A comparison of self-esteem, dogmatism and fantasy in psychiatric inpatient adolescents and their parents with non-hospitalized adolescents and their parents

Forty in-patient adolescents and 40 non-hospitalized adolescents, comparable in age, sex, education, birth position and socioeconomic level, and their parents were administered the Rokeach Dogmatism Scale, Barksdale Self-Esteem Evaluation Scale, the Singer and Antrobus Imaginal Process Inventory, and the Elms Empathic Fantasy Scale. Distinct differences were found between the in-patient adolescent and his/her parents in aspects of fantasy, empathy, dogmatism, and self-esteem, while the non-hospitalized adolescents were very similar in fantasy with both parents. In addition, both parents of the nonhospitalized adolescents had greater levels of self-esteem with less dogmatism evident in the fathers. The results are discussed in terms of the identification process and modeling, the socialization process with its suppression or reduction of taboo drive manifestations and fantasy as a means of achieving unattainable drives.     

Mental health policy and the psychiatric inpatient care of children

Recent changes in psychiatric inpatient treatment of children and youth are placed in the more general context of, first, the inpatient treatment of adults and, second, multiple public policies affecting children. For adults, the experimental evidence shows that the majority of psychiatric inpatients could be treated in programs outside the hospital more effectively and less expensively. For children, no such data base exists. Contrary to policy intent, between 1980 and 1985 inpatient care of children and youth increased substantially in residential treatment centers, private psychiatric hospitals, and scatter hospitals (general hospitals without any formal specialized units). Thus, psychiatric inpatient care of children and youth is increasing, dramatically so at largely uninvestigated and more expensive sites. The failure of children's mental health policy is placed in the context of the multiple policy failures for children regarding health, welfare, education, and housing. Recent positive efforts by federal agencies are described, but the need is great for data on efficacy and cost-effectiveness of inpatient treatment of children.     

A comparison of two mental status examinations in an inpatient psychiatric sample

This study compares the psychometric properties and clinical use of the Mini-Mental Status Exam (MMSE) and the Modified MMSE (3MS) in patients admitted to an acute medical-psychiatric inpatient unit. Internal consistencies were .56 for the estimated MMSE and .72 for the 3MS. Regression analyses revealed that the 3MS was a significant predictor of both length of hospital stay (LOS) and the need for additional services postdischarge. Regressions were also used to evaluate the contribution of the four new items contained in the 3MS: Word Generation, Similarities, Second Recall, and Date and Place of Birth. The 3MS was a significant predictor of LOS and the need for discharge services, whereas the MMSE did not contribute to any regression model. Word Generation was found to be a significant predictor of patients' needing posthospital services. Results support prior findings of the 3MS's superiority over the (estimated) MMSE and help to demonstrate the continued importance of cognitive screening in psychiatric samples.     

Children and adolescents discharged from public psychiatric hospital: Evaluation of outcome in a continuum of care

Ninety children and adolescents admitted to two state-operated psychiatric hospitals were followed from the time of their admission through one year post discharge. Data were collected from the children and adolescents, their families and clinicians at three intervals (during hospitalization, three months post discharge, and one year post discharge) to identify demographic, clinical, and service history characteristics of the children and adolescents, as well as to track their placement and other dispositional status following discharge from the hospital. The data indicated that the children and adolescents were seriously emotionally and behaviorally disturbed, came from families which were economically disadvantaged, and did not typically live in two-parent families. While the majority of the children and adolescents received recommended aftercare services during the three months following discharge from the hospital, there was a decline in placement stability for the children at the one-year post discharge followup. The most important predictors of successful outcome at discharge were living with a family member at the time of hospitalization and the participation of the family in the treatment planning during hospitalization.     

Behavioral knowledge among direct care staff in an inpatient psychiatric setting

Despite demonstrations of the utility and cost effectiveness of behavioral programming, such techniques are not commonly employed in psychiatric inpatient settings. Several explanations for this have been proposed, including inadequate levels of training and competence in behavioral programming among prevalent treatment staff. This study employed a multiple choice inventory to assess behavioral knowledge among subjects representing several direct care disciplines commonly found in inpatient psychiatric settings. The results support assertions of relatively low levels of behavioral knowledge among disciplines that are most prevalent in such settings. The implications of these results for initiatives to enhance behavioral knowledge and skills are discussed.     

Timing of bimanual alternating finger-tapping sequences in adolescents with mental retardation: a pilot study

We examined differences between the synchronization and self-pacing tasks using repetitive tapping with alternate hands. 9 adolescents with mental retardation made faster and more variable movements on the self-pacing task than on the synchronization task at target intervals of 400 and 800 msec. This suggests that they were able to coordinate the timing of individual responses with individual stimuli on the synchronization task but on the self-pacing task they controlled the timing by memory or generation or setting of an incorrect timer rate.     

Word-attack skills in individuals with mental retardation

This article assesses the state of the literature on word-attack skills and phonological awareness (PA) in individuals with mental retardation, in light of progress towards the development of effective teaching procedures. The literature contains promising findings. Studies have shown PA to be correlated with word-attack skills in individuals with mental retardation, as has been shown conclusively in typically developing children. This suggests that instruction in PA would facilitate the acquisition of word-attack skills in individuals with mental retardation, as it does with typically developing children. As of yet, however, very few experimental studies designed to demonstrate effective teaching procedures for PA and word-attack skills have been published. This research field might evolve most effectively and efficiently by following a two-step research program. First, test new teaching procedures in a series of small-N studies, each study incorporating modifications of teaching procedures based on the results of the previous study. Once procedures prove effective at this level, the resources necessary to pursue large-scale studies can be used to their best advantage.     

