Multimodal therapy in an inpatient setting

Inpatient Multimodal Therapy (imt) is a residential treatment program, lasting a maximum of 36 weeks, for patients with severe neurotic symptoms. A group of 44 chronic obsessive-compulsive patients and a group of 40 chronic phobic patients were treated in order to assess the outcome and the process of treatment and to identify prognostic factors associated with the effect. At follow-up—on average, eight months after discharge—it was found that 60% had improved, 32% had remained the same, and 8% had deteriorated, indicating that, in general, the treatment was beneficial. That these effects were long-lasting is supported by the fact that, at follow-up, 78% of all patients were no longer receiving treatment, 18% were receiving outpatient or day treatment, and 4% were receiving inpatient treatment. Phobic patients appear to have gained more from the multimodal approach than did obsessive-compulsive patients, as indicated by the fact that the severity of symptoms decreased as they improved in rational thinking, assertiveness, and arousal. By contrast, obsessive-compulsive patients relapsed more than phobic patients did. This was attributed to the fact that the former gained less from the rational-emotive training, denied problems with assertiveness, and did not practice the acquired relaxation skills. It further appeared that a favorable outcome could be induced in patients who (1) expressed relatively mild symptoms in this otherwise severe group, (2) reported relatively few additional complaints, (3) could clearly indicate interpersonal problems, and (4) did not use psychotropic drugs. These prognostic factors are so widespread that not much weight can be ascribed to them. Yet they are useful for indication ofimt until better predictors are found.     

Incremental validity of selected MMPI-A content scales in an inpatient setting

To date, relatively few studies have been published evaluating the validity or incremental validity of the content scales from the adolescent version of the Minnesota Multiphasic Personality Inventory (MMPI-A; J. N. Butcher et al., 1992). A sample of 629 psychiatric inpatient adolescents who had completed the MMPI-A was used to evaluate the ability of selected clinical and content scales to predict conceptually related clinical variables. Criteria were based on clinician ratings, admission and discharge diagnoses, and chart reviews. Results from hierarchical multiple and logistic regression analyses indicated the content scales offered incremental validity over the clinical scales and supported the use of the content scales as an adjunct to the traditional clinical scales.     

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.     

Different origins and meanings of acute acting-out in an inpatient psychotherapeutic setting

In this paper I describe four different sources of acute acting-out behaviour as may be observed in long-term hospitalised patients suffering from severe personality disorders. I hope to demonstrate that acute psychological distress does not happen in a vacuum, but that specific intrapsychic and interpersonal dynamics within the hospital setting are at the root of what appears overtly as nonspecific emotional and behavioural disturbance. I argue that the hospital team's correct insight into the factors underlying acute acting-out is crucial to the implementation of therapeutic interventions aimed to decrease the patient's disturbed state of mind.     

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.     

Developmental Progression of Clock Face Drawing in Children

The clock drawing test has been routinely administered by many neuropsychologists as part of their testing battery with the adult population. Our study investigated the development of clock face drawing in normal children ages 6 to 12 years. Conceptualization of time and construction of the clock face were assessed by an adapted scoring system developed as part of the investigation. As a group, the results indicated an upward progression with regard to the concept of time through age 8 and clock construction through age 12. Results further demonstrated that number reversals were more frequent among left-handers but were no longer evident by age 7 regardless of handedness. It also was determined that left visuospatial neglect specific to the upper quadrant was relatively common in 6- and 7-year olds but not evidenced by age 8. Given the pattern of the findings, it is likely that the neglect was secondary to poor planning and not a visuo-spatial deficit. In general, development of clock face drawing most closely paralleled that of frontal lobe maturation. Implications of these findings and the usefulness of clock face drawing with the pediatric population are presented.     

Effectiveness of dialectical behaviour therapy for borderline personality disorder in an inpatient setting

This study evaluates the effectiveness of dialectical behaviour therapy (DBT) for borderline personality disorder (BPD) in an unselected, comorbid population seeking 3-month inpatient treatment. We studied 50 consecutively admitted individuals (44 women, six men) with BPD as defined by DSM-IV at three time points (at admission, at discharge, and at the 15-month follow-up). For the clinical diagnoses, we used the Structured Clinical Interview for DSM-IV (SCID) and compared the frequencies of comorbid axis I and axis II disorders at admission and at the 15-month follow-up. Overall, participants showed a high degree of comorbidity. Psychopathology was significantly reduced at post-treatment and at follow-up. Effect sizes for outcome measures were within the range of those of previous studies. Our findings support the notion that the results of the DBT efficacy research can be generalized to an inpatient setting and to patients with BPD disorder with high comorbidity.     

