Kinetic Family Drawings and MMPI diagnostic indicators in adolescent psychiatric inpatients

Correlations among Kinetic Family Drawings and MMPI indicators of depressive, anxiety, behavioral, and thought disorders and diagnostic category were estimated for a group of 52 adolescent psychiatric inpatients. No statistically significant values were found between test indicators and corresponding MMPI scales or diagnoses, although MMPI D and Sc scales were significantly related to diagnosis. Results do not support the concurrent or construct validity of the drawings.     

Family interaction and the course of adolescent psychopathology: An analysis of adolescent and parent effects

This study focused on evaluating the utility of three family measures for predicting outcome in a sample of disturbed but nonpsychotic adolescents: (a) the affective quality of the adolescents' voice tone when communicating with his/her parents; (b) the predominant affective quality of the parents' voice tones when communicating with the adolescent, and (c) the affective quality of the content of the parents' verbalizations to the adolescent. These measures were derived from 5-minute face to face discussions between parents and their disturbed adolescent. Results indicated that adolescents using positive or neutral voice tones during emotionally laden discussions with their parents tended to show relatively adequate levels of psychosocial adjustment as young adults, while adolescents using exclusively negative voice tones tended to show sufficient adjustment difficulties in early adulthood to warrant diagnoses within the extended schizophrenia spectrum. Although adolescent voice tone was associated with outcome, considering both adolescent and parent affective response led to improved prediction, with consideration of adolescent and parent variables leading to accurate prediction of outcome for 30 of the 33 sample cases.     

Bender-Gestalt emotional indicators and acting-out behavior in young children.

This study was designed to investigate the relationship between 15 emotional indicators on the Bender-Gestalt Test and acting-out behavior in young children. The subjects were 93 children ranging in age from five to 12 years. Each was administered the Bender. A measure of each subject's overt acting-out behavior was then obtained by having teachers rate each student on a Behavioral Rating Scale. Subjects' records were then divided into groups on the basis of both sex and age. Results indicated that neither the total number of Bender indicators nor any of the individual Bender indicators were correlated significantly with total scores on the rating scale. Use of the Bender as a projective device to measure acting-out behavior was seriously questioned.     

Foreseeability and self-interest as moral judgment factors with normal and acting-out adolescent boys

Thirty-two male adolescents participated in a study of moral judgment and its relationship to social functioning. Half of the subjects were selected for frequent acting-out, aggressive behavior, and half were selected from regular eighth-grade classes and matched for intelligence. The moral stories featured good intentions with bad outcomes and varied as to whether or not the outcome was foreseeable and in the actor's self-interest. Subjects judged the actor, attributed judgments to adults, and casually explained the outcome. The difference in judgments between foreseeable and nonforeseeable actions was greater for “normal” subjects. Furthermore, although normal subjects judged foreseeable actions more harshly than acting-out subjects, the reverse was true for nonforeseeable actions. Judgments attributed to adults were harsher than subjects' own judgments, and this difference was greater for acting-out subjects. Causal attributions (personal vs. situational) and other reasoning related strongly to the foreseeability and self-interest factors but not to subject group.     

Helping affluent families help their acting-out,alienated, drug abusing adolescent

Abstract

The article outlines the steps in Action Counseling, a normological, problem-solving method, which capitalizes on the described strengths and modal characteristics of poor families to help them mobilize and organize cooperatively for the tasks of solving family problems and improving their situation. Steps include setting a theme, identifying and clarifying positively stated goals, designing mutually agreed upon action plans, overcoming obstacles, obtaining commitments, following-through, and following-up.     

Group therapy with inner city hispanic acting-out adolescent males: Some theoretical observations

Group therapy with inner city Hispanic acting-out adolescent males is described as an effective psychotherapeutic modality in treating this difficult population. Topics addressed include the development of personality during adolescence, Hispanic family dynamics and gender roles, group therapy as a pseudofamily structure, stages of group development as they pertain to this population, and the group therapist's role and characteristics in the treatment situation.     

