Group therapy reduces medical and psychiatric hospitalization.

This article studies the impact of outpatient group therapy on medical care at a large city-county hospital. Of the 65 group therapy outpatients, 33 persons met the criterion of having attended at least 12 group sessions over the course of a year. We compared a control period (the year prior to initiating group therapy) with a study period (months 6-18 after starting group) and found a sharp decrease in the number of hospitalizations and in-hospital days. There was significantly increased use of neuroleptics and nonpsychotropics and increased attendance at nonpsychiatric clinics.     

A checklist for testing measurement invariance

The analysis of measurement invariance of latent constructs is important in research across groups, or across time. By establishing whether factor loadings, intercepts and residual variances are equivalent in a factor model that measures a latent concept, we can assure that comparisons that are made on the latent variable are valid across groups or time. Establishing measurement invariance involves running a set of increasingly constrained structural equation models, and testing whether differences between these models are significant. This paper provides a step-by-step guide to analysing measurement invariance.     

Griesinger's psychiatric approach

The standpoint from which Griesinger considered mental illness and the closely connected relationship between body and mind is described. The conclusion is drawn that Griesinger, realising that body and mind form an entity with the brain as an organ and psychological processes as its function, regarded mental illness as an organopathological process. This played a great role in raising psychiatry to the status of the purely somatic fields of medicine.     

Psychometric evaluation of the symptom checklist (SCL-90) in psychiatric inpatients

The factorial validity, temporal stability and discriminatory power of the Symptom Checklist (SCL-90) were investigated in a heterogeneous sample of short-stay psychiatric inpatients (n=437). Results from a confirmatory factorial approach suggested a reduced dimensionality for the SCL-90 rather than supporting the 10 or 9 a priori symptom dimensions. From exploratory factor analyses 4 clinically interpretable and moderately intercorrelated dimensions emerged: depression, hostile-suspiciousness, somatization and phobic anxiety. Internal consistency and temporal stability coefficients of these 4 subscales and of the global scale were satisfactory. SCL-90 discriminated poorly between different clinical groups. However, the scale quite successfully discriminated patients from healthy subjects from the general population. It is concluded that SCL-90 might be a valuable instrument for the detection of potential psychiatric cases in the general population.     

Ethical Criteria for Health-Promoting Nudges: A Case-by-Case Analysis

Health-promoting nudges have been put into practice by different agents, in different contexts and with different aims. This article formulates a set of criteria that enables a thorough ethical evaluation of such nudges. As such, it bridges the gap between the abstract, theoretical debates among academics and the actual behavioral interventions being implemented in practice. The criteria are derived from arguments against nudges, which allegedly disrespect nudgees, as these would impose values on nudgees and/or violate their rationality and autonomy. Instead of interpreting these objections as knock-down arguments, I take them as expressing legitimate worries that can often be addressed. I analyze six prototypical nudge cases, such as Google’s rearrangement of fridges and the use of defaults in organ donation registration. I show how the ethical criteria listed are satisfied by most—but not all—nudges in most—but not all—circumstances.     

Chaplains' medical approach to psychiatric patients

Chaplains' understanding of people's psychiatric and medical problems may aid them in dealing with people's spiritual problems. However, exploratory interviews and observations of chaplains and inpatients at a VA psychiatric facility indicate that chaplains take a medical model perspective with patients, often attempting to treat patients' psychiatric problems rather than focusing on their reliigious needs. Chaplains avoid one-on-one religious discussions despite the importance of these conversations to patients. Discussed are implications for the utilization of health services and for the formation of treatment teams.This paper is a revised version of a paper presented at the Society for Applied Anthropology meetings held in Lexington, Kentucky, March 1982.