Detecting the Unidentified Victims: Recognized Versus Unrecognized Child Sexual Abuse Sarah DeGue1, John Clemmons1, David DiLillo1, and Issac Martinez2 University of Nebraska-Lincoln1 Family Violence and Injury Lab Our Lady of the Lake University2

1

An Exploratory Analysis of Functioning Across
Biosystemic Levels of Organization in Inpatients
and Outpatients with Serious Mental
Illness Elizabeth A. Cook, Charlie A. Davidson,
Hayden C. Bottoms, Petra Kleinlein, Ashley Wynne,
Melissa Tarasenko, Felice Reddy, Jeffrey Nolting,
Kee-Hong Choi, William D. Spaulding University of
Nebraska-Lincoln
Introduction

• The biosystemic paradigm of psychopathology
  asserts that humans consist of a network of
  interrelated processes and mechanisms which are
  organized according to the following levels
  neurophysiological, neurocognitive,
  sociocognitive, sociobehavioral, and
  socioenvironmental (Spaulding, Sullivan,
  Poland, 2003). These concepts are especially
  relevant to people with serious mental illness
  (SMI) because many people within this population
  experience deficits in these areas. Furthermore,
  given the heterogeneity of individuals with SMI,
  these concepts are important to consider when
  implementing individualized assessment and
  treatment.
• Although there is a vast body of research
  examining relationships between various levels of
  organization in those with SMI, these
  relationships remain unclear. The primary purpose
  of this study is to assess relationships between
  neurocognition, locus of control and theory of
  mind (sociocognitive functioning), and social
  competence (sociobehavioral functioning) to
  address this issue.
• Few studies have investigated differences in
  functioning across biosystemic levels between
  inpatient and outpatient groups. Some research
  has provided evidence that there are distinct
  differences between these groups (Midorikawa et
  al., 2008 Tarasenko, 2010 Nakanishi et al.,
  2007). Thus, a secondary aim of this study is to
  compare relationships between different levels of
  biosystemic organization in inpatients and
  outpatients.
• It was hypothesized that 1) higher levels of
  external locus of control would be associated
  with poorer neurocognitive functioning while
  internal locus of control would not be
  significantly related to neurocognitive
  functioning, 2) theory of mind would be
  positively associated with neurocognition, 3)
  neurocognitive and social cognitive variables
  (with the exception of external locus of control)
  would be positively related to social competence,
  4) neurocognition, locus of control, theory of
  mind, and social competence would constitute
  separate, but related, domains, and 5) inpatients
  and outpatients would not differ regarding
  relationships between functional domains.

p lt 0.05 p lt 0.01
p lt 0.05 p lt 0.01
Attention, Language, Immediate Memory, Delayed
Memory, and Visuo-Construction are RBANS indexes
ILSIIN ILSI Interpersonal Skills Internality
I-SEE Internal Locus of Control Externality
I-SEE External Locus of Control
S-ATT NAB Attention S-LAN NAB Language
S-MEM NAB Memory S-SPT NAB Spatial Ability
S-EXE NAB Executive Functions Socialtotal
MCAS Social Competence Internality I-SEE
Internal Locus of Control Externality I-SEE
External Locus of Control
Discussion

• This study provides empirical support for
  relationships among processes that comprise the
  biosystemic paradigm.
• In partial support of the first hypothesis, a
  higher level of external locus of control was
  associated with poorer functioning within most
  neurocognitive domains in outpatients only.
  Internal locus of control was not significantly
  related to neurocognitive functioning in
  outpatients, but was related to memory in
  inpatients.
• As hypothesized, theory of mind was positively
  associated with neurocognition in both groups. In
  outpatients, Hinting Task scores loaded on the
  neurocognition factor, suggesting a strong
  relationship between theory of mind and
  neurocognition.
• In partial support of the third hypothesis,
  attention, memory, theory of mind, and external
  locus of control were significantly associated
  with social competence in inpatients however, in
  outpatients, only neurocognitive variables were
  significantly related to social competence.
• Contrary to the fourth hypothesis,
  neurocognition, locus of control, theory of mind,
  and social competence did not always constitute
  separate latent constructs. Factor analyses
  revealed that these constructs were highly
  interrelated such that only social competence
  remained a separate latent construct between
  groups.
• Results from this study imply that inpatient and
  outpatient SMI groups may have unique treatment
  needs and characteristics. For example, in more
  acutely ill SMI groups, cognitive remediation
  targeting memory enhancement may help to improve
  ones sense of control over life events. In
  higher functioning SMI groups dwelling in the
  community, cognitive remediation within the
  broader domain of neurocognition may also promote
  improvement in social cognitive functioning,
  particularly within the domain of theory of mind.
  
• Because different assessments of neurocognition
  and social competence were used in the inpatient
  and outpatient groups in this study, future
  research should seek to replicate these findings
  using a uniform battery of assessments.

Methods

• Measures Inpatients completed the Repeatable
  Battery for the Assessment of Neuropsychological
  Status (RBANS Randolph, 1998) and outpatients
  completed the Neuropsychological Assessment
  Battery Screening Module (S-NAB Stern White,
  2003). Both groups were administered the
  Inventory for the Measurement of Self-Efficacy
  and Externality (I-SEE Krampen, 1991) and the
  Hinting Task (Corcoran, Mercer, Frith, 1995).
  Program staff completed the Independent Living
  Skills Inventory (ILSI Sanchez, 1986) for
  inpatients, and the Multnomah Community Ability
  Scale (MCAS Barker, Barron, McFarland,
  Bigelow, 1994) for outpatients. Two scales from
  these instruments (ILSI Interpersonal Skills and
  MCAS Social Competence) were used to measure
  social competence. Data were coded such that
  higher scores on each assessment were better.
• Data Analysis Pearsons correlations and
  confirmatory factor analyses were performed
  within each group. Robust maximum likelihood was
  used as the fitting function.

Visit the Severe Mental Illness Research Group
website at the University of Nebraska-Lincoln
http//www.unl.edu/dsc

• Note. All values are standardized coefficients.
• ?230.93, CFI .95, TLI .95, AIC 5776.63,
  BIC 5878.72, RMSEA .04, SRMR .09

• Note. All values are standardized coefficients.
• ?232.51, CFI .98, TLI .96, AIC 10421.87,
  BIC 10514.87, RMSEA .05, SRMR .05