Evaluation of a comprehensive inpatient rational-emotive therapy program: Some preliminary data

Mental health practitioners are faced with a profound challenge surrounding the prevalence of adult mental disorders, the need for inpatient treatment programs, and the costs of such programs. This paper describes the development of an adult inpatient psychiatric program based on Rational-Emotive Therapy. Specific elements of this program are described briefly, and preliminary outcome data presented on 372 patients. Concerns and future directions are also discussed. Development of adult inpatient psychiatric programs based on Rational-Emotive Therapy would appear to be one method of providing effective and cost-efficient treatment within the current cost-containment atmosphere of psychiatric treatment.Dr. Nottingham is an Associate Fellow and Approved Supervisor of the Institute for Rational-Emotive Therapy. He is in independent practice with Germantown Psychological Associates, P.C. and is Director of Psychology at Parkwood Hospital, Olive Branch, MS. Dr. Neimeyer is an Associate Professor and Director of Clinical Training in the Department of Psychology of Memphis State University. He has written extensively in the areas of cognitive and constructivist psychotherapy, and is co-editor of the International Journal of Personal Construct Psychology.The authors would like to thank Kat Bagley, Joe Grillo, Ivey Bright, Brooke Bensen, Cathy Michas, Brad Barris, Lori Passmore, David Wilkins, and Dee Conrad for their help with data collection. Additionally, without the assistance and support of the Parkwood Hospital administration and staff, neither this treatment program nor this paper could have been developed.Portions of this paper based on earlier data analyses were presented at the Mississippi Psychological Association Convention, September, 1990. This research was conducted at Parkwood Hospital.     

Pharmacological treatment of affective disorders: A review and guide for the non-medical practitioner

Mental health professionals who lack medical training may also lack knowledge and understanding of the potential utility of medications in the treatment of emotional disturbance. They may also lack information regarding the effects and side-effects of medications which their clients may already be taking, or be uncertain when the nature of their client's situation suggests a psychiatric assessment regarding drug therapy. This paper offers an educational review in one such area: the pharmacological treatment of depression. It includes a brief review of theories regarding the aetiology of affective disorder, examines the methodes, mechanisms and efficacy of anti-depressants, and draws conclusions regarding the appropriate use of pharmacological treatment.     

Premissary relevance

Premissary relevance is a property of arguments understood as speech act complexes. It is explicable in terms of the idea of a premise's lending support to a conclusion. Premissary relevance is a function of premises belonging to a set which authoritatively warrants an inference to a conclusion. An authoritative inference warrant will have associated with it a conditional proposition which is true— that is to say, which can be justified. The study of the Aristotelian doctrine of topoi or argument schemes may contribute to the task of identifying authoritative warrants.     

WHEN PREDICTIONS CREATE REALITY:

Abstract —Nelson and Dunlosky (Psychological Science, July 1991) reported that subjects making judgments of learning (JOLs) can be extremely ac curate at predicting subsequent recall performance on a paired-associate task when the JOL task is delayed for a short while after study They argued that this result Is surprising given the results of earlier research, as well as their own current experiment, indicating that JOLs are quite inaccurate when made immediately after study We note that the delayed-JOL procedure used by Nelson and Dunlosky invited covert recall practice (which was reported by their subjects) Retrieval practice is a welt-known determinant of subsequent recall Accordingly, Nelson and Dunlosky s findings can be explained by the simple assumption that people base delayed JOLs on an assessment of retrieval success which in turn influences their retrieval success on the subsequent recall test     

The legal consensus about foregoing life-sustaining treatment: its status and its prospects

The legal consensus that has evolved through adjudication and legislation since the Karen Quinlan case in 1976 is founded on the premise that there is a bright line between passive euthanasia and active euthanasia. Indeed, the term passive euthanasia is often eschewed in favor of less emotionally-laden terminology such as "forgoing life-sustaining treatment" or "terminating life support" so as to further sever any possible connection with active euthanasia. Legal approval has been bestowed upon passive euthanasia under certain circumstances while active euthanasia is routinely condemned. This consensus was put to a test in 1990 when the United States Supreme Court ruled on the Cruzan case. However, the Court's narrow decision did not upset the consensus, and in the most significant appellate decisions handed down by state courts since Cruzan, there has been a reaffirmation--and possibly even an extension--of the consensus. Two other threats to the legal consensus about forgoing life-sustaining treatment have begun to manifest themselves: the increasing pressure for mercy killing and "futility" cases. Both of these challenge the fundamental premises on which the consensus is grounded.     

