Evaluation of an intervention designed to improve patients' hospital experience.

The influence of a videotape, shown in a hospital admitting room, on patients' state anxiety and concerns about hospitalization was assessed in a preliminary study. For both state anxiety and specific concerns regarding hospitalization the pretest scores on each variable accounted for the preponderance of the variance in the posttest scores. In both instances, the intervention and the interaction of the intervention with the pretest scores accounted for less than 1% of variance in the outcome. While finding small effects to be significant for such a small sample (N = 93) is unlikely, the sample size was adequate to detect medium to large effects. More important was the fact that 73.33% of the videotape intervention group indicated that they did not watch the video, which leads us to the conclusion that this intervention as tested is not worthwhile.     

Interpretation style and reactance in counselor's social influence.

This study compared two different interpretation styles (tentative and absolute), two levels of subjects' reactance (high and low), and gender on the counselor's social influence, willingness to see the counselor, willingness to help, ability to help, and subjects' anger. No significant main effects or interaction were found for the counselor's social influence, but men in contrast to women perceived the counselor as more willing to help and indicated that they were more willing to see the portrayed counselor. Highly reactant subjects were more willing to see the counselor when absolute interpretations were used; they also thought the counselor was more willing to help when absolute interpretations were used, whereas low reactant subjects thought the counselor was more willing to help when tentative interpretations were used. Mixed results were found for subjects' anger.     

Validity and clinical scale comparisons between the MMPI and MMPI-2 with psychiatric inpatients.

This study was designed to investigate the comparability of the original MMPI (1950) and the MMPI-2 (1989) with a psychiatric patient population. 34 male and 3 female patients, shortly after admission to one of two acute psychiatry units, completed the old and revised versions of the MMPI. Paired t tests indicated but scant differences for raw scores, while many more differences were found among T scores for validity, clinical, and supplemental scales. Analyses, however, showed all scales on the two forms to be highly correlated. Analysis of the high-point and two-point codes across the two administrations also showed relative stability, although the proportion of Scales 2 (Depression) and 8 (Schizophrenia) decreased, while those for Scales 6 (Paranoia) and 7 (Psychasthenia) increased markedly in the MMPI-2 protocols. Examination of each version's discriminability among mood- and thought-disordered subsamples suggested that the MMPI provides slightly better delineation between diagnostic classes. Discriminant function analyses showed that there were essentially no differences between the two forms in the accurate classification of clinical and nonclinical groups. The findings reported here provide support for the MMPI-2; despite modification, the newer form retains the advantages of the original MMPI. Differences found here may be unique to psychiatric patients and their patterns of MMPI/MMPI-2 equivalence and may not generalize to other special populations.     

Demoralization and living alone: outcome from an urban community study.

The purpose of the present study was to investigate differences in demoralization between those who live in single-person households and those who live in households with others in a random sample of 8,634 urban adults. Responses to the 26-item Psychiatric Epidemiologic Research Interview did not substantiate that adults who live alone are more likely to be demoralized than those who live with others, until age and gender are considered. Men who live alone scored higher on demoralization than men who live with others, yet women who live with others scored higher on demoralization than those who live alone. An interaction for living arrangement and age group on demoralization was also observed.     

Psychological compensation: a theoretical framework.

The 2 main objectives of this article are to review a variety of literatures in which the concept of compensation is used and to integrate the results of this review into a general framework of compensation. The review focuses on 4 domains of psychological inquiry: compensation for sensory handicaps, cognitive deficits, interpersonal losses, and brain injury. In the proposed framework, underlying dimensions and 4 basic steps in the progression of compensatory behavior are distinguished. The latter include origins, mechanisms, forms, and consequences. Finally, we describe ways in which researchers in particular domains can benefit from the global, process-oriented framework we propose. For most of the areas of compensation research reviewed, investigators can profit from a consideration of a broader selection of dimensions, additional steps in the process, alternative outcomes, and both objective and subjective assessment procedures.     

Sensory and affective components of pain: separation and synthesis.

