Taking an individualized approach to the assessment of self-efficacy and the prediction of alcoholic relapse

The present study reports on a clinical instrument designed for assessing self-efficacy in alcoholics. In contrast to studies that construct general measures, it was proposed that taking an individualized approach to assessment might offer an effective methodology. Thirty-four alcoholics in an outpatient, behaviorally oriented treatment program participated as subjects. During therapy, an Individualized Self-Efficacy Survey (ISS) was developed for each subject. The ISS was developed by (a) administering the Drinking Patterns Questionnaire (DPQ) to identify important problem areas (e.g., work, children, marital) and specific drinking antecedents and (b) constructing a 15-item scale using each drinker's most important cues. The utility of having clients choose their own items was supported by finding a significant relationship between problem areas identified as important on the DPQ and the areas reported as surrounding relapse. ISS ratings were reflective of efficacy changes during treatment, while posttreatment ISS scores were predictive of subsequent relapse. Situation-specific prediction of relapse was not found. The advantages of this methodology for clinical use are discussed, while general directions for future research are suggested.     

Opportunity,opportunism, and progress:Kairos in the rhetoric of technology

As the principle of timing or opportunity,kairos serves both as a powerful theme within technological discourse and as an analytical concept that explains some of the suasory force by which such discourse maintains itself and its position in our culture. This essay makes a case for a rhetoric of technology that is distinct from the rhetoric of science and illustrates the value of the classical vocabulary for understanding contemporary rhetoric. This case is made by examining images and models of technological change that underlie and justify the thematizations ofkairos that appear in so much technological discourse and by exploring the phenomenon of technological forecasting, in which the characterization and construction of moments in the present are crucial to the projection of the future. One example of forecasting is examined in detail: the Japanese Fifth Generation computer project, which illustrates the twin themes of opportunity and threat.     

Attentional effects on concurrent psychophysical discriminations: Investigations of a sample-size model

In two experiments, a concurrent discrimination paradigm was used to study the effects of visual attention on psychophysical judgments and the consistency of these effects with a sample-size model in which attention influences the variance of the internal representation used to make psychophysical judgments. Two pairs of lines were presented simultaneously—one on each side of fixation—and subjects had to indicate for each pair separately whether or not the lines had the same length. Attention was manipulated by instructing subjects to pay 100%, 75%, 50%, 25%, or 0% of their attention to the discrimination on one side, with the complementary amount of attention to the other side. In the first experiment, the relationship between attention and discrimination accuracy was consistent with the sample-size model both when attentional allocation varied from trial to trial and when it varied between blocks, and the relationship held over more widely varying attentional allocations than had previously been studied. In addition, discriminations were more accurate overall with varied than with blocked attentional allocation, suggesting that the two types of allocation do not merely differ in the degree to which attention is focused. The second experiment examined the effects of attentional allocation and stimulus variance, the latter being manipulated by randomly incrementing or decrementing line lengths. These manipulations had additive effects on total Thurstonian variance, and a version of the samplesize model gave an excellent quantitative fit to the obtained results. Besides supporting the samplesize model, the results of Experiment 2 suggest that criterion variance is at least as large as sensory variance and that criterion but not sensory variance increases with stimulus variance.     

Dual diagnosis: Clinical issues in the treatment of substance abuse,and affective,personality, and psychotic disorders

Co-morbidity of alcohol and substance with the spectrum of other psychiatric diagnoses is examined with specific emphasis on diagnostic indicators for anxiety and mood disorders. Diagnostic issues for the chemically dependent person are examined with the context of borderline personality disorder, schizophrenia and other psychiatric disorders. Clinical research related to the dually-diagnosed patient is explored     

Discrimination of methadone and cocaine by pigeons without explicit discrimination training.

