Construction and cross-validation of an MMPI Black-White scale

A robust set of MMPI items, sensitive to the effect of race (Blacks versus Whites), was constructed by compiling the results of six prior studies. Thirty-two items comprised the MMPI B-W scale. The scale was cross-validated on psychiatric patients and police cadets. Statistically significant mean differences were found between races in both groups, with 83% and 60% correct racial classification, respectively. These findings suggested that when used as a clinical instrument, the MMPI might pick up nonpathology-related racial variance contributing to scale devotion biased against the black respondent, but the degree of nonpathology-related racial scale score covariance has yet to be determined. For future research, the B-W scale was proposed as a set of standard queries in studies assessing connotative meaning for Black-White contrast groups, and to index "functional" as opposed to "objective" race membership.     

The Prevalence of Serious Emotional Disturbance: A Re-Analysis of Community Studies

The goal of these analyses was to use existing data to provide an empirically-based estimate of the prevalence in the population of Serious Emotional Disturbance (SED) in children and adolescents, to assist States in their task, required under PL 102-321, of including such estimates in their applications for Block Grant funds. Seven data sets were identified that could provide estimates of SED. The principal investigators agreed on common definitions of the key components of SED: a psychiatric diagnosis and significant functional impairment. Two definitions of impairment were used: domain-specific (impairment in one or more of three areas of functioning) and global (in the worst 10% over all). They also defined a set of correlates and risk factors for SED: age, gender, race/ethnicity, and poverty. Investigators then reanalyzed their own data, using these standard definitions, and calculated the proportion of SED youth who received mental health care. The median estimate of SED with global impairment was 5.4%, with a range from 4.3% to 7.4%. Estimates of SED with domain-specific impairment ranged from 5.5% to 16.9% (median 7.7%). Rates were slightly higher in boys. There were no clear ethnic differences. Poverty doubled the risk of SED. Only one SED child in four had recently received mental health care. Estimates of SED are critically dependent on the method used to define diagnosis and functional impairment. Using common definitions, seven studies produced fairly consistent estimates, which were similar to the estimate of prevalence of Serious Mental Illness (SMI) in adults. Implications for the estimate of State-by-State prevalence rates are discussed.     

Explorations of the effectiveness of a voluntary sector psychodynamic counselling service

This paper reports two studies of individual psychodynamic counselling provided by a voluntary sector service. The first study examines evidence of the effectiveness of counselling, as evaluated by the General Health Questionnaire and Personal Opinion Survey. Measures of the process of counselling indicated the improvements that clients attributed to counselling, the changes that occurred during it, and the factors that were most beneficial, as well as the approaches used by counsellors. The second study, using the CORE Outcome Measure and ratings of problem severity, found counselling to be equally effective with disadvantaged and non‐disadvantaged clients, as defined by British Department of Health criteria, but these clients differed somewhat in their perceptions of helpful aspects of counselling. Both studies also indicated predictors of positive outcome of counselling. The studies are used to illustrate some of the methodological issues around research in this area.     

Is overt stuttered speech a prerequisite for the neural activations associated with chronic developmental stuttering?

Four adult right-handed chronic stutterers and four age-matched controls completed H(2)(15)O PET scans involving overt and imagined oral reading tasks. During overt stuttered speech prominent activations occurred in SMA (medial), BA 46 (right), anterior insula (bilateral), and cerebellum (bilateral) plus deactivations in right A2 (BA 21/22). These activations and deactivations also occurred when the same stutterers imagined they were stuttering. Some parietal regions were significantly activated during imagined stuttering, but not during overt stuttering. Most regional activations changed in the same direction when overt stuttering ceased (during chorus reading) and when subjects imagined that they were not stuttering (also during chorus reading). Controls displayed fewer similarities between regional activations and deactivations during actual and imagined oral reading. Thus overt stuttering appears not to be a prerequisite for the prominent regional activations and deactivations associated with stuttering.     

Lysergic Acid Diethylamide (LSD 25) and behaviour therapy

This paper deals with the problems involved in the treatment of complex neurotic conditions. A seventh feature is added to Wolpe's list of the six features that make a neurosis complex. The use of Lysergic Acid Diethylamide (LSD 25) in the treatment of such difficult cases is discussed and three cases are presented.     

HIV infection with immunodeficiency presenting with subacute cognitive decline: recent illustrative cases

We describe three recent patients in whom evaluation of subacute, progressive encephalopathy led to the initial diagnosis of human immunodeficiency virus infection. The clinical neurological picture of a predominance of abnormalities of mental function with few elementary neurological deficits, in conjunction with a paucity of systemic symptoms and lack of evidence for prior opportunistic infections preceding the encephalopathy are notable. The cognitive, behavioral, and neuropsychiatric disturbances are described in detail to illustrate the range of manifestations of disordered mental states associated with encephalopathy in individuals with HIV infection. The importance of a comprehensive and broad-minded work-up by brain magnetic resonance imaging, cerebrospinal fluid examination, and specific microbiological tests in delineating the potential multifactorial pathogenesis of the cerebral syndromes in relation to the HIV infection is emphasized. The gratifying long-term clinical improvements in parallel with resolution of neuroimaging and other laboratory abnormalities in response to antiretroviral drug treatment are reported.