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    ABSTRACT: The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called “experts” in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.
    International Journal of Law and Psychiatry 01/2014; · 1.19 Impact Factor
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    N. Kostogianni, A. Andronikof
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    ABSTRACT: Background According to empirical literature, low self-esteem is highly correlated to behavioural and emotional problems in gifted children and adolescents. Since self-esteem is an indicator of social and emotional adjustment, it would be interesting to better understand the meaning of this construct, as it is evaluated explicitly with the use of self-report questionnaires. In order to explore the psychological processes underlying the explicit self-esteem, we studied the relation of a self-report questionnaire and an indirect measure of self and interpersonal perception using the Rorschach Comprehensive System (CS). Method The participants were 93 children, aged between 9 and 15 years old, with an IQ ≥ 130. They were attending regular classes (no curriculum difference). Self-esteem was evaluated using the Coopersmith Self-Esteem Inventory (SEI). We used the Rorschach CS measures of self and interpersonal perception. Results The results showed no significant correlation between self-esteem and high IQ. A negative correlation between self-esteem evaluated on the SEI and the Rorschach Vista responses was found, which reflected self-critical introspection and painful self-appraisal. Then a positive correlation was observed between self-esteem and reflection answers on the Rorschach (Fr + rF > 0), which are related to narcissistic-like features of personality. We also found a positive correlation between self-esteem and the Rorschach egocentricity index (EGO), which provides an estimate of self-concern. Finally, the strongest correlation was found between self-esteem and the dominance of good over poor human representations (GHR > PHR), which reveals effective interpersonal behaviour. Discussion The psychological processes which seem to be related to low self-esteem in gifted children and adolescents are maladaptive interpersonal behaviours, painful experience of introspection focusing on perceived negative aspects of the self, absence of narcissistic-like features of the personality and low self-concern. These findings may suggest that intervention planning with gifted children and adolescents with low self-esteem should emphasize the accurate interpretation of interpersonal data, develop social skills and restructure negative self-thoughts.
    L'Encéphale. 01/2014; 40(1):3–8.
  • A. Andronikof, P. Fontan
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    ABSTRACT: Psychological assessment of children is a difficult task and is sometimes underestimated by clinicians who fear to be used as technicians rather than psychologists. The aim of this article is to show the relevance and beneficial aspects of a psychological assessment when performed in a scientific and ethical framework. Psychological assessment is viewed as a privileged encounter between a child presenting problems and an expert in child development, psychopathology and assessment. Distinct parts of assessment are described: preliminary interview with the parents and the child, choice of test battery, feedback. Feedback to the child and parents, often neglected because time-consuming, is a key element of assessing. It enables the child (and parents) to feel directly concerned and taken seriously, to understand the outcome of the procedure, to reflect on personal difficulties and assets, to find hope in future development. When the feedback is performed before the final report is written, it enables psychologists to adjust their interpretations, their language and their recommendations.
    Neuropsychiatrie de l Enfance et de l Adolescence 11/2013;
  • N Kostogianni, A Andronikof
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    ABSTRACT: BACKGROUND: According to empirical literature, low self-esteem is highly correlated to behavioural and emotional problems in gifted children and adolescents. Since self-esteem is an indicator of social and emotional adjustment, it would be interesting to better understand the meaning of this construct, as it is evaluated explicitly with the use of self-report questionnaires. In order to explore the psychological processes underlying the explicit self-esteem, we studied the relation of a self-report questionnaire and an indirect measure of self and interpersonal perception using the Rorschach Comprehensive System (CS). METHOD: The participants were 93 children, aged between 9 and 15 years old, with an IQ≥130. They were attending regular classes (no curriculum difference). Self-esteem was evaluated using the Coopersmith Self-Esteem Inventory (SEI). We used the Rorschach CS measures of self and interpersonal perception. RESULTS: The results showed no significant correlation between self-esteem and high IQ. A negative correlation between self-esteem evaluated on the SEI and the Rorschach Vista responses was found, which reflected self-critical introspection and painful self-appraisal. Then a positive correlation was observed between self-esteem and reflection answers on the Rorschach (Fr+rF>0), which are related to narcissistic-like features of personality. We also found a positive correlation between self-esteem and the Rorschach egocentricity index (EGO), which provides an estimate of self-concern. Finally, the strongest correlation was found between self-esteem and the dominance of good over poor human representations (GHR>PHR), which reveals effective interpersonal behaviour. DISCUSSION: The psychological processes which seem to be related to low self-esteem in gifted children and adolescents are maladaptive interpersonal behaviours, painful experience of introspection focusing on perceived negative aspects of the self, absence of narcissistic-like features of the personality and low self-concern. These findings may suggest that intervention planning with gifted children and adolescents with low self-esteem should emphasize the accurate interpretation of interpersonal data, develop social skills and restructure negative self-thoughts.