Simple mental addition in children with and without mild mental retardation.

The speeded performance on simple mental addition problems of 6- and 7-year-old children with and without mild mental retardation is modeled from a person perspective and an item perspective. On the person side, it was found that a single cognitive dimension spanned the performance differences between the two ability groups. However, a discontinuity, or "jump," was observed in the performance of the normal ability group on the easier items. On the item side, the addition problems were almost perfectly ordered in difficulty according to their problem size. Differences in difficulty were explained by factors related to the difficulty of executing nonretrieval strategies. All findings were interpreted within the framework of Siegler's (e.g., R. S. Siegler & C. Shipley, 1995) model of children's strategy choices in arithmetic. Models from item response theory were used to test the hypotheses.     

Ministry and mental retardation

Conclusion This has been an attempt to show how the parents of the mentally retarded inspired me to take a second look at my theological views, to show the method I used, and to give a few instances out of many in which my theological views have been affected. If space had allowed, it would have been good to show how this human predicament can cast new light on our theological thinking about grace, redemption, and many other categories. On the other hand, each of us has a chance to pursue in depth any single doctrine, using the added perspective of this particular crisis situation.Each of us has the original theological perspective which we had before beginning our pastoral involvements with the mentally retarded and their families. Then, as we focus on this human situation we become aware of an added theological perspective that helps us to take a second look from a different viewpoint. We then find our original view has been reinforced, modified, or enlarged. It is my feeling that a pastor who becomes involved with these particular persons-who need his services very much—will find a golden opportunity to grow theologically.If any of us feel we know all we need to know about God and life and man, this would be a good time to become involved in a pastoral way with a mentally retarded person and his family and get to know them well.     

Culture and mental retardation

The Psychological Record -     

Equivalence relations in individuals with language limitations and mental retardation

The study of equivalence relations exhibited by individuals with mental retardation and language limitations holds the promise of providing information of both theoretical and practical significance. We reviewed the equivalence literature with this population, defined in terms of subjects having moderate, severe, or profound mental retardation. The literature includes 55 such individuals, most of whom showed positive outcomes on equivalence tests. The results to date suggest that naming skills are not necessary for positive equivalence test outcomes. Thus far, however, relatively few subjects with minimal language have been studied. Moreover, we suggest that the scientific contributions of studies in this area would be enhanced with better documentation of language skills and other subject characteristics. With recent advances in laboratory procedures for establishing the baseline performances necessary for equivalence tests, this research area is poised for rapid growth.     

HIV/AIDS communication among adolescents in psychiatric care and their parents.

The authors examined HIV/AIDS communication among 207 parent-adolescent dyads in psychiatric care to better understand the relationship between family communication and sexual risk behavior in an at-risk population. Dyads reported content and rated quality of family HIV/AIDS discussions, and adolescent sexual risk was assessed. Families discussed transmission, prevention, consequences, myths, and compassion. Parent-reported discussion of consequences was associated with greater sexual risk behavior, but only for girls. Higher quality communication reported by adolescents was associated with less sexual risk. Parents may send different messages about HIV/AIDS to sons versus daughters, and messages related to consequences may not effectively reduce risk among daughters. However, for boys and girls in psychiatric care, teaching parents how to discuss HIV/AIDS may promote safer sexual behavior.     

Neuropsychological evaluation and rehabilitation in mental retardation

A discussion is provided of issues related to neuropsychological assessment of mentally retarded individuals. The first matters considered are test selection in relation to mental age and diagnostic issues. Various methods of evaluation are then considered, including assessment of orientation to sound and visual stimuli, language comprehension, right-left discrimination, and abstract and symbolic processes. Methods are also reviewed for detailed evaluation of language functions including testing for aphasia and for academic skills such as reading, writing, and calculation, as well as for spatial and constructional abilities. A section is devoted to use of neuropsychological assessment for rehabilitation of various disorders such as congenital aphasia, alexia, and spatial-constructional disorders.     

Conversational skills training with a chronically hospitalized psychiatric inpatient

While conversational skills training has been conducted with select psychiatric populations, it has rarely been used with severely debilitated inpatients. The purpose of this study was to use a multiple baseline design across conversational components to evaluate the effectiveness of a conversational skills training package to enhance the conversational repertoire of a severely impaired inpatient. Audiotaped conversations with a standard confederate were evaluated for the frequency of questions, self-disclosures, and reinforcing/acknowledging comments. Generalization probe conversations to novel partners were also obtained. Training effects were noted for the 3 conversational units. Mixed results were obtained for generalization and follow-up.     

Behavioral aspects of epilepsy in children with mental retardation

Epilepsy and mental retardation, two relatively common childhood conditions, are both associated with a wide range of behavioral disorders. This article reviews the behavioral disturbances found in children with epilepsy, mental retardation, and both conditions. The behavioral disturbances found in children with epilepsy are associated with seizure-related, cognitive, developmental, and psychosocial factors. Although children with mental retardation also demonstrate a broad spectrum of behavioral disturbances, children with specific mental retardation syndromes have better-defined patterns of psychopathology. The presence of epilepsy and mental retardation seems to increase the severity of psychopathology. Further studies are needed, however, to define better the interaction of these two conditions and how they impact the behavior of children.