as it is associated with emotional distress immediately and one year after medical intervention. Problem-solving style should be evaluated early, and interventions established for those most at risk for emotional distress.

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This study examined 3 coping strategies (reflective, suppressive, and reactive), along with self-esteem, as moderators of the relation between perceived discrimination and depressive symptoms. International students (N = 354) from China, India, Korea, Taiwan, and Hong Kong provided data via an online survey. The role of perceived general stress was statistically controlled. Hierarchical regression analyses indicated a significant direct effect of perceived discrimination, a significant 2-way interaction of perceived discrimination and suppressive coping, and a significant 3-way interaction of perceived discrimination, reactive coping, and self-esteem in predicting depressive symptoms. An increased tendency to use suppressive coping appeared to strengthen the association between perceived discrimination and depressive symptoms. In contrast, the association between perceived discrimination and depressive symptoms was not significant when reactive coping was infrequently used, but only for students with relatively high self-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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We developed a 12-item, short form of the Experiences in Close Relationship Scale (ECR; Brennan, Clark, & Shaver, 1998) across 6 studies. In Study 1, we examined the reliability and factor structure of the measure. In Studies 2 and 3, we cross-validated the reliability, factor structure, and validity of the short form measure; whereas in Study 4, we examined test-retest reliability over a 1-month period. In Studies 5 and 6, we further assessed the reliability, factor structure, and validity of the short version of the ECR when administered as a stand-alone instrument. Confirmatory factor analyses indicated that 2 factors, labeled Anxiety and Avoidance, provided a good fit to the data after removing the influence of response sets. We found validity to be equivalent for the short and the original versions of the ECR across studies. Finally, the results were comparable when we embedded the short form within the original version of the ECR and when we administered it as a stand-alone measure.

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Asian American Pacific Island college students (N = 93) completed measures of acculturation and mental health worldview, in the form of beliefs about the likely causes of 24 typical counseling presenting problems. A criterion sample of 27 staff from 2 university counseling centers reported their beliefs about the most likely cause of the same 24 problems for a typical client. A response similarity index was calculated, with higher scores reflecting greater similarity between student and counselor mental health worldviews. Results suggest that higher acculturation was associated with greater level of match between the students' etiology beliefs and those of counselors. The greatest differences were observed for serious personal problems, whereas there was more belief convergence about causes of academic problems.

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