    L Encéphale 03/2013; · 0.49 Impact Factor
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    ABSTRACT: The author presents a descriptive study focused on the replenishment of a suicide attempt. Thirty-three suicide attempters have agreed to answer a semi-structured interview (interview IMSA) to reconstruct the sequence of events pre-suicide and mental condition of the subject at the time when he proceeded to act. The results show that 82% of them had behavioral preparatory gesture and 75.8% a real suicidal scenario. The data also suggest the existence of a transition phase before the act consisting in tonic disturbance and/or a conditioning state. At the time of the suicidal gesture, 59.4% of patients reported an altered state of consciousness and 60% experience a phenomenon of intense emotional confusion. The author also stresses unusual clinical manifestations at the subjective sensation of movement and the sudden loss of motor control.
    L'Évolution Psychiatrique. 09/2012; 77(3):352–372.
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    Anne Andronikof, Yifat Weinberger
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    ABSTRACT: The present study explores the human face responses in the Rorschach test. We suggest that, although the experience of the human face is essential to our psychological development and to our interaction with the world, this category of responses has always been considered as one of the partial human contents, together with responses such as an eye or a finger. The study provides background information about recent research findings concerning face perception and the role of face perception in early psychological development and suggests that Rorschach face responses may be better distinguished from other human detail contents and may have a special clinical significance. In order to explore face responses in the Rorschach, these responses were analyzed in a reference sample of nonpatients (n = 247) conducted in France as part of a of the French-language normative project. Descriptive data on face responses according to the Comprehensive System are provided as well as an analysis of their perceptual characteristics. In addition, a subgroup of nonpatients giving a relatively high number of face responses was found to differ from other nonpatients on several self and interpersonal perception variables. The perceptual features and the possible clinical significance of face responses on the Rorschach are discussed with an emphasis on the possible merit of distinguishing the face category from the other human content details. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    Rorschachiana Journal of the International Society for the Rorschach 01/2012; 33:23-48.
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    ABSTRACT: Résumé L'évaluation des troubles anxiodépressifs dans la population cancéreuse pose la question de la possible discor-dance entre le discours rapporté et l'éprouvé émotionnel. Les troubles anxiodépressifs ont été évalués chez 101 femmes atteintes d'un cancer du sein avec l'HADS et le Rorschach-SI. Cette étude propose une réflexion dans le sens d'une évaluation plus approfondie de la détresse psychologique en prenant aussi en considération les processus inconscients par-ticipant à l'élaboration du discours. Cette double approche (analyse des processus de restitution verbale en lien avec les processus cognitifs, émotionnels et conatifs inconscients éva-lués par une méthode projective) s'appuie sur deux points de vue épistémologiques différents, qui sans s'opposer peuvent devenir complémentaires. Pour citer cette revue : Psycho-Oncol. 5 (2011). Mots clés Cancer du sein · Anxiété · Dépression · Autoévaluation · Processus inconscients Abstract The assessment of anxiety-depressive disorders in cancer population raises the question of the possible discor-dance between the reported speech and felt emotional. Anxiety and depression were assessed in 101 women suffe-ring from breast cancer with the HADS and the Rorschach-SI. This study presents a reflection about evaluation of unconscious processes involved in the development of discourse, which elements should be included next to self-assessment scales in a complementary approach. To cite this journal: Psycho-Oncol. 5 (2011).
    Psycho-Oncology 12/2011; 5:219-226. · 3.51 Impact Factor
  • A. Andronikof
    Psychothérapies 06/2011; 59(4):255.
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    ABSTRACT: This study deals with the frequency with which expert psychiatrists and psychologists make structural or nosographic diagnoses within the context of expert assessment. Thus, the rates of concordance between psychiatrists and psychologists in both types of diagnoses will be assessed. To do so, the level of inter-observer agreement on diagnoses between 1990 and 2003 was studied retrospectively in France through psychiatric and psychological assessments of 505 male offenders. The assessment of the correlation rates was carried out using the Kappa coefficient. The results show a range of 0.55 to 0.71 in inter-observer (psychiatrists vs psychologists) agreement for structural diagnoses, and 0.51 to 0.89 for nosographic diagnoses. In addition, a marked correlation between psychiatrists and psychologists may be noted regarding abstention in both structural (k=66) and nosographic (k=73) diagnoses. In fact, recommendations are made for improvement in the consistency of offender assessment in the psycho-legal French context.
