Using the MMPI-2 to Predict Symptom Reduction During Psychotherapy in a Sample of Community Outpatients

In the present study, potential MMPI-2 predictors of psychotherapy outcome were examined in a community clinical sample of 51 patients seeking treatment at a university training clinic. Results indicated that particular MMPI-2 scales (L, F, Pd, Pa, Sc, Trt) were the most predictive of initial levels of patient distress, whereas three other clinical scales (Hs, D, Hy) were significantly associated with actual symptom reduction over time. The clinical implications of these data include the use of the MMPI-2 in clinical practice as a means to frame the provision of direct feedback to patients regarding the likelihood of treatment response, which in turn, might actually have therapeutic benefits. The limitations of the study are reviewed and suggestions for future research are offered, including the potential use of widely known and utilized instruments in helping to predict response to psychotherapy.     

Spiritual Development: Han F. De Wit's and Stanislav Grof's Differing Approaches

For both Han F. de Wit and Stanislav Grof, spirituality constitutes an essential part of humaneness; a life built on materialism is deemed an impoverished life. For de Wit, spirituality yields courage, compassion, joy, clarity of mind, and consequently wisdom. For Grof, personal spiritual experiences gained during altered states of consciousness are of central interest. After defining spirituality, these views, built on long-term personal experiences of the authors and those of others, are explicated in detail. Both authors describe their respective approaches to spiritual development. In either approach, third-person knowledge and judgments (e.g., on humanness) have to be supplemented by first-person knowledge and judgments arrived at appropriately (e.g., on humaneness).     

NONCONTINGENT DELIVERY OF ARBITRARY REINFORCERS AS TREATMENT FOR SELF-INJURIOUS BEHAVIOR

Results of recent research have shown that noncontingent reinforcement (NCR) can be effective in reducing the frequency of behavior problems. In typical NCR applications, the reinforcer that is responsible for behavioral maintenance (as demonstrated through a functional analysis) no longer follows occurrences of the target behavior but instead is delivered according to a time-based schedule. Thus, it is unclear if NCR would be effective if the target behavior continued to be reinforced or if arbitrary reinforcers (i.e., those irrelevant to behavioral maintenance) were substituted for the maintaining reinforcers in the NCR procedure. In this study, 2 individuals whose self-injurious behavior (SIB) was maintained by positive reinforcement were exposed to conditions in which arbitrary and maintaining reinforcers were withheld and were delivered either contingently or noncontingently. Results indicated that noncontingent delivery of arbitrary reinforcers was effective in reducing SIB even though occurrences of SIB produced access to the maintaining reinforcer. These results suggest that (a) arbitrary reinforcers may sometimes be substituted for maintaining reinforcers, (b) an important component of NCR procedures is alteration of a behavior's establishing operation, and (c) NCR with arbitrary reinforcers might therefore be effective when maintaining reinforcers cannot be identified or withheld during the course of treatment.     

DOES FUNCTIONAL COMMUNICATION TRAINING COMPETE WITH ONGOING CONTINGENCIES OF REINFORCEMENT? AN ANALYSIS DURING RESPONSE ACQUISITION AND MAINTENANCE

We examined the effectiveness of functional communication training (FCT) in reducing self-injurious behavior (SIB) and in shaping an alternative (communicative) response while SIB continued to be reinforced. Following a functional analysis of 3 individuals' SIB, we attempted to teach an alternative response consisting of a manual sign to each individual, using the reinforcer that maintained SIB. When FCT was implemented without extinction, SIB remained at baseline rates for all participants, and none of the participants acquired the alternative response. When extinction was added to the training procedure, SIB decreased and manual signing increased for all participants. To determine if signing, when established, would compete with SIB when both were reinforced, extinction was then withdrawn. Signing was maintained and SIB occurred at low rates for 2 individuals, but SIB returned to baseline rates for the 3rd individual, necessitating the reimplementation of extinction. These results suggest that it may be difficult to establish alternative behaviors if inappropriate behavior continues to be reinforced, but that, when established, alternative behavior might compete successfully with ongoing contingencies of reinforcement for inappropriate behavior.     

