The classification of violence risk

The Classification of Violence Risk (COVR) is an interactive software program designed to estimate the risk that a person hospitalized for mental disorder will be violent to others. The software leads the evaluator through a chart review and a brief interview with the patient. At the end of this interview, the software generates a report that contains a statistically valid estimate of the patient's violence risk-ranging from a 1% to a 76% likelihood of violence-including the confidence interval for that estimate, and a list of the risk factors that the program took into account to produce the estimate. In this article, the development of the COVR software is described and several issues that arise in its administration are discussed.     

Re-evaluating the therapeutic misconception: response to Miller and Joffe

Responding to the paper by Miller and Joffe, we review the development of the concept of therapeutic misconception (TM). Our concerns about TM's impact on informed consent do not derive from the belief that research subjects have poorer outcomes than persons receiving ordinary clinical care. Rather, we believe that subjects with TM cannot give an adequate informed consent to research participation, which harms their dignitary interests and their abilities to make meaningful decisions. Ironically, Miller and Joffe's approach ends up largely embracing the very position that they inaccurately attribute to us: the belief that, with some exceptions, it is only the prospect of poorer outcomes that should motivate efforts to dispel TM. In the absence of empirical studies on the steps required to dispel TM and the impact of such procedures on subject recruitment, it is premature to surrender to the belief that TM must be widely tolerated in clinical research.     

The Problem-Solving Aspect of Suicide

G. B. Gottsegen, and M. G. Gottsegen, Professional School Psychology, Vol. 3. New York: Grune &; Stratton, 1969, 407 pages, $17.75. Reviewed by Gilbert R. Gredler     

Ought we to require emotional capacity as part of decisional competence?

The preceding commentary by Louis Charland suggests that traditional cognitive views of decision-making competence err in not taking into account patients' emotional capacities. Examined closely, however, Charland's argument fails to escape the cognitive bias that he condemns. However, there may be stronger arguments for broadening the focus of competence assessment to include emotional capacities, centering on the ways in which emotions aid humans in processing information. Before emotional capacities are added to the list of functions essential for decisional competence, though, the feasibility and utility of such a reorientation must be demonstrated.     

Self-help with diagnosis (a self-administered semi-projective device).

Studied the validity of a self-administered semi-projective packet of tests and questionnaires developed to provide quick, inexpensive information preparatory, or ancillary, to further diagnostic examinations. Brief writeups of inferences derived from the packet of tests were compared to diagnostic inferences based on from one to three psychiatric interviews, and with full examinations, which included psychiatric and social work interviews and extensive psychological testing. Generally, high comparability between the packet and both criteria were shown on questions of global diagnostic impression, character and defense, central conflicts, and basic ego functions; and significant information was often added by the packet to the data collected in diagnostic interviews. The patients filled out the packet forms conscientiously, and their written self-reports indicated that some patients could learn and otherwise benefit just from performing this task.     

When Effort is Threatening: The Influence of the Belief in a Just World on Americans' Attitudes Toward Antipoverty Policy

In the political context of the reauthorization of federal welfare reform legislation, a nationally representative sample of 1,570 adults in the United States completed a survey examining the factors that affect attitudes and policy preferences with regard to aid for low-income individuals and families in the United States. This study utilized an innovative survey technique, the factorial survey methodology (Rossi & Nock, 1982), which allows for the simultaneous experimental manipulation of a large number of factors through the use of a vignette. This research demonstrates how the portrayal of difficulties faced by people in need and the ways in which they attempt to overcome these difficulties affect support for policies designed to aid low-income individuals and families. In addition, this study of public attitudes considers the role that psychological orientations of the evaluators play in judgments of families in need. In this case, we examined how the evaluators' belief that the world is a just place influences their evaluations of deservingness. Consistent with our expectations, we found that the more efforts the vignette subject engaged in improving her situation, the less deserving of government benefits she was judged to be by respondents with a strong belief in a just world. The reverse was found among respondents with a weaker belief: more efforts were associated with greater judgments of deservingness.     

Sociolinguistic inference and intercultural coorientation.

We present a model that examines the effects of cultural differences on coorientation (the ability of communicators to accurately encode and interpret the referential and relational meanings of messages). Intercultural coorientation is made problematic by the absence of certain shared communication system knowledge, which in same‐culture interactions is used in the dynamic sociolinguistic negotiation of relational rights and obligations. We propose that the process of sociolinguistic negotiation of meanings relies fundamentally on probabilistic inference and have constructed a model based on Bayes' theorem. The model predicts the effects of the communication situation, communicator stereotypes and prejudice, and some other‐culture speaker errors on conclusions the receiver draws about the message. Using the model, we distinguish between the ethnocentric error of interpreting a communication in terms of one's own culture and the error of not seeing the communication as diagnostic. Among our predictions are: (a) the less diagnostic the communication, the more impact cultural stereotypes will have on attributions; (b) although evidence of sociolinguistic incompetence sometimes causes misunderstanding, it sometimes prevents misunderstanding; (c) multiple consistent features make intentions clearer than would a single cue, but multiple features violating co‐occurrence norms often lead to the attribution of incompetence.