Differential Diagnosis in Older Adults: Dementia,Depression, and Delirium

Research shows that misdiagnosis can have particularly damaging consequences in older adults. It is frequently difficult, however, to determine whether observed symptoms are due to aging or to a medical condition. The author examines three common disorders that can be particularly challenging to diagnose in older adults: dementia, depression, and delirium. Three general questions are discussed for each: What are the age-related differences in the disorder's presentation? What medical issues need to be ruled out? What assessment methods are particularly useful in the diagnostic process?     

A DEVELOPMENTAL DEFICIT IN LOCALIZING OBJECTS FROM VISION

Abstract— We describe a college student, A. H., with a developmental deficit in determining the location of objects from vision. The deficit is selective in that (a) localization from auditory or tactile information is intact, (b) A H reports the identity of mislocalized objects accurately, (c) visual localization errors preserve certain parameters of the target location, and (d) visual localization is severely impaired under certain stimulus conditions, but nearly intact under other conditions. These results bear on the representation and processing of location information in the visual system, and also have implications for understanding developmental dyslexia.     

Social integration and social support in a life crisis: Effects of macrosocial change in east Germany

This process evaluation study examined what variables moderate and mediate treatment effects on days in stable housing and client satisfaction for homeless mentally ill clients. In general, demographic characteristics did not moderate either outcome variable. Housing contacts, entitlement contacts, mental health contacts, and supportive services were significant mediators of the treatment effect on days in stable housing. Program contacts, mental health contacts, and supportive services were significant mediators of client satisfaction. The authors thank the National Institute of Mental Health for their financial support (MH43248, MH42357) for this project, Dorothy Gano for word processing and editorial assistance, and Gitry Heydebrand, Melissa Dannelet, Betty Tempelhoff, Ruth Smith, and Laeeq Ahmad for assisting in the interviews of clients. We are also appreciative of the cooperation given to us by the staffs of Malcolm Bliss Mental Health Center, St. Patrick's Center, the Community Advocacy and Support Alliance Program, and the St. Louisemergency shelters. Finally, we thank all of the participants in this study; we hope that their homelessness has now ended. (The conclusions presented in this paper are the sole responsibility of the authors and do not necessarily reflect official National Institute for Mental Health policy.)     

Aspects of preschoolers' comprehension of indoor and outdoor gender-typed toys

Forty-nine 44- to 81-month-old predominantly white children's classification of and clustering in recall of gender-typed indoor and outdoor toys, and their gender schematicity, were assessed. Consistent with predictions, children high in gender schematicity demonstrated significantly greater clustering in their recall by gender type than children low in schematicity. As expected, all children demonstrated more accurate classification of same-sex than other-sex gender-typed toys in general. However, boys and girls showed distinctively different patterns in their abilities to accurately classify same-sex and other-sex indoor and outdoor gender-typed toys. Results are discussed in terms of the different social and play contexts inhabited by preschool boys and girls.Completion of this project was facilitated by funds received when the author was a National Institute of Mental Health Postdoctoral Fellow at the University of Denver; Grant 5T32 MH 15780-09, in addition to an Academic Challenge Award from the University of Toledo. This support is gratefully acknowledged. Special thanks to Maryjo Jones for her data collection efforts and to the faculty, children, and parents of Iliff Preschool of Denver, Colorado, and especially to Director Jean True for assisting in the completion of this research. Thanks also to Joan M. Barth, Narina N. Nightingale, Kathy A. Park, and Peg Hull-Smith for their comments on earlier versions of this article. A shorter version of this paper was presented at the Conference on Human Development, Richmond, Virginia, March 1990.To whom reprint requests should be addressed at Department of Psychology, University of Wyoming, P.O. Box 3415, Room 135 Biological Sciences Building, Laramie, WY 82071-3415.     

Promotion and employee turnover: Critique,meta-analysis,and implications

Qualitative reviews of the withdrawal literature have reached inconsistent conclusions regarding the strength of the relationship between promotion and turnover. Several issues were addressed in this study which may account for these inconsistencies. First, we differentiate among three distinct operationalizations of promotion: (1) promotion satisfaction; (2) perceptions of promotional opportunity; and (3) actual promotion. We then conduct quantitative reviews using meta-analytic procedures on turnover and the three operationalizations of promotion. We found no significant relationships between promotion satisfaction and turnoveror between perceived promotional opportunities and turnover. However, a significant negative relationship was found between actual promotion and turnover. Theoretical implication of these findings are presented.     

AN EXPERIMENTAL COMPARISON OF THREE DIFFERENT SCHEDULES OF REINFORCEMENT OF DRUG ABSTINENCE USING CIGARETTE SMOKING AS AN EXEMPLAR

The efficacy of three different schedules of reinforcement for promoting and sustaining drug abstinence was compared in this study. Cigarette smoking was studied as an exemplar of stimulant drug self-administration. Sixty cigarette smokers were assigned to one of three groups (progressive rate of reinforcement, fixed rate of reinforcement, and yoked control). Participants in all three groups were asked to refrain from smoking for 1 week. Participants in the progressive and fixed groups achieved greater mean levels of abstinence than those in the control group. Participants in the progressive group were significantly less likely to resume smoking when they became abstinent than participants in the other groups.     

An Empirical Examination of Same- and Other-Gender Sexual Harassment in the Workplace

This study examines sexual harassment (SH) whichinvolves members of the same gender, either male orfemale. Data are taken from the 1988 Department ofDefense Survey of Sex Roles in the Active Duty Military. Separate comparisons for male (38% White, 31%Black, and 31% ‘other’) and female (48%White, 27% Black, and 25% ‘other’) targetsare made between sameand other-gender SH related to fourmajor components of a conceptual model proposed by Fitzgerald,Drasgow, Hulin, Gelfand, & Magley (1997). Thesecomponents include sexual harassment behaviors, personalvulnerability, target response styles, and consequences of the SH for the target. The sexualorientation of targets and perpetrators is notconsidered because data were unavailable. Results reveala number of meaningful differences between sameandother-gender SH. The most striking result is that maletargets of same-gender SH experience consequences thatare significantly more pervasive and severe than thoseexperienced by male targets of other-gender SH.Organizational implications are discussed.     

Academic Gender Bias and Women's Behavioral Agency Self-Efficacy

The relationship between academic gender bias and female students' agentic self-efficacy expectations was examined. Agentic self-efficacy expectations was defined as an individual's beliefs about her ability to successfully engage in proactive educational and career facilitative behaviors. Participants included 67 full-time junior and senior undergraduate women enrolled in traditional, nontraditional, and gender-neutral majors. Results revealed that perceived academic gender bias was significantly predictive of agentic self-efficacy expectations, above and beyond the contributions of sex role attitudes, gender concentration of major, and race/ethnicity. Implications for women's career development and future research are discussed.     

Boundary regulation in family and personal systems: Perceptions of late adolescents

Examination of boundary regulation can provide family therapists with a framework to describe both the functioning of family systems and personal systems (i.e., the intrapsychic functioning of individual family members). In the present study, late adolescents' perceptions of boundary regulation within their family systems (i.e., ratings of family health, communication, leadership, expressiveness, cohesion, and family conflict) were related to regulation of their personal boundaries (i.e., self-reported personal competence, distress, and patterns of defense mechanism use). In addition, personal system variables reliably discriminated between adolescents who described their families as psychologically healthy versus psychologically unhealthy.