Development of a Structured Psychiatric Interview for Children: Agreement Between Child and Parent on Individual Symptoms

To test the reliability of children's reporting as compared with that of their mothers, a highly structured psychiatric diagnostic interview was used with 307 subjects, ages 6 through 16. Another interviewer gave each mother a similar interview about the child. Responses of each mother-child pair to 168 questions were compared using the kappa statistic. Highest agreement was found on questions concerning symptoms that are concrete, observable, severe, and unambiguous. Mothers tended to report significantly more behavioral symptoms, and children more subjective symptoms. Reasons for low kappas and asymmetrical reporting of symptoms are discussed.     

Some everyday life consequences of disability and bereavement for older adults

The study analyzed daily event differences between groups experiencing the major stressors of conjugal bereavement and physical disability, and analyzed the association of everyday events with self-reports of mental health for different groups across a 3-month time span. Monthly interviews were conducted with 61 recently conjugally bereaved, 62 recently physically disabled, and 123 matched-comparison older adults between the ages of 60 and 80. The purpose of these interviews was to obtain a comprehensive assessment of the monthly frequencies of everyday life events. Self-reports of mental health were obtained from paper-and-pencil measures filled out after each interview. Causal models were used to analyze the best-fitting structure of event/mental health relationships for the first 3 monthly interviews. Undesirable events showed uniformly adverse effects on mental health. Desirable events benefited the psychological well-being of the disabled the most and had no positive effects on the mental health of the bereaved. The bereaved also evidenced less stability over time than other groups in the frequency of small undesirable events.     

Involvement and response language effects in attitude scaling

An analytic procedure was developed for separating the effects of involvement from the number of response language categories the subject employs in judging a set of sentence stimuli. The procedure treats category usage as an independent variable and an aspect of the subject's response language. Category usage was shown to have significant influence on several attitudinal judgment processes: Informational complexity, mean judgment functions, and a successive intervals analysis testing Thurstone's assumption of the effect of involvement on equal category spacing. The decrement in scale responding typically associated with involvement is shown to depend on category usage operating either singly or in interaction with involvement. Some tentative conclusions about category usage as a response language variable are discussed.     

Positive and negative social ties among older adults: Measurement models and the prediction of psychological distress and well-being

The factor structure of positive and negative social ties was studied among 246 older adults who were either recently physically disabled, recently conjugally bereaved, or matched controls. Covariance structure analyses were carried out on a network measure to determine whether positive and negative social ties represent independent domains of social experience, and to assess the degree to which their structure is invariant across groups undergoing major loss transitions. Positive and negative social ties were found to be independent and there was substantial similarity in their factor structure across the three groups. Hierarchical regression analyses revealed that, whereas positive social ties were related to psychological well-being, negative social ties were predictive of both psychological well-being and distress. These results demonstrate the importance of assessing both positive and negative ties in explaining the psychological adjustment of older adults.     

Development of a structured psychiatric Interview for children: Agreement on diagnosis comparing child and parent interviews

Similar structured diagnostic interviews about the child were given by different interviewers to a cohort of 307 mother-child pairs. A diagnosis was made by computer on each interview, using specified criteria. Diagnoses on mother-child interviews were compared using the kappa statistic. Kappas of .30 or higher were found for the diagnosis of antisocial personality, conduct disorder, enuresis, mixed behavior-neurotic disorder, and possible depression. Comparisons were made for sex and age. Possible depression and enuresis were diagnosed reliably at all age levels and for both sexes. The limitations of the interview and diagnostic system used are discussed. The findings support the need for further efforts to develop diagnostic research interviews for use with children and adolescents.     

Word frequency and children's stuttering: The relationship to sentence structure

This study investigated the relationship between word-frequency level and stuttering within the context of four slected sentence types. Fifteen stuttering children, aged 8–12, read 48 sentences of four different transformational types, and three word-frequency levels 12 simple active-affirmative-declarative (SAAD), 12 negative, 12 passive and 12 negative-passive. All sentences were identical in terms of underlying swings and variations of the SAAD sentences. Results agreed with Ronson's study with adults (1976) in that when the group rating was severe and the sentence type was negative, stuttering increased significantly as word-frequency level decreased. It appears that children's stuttering in relationship to word-frequency level is a different response that is subject to variables of sentence type and the severity rating of stuttering.