Noncompliance in hemodialysis patients as measured with the MBHI

Abstract

Fifteen patients beginning maintenance hemodialysis due to renal failure were administered the Millon Behavioral Health Inventory, the Family Environment Scale and Beck Depression Inventory at the outset of treatment. They were then followed regarding their compliance with fluid, diet and medication, using weight change and serum potassium and phosphorus levels. Statistically significant differences were found on independence/dependence conflicts and between patients showing at least moderate noncompliance with weight and/or phosphorus limitations. Significantly higher levels of depression were associated with consistently poorer compliance patterns.     

Word Memory Test Performance in Children

One-hundred and thirty-five children between the ages of 7 and 18 years were evaluated clinically. Their diagnoses included Fetal Alcohol Syndrome (FAS) or Effects, Schizophrenia, Bipolar Mood Disorder, various neurological diseases, Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder, Oppositional-Defiant Disorder and learning disabilities. As part of a comprehensive neuropsychological assessment, the children were given the Word Memory Test (WMT; Green, Allen, & Astner, 1996; Green & Astner, 1995), containing various subtests which measure, respectively, effort and verbal memory. Although age and verbal intelligence are known to affect scores on most ability tests, they were not found to be significant determinants of WMT effort scores. Younger children did not score any lower on the effort subtests than older children. The children scored as well as a group of parents seeking custody of their children and they scored higher than adult patients with mild head injuries. The computerized WMT requires some basic reading skills and some children with lower than a grade 3 reading level scored at a relatively low level on the effort subtests. The current data suggest that most children with at least a grade 3 reading level can pass the WMT using the adult criteria. It is concluded that the WMT is potentially useful in the evaluation of effort during pediatric neuropsychological evaluations. Further research is needed to replicate these findings and to develop child norms for the memory subtests.     

Val Plumwood

Miller's reply to Nelson misses the point because it does not attend to the difference between identifying the truth conditions for a proposition and explaining why those conditions are the ones in which the proposition is true.     

Distracted by Details: Narrative Influence Following Conflicting Stories

Work on narrative influence has demonstrated that stories can have a strong effect on people's thoughts and attitudes. However, existing research has not addressed how people respond to multiple stories endorsing different conclusions. The current studies examined how reading two conflicting narratives influences people's decisions about a subsequent situation, with particular emphasis on how resemblances between the narratives and the situation moderate the effects. Across two studies, participants read two testimonials that described the successful use of different treatments for a medical disorder. Participants subsequently made treatment recommendations for a patient who resembled one of the testimonials in treatment-relevant ways. The key manipulation was whether the patient also resembled the other testimonial in treatment-irrelevant ways. Both studies found that these distracting, irrelevant similarities led to less appropriate treatment recommendations. The effect on decision confidence, however, was less clear, with some suggestion of both an increase (Study 1) and a decrease (Study 2) in confidence.     

Refocusing on the Data: A Reply to Hardman

Hardman in press claims that the results of Green and Larking 1995 favour a mental rules theory account of performance in the selection task over a mental model theory account. This reply rebuts his claim.     

Spiritual care in psychiatry: Professionals’ views

In this study we explored the views of Mental Health professionals and general practitioners (GPs) regarding spiritual care and the effect of personal and cultural background on their views. Data were collected through anonymous questionnaires posted to hospital nursing and medical staff at Hollins Park Hospital, Warrington, UK, and to all GPs within the hospital catchments area. Forty-five percent of GPs, 33% of psychiatrists, and 76% of nursing staff (p < 0.05) felt strongly that human beings are made up of spirit as well as body. More nurses felt that spiritual care is equally as important as other forms of care (52%) compared with psychiatrists (33%) and GPs (29%). A higher percentage of nursing than medical staff had previous training in this area and were more likely than medical staff to consider themselves appropriate to give spiritual advice. A total of 20% of GPs and 33% of psychiatric staff stated the need for training in this area and GPs especially felt they lacked time. Professionals’ views are influenced by cultural and religious backgrounds, with significantly more non-UK born respondents feeling strongly that human beings all have a spiritual component. Many doctors do not consider spiritual care has a role for them to be involved in and many feel too pressured in daily life to take this on. Nurses are more inclined to take a holistic approach to care in this respect. Some people with mental health problems have spiritual care needs and we should be aware of this as an important facet to therapy.     

A review of: “Real events revisited: Fantasy,memory and psychoanalysis”

Ann Scott (1996) Real Events Revisited: Fantasy, Memory and Psychoanalysis, London: Virago, $12.99

Caroline Malone, Linda Farthing and Lorraine Marce (eds) (1996) The Memory Bird: Survivors of Sexual Abuse, London: Virago, $8.99     

A review of: “Challenges to counselling and psychotherapy”

Alex Howard (1996) Challenges to Counselling and Psychotherapy, London: Macmillan, $11.99