Naturalistic observations of pathological behavior in hospitalized psychiatric patients

Naturalistic observations were conducted on 19 acutely ill psychiatric patients in the hospital ward milieu. The study was designed to determine relationships between selected social and environment variables and overt atypical behavior. Patients were observed on an individual basis with time-sampling techniques. In total, 16 pathological behaviors were coded and the most frequent (postural deviance, pace, agitation, hyperactivity, withdrawal, foot shake/body sway, leg swing) were selected in order to determine variation in frequency of these behaviors as a function of the following variables: area within hospital, week of hospitalization, distance between the focal subject and his/her nearest neighbor, number of people in an area, and time of day. Results showed differential changes in pathological behavior as a function of week of hospitalization, number of people in a given area, and distance from the focal subject's nearest neighbor. There was no significant change in the frequency of pathological behaviors as a function of area within hospital or time of day. In addition, most pathological behaviors decreased significantly when patients were engaged in the sending or receiving of verbal behavior. Cluster analyses revealed varying degrees of dissociation between pathological behaviors and social-interaction behaviors. These results support (a) a nonunitary concept of the general category pathological and (b) the view that there are inhibitory effects of social interaction on the enactment of atypical behaviors. Clinical implications of these findings are discussed.R.H.P. completed this research during his tenure as a postdoctocal fellow in the Department of Psychiatry, Human Ethology Laboratory, UCLA (NIMH Fellowship 1 F32MHO7627-01). Support for this research also came from the Veterans Administration.     

An investigation of verbal interaction, knowledge of sexual behavior and self-concept in adolescent mothers

Variables commonly considered to be major factors in contributing to the incidence of adolescent pregnancy may be only part of the total pattern. This study sought to examine the adolescent mothers' communication with significant others and their knowledge about sex, pregnancy, and birth control methods. Self-concepts of the adolescent mothers were compared with those of the published norms of the Tennessee Self-Concept Scale. The study included 23 adolescent mothers between the ages of 13 and 19 who were gravida 1 as indicated by their medical records. They were given a questionnaire constructed from previous research. They also completed a communication scale and the Tennessee Self-Concept Scale. The findings of the present study indicated that most adolescent mothers considered their communication with their parent mothers to be one of mutual understanding. However, it appears that most adolescent mothers obtain much of their information about sex, pregnancy, and birth control methods from significant others. The self-concepts of these adolescent mothers were lower in comparison to the norm. The results indicate a need for further research in the area of adolescent sexual development, sex education in the school, and increased involvement of parents in the communication of sexual mores.     

Attitudes of adolescents toward adolescent psychiatric treatment

Perceptions held by adolescents about the value and social stigma of both psychiatric hospitalization and outpatient therapy for adolescents are examined. Perceptions about preferred forms of treatment for specific adolescent problems are also analyzed. The results indicate that attitudes are significantly influenced by proximity to treatment setting, i.e., adolescents currently being treated are more positive than adolescents who have been previously or never treated. Contextual and attributional explanations are considered.     

CHRM2, parental monitoring, and adolescent externalizing behavior: evidence for gene-environment interaction

Psychologists, with their long-standing tradition of studying mechanistic processes, can make important contributions to further characterizing the risk associated with genes identified as influencing risk for psychiatric disorders. We report one such effort with respect to CHRM2, which codes for the cholinergic muscarinic 2 receptor and was of interest originally for its association with alcohol dependence. We tested for association between CHRM2 and prospectively measured externalizing behavior in a longitudinal, community-based sample of adolescents, as well as for moderation of this association by parental monitoring. We found evidence for an interaction in which the association between the genotype and externalizing behavior was stronger in environments with lower parental monitoring. There was also suggestion of a crossover effect, in which the genotype associated with the highest levels of externalizing behavior under low parental monitoring had the lowest levels of externalizing behavior at the extreme high end of parental monitoring. The difficulties involved in distinguishing mechanisms of gene-environment interaction are discussed.     

