How Does Your Doctor Talk with You? Preliminary Validation of a Brief Patient Self-Report Questionnaire on the Quality of Physician–Patient Interaction

The quality of physician–patient interaction is increasingly being recognized as an essential component of effective treatment. The present article reports on the development and validation of a brief patient self-report questionnaire (QQPPI) that assesses the quality of physician–patient interactions. Data were gathered from 147 patients and 19 physicians immediately after consultations in a tertiary care outpatient setting. The QQPPI displayed good psychometric properties, with high internal consistency and good item characteristics. The QQPPI total score showed variability between different physicians and was independent of patients’ gender, age, and education. The QQPPI featured high correlations with other quality-related measures and was not influenced by social desirability, or patients’ clinical characteristics. The QQPPI is a brief patient self-report questionnaire that allows assessment of the quality of physician–patient interactions during routine ambulatory care. It can also be used to evaluate physician communication training programs or for educational purposes.     

Mental Health Research in Correctional Settings: Perceptions of Risk and Vulnerabilities

With more than half of individuals incarcerated having serious mental health concerns, correctional settings offer excellent opportunities for epidemiological, prevention, and intervention research. However, due to unique ethical and structural challenges, these settings create risks and vulnerabilities for participants not typically encountered in research populations. We surveyed 1,224 researchers, Institutional Review Board (IRB) members, and IRB prisoner representatives to assess their perceptions of risks and vulnerabilities associated with mental health research conducted in correctional settings. Highest ranked risks were related to privacy, stigma, and confidentiality; lowest ranked risks were related to prisoners’ loss of privileges or becoming targets of violence due to having participated in research. Cognitive impairment, mental illness, lack of autonomy, and limited access to services emerged as the greatest sources of vulnerability; being male, being female, being older than age 60, being a minority, and being pregnant were the lowest ranked sources of vulnerability. Researchers with corrections experience perceived lower risks and vulnerabilities than all other groups, raising the question whether these researchers accurately appraise risk and vulnerability based on experience, or if their lower risk and vulnerability perceptions reflect potential bias due to their vested interests. By identifying areas of particular risk and vulnerability, this study provides important information for researchers and research reviewers alike.     

Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years

Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n?=?138) or SCT (n?=?96) (age 18–35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p?=?.004) but not intention (p?=?.18) or behavior (p?=?.69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p?=?.04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.     

Outcome evaluation in brief mother-infant psychotherapies: Report on 75 cases

The effects of brief mother–infant psychotherapies (maximum of 10 sessions) were examined in cases of functional and behavioral disturbances in children less than 30 months old. Seventy-five mother-infant dyads were assessed prior to treatment, at 1 week, and 6 months after therapy ended. The outcome measures were changes in the infant's symptoms, the behavioral interactions between mother and infant, and maternal representations. The effect of two forms of intervention—Psychodynamic Therapy and Interaction Guidance Therapy—were compared. Results indicated a significant symptom reduction; dyadic interactions became more harmonious (mothers became less intrusive and infants more cooperative). Maternal self-esteem grew significantly and negative affects decreased. Improvements lasted as least several months, with some positive improvement detected at the 6-month follow-up. No major difference in outcome was found between the effects of the two forms of intervention. Within the limitations of research in a clinical context, this study suggests that brief mother–infant psychotherapies are a cost-effective method of early intervention.     

La compréhension d'un texte procédural: Un processus à profondeur variable

This study investigates the comprehension of a dosage according to the desired aim before reading. The results of the two experiments carried out indicate that only the cognitive activities underlying the performance of the instructions (versus comprehension/memorisation) require the transformation of the declarative representation into a procedural one. The inferences generated attest a result/procedure relation and a hierarchical organisation of the planification of actions brought into play. Moreover, information which is directly goal‐related receives more extensive treatment than other information.     

The lost postcard technique: Formal aspects of the message as legibility indices of social perception

The return rate of lost postcards was hypothesized to depend upon the precision of the image that the finder can form of the relationship sender-recipient, Signature and length of the message were taken as indices and confirmed this role in two studies using a representative design.     

Effect of socioeconomic status of biological and adoptive parents on WISC-R subtest scores of their French adopted children

Analyses from an a priori full cross-fostering study (Capron & Duyme, 1989, 1991), investigating the IQs of 38 children whose average age was 168 (SE = 3.28) months, indicated a link between the socioeconomic status (SES) of both biological and adoptive parents and Full, Verbal, and Performance IQs of the WISC-R scale. Here detailed analyses of the WISC-R scale are presented. These show that these two factors affect Block Design and Information subtests, and other subtests are affected either by one or the other factor. Two subtests—Picture Arrangement and Picture Completion—are not affected by either factor. There is no evidence for an interaction between these factors on adopted children's subtest scores. As the sample size is small for a test of nonadditivity, the analysis is extended to the power of interaction test.     

Self-reported levels of psychopathology of drug abusers not currently in treatment

This study assessed levels of psychopathology, as measured by the Symptom Checklist-90-Revised, of drug users not in treatment. These levels were then compared with levels of psychopathology reported previously in the literature of drug users in treatment, the general population, psychiatric inpatients, and psychiatric outpatients. Results suggest that drug users not in treatment endorse significantly lower levels of psychopathology than drug users in treatment, psychiatric inpatients, and psychiatric outpatients. However, they endorse significantly higher levels of pathology than adult nonpatients and they appear most similar to adolescent nonpatients. Implications for clinical work (prevention and intervention) as well as for future research are discussed. The study also established preliminary cultural validity of SCL-90-R with Alaska Natives.     

Subtle-obvious scales of the MMPI: indicators of profile validity in a psychiatric population.

This study explored the usefulness of the Minnesota Multiphasic Personality Inventory (MMPI) Subtle-Obvious scales as profile validity indicators with a inpatient psychiatric population. Some 292 MMPI profiles were utilized and divided into overreporters, underreporters, and standard reporters, based on their Subtle-Obvious scale scores. Reporting style was shown to be unrelated to actual patient pathology because of the lack of relationship between reporting style and diagnostic categorization according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987) Axis I and II. Comparisons of MMPI profiles of the three groups revealed that overreporters endorsed more pathology on the MMPI clinical scales than did either underreporters or standard reporters. The same pattern of response style was demonstrated by subjects on another objective measure, the Beck Depression Inventory, whereas on a projective measure, the Rorschach Inkblot Test, there were no differences between groups. These findings suggest that clinicians may want to utilize the Subtle-Obvious scales to gain information about MMPI profile validity. Specifically, profiles of patients identified as overreporters should be interpreted with caution so as to not overstate their level of pathology.