Predicting treatment outcome and recidivism among patients in a maximum security token economy

The relationship between program performance and outcome for patients in maximum security token economy programs has not been previously studied. We examined variables related to success in a token economy program and to postrelease failure for 92 men in a maximum security psychiatric hospital. Point earnings later in the program were best predicted by earlier point earnings. Variables that best predicted postrelease failure, defined in various ways, were similar to those found in other studies; youthfulness, having spent more time in institutions, a diagnosis of personality disorder or retardation rather than psychosis, not having been found not guilty by reason of insanity or unfit to stand trial, and having been referred from another psychiatric hospital. That program variables were generally unrelated to later outcome suggests that treatment programs for patients in maximum security settings must emphasize skills that are relevant to postrelease success.     

Spirituality as a Component in a Treatment Program for Sexually Addicted Roman Catholic Clergy

This article describes one treatment program that integrates spirituality and therapy for sex abusers who are Roman Catholic priests or brothers. It includes selections from an interview with the program director covering definition, philosophy, women as therapists, daily activity, suitable candidates, as well as related research. The program is based in Europe and has a clientele representative of an international clerical community.     

The Future of Psychology in Departments of Psychiatry

Health care reform has put increasing pressure on faculty of medical schools to become self-supporting. Opportunities for clinical revenue will decrease, but psychologists who are able to generate research funding will become increasingly competitive, albeit as mercenaries, i.e., capable of paying their own way plus generating a profit to support departmental operations and educational programs. Changes in the health care system signal an end to psychiatry's paternalistic relationship to psychology and present opportunities for psychology proactively to influence its future role in health care. Research, political action, and revised scientific mission, models, and roles represent important strategies in the redefining of psychology as a basic science and major profession in health care.     

A review of patient outcomes in pharmacological studies from the psychiatric literature, 1966–1993

A literature search was conducted on studies of new drugs used with patients with schizophrenia reported by U.S. and non-U.S. researchers from 1966–1993, yielding 41 U.S., and a total of 24 other non-U.S. studies, among them 11 British studies. Results of the U.S. and non-U.S. studies were pooled separately and compared. Among several comparable conditions discussed, the lack of any data on suicides in the U.S. studies was observed. For a second statistical analysis of suicide rates ‘person-years’ were calculated to adjust for differing washout durations. The results obtained include findings that the percentage of patients relapsing in U.S. studies was slightly lower (37.9%) than in non-U.S. studies (46%); the percentage of patients dropping out in U.S. studies (10.5%) was higher than in non-U.S. studies (7.6%); known location of dropout patients in U.S. studies was 1.7%, compared to 2.6% in non-U.S. studies. The most interesting finding was that no suicides were reported in U.S. studies, compared to 0.6% of patients reported in British studies. Some U.S. studies used ‘challenge doses’, such as amphetamines or L-dopa; no non-U.S. studies reported their use. Compared to U.S. studies, those by non-U.S., and particularly British, researchers appeared to report adverse events in their studies. ‘Challenge’ drugs were not used; suicides were reported. It is estimated that the probability that no patients suicided who participated in the U.S. is small—one in 500.     

The lost e-mail method: Milgram’s lost-letter technique in the age of the Internet

We examined Milgram’s (1977) lost-letter technique using e-mail. In the first experiment, 79 college faculty received mock lost e-mail messages. Nineteen percent of those who received the messages responded, in all cases by returning the message to the “sender” instead of forwarding it to the “recipient.” In the second study, attitudes toward presidential candidate Ross Perot were examined by sending out two different messages to 200 randomly selected e-mail addresses in the United States. Although there was no differential response rate, examination of content revealed attitudes consistent with concurrent poll data.     

TheP system: A scheme for organizing Pavlovian procedures

The present paper introduces theP system as a scheme for organizing Pavlovian procedures in an orderly and comprehensive manner. The system is defined by three temporal variables and three restrictions on their possible values. It can be used to define all standard temporal variables—namely, stimulus duration, interstimulus interval, trace interval, and intertrial interval—as well as variables C and T of scalar expectancy theory. The system also permits the definition of new independent variables through combinations of the basic temporal parameters. We exemplify this possibility by defining two ratios of temporal intervals. These ratios lead to a space where traditional Pavlovian arrangements (viz., simultaneous, forward-trace, forward-delay, backward) become points on a continuum, and optimal conditions across different experimental preparations become equivalent. Finally, the system can be used to define contingency variables such asp(US/CS),p(US/～CS), and the phi coefficient (φ). In this manner, an organization of different kinds of Pavlovian procedures is achieved on the basis of a single parametric scheme. Such an organization facilitates establishing procedural and theoretical relationships between temporal and contingency variables. The paper concludes with a discussion of certain limitations of the system and other related issues