Pigeons were trained to peck a key on a variable-interval 2-min schedule of food reinforcement. Prior to each session, either 2.0 mg/kg methadone (n = 3), 3.0 mg/kg cocaine (n = 4), or 5.6 mg/kg cocaine (n = 2) was administered. When each pigeon's rate of pecking was stable, a range of doses of the training drug and saline were administered prior to 20-min extinction sessions separated by at least four training sessions. Rate of pecking during these extinction tests was generally an increasing function of dose, with the lowest rates obtained following saline and low doses and the highest rates obtained following doses near the training doses. Dose functions from pigeons trained with 5.6 mg/kg cocaine were steeper than those from pigeons trained with 3.0 mg/kg cocaine. Pigeons trained with methadone or 3.0 mg/kg cocaine were then given discrimination training, in which food reinforcement followed drug administration and 20-min extinction sessions followed saline administration. Rates of pecking under these conditions quickly diverged until near-zero rates were obtained following saline and high rates were obtained following drug. Discrimination training steepened dose functions for the training drugs, and the effects of several other substituted drugs depended on the pharmacology of the training drug. The pigeons trained with 5.6 mg/kg cocaine were tested with d-amphetamine, methadone, and morphine prior to discrimination training. d-Amphetamine increased rates dose dependently, and methadone and morphine did not. The results suggest that discriminative control by methadone and cocaine was established without explicit discrimination training.     

The relationship between childhood violence and alcohol problems among men who batter: An empirical review and synthesis

The available literature indicates that: (a) experiences of childhood violence are associated with mediator variables, including antisocial behaviors and depressive symptomatology, that are themselves associated with development of alcohol problems and perpetration of partner violence for men in adulthood; (b) experiences of childhood violence and, more strongly, observation of interparental violence during childhood predict perpetration of partner violence in adulthood for males; (c) presence of partner violence is associated with certain types of alcohol problems for men; and (d) both partner violence and alcohol problems are associated with marital conflict. However, available research has often excluded important moderator variables, such as history of familial and parental alcohol problems and history of parental psychiatric disorders. Based on the available research, two indirect pathways between childhood violence and adulthood problems (i.e., alcohol problems and partner violence) are proposed as guides for future research in the areas of family violence and alcohol problems for men. Further, bidirectional associations between alcohol problems and partner violence are proposed. Finally, inclusion of important moderator and mediator variables in multivariate research designs is suggested.     

The sampling distribution ofd′

The distribution of sample $\hat d's$ , although mathematically intractable, can be tabulated readily by computer. Such tabulations reveal a number of interesting properties of this distribution, including: (1) sample $\hat d's$ are biased, with an expected value that can be higher or lower than the true value, depending on the sample size, the true value itself, and the convention adopted for handling cases in which the sample $\hat d'$ is undefined; (2) the variance of $\hat d'$ also depends on the convention adopted for handling cases in which the sample $\hat d'$ is undefined and is in some cases poorly approximated by the standard approximation formula, (3) the standard formula for a confidence interval for $\hat d'$ is quite accurate with at least 50–100 trials per condition, but more accurate intervals can be obtained by direct computation with smaller samples.     

The psychologist's role in assessing and facilitating patients' knowledge of advance directives in medical settings: A preliminary investigation

In a time of budgetary shortfalls in the medical industry, an aging population, and an increased emphasis on health care choices, psychologists are being called upon to administer advance medical directive programs to patients. This study reports preliminary findings from a program to assess and facilitate patients' knowledge of advance directives (ADs) by the Psychology Service at the Ann Arbor VA Medical Center. The participant pool included 243 male veteran patients admitted to medical and surgical wards at the hospital. The intervention included the use of a computer-generated prompt for consultation, which was sent to the psychology staff in response to a patient inquiry regarding ADs. It also involved an increased emphasis on the delivery of written material on ADs by the admissions clerks. The intervention appeared to result in a modest increase in patients' knowledge of advance directives. Suggestions are offered for areas that should be emphasized in future attempts to increase patients' knowledge and utilization of advance directives.