Developing an efficient clinical information system for a comprehensive psychiatric institute: I. Principles,design, and organization

The principles, design considerations, and components of a clinical information system intended to support and enhance the patient care, educational, and research missions of a comprehensive psychiatric institute are presented. Major characteristics of the system are its emphases on efficiency, simplicity, and intensive user involvement throughout the development of the system.     

The diagnosis of brain-damage by the MMPI: a comprehensive evaluation.

A number of research studies have proposed various methods for using the MMPI to identify brain dysfunction. This previous research has taken one of three major approaches. The present study compared the major approaches in a population consisting of 30 schizophrenic, 30 brain-damaged and 30 hospitalized normal patients. The results indicated that the most effective diagnosis device was the use of the Sc scale alone or in conjunction with the remaining clinical scales and the F scale. None of the organic scales or keys were able to match the performance of the Sc scale alone. The poor results obtained bring into question the use of these scales in any other setting without an extensive research validation. An alternate method that might be used to employ the MMPI in the diagnosis of brain dysfunction was suggested.     

Duss Fairy Tales: some data from a new evaluation form.

The purpose of this paper is to extend the research on the Duss Fairy Tales in an Italian sample. Attention has been paid, in particular, to the study of some variables identified in a newly devised schedule. The protocols were scored for four indexes: (1) the main hero of the stories, (2) number and types of characters, (3) number of emotions expressed, and (4) number of heroes' and characters' actions and behaviors. Subjects were 70 children aged 3.5 to 10.5 yr. enrolled in kindergartens and elementary schools in Italy. The relationships of scores with age and sex were also investigated. There was an increase across three age groups in the richness of stories in terms of emotions and characters' identification.     

An experimental evaluation of a prototype public access nutrition information system for supermarkets

Located the Nutrition for a Lifetime System (NLS-1), a prototype interactive information system, in a large supermarket to help users decrease high-fat food purchases and increase high-fiber food purchases. Study participants were randomly assigned to control (n = 23; used the NLS-1 to enter food purchases only) or experimental (n = 26; viewed videodisc instructional programs, received prompts, made commitments, received feedback from the NLS-1) conditions. According to data entered in the NLS-1 and actual food shopping receipts, experimental participants significantly reduced higher fat purchases. Increases in higher fiber purchases favored the experimental group but were not significant.     

Development and evaluation of CHIPASAT, an attention test for children: II. Test-retest reliability and practice effect for a normal sample.

The CHIPASAT (Children's Paced Auditory Serial Addition Task), developed to assess auditory-verbal attention, was administered to a sample of 70 normal school children on two occasions separated by an interval of approximately 4 weeks. A significant practice effect was found, independent of age and sex, with performance improved by approximately 20% on retest. The test-retest reliability of .90 was significant, indicating task stability. The practice effect was consistent with that reported in the literature for the adult PASAT, and reasons for this effect are discussed. Initial test raw scores on WISC--R Arithmetic and Digit Span subtests yielded low but significant correlations of .38 and .35 with CHIPASAT scores.     

Behaviour patterns within a general hospital psychiatric unit: an observational study.

Employing a reliable and objective ‘behavioural mapping’ procedure, information was obtained by three independent observers, on what, where and when staff and patients engaged in various categories of behaviour, within a general hospital psychiatric unit. Observations were undertaken during two separate 6-day periods, using a seven category behaviour rating scale. Staff and patient behaviour profiles were found to be stable across the two rating periods, despite an almost complete change in the patient population from the first to the second set of observations. Results also indicated that staff spend a majority of their time engaged in interaction with their peers, or engaged in solitary task activity, with little of their time being spent in interaction with patients. Patients spent approximately half of their time in solitary behaviour, and when they were observed to be interacting it was found to be primarily with their peers. A significant negative correlation was obtained between those areas of the unit most frequently occupied by staff and patients, suggesting a territorial separation of the two groups. Analysis, of interaction rates by time, further indicated that the vast majority of interaction was observed to occur during the period 9.00a.m. to 5.00p.m. Monday to Friday. Some implications of the observed findings are discussed and it is concluded that the data suggest that the therapeutic potential of the observed unit is under-utilized.     

Asymmetrical evaluation of ingroup versus outgroup members: a look from an information integration perspective

In evaluating ingroup versus outgroup members two types of information can be used: ‘Categorizing information’ related to the target's group membership and ‘individuating information’ related to pieces of information specific to the target to be judged. Information integration theory (IIT, Anderson, 1981) is applied as a formal tool for predicting the judgement resulting from these different pieces of information. It is further assumed that due to a general positivity bias in evaluating own affairs judges tend to evaluate ingroup members more positively than outgroup members. By applying IIT ingroup favouritism on the level of individual targets can be predicted. More importantly, an interaction concerning an asymmetrical impact of ingroup versus outgroup membership information dependent on the individuating information's valence can be predicted: the enhancement of ingroup members should be stronger for negative individuating information, whereas the devaluation of outgroup members should be stronger for positive individuating information. Further a negative correlation between intragroup differentiation and intergroup differentiation on the level of individual judgements is assumed. In a two (judge's group membership: overestimator versus underestimator) by three (target's group membership information absent; target's group membership information present as either ingroup, or outgroup member) by three (valence of the individuating information: positive, neutral, negative) factorial minimal group design with repeated measures on the last two factors the targets' likability had to be rated. The findings are in accord with predictions. Theoretical conclusions with respect to social judgement—and to intergroup theories as well as with respect to general approaches to context effects in social judgement are discussed.     

