An empirical approach to the classification and treatment of maximum security psychiatric patients

Treatment approaches with forensic patients have traditionally been nonspecific and have been based primarily on legal or diagnostic categories. The current study, stimulated by the need to reorganize treatment and assessment services, examined the incidence among 189 maximum security psychiatric patients of 70 problems commonly exhibited either in the community prior to admission or within the institution. Through a series of factor and cluster analyses, a model for the placement and treatment of these patients was developed that included assaultiveness, level of functioning, social withdrawal, and active psychotic symptoms.     

The parental attitude research instrument: An approach to use of attitude questionnaires

Parental attitude questionnaires such as the Parental Attitude Research Instrument (PARI) are still in use despite their inherent difficulties. In light of the need to test theoretical models by measuring a range of parental characteristics, the properties of the PARI were re-examined and, on the basis of a factor analysis of the 23 subtests of the PARI, a shortened version was constructed. A measure of maternal Authoritarian Control, which was found to be associated with measures of maternal mental ability, personality, level of education, reading age, number of adverse family conditions and child-rearing practices, has proved useful for other projects related to this ongoing study. It is recommended that such instruments be used only in conjunction with other measures which examine the family environment, for example in an index of child-rearing practices.     

The omega project: An empirical study of the NDE-prone personality

Seventy-four near-death experiencers (NDErs) and 54 persons interested in near-death experiences (NDEs) participated in a mail questionnaire survey to assess the role of psychological factors in influencing susceptibility to NDEs and to measure aftereffects stemming from such events. NDErs, while not more fantasy-prone than control subjects, reported greater sensitivity to nonordinary realities as children and a higher incidence of child abuse and trauma. NDErs also scored higher on a measure of psychological dissociation. We discuss the implications of these findings for the concept of an NDE-prone personality. In addition to substantial shifts in values and beliefs, NDErs described far more psychophysical changes, including symptoms of kundalini activation, following their NDEs than did controls. We then discuss the implications of these findings with respect to their possible significance for human transformation and the emergence of a more highly evolved human being, the Omega Prototype.At the time of this study, Mr. Rosing was a student at the University of Connecticut     

An empirical study of item-test regression

Certain questions about the shape of item-test regressions are answered on the basis of data obtained from 103,275 examinees. Ten of the regressions obtained are shown in illustrative plots.This work was supported in part by the College Entrance Examination Board.     

The neurophenomenology of early psychosis: An integrative empirical study

BackgroundThe integration of various domains or levels of analysis (clinical, neurobiological, genetic, etc.) has been a challenge in schizophrenia research. A promising approach is to use the core phenomenological features of the disorder as an organising principle for other levels of analysis. Minimal self-disturbance (fragility in implicit first-person perspective, presence and agency) is emerging as a strong candidate to play this role. This approach was adopted in a previously described theoretical neurophenomenological model that proposed that source monitoring deficits and aberrant salience may be neurocognitive/neurobiological processes that correlate with minimal self-disturbance on the phenomenological level, together playing an aetiological role in the onset of schizophrenia spectrum disorders. The current paper presents full cross-sectional data from the first empirical test of this model.MethodsFifty ultra-high risk for psychosis patients, 39 first episode psychosis patients and 34 healthy controls were assessed with a variety of clinical measures, including the Examination of Anomalous Self-Experience (EASE), and neurocognitive and neurophysiological (EEG) measures of source monitoring deficits and aberrant salience.ResultsLinear regression indicated that source monitoring (composite score across neurocognitive and neurophysiological measures), with study group as an interaction term, explained 39.8% of the variance in EASE scores (R² = 0.41, F(3,85) = 14.78, p < 0.001), whereas aberrant salience (composite score) explained only 6% of the variance in EASE scores (R² = 0.06, F(3,85) = 1.44, p = 0.93). Aberrant salience measures were more strongly related to general psychopathology measures, particularly to positive psychotic symptoms, than to EASE scores.DiscussionA neurophenomenological model of minimal self-disturbance in schizophrenia spectrum disorders may need to be expanded from source monitoring deficits to encompass other relevant constructs such as temporal processing, intermodal/multisensory integration, and hierarchical predictive processing. The cross-sectional data reported here will be expanded with longitudinal analysis in subsequent reports. These data and other related recent research show an emerging picture of neuro-features of core phenomenological aspects of schizophrenia spectrum disorders beyond surface-level psychotic symptoms.     

Gender roles and care giving to the elderly: An empirical study

The purpose of this research was to examine care giving to the elderly from a gender role perspective. Data were collected from a randomized sample of Québec care givers (n=294) who provide various levels of care giving to people with different kinds of impairments. The results indicate that although women provide more care than men, both experience an equivalent burden. Familial obligations (Presence of a Spouse × Presence of Children) affect men and women care givers differently. An intersex generation effect is evident with regard to professional burden: husband care givers report a greater burden than wives, whereas daughters and sons report the same level. The findings suggest that men have more difficulty assuming responsibilities associated with multiple roles, whereas women have adopted new roles in addition to the traditionally ascribed care-giving role.The research reported in this paper is part of a study funded by the Conseil québécois de la recherche sociale, the Social Sciences and Humanities Research Council of Canada, and the Ministère de la Santé et des Services sociaux. The authors wish to thank Jocelyne Boivin for her helpful work with the documentation and Lottie White for her help with the English version of this paper, as well as the anonymous reviewers of whose judicious comments were greatly appreciated.     

An empirical study of the diathesis-stress theory of disease

One thousand, one hundred and twenty-one Jewish concentration camp survivors were compared with 367 Jewish controls who had not been in a concentration camp, and had not lost any family members in such a camp. Of interest was the mortality of camp and comparison groups, on the hypothesis that the stress of being in a camp would adversely affect inmates. It was found that former camp inmates were over twice as likely to die of cancer, coronary heart diesease, or other causes as the comparison subjects of similar age and sex composition, and that severity of stress was correlated with mortality in the expected direction. Diathesis, determined by means of a special interviewer-administrated questionnaire, was found to interact synergistically with stress in producing high mortality.     

An empirical study of the validity of handwriting analysis

The EPQ was administered to 99 Ss, and a handwriting sample provided by each. A professional graphologist undertook to analyse the handwritings, and fill in the EPQ as she thought would have been done by the respondents. Significant correlations were only obtained for the P category; neither E, nor N, nor the L scale showed significant correlations between Ss and the graphologist.     

An empirical study of the factor analysis stability hypothesis

Note is taken of four related sources of confusion as to the usefulness of Thurstone's factor analysis model and of their resolutions. One resolution uses Tucker's distinction between exploratory and confirmatory analyses. Eight analyses of two sets of data demonstrate the procedures and results of a confirmatory study with statistical tests of some, but not all, relevant hypotheses in an investigation of the stability (invariance) hypothesis. The empirical results provide estimates, as substitutes for unavailable sampling formulations, of effects of variation in diagonal values, in method of factoring, and in samples of cases. Implications of these results are discussed.The computational costs of this study were defrayed, in part, by a research small grant M-1922 from the National Institute of Health, and, in part, by support under project 176-0002 by the University of Iowa Computing Center, Dr. J. P. Dolch, Director. The assistance of Dr. Kern Dickman and Mr. Leonard Wevrick of the University of Illinois and of Mr. Norman Luther of the University of Iowa in handling the computing problems is gratefully acknowledged.     

An empirical study of the traditional Mach card effect

The traditional achromatic Mach card effect is an example of lightness inconstancy and a demonstration of how shape and lightness perception interact. We present a quantitative study of this phenomenon and explore the conditions under which it occurs. The results demonstrate that observers show lightness constancy only when sufficient information is available about the light-source position, and the perceptual task required of them is surface identification rather than direct colour-appearance matching. An analysis and comparison of these results with the chromatic Mach card effect (Bloj et al 1999 Nature 402 877-879) demonstrate that the luminance effects of mutual illumination do not account for the change in lightness perception in the traditional Mach card.     

The effects of interactive staff training on staff programing and patient aggression in a psychiatric inpatient ward

Interactive staff training (IST) uses principles of organizational psychology to help line-level staff members design and implement social learning programs for severely mentally ill inpatients. IST is a training package that includes assessment of staff perceptions regarding programatic needs, selection of appropriate social learning strategies to meet these needs, appointment of a program committee from within the ward to champion development of the social learning strategy, and participative decision making about aspects of the social learning strategy. Staff on an extended care ward at a state hospital participated in IST for 15 months as part of a pilot study of its effects. Ongoing examination of ward programing showed that IST significantly increased staff and patient participation in rehabilitation programing and decreased the rate of physical restraints and aggression-related. Changes in staff attitudes about rehabilitation programing were noted on a subsample of IST participants. Implications for more controlled research into IST are discussed.     

An empirical study of medical termination of pregnancy

Several studies (Senturia and Rothman, 1967; Simon et al., 1969; Stewart et.al., 1973) have shown that therapeutic abortion may be accompanied by various psychological problems (e.g., psychiatric illness, confused sexual identity, sadomasochism). This study attempts to determine the personality characteristics, e.g., extraversion-introversion, neuroticism-stability and manifest anxiety of women who seek abortion and compare them with a control group. The Eysenk Personality Inventory and the Manifest Anxiety scale adapted by George (1965, 1974) were administered to 2 groups, the experimental group (n=50; mean age, 25.8) consisting of women seeking abortion, and the control group (n=30; mean age, 25.4 years; matched for age and socioeconomic status with the experimental). Mean values for extraversion-introversion, neuroticism-stability, and manifest anxiety for the experimental group were 11.08, 15.5 and 23.74 respectively. Corresponding figures for the control group were 11.00, 10.46, and 11.96 respectively. The results show that the experimental group differed significantly from the control group in the dimensions of neuroticism and manifest anxiety. No significant differences were found between the 2 groups in terms of extraversion. The stressful nature of pregnancy is briefly discussed.     

An empirical look at the Defence Mechanism Test (DMT) Stimulus effects

Based on a sample of non-clinical subjects (N=74) the study examines the Defence Mechanism Test (DMT) by focusing on when perceptual distortions, called ‘signs of defence’ in DMT terminology, occur (distribution in exposure duration), which part of the picture is involved (distribution in localisation), and which ‘signs’ go together (using correlation and factor analyses). The results disclosed that the occurrence of perceptual distortions (‘signs of defence’) was related to exposure duration (some ‘defences’ are more frequent at brief exposures, some others at longer exposure durations), and to localisation on the picture. The location of misperceptions to the central person (hero) or the peripheral person (pp) of the picture was the major explanatory principle for the distribution of ‘signs’ on factors. Rather than capturing psychodynamic defence mechanisms, which is the theoretical basis of the test, the analyses imply that the DMT seems to measure misperceptions which are a function of the localisation of persons on the stimulus picture and of exposure durations.     

An empirical study of seriously disturbed suicidal patients

Aspects of unconscious processes in a group of seriously disturbed psychiatric patients are examined in an effort to predict near-lethal suicide attempts and explore psychoanalytic formulations of suicide. The Rorschach Inkblot Test, the most widely used projective measure in suicide research (Bongar 1991), was chosen for its potential to shed light on specific unconscious processes. Psychic states commonly associated with suicide were measured by psychoanalytic Rorschach analog scales and then subjected to a progression of statistical analyses in order to predict future occurrence and lethality of suicide attempts. On the basis of a priori hypotheses, the authors developed a suicide index comprising four psychoanalytic Rorschach signs that predicted, with considerable accuracy, which patients would later make near-lethal suicide attempts. The best predictors were unconscious processes indicative of penetrating affective overstimulation, disturbance in the capacity to maintain adequate ego boundaries, and depressive affective states characterized by a morbid preoccupation with death and inner decay. These findings provide empirical support for several well-known formulations of the unconscious motivations for suicide.     

Conservatism and attitude to love: an empirical rebuttal of Eisler and Loye

Eisler and Loye propose that there is an age-old polarity underlying contemporary liberal-conservative differences. They identify this as affectionate, linking attitudes versus hierarchical, aggressive attitudes. These are also linked to sexual equality/inequality. There are however other previous proposals for what underlies the Right-Left division and the evidence advanced for their case by Eisler and Loye seems to consist principally of quotations from past ‘authorities’ (philosophers, historians, feminists etc.). Empirical evidence from contemporary society is lacking. To remedy this deficit, the Munro-Adams Love-attitude Scale was administered together with four scales of conservatism to a random postal sample of 377 Australians. By far the most love-oriented people were moral conservatives— people who reject sexual permissiveness. The results are then quite the opposite of what the Eisler and Loye theory requires.     

Posttraumatic play in young children exposed to terrorism: An empirical study

The phenomenon of “posttraumatic play” (PTP) has received much clinical recognition and little empirical support. The objective of this study was to examine various aspects of PTP in young children exposed to terror events and their relation to posttraumatic stress disorder (PTSD). Individual play sessions, conducted with 29 young Israeli children directly exposed to terrorism (M age = 5.47, SD = 1.34) and 25 matched unexposed children (M age = 5.62, SD = 0.87), were coded using the Children's Play Therapy Instrument–Adaptation for Terror Research (CPTI‐ATR; S.E. Chazan & E. Cohen, 2003). Analyses using these ratings showed (a) significant differences between the two groups, (b) significant associations with the caregiver's reports on child's exposure, and (c) significant associations with the caregiver's reports on the child's PTSD symptoms. Play activity ratings of predominant negative affects, frequent acting‐out/morbid themes, lowered developmental level, and reduced awareness of the child of him‐ or herself as a player significantly predicted more PTSD symptoms. PTP which included more coping strategies classified as “overwhelmed reexperiencing” and less “reenactment with soothing” was associated with a higher level of PTSD. Play analysis with the CPTI‐ATR may be helpful in identifying PTSD in children and also guide the selection of therapeutic techniques.