Community psychology in Hong Kong: Past,present, and future

The expansion of mental health services during the 1960s from a single remote mental hospital to centers and clinics in mainstream communities fostered the development of community psychology in Hong Kong. Few psychologists were initially involved in the local community mental health movement, but its momentum resulted in increasing numbers of practitioner psychologists working in community-based service settings. Community psychology in Hong Kong today consists primarily of service delivery, but also includes applied research, community organization/consultation, and community education. Despite having many parallels with the American situation, key concepts underpinning the practice of community psychology in the Territory possess their own character as a reflection of nuances in the local scene. Prospects for the continued development of community psychology in Hong Kong appear favorable. Of special relevance is the field's potential contribution to a better understanding of the psychological phenomena associated with the Territory's sociopolitical transformation in 1997.     

The Children's Firesetting Interview with psychiatrically referred and nonreferred children

This study evaluated the Children's Firesetting Interview (CFI). The measure was developed to operationalize multiple domains of functioning derived from a riskfactor model of firesetting. The model poses that child, parent, and family characteristics promote firesetting and continuation of a pattern of firesetting. Major factors include curiosity about fire, involvement in and exposure to firerelated activities, and knowledge about first safety The CFI, consisting of 46 questions reflecting six a prioridimensions, was administered to 519 children (ages 6–13) recruited from nonpatient, outpatient, and inpatient samples. Internal consistency and testretest reliability of the measure were satisfactory. Criterion validity was supported by the findings that firesetters showed greater curiosity about fire, involvement in firerelated activities, exposure to models/materials, and knowledge about things that burn than did nonfiresetters. These findings did not vary as a function of the child's patient status or level of antisocial behavior. Implications for the evaluation of firesetting risk are discussed.This study was supported by grant MH-39976 from the Antisocial and Violent Behavior Branch of the National Institute of Mental Health and by a Research Scientist Development Award (MH00353) from the National Institute of Mental Health. The authors acknowledge the constructive suggestions of two anonymous reviewers.     

Can dyslexia be treated? Treatment-specific and generalized treatment effects in dyslexic children's response to remediation

A total of 178 reading disabled children were randomly assigned to one of three treatment conditions providing training in word recognition and decoding skills (DS), oral and written language (OWLS), or classroom survival skills (CSS. an alternative treatment control). Pre- and post-treatment comparisons on an array of standardized and experimental measures indicated that the two experimental treatments (DS, OWLS) resulted in improvement on selected tests significantly greater than that resulting from a third treatment intervention which controlled for treatment time and individual attention (CSS). Effects specific to each experimental treatment were identified, as well as some generalized treatment advantages shared by both experimental groups at post-test. These results indicate that some of the deficits associated with developmental dyslexia are amenable to treatment. Greater generalization of treatment effects was observed following the DS than the OWLS treatment. While DS-instructed children exhibited better word recognition skills, however, their knowledge of grapheme-phoneme correspondence rules was not improved. Several OWLS-specific effects observed on experimental reading and language measures were not replicated on standardized tests which purport to measure the same skills. These results are discussed with respect to (i) possible mechanisms by which disabled readers may acquire word recognition skills, (ii) their failure to acquire and use grapheme-phoneme correspondence rules, and (iii) a possible reduced tendency in the present population to generalize newly acquired specific knowledge to related knowledge domains.     

Base-rate effects in category learning: a comparison of parallel network and memory storage-retrieval models

Exemplar-memory and adaptive network models were compared in application to category learning data, with special attention to base rate effects on learning and transfer performance. Subjects classified symptom charts of hypothetical patients into disease categories, with informative feedback on learning trials and with the feedback either given or withheld on test trials that followed each fourth of the learning series. The network model proved notably accurate and uniformly superior to the exemplar model in accounting for the detailed course of learning; both the parallel, interactive aspect of the network model and its particular learning algorithm contribute to this superiority. During learning, subjects' performance reflected both category base rates and feature (symptom) probabilities in a nearly optimal manner, a result predicted by both models, though more accurately by the network model. However, under some test conditions, the data showed substantial base-rate neglect, in agreement with Gluck and Bower (1988b).     

