Developing an efficient clinical information system for a comprehensive psychiatric institute: I. Principles,design, and organization

The principles, design considerations, and components of a clinical information system intended to support and enhance the patient care, educational, and research missions of a comprehensive psychiatric institute are presented. Major characteristics of the system are its emphases on efficiency, simplicity, and intensive user involvement throughout the development of the system.     

PERCEIVING PERVASIVE DISCRIMINATION OVER TIME: IMPLICATIONS FOR COPING

This study provides evidence that the effects of perceived pervasive discrimination may be dynamic over time. It was expected that participants who perceived discrimination to be highly pervasive would initially be more likely to engage in inactive coping strategies than those who perceived low pervasiveness; however, those who continued to perceive high pervasiveness over time were expected ultimately to engage in more active strategies than those perceiving low pervasiveness. Using a 28-day diary, women and ethnic minorities described their daily experiences of discrimination and indicated their appraisals of its pervasiveness as well as their coping strategies. Results showed that participants who initially perceived low pervasiveness reported more active coping and religion use as well as less behavioral disengagement than those initially perceiving high pervasiveness. However, this pattern was reversed by the end of the study. Implications for integrating time into the assessment of coping with discrimination are discussed.     

Type A behavior, family history of hypertension, and cardiovascular responsivity among black women

The purpose of this study was to determine the effects of Type A behavior and family history of hypertension on cardiovascular reactivity to mental stress in a group of employed black women. Measures of heart rate and of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were taken at rest, during a mental arithmetic task, and during the Type A Structured Interview (SI). Results indicated that the Type A behavior pattern was associated with SBP and DBP hyperresponsivity during the SI but not during mental arithmetic. Additionally, certain speech components of the Type A pattern, as well as features of the potential-for-hostility component, were also related to cardiovascular responses during the SI. Family history of hypertension did not influence the cardiovascular parameters either alone or in combination with Type A behavior. The results suggest that many of the cardiovascular response characteristics of the Type A pattern that have been observed in predominantly white samples also hold true for blacks. Replication of these findings with other subgroups of blacks, such as young females and middle-aged males, will help document the generality of these findings within the black population.