Systems use to objectify program evaluation,clinical, and management decisions

The utility of the observational assessment systems at different levels — from local clinical to systemwide management — is outlined. An overview is provided of TSBC information applied to individualized problem identification and programming/monitoring, discharge and competency determinations, and both absolute and comparative program evaluation. The utility of SRIC information for prgoramming/monitoring and for staff training and evaluation is outlined in addition to the applied uses of the information of the assessment systems in combination. Once implemented, the continuous data from the systems allow for empirically based self-corrective improvements in the quality of mental health services while automatically providing a basis for legal documentation and accurate cost/effectiveness comparisons of mental health programs.Preparation of this article and the research and development on which the article is based were supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health, and by grants from The Joyce Foundation and the Illinois Department of Mental Health and Developmental Disabilities.Presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979, as part of a symposium on New assessment systems for residential treatment, management, research, and evaluation.     

Clinical Frequencies Recording System: Standardizing staff observations by event recording

Certain aspects of staff performance and resident behavior are less adequately assessed by standardized time sampling procedures than by complete recording of the incidence of specified events. An approach to gathering such data through systematizing the observations of clinical staff — the Clinical Frequencies Recording System — is described. Scores from the Clinical Frequencies System reflect the rate per opportunity with which individual behaviors are performed, with computer summarization providing higher-level behavioral indexes for research and evaluation purposes. Staff training and system implementation are discussed, and reliability and validity data from a system employed on two different treatment units over a period of several years are presented.The research reported in this article was supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health.Presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979, as part of a symposium on New assessment systems for residential treatment, management, research, and evaluation.     

A demonstration of the value of interchangeable observers

The remarkably high agreement between observers using the SRIC, the TSBC, and the CFRS makes the observers interchangeable. This agreement is a product of the intensive and extensive training and monitoring of full-time observers, the use of categories rather than continua, the low degree of interpretation required by the procedures, the use of lay language, the immediate recording after short observational periods, and the familiar and standard setting. Other important features include use of rates, emphasis on time, concern for positive behavior, and close linkages between concepts and categories so that concepts are explicitly specified. Taken together, these characteristics make these systems powerful instruments for the guidance of treatment and the prediction of outcomes. The key to their success seems to be the recording of simple actions and action sequences (the basic phenomena of psychology) as the basic data from which a variety of useful indexes can be readily formed.Preparation of this article was supported by Grant MH-30654 from the National Institute of Mental Health to S. Duncan and D. Fiske.Presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979, as part of a symposium on New assessment systems for residential treatment, management, research, and evaluation.     

Judgmental relativism as a validity threat to standardized psychiatric rating scales

Judgemental relativism is a threat to the replicability and validity of measures of client behavior from direct rating scales whenever raters are exposed to different levels of client functioning since the internal standards, or anchor points, used to judge dimensional continua may vary on the basis of prior experience. Traditional interrater reliability indexes fail to identify such effects. The influence of judgmental relativism on summated ratings from the Nurses Observational Scale for Inpatient Evaluation (NOSIE-30) for 1040 adult mentally ill clients was examined with clinical staff raters from 24 treatment units in which the Time-Sample Behavioral Checklist (TSBC) provided full-week objective measures of actual client functioning via hourly direct observational coding (DOC). Regression analyses found that the same level of objective performance received higher or lower ratings across treatment units dependent on the raters'exposure to client groups that differed in level of functioning. Analyses of rating errors found that clients with better levels of functioning relative to others within treatment units were rated even higher than performance warranted. The operation of halo and contrast effects is explored and guidelines are provided for determining when judgmental relativism may produce or nullify significant differences. DOC assessments should be used instead of retrospective ratings to support most decisions in residential settings. Specific recommendations for the application of rating scales and improving data quality are provided.This study was the basis of a master's thesis at the University of Houston by Betty E. Rich under the direction of Gordon L. Paul and Marco J. Mariotto. Richard M. Rozelle, to whom appreciation is expressed for helpful comments, served on the examination committee. This study was partially supported by grants to Gordon L. Paul from the National Institute of Mental Health, Public Health Service (MH-15353; MH-25464); the Illinois Department of Mental Health and Developmental Disabilities; the Joyce Foundation; the MacArthur Foundation; the Owsley Foundation; the Cullen Foundation; and the Center for Public Policy, University of Houston.     