It has become increasingly accepted that pain is not simply a sensation generated by nociceptors, but a perceptual phenomenon with particular emotional qualities. The purpose of this article is to bring together vastly different streams of research on the divisibility of pain into sensory and affective components. Empirical evidence for this divisibility is drawn from recent studies using multivariate statistics, signal detection theory, and unidimensional scaling. An important conclusion is that separable though pain components may be, they are not necessarily independent. In critiquing previous research, new criteria are derived for partitioning pain into sensory and affective components. Finally, speculations are offered as to how these same components might be synthesized on the basis of theories of perceptual organization.     

The role of fathers in child and adolescent psychopathology: make room for daddy.

This review summarizes research concerning the relation between paternal factors and child and adolescent psychopathology. When compared with mothers, fathers continue to be dramatically underrepresented in developmental research on psychopathology. However, findings from studies of children of clinically referred fathers and nonreferred samples of children and their fathers indicate that there is substantial association between paternal characteristics and child and adolescent psychopathology. Findings from studies of fathers of clinically referred children are stronger for fathers' effects on children's externalizing than internalizing problems. In most cases the degree of risk associated with paternal psychopathology is comparable to that associated with maternal psychopathology. Evidence indicates that the presence of paternal psychopathology is a sufficient but not necessary condition for child or adolescent psychopathology.     

Efficient pain assessment in clinical settings.

The need for efficient and practical assessment techniques of the multidimensional nature of chronic pain remains paramount in clinical settings. Visual analogue scales (VASs) and simple behavioral observation methods have been proposed as efficient, reliable, and valid measures of the subjective (sensory and affective) and overt behavioral aspects of the pain experience. The relationships among VASs and the UAB Pain Behavior Scale were examined among 48 chronic pain patients. Ratings of overt behavior were significantly related to both the VAS sensory and VAS affective ratings. Regression analysis indicated that the VAS scores accounted for significant amount of the variance (27.7%) in UAB scores. Moreover, the affective dimension of self-reported pain tended to be more strongly related to the visible manifestations of pain than were ratings of pain intensity.     

Predictors of short-term treatment outcome in bulimia nervosa inpatients.

Recent studies, mostly performed on bulimic outpatients, did not find consistent predictors of treatment outcome in bulimia nervosa. This is the first study to investigate anamnestic and clinical factors predictive of the short-term outcome of hospital treatment in 31 female bulimia nervosa patients with a mean age of 22.9 yr. Treatment outcome was assessed by several self-rating instruments measuring different features of the specific and unspecific psychopathology of bulimia nervosa. The most relevant predictors of the outcome of the 8-week hospital treatment were duration of previous inpatient treatments for bulimia, the intensity of anorexic tendency and the pretreatment level of depression. The majority of predictors tested did not show a strong relationship to treatment outcome. The findings are discussed in relation to results of other studies as well as to possible implications for treatment and research.     

Art alone endures.

Sigmund Freud, a passionate collector of antiquities, often treated these objects as animate beings. He described such blurring of boundaries between persons and things in the protagonist of W. Jensen's novella, Gradiva. Freud began collecting when his father died, but his unusual attitude toward artefacts was established much earlier, presumably as a consequence of repeated early disappointments in human caretakers. It is postulated that this adaptive maneuver was not simply a displacement of love and hate, but a turning away from vulnerability in relationships, toward attachments over which he might retain effective control. The Freud Collection is largely focused on Greco-Roman and Egyptian objects. Freud's profound interest in classical civilization was established in childhood; he was particularly concerned with the struggle between Aryan Rome and Semitic Carthage, a conflict in which he identified with both sides. This ambivalence reflected growing up within a marginal Jewish family in a Germanic environment. Commitment to classical ideals represented an optimal manner of bridging these contrasting worlds. Egyptian artefacts were, for Freud, links to the prehistory of the Jewish people; they also represent an era when maternal deities found their proper place in man's pantheon--an echo of Freud's prehistoric past.