Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

The Impact of Sex and Gender Role Self-Perception on Affective Reactions to Different Types of Film

To what extent do differences in biologicalsexand psychological gender identity influence affectivereactions to different genres of film? In order toaddress this question, this investigation examined the impact of sex and gender roleself-perceptions on viewers' responses to neutral,melodramatic, and violent film segments. Working with apredominantly Caucasian population (93% Caucasian) at asoutheastern university, the results emphasize theimportance of sex and gender role self-perceptions onviewers' affective responses to media entertainment. Theimplications of these findings are discussed.

     

Empirically defined symptom scales using the DISC 2.3

Empirically defined scales of depressive, attention deficit hyperactivity disorder, oppositional-defiant disorder, and conduct symptoms from the lay-administered National Institute of Mental Health (NIMH) Diagnostic Interview Schedule for Children (DISC), version 2.3, and evidence of their reliability and validity, are presented. The scales were developed using factor analyses of data obtained from an epidemiologic survey of over 1,200 children drawn from four sites across the U.S. and Puerto Rico (the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders, or MECA Study). Their psychometric properties were tested in a subsample of children reinterviewed by clinicians. The findings support the use of these continuous measures. The scales are strongly related to the diagnostic categories and show good test-retest reliability. The scales can be used to characterize severity in children with diagnoses and to describe problems and symptoms in children without diagnoses. Because these scales can measure gradations in symptomatology, they may be more useful than categorical measures. Like categorical measures, the scales based on the DISC are greatly influenced by the informant, whether child or parent.This research was supported by grant MH-46732 from the National Institute of Mental Health, Bethesda, Maryland.The MECA Program is an epidemiologic methodology study performed by four independent research teams in collaboration with staff of the Division of Clinical Research, which was reorganized in 1992 with components now in the Division of Epidemiology and Services Research and the Division of Clinical and Treatment Research, of the NIMH, Rockville, Maryland. The NIMH Principal Collaborators are Darrel A. Regier, MD, MPH, Ben Z. Locke, MSPH, Peter S. Jensen, MD, William E. Narrow, MD, MPH, and Donald S. Rae, MA; the NIMH Project Officer was William J. Huber. The Principal Investigators and Coinvestigators from the four sites are as follows: Emory University, Atlanta, Georgia, UO1 MH46725: Mina K. Dulcan, MD, Benjamin B. Lahey, PhD, Donna J. Brogan, PhD, Sherryl Goodman, PhD, and Elaine Flagg, PhD; Research Foundation for Mental Hygiene at New York State Psychiatric Institute (Columbia University), New York, New York, UO1 MH46718: Hector R. Bird, MD, David Shaffer, MD, Myrna Weissman, PhD, Patricia Cohen, PhD, Denise Kandel, PhD, Christina Hoven, PhD, Mark Davies, MPH, Madelyn S. Gould, PhD, and Agnes Whitaker, MD; Yale University, New Haven, Connecticut, UO1MH46717: Mary Schwab-Stone, MD, Philip J. Leaf, PhD, Sarah Horwitz, PhD, and Judith H. Lichtman, MPH; University of Puerto Rico, San Juan, Puerto Rico, UO1 MH46732: Glorisa Canino, PhD, Maritza Rubio-Stipec, MA, Milagros Bravo, PhD, Margarita Alegría, PhD, Julio Ribera, PhD, Sarah Huertas, MD, and Michael Woodbury, MD.The authors gratefully acknowledge Zenaida González and José Martínez who performed the data nalayses, as well as Elizabeth Pastrana, and Felícita Laboy, secretaries, for their valuable contributions to this work.     

Gender and aggression II: Personal aggressiveness

To investigate how gender, ethnicity, age and education influence aggressiveness, we surveyed 115 male and female college students (56% male; 50% Anglo and 26% Hispanic) and 79 persons (72% male; 92% Anglo) working on a military base. Participants were administered the Buss-Perry Aggression Questionnaire and asked about their own aggressive behaviors. In both samples, men scored significantly higher than women on the Physical Aggression scale of the Aggression Questionnaire but not on the other scales. In the military sample, men indicated that they expected to behave more aggressively than women. Positive correlations among different aspects of aggressiveness were found for both men and women. Increasing age and education were associated with lower aggressiveness in both genders, suggesting that aggressiveness may be susceptible to modification over the course of one's life.We would like to thank Angela Bennett, Gail Bliss, Kayleigh Carabajal, Julie Depree, Carmen Gonzales, Deborah Good, Scott Griffin, Gladys Herrera, George Selix, Ruth Tangman, and Jon Woodland for their assistance with the development, distribution, and coding of the questionnaire.     

An investigation of the validity of the SPSI and SPSI-R in differentiating high-suicidal from depressed,low-suicidal college students

The present study examined the validity of the Social Problem-Solving Inventory (SPSI) and SPSI—Revised in differentiating 65 high-suicidal from 63 depressed, low-suicidal college students. Results from multivariate analyses indicated overall differences in problem-solving between these two groups as measured by the SPSI but not by the SPSI-R. Further examination of these differences revealed the high-suicidal group was different in problem-solving orientation, rather than problem-solving skills, compared to the depressed, low-suicidal group. However, when depression was statistically controlled in hierarchical regression analyses, none of the problem-solving measures predicted group membership. The superiority of the SPSI to the SPSI-R in differentiating these two groups appears to be accounted for by the elimination of 28 items in the revised version, many of which measure orientation to problem-solving. Also explored was the possibility that objective measures of problem-solving provide a better prediction of adjustment than do self-report measures.     

Corporate consciousness: Defining the paradigm

The concept of corporate consciousness is defined and discussed. In response to Campion and Palmer (1996), it is asserted that corporate consciousness is not a construct related to conscientiousness or moral responsibility, but an entirely new paradigm, related to awareness and information processing; the concept is cognitive, not metaphysical. Corporate consciousness serves as a framework for understanding the current trend within organizations toward greater awareness of societal realities, and of the organization's impact within larger systems. This framework borrows heavily from the cognitive, social, and organizational psychological literature and can be understood from both micro and macro levels of analysis. Also discussed are the issues of why and how to study corporate consciousness, as well as implications for the organizational practitioner.     

Varieties of positive and negative priming

Numerous recent investigations have focused on a particular relation between the roles a stimulus plays in successive displays: when a stimulus ignored by a subject on one occasion is to be attended on a succeeding occasion, reaction time to that stimulus is slowed relative to a control condition. But this is but one possible case ofnegative priming. There are other ways in which negative priming might occur, and there are several varieties of positive priming as well. All these possibilities were explored in the present experiment.     

Family-centered intensive case management: A step toward understanding individualized care

New York State's initial attempt at individualizing services occurred within the context of an experiment. We randomly assigned children 5–12 years old who were referred for out-of-home placement in treatment foster care to either treatment foster care, Family-Based Treatment (n=15), or to Family-Centered Intensive Case Management (FCICM) (n=27). FCICM used teams of case managers and parent advocates to provide in-home services. Flexible service dollars, respite care, and behavior management skills training were available to assist teams in individualizing care. Preliminary outcomes indicate that children in FCICM are doing as well or better than children assigned to FBT in their functioning and symptom reduction. Parents of children in FCICM have made gains, although not at a statistically significant level, in behavior management skills and family strengths that allow them to provide care for their children at home.