Lorenz Curves: A New Model for the Distribution of Psychiatric Services

The growth of child and adolescent psychiatric services based on the wraparound philosophy raises new questions for medical directors, investigators, and clinicians interested in improving quality of care and outcomes. Typically, quality improvement studies have focused on standardizing care and decreasing variation while community based services following a wraparound model are by definition individualized. To date, little information on how to evaluate such services in a managed care environment has been available. We present one option for evaluating the distribution of medical services and the extent to which providers individualize services for children with severe emotional disorders. Specifically, we (a) review the philosophy and goals of wraparound services, (b) introduce the Lorenz curve as a tool for determining the degree of inequality in service distribution at a given institution, and (c) present a case study on the use of Lorenz curves by a Medicaid Behavioral Health Organization in profiling behavioral providers.     

Presurgical Coping, Depression, and Quality of Life in Persons with Parkinson's Disease

This study describes utilization of coping strategies and evaluates the interaction between coping strategies, depression, and quality of life (QOL) in patients with Parkinson's disease (PD) who are being considered for neurosurgical intervention. Eighty patients (mean age 61.7 years) with PD being evaluated for possible deep brain stimulation completed self-report instruments of coping strategies (Coping Responses Inventory), depression (Beck Depression Inventory), and disease-specific QOL (Parkinson's Disease Questionnaire-39). Analyses showed that patients with PD cope with the acute stressor of approaching neurosurgery through a variety of strategies, but particularly avoidant and behavioral strategies. When the correlated but apparently opposing effects of cognitive and behavioral strategies were teased apart, greater use of cognitive strategies was associated with more severe depressive symptomatology (and poorer QOL), while greater use of behavioral strategies appeared to be associated with less depression. Depressive symptomatology, in turn, was associated with poorer QOL. However, coping had minimal direct association with QOL. From this it was concluded that patients with advanced PD generate a variety of coping responses to an acute stressor such as surgery, and the use of behavioral strategies, in particular seeking of alternative enjoyable activities, may be associated with better mood if salutary effects are not overwhelmed by less helpful cognitive coping techniques. The minimization of depressive symptomatology, in turn, is associated with better QOL.     

Refining Measurement of Career Indecision Types: A Validity Study

The authors conducted this study to address some of the limitations in previous indecision typology research and to provide validity evidence for the indecision types that were derived. The participants were 566 first‐semester, undecided students enrolled in a career exploration course. Career indecision, personality, and ability measures were used to derive career indecision types through cluster analysis. Four distinct career indecision types were identified. Subsequently, the effect of indecision type on response to a career exploration course was examined. Level of career indecision, the criterion variable, was not differentially affected by indecision type. Implications of the findings for career counseling are discussed.     

Age Differences in Proactive Newcomer Socialization Strategies in Two Populations

We investigated the role of age as a predictor of newcomer socialization behaviors, and documented relationships between specific strategies and subsequent role-relevant outcomes. Academic and retail newcomer populations were each surveyed over three time periods. A negative relationship was found between age and covert forms of information seeking in both samples. Further, the use of covert information seeking was related to lower subsequent levels of role clarity and job satisfaction.     

Dropping out of school: A review of intervention programs

This article reviews the literature on dropout prevention for school-aged children. A review of dropout prevention programs identified in the literature highlights methodological concerns, with a discussion of design, sampling, statistical analysis, and implementation issues. The interventions employed with greatest frequency in the studies reviewed emphasized academic enhancement, psychosocial skill development, mentoring, and parent/teacher behavior management training. Programs that were academically oriented or those that were multi-component programs emerged with the most promising empirical base. However, at the present time, there is a lack of consistent and persuasive outcome evidence that meet Kratochwill and Stoiber's [Sch. Psychol. Q. 15 (2001) 233] criteria for empirically supported interventions. This deficiency leads to the conclusion that there is no one particular best practice or beneficial treatment currently available to address the problem of school dropout even though a number of intervention programs appear to hold promise. Implications for school psychologists include both practice and research applications.     

Velocity as a Predictor of Performance Satisfaction,Mental Focus,and Goal Revision

In a longitudinal study, the authors examined the role of students' rate of progress, or velocity, in goal‐striving over one semester of a college‐level Introductory Psychology course. At both mid‐course and near end‐of‐course time periods, results demonstrated that velocity uniquely contributed to the prediction of students' performance satisfaction, mental focus, and goal revision, above and beyond the influence of performance‐goal discrepancies and ability. Specifically, velocity demonstrated main effects on performance satisfaction and mental focus. Velocity significantly interacted with goal importance in the prediction of goal revision. The authors call for increased attention to the role of velocity in self‐regulation. Dans une étude longitudinale, les auteurs examinent le rôle du taux de progrès des étudiants ou leur rapiditéà atteindre des buts sur un semestre pour un cours d'introduction à la psychologie en faculté. Deux mesures ont été faites: l'une à la moitié du semestre et l'autre à la fin de ce même semestre. Les résultats montrent que uniquement la rapidité contribue à prédire la satisfaction de la performance des étudiants, la concentration, et la révision de l'objectif quels que soient les écarts entre le but de la performance et les capacités. Plus spécifiquement, la rapidité a des effets importants sur la satisfaction de la performance et la concentration. La rapidité interagit significativement avec l'importance des buts dans le cas où l'on envisage leur révision. Les auteurs soulignent le rôle de la rapidité sur l'auto‐régulation.