    International Journal of Law and Psychiatry 01/2011; 34(1):44-8. · 1.19 Impact Factor
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    ABSTRACT: Lydia Fernandez et collaborateurs traitent la question de la co-occurrence entre addictions et troubles psychiatriques, et particulièrement dépressifs qui conduit à porter chez des patients un « double diagnostic ». Le cas clinique de madame S. vient expliquer cette association.
    In L. Fernandez, Psychopathologie des addictions : 12 cas cliniques., Paris : In Press, concept psy. 09/2010: chapter Addictions et dépression : « le double diagnostic ».: pages 147-168.;
  • Anne Andronikof
    06/2010;
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    J Vandevoorde, A Andronikof, T Baudoin
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    ABSTRACT: Suicidal risk factors are nowadays well known. We often detect many of these risk factors in clinical situations, but their interaction and their writing in the suicidal sequence are still largely unrecognized. Building on narratives from suicidal patients, the authors propose a method for investigating the upstream components of suicide in an attempt to understand how the risk factors and the state of the person interact and converge on the suicidal action better. The interview is divided into the following four sections. (1)The patient is invited to mentally go back to the hours immediately preceding the suicide attempts and reconstruct the sequence of thoughts, feelings and doings of the day. Here, we explore the dynamic progression of his cognitions, emotions, actions and state of consciousness. We also note the social affective context of the suicidal act. (2) Proceeding backwards into the memory, the patient is invited to retrieve all foreshadowing elements, situating them on two axes: behavioural planning, that is, effective or contemplated actions in relation to suicide (stocking drugs, seeking information about substance toxicity, weapon training, etc.). (3) The second axis focuses on the phenomenology of the suicidal ideation, that is, intensity, frequency, proximity/availability of suicidal ideation, etc. These are assessed by means of an analogical rule. Finally, the current attempt is situated in the context of the suicidal history of the patient: previous attempts, severity, operative mode, etc. Our clinical experience using this semi-structured interview has shown that the method gives an insight into the unique combination of factors leading to the suicidal act in a given person and permits to understand and foresee relapses better. A new model of suicide is emerging from our data, suggesting the importance of the preparatory phase, which combines a progressive non-conscious learning of the gestures to accomplish, rumination of suicidal ideations and alteration of consciousness and the sense of self. The method is illustrated through an example. The necessity to further test this interview method is called for.
    L Encéphale 06/2010; 36 Suppl 2:D22-31. · 0.49 Impact Factor
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    J. Vandevoorde, A. Andronikof, T. Baudoin
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    ABSTRACT: Suicidal risk factors are nowadays well known. We often detect many of these risk factors in clinical situations, but their interaction and their writing in the suicidal sequence are still largely unrecognized. Building on narratives from suicidal patients, the authors propose a method for investigating the upstream components of suicide in an attempt to understand how the risk factors and the state of the person interact and converge on the suicidal action better. The interview is divided into the following four sections. (1)The patient is invited to mentally go back to the hours immediately preceding the suicide attempts and reconstruct the sequence of thoughts, feelings and doings of the day. Here, we explore the dynamic progression of his cognitions, emotions, actions and state of consciousness. We also note the social affective context of the suicidal act. (2) Proceeding backwards into the memory, the patient is invited to retrieve all foreshadowing elements, situating them on two axes: behavioural planning, that is, effective or contemplated actions in relation to suicide (stocking drugs, seeking information about substance toxicity, weapon training, etc.). (3) The second axis focuses on the phenomenology of the suicidal ideation, that is, intensity, frequency, proximity/availability of suicidal ideation, etc. These are assessed by means of an analogical rule. Finally, the current attempt is situated in the context of the suicidal history of the patient: previous attempts, severity, operative mode, etc. Our clinical experience using this semi-structured interview has shown that the method gives an insight into the unique combination of factors leading to the suicidal act in a given person and permits to understand and foresee relapses better. A new model of suicide is emerging from our data, suggesting the importance of the preparatory phase, which combines a progressive non-conscious learning of the gestures to accomplish, rumination of suicidal ideations and alteration of consciousness and the sense of self. The method is illustrated through an example. The necessity to further test this interview method is called for.
    Encephale-revue De Psychiatrie Clinique Biologique Et Therapeutique - ENCEPHALE. 01/2010; 36.
