Validation of the Poisoning Severity Score (PSS) in suicidal behavior by self‐poisoning

Intentional self‐poisoning is the leading method of suicidal behavior leading to medical attention worldwide. The medical severity of self‐poisoning events has major treatment, prognostic, and medico‐legal implications, yet measures of severity are limited. The Poisoning Severity Score (PSS) is a widely used scale but validation data are limited, particularly in the study of suicidal behavior per se. The sample was a consecutive series of intentional self‐poisoning patients aged 13 to 65 treated at a large university medical center (n = 673). PSS scores, with a range 0 (none) to 4 (death), were calculated along with other structured clinical data and analyzed in a series of linear regressions adjusted for age and sex. Higher PSS scores were consistently associated with greater medical morbidity and more intensive acute medical treatments, and nearly all effect sizes were large. Results support the validity of the PSS in hospital‐treated self‐poisoning patients.     

Just How Effective are Antidepressant Medications? Results of a Major New Study

The STAR*D (Sequenced Treatment Alternatives to Relieve Depression) project was the largest and most extensive trial of antidepressants ever conducted. The study used state of- the-art methods to treat real patients coming to a hospital or psychiatric clinic for relief from depression. Because the first antidepressant is often ineffective for most patients, a sequence of drug treatments targeting various brain neurochemicals was carefully planned. This article will review the complex treatments and the various outcomes, including the frequency of relapse during twelve months of follow-up care.     

Stochastic transitivity and the unidimensional control of choice

A concurrent-chains paradigm was used to test three models of preference for schedules of reinforcement. Each model assumes choice to be a monotonic function of values on a single dimension (“simple scalability”). For choices involving variable-interval and fixed-interval schedules, this dimension is assumed to be an harmonic average of the interreinforcement intervals; for choices involving fixedinterval and fixed-ratio schedules, the dimension is the time to reinforcement irrespective of response rate; for choices involving different combinations of rate and duration of reinforcement, the dimension is the rate of “reinforcement-time”, or the product of the two parameters. Each model implies a strong form of transitivity (“functional equivalence”), which held for half the subjects (that half exclusively sensitive to the reinforcement variable specified by the model). An alternative unidimensional model which implies a weaker form of transitivity (“weak binary utility model”) was consistent with the preferences of all subjects. This model states that a single factor controls the direction of preferences but not necessarily the exact choice probability, as simple scalability assumes.     

Ethical issues in managed care: a Catholic Christian perspective.

A Christian analysis of the moral conflicts that exist among physicians and health care institutions requires a detailed treatment of the ethical issues in managed care. To be viable, managed care, as with any system of health care, must be economically sound and morally defensible. While managed care is per se a morally neutral concept, as it is currently practiced in the United States, it is morally dubious at best, and in many instances is antithetical to a Catholic Christian ethics of health care. The moral status of any system of managed care ought to be judged with respect to its congruence with Gospel teachings about the care of the sick, Papal Encyclicals, and the documents of the Second Vatican Council. In this essay, I look at the important conceptual or definitional issues of managed care, assess these concerns over against the source and content of a Catholic ethic of health care, and outline the necessary moral requirements of any licit system of health care.     

Judged Likelihood of Different Second Crimes: A Function of Judged Similarity

Numerous studies have concluded that the judged probability of conviction for a crime is higher when information concerning a prior conviction is disclosed. This is even more true when the prior and present crimes are the same. This paper examines the argument that the influence of a hypothetical previous conviction on the judgment of predilection toward a hypothetical present crime is a continuous function of the degree of similarity between past and present crimes. The subjects were presented with all possible pairs of 10 crimes, the first being considered as a prior conviction and the second as a presently charged crime. The subjects judged the subjective likelihood that a person convicted of the first crime (C1) would, in fact, he of a mind and inclination to commit the second one (C2). Independent judgments of intercrime, undefined similarity also were obtained. The main experimental findings, as expected, were that the judged probability of C2. given C1, was: (a) greatest when C2 was a repeat of C1; (b) uniquely different for each C1; (c) predicted quite well by degree of intercrime similarity; (d) poorly predicted by crime seriousness values. Thus, the subject appears to make judgments of predilection on the basis of simple representativeness heuristics, which specify that certain crimes will be considered more likely if they are more semantically related to earlier ones. Such a mental device unfortunately would he systematically biased in courtroom settings because judgments of intercrime similarity are not influenced by real-world probabilities.     

Nonmetric grouping: Clusters and cliques

A class of related nonmetric (“monotone invariant”) hierarchical grouping methods is presented. The methods are defined in terms of generalized cliques, based on a systematically varying specification of the degree of indirectness of permitted relationships (i.e., degree of “chaining”). This approach to grouping is shown to provide a useful framework for grouping methods based on ana priori specification of the properties of the desired subsets, and includes a natural generalization for “complete linkage” and “single linkage” clustering, such as the methods of Johnson [1967]. The central feature of the class of methods is a simple iterative matrix operation on the original disparities (“inverse-proximities” or “dissimilarities”) matrix, and one of the methods also constitutes a very efficient single linkage clustering procedure.     

The effects of visual presentation method on single-trial free recall

In two experiments four different conditions of visual presentation were studied with the purpose of furthering our understanding of the role of temporal and spatial factors underlying modality effects in single-trial free recall. Enriching spatial factors in the visual presentation did not produce a higher performance in the recency part of the serial-position curve, and it was therefore concluded that the modality effect could not be due to any visual handicap. A lag distribution measure was suggested and applied to the data to characterize output order (the order of recall) in single-trial free recall. The two experiments carried out used a within-subjects and a between-subjects design, respectively, and illustrate the importance of the methodological difference between these two designs.     

Hebrew thoughts on immortality and resurrection

International Journal for Philosophy of Religion -     

The Observation of Intimacy in Groups

An instrument for the analysis of verbal statements along a continuum from most intimate to least intimate is the Levels of Verbal Intimacy Technique (LOVIT). It enables an observer to place all verbal statements in one of ten categories along this intimacy continuum. The technique has been used in research on small groups and also can be used to provide feedback in groups, for example, to couples in marriage counseling.