Aggressiveness and hyperactive behaviour as related to adrenaline excretion

The central question concerns the relationship between aspects of behaviour and physiological reactions. Measures of sympathetic-adrenal activity in terms of adrenaline excretion in a normal and a stressful situation as well as teacher ratings of behaviour were analysed for a representative group of 86 boys aged 13. Adrenaline excretion was in both situations significantly negatively related to ratings of aggressiveness, motor restlessness, and concentration difficulties and also to the sum of the latter two, used as an indicator of hyperactive behaviour. The association between hyperactive behaviour and adrenaline excretion persisted in the stressful situation when aggressiveness was controlled, whereas there was no significant relationship between aggressiveness and adrenaline output when hyperactive behaviour was controlled. Furthermore, hyperactive boys differed significantly from non-hyperactive boys in displaying lower adrenaline excretion in both situations. The results are discussed in terms of low sympathetic-adrenal reactivity to external demands as a risk factor and as a possible indicator of vulnerability for social and/or pervasive conduct disturbances.     

Age differences in the acculturation process

Age differences were assessed in a conceptual model that seeks to explain how acculturation affects psychological well-being among Mexican Americans. The data were from a national probability sample of 859 persons of Mexican decent. It was hypothesized that low acculturation creates financial stress. Moreover, low acculturation and financial stress were in turn predicted to erode feelings of personal control and self-esteem. Finally, diminished feelings of control and low self-esteem were hypothesized to exert a negative impact on psychological well-being. When data from respondents of all ages was assessed, empirical support was found for all of the hypotheses except the linkage between acculturation and financial stress. However, few age differences emerged in the model. The authors conclude that older Mexican Americans may not be more vulnerable to the stressors associated with acculturation.     

Frontal lobe dysfunction and memory impairment in patients with chronic progressive multiple sclerosis

Deficits in semantic encoding have been described in patients with frontal lobe disease who also show memory impairments. As a group, patients with multiple sclerosis (MS) exhibit memory impairment, fail to make effective use of semantic encoding to aid memory, and perform poorly on verbal fluency and concept formation tests which are sensitive to frontal lobe damage. In the present study the semantic encoding capacity of MS patients was measured using a modification of Wicken's release from proactive interference (PI) paradigm. Individual patients varied considerably in the severity of their impairments on verbal fluency, verbal recognition memory and on Wisconsin Card Sorting Task, but even patients who evidenced both memory impairment and signs of frontal lobe dysfunction showed normal release from PI after a categorical shift. Memory disturbances in MS are unlikely to result from an incapacity for semantic encoding, which seems preserved in MS, but may arise instead from deficits in processing information rapidly.     

Psychiatric malpractice in the military

Available data indicates that the incidence of malpractice in military psychiatry, involving both civilian and active duty beneficiaries, is the lowest of all specialties and may be lower than in the civilian sector. Recovery for malpractice damages by means of claim versus suit is restricted to civilian patients; active duty service members recover through a special disability system. The federal government provides military psychiatrists with considerable protection from personal financial loss when involved in malpractice, but there may be limits to that protection. There have been recent efforts to criminally prosecute military physicians in some instances. A registry review of military psychiatry malpractice cases from 1978 to 1987provides a profile of the malpractice situation and suggests areas of practice that need vigilance. The Department of Defense has established a broad-based, comprehensive program of quality assurance and risk management in the interest of maximizing the benefit of medical care and minimizing substandard practice.     

How and when to correct for juror hindsight bias in mental health malpractice litigation: Some preliminary observations

This article examines the hindsight bias in the context of mental health malpractice litigation, analyzes various legal mechanisms for dealing with the bias, and discusses whether the law should strive for debiasing in all mental health malpractice cases.