Assessing depression in community samples of children using self-report inventories: Ethical considerations

Although the methodological problems associated with the use of children's self-report depression inventories have previously been discussed in detail, the ethical problems related to the use of these instruments have been largely ignored. The primary purpose of this survey study was to determine how childhood depression researchers have prepared for and responded to children from community (i.e., nonclinic) samples whose nonanonymous scores on self-report depression inventories have indicated that they might be severely depressed or suicidal. Several recommendations, based upon (a) the results of this survey study, (b) the existing literature relevant to the ethical responsibilities of investigators who conduct research with children, and (c) our own experiences with these instruments and populations, are made to assist researchers in their attempts to use these inventories in an ethical manner.The authors would like to thank those childhood depression researchers who were kind enough to return completed surveys.     

The relationship between eye movements and spatial attention

Most previous studies of the attentional consequences of making saccadic eye movements have used peripheral stimuli to elicit eye movements. It is argued that in the light of evidence showing automatic “capture” of attention by peripheral stimuli, these experiments do not distinguish between attentional effects due to peripheral stimuli and those due to eye movements. In the present study, spatial attention was manipulated by varying the probability that peripheral probe stimuli would appear in different positions, while saccades were directed by a central arrow, enabling the effects of attention and eye movements to be separated. The results showed that the time to react to a peripheral stimulus could be shortened both by advance knowledge of its likely position and, separately, by preparing to make a saccade to that position. When the saccade was directed away from the most likely position of the probe, the targets for attention and eye movements were on opposite sides of the display. In this condition, the effects of preparing to make a saccade proved to be stronger than the effects of attentional allocation until well after the saccade had finished, suggesting that making a saccade necessarily involves the allocation of attention to the target position. The effects of probe stimuli on saccade latencies were also examined: probe stimuli that appeared before the saccade shortened saccade latencies if they appeared at the saccade target, and lengthened saccade latencies if they appeared on the opposite side of fixation. These facilitatory and inhibitory effects were shown to occur at different stages of saccade preparation and suggest that attention plays an important role in the generation of voluntary eye movements. The results of this study indicate that while it is possible to make attention movements without making corresponding eye movements, it is not possible to make an eye movement (in the absence of peripheral stimulation) without making a corresponding shift in the focus of attention.     

A comparison of three predictors of an individual's memory performance: the individual's feeling of knowing versus the normative feeling of knowing versus base-rate item difficulty

Distinctions are drawn between different predictors of an individual's memory performance, with emphasis on the notion of privileged access to idiosyncratic knowledge. Research is reported in which undergraduates attempted to recall the answers to general-information questions, then made feeling-of-knowing judgments on nonrecalled items, and subsequently had a criterion test (relearning, perceptual identification, or one of two versions of recognition). For predicting an individual's criterion performance, the individual's own feeling-of-knowing predictions were intermediate between two kinds of normative predictions: The individual's feeling-of-knowing predictions were more accurate than predictions derived from normative feeling-of-knowing ratings but were less accurate than predictions derived from base-rate item difficulty (normative probabilities of correct recall). Subsidiary analyses showed that factors other than unreliability are responsible for the partial inaccuracy of the individual's feeling of knowing. Ramifications are discussed for possible ways to improve the accuracy of an individual's feeling-of-knowing predictions.     

Cue depreciation: when word fragment completion is undermined by prior exposure to lesser fragments

The ability to think of a previously studied item has often been shown to be impaired when, in one way or another, the extraitem context is changed from study to test. In a series of five experiments, such impairment is induced in a somewhat different way. A fragment (e.g. r-i--rop) of a just-studied word (raindrop) is shown to be less readily completed if it is presented bit by bit (r------p, r----r-p, r-i--r-p, r-i--rop) rather than all at once (Experiments 1, 3, 4, and 5). No such effect is found if the word has not been studied beforehand (Experiments 2, 3, 4, and 5). This pattern of results occurs even when fragments of studied and nonstudied words occur in the same test and under conditions in which subjects cannot tell whether a given fragment is of a studied or nonstudied word (Experiments 4 and 5). In addition, for words that have been studied beforehand, the impairment is shown to increase systematically with the number of steps involved in the presentation of the word fragment (Experiment 3) and also to persist when the time allowed for completion of the final version of the fragment is increased from 4 s to a full minute (Experiment 5).     

Relationship of physicians' nonverbal communication skill to patient satisfaction, appointment noncompliance, and physician workload

A field study of 28 residents in family practice was conducted. Physicians' self-reports of empathy, self-monitoring ability, and affective communication skill as well as their objectively measured nonverbal communication skills were examined as predictors of patient satisfaction, appointment noncompliance, and physician workload (schedule density). Physicians completed the Hogan Empathy Scale, Snyder Self-Monitoring Scale, Affective Communication Test, short form of the Profile of Nonverbal Sensitivity, and a nonverbal encoding task. Patient satisfaction with communication, affective care, and technical care was assessed using a 25-item, visit-specific satisfaction scale. Appointment records were used to determine the number of patients seen by each physician and the compliance of patients with scheduled appointments. Results indicated that the three self-report measures were unrelated to the measures of patient noncompliance and patient satisfaction, but self-reported affective communication ability was significantly correlated with physician workload. Objectively measured physician sensitivity to audio communication predicted patient compliance: More sensitive physicians experienced fewer unrescheduled appointment cancellations. Nonverbal encoding skill was significantly related to patient satisfaction with affective care and to physician workload.     

Counseling Clients with AIDS

The authors discuss issues and suggestions relative to counseling clients with AIDS. Several psychosocial issues are presented, and a psycho-educational model of treatment to meet the needs of AIDS clients is described.     

Effects of Administrator and Participant Sex and Ethnicity on Self-Disclosure

Self-disclosure patterns of Anglo-Americans and Mexican Americans were analyzed according to overall frequency of reported self-disclosure and preferred targets (i.e., mother, father, male friend, female friend). Administrator sex and ethnicity were systematically varied so that the interaction of these variables with participant sex and ethnicity could be investigated. Results revealed that Anglo-Americans reported the most disclosure and Mexican-American men the least. Some suggestions are provided for counselors working with Mexican-American men.     

Psychopathology subtypes and symptom correlates among former prisoners of war

Psychopathology and symptom patterns were studied in 60 former prisoners-of-war (POWs) by administering standardized tests including the Minnesota Multiphasic Personality Inventory (MMPI), an adjustment problem checklist, and a structured clinical interview. Most POWs showed marked psychological impairment, but modal profile analysis identified two prototypic MMPI patterns, which differed in pervasiveness and type of psychopathology. Profile subtypes were defined by unique clusters of clinical symptoms and differed in confinement stress severity. The typology of symptoms argues against a homogeneous conceptualization of stress-induced disorders and suggests the need for definition of the severity and subtype of stress phenomena and individual difference factors in responding to trauma.     

Behavioral assessment of methylphenidate in a child with frontal lobe damage

The assessment and management of inattentive, hyperactive, and impulsive behavior in a 6-year-old girl who experienced frontal lobe damage are described. A multimodel approach combining medical, educational, and behavioral techniques to assess hyperactive behavior, optimal medication level, and medication and psychotherapeutic effectiveness is described. The results of the study suggest that in similar cases, children and adolescents manifesting these behaviors should be given a trial of stimulant medication in a controlled environment to assess if such therapy is indicated. Additional support is given for the increasing need for detanté and cooperation with health-care professionals.