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.     

Verb Comprehension Deficits in Probable Alzheimer's Disease

Studies of lexical comprehension in probable Alzheimer's disease (pAD) have focused almost exclusively on nouns. In the following preliminary study, we examined whether lexical comprehension for verbs is also impaired in 25 pAD patients. The semantic meaning of motion verbs, cognition verbs, and perception verbs was assessed with a triadic comparison task. Structural meaning associated with these verbs was evaluated by asking the patients to judge the coherence of sentence frames that accept these verbs naturally or awkwardly. We found that pAD patients are significantly impaired at identifying semantic relations among verbs. pAD patients also encountered significantly more difficulty judging the coherence of sentences than control subjects. Correlation and regression analyses demonstrated that semantic characteristics of verbs are projected from the verbs' sentence frames in control subjects, but there was minimal evidence for such a structural–semantic relationship in pAD. We consider several possible explanations for our preliminary observations of an impairment that has consequences for processing both semantic and structural aspects of verb meaning.     

A critical review of theS/L reliability index

The meaning and properties of a commonly used index of reliability, S/L,were examined critically. It was found that the index does not reflect any conventional concept of reliability. When used for an identical behavioral observation session, it is not statistically correlated with other reliability indices. Within an observation session, the standardizing measure of Lis beyond the control of the investigator. Furthermore, the reason for the choice of Las the standard is unclear. The role of chance agreement in S/Lis not known. The exact interpretation of the index depends on which observer reports L.Overall the conceptual and mathematical meaning of S/Lis dubious. It is suggested that the S/Lindex should not be used until its nature is shown to be a measure of reliability. Other approaches such as the intraclass correlations and generalizability coefficients should be used instead.The authors are indebted to Johnny Matson for his critique of an earlier version of this paper.     

SEVERE CLASSROOM BEHAVIOR PROBLEMS: TEACHERS OR COUNSELLORS

This experiment was designed to determine the relative effectiveness of teacher and counselling approaches in the reduction of disruptive or inappropriate classroom behavior. Inappropriate classroom behavior frequencies of 12 academically low achieving, seventh-grade, black male students, with a reported high rate of inappropriate classroom behavior, were recorded. Three groups, with nearly equal mean inappropriate behaviors, were randomly assigned to one of three treatment conditions: behavioral counselling, client-centered counselling, or no counselling. Each counselling group received fifteen 30-minute counselling sessions, at a rate of two to three times a week. In addition to counselling, all students subsequently received teacher approval within the classroom. Results indicated that the teacher was able to reduce inappropriate behavior more than any counselling group. There were also indications that behavioral counselling, but not client-centered counselling, was moderately helpful in reducing inappropriate classroom behavior.     

APPLICATION OF A SOCIAL SKILLS TRAINING PROGRAM IN THE MODIFICATION OF INTERPERSONAL DEFICITS AMONG RETARDED ADULTS: A CLINICAL REPLICATION

Six mentally retarded adults, equally divided into two treatment groups, were provided with individualized social skills training programs. Treatment, evaluated via a multiple-baseline design strategy, was sequentially and cumulatively applied across target behaviors over a four-week intervention period. Behavioral observation probes and social validation measures served as the primary dependent variables. Results indicated that (a) treatment was effective for virtually all behaviors across all subjects, (b) improvements occurred for both training and generalization scenes, and (c) behavioral performance was maintained one month following the termination of treatment.