The criterion validity of the Borderline Personality Features Scale for Children in an adolescent inpatient setting

The purpose of the current study was to examine the criterion validity of the Borderline Personality Features Scale for Children (BPFS-C) by assessing the performance of the self-report and a newly developed parent report version of the measure (BPFS-P) in detecting a borderline personality disorder (BPD) diagnosis in adolescent inpatients. This study also examined parent-child agreement and the internal consistency of the BPFS subscales. An inpatient sample of adolescents (n = 51) ranging from ages 12-18 completed the BPFS and were administered the Child Interview for DSM-IV Borderline Personality Disorder (CI-BPD) by trained clinical research staff. ROC analyses revealed that the BPFS-C has high accuracy (AUC = .931; Se = .856; Sp = .840) in discriminating adolescents with a diagnosis of BPD, as measured by the CI-BPD, while the BPFS-P has moderate accuracy (AUC = .795; Se = .733; Sp = .720). Parent-child agreement on total scores was significant (r = .687; p < .005). Cronbach's alphas suggested internal consistency for the four subscales of the BPFS. These findings support the criterion validity of this measure, particularly the self-report version, in adolescent inpatient settings.     

执行控制研究的重要范式——任务切换

任务切换是当前研究执行控制的重要范式。被试完成切换任务要慢于完成重复任务,并且往往有更高的错误率,这种差异称为切换损失。该文对此领域的研究进行了回顾,介绍了任务切换研究范式的发展,重点阐述了对切换损失来源的三种主要解释：任务重建、联结竞争和任务设置的惯性;指出任务切换与其他范式的结合是更深入地了解执行控制的可行途径。最后进行了简要的总结与展望。     

Psychometric properties of the Psychological Flourishing Scale in an Egyptian setting

The specific goals of the present research were twofold: i) to test the structure validity, and internal reliability of scores from the Psychological Flourishing Scale (PFS) with Egyptian college students; and ii) to test the PFS’s temporal stability and convergent validity properties. Two samples of Egyptian college students completed the PFS (n = 374; n = 173) to address the two research aims in two studies. The students also completed the Mental Health Continuum-Short Form (MHC-SF) and the Satisfaction With Life Scale (SWLS) for determining the concurrent validity of scores. In the first study, the internal consistency was evaluated. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed. In the second, the temporal stability and convergent validity were tested. The Arabic version of PFS showed a high internal reliability, structure, and convergent validity, and moderate temporal stability.     

Task performance and perceptions of anxiety: averaging and summation in an evaluative setting

Suggests that individuals' "stage fright," or perceptions of anxiety and performance, is a function of tendencies to both average and summate the impact of audience members. We found that under certain conditions adding an evaluative member to an audience decreased anxiety, whereas in other conditions the addition of evaluative members increased anxiety. These results are not expected from social impact theory or social facilitation research and suggest that individuals do not react to groups of individuals in a manner analogous to the way in which trait information is typically averaged in forming impressions of individuals (Anderson, 1981). An averaging-summation model that does account for these findings is presented. This research has implications for research on crowding, stress, social influence, and affective responses.     

Prevalence of renewal of problem behavior: Replication and extension to an inpatient setting

Individuals with intellectual and developmental disabilities who exhibit problem behavior often receive behavioral assessment and treatment in specialized inpatient and outpatient clinics. However, problem behavior sometimes reemerges as a function of changes in contexts and stimulus conditions, such as returning to the home environment. This reemergence is called renewal. Recently, Muething et al. (2020) found that renewal occurred in over half (67%) of cases from an outpatient clinic. Their sample was obtained exclusively from an outpatient setting and despite the applied relevance of renewal, its clinical prevalence in other populations is unknown. Accordingly, we replicated Muething et al.’s procedures and analyzed renewal in 37 inpatient treatment applications across 34 cases via consecutive‐controlled case series. Renewal was present in 59% of cases; however, we found that renewal occurred in only 24% of context changes compared to 42% reported by Muething et al. Various factors related to the prevalence of renewal were evaluated.     

Factors delaying rehabilitation in inpatient treatment of schizophrenic patients

An empirical study involving 104 German and 208 Soviet schizophrenics showed that the main factors delaying rehabilitation are a large number of previous hospitalizations, long periods preceding hospitalization, the type of schizophrenia, the desired aim of treatment, disturbed relationship of he patient to his or her environment and performance disturbances. Apart from certain personality deviations, the therapeutic measures also involve factors that delay rehabilitation. The rehabilitation barriers mentioned here could be overcome by the more widespread establishment of follow-up care centres.     

