The classification of neuropsychological deficit

The study involves classification of neuropsychiatric patients on the basis of neuropsychological and intelligence test performance. One hundred twenty-five hospitalized male neuropsychiatric patients with various diagnoses were administered the Halstead-Reitan and Luria-Nebraska neuropsychological test batteries, as well as the Wechsler Adult Intelligence Scale. A cluster analysis was performed for each of those three procedures utilizing Ward's method. It was found in all cases that clusters were determined on the basis of level rather than pattern of performance. Relationships were found between cluster membership and age, education, and presence or absence of structural brain damage but were not found for diagnoses of schizophrenia or alcoholism. Schizophrenic and alcoholic patients were found in all clusters in the case of all three test procedures. Differences in clustering among the three test procedures were noted, with the WAIS being relatively more sensitive to educational differences while the Halstead-Reitan was more sensitive to age differences. The clinical utility of classifying patients on the basis of neuropsychological and cognitive test performance was discussed.Acknowledgement is made to the Veterans Administration for support of this research.     

IDENTIFYING REINFORCERS FOR PERSONS WITH PROFOUND HANDICAPS: STAFF OPINION VERSUS SYSTEMATIC ASSESSMENT OF PREFERENCES

We evaluated a systematic means of determining stimulus preferences among seven profoundly handicapped persons. Preferences were determined by observing student approach responses to individual stimuli. Results indicated that there were differential stimulus preferences across the multiply handicapped participants. However, results of the systematic assessment did not coincide with the results of a more traditional, caregiver-opinion method of assessing student preferences. A second experiment was then conducted with five participants to evaluate whether stimuli that were assessed to consistently represent preferences would function as reinforcers in skill training programs. Results indicated that stimuli that were systematically assessed to represent student preferences typically functioned as reinforcers when applied contingently. However, preferred stimuli as reflected by caregiver opinion did not function as reinforcers unless those stimuli were also preferred on the systematic assessment. Results are discussed in terms of assisting profoundly handicapped persons by (a) improving the effectiveness of training programs by increasing the likelihood of using stimuli that have reinforcing value and (b) increasing the overall quality of life by providing preferred stimuli in the routine living environment.     

Nonwaking Responses to Waking Stressors: Dreams and Nightmares1

A distinction between self-reported dreams and nightmares made it possible to test the relative sensitivity of these nonwaking cognitions to different kinds of life stressors including combat expasure, childhood and adolescent stressom, and recent life events. Survey interview data were collected on 442 men from the cohort eligible for military duty during the Vietnam Conflict who varied in their partiapation in that war. Dreams were over 3.5 times more prevalent than nightmares. Nevertheless, it was the prevalence, frequency, and content of nightmares, not dreams, that were consistently associated with life stresors. Links between nonwaking cognitions and life stressors are explored with regard to hypothesized mechanisms involving affect and cognition, wish fulfillment, and working-through processes.     

Vulnerability to economic stress

A stress vulnerability model was applied to the relationship between economic stress and mental health. Longitudinal data were obtained by reinterviewing 291 respondents from a prior community survey of economic change and health (Catalano & Dooley, 1983). The follow-up survey was conducted at the height of the last recession, approximately 1 year after the first. As predicted, increases in self-reported economic stress adversely affected psychological health, controlling for prior mental health status. However, individuals with poor prior mental health status were more vulnerable to economic stress: They were more likely to experience it during this economic contraction and were somewhat less likely to recover from it. Economic stress and mental health appear to have reciprocal effects, suggesting a spiral model of adaptation. Implications for interventions concerning economic change and mental health are discussed.     

Dimensions of the group environment scale

Student teachers in yearlong mental health consultation groups completed Moos's Group Environment Scale (GES) and three semantic differential ratings of their satisfaction with the group experience. Factor analysis of the GES yielded four dimensions, the first two corresponding to Moos's hypothesized dimensions of Relationship and System Maintenance/System Change. Intercorrelations of factor composite scores with the differential ratings provided concurrent validity evidence for the factored dimensions. Results were interpreted as supporting a multidimensional rather than unidimensional structure for the GES.     

Androgyny as synthetic narcissism: Sex role measures and Kohut's psychology of the self

In Kohut's analysis of narcissism, the self emerges as a bipolar structure characterized by grandiosity at one pole and dependency at the other. Through appropriate developmental processes, grandiosity grows into a mature ambitiousness, and early dependencies are converted into a stable system of ideals. The present investigation predicted that sex role constructs essentially measure these two aspects of the self. Expected relationships between masculinity and grandiosity, and between femininity and dependency, were in fact obtained. Based in large part on Westin's (Self and Society, Cambridge: Cambridge University Press, 1985) analysis of Kohut's theory, synthetic, internal, external, and archaic narcissistic self styles were hypothesized to exist and to parallel the androgynous, masculine, feminine, and undifferentiated sex roles, respectively. Rough comparabilities were in fact evident between these two typologies. Factor analyses also demonstrated that narcissism and sex role measures load on factors in ways revealing the intimate ties between pathological narcissism and the failure to achieve desirable sex role characteristics.     

Prospective assessment of late-luteal phase dysphoric disorder

This investigation evaluated a method for the prospective assessment of the symptoms of premenstrual syndrome (PMS). The American Psychiatric Association has proposed a diagnostic category for PMS in the DSM-III-R entitled late-luteal phase dysphoric disorder (LLDD). The criteria for this disorder include prospective documentation of at least two symptomatic cycles. Two groups of women were studied, one group that met the DSM-III-R diagnostic criteria for LLDD and a comparison group that did not. Subjects recorded symptoms related to PMS for two menstrual cycles. A clinically significant worsening of symptoms was defined as a symptom increase during the premenstruum of greater than one standard deviation above normal. These effect sizes were then used to determine if the subject met the DSM-III-R criteria for prospective confirmation. Data analysis showed that although the LLDD group showed evidence for PMS in several symptom groups, only a minority (31%) met the requirement of prospective confirmation of significant PMS symptoms for the two cycles recorded. These results were discussed in terms of the need for prospective behavioral assessment of LLDD and the implications of these findings for past and future research.Portions of this paper were derived from the master's thesis of the first author.