Social skill performance among normal and psychiatric inpatient children as a function of assessment conditions

The present investigation examined the effects of varying the standard assessment conditions on performance of social skills among normal and psychiatric inpatient children. Sixty children (30 normals, 30 patients), ages 6–12, completed behavioral and self-report measures of social skills on two separate occasions. During the second assessment, half of the children received feedback and incentives for performance; the other half did not. The testing conditions consistently altered social skill performance. Children who received the incentives during assessment showed significantly higher levels of social skills, as reflected in concrete behavior (e.g. eye contact, facial expressions), and molar responses (e.g. giving compliments, responding to provocation). The results suggest that social skills performance varies considerably as a function of the assessment conditions. Training programs should not assume that persons do not have the responses in their repertoires merely because of low pretest performance unless more extensive efforts are made to evoke appropriate responses.     

The effects of instructional set on physiological response to stressful imagery

Centrally mediated or cognitive variables have received considerable attention in clinical research. With the establishment of the effectiveness of such specific treatment techniques as systematic desensitization (Paul. 1969a. 1969b). a question arises as to the influence of cognitions on process and outcome variables in such learning based treatments (Lang. 1971). Research investigating the influence of demand characteristics and subject expectancies has demonstrated such centrally mediated variables can significantly influence overt, behavioral and self-report measures of fear, stress, or anxiety (cf. Borkovec. 1972: Marcia. Rubin and Efran. 1969; McGlynn. Maelia and Nawas. 1969: McGlynn. Reynolds and Linder. 1971: Oliveau. Agras. Leitenberg and Wright. 1969; Rappaport. 1972: Rosen. 1974).However. Borkovec (1972) and Rappaport (1972) failed to obtain expectancy effects on physiological measures of anxiety. Neither investigation provided for an independent assessment of subjects' actual expectancies, or belief in the instructions, as recommended by Davison and Wilson (1973). Borkovec administered clinical procedures over four sessions and varied the information communicated about the ‘purpose’ of the treatments (physiological versus therapeutic instructions). Differential rationales for differential expectancies of physiological reactivity were not provided. After each session, subjects reviewed the same false physiological records depicting reductions in fear responses. Although these changes were explained either physiologically or therapeutically. the fact that such reductions were emphasized should have attenuated differences between groups. Rappaport (1972) exposed subjects to a fearful stimulus and varied the suggestion and rationale for the pseudotreatment: no expectancy (stress research): therapeutic expectancy (fear reduction); and negative expectancy (fear increase). The lack of an independent assessment of the expectancy manipulation, as well as the exclusion of a specific therapeutic procedure, make it impossible to interpret the results in relation to expectancy effects on physiological fear responses during the administration of therapeutic procedures. There is other evidence, however, that suggestion and instructional set can significantly influence somatic and autonomic response systems (Barber. 1961. 1965; Sternbach. 1964. 1965).The primary purpose of this study was to evaluate the effects of instructional set on physiological responses to stressful imagery. This was an early step in a research program investigating the effects of instructional and informational variables on physiological responses of clinical interest. One half of the subjects received abbreviated live relaxation training (R) as described m a manual by Bernstein and Borkovec (1972) and based upon the original work of Jacobson (1938). The other half received an inert placebo pill and undertook a target detection task (P). The latter procedure was similar to that used by Paul (1966). Although both procedures had previously been shown to have relaxing effects, the P task was included as an additional control for any potential effects specific to the tension-release procedure of R. In order to evaluate the effects of instructional set, one half of each of the above two groups received instructions designed to lead to an expectancy of response inhibition to stressful imagery by the respective procedure (Decrease Stress Response. DSR). while the other half received instructions designed to lead to an expectancy of an increased response to stressful imagery by the respective procedure (Increase Stress Response. ISR). Each subject visualized three individually specified items that were the most frightening scenes imaginable prior to training and four times after training visualized the scene producing the largest response. Considerable effort was devoted to eliciting from each subject the most frightening items possible for her. and it was clear from subject comments that the items did elicit negative emotional responses.Since previous research (Barber. 1961. 1965; Sternbach. 1964. 1965) indicated that instructional set can influence physiological reactivity, it was hypothesized the DSR) subjects should exhibit a greater reduction in emotional response from pre- to posttraining than ISR subjects.     

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.     