Extratest validity of selected personality assessment inventory scales and indicators in an inpatient substance abuse setting

The purpose of this study was to extend previous findings regarding the extratest validity of the Personality Assessment Inventory (Morey, 1991, 2007) scales and indicators in forensic contexts to an inpatient substance abuse setting. The Aggression Scale, and particularly the Physical Aggression subscale, related to assault history; the Suicide Scale and Suicide Probability Index related to history of suicide attempts; Antisocial Features, and particularly the Antisocial Behaviors subscale, predicted rule infractions; and the Treatment Process Index predicted treatment completion. We discuss clinical implications in the context of extant findings.     

Executive Functioning Demands of the Object Retrieval Task for 8-month-old Infants

At 8 to 11 months of age, infants are more successful in negotiating opaque relative to transparent barriers. However, 7-month-old infants have more difficulty with opaque barriers relative to semitransparent barriers. Here, 8-month-old infants spent more time in ineffective direct reaches with more the transparent barriers (Experiments 1 & 2) and were faster with the fully opaque barrier (Experiment 2). This demonstration of the graded effects of transparency confirms the working memory and/or response inhibition demands of the object retrieval task.     

Interfering with the Central Executive by Means of a Random Interval Repetition Task

Four dual-task experiments are reported in which a short-term memory task is performed concurrently with a random interval repetition task, which was designed to interfere with functions normally attributed to the central executive in the working memory model of Baddeley and Hitch (1974). The task was found to interfere with supra-span serial recall and with backward memory span, but did not disrupt performance on a forward-memoryspan task. The effects were observed in dissociation with effects of articulatory suppression and matrix tapping, so that the locus of the effects of the new task is not due to the slave systems. In addition, single-task random-interval repetition performance was sampled and compared to performance in the dual-task conditions of all four experiments. Although quality of tapping performance differed between the single-task and the dual-task conditions, it was not related to recall performance. All the results are discussed with reference to the working memory model.     

Measurement of Human Performance in Complex Task Environments

This article outlines a model of human performance representing an alterna- tive to studying human interaction in complex systems solely as a function of traditional performance measures (i.e., speed- and accuracy-based measures taken from the system itself). The model described was developed to focus on pilot/operator strategies as they are formulated in the context of the task en- vironment. This model facilitated the development of human-system interac- tion (HSI) measures which allow the quantitative assessment of operator strategies, in terms of the functions affected and the sequence of actions taken in response to external challenges. In conjunction with the more tradi- tional pilot performance measures, HSI measures can be used to investigate how strategic responses impact overt performance.     

The Interaction of Criterion and Feedback Information in Learning a Drawing Task

Experiments were designed to examine the influence of criterion and feedback information in the learning of a two-dimensional drawing task. Experiment 1 showed that when the task criterion is well known to the subject, the combined presentation of criterion information and information feedback facilitates the rate of acquisition of the skill but not its overall performance level of achievement. Experiment 2 showed that when the task criterion information is not well known to the subject, presentation of criterion information facilitates both the rate of acquisition and the overall performance level and, furthermore, is essential if configuration information feedback is to be utilized effectively. Experiment 3 showed that it is the combined presentation of criterion and configuration information feedback, rather than the isolated presentation of either type of information alone, that facilitates learning and performance. Collectively, the findings from the three experiments suggest an interactive effect of prior knowledge by the learner and type of augmented information in facilitating the acquisition of skill, according to the constraints imposed in the task. The data are consistent with the proposal that the degrees of freedom in the information available to support motor skill learning must match the degrees of freedom to be constraint in the perceptual-motor workspace.     

Detecting back irrelevant responding on the Personality Assessment Inventory in a psychiatric inpatient setting

The present studies focus on strategies for detecting back irrelevant responding (BIR) on the Personality Assessment Inventory (PAI; L. C. Morey, 1991). Moderate BIR levels can greatly affect the clinical scales of the PAI. Further, the PAI's Inconsistency and Infrequency validity scales are less than optimal for detecting BIR. L. C. Morey and C. J. Hopwood (2004) developed an alternative strategy for detecting BIR that involves comparison of 2 scales from the PAI short-form with the same 2 scales from the PAI full-instrument. The present study examines how different BIR levels affect the clinical, treatment, and interpersonal scales of the PAI in 2 psychiatric inpatient samples. The effectiveness of various strategies for detecting BIR in an inpatient setting is also discussed. Consistent with previous research, moderate rates of BIR impacted several PAI scales in a meaningful way. The Inconsistency and Infrequency validity scales of the PAI were relatively ineffective for detecting low-to-moderate BIR levels. Conversely, the short-form full-instrument comparison strategy was much more sensitive to BIR. Finally, a new BIR detection indicator is presented that improves sensitivity rates for detecting all BIR levels in an acute setting. The implications of these results for detecting BIR in inpatient settings are discussed.