Outcome comparison of patients receiving oral or depot neuroleptic medication

Three outcome measures of psychiatric treatment were retrospectively compared between two groups of acutely hospitalized psychotic patients who had been prescribed either oral haloperidol (n = 58) or depot haloperidol (n = 95) as the only medication at the time of discharge. There were no significant differences between the groups on demographic variables, including sex, age, and ethnicity. There were no significant differences between the groups on keeping the initial outpatient appointment, in readmission history over a 4-yr. follow-up, or in length of time to subsequent readmission, if any. It appears that there is no benefit in choosing one form of medication over the other from a clinical perspective, as neither appears more clinically efficacious when examined on these outcome variables. However, there is a significant difference in cost of the two forms of the medication in favor of the oral form, making the oral form more favorable if cost is to be minimized.

Dementia and mental retardation markers on the Rey 15-item Visual Memory Test

This study examined the qualitative errors of repetitions and confabulations on the Rey 15-item Visual Memory Test among 500 psychiatric patients who were divided into groups with (1) low IQ scores, (2) a diagnosis of dementia, and (3) other psychiatric diagnoses. These groups were compared on the presence of confabulated figures and repetitions on the Rey. The low IQ patients had the highest rate for both confabulations (48.2%) and repetitions (43.6%). Demented patients had the next highest rate of confabulations (39.8%) and repetitions (39.8%). The general psychiatric patients had the lowest rates on confabulations (16.2%) and repetitions (26.8%). Chi squared analysis showed that both confabulations and repetitions significantly differentiated these patients of low IQ and demented patients from general psychiatric patients. These results suggest that clinicians who use the Rey 15-item Visual Memory Test and find either confabulated or repeated figures should further explore the possibility that the patient might have low intellectual functioning or dementia.

An outcome survey of psychology residency training program graduates of the University of Texas Houston Medical School

A survey of 71 graduates of the psychology residency program at The University of Texas Houston Medical School and the Texas Research Institute of Mental Science indicated that two-thirds of the respondents were involved in private practice, conducting primarily individual therapy, with assessment also playing a major role in their practice. Managed care had the effect of placing limits on the numbers of sessions available to patients, reducing income, and increasing paperwork associated with practice. Implications for training during residency are that individual therapy, using focused short-term approaches, and assessment should continue to be the primary clinical experiences for trainees, and that there should also be training in the business aspect of practice, including marketing.

Note on concurrent validation of the personality assessment inventory in law enforcement

This study compared the Personality Assessment Inventory and MMPI-168 profiles of 9 law enforcement applicants with published MMPI profiles to provide concurrent validation for the use of the Personality Assessment Inventory to assess personality pathology of peace officer applicants. The sample showed subclinical elevations of the Positive Impression and Treatment Rejection scales on the Personality Assessment Inventory and subclinical elevations on the MMPI validity scales of Lie and Correction and the clinical scales of Psychopathic Deviate and Hypomania. The applicants' mean MMPI profile provided concurrent validation for the use of the Personality Assessment Inventory in this decision on fitness to serve.

Comparison of the Shipley Institute of Living Scale and WAIS-R IO scores for a sample of public sector psychiatric inpatients

This study examined the use of the Shipley Institute of Living Scale as a screening device in an intellectually low functioning psychiatric population of 40 inpatients. Shipley IQ scores were significantly correlated .72 with Full Scale WAIS-R IQ scores. There was no significant difference between the mean IQ scores generated from the two measures. These findings suggest that the Shipley scale may be used in this population despite a caution by the test's publisher that the test should not be used in assessing intellectual functioning in individuals with borderline or lower intelligence.

WAIS-R profile variability of psychiatric inpatients

This study examined the variability of WAIS-R profiles using the subtest range and profile variance in a large sample ( N = 1,684) of psychiatric inpatients.