New assessment systems for residential treatment,management, research,and evaluation: A symposium

An introduction and overview are presented to new observational assessment systems for ongoing assessment and monitoring of both staff and resident (client or patient) functioning in residential treatment programs for emotionally disturbed and mentally retarded adults.Preparation of articles and the research and development on which the articles are based was supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health, and by grants from the Joyce Foundation and the Illinois Department of Mental Health and Developmental Disabilities.A symposium presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979.     

Endogenous Ketamine-Like Compounds and the NDE: If So, So What?

This commentary on Karl Jansen's ketamine model for the near-death experience expands upon and raises additional questions about several issues and hypotheses: self-experimentation as a source of data; ketamine's similarities to and differences from classical hallucinogens; the need for quantification of unusual subjective states; clinical research and toxicological implications of this model; drugs as gateways to religious states; and evolutionary versus religious significance of naturally occurring compounds released in the near-death state. I suggest future research that could help explicate several of these areas.Formerly Associate Professor of Psychiatry at the University of New Mexico School of Medicine     

The fallacy of fallacies

Several of the so-called fallacies in Aristotle are not in fact mistaken inference-types, but mistakes or breaches of rules in the questioning games which were practiced in the Academy and in the Lyceum. Hence the entire Aristotelian theory of fallacies ought to be studied by reference to the author's interrogative model of inquiry, based on his theory of questions and answers, rather than as a part of the theory of inference. Most of the fallacies mentioned by Aristotle can in fact be diagnosed by means of the interrogative model, including petitio principii, multiple questions, babbling, etc., and so can Aristotle's alleged anticipation of the fallacy of argumentum ad hominem. The entire Aristotelian conception of inquiry is an interrogative one. Deductive conclusions caught Aristotle's attention in the form of answers that every rational interlocutor must give, assuming only his own earlier answers. Several features of Aristotle's methodology can be understood by means of the interrogative model, including the role of endoxa in it. Theoretically, there is also considerable leeway as to whether fallacies are conceived of as mistakes in questioning or as breaches of the rules that govern questioning games.     

Egalitarian sex role attitudes: Scale development and comparison of American and Japanese women

The English Form of the Scale of Egalitarian Sex Role Attitudes was administered to 238 American women after the original Japanese Form was developed and administered to 420 Japanese women. The results reveal that the English Form has a potential for use as a measurement of American women's sex role attitudes. The results of cross-cultural comparisons suggest that American women have more egalitarian attitudes than their Japanese counterparts. However, they have basically similar attitudes toward more general egalitarian values. Among the four roles of woman, wife, mother, and person, the majority of the American women choose person as the most important role, whereas the Japanese women do not claim any clear dominant role. But the results show that the Japanese women's attitudes toward women's roles have become more egalitarian and individualistic during the past two decades.This research was partly supported by a grant from the Dentsu Corporation's Yoshida Hideo Memorial Foundation. The author wishes to thank Roger Brown, Cynthia Chataway, Matina Horner, Ellen Langer, and Annemette Sorensen, Yoshiyasu Uno, and the reviewers for their critical and helpful comments on an earlier version of this article. The statistical help by Ellen Herbener and Valerie Leiter are gratefully acknowledged.     

The importance of conduct problems and depressive symptoms in predicting adolescent substance use

The current study assessed the relative importance of conduct problems and depressive symptoms, measured at two ages (11 and 15), for predicting substance use at age 15 in an unselected birth cohort of New Zealand adolescents. Among males, when the relative predictive utility of both conduct problems and depressive symptoms was assessed, only pre-adolescent depressive symptoms were found to predict multiple drug use 4 years later. No predictive relation was found between early symptomatology and later substance use among females. The strongest association between predictors and substance use emerged between age 15 multiple drug use and concurrent conduct problems for both males and females. Finally, both conduct problems and depressive symptoms at age 15 were also found to be associated with concurrent self-medication among females.This work was supported by USPHS grants MH-43746 and MH-45070 from the Antisocial and Violent Behavior Branch of the National Institute of Mental Health to Terrie Moffitt. Bill Henry was funded by a Fulbright Travel Award. The Dunedin Multidisciplinary Health and Development Research Unit is supported by the Medical Research Council and Health Research Council of New Zealand. Appreciation is expressed to the interviewers who collected the data, and to the young New Zealanders who were members of the sample.     