Integration of information in a clinical judgment task, an empirical comparison of six models.

Six models were compared for their effectiveness in reproducing six clinical psychologists' judgments of 38 patients on intelligence, ability to establish contact, and control of affect and impulses. In two of the models, subjective weights were used in the prediction of a judge's ratings. The judges based their judgments solely on verbal protocols from the Rorschach, a sentence completion test, and the Thematic Apperception test. The stability of the linear aspect of the judgment process was very high but decreased as the depth of interpretation of the rating variable increased. The nonlinear aspect of the judgment process had considerably low stability. In general, a model based on subjective weights was most effective in reproducing the judges' ratings.     

The team meeting on a rapid turnover psychiatric ward: clinical illustration of a model for stages of group development.

This article illustrates stages of group development in a semi-structured team meeting of staff and patients in an inpatient psychiatric unit. Clinical material drawn from such a group at the Massachusetts Mental Health Center is presented in support of the view that, even in a rapid-turnover ward, group process in a mixed-level, mixed-diagnosis "ward meeting" follows some predictable lines and responds to the articulation of certain predictable concerns. Garland's (1981) model of group development is adapted to show the cyclical nature of group process in a teaching hospital, where doctors as well as patients may make only brief stays. Effective leadership strategies are suggested.     

Brief psychosocial assessment of a clinical sample: an evaluation of the Personal Problems Checklist for Adults

In light of the requirements for managed health care organizations to use assessment instruments that are psychometrically sound, cost and time efficient, and theoretically useful, the present study examined the psychometric properties of one such potential instrument, the Personal Problems Checklist for Adults (PPCA). Designed to measure problems in 13 areas of everyday functioning, the PPCA along with the Brief Symptom Inventory were completed by 132 individuals in an outpatient drug rehabilitation program. Counselor ratings on the Adjective Check List were also obtained. Results clearly showed that personal problems as measured by the PPCA were related to self-reported psychological symptoms and to perceptions by their counselors. The PPCA proved to have good psychometric properties and warrants greater attention by testing psychologists given its potential to meet criteria set forth by managed health care.     

A new nonpatient sample for the rorschach comprehensive system: a progress report

Some concern about recently published nonpatient data, plus the fact that some records in the published sample of 600 nonpatients (Exner, 2001) were collected more than 20 years ago, prompted the initiation of a project to develop a new nonpatient sample. In this article, findings are presented for the first 175 participants tested in the new project. It is noted that the data from the new project are quite similar to those for the sample of 600. Results suggest that the similarities between the data sets supports the notion that the published sample is probably representative and provides a reasonable basis from which to identify response rates and the proportions of nonpatients expected to fall in, or outside of, established parameters for various ratios and other structural indexes.     

Developing stimulus control of the high-rate social-approach responses of an adult with mental retardation: a multiple-schedule evaluation

We evaluated a multiple schedule in which the extinction (S-) components were signaled overtly by a black lanyard and the reinforcement (S+) components were not correlated with any programmed stimuli in developing stimulus control over the high-rate social-approach responses of an adult with mental retardation. Responding was consistently low in the presence of the S- and consistently high when the lanyard was absent (i.e., the S+ condition). Component durations were thinned successfully to a level that was manageable for caregivers.     

ERP correlates of form and rhyme letter tasks in impaired reading children: a critical evaluation.

Event-related potentials (ERPs) were obtained from 15 electrode sites in six average and six impaired reading children, 12 years of age, during visual letter discrimination tasks. Subjects responded to target letters with an enclosed area in the form task and to letters that rhymed with "e" in the rhyme task. Response accuracy was similar between the groups. Reaction time was relatively longer for the impaired group during the rhyme task. At lateral sites, condition differences were evident as greater negative shifts in the rhyme task than the form at 170 and 470 ms as well as a delayed late positivity for the rhyme. In terms of reading ability, the average readers' ERPs were more negative than those of the impaired group at 270 and 450 ms. Inter-hemispheric variations were also seen between the groups, with the average readers more negative than the impaired readers at right hemisphere sites. Contrary to expectations, group differences in the ERP did not vary substantially as a function of condition, and task demands were evaluated in view of these findings.     

Empirical evaluation of a model of global psychophysical judgments: III. A form for the psychophysical function and intensity filtering

In part I, a concept of ratio estimation is defined and it is shown that if such estimates depend only upon the physical ratio of the signal to the reference signal, the psychophysical function must be a power function. Assuming the same exponents for each component, an invariance condition, equivalent to a sum of power functions, is studied empirically for binaural loudness. It is fully or partially sustained for 19 of 22 respondents. Since failures may be attributable to different exponents in the two ears, the ratio of the two exponents is estimated but that fails to explain the failures. Other possible explanations are suggested. In part II, an intensity filtering model is presented, accounting for the phenomenon where monaural loudness matches show a bias depending on the matching ear. We show (a) that the existence of such a bias does not alter the prior experimental results; and (b) assuming the power function, that five respondents attenuate the opposite ear and two enhance it.     

Making ethical choices: a comprehensive decision-making model for Canadian psychologists.

This paper proposes a theoretical augmentation of the seven-step decision-making model outlined in the Canadian Code of Ethics for Psychologists. We propose that teleological, deontological, and existential ethical perspectives should be taken into account in the decision-making process. We also consider the influence of individual, issue-specific, significant-other, situational, and external factors on ethical decision-making. This theoretical analysis demonstrates the richness and complexity of ethical decision-making.