Spiritual health,illness, and death

This essay outlines a view of spiritual health in middle life, particularly as it relates to an individual's confrontation with mortality. It was originally offered as part of a symposium on “Living and Dying” at the twenty-fifth reunion of the Harvard-Radcliffe Class of 1968 in Cambridge, Massachusetts, in June, 1993.     

Book reviews

Private Practice Youngstown, Ohio 44512     

Understanding and Evaluating Bureaucratic Politics: The Nexus Between Political Leaders and Advisory

Bureaucratic politics—for example, the "political" interaction between individuals and organizations in the executive branch of government—is a potentially significant force affecting the course and outcomes of governmental policymaking processes. In this article, an empirical and normative model and operationalization of bureaucratic politics is developed, treating it as a variable rather than as an immutable (and by definition problematic) property of policy decision-making. A conceptual model, linking the nature and intensity of bureaucratic politics in advisory systems to the characteristics of the political leaders served by them, is also developed. On the basis of earlier studies of presidential leadership (e.g., Preston, 1996), the leader's need for power, cognitive complexity, and prior policy experience/expertise are hypothesized to affect the organization and operation of the advisory system in terms of bureaucratic politics. Using Hermann's (1983) Personality Assessment-at-a-Distance (PAD) coding technique, theoretical assertions are illustrated in a detailed case study of two critical episodes in U.S. decision-making in the conduct of the Vietnam war in 1965 and 1968.     

Psychopathy and the DSM-IV criteria for antisocial personality disorder

The Axis II Work Group of the Task Force on DSM-IV has expressed concern that antisocial personality disorder (APD) criteria are too long and cumbersome and that they focus on antisocial behaviors rather than personality traits central to traditional conceptions of psychopathy and to international criteria. We describe an alternative to the approach taken in the rev. 3rd ed. of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; American Psychiatric Association, 1987), namely, the revised Psychopathy Checklist. We also discuss the multisite APD field trials designed to evaluate and compare four criteria sets: the DSM-III-R criteria, a shortened list of these criteria, the criteria for dyssocial personality disorder from the 10th ed. of the International Classification of Diseases (World Health Organization, 1990), and a 10-item criteria set for psychopathic personality disorder derived from the revised Psychopathy Checklist.     

SCL-90-R symptom patterns for adolescent psychiatric inpatients

We collected Symptom Check List-90-Revised (SCL-90-R) symptom pattern and severity data from a sample of 486 adolescent psychiatric inpatients. Preliminary comparison of these data with previously published data for adolescent nonpatients suggested no meaningful differences in overall symptom severity, although the data suggested higher Positive Symptom Distress Index (PSDI) scores for inpatients, less severe somatization and psychoticism symptoms for inpatient males compared to nonpatient males, and more severe depressive symptoms for inpatient females compared to nonpatient females. Future studies should be directed toward further analyses of such data and the development of representative and generalizable adolescent inpatient norms for the SCL-90-R.     

Rate of forgetting in mild Alzheimer's-type dementia

Patients with mild dementia of the Alzheimer's type (DAT) and matched controls were examined for rate of forgetting line drawings of common objects. DAT patients demonstrated rapid forgetting in the first 10 min after learning to criterion. This finding is discussed with respect to memory consolidation and neuropathologic changes in dementia of the Alzheimer's type.