Trail Making Test norms for psychiatric patients

The Trail Making Test was administered to a sample of 661 inpatients in a publicly supported psychiatric hospital. The patients' mean IQ of 83.7 (SD = 13.0) was in the low end of the low average range. Multiple regression analysis of the scores showed significant IQ and age components of Trail Making Test scores; however, education and gender differences in performance were not significant once IQ and age were factored into the regression equation. Ability-based norms using time in seconds to completion as the score and IQ as a moderator variable are presented. Such norms allow more appropriate evaluation of the differential cognitive functioning of this population than previously published norms. Normal standard score conversions from raw scores, the intercept, regression weights for IQ and age, and standard error of the regression for both the Trails tasks are provided for individuals desiring to write a program to provide scores corrected for IQ and age.

Psychiatric norms for the Rey 15-item Visual Memory Test

The 15-item Visual Memory Test was proposed by Rey in 1964 as a measure of malingering of visual memory. Among psychiatric patients the task has a significant cognitive component, with IQ accounting for 37% of the variance in scores (r = .60). Any interpretation of scores on this task should be ability-based. Such ability-based norms are provided in this study of psychiatric patients (N = 300). Use of a single cut-off score to indicate malingering or any other interpretation is inappropriate given the psychometric properties of the task. In the assessment of immediate visual memory the task has some utility, which is greatly enhanced with the use of ability-based norms.

Students' knowledge of AIDS and sexual risk behavior

College students appear to be knowledgeable of the methods of transmission and risks of the AIDS virus. However, the reality of susceptibility to infection does not seem to have altered their conduct. In a study of 19 heterosexual college students, knowledge and intention do not appear to be good predictors of sexual behavior. Young people appear to continue high-risk sexual behavior even while knowledgeable of the risks of AIDS.

Self-efficacy among hospitalized mentally ill patients

General self-efficacy and social self-efficacy were measured in a psychiatric inpatient population of 105 and compared with Sherer's 477 college students. Patients have lower self-efficacy than college students. A small but significant correlation of .38 was noted between general self-efficacy and social self-efficacy. Age was related to general self-efficacy but not social self-efficacy in this population.

Methadone patients' opinions on legalization of drugs

Clear differences in the attitudes of 1,226 adults in a Gallup survey and 130 patients in 4 methadone treatment programs were observed. Patients were more permissive on legalization of use of and education about drugs than the adult sample.

Some comments on the Peschels' model of biologically-based brain disease

The model of treatment of mental disorders described by Peschel and Peschel (1990) raises the problem of medical patriarchy. The model does not consider the marked impact of cognition, volition, and affect on the physical realm. While a model of treatment based on a psychological matriarchy is no better, a model of training in health promotion with an appropriate balance of the physical, mental, and spiritual aspects of life gives more hope of training professionals who can see the larger picture of their patients' lives and a better record of success than presently exists.

The role of Addington v Texas on involuntary civil commitment

The United States Supreme Court in 1979 set the standard for involuntary commitment. This decision, styled Addington v Texas, raised the burden of proof required to commit persons from the usual civil burden of proof of "preponderance of the evidence" to "clear and convincing" evidence. There was no reduction in the rates of commitment as a result of the decision. The proportion of patients committed in Texas grew in almost linear fashion during the years 1972-1986. Various economic, sociological, and treatment factors may have more influence on commitment of patients than does a court decision.

Self-esteem and stress as factors in abuse of children

A comparison of stress and self-esteem as made between a group of 23 couples in treatment who had abused their children and 23 control couples who were matched for age, race, sex, education, and occupation. Stress was measured by the Recent Life Changes Questionnaire. Self-esteem was measured by a synthesis of 38 items selected by mental health professionals from the Clarke Parent/Child Relations Questionnaire and the Self-description and Mate Description Form. Analysis of variance showed that couples who had abused their children had significantly greater stress than control couples. However, there was no significant difference between the groups on the measure of self-esteem. There was also no interaction effect of stress with self-esteem on abuse. While it seems well established that stress is a major contributor in child abuse, the interaction of stress with personality factors of parents who abuse their children remains uncertain.

