Psychiatric malpractice in the military

Available data indicates that the incidence of malpractice in military psychiatry, involving both civilian and active duty beneficiaries, is the lowest of all specialties and may be lower than in the civilian sector. Recovery for malpractice damages by means of claim versus suit is restricted to civilian patients; active duty service members recover through a special disability system. The federal government provides military psychiatrists with considerable protection from personal financial loss when involved in malpractice, but there may be limits to that protection. There have been recent efforts to criminally prosecute military physicians in some instances. A registry review of military psychiatry malpractice cases from 1978 to 1987provides a profile of the malpractice situation and suggests areas of practice that need vigilance. The Department of Defense has established a broad-based, comprehensive program of quality assurance and risk management in the interest of maximizing the benefit of medical care and minimizing substandard practice.     

How and when to correct for juror hindsight bias in mental health malpractice litigation: Some preliminary observations

This article examines the hindsight bias in the context of mental health malpractice litigation, analyzes various legal mechanisms for dealing with the bias, and discusses whether the law should strive for debiasing in all mental health malpractice cases.     

Automation of learning-set testing: The video-task paradigm

Researchers interested in studying discrimination learning in primates have typically utilized variations in the Wisconsin General Test Apparatus (WGTA). In the present experiment, a new testing apparatus for the study of primate learning is proposed. In the video-task paradigm, rhesus monkeys (Macaca mulatta) respond to computer-generated stimuli by manipulating a joystick. Using this apparatus, discrimination learning-set data for 2 monkeys were obtained. Performance on Trial 2 exceeded 80% within 200 discrimination learning problems. These data illustrate the utility of the video-task paradigm in comparative research. Additionally, the efficient learning and rich data that were characteristic of this study suggest several advantages of the present testing paradigm over traditional WGTA testing.     

Cognitive bias and irrational belief as predictors of avoidance

Cognitive bias, i.e. overestimates of subjective probability and cost of catastrophic events, and irrational belief were explored as predictors of avoidance. Three groups-anxiety disordered clients, a mixed group of clinic outpatients, and normals--were administered several self-report inventories. Multiple regression analyses were used to investigate a modified version of the Agoraphobic Cognitions Questionnaire, the Belief Scale, and the Body Sensations Questionnaire as predictors of avoidance, as measured by the Mobility Inventory. It was hypothesized that frequency x probability x cost of catastrophic cognitions (and the occurrence of the events they represent) would be a better predictor of avoidance than frequency alone. It was also hypothesized that irrational thinking would be a significant predictor of avoidance. The results generally supported the hypotheses, with subjective probability emerging as a particularly potent predictor of avoidance. Theoretical and clinical implications are discussed.     

A TEST OF SHAVELSON'S HIERARCHICAL MULTIFACETED SELF-CONCEPT MODEL IN A FILIPINO COLLEGE SAMPLE

Shavelson's hierarchical, multifaceted self-concept model (HMFM) has proven useful to educational and psychological researchers. The reliability and factorial validity of a well-known HMFM instrument - the Fleming-Courtney Self-Rating Scales (SRS) - were examined for a sample of 198 Filipino college students. Confirmatory factor analysis compared six structural models. A six-factor, oblique model that included two social factors (Social Acceptance and Social Anxiety) fit the data best, and a second-order factor analysis supported the hierarchical structure of the SRS. The men were significantly higher than the women on three self-concept scales, but the only large effect was for Physical Abilities, consistent with findings in a U.S. college sample. Results provided some support for the utility of both the SRS and HMFM for Filipinos.     

Violent Men In Intimate Relationships: An Analysis of Risk Markers1

In the family violence literature, a number of risk markers associated with men's use of violence against women have been identified. Using the 1975 National Family Violence Survey, a multivariate analysis was performed to examine which risk markers best differentiated among nonviolent men, verbally aggressive men, men who exhibit minor physical violence, and severely physically violent men. High levels of marital conflict, lower socioeconomic status, and greater exposure to violent role models in the home of origin emerged as primary correlates of levels of violence between intimates. Theoretical and research implications are discussed.     

DISTRACTION: ITS UTILIZATION AND EFFICACY WITH CHILDREN UNDERGOING DENTAL TREATMENT

We investigated the utilization and efficacy of distraction in reducing the anxious and disruptive behavior of 4 children undergoing dental treatment. During the distraction procedure, the children were shown a poster and told a story about it during dental treatment. They earned a prize if they attended to the poster and story and could correctly answer questions about them following each intervention visit. The children's disruptive behavior was assessed via direct observation, and results were analyzed within a multiple baseline design. The children exhibited high levels of anxious and disruptive behavior across baseline visits, regardless of the length of time in treatment or number of visits. Anxious and disruptive behavior decreased upon introduction of the intervention for all children. This was accompanied by the children meeting the criterion for correct answers on the distraction quiz. However, 2 of the children demonstrated an increase in their anxious and disruptive behavior across intervention visits. Results are discussed in terms of the need to evaluate treatment strategies that promote maintenance as well as initial changes.     

EVALUATION OF TACTILE PROMPTS WITH A STUDENT WHO IS DEAF,BLIND, AND MENTALLY RETARDED

We provided tactile cues to a student who was deaf, blind, and mentally retarded to guide her performance on a variety of packaging tasks. The student had previously received extensive training on multiple packaging and sequencing tasks through her vocational education program. Although she was able to complete these tasks, each change in materials necessitated that similar levels of retraining be conducted in order for her to perform revised tasks. Tactile cues were introduced and evaluated through a multiple baseline with sequential withdrawal design for two envelope-stuffing tasks and one bagging task. Results indicated that the tactile prompts were effective in guiding her performance on the training task and in promoting generalization to novel tasks and cues. Continued use of the cues was necessary to maintain the student's performance. Our findings suggest that tactile prompts function similarly to picture prompts and may be an effective alternative external prompting system for persons for whom picture prompts would not be appropriate.