The Fort Bragg managed care experiment: Short term impact on psychopathology

Many concerns have been raised about mental health services for children and adolescents. These concerns have included not treating those in need and providing inappropriate services to those who are treated. The continuum of care philosophy purports to remedy these problems by offering a comprehensive and coordinated range of services emphasizing community-based treatment. Services in the continuum include alternatives to trditional restrictive forms of care such as hospitalization. The provision of more appropriate care is hypothesized to improve the clinical outcomes of children treated in a continuum of care. The Fort Bragg Evaluation compared quality, use, outcome, and cost of the continuum of care model to a more traditional, fragmented system of care. This paper presents the effects of a service delivery system on short term psychopathology outcomes.     

Research in the Psychological Laboratory: Truth or Triviality?

This article examines the truism that studies from psychological laboratories are low in external validity. Past rational and empirical explorations of this truism found little support for it. A broader empirical approach was taken for the study reported here; correspondence between lab and field was compared across a broad range of domains, including aggression, helping, leadership style, social loafing, self-efficacy, depression, and memory, among others. Correspondence between lab- and field-based effect sizes of conceptually similar independent and dependent variables was considerable. In brief, the psychological laboratory has generally produced psychological truths, rather than trivialities. These same data suggest that a companion truism about field studies in psychology—that they are generally low on internal validity—is also false.     

Sensitivity to Levels of Importance in the Logical Memory Subtest

The performance of Alzheimer's disease (AD) and neuropsychiatric patients was examined using the Logical Memory (LM) subtest of the WMS-R, utilizing a levels of importance methodology described by Haut et al. (1990). Although patient groups were matched for dementia severity, we found the expected differences between groups in terms of absolute level of performance. There was considerable variability, however, in the AD patients' performance. AD patients' recall and sensitivity to levels of importance depended on the story (Anna or Robert), and when the passages were recalled (immediate or delayed recalls). Results suggested that AD patients were able to utilize semantic information in their immediate recall, though this was dependent on individual story characteristics. AD patient's delayed recall was essentially absent. Thus, no conclusions could be drawn with respect to the level of importance factor. NP patient's recall performance was similar to patterns observed in other clinical samples for both immediate and delayed memory.     

Difference threshold for intensity of tactile stimuli

The difference threshold (DL) for brief tactile stimuli (taps) and vibrotactile stimuli was determined using a 2IFC procedure. The measurements were made at several intensities both in quiet and in the presence of a background vibration. The results show that in the absence of background vibration the DLs for higher intensity stimuli are similar for both taps and vibration, whereas at lower intensities the DL is larger for taps. In the presence of background vibration the DL for vibratory stimuli is elevated to a much greater extent than it is for tap stimuli. The DL is affected by both the intensity of the signal and the intensity of the background vibration.     

Framing effects in judgment tasks with varying amounts of information

Subjects were asked to make evaluations in each of three tasks—a gambling task, a consumer judgment task, and a student evaluation task. Each task involved two important attributes, but information about one attribute was missing on some trials. Half of the subjects received a version of the task in which a key attribute was presented in positive terms (e.g., probability of winning a gamble) and half received a version in which that same attribute was presented in negative terms (e.g., probability of losing a gamble). Even though the information was objectively equivalent in the two versions of each task, there were two significant framing effects. (1) In all tasks, responses to two-attribute stimuli were more favorable in the positive condition than in the negative condition. (2) When the key attribute was missing, evaluations of one-attribute stimuli relative to evaluations of two-attribute stimuli were lower in the positive condition than in the negative condition. Results were discussed in terms of the constructs of prospect theory and information integration theory.     

Reliability and concurrent relations between the teacher version of the child behavior profile and the conners revised teacher rating scale

A total of 104 disturbed boys aged 6–11 were assessed with the teacher version of the Child Behavior Profile and the Conners Revised Teacher Rating Scale (TRS). A subsample of 55 boys were reassessed with both measures at an interval of 1 week. For the teacher Profile, test-retest correlations averaged r=87 for eight behavior problem scales and r=91 for four adaptive functioning scales. Reliabilities were slightly higher for Externalizing scales (average r=.91) than for Internalizing scales (r=.80). Reliabilities averaged .94 for the Revised TRS. Correlations between the two measures indicated a strong correspondence between the three Externalizing scales of the Profile and the factor-based TRS scales. Specifically, Profile scales labeled Inattentive, Nervous-Overactive, and Aggressive correlated highly (p < .001) with TRS scales labeled Inattentive-Passive, Hyperactivity, and Conduct Problem, respectively. The Conners Hyperkinesis Index correlated highly with all three Externalizing scales of the Profile, particularly Aggressive (r=.82). Overall, these results support the reliability and concurrent validity of both measures.This research was supported by an NIMH Research Scientist Development Award (MH00403) to the first author and by NIMH grant number MH37372. The support of the William T. Grant Foundation is gratefully acknowledged. The authors are indebted to the students, teachers, and staff of PACE School for their cooperation. Tom Achenbach provided valuable comments on an earlier draft.     

Personality characteristics of drug addicts and alcoholics on the Millon Clinical Multiaxial Inventory

The Million Clinical Multiaxial Inventory (MCMI) was administered to 106 alcoholics and 100 addicts in separate VA inpatient rehabilitation treatment programs. The alcoholics scored higher on the personality style scales of Avoidant, Passive-Aggressive, Schizotypal, Borderline and Paranoid, while the opiate addicts scored higher on the Narcissistic personality disorder scale. Separate cluster analyses for both groups further revealed common personality styles among both groups. Several MCMI scales showed significant correlations with age, but in no case were the effects attributed to age larger than 5% of the total variance. The MCMI may alert clinicians to subtle similarities and differences between and among alcoholics and opiate addicts.     

Control of responding by the location of sound: role of binaural cues.

In auditory localization experiments, where the subject observes from a fixed position, both relative sound intensity and arrival time at the two ears determine the extent of localization performance. The present experiment investigated the role of binaural cues in a different context, the sound-position discrimination task, where the subject is free to move and interact with the sound source. The role of binaural cues was investigated in rats by producing an interaural imbalance through unilateral removal of the middle auditory ossicle (incus) prior to discrimination training. Discrete trial go-right/go-left sound-position discrimination of unilaterally incudectomised rats was then compared with that of normal rats and of rats with the incus of both sides removed. While bilateral incus removal affected binaural intensity and arrival times, the symmetry of sound input between the two ears was preserved. Percentage of correct responses and videotaped observations of sound approach and exploration showed that the unilateral rats failed to localize the sounding speaker. Rats with symmetrical binaural input (normal and bilaterally incudectomised rats) accurately discriminated sound position for the duration of the experiment. Previously reported monaural localization based upon following the intensity gradient to the sound source was not observed in the unilaterally incudectomised rats of the present experiment. It is concluded that sound-position discrimination depends upon the use of binaural cues.