Do substance abuse and mental health clients prefer automated assessments?

In both psychiatric and substance-abuse services, clinicians have been concerned with the introduction of automated assessments and with their clients’ reactions toward those assessments. The positive reactions of psychiatric clients have been well documented, but little has been known about substance-abusing clients’ impressions of automated assessments. The impact of automated assessment on clients seeking substance-abuse services was evaluated and compared with a previously analyzed sample of clients seeking mental health services. On the whole, both groups responded similarly and positively to automated assessments. Factor analyses revealed three underlying dimensions in client attitudes toward automated assessment,Completeness and satisfaction,Ease of use and enjoyment, andNegative attitudes. In addition, statistically, though not clinically, significant differences in attitudes were found between various demographic groups. Overall, the results support the use of automated assessments with individuals seeking either substance-abuse or mental-health services.     

Inhibitory control over no-longer-relevant information: Adult age differences

Hartman and Hasher (1991) used a garden-path task in which younger and older adults generated the final word for each of a series of high-cloze sentences. Under instructions to remember the final word, the experiment included critical sentences for which the generated word was replaced by a new, to-be-remembered target. Using an implicit priming task, the first experiment replicated a basic finding: Younger adults showed priming only for the target words, whereas older adults showed priming for both the generated and target words. Two experiments explored boundary conditions. One showed that an additional sentence that interpreted the new target word enabled older adults to narrow access to only the target word. The provision of additional time following the introduction of the new target word did not. Specific information, not more time, is required for inefficient inhibitory mechanisms to clear the recent past from memory.     

Clinical pragmatism: a method of moral problem solving

This paper presents a method of moral problem solving in clinical practice that is inspired by the philosophy of John Dewey. This method, called "clinical pragmatism," integrates clinical and ethical decision making. Clinical pragmatism focuses on the interpersonal processes of assessment and consensus formation as well as the ethical analysis of relevant moral considerations. The steps in this method are delineated and then illustrated through a detailed case study. The implications of clinical pragmatism for the use of principles in moral problem solving are discussed.     

Externalism and first-person authority

Externalism in the philosophy of mind is threatened by the view that subjects are authoritative with regard to the contents of their own intentional states. If externalism is to be reconciled with first-person authority, two issues need to be addressed: (a) how the non-evidence-based character of knowledge of one's own intentional states is compatible with ignorance of the empirical factors that individuate the contents of those states, and (b) how, given externalism, the non-evidence-based character of such knowledge could place its subject in an authoritative position. This paper endorses a standard strategy for dealing with (a). The bulk of the paper is devoted to (b). The aim is to develop an account of first-person authority for a certain class of intentional states that is capable of explaining (1) why knowledge of one's own intentional states is peculiarly authoritative, and (2) why such authority is compatible with externalism.     

Patterns of mother-infant interaction and attachment: A cluster-analytic approach

This study examined stability and change in patterns of mother-infant interaction between 5 and 10 months and their relation to attachment security at 18 months. Cluster analysis was used to identify patterns of dyadic interaction. There was significant, but not substantial, stability in cluster membership from 5 to 10 months. For females, being in the most optimal cluster at 5 months related to subsequent attachment security, regardless of the 10-month pattern of interaction. For males, who were significantly more likely to be insecure than females, insecure attachment was predicted by negative change from 5 to 10 months (moving from a more optimal to a less optimal cluster).     

The assessment of cortisol using salivary ultrafiltrate

Cortisol can be used to indicate stress level as well as to monitor certain disease states. Although cortisol can be sampled from blood and urine, saliva sampling has decided advantages. Unfortunately, whole saliva contains a number of substances that can metabolize or bind with cortisol, potentially confounding analysis and quantitation. We introduce a semipermeable pouch that accumulates a contaminant-free salivary ultrafiltrate, thereby overcoming a number of the problems encountered with whole saliva. In three studies, we demonstrate accuracy and utility of the device for cortisol determination: (1) in an artificial medium, 60%–77% of the cortisol was recovered in the ultrafiltrate; (2) in vivo, ultrafiltrate cortisol correlated highly with whole-saliva cortisol collected under ideal conditions; and (3) ultrafiltrate cortisol evinced positive relationships with depression and cigarette use, consistent with studies in the literature. We conclude that this device and saliva-filtering technologies in general are useful in applications requiring quantitation of cortisol.     

Antecedents and Consequences of Victimization of Lesbian, Gay, and Bisexual Young People: A Structural Model Comparing Rural University and Urban Samples

Research indicates that antigay victimization is widespread and that lesbian, gay, and bisexual young people may be very vulnerable to such victimization. The current study builds upon previous work by Hershberger and D'Augelli (1995), who studied the consequences of sexual orientation-based victimization in 194 urban lesbian, gay, and bisexual youths. Using structural equation modeling, the present study models both antecedents and consequences (including psychological distress, self-esteem, and suicidality) of victimization via a secondary analysis of their data set. In addition, a second sample of 54 lesbian, gay, and bisexual youths from a rural university setting was examined to cross-validate and generalize the relationships found in urban settings. Results indicated that a revised model of victimization exhibited sufficient fit to the urban sample data and provided preliminary support for the generalizability of the model beyond the initial sample. Additional similarities were found between the urban and rural university community samples, including a high prevalence of reported suicide attempts: 42% of the urban sample and 32% of the rural university sample had attempted suicide at least once. Results indicated that victimization based on sexual orientation has similar correlates for young people in different community settings.     

Male-female differences in sexual fantasy

A questionnaire about thoughts and ideas during sexual activity was returned by 51 females and 50 males in a random sample of college undergraduates. A high response rate (91%) and the similar sexual experience of male and female respondents make possible a strong conclusion about the college population sampled: Males are thinking more about past experiences and current behavior, while females are thinking more of imaginary experiences. This difference occurs for thoughts during masturbation as well as for thoughts during heterosexual activity. It appears that females prefer a different kind of sexual fantasy than males, rather than being generally less interested in sexual fantasy as claimed by Kinsey, Pomeroy, Martin, and Gebhart (Sexual behavior in the human female, Philadelphia: Saunders, 1953).