Evaluations of causal and conditional hypotheses

This study examined evaluations of causal and conditional hyptheses on the basis of individual exemplars. Subjects were presented scenes describing something that is malfunctioning and is taken to an expert. The expert makes a causal diagnosis and a prediction concerning an outcome following treatment. Four types of outcome evidence were provided: (1) treatment is provided and the problem is eliminated; (2) treatment is not provided and the problem is eliminated; (3) treatment is provided and the problem is not eliminated; and (4) treatment is not provided and the problem is not eliminated. Subjects were required to judge whether individual exemplars prove the diagnosis, disprove the diagnosis, or fail to test the diagnosis. A second form of problem presented the same scenes but required evaluation of the conditional prediction. A third form of problem did not present the causal scenes; the subject evaluated the conditional predication and no context. Three content domains were used: medical, mechanical, and arbitrary. There were three general results: (1) diagnoses were judged as less open to testing than predictive conditional hypotheses; (2) medical problems were judged differently from mechanical problems; and (3) problems lacking meaningful content or contexts led to more primitive response strategies.     

Norms and screening utility of the Dutch version of the Children's Depression Inventory in clinical and nonclinical youths

This study aimed to (a) assess relationships between the Children's Depression Inventory (CDI) and DSM-oriented depression and anxiety scales of the Youth Self Report, (b) develop reliable norms for the CDI, and (c) determine CDI cutoff scores for selecting youngsters at risk for depression and anxiety. A total of 3,073 nonclinical and 511 clinically referred children and adolescents from The Netherlands and Belgium were included. Results showed that CDI scores were significantly related to DSM-oriented symptoms of both depression and anxiety. CDI scores correlated highly with depression symptoms and moderately with anxiety symptoms. Norms for the CDI were determined by means of multiple regression analysis and depended on sex, age, and country. CDI cutoff scores for selecting individuals at risk for depression and anxiety as measured by the DSM-oriented depression and anxiety scales of the Youth Self Report were determined by means of multiple regression analysis and receiver operating characteristic analysis. A CDI score of 16 was found to have the most optimal balance between sensitivity and specificity for depression, whereas a score of 21 provided the best sensitivity and specificity for anxiety in a subsample of children. We conclude that the CDI is an effective instrument for screening depression and to a lesser extent anxiety in primary and secondary care centers, before applying further assessment of high-risk individuals.     

A diagnosis of conflict: theoretical barriers to integration in mental health services &; their philosophical undercurrents

This paper examines the philosophical substructure to the theoretical conflicts that permeate contemporary mental health care in the UK. Theoretical conflicts are treated here as those that arise among practitioners holding divergent theoretical orientations towards the phenomena being treated. Such conflicts, although steeped in history, have become revitalized by recent attempts at integrating mental health services that have forced diversely trained practitioners to work collaboratively together, often under one roof. Part I of this paper examines how the history of these conflicts can be understood as a tension between, on the one hand, the medical model and its use by the dominant profession of psychiatry, and on the other, those alternative models and practitioners in some way differentiated from the medical model camp. Examples will be given from recent policy and research to highlight the prevalence of this tension in contemporary practice. Part II of this paper explores the deeper commonalities that lay beneath the theoretical conflict outlined in Part I. These commonalities will be shown to be apart of a captivating framework that has continued to grip the conflict since its inception. By exposing this underlying framework--and the motivations inherent therein--the topic of integration appears in wholly different light, allowing a renewed philosophical basis for integration to emerge.