Family systems training in psychiatric residencies

Both extensive research and common sense dictate that attention to families is necessary for appropriate care of psychiatric patients. However, training in family skills has often been difficult to integrate into psychiatric residency programs because of conflicting paradigms, turf battles, constraints of time and money, and confusion over whether family-centered care or family therapy should be taught. Current changes in residency accreditation mandate that family skills (not necessarily family therapy in its sophisticated form) be part of all residency programs. This article reviews the history of systems training in residencies, current accreditation requirements, and the GAP proposal for family systems skills, knowledge, and attitudes that that are teachable within the limited time available to residents. The application of these core skills is described using a case example and formulation. Challenges in teaching and ways of overcoming programmatic constraints are outlined.     

Family factors related to adolescent autonomy

This paper analyzes the role that the family plays in the development of adolescent autonomy. Three family factors are analyzed in relation to the development of adolescent autonomy; parenting styles, family interaction, and transitions related to the family life cycle.     

Substance use by adolescent psychiatric inpatients and their parents

The relationship between adolescent psychiatric inpatients' and their parents' drug use was studied using a questionnaire format. The major finding was that there was no systematic relationship. It is hypothesized that due to recent family realignments, adolescents are turning away from their parents and toward peers for their role models in drug use.     

Family interaction and caregivers of Alzheimer's disease patients: correlates of depression.

Depression is ubiquitous in primary family caregivers of Alzheimer's Disease (AD) patients, but its relationship to the overall behavior patterns of these families has received little attention thus far. The focus of the exploratory study reported here was on one aspect of this issue — affective responses between caregiver and other family members as they relate to level of depressive symptoms in the primary caregivers. Family affective responses, especially negative responses, have proven of particular salience in studies of major psychiatric disorders. Would they be equally salient in a study of depressive symptoms in primary caregivers of Alzheimer's patients? Apparently so. Thirty caregivers and extended family members participated in problem-solving family interaction tasks that were videotaped, transcribed, and coded on affect. Two variables representing angry and sad responses of extended family members to the caregiver accounted for over 44% of the variance in caregiver depressive symptoms. The relevance of these findings for treatment approaches and future research efforts are discussed.     

Risk-taking behavior and adolescent suicide attempts

This study examined the overall rates of common risk-taking behaviors in a sample of 109 adolescents, aged 13 to 18 years, who made a suicide attempt, compared to a matched control sample of 218 adolescents in the community. No differences in either the total number of risk-taking behavior or the frequency of individual risk-taking behaviors were found. These findings suggest that suicide attempts in adolescents are not a function of risk-taking behavior.     

Female adolescent friendship and delinquent behavior

Young female offenders (n = 29) and female high school students (n = 47) were compared in terms of delinquent behavior and relationships with their best female friend and peer group. Young offenders exhibited significantly more delinquent behavior than did high school students in the past year. Delinquents and nondelinquents did not significantly differ in amount of companionship, conflict, help, security, and closeness with their best female friend, and amount of trust, alienation, and perceived intimacy in their peer group. Less communication and more perceived peer pressure in the peer group distinguished delinquent females from nondelinquent females. Perceived peer pressure significantly predicted delinquent behavior in female adolescents. In short, friendships of delinquent and nondelinquent female adolescents are essentially similar despite higher levels of peer pressure among delinquents.     

Family correlates of adolescent self-monitoring and social competence.

The purpose of this study was to investigate linkages between adolescent self-monitoring, global social competence, and parenting and family environment dimensions of support and encouragement of autonomy. The sample consisted of 233 young women and 199 young men at 2 southwestern universities. The primary measures used were the Family Environment Scale (R. H. Moos, 1981), the Parent Behavior Form (L. Worell & J. Worell, 1974), the revised Self-Monitoring Scale (M. Snyder, 1987), and the Texas Social Behavior Inventory (R. Helmreich, J. Stapp, & C. Ervin, 1974). Findings indicated that family variables are more strongly associated with social competence than with self-monitoring; family support was, overall, a more important ingredient of social competence than was autonomy. Women and men had different patterns of associations among specific variables.