Discovering what it all means

This article deals with appropriate communication and interpersonal skills that nurses may use in order to support patients who are experiencing self-concept changes related to their health problems. Three areas of patient need related to self-concept are explored. The stages of adaptation to loss and the crucial task of grief work are reviewed, and nursing interventions designed to strengthen the self-concept and support patients as they adapt to loss are suggested. Sensitive communication, although a low-visibility nursing skill, is cited as critical in assisting the patient to achieve an optimum level of wellness.     

Alcoholism: A conflict of models

Adherents to the traditional model of alcoholism explain alcoholic behavior as a consequence of alcoholism. Alcoholism is identified as an unseen, unmeasured entity inherent in alcoholics. This concept parallels the thinking of Copernicus, Kepler, Galileo, and Newton, who believed in an unseen, unmeasurable creator behind the physical world. These traditional approaches contrast with the emergent model of alcoholism and twentieth-century scientific thought. Emergent scientific model adherents explain alcoholic behavior without resort to unseen factors. Since the traditional and emergent scientific models begin with different assumptions, model adherents experience communication difficulties. Future developments with determine which model will dominate the field of alcohol studies and treatment.     

Choice between reliable and unreliable outcomes: mixed percentage-reinforcement in concurrent chains.

Pigeons' choices between alternatives that provided different percentages of reinforcement in mixed schedules were studied using the concurrent-chains procedure. In Experiment 1, the alternatives were terminal-link schedules that were equal in delay and magnitude of reinforcement, but that provided different percentages of reinforcement, with one schedule providing, reinforcement twice as reliably as the other. All pigeons preferred the more reliable schedule, and their level of preference was not systematically affected by variation in the absolute percentage values, or in the magnitude of reinforcement. In Experiment 2, preference for a schedule providing 100% reinforcement over one providing 33% reinforcement increased systematically with increases in the duration of the terminal links. In contrast, preference decreased systematically with increases in the duration of the initial links. Experiment 3 examined choice with equal percentages of reinforcement but unequal delays to reinforcement. Preference for the shorter delay to reinforcement was not systematically affected by variation in the absolute percentage of reinforcement. The overall pattern of results supported predictions based on an extension of the delay-reduction hypothesis to choice procedures involving mixed schedules of percentage reinforcement.     

Spiritual issues in mental health care

Religious and spiritual issues in mental health are explored in the context of four conceptual models: the medical, the nursing, the humanistic, and the pastoral. This is done by looking at each model in terms of content, diagnostic focus, language and treatment goals, and primary qualities in the health provider.The models are illustrated by case studies gathered from a multidisciplinary setting. The discovery that each model can incorporate the religious and spiritual dimension in mental health care, but that each model does this in distinctive ways, is a key point.     

Invariance in the MMPI's component structure

Bernstein and Garbin (1985b) suggested that the Minnesota Multiphasic Personality Inventory's major clinical scales (excluding Scales ? and 5) can be approximated by an oblique three-component structure: (a) Profile Elevation, (b) Test-taking Attitudes, and (c) Optimism-Pessimism, collectively termed the salient weight model. In this study, we found that both this model and the MMPI's principal component structure remain invariant across race, sex, and, as previously noted, context of testing (job applicants vs. inmates in correctional institutions). We further noted that several alternative definitions of Profile Elevation provide equally satisfactory representation of the relations among the scales. This factor invariance is necessary, but not sufficient, for the MMPI to be viewed as unbiased.     

The prediction of drug use among college students from MMPI, MCMI, and sensation seeking scales

This study examines the ability of five self-report assessment measures to predict college students' drug use across 12 pharmacological drug categories. Subjects were 125 female and 61 male university undergraduate students. The test battery included the following instruments: the Psychopathic Deviancy (Pd) scale of the Minnesota Multiphasic Personality Inventory (MMPI); the MacAndrew Alcoholism scale (MAC), a special scale of the MMPI; the Sensation Seeking Scale (SSS); the Millon Alcohol Abuse Scale; and the Millon Drug Abuse Scale. Scores from these instruments were utilized in linear combinations to predict individual drug use outcomes as well as polydrug versus single drug use patterns. The drug categories included in this investigation are coffee, tobacco, alcohol, marijuana, tranquilizers, depressants, amphetamines, LSD, other hallucinogens, solvents, narcotics, and cocaine. Results demonstrate significant and meaningful relationships between predictors and drug use levels among college students. Weighted equations derived from linear discriminant function analyses were generally capable of accurately classifying subject's drug use levels across drug categories and in discriminating single drug use from polydrug use patterns. Typically, the Sensation Seeking Scale entered as the most powerful predictor of substance use and abuse.     

The operant conditioning of response variability: Free-operant versus discrete-response procedures

The operant conditioning of response variability under free-operant and discrete-response procedures was investigated. Two pigeons received food only if their pattern of four pecks on two response keys differed from the patterns emitted on the two immediately preceding trials. Under the free-operant procedure, the keys remained illuminated and operative throughout each trial. There was little variability in the response patterns that resulted, and the pigeons received fewer than one third of the available reinforcers. Under the discrete-response procedure, a brief timeout period followed each response. Variability increased under this procedure, and the pigeons obtained three fourths of the available reinforcers. Previous successes and failures to produce response variability may have been due to the use or failure to use, respectively, a discrete-response procedure. Respondent effects inherent in the free-operant procedure may encourage the development of response stereotypy and, in turn, prevent the development of response variability.     

The psychology of self-esteem: Promise or peril?

The psychology of self-esteem bypasses consequential issues of everyday behavior and moral responsibility in favor of pursuing a global goal of enhanced self-esteem on the assumption that happiness, success, and responsible behavior will automatically follow. The goal is vague and ways of achieving it are confused and conflicting. Greater attention to concrete tasks and challenges and sensitivity to moral issues could help make therapy more clear, effective, and socially useful.