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    N Kostogianni, A Andronikof
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    ABSTRACT: There is an ongoing debate of how giftedness affects social-emotional adjustment. Self-esteem may be an indicator of social-emotional adjustment but insufficient in its explanatory capacity, especially high self-esteem which tends to produce opposite responses in regards to adjustment. A distinction between defensive and genuine high self-esteem could account for these results. In order to understand how self-esteem operates on social-emotional adjustment, it should be associated with other measurements relating to self-concern. In the Rorschach comprehensive system (CS), egocentricity index measures self-centeredness, which can be defined as the balance between self-concern and concern for others. High self-concern is associated with a neglect of the others. Operationalized here, as the interaction of high self-esteem and excessive self-concern, defensive high self-esteem should predict maladaptive outcomes. Participants were aged from 9 to 15 years old, with an IQ greater or equal to 130 on the WISC-III. They were attending regular classes and were not in counseling or psychotherapy. Children and adolescents were administrated the Rorschach CS and the Coopersmith self-esteem inventory. Parents completed the child behaviour checklist (CBCL) which assesses general psychopathology. Seventy-eight subjects' data satisfy the conditions of validity of the instruments used. Gifted boys present more behavior and emotional problems than gifted girls in this study. Self-esteem predicts social-emotional adjustment. There is an interaction between self-esteem and self-concern on psychopathology only for high values of self-esteem. Gifted with high self-esteem associated with high self-concern are more vulnerable to maladjustment than high self-esteem associated with low self-concern. Gifted children and adolescents with low self-esteem experience more problems anyhow. These findings reinforce the view that the gifted are a diverse group in terms of social-emotional adjustment and self-esteem. Self-esteem operates as a valuable resource for the social-emotional adjustment of gifted children and adolescents but only under some conditions. Low self-esteem gifted seem to be at more risk of maladjustment, but that does not mean any causal relationship. Gifted children and adolescents with high self-esteem can be considered as a heterogeneous category. High self-esteem associated to excessive self-concern has less beneficial effects on adjustment than high self-esteem associated to low self-concern.
    L Encéphale 10/2009; 35(5):417-22. · 0.49 Impact Factor
  • N. Kostogianni, A. Andronikof
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    ABSTRACT: Background There is an ongoing debate of how giftedness affects social-emotional adjustment. Self-esteem may be an indicator of social-emotional adjustment but insufficient in its explanatory capacity, especially high self-esteem which tends to produce opposite responses in regards to adjustment. A distinction between defensive and genuine high self-esteem could account for these results. In order to understand how self-esteem operates on social-emotional adjustment, it should be associated with other measurements relating to self-concern. In the Rorschach comprehensive system (CS), egocentricity index measures self-centeredness, which can be defined as the balance between self-concern and concern for others. High self-concern is associated with a neglect of the others. Operationalized here, as the interaction of high self-esteem and excessive self-concern, defensive high self-esteem should predict maladaptive outcomes. Method Participants were aged from 9 to 15 years old, with an IQ greater or equal to 130 on the WISC-III. They were attending regular classes and were not in counseling or psychotherapy. Children and adolescents were administrated the Rorschach CS and the Coopersmith self-esteem inventory. Parents completed the child behaviour checklist (CBCL) which assesses general psychopathology. Results Seventy-eight subjects’ data satisfy the conditions of validity of the instruments used. Gifted boys present more behavior and emotional problems than gifted girls in this study. Self-esteem predicts social-emotional adjustment. There is an interaction between self-esteem and self-concern on psychopathology only for high values of self-esteem. Gifted with high self-esteem associated with high self-concern are more vulnerable to maladjustment than high self-esteem associated with low self-concern. Gifted children and adolescents with low self-esteem experience more problems anyhow. Conclusion These findings reinforce the view that the gifted are a diverse group in terms of social-emotional adjustment and self-esteem. Self-esteem operates as a valuable resource for the social-emotional adjustment of gifted children and adolescents but only under some conditions. Low self-esteem gifted seem to be at more risk of maladjustment, but that does not mean any causal relationship. Gifted children and adolescents with high self-esteem can be considered as a heterogeneous category. High self-esteem associated to excessive self-concern has less beneficial effects on adjustment than high self-esteem associated to low self-concern.
    Encephale-revue De Psychiatrie Clinique Biologique Et Therapeutique - ENCEPHALE. 01/2009; 35(5):417-422.
