Dimensions of behavior in children with speech and language disorders

The behavioral symptoms of a population of children with speech and language disorders (with a mean age of approximately 6 years) were studied with a teacher and a parent questionnaire. A factor analysis produced similar factors for both questionnaires: Hyperactivity-Conduct, Affect, and Language. An Asocial factor was also found with the teacher questionnaire. The factors of this study were in good agreement with the general factors of Aggression and Withdrawal found in other quantitative studies. Mean factor score profiles were reported for this unique population of children.The authors would like to thank Dr. Donald Guthrie for his statistical consultation and Dr. Howard Grey for the use of his patient population.     

A PARTICIPATIVE MANAGEMENT APPROACH FOR IMPROVING DIRECT-CARE STAFF PERFORMANCE IN AN INSTITUTIONAL SETTING

The present study evaluated a participative management approach for increasing the frequency of interactions between institutional staff and severely/profoundly retarded residents. The participative management approach involved teaching staff how to use self-monitoring, standard setting, self-evaluation, and self-reinforcement procedures. These procedures were then used by staff with minimal involvement of supervisory personnel. Although supervisors provided feedback and praise to staff for using these self-management behaviors, feedback and praise were never dispensed contingent on staff interactions with residents. Results indicated that during the participative management program there was an increase in staff interactions that were contingent on appropriate resident behavior. The increase in this type of staff interaction was accompanied by an increase in appropriate resident behavior. Follow-up data on both staff and resident behaviors, although showing moderating trends, suggested generally good maintenance of the initial behavior changes. Acceptability data suggested that staff were quite receptive to the program. The advantages of participative management procedures for improving staff performance in residential settings are discussed.     

Recent developments in psychiatric malpractice

Common issues of mental health liability are examined in relationship to recent legislative and case law. Matters of practical importance to practitioners including the applicability insurance coverage to punitive damage awards of arising from malpractice are addressed. Specific legal doctrines involving proof of liability, proximate cause and the standard of care are explored as they relate to mental health malpractice cases.     

The use of family myths as an aid to strategic therapy

The concept of family myth can be used by the therapist to help organize the wealth of information provided by a family in therapy. Rituals, symbols and metaphors can be viewed as structurally related components within the family myth system which enable the therapist to interpret non-literal, analogic communications as a coherent yet primarily symbolic, narrative about the family's shared perceptions of its functioning. The concept of myth is explored in relation to mythology, the family therapy literature, and a case study. Several strategic intervention strategies are proposed which utilize the family's own metaphors, symbols and rituals to re-edit the family myth. Re-editing the myth on a symbolic level should be associated with improved system functioning, including more concrete areas of the family's life.     

A decade of research and services for homeless mentally ill persons. Where do we stand?

Over the past decade, researchers have documented the range of needs and devised new methods for increasing our understanding of the homeless severely mentally ill population. Clinicians have developed an appreciation of the difficulty and complexity of effectively treating this population, and policymakers have become increasingly aware of the barriers to developing services and housing. In this article, the progress-to-date in research, the evolution of new service approaches, and the development of federal, state, and local policies to meet the needs of homeless mentally ill individuals are assessed. The many challenges that remain are also considered.     

Multifactorial assessment of bulimia nervosa

We investigated a multifactorial approach to the assessment of bulimia nervosa by means of hierarchical factor analysis. Two hundred forty-five bulimia nervosa patients and 68 patients with either anorexia nervosa or eating disorders not otherwise specified were administered a self-report battery that was organized into 21 dimensions relevant to eating disorder patients. When dimensions from this battery were subjected to hierarchical factor analysis, support for bulimia nervosa as a unique diagnostic category was obtained. However, the emergence of 3 secondary factors and 6 primary factors suggests that bulimia nervosa can also be described more complexly. The emergence of a multifactorial model of bulimia nervosa that incorporates several existing undimensional models suggests the potential for both divergent and complicated clinical presentation in bulimia nervosa patients.     

A COMPREHENSIVE EVALUATION OF REINFORCER IDENTIFICATION PROCESSES FOR PERSONS WITH PROFOUND MULTIPLE HANDICAPS

We evaluated comprehensively a preference assessment for identifying reinforcers for persons with profound multiple handicaps. Four experiments were conducted involving 18 individuals. Results of Experiment 1 replicated previous findings in that the assessment identified student preferences for respective stimuli, and caregiver opinion of preferences did not coincide with the systematic assessment. Results of Experiment 2 indicated highly preferred stimuli were likely to function as reinforcers in training programs, whereas stimuli not highly preferred did not function as reinforcers. Results of Experiment 3 suggested the 12 stimuli used in the assessment represented a comprehensive stimulus set for identifying preferences, although the utility of the set sometimes could be enhanced by caregiver opinion. Results of Experiment 4 indicated the assessment identified preferences likely to be maintained over time. Overall, results are discussed in terms of identifying limits and alternatives to a behavioral teaching technology when applied to persons with profound multiple handicaps.     

The Measurement of Self-Esteem, Stress-Related Life Events, and Locus of Control Among Unemployed and Employed Blue-Collar Workers

The purpose of this study was to measure the self-esteem, stress of life events, and locus of control among unemployed and employed blue-collar workers. It was hypothesized that (a) being unemployed decreases an individual's self-esteem, (b) being unemployed increases an individual's stress level by experiencing significant life changes, and (c) being unemployed increases an individual's external locus of control orientation. The study was conducted in a production/manufacturing organization, utilizing a systematic random sampling procedure that yielded 562 subjects. The results from the collected data did not support Hypothesis A or C. A significant change with stress in conjunction with life events was found but was mediated by several factors, including age and a nonsignificant correlation between time laid-off and stress levels. The study suggests that an individual's reaction to unemployment does not appreciably affect their self-esteem and locus of control when compared to the employed.