Evaluating pediatric psychology consultation services in a medical setting: An example

We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research.     

The relationship between qualitative and quantitative research: Lessons from feminist psychology

The dominant methodological approach in psychological research has involved the use of quantitative methods within a positivist framework. In this article we argue that both qualitative and quantitative methods have their strengths and limitations, depending on the research question under investigation. We examine some of the advantages of qualitative methods, paying particular attention to the value of such methods for feminist researchers. We challenge the positivist assumption that all research should be apolitical and value-free, arguing that the political context in which all research studies take place plays an important role in decisions about the appropriate research methods to use. Despite the value attached to qualitative methods by feminist researchers, there may be projects for which quantitative methods, or a combination of qualitative and quantitative techniques, are more suitable. We draw on examples from our research on the transition from school to the job market for young people, and a study of 16- to 19-year-old first time mothers to illustrate these points, examining the practical implications of our arguments for applied social psychology research.     

Obsessive intrusive thoughts in nonclinical subjects. Part I. Content and relation with depressive, anxious and obsessional symptoms

The present study reports on the development and preliminary validation of a 52 item self-report instrument designed to assess intrusive thoughts, images and impulses that are similar to the aggressive, sexual and disease-related thinking characteristic of clinical obsessions. Two hundred and ninety-three students completed the Obsessive Intrusions Inventory (OII) as well as standard self-report measures of negative cognitions and obsessive, anxious and depressive symptoms. Regression analysis revealed that intrusive thinking was a significant and unique predictor of obsessional but not anxious or depressive symptoms. Furthermore, intrusive thinking showed a moderate correlation with anxious but not depressive cognitions. The results indicate that the intrusive thoughts assessed by the OII are distinct from other forms of negative thinking and may, in fact, constitute an analogue form of clinical obsessions in nonclinical populations.     

Physical characteristics of residential psychiatric and substance abuse programs: Organizational determinants and patient outcomes

Described the Physical and Architectural Characteristics Inventory (PACI), which assesses the physical characteristics of hospital- and community-based psychiatric and substance abuse residential treatment programs for adults. Developed using data from 94 representative programs, the PACI has 7 dimensions that assess community accessibility, physical features that add convenience, aid recreation, and provide support for patients, and space for patient and staff functions. In comparison to community-based programs (n=63), hospital programs (n=31) had more social-recreational and prosthetic aids, safety features, staff facilities, and space. The PACI dimensions were also related to other organizational features, such as facility ownership and program size and staffing level. Programs with more physical amenities had patients who were more involved in self-initiated and community activities and were more likely to successfully complete the program and be discharged to independent living situations and paid jobs. Programs with more social-recreational and prosthetic aids, space, and access to community resources also had better patient outcomes. In addition, PACI dimensions were related to observers' ratings of facility attractiveness. Potential applications of the PACI and the full inventory of which it is a part are discussed.     

A house divided? Cognitive functioning with callosal agenesis

An anatomical and behavioral review of 29 reported cases of corpus callosum agenesis is presented. This review addresses itself to two questions: (1) Do acallosals manifest split-brain symptoms? (2) Is the corpus callosum necessary for the establishment of lateralization? Unlike the commissurotomy cases, acallosals show few symptoms of hemispheric disconnection. Behavioral strategies, use of noncallosal commissures, elaboration of ipsilateral pathways, and bilateral representation of function are discussed and evaluated as possible mechanisms of compensation. An impairment in spatiomotor functioning often accompanies callosal agenesis. Results of acallosal lateralization testing are examined and problems in interpretation are discussed. Current evidence does not conclusively establish that the corpus callosum is needed for lateralized development of some functions. However, the corpus callosum may play a role in the satisfactory performance of “lateralized” (i.e., spatial, linguistic) functions.     

Construction of new scales for the Multiple Affect Adjective Check List

Factor analyses were used to develop new scales for the Multiple Affect Adjective Check List (MAACL) measuring anxiety, depression, hostility, positive, and sensation-seeking affects. Anxiety, depression, and hostility scales were moderately intercorrelated and a combined score called “dysphoria” was formed from their addition. Positive and sensation-seeking affects were also correlated and combined in a summary score (PASS). The dysphoric and PASS scores were not highly correlated. The number of items checked correlated highly with the positive affect scale, moderately with sensation seeking, and relatively low with the negative affect scales. Internal reliabilities were high and retest reliabilities were low, in conformance with the model for state scales. The anxiety score increased and the positive affect score and number of items checked decreased just prior to a classroom examination. Further plans for scale development are discussed.     

TRAINING FAMILY THERAPISTS: AN EXPERIMENTAL ANALYSIS

This study implemented and evaluated a training program (a written manual, videotaped models, rehearsal, role plays, and performance feedback) designed to teach five subjects the skills to become effective family therapists. The study examined the therapists' use of three target behaviors: instructing, informing, and praising. The therapists, each paired with a parent and a preschool-aged child (2 1/2–4 1/2 yr old), were trained in the clinic to use, and to teach to the parents, several behavioral skills (e.g., praising, planned ignoring, and time-out) relevant to teaching children compliance to parental instructions. A multiple-baseline design across triads (therapist/parent/child) demonstrated that after the training program was instituted, the therapists increased their rates of instructing, praising, and informing the parents; all parents increased attention to compliance, decreased attention to noncompliance, and increased rates of praise to their children; and all children increased their compliance and decreased their noncompliance.