The modulation of oxygen toxicity by intermittent exposure

Intermittent delivery of hyperbaric O2 protects animals from pulmonary and central nervous system toxicity: more total O2 time can be tolerated if interrupted by short periods of low O2. Little is known about the mechanisms or optimization of systematically varied intermittency. Survival time was recorded in groups of 16 awake guinea pigs (239 +/- 23(SD) g) exposed to continuous O2 at 2.8 ATA or to one of six different schedules of O2 delivered with periodic air (PO2 = 0.588 ATA) interruptions. The survival curves had a lag time (11-14 hr of O2 time depending on the intermittency schedule) with a rapid loss of animals thereafter. Data were analyzed with risk models linking the probability of death to the accumulation of a putative toxic substance, X1. A model in which X1 accumulated in proportion to the PO2 and disappeared by first-order decay during periods of low O2 exposure was modified to include an effective rate constant for changes in X1: dX1/dt = a.PO2 + K1.(PO2 - Os).X1. First-order kinetics operated when PO2 was below the oxygen set point (Os), but the rate constant reversed sign to become a self-amplifying system when PO2 was above Os. This model achieved an excellent fit as judged by goodness-of-fit statistics while a simpler one did not. Our analysis suggests that the accumulation of toxicity does not correspond to a stable linear toxic process, but requires one in which a toxic process grows autocatalytically.

Ethics of prediction of future dangerousness

23 psychologists were questioned about their belief in the accuracy of predictions of dangerousness and the ethics of such predictions based on hypothetical questions. Psychologists apparently believe predictions can be made but do not believe that such predictions can be made on limited facts. Predictions made on limited facts presented as hypothetical questions were seen as unethical.

Personality characteristics and employability of mentally retarded adults

Work adjustment and personality factors were measured on 27 mentally retarded adults living in a halfway house. Successful employment ( n = 21) was related to conscientiousness, assertiveness, self-sufficiency, and imaginativeness as personality variables and die attitudinal variables of cooperativeness, punctuality, completing work on time, attendance, and quality of work. It appears that both personality and attitudinal variables have a major impact upon the successful employment of retarded persons. These factors may be quite independent of specific job skills.

Sexual contact between psychotherapist and patient: legal remedies

This article examined the extent of sexual contact between psychotherapist and patient, the nature of the remedies available for a patient who has been damaged by such an experience, the defenses available for the therapist, specific case examples, and predictions about the future course the remedies for this activity are likely to take. There are not presently any reported appellate level civil cases with allegations of sexual improprieties by a psychologist. The major activity in sanctioning this type of behavior appears to be among licensing boards in hearing complaints. It appears from the data examined that licensing boards are the quickest and most effective mechanisms for dealing with this problem.

Comparison of WISC-R and Culture Fair Intelligence Test scores for three ethnic groups of juvenile delinquents

Culture Fair and WISC-R scores were obtained from 116 juvenile delinquents in three ethnic groups. There were significant differences among the three ethnic groups (41 whites, 46 blacks, 30 Mexican-Americans) for the WISC-R Full Scale, Verbal, Performance, and Culture Fair IQ scores. Pearson correlations between WISC-R scores and the Culture Fair scores for the combined groups were generally significant ranging from .58 to .64. The Culture Fair provides a rapid screening device for intellectual ability which more nearly equates the IQs of the three ethnic groups. For a complete assessment of intellectual capacity with ethnic minorities both the Culture Fair and WISC-R should be used.

Comparative study of delinquent and non-delinquent Mexican-American youths

Delinquent and non-delinquent Mexican-American youths were compared on factors which correlate with juvenile delinquency including self-concept, perception of family environment, attitude toward school, and level of aspiration. Mexican-American males (30 delinquents and 30 non-delinquents) were matched on age and socio-economic status, and the Piers-Harris Self-concept Scale, the Family Environment Scale, and the School Attitude Scale were administered. The aspired and expected level of educational and occupational status was measured by direct questions. Non-delinquent Mexican-Americans scored higher on self-concept, school attitude, and level of aspiration than delinquents. There was no significant difference between groups on the perception of family environment. These results support research conducted on other ethnic groups. Cultural and social-class biases must be considered in evaluating the self-concepts of minority delinquent youth.

Job satisfaction and perceived congruence of attitude between workers and supervisors in a mental health setting

The Community Mental Health Ideology Scale and Minnesota Satisfaction Questionnaire were administered to the staff of an outpatient treatment facility. Perceived congruence of attitude and job satisfaction including working conditions, pay, agency policy, and other variables were examined. Congruence of attitude between worker and supervisor was positively related to satisfaction with supervisor and agency policy. There were differences among the various disciplinary groups with those workers who had the least education tending to be satisfied in more spheres than those with more education or advanced professional degrees.

Intellectual characteristics of juvenile murderers versus status offenders

WISC data were obtained from 25 juvenile murderers and 39 juvenile status offenders. The intellectual pattern of the juveniles was similar to that of their adult counterparts. The over-all scores of the murderers were significantly lower than for status offenders. For both murderers and status offenders the verbal scores were lower than performance scores.

Comparison of the WISC-R and culture fair intelligence test in a juvenile delinquent population

Culture Fair and WISC-R scores were obtained of 51 delinquent juveniles. Comparison of mean scores on the two tests for minority and white juveniles demonstrated the Culture Fair to be less culturally biased than the WISC-R. On analysis of variance there was a significant difference due to ethnicity and test used, and a significant interaction of those two factors. The interaction was due to the elevation of the score of minority juveniles on the Culture Fair compared with WISC-R scores. Correlations between the WISC-R scores, subtest scale scores, and Culture Fair scores were significant at the .01 level which provides further validation of the WISC-R.

Three methods of peer review in a state mental hospital system

Three methods of peer review were examined in three public mental hospitals. A multidisciplinary committee developed admissions criteria and standards of care which were applied in each hospital. The three methods of review did not show significant differences in judgments based on the clinical records of patients or cost. The recommended model of review is the use of hospital staff providing primary review and consultants providing periodic external review necessary for quality assurance, development of the local review model, and assistance in implementing any changes required as a result of the review process. The system should form a complete feedback loop between service providers, the review committee, and facility administration with the aim of improved patient care through staff education. Psychologists, in addition to their clinical skills, brought to the review process the knowledge of psychological assessment and research skills. The research skills are necessary if the review process is to be systematic and the conclusions drawn from the process are valid. Psychologists should actively pursue involvement in the review process so that psychology will not simply be an adjunct to the assessment phase of treatment and hospitalization.

Descriptive study of behavior during transition from heroin addict to methadone patient

This study examined the behavior of 6 cooperative heroin addicts prior to and during the initial phase of methadone maintenance. Data on activity, setting, and interpersonal contacts were obtained by self-report (about 2500 hr.). Comparisons were drawn between daily behavior prior to and during treatment. The behavior of the addicts indicates a common pattern even though these subjects do not represent a homogeneous group in age, ethnicity, or marital status. Characteristics observed in the life-style of the subjects were their limited socialization, their limited range of activity, and their infrequent visits to settings other than their own residence. Socialization time and the pattern of affective and somatic complaints changed when treatment began. The results indicate that behaviorally, in life-patterns and habits, heroin addicts may be a homogeneous group.

A comparison of the WISC and WISC-R in a juvenile delinquent population

WISC and WISC-R subtest and IQ scores were compared in two samples of juveniles referred to a large metropolitan juvenile probation department (Ns = 180 and 185, respectively). The samples were equated for age, sex, race, and grade level. Significant differences were found on six of the 10 subtests. There were also significant differences between WISC and WISC-R scores on the Verbal, Performance, and Full Scale scores. In each case the WISC-R score was lower than the WISC score with the exception of the Arithmetic subtest. We conclude from these data that juvenile delinquents score significantly lower on the WISC-R than on the WISC. Psychologists using the WISC-R where the WISC had been previously used should educate their referral sources and other users of scores from the WISC-R to the differences in the test scores between the WISC and WISC-R.

Performance under health-engendering and health-depressing conditions

Undergraduate psychology majors (four males, four females) were trained to role play health-engendering (HE) and health-depressing (HD) behaviors. Introductory psychology students (N = 48) were tested under different role playing conditions. Measures were taken before and after the role playing by an investigator who played a neutral role. A balanced two-way design was used. Four groups (N = 12 each) were thus formed: males under HE conditions, males under HD conditions, females under HE conditions, and females under HD conditions. Results indicated that the Ss did discriminate the roles when asked to rate a variety of characteristics. On two measures of learning (CVC lists and abbreviated digit span) the role of E had no effect; the role playing did not interfere with performance. It was found that the self figure in the human figure drawing was significantly smaller under HD conditions. This finding lends support to the body image hypothesis.

Use of heroin addiction scale to differentiate addicts from rehabilitation clients

The profile patterns of addicts and rehabilitation clients using the MMPI and the heroin addiction scale ( He) were compared to determine differences and to extend the applicability of the He scale. The subjects were a group of addicts, 76 males and 21 females, and a group of vocational rehabilitation clients, 56 males and 14 females. Significant differences on scale elevations between the two groups were found, with the heroin addicts obtaining substantially higher elevations. The He scale successfully discriminated addicts from non-addicts and in fact was the best predictor of group status, i.e., addict versus non-addict, among all the variables.

Comparison of WISC profiles of alleged juvenile delinquents living at home versus those incarcerated

Comparison was made between the WISC subtests and IQs of 91 juveniles living on a juvenile detention ward and 91 juveniles living at home. All subjects were alleged juvenile delinquents and were awaiting adjudication. No differences were found on either IQs or subtest standard scores between ward and home group. There were, however, significant differences among the subtests. A Newman-Keuls test indicated a grouping of the subtests which was different from that described by Wechsler (1958). The highest ranked subtests were Similarities, Picture Completion, and Object Assembly; the lowest ranked were Information, Vocabulary, and Arithmetic. The data indicate that the verbal-performance discrepancy is not useful to describe alleged juvenile delinquents.

An analysis of the function of color in the Rorschach

Slide reproductions of a standard and an achromatic series of Rorschach plates were rated by 120 Ss on 12 bipolar adjective pairs. Four adjective pairs from each of the three major factors of meaning were used. Mean factor scores were computed for each factor, and a comparison among cards was made. The chromatic cards were rated, in general, as more positive and more active but less potent than their achromatic representations. There was a significant inverse relationship between the evaluative factor and the potency factor. No sex differences were found in the connotation of the cards. The results of this study are consistent with prior studies.

Discrimination reaction performance as a function of anxiety and sex parameters

From a sample of 681 college undergraduates 4 groups of 20 Ss of each sex (M, F), comparable in age and reasoning ability, were selected for low (L = 3 to 9) and high (H = 27 to 41) anxiety on the basis of Taylor MAS scores. All 80 Ss received 320 trials on the Air Force Discrimination Reaction Timer with nonspecific instructions designed to produce a high degree of task complexity. The results were as follows: (1) Group HF was slightly inferior in reaction speed ( Ra) to Group LF initially, superior later; (2) Group HM remained markedly inferior to Group LM throughout; (3) men were generally faster than women; (4) women were significantly more anxious pre-experimentally than men; (5) the main effects of Practice, Sex, and their interaction were significant, as predicted, but Anxiety was a clear decremental factor only among males; (6) mean acquisition curves for 4 augmented groups of 50 Ss each were exponential and also revealed a marginal Practice × Sex × Anxiety interaction. The equations fitted the Ra data with an average error of less than 1%, which is in excellent agreement with the Hull-Spence theory. Implications for prior research by Grice, Noble, Spence, and Taylor were discussed.