Cognitive Slippage in Children Vulnerable to Schizophrenia

Psychological deficit research with adult schizophrenics has been hindered by numerous methodological problems that may be avoided by the prospective study of children vulnerable to the disorder. An object sorting task was administered to 156 children of schizophrenic patients, 102 children of depressed patients, and 139 children of normal parents. The children were between 6 and 15 years old. The children of schizophrenic parents made fewer superordinate sorting responses than those of normal parents, and more complex sorts (a category of inadequate responses) than children of either normal or depressed parents. Our analyses showed that these deficits could not be explained by differences in intelligence. These deficits in conceptual performance may reflect the genotypic predisposition to schizophrenia and/or represent an early precursor of later maladjustment.This research was supported by grant MH 21145 from the National Institutes of Mental Health and by funds from the William T. Grant Foundation. We would like to thank Linda Doll, Diane Liebert, and Jean C. Sullivan for testing the children, and Barbara Mosbacher and Rochelle Weinberger for scoring the protocols.     

The structure and correlates of self-reported symptoms in 11-year-old children

Self-reports of DSM-III symptomatology were obtained from 792 11-year-old children using the Diagnostic Interview Schedule for Children (DISC). We report results concerning 13 subscales derived from the DISC. Factor-analysis of the subscales suggested a broad distinction between externalizing and internalizing disorder for boys' self-report. For girls, two separate internalizing factors representing anxiety and depression emerged. We also found sex differences in correlates of self-reported disorder. Finally, we examined agreement between child and parent and teacher reports. Overall, agreement was relatively low, although somewhat higher for child-parent than for child-teacher.The Dunedin Multidisciplinary Health and Development Research Unit is supported by the Medical Research Council of New Zealand and the Departments of Education and Health, and involves several departments of the University of Otago. Much of the data are gathered by voluntary workers from the Dunedin community. The authors are indebted to the many people whose contributions make this ongoing study possible.     

Scales,diagnoses, and child psychopathology: II. Comparing the CBCL and the DISC against external validators

Using a multimethod multistage screening procedure, the authors interviewed 201 parents and their children with the Diagnostic Interview Schedule for Children (DISC 2.1). In addition, parents completed the Child Behavior Checklist (CBCL) and other survey measures, while their children completed self-report scales. Receiver operating characteristic (ROC) analyses were done to determine optimal cutpoints on the CBCL, referenced to DISC diagnostic caseness. DISC diagnoses, DISC stem symptoms, CBCL scores, and CBCL ROC-cutpoints were compared against external validators, in order to determine the comparative advantages of each approach for assessing child psychopathology. Overall findings suggest that the controversies about best assessment strategies may be artificial: When both assessment approaches are compared using similar methods, they are reasonably comparable. However, highly specific diagnostic categories may show fewer relationships with external validators and may therefore need more systematic validational studies.The opinions and assertions contained in this paper are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services, the National Institute of Mental Health, the Walter Reed Army Institute of Research, or the Department of the Army.     

Strong Boethius’ Thesis and Consequential Implication

The paper studies the relation between systems of modal logic and systems of consequential implication, a non-material form of implication satisfying Aristotle's Thesis (p does not imply not p ) and Weak Boethius' Thesis (if p implies q, then p does not imply not q ). Definitions are given of consequential implication in terms of modal operators and of modal operators in terms of consequential implication. The modal equivalent of Strong Boethius' Thesis (that p implies q implies that p does not imply not q) is identified.     

A matched-subject comparison of underachievers with normals on intellectual,behavioral, and emotional variables

Children labeled as under achievers are compared to a matched group functioning normally within the classroom. Factor analyses of the data from several tests reveal that the normal children not only have achieved higher academic performance but also have better learning aptitude. The inference may be made that many underachievers actually have a low general aptitude when carefully measured.This study was supported from funds from the Holden Foundation at the Children's Hospital of Michigan. The authors extend their thanks to Mrs. Barrie Lowy, Mrs. Sheila Kempler, and Ms. Enid Braun.     

The context of clinical judgment: The effect of resource availability on judgments of amenability to treatment in juvenile offenders

Conclusion The present study demonstrates that the contextual factors of resource availability and agency setting may have a significant, systematic relationship to assessments of potential treatment outcome. The value of this finding is not to debunk the idea of the objective clinician one more time but, instead, to provide leads regarding the possible factors worth further investigation in constructing models of clinical judgment. We are aware that clinicians do not necessarily optimize (Simon, 1976) when making treatment recommendations, but we know very little about the influences that structure the clinician's compromises in clinical judgment. A clearer understanding of this judgment process may come, however, as a result of applying a model that considers the clinician as a practitioner of human judgment, much of which is an adapative response to contextual influences (Hogarth, 1981; Nisbett & Ross, 1980).This research was part of the first author's doctoral dissertation and funded by a grant from the National Institute of Mental Health (MH-8792-01). The authors thank Jean Ann Linney, John Monahan, and Walter Wadlington for their helpful comments, and the Center for the Study of Law and Children (especially Elizabeth Scott and Richard Bonnie) at the University of Virginia for support and guidance.     

Depression and Anxiety in Persons with Parkinson's Disease With and Without “On–Off” Phenomena

On–off phenomena in Parkinson's disease (PD) are unpredictable motor fluctuations associated with long-term levodopa use. Mood fluctuations have been found to coincide with the motor fluctuations in that depression and anxiety increase while the person with PD is in the off state. What has been relatively unexplored is whether those persons with PD who have on–off phenomena differ psychologically in fundamental ways from those who do not have on–off phenomena. In the present study, depression and anxiety symptoms were assessed in 36 persons with PD (n = 14 with on–off phenomena, n = 22 without on–off phenomena). All those with on–off phenomena were assessed in their on state. Those persons with PD with on–off phenomena had significantly higher levels of anxiety than those without on–off phenomena. However, both groups, regardless of on–off status, were mildly depressed. Neurobiological interpretations of the results implicate the locus coeruleus in the pathogenesis of both on–off phenomena and anxiety, whereas psychological interpretations of the results involve the issues of learned helplessness and control over health symptoms in PD.     

“Motority” in three functional domains of word meaning

This article deals with relations between mental motor evoking capacity (motority, Putnoky, 1975a, b) and the sensory and affective connotations, as well as certain denotations, of words. Sensory connotation is indexed by degree of visual auditory, and tactual imagery, as assessed on a 7-point scale, while affective connotation is indexed by the usual three factors tapped by the semantic differential. The aspect of denotation used here is the abstractness value of words, also based on rating by scales. The general conclusions about motority are as follows: (1) the finding that its sensory connotations are mainly via theauditory modality of imagery, and especially in correlation with abstract words, suggests that it has a specific function that may have originated in the processing of heard language; (2) it correlates with thepotency andactivity factors of affective connotation, which suggests the existence of a nonspecific function or component in it; (3) correlations with abstractness reflect that motority must have a denotative function or component, especially in case of abstract verbal stimuli. On the basis of the results, motority is supposed to play a regulative role at higher levels of the organization of word meaning in particular.Computation of SD data was carried out under the direction and according to the programming of Professor William H. May in the Center for Comparative Psycholinguistics (Director: Charles E. Osgood), University of Illinois, Urbana-Champaign, with support provided by the National Institute of Mental Health (NIMH 07705) and National Science Foundation (NSF GS 360 and 2012-X).     

Tomboys and sissies: Androgynous children?

Psychological studies of masculinity-femininity in children have paralleled those done with adults, which often consider deviations from masculinity for males and femininity for females as abnormal and perhaps pathological. Children who demonstrate cross-sex behaviors, however, may become androgynous adults whose cross-sex behaviors mean flexibility, not pathology. This study had two purposes: (1) to identify potentially androgynous children as those labeled by their peers as tomboys and sissies; (2) to compare personality characteristics of androgynous children with those of peers. Subjects were 312 elementary school children in a midwestern city. Results indicate that the labels tomboy and sissy are not necessarily indicators of androgynous children, but important social behaviors are related to the labels. For males, the possibility of frustrated creativity was raised.     

Gender stereotypes and dimensions of effective leader behavior

Research has consistently found that effective leadership is perceived as characterized by traits similar to those associated with masculine gender roles. These perceptions would appear to be at odds with extensive research indicating that effective leadership requires consideration and structuring behaviors—behaviors that seem to represent both masculine and feminine styles. In two separate studies, the correspondence between gender stereotypes and dimensions of effective leadership were assessed. Results indicate that consideration behaviors are perceived to be feminine, while structuring behaviors are perceived to be masculine. Similarly, qualities that characterize the masculine gender role are perceived to be consistent with structuring, while qualities associated with the feminine gender roles are perceived to be consistent with consideration. It is suggested that an increased awareness of the androgynous nature of effective leadership behaviors might weaken the biases in favor of male leaders.     

Response to Gracia Fay Ellwood's “Religious Experience,Religious Worldviews,and Near-Death Studies”

After a brief glance at religious wars that now embroil the field of near-death studies, I respond to Gracia Fay Ellwood's commentary on Light & Death (Sabom, 1998), in which she alleges serious problems with my discussion of Raymond Moody's research, my views on the psychic and the occult, my use of the Bible as an authoritative document, my research methodology, and my definition of Christianity.