Low-dimensional chaos maps learning in a model neuropil (olfactory bulb).

Quantification of a chaotic system can be made by calculating the correlation dimension (D2) of the data that the system generates (Packard et al., 1980). The D2 algorithm, however, requires stationarity of the generator, a feature that biological data rarely reflect (Mayer-Kress et al., 1988). So we developed the "point correlation dimension" (PD2), an algorithm that accurately tracks D2 in linked data of different dimensions (Carpeggiani et al., 1991). We now present a mathematical argument that, for stationary data, individual PD2s converge to D2 and we demonstrate that the algorithm rejects contributions made by bursts of noise. Data were obtained from the surface of the olfactory bulb of the conscious rabbit (64 electrodes, 640 Hz each, 1.3 sec epochs) before and after presentation of a novel or habituated odor. D2 could be calculated in only 1 of 10 novel-odor trials, whereas PD2 could be calculated in all. Both algorithms indicated that a novel odor evokes a spatially uniform dimensional increase. The PD2 uniquely exhibited the dimensional decreases that occur during inspiration and the gradients of mean dimension present during the nonstimulated control state. These control gradients remained unchanged without odor experience, but showed spatially specific PD2 increases following odor habituation. It is interpreted that, 1) the PD2 is sensitive, accurate, and appropriate for dimensional assessment of biological data, 2) that during analysis of unfamiliar information a single global process is transiently evoked in the neuropil, and 3) after experience multiple spatially specific processes tonically map the sites of learning.     

Delayed constructed-response identity matching improves the spelling performance of students with mental retardation

We assessed the effects of a computerized matching-to-sample procedure on the spelling performances of three students with mental retardation. Initially, the students could 1) match pictures and printed words to one another, and 2) match pictures and printed words to spoken words. However, they could not construct words to either pictures or spoken words (e.g., touch, in order, the letters s->h->o->e given the spoken-word sample Shoe). Word constructions then improved markedly after exposure to delayed constructed-response identity matching (e.g., touch the letters s->h->o->e given the printed-word sample shoe). One subject's oral and written spelling also improved. The results extend previous research by showing multiple positive effects of a computerized spelling intervention. These effects may have occurred in part because of the formation of stimulus classes among pictures, printed words, and spoken words.     

Case vignette: premature surrender

Three commentaries are offered on the following case: George, age 57, is a previously healthy man who recently underwent surgery for removal of a low-grade malignant thymoma. At the time of admission to the hospital, George stressed to the staff that he had long ago signed a "living will," which he renewed immediately after he learned of his cancer diagnosis. At the time of surgery, the tumor was found to extend into his mediastinum; although it was removable, this required revision of part of the sternum and grafting of the vessels feeding the heart chambers. Because of the resultant tissue damage and neuronal hyperactivity, George experienced postoperative episodes of cardiac arrhythmia and bronchospasm. Unanimous medical opinion was that this situation was a temporary problem that would resolve itself as the tissues healed. Until that time, however, it will be difficult to wean him from ventilatory support. When his stay in the intensive care unit became prolonged, George and his family began to insist that his status be changed to "do not resuscitate" and reminded the staff about his longstanding living will. All of this is happening despite the fact that the patient and family seemingly comprehend that although the short-term interventions are invasive, there is a high probability of a successful outcome. George's cancer prognosis is excellent, and, although he may well have an episode of life-threatening arrhythmia, he is likely to respond to resuscitation interventions. Once the immediate postoperative period is over, his potential for a long and productive life with full capacities is excellent. Consider the following questions: (a) Should George's expressed wishes be respected, or should the staff take additional steps to help him survive the postoperative period, even if that means violating his stated wishes? and (b) What steps might the staff follow in sorting through this problem?