San Diego suicide study: comparison of gay to straight males

Previous large studies of completed suicides have not considered sexual orientation in their data analyses. In this study, data from the known homosexual subpopulation (13 males, aged 21-42) in a series of 283 suicides were examined. They were compared with all other aged male suicides 21-42 (n = 106). Both groups showed considerable substance abuse plus a variety of other psychiatric diagnoses. Both also had a high frequency of relationship difficulties near the time of death. Gays who committed suicide did not have a history of more police trouble and were no more likely to be living alone than the comparison group. They did not have more prior suicide attempts or previous psychiatric treatment. We conclude that, among the factors examined here, there appears to be little difference between gay and heterosexual male suicides.     

Reserve capacity of the elderly in aging-sensitive tests of fluid intelligence: replication and extension

Fluid intelligence belongs to that cluster of intellectual abilities evincing aging loss. To examine further the range of intellectual reserve available to aging individuals and the question of replicability in a new cultural and laboratory setting, 204 healthy older adults (mean age = 72 years; range = 60-86) participated in a short-term longitudinal training study. For experimental subjects, 10 sessions consisted of cognitive training involving two subability tests (Figural Relations, Induction) of fluid intelligence. The pattern of outcomes replicates and expands on earlier studies. Older adults have the reserve to evince substantial increases in levels of performance in fluid intelligence tests. Transfer of training, however, is narrow in scope. Training also increases accuracy of performance and the ability to solve more difficult test items. Difficulty level was estimated in a separate study, with a comparable sample of N = 112 elderly adults. Future research is suggested to examine whether intellectual reserve extends to near-maximum levels of performance.     

Cross-sectional studies of personality in a national sample: 1. Development and validation of survey measures

Short scales were developed to measure three broad dimensions of personality in the National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Followup Study. Items to measure neuroticism were selected rationally from the General Well-Being Schedule, and items to measure extraversion and openness to experience were selected by multiple regression from the NEO Personality Inventory. In a sample of 654 men and women from the Augmented Baltimore Longitudinal Study of Aging, all three short scales showed clear evidence of convergent and discriminant validity against full scales in self-reports, and against peer and spouse ratings. Because they were developed and validated on a sample with a comparable age range, the NHANES scales should be useful in examining age trends in these three personality dimensions in a national sample.     

Accident reduction through stress management

The deleterious effects of occupational stress on worker health and well-being have been described in numerous reports for a wide range of work groups. Work overload (and underload), deadline pressures, role Stressors, underutilization of abilities, and physical discomfort have been identified as work factors associated with increased stress symptom reporting. The relationship between work stress and accident/injury occurrences is less clearly documented, although scattered reports in the literature suggest a contributory role for stress in the accident process. In this article, data linking stress to unsafe work behavior are reviewed and a model is proposed wherein accidents can arise from impaired worker capabilities (e.g., slower reaction time) brought about by stress symptom activity (e.g., anxiety). The potential usefulness of stress management training (SMT) for shortcircuiting the stress/accidents cycle by alleviating stress symptoms is discussed in light of recent empirical research.Portions of this article were presented at the Third Annual Scientist/Practitioner Conference in Industrial/Organizational Psychology, Virginia Beach, Virginia, October, 1982.     

Cast of characters work: Systemically exploring the naturally organized personality

Cast of Characters Work conceives of the personality as a naturally organized unique group of characters who, together, function in an internal system. All characters bring their own histories, perceptions, feelings, beliefs, and behaviors to life's situations. Their survival strategies and interrelationships are felt as anxiety, conflict, ambivalence, or confidence. Heightening awareness of these multiple, simultaneous events increases access to the actual living process. The complex inner world of individuals, couples, and families can be precisely explored by working directly with each character and their relationships. Objectives are accountability and more functional, flexible, and satisfactory arrangements among characters internally and in couples and families.Also in private practice at 2 Pine Circle, Urbana, IL 61801.     

Marital dissolution and distress in a psychiatric population: A longitudinal design

There has been interest in recent years in the relationship between marital distress and psychopathology. It has been rare, however, for investigators to follow patients after their release from the