Token economy: patient and staff changes

A token economy program conducted with severely regressed, “backward” state hospital patients is described. An evaluation of the effects of the reinforcement program after one year has revealed substantial gains in patient eating, grooming, and dressing behavior and involvement in activities on and off the ward. In addition, several measures of staff attitudes toward patients evidence meaningful gains in staff expectations about the treatability of patients and the degree of the latters' psychological deficit.     

Paper and voice MAYSI-2: format comparability and concordance with the voice DISC-IV

The authors examine the comparability of paper and voice formats of the Massachusetts Youth Screening Instrument-Second Version (MAYSI-2) as well as each format's concordance with the Voice Diagnostic Interview Schedule for Children (DISC) among adjudicated youth. Comparability is assessed among 248 youths admitted to a South Carolina Assessment Center. Mean scores and alpha coefficients are calculated, and area under the curve and positive and negative predictive values are used to compare concordance to the DISC. Paper and voice formats are significantly correlated, have similar alpha coefficients, and have comparable concordance with the DISC, suggesting that the MAYSI-2 paper and voice formats are comparable instruments. The voice format may be preferable to the paper format for screening justice youth for mental health problems because it may reduce incomplete data and increase reporting of stigmatized behaviors and because of its ability to automatically generate scored reports and aggregate data.     

Suicide risk at juvenile justice intake

Many risks for suicidal behavior, identified in population samples, are elevated in justice youth. We examined whether risks operate similarly in a justice sample. We measured suicidal behavior and disorder on the Diagnostic Interview Schedule for Children in 991 randomly selected youths, and examined associations between demographic, offense, and disorder characteristics and past attempts. Recent attempts were more common in girls, in those with depression or substance disorder, and in violent offenders. While more girls reported recent attempts regardless of depression, depressed boys' attempt risk was as high as girls'. Depression contributed more to attempt history than did substance disorder.