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    ABSTRACT: Our focus is to study how frequently psychologists and psychiatrists make diagnoses in forensic reports, whether structural or nosographic, in relation to judicial expertise. Our goal is thus to assess the conformability ratio between psychologists and psychiatrists for both diagnoses. To do so, we studied the level of inter-observer agreement for the diagnoses of 505 male criminals made in France by expert psychologists and psychiatrists between 1990 and 2003. The measurement of agreement was done with the Kappa coefficient. The inter-observer agreement (psychiatrics versus psychologists) shows a 0.55 to 0.71 variation for the structural diagnoses and 0.51 to 0.89 for the nosographic diagnoses.Furthermore, the results also show a high level of agreement between the psychiatrists and psychologists for not making diagnoses, whether structural (k=0.66) or nosographic (k=0.73). Hence, we provide specific advice to improve the consistency of expert diagnoses for criminals in France.
    European Review of Applied Psychology-revue Europeenne De Psychologie Appliquee - EUR REV APPL PSYCHOL. 01/2009; 59(1):9-15.
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    N. Kostogianni, A. Daoudi, A. Andronikof
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    ABSTRACT: We study the relationship between intellectual profile (even versus uneven profile in favor of verbal abilities), emotional/behavioral problems, self-perception and interpersonal perception in gifted children and adolescents.
    Neuropsychiatrie De L'enfance Et De L'adolescence. 01/2009; 57(5):379-384.
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    Anne Andronikof
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    ABSTRACT: Based on an analysis of John Exner’s peer-reviewed published work from 1959 to 2007, plus a brief comment for an editorial in Rorschachiana, the author draws a comprehensive picture of the scientific work of this outstanding personality. The article is divided into three sections: (1) the experimental studies on the Rorschach, (2) the clinical studies using the Rorschach, and (3) Exner’s "testament," which we draw from the last paper he saw published before his death (Exner, 2001/2002). The experimental studies were aimed at better understanding the nature of the test, in particular the respective roles of perception and projection in the response process. These fundamental studies led to a deeper understanding of the complex mechanisms involved in the Rorschach responses and introduced some hypotheses about the intentions of the author of the test. The latter were subsequently confirmed by the preparatory sketches and documents of Hermann Rorschach, which today can be seen at the H. Rorschach Archives and Museum in Bern (Switzerland). Exner’s research has evidenced the notion that the Rorschach is a perceptive-cognitive-projective test.
    Rorschachiana Journal of the International Society for the Rorschach 01/2008; 29(2):81-107.
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    N. Combalbert, A. Lemghairbat, A. Andronikof
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    ABSTRACT: In France, youth delinquency usually is studied from the point of view of socio-demographical characteristics, in terms of risk factors, which are not of an explanatory nature. In this study we explore the perception of cultural affiliation, identity and parental education by first generation adolescents of North African immigration, following the intercultural models developed by Berry (1989) and Franchi (1999). We compare these perceptions in two groups of first generation adolescents with the same sociocultural background and suburbian environment: 30 delinquents and 30 non delinquents. Results indicate that cultural attitudes differ significantly in the two groups: non delinquents are bi-culturally oriented (integration), attached to their family culture (separation) and define their identity as being both North African and French. In contrast, delinquent adolescents favour the French culture (assimilation) but define themselves as foreigners and North Africans. This internal dissonance could be at the root of an intrapsychic conflict and contribute to producing maladjusted behaviours. Important differences also are shown in the perceptions by the adolescents of parental education.
    Neuropsychiatrie De L'enfance Et De L'adolescence. 01/2007; 55(1):10-16.
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    ABSTRACT: The objective of this study was to provide new primary data on Rorschach Comprehensive System stability levels. To achieve this, we tested 75 French nonpatient adults twice on the Rorschach with a 3-month interval between the tests. Interrater reliability was in the excellent range for most of the variables studied. The overall stability level in a selected set of previously studied variables was below expectations (median r = .53). Personality, cognitive or self/relational variables yielded higher test-retest correlations than emotional and coping variables. Moderators of stability could be identified: (a) overall level of Task Engagement (TE) in F, m, FM + m, a, FC, Sum C', Sum V, Sum Shd, Fr + rF, INC + FAB, COP, es, Adj es, EGO, and Blends; (b) variations in TE in F, FM, and p; (c) state distress in Zd, m, FM + m, a, C, CF + C, WSumC, FD, and es; (d) variables derived from the number of responses impacted stability in P, Zf, m, FC, CF + C, Sum C', Sum V, MOR, EA, es, and Blends. These results provide further support for the reliability of several measures. Examiner effects as an influence on productivity and TE were identified as an important area for future research.
    Journal of Personality Assessment 01/2007; 87(3):330-48. · 1.29 Impact Factor

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