The psychiatric inpatient treatment of children and youth in general hospitals

National attention has recently focused on the mental health needs and services of children and youth. The lack of outpatient services and their coordination has been noted, as well as the consequent press towards inpatient care. We describe the inpatient treatment of children and adolescents (ages 0-18) in short-term, non-Federal general hospitals in 1980. Nationally, 128,300 children were treated for mental disorders in general hospitals at an estimated cost of over $1.5 billion. Compared to adults, children were more likely to be treated in scatter beds (vs. specialty units); have a diagnosis of mental disorder (vs. alcohol/drug disorder); stay much longer; and pay with commercial insurance. Previous work focusing on psychiatric units of general hospitals identified less than 40% of the total episodes, a figure very similar to that for adults. The majority of psychiatric inpatient episodes for children and youth in the United States takes place in short-term general hospitals. Community psychologists need to be aware of national trends in inpatient care and be involved in the development and promulgation of alternative models of care.     

Overt and covert antisocial behavior: Child and family characteristics among psychiatric inpatient children

The present study examined child and family characteristics associated with overt and covert antisocial child behaviors. Child psychiatric inpatients (N=258, ages 6–13) were identified as high in overt and/or covert antisocial behaviors (e.g., aggression and stealing, respectively) based on a structured parent interview measuring antisocial behavior. Children were classified into four groups derived from the factorial combination of level of overt (high vs. low) and covert (high vs. low) antisocial behaviors. Analyses were made of the children's reactions to hostile and anger-provoking situations, deviant and prosocial child behaviors at home and at school, and family structure and organization. Children higher in overt antisocial behaviors were more negative, resentful, and irritable in their reactions to hostile situations and more aggressive at school. They came from families with significantly greater conflict and less independence among family members. Children higher in covert antisocial behavior participated in fewer social activities and were higher in anxiety; their families showed significantly lower family cohesion and organization and less of an emphasis on moral-religious values. The results suggest reliable differences in child and family functioning as a function of patterns of overt and covert antisocial behavior.     

Hyperactive children and peer interaction: Knowledge and performance of social skills

This study investigated hyperactive children's peer relations using the framework of social skills theory. Subjects' (15 hyperactive and 15 control boys aged 7 through 11) knowledge of socially appropriate behavior was assessed using the Social Knowledge Interview (Geraci & Asher, 1980). Additionally, performance of social skills with peers was rated by independent judges during free play, a cooperative puzzle task, and a persuasion task. Peers also rated subjects'desirability as partners for work, play, and friendship. Analyses showed that hyperactive subjects had deficits in knowledge of how to maintain relationships and handle interpersonal conflict, and demonstrated more negative behavior in the cooperative puzzle task than did controls. Hyperactive subjects also were rated by judges as less likely to achieve academic success than controls and were rated by peers as less desirable potential work partners in school. Significant correlations between social knowledge and performance with peers were found. It was concluded that hyperactive boys exhibit deficits both in their social knowledge and in their performance of socially skilled behavior.This research was conducted as part of doctoral research by the first author, under the supervision of the second and third authors. We are grateful for the assistance of Diane Arnkoff, who served on the committee, for her helpful comments and suggestions. Thanks also go to Al Farrell for his statistical consultation. We gratefully acknowledge the support and assistance of the Georgetown University Child Development Center, where the data were collected.     

The use of publicly-posted performance feedback in an inpatient psychiatric treatment setting

This study examined the effects of publicly-posted performance feedback on the in-hospital behavior of patients residing on a self-management unit at a large, state operated, psychiatric treatment facility. When contrasted to a baseline phase in which staff received weekly information regarding patients' performance, scores in six of the eight assessment areas improved when this information was provided directly to patients. The authors' conclude that performance feedback may be a useful adjunct to inpatient treatment programs because it clarifies programmatic expectations, helps focus attention on developing strategies or interventions to meet those expectations, and encourages active treatment participation from patients and staff.     

Teaching social skills to isolated children

The effects of a social skill training program on socially isolated children are reported. The training program was derived from the results of a previous study of the specific social skills that discriminated popular from unpopular children. Training effects in the present investigation were assessed on sociometric position, and on the quality, frequency, and distribution of social interaction to peers. Time-series analyses were performed on the frequency and distribution of peer interaction. Two isolated children received social skill training with an adult coach, and two isolated children spent an equivalent amount of time with an adult. Results indicated that socially isolated children in the treatment group changed significantly in sociometric position on a follow-up assessment 9 weeks after the end of the intervention, did not change in the total frequency of peer social interaction, but did redistribute their interaction to peers. The two isolated children who did not receive the treatment program did not change significantly on the total frequency of peer interaction, and tended to withdraw from peers rather than redistribute their interaction. The insensitivity of total peer interaction frequency as a measure of outcome was discussed.     

