Anxiety disorders research with African Americans: current status

Anxiety disorders are the most common psychiatric disorders in the general population of the United States. Recent findings indicate that the prevalence of certain anxiety disorders may be higher in African Americans. In addition, anxiety disorders in African Americans may be manifested differently. Despite the high prevalence and the suggestion of different patterns of manifestation, a paucity of research exists on anxiety disorders in this population. This may be due in part to the pattern of help-seeking behavior among African Americans, a negative perception of research by members of this community, the small number of African American researchers, and perhaps to some extent a general disinterest on the part of researchers. The available research on anxiety disorders in African Americans is critically reviewed, the need for research in the area is highlighted, and ways to facilitate such research are discussed.     

Factors facilitating adjustment to unemployment: Implications for intervention

Conducted a community survey in the Fall of 1984 in a sample of high unemployment blue-collar census tracts in southeastern Michigan. Results of earlier analyses using these data showed that involuntarily unemployed workers had significantly elevated levels of depression, anxiety, somatization, and self-reported physical illness relative to a stably employed comparison group (Kessler, House, & Turner, 1987). Results presented in this paper document that this relationship is modified by social support (as measured by social integration and the availability of a confidant), self-concept, and various coping processes. Further analyses allowed us to determine the way in which these modifiers operate. The modifying effects of social support and coping operate primarily by buffering the impact of unemployment-related financial strain on the health outcomes. Self-concept operates primarily by attenuating vulnerability to other stressful life events. The implications of these results for the design and implementation of preventive interventions are discussed.     

A comparative evaluation of parent-training interventions for families of chronic delinquents

Fifty-five families of chronically offending delinquents were randomly assigned to parent-training treatment or to service traditionally provided by the juvenile court and community. The families in the parent-training group received an average of 44.8 hours of professional contact (23.3 hours of which were phone contacts), and each control group family received treatment estimated at more than 50 hours on the average. Comparisons of police contact data at baseline and subsequent years for the two groups showed that subjects in both groups demonstrated reduced rates of offending during the followup years. The finding most relevant was significant treatment-by-time effect for offense rates, with most of this effect accounted for by a greater reduction in serious crimes for the experimental group during the treatment year, and a similar reduction of the community control group occurring in the first of three followup years. These early decrements in offense rates persisted during followup for both groups. Throughout the study, boys in the experimental group spent significantly less time in institutional settings than did boys in the control group. Parent training had a significant impact, but the reduction in offending was produced at very high emotional cost to staff. Although it is clear that this population requires substantial treatment resources, this study underscores the need for more work on prevention.Research for this paper was supported by grant MH 37938 from the Center for Studies of Antisocial and Violent Behavior, National Institute of Mental Health (NIMH), U.S. Public Health Service (PHS). The writing was supported in part by grants MH 17126 and MH 37940 from the same Center, grant DA 05304 from the National Institute of Drug Abuse, U.S. PHS., and grant MH 38730 from the Child and Adolescent Disorders Research Branch, NIMH, U.S. PHS. The authors gratefully acknowledge the enduring commitment of the treatment staff that made this study possible: Patricia Chamberlain, Marion Forgatch, and Kate Kavanagh.     

Use of the family adaptability and cohesion evaluation scales in child clinical research

Although the FACES has become a widely used instrument for assessing children's family relations, the possible linearity vs. curvilinearity of its cohesion and adaptability scales has been treated inconsistently by investigators. This study evaluated whether samples of adolescent repeat offenders, young adult prisoners, and adolescent nonoffenders were discriminated better by a linear or curvilinear treatment of the FACES scores. Between-groups comparisons showed that significant effects were observed for each of the three curvilinear measures (cohesion-curvilinear, adaptability-curvilinear, distance-from-center) and only one of the two linear measures (cohesionlinear). These findings support the superiority of a curvilinear treatment of the FACES. In light of these findings, it is suggested that investigators who use FACES evaluate the linearity of the scales and determine whether a linear or curvilinear treatment of the data produces more meaningful results.     

Aversive procedures: The minnesota experience

Aversive and deprivation procedures for controlling and reducing challenging behaviors have received increasing attention. Many states have adopted guidelines on the use of these procedures treating persons with developmental disabilities. The Minnesota state rule promulgated in October, 1987 requires reviews from both local and state-wide review committees on permitted, but controlled procedures. Data generated from state-wide committees revealed that (a) state operated regional treatment centers (RTCs) employed individual habilitative training programs with controlled procedures more frequently than community-based agencies (b) a higher proportion of RTC submissions were for treatment of self-injury than submissions from community services, and (c) RTCs had a higher usage of mechanical restraints than community facilities with both services settings using manual restraints more frequently than all other controlled procedures combined. Reasons for the above differences in the two service settings were discussed.     

The effect of training on visual alignment discrimination and grating resolution

The effect of training on an observer’s ability to detect the misalignment of three points, a hypes-acuity, and to resolve a six-line grating was studied in a transfer-of-training design with observers (4 in each of two experiments) who were experienced in making psychophysical judgments of other visual stimuli. The transfer-of-training design enabled us to look for any training-based improvement. Long periods of training produced no statistically significant improvement in performance under any condition. There were small practice-based improvements, but the primary patterns indicated threshold fluctuation rather than improvement. We interpret the results to indicate that the neural mechanisms underlying three-point alignment and grating discrimination, like those for gap bisection (Klein & Levi, 1985), are not malleable to any significant extent.     

Effects of live modeling, covert modeling and rehearsal on assertiveness in psychiatric patients.

The present study evaluated the effects of live modeling, covert modeling, and rehearsal in unassertive psychiatric patients. Psychiatric patients scoring 19 or below on the Wolpe-Lazarus Assertiveness Scale were assigned to one of five conditions, with 10 subjects in each group: (1) Test-retest (no treatment). (2) Live modeling plus rehearsal. (3) Live modeling without rehearsal. (4) Covert modeling plus rehearsal, and (5) Covert modeling without rehearsal. All subjects were videotaped (pre- and post-test) while responding to eight interpersonal situations (four training scenes; four generalization scenes) requiring assertive responses. Pre- and post-test responses for all subjects were rated independently by judges on several verbal and non-verbal components of assertiveness. The results indicated that live modeling and covert modeling effected improvements in the assertive behavior of the patients, but that the two treatments were not differentially effective. Generally, the addition of rehearsal to live or covert modeling failed to enhance treatment. But on two measures, the covert modeling plus rehearsal condition was superior to the other treatments. There was evidence for transfer of treatment effects from training to generalization scenes. No differences were found among the groups on the Wolpe-Lazarus Assertiveness Scale and the Eysenck Personality Questionnaire. The results were discussed in light of prior findings with live and covert modeling procedures.