Linear Analogue Self-Assessment and Procrustean Measurement: A Critical Review of Visual Analogue Scaling in Pain Assessment

Visual analogue scales (VASs) are one of the most widely used self-report measures of clinical pain. This article reviews the empirical literature on linear analogue self-assessment (LASA) and critically examines the features that appear to have made it such an attractive measurement option in pain assessment. It is concluded that analogue scaling does not withstand critical scrutiny as a primary measure of either pain intensity or pain affect and that, in most circumstances, the overall clinical utility of VASs is inferior to that of more structured pain indices.     

An object-oriented simulation of a brain system underlying human aggression

Neural structures involved in aggression were incorporated into a model on the basis of neuro-anatomical data. A software program written in Smalltalk, the Brain Structure Simulator (Seguin, 1994) was used to simulate the effects of activity levels of different brain structures. Relationships among brain structures were then tested by changing activity levels of key structures. Results were consistent with research reports on the brain basis of aggression (Albert, Walsh, & Jonik, 1993; Pontius, 1984).     

Reducing MMPI-2 defensiveness: the effect of specialized instructions on retest validity in a job applicant sample

The MMPI-2 is often used for screening job applicants when public safety or security are at risk. Inherent in such applications is concern for profile validity and test defensiveness. In this study, we examine the impact of revised instructions on profile validity for a group of job applicants who initially produced invalid profiles. Participants were 271 male applicants for airline pilot positions. Of these, 72 produced invalid defensive MMPI-2 profiles during preemployment screening. The MMPI-2 was readministered to these applicants with instructions informing them of validity scales and instructing them to respond in a more open, honest manner. Comparisons were made between valid and invalid profiles for initial administrations and between valid and invalid profiles at readministration. Some clinical scales were more elevated for valid, nondefensive profiles. Most content scales showed more elevation for valid profiles, and 12% of the applicants who were retested produced significant elevations (T>or=65) on the content scales. Profiles were similar to those produced by employed pilots of a previous study.     

A general linear model for estimating effect size in the presence of publication bias

When the process of publication favors studies with smallp-values, and hence large effect estimates, combined estimates from many studies may be biased. This paper describes a model for estimation of effect size when there is selection based on one-tailedp-values. The model employs the method of maximum likelihood in the context of a mixed (fixed and random) effects general linear model for effect sizes. It offers a test for the presence of publication bias, and corrected estimates of the parameters of the linear model for effect magnitude. The model is illustrated using a well-known data set on the benefits of psychotherapy.Authors' note: The contributions of the authors are considered equal, and the order of authorship was chosen to be reverse-alphabetical.     

The Cost of Client Transfer

Clients undergoing transfer from one counselor to another were compared on the Generalized Contentment Scale and a DSM-III-R measure with clients staying with the same counselor over the same length of treatment. In three 12-week blocks, the clients with the same counselor made the greatest progress in the first 12 weeks, making less progress in each successive block. The clients who were transferred in the middle of the second 12-week block also made the greatest progress in the first time block, lost some of the progress in the transfer block, and made significant progress with the new counselor in the third time block, ending with no significant differences in either generalized contentment or DSM-III-R outcome from clients who had not been transferred.     

Case study: Examining the relationship between self-initiations of an individual with disabilities and directive behavior of staff persons in a residential setting

This case study examines the relationship between self-initiations of an adult woman with severe disabilities and the directive behavior of staff persons in a community residential setting. Hypotheses generated from functional assessment procedures indicated that (a) Susan's low self-initiations were very likely related to high directive behavior of staff persons, and (b) infrequent problem behaviors during the morning routine were maintained by escape from repeated staff demands. An intervention was implemented to enable Susan to increase self-initiation in choice and sequence of activities and simultaneously decrease staff directives. Results and discussion focus on the need for a contextual approach for addressing problematic situations and an affirmation of the effectiveness of the positive behavioral support technology for increasing adaptive behaviors in individuals with severe disabilities.     

Non-heart-beating organ donation: a reply to Campbell and Weber.

In the preceding commentary, Campbell and Weber raise two valid and important issues concerning non-heart-beating organ donation (NHBOD). First, because the procedure links withdrawal of life support and the potential for subsequent organ donation, the desire for organs may create a situation in which care of the dying individual has relatively less importance and the dying may receive suboptimal care. Second, even if concerns about care of the dying were dealt with adequately, there will not be enough non-heart-beating donors to significantly decrease the organ shortage that exists, making the procedure not worth the risk. We agree that attention to the important details of caring for the dying are, and must be, the primary concern of all health care workers caring for those individuals. Ensuring the patients' comfort, dignity, and autonomy, and providing for family and social support are the mainstays of this care. All policies for NHBOD should clearly support and mandate these concepts. Regarding the second concern, we agree that NHBOD is currently rare; however, evidence is increasing that this type of donation has great potential. Continued growth of the practice in this country will depend largely on public acceptance, which we believe will be directly influenced by whether the public perceives that care of the dying is not compromised by this procedure.     

Quantitative measurement of observed workload in the analysis of aircrew performance

A methodology for the quantitative evaluation of observed workload was proposed. The model was designed to provide point estimations of observed workload at any time during the performance of a set of tasks. The model was also designed to provide information about the task-scheduling strategies used to complete a set of tasks. The proposed model was then tested with data from a full mission flight simulation. The model predictions correlated significantly with expert ratings of workload management made during the flight simulation. The model was also able to distinguish between low- and high-performing aircrews when performance was based on the number of errors made during flight simulations.