Conflict performance as a function of instructional set and absolute strength

One-hundred-twenty-eight male and female introductory psychology students performed in a conflict task. It was found that neither prior knowledge of the “correct” response nor number of practice trials prior to the conflict trial (8 versus 24) had differential effects on performance on the conflict trial. However, subjects who were shocked following an incorrect response took longer to make a decision on the conflict trial than subjects who were not shocked, and females took significantly longer than males.     

The effects of self-selection on trainees' verbal helping skills performance

Self-selected paraprofessional trainees enrolled in a helping skills training program participated in a 6-minute pretraining helping interview from which their frequency of continuing responses was obtained. Continuing responses allow helpees to present their concerns in a nonthreatening, supportive environment and are important in the relationship establishing stage of the helping process. For data analysis purposes only, trainees were divided into three groups, a high, medium, and low group, based on the frequency of continuing responses made. Following training, at posttest, no significant differences were found among the three groups on the amount of continuing responses made during a second identical 6-minute interview. Implications for various selection procedures and training are discussed.     

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 systematic program to enhance clinician group skills in an inpatient psychiatric hospital

This article describes the collaborative effort of a team of discipline directors, administrators, and academicians to create a systematic program to enhance the group competencies of a large clinical staff working at a state hospital. The effects of the program were tested by a quasi-experimental field study. Quantitative measures of group process provided limited support for program effectiveness. Stronger support came from qualitative inquiry. The development and effectiveness of the program is examined within a larger context of group programs housed in large health care organizations.     

The interaction of response complexity and instructional set

This study investigated the interaction of experimental instructions and response complexity in an attempt to provide a possible explanation for some of the equivocalness in the programming time literature. Response complexity was manipulated by varying the accuracy required of subjects striking circular targets in a simple reaction time paradigm. Subjects were tested on two days, one week apart, during which experimental instructions emphasized either leaving the start position as soon as possible (initiation emphasis) or completing the response with a rapid but smooth movement (form emphasis). Subjects had shorter reaction times but longer movement times when they performed under initiation-emphasis instructions rather than under form-emphasis instructions. Furthermore, in contrast to form-emphasis conditions, there was no effect of response complexity on reaction time in conditions of initiation emphasis. It appears that subtle changes in experimental instructions can lead to very different patterns of reaction time and movement time data. These findings highlight the need for caution in preparing subject instructions in response programming experiments.     

The effects of various rater training procedures on the perception of social skills and social anxiety

Procedures for the behavioral assessment of social skills typically rely on judges' perceptions of subjects' behavior in several simulated situations. This study examined two methodological variables which could influence the degree of situational specificity perceived by social skill judges. Forth-eight judges were presented videotapes of 15 actors who role played responses to eight simulated social situations. Half of the judges viewed the situations in a sequential fashion and the remaining half viewed the tapes grouped by situations. The second factor of this design included three different expectancy conditions included in an analogue training procedure. Differences in observed variability were examined for both social skill and social anxiety constructs. Order of stimulus presentation had no effect on variability. The expectancy manipulation significantly increased variability among social skill ratings but had no effect on reliability.This study was supported in part by the Veterans Administration.     

The effects of instructional cues on performance and mechanics during a gross motor movement

Externally focused instructions specific to performance have shown to improve body mechanics (Gokeler et al., 2015; Welling, Benjaminse, Gokeler, & Otten, 2016). However, the effect of using an external focus instruction may have been more profound if the content of the instruction had been relevant to mechanics. Therefore, the present study examined the effects of externally focused instructions specific to performance and externally focused instructions specific to body mechanics on mechanics and performance. Twenty-four adults (n = 12 males; n = 12 females) performed a series of drop jumps following external focus cues that were specific to performance and landing mechanics. Participants completed a drop jump followed by a maximal effort vertical jump. The initial contact, maximal angle, and range of motion at the knee in the sagittal and frontal plane motion were measured for mechanics and the height of the second vertical jump was measured for performance. The results suggest external focus instructions specific to performance are beneficial for performance, but not for improving landing mechanics. This suggests that external focus instructions must be specific to the contents of the instruction.