Private-sector care for chronically mentally ill individuals. The more things change, the more they stay the same

Two profit-making industries, nursing homes and board-and-care homes, care for about one million chronic mental patients. This care is primarily custodial and probably not very different from the care patients received in the public sector prior to deinstitutionalization. Moreover, certain characteristics of privately owned facilities encourage poor patient care so as to maximize profit. The problem could be ameliorated if chronic mental patients were strong and informed consumers or if the public sector strongly regulated proprietary care. However, neither of these two conditions now hold. Perhaps the apparent difficulties in significantly improving care for chronically mentally ill individuals despite seemingly major changes in policy reflect a fundamental problem in overall social policy--a reluctance to care for chronically indigent individuals of all kinds.     

Occult participation: its impact on adolescent development

This study investigated the relationship between occult participation, substance abuse, and level of self-esteem in adolescents. Data were collected from 50 adolescents who ranged in age from 12 to 19 years and who spoke English as their primary language. The combined group of adolescents consisted of 25 clinical and 25 nonclinical youth. Participants completed a three-part questionnaire package which included Rosenberg's Self-Esteem Scale, the Adolescent Magic Questionnaire, and the Drug and Alcohol Assessment Scale. Results indicated that adolescent substance abuse and occult participation were significantly related. High and low occult participation groups were determined, and significant differences were found between the high versus low occult groups when compared on the primary variables of self-esteem and substance abuse. Significant differences were also noted when comparing the high versus low occult groups with various psychosocial developmental variables. Included is a discussion of the impact of occult participation on the psychosocial elements of adolescent self-esteem, self-concept, tolerance for deviance, and religious involvement.     

Emotional disturbance and the development of self-consciousness in adolescence

The development of self-consciousness and its relationship to emotional disturbance was examined in early and late adolescence. The Imaginary Audience Scale was administered to emotionally disturbed and nondisturbed adolescents. As predicted, results indicated that self-consciousness decreased with age in nondisturbed adolescents. For the emotionally disturbed adolescents, the development of self-consciousness in temporary situations did not follow consistent patterns, as indicated by interaction effects. A significant negative relationship was found between intelligence test scores and self-consciousness in the disturbed group. The findings support the premise that social-cognitive shifts found in early to late adolescence are disrupted in disturbed populations. The mediating role of social experience as a factor in cognitive and emotional development is discussed.     

Adolescent school performance following parental divorce: are there family factors that can enhance success?

Most research on the effects of divorce on children has focused on delineation of specific areas of child maladjustment. A more optimistic approach seeks to identify variables that may mediate negative effects of a stressor, such as parental divorce. The goal of this study was to examine the relationship between one area of child adjustment, school achievement, and family factors which may mediate the negative influence of divorce. The subjects were 71 early adolescents and their recently divorced mothers. The adolescents were divided into low, medium, and high grade achievement groups. Analyses of variance and subsequent Newman-Keuls tests revealed that adolescents with high grade point averages had mothers with a lower level of depression, a higher educational level, less conflict with their ex-spouse, and less intense levels of conflict between mother and adolescent than those in the low grade point average group. A discriminant analysis resulted in a two-variable equation which accounted for 33% of the variance between low and high grade achievers. The two variables were mother's report of conflict between her and her ex-spouse in front of the adolescent and the adolescent's report of the intensity of arguments between him/herself and mother. These results indicated that school performance following divorce is not uniform for all adolescents and that family factors may mediate scholastic achievement problems.     

Visual control of movement patterns and the grammar of action

In this experiment adult subjects copied three types of material (letters, reversed letters and geometric shapes) with and without sight of the hand and the writing trace. Without vision the number of movement segments decreased and the sequence and direction of movements were altered. This means that subjects did not use a fixed stored representation to produce items nor did they obey the rules of Goodnow and Levine's (1973) grammar of action. When spatial location is made more difficult by the removal of vision, movement production is simplified to reduce the number of relocations required. The use of consistent directions of movement depends on the ability to use visual control of spatial location.     

The Social Phobia and Anxiety Inventory: concurrent validity with a clinic sample

The Social Phobia and Anxiety Inventory (SPAI) is an empirically derived self-report inventory developed as a specific measure of social phobia. The current investigation included two studies. The first examined the correlation of the SPAI with daily social behavior of a clinic sample of social phobics. The results indicated that the SPAI provides a reasonable indication of the distress experienced during daily social encounters in three dimensions: behavior, cognitions, and overall distress. The second study examined the validity of the SPAI with reference to the somatic response and avoidance behavior of social phobics. The results indicated that the somatic items of the SPAI are related to the somatic response of social phobics and that performance on the SPAI is associated with avoidance behavior in an anxiety-producing task.     

Cognitive bias and irrational belief as predictors of avoidance

Cognitive bias, i.e. overestimates of subjective probability and cost of catastrophic events, and irrational belief were explored as predictors of avoidance. Three groups-anxiety disordered clients, a mixed group of clinic outpatients, and normals--were administered several self-report inventories. Multiple regression analyses were used to investigate a modified version of the Agoraphobic Cognitions Questionnaire, the Belief Scale, and the Body Sensations Questionnaire as predictors of avoidance, as measured by the Mobility Inventory. It was hypothesized that frequency x probability x cost of catastrophic cognitions (and the occurrence of the events they represent) would be a better predictor of avoidance than frequency alone. It was also hypothesized that irrational thinking would be a significant predictor of avoidance. The results generally supported the hypotheses, with subjective probability emerging as a particularly potent predictor of avoidance. Theoretical and clinical implications are discussed.     

Restrained eaters are rapidly habituating sensation seekers

Several authors have pointed to similarities between eating disorders and addictive behaviors. In earlier studies, addicts were found to score high on the Sensation Seeking Scale (SSS) and to habituate rapidly to neutral stimuli. In this study, we found experimental support for an addiction model of eating disorders: restrained eaters also scored significantly higher on the Sensation Seeking Scale and also habituated significantly quicker to a series of neutral stimuli than unrestrained eaters. No clear evidence was found for the hypothesis that restrained eaters score lower on measurements of anxiety. It is hypothesized that rapid habituation promotes sensation seeking, which may be manifested in excessive consumption of either drugs or food. Restraint may be a strategy to prevent negative consequences of sensation seeking and excessive consumption. The model is related to earlier experimental findings.     

Research-structured vs clinically flexible versions of social learning-based marital therapy

The purpose of this study was to compare our structured research-based version of marital therapy from a social learning perspective with a clinically flexible version of the same treatment where treatment plans were individually-based and there was no specific number of treatment sessions. Thirty distressed married couples were randomly assigned to one of these two treatments. Assessment of outcome was based on global marital satisfaction, spouse reports of functioning in specific areas, and direct observational measures of communication. At posttest there were no differences in efficacy between structured and flexible treatments, although both treatments led to significant improvements. At a 6-month follow-up couples treated with the structured format were more likely to have deteriorated and flexibly treated couples were more likely to have maintained their treatment gains.     

Interparental conflict and adolescent problem behavior: an examination of mechanisms

The purpose of the present study was to examine several competing hypotheses which have been utilized to explain the negative relationship between interparental conflict and child/adolescent problems. These mechanisms of operation have included modelling, genetic transmission, disrupted parenting, the role of perceptual/appraisal processes of the conflict, and an inhibition hypothesis. One hundred and forty-two young adolescents and their mothers served as subjects. Eighty were from intact families and 62 from recently divorced families. Data were collected from the perspective of the adolescent, mother, behavioral observer, and social studies teacher. The results indicated that intact and divorced samples had to be considered separately as different pathways contributed to adolescent behavior problems in the two samples. For externalizing problems, a direct path between interparental conflict and problem behavior existed for the divorced sample whereas an indirect path through the adolescent's perceptions of the conflict existed for the intact sample. The different context in which the interparental conflict occurred for the two samples was offered as an explanation of this difference. For internalizing problems a significant direct path existed between conflict and problem behavior for both samples; however, the indirect paths through the adolescent's perceptions and through poor parenting skills contributed only for the divorced sample. The results suggest that various mechanisms appear to operate in influencing how interparental conflict influences behavior problems of young adolescents. Both the type of problem examined and the marital status of the parents appear important in determining the relative impact of the mechanisms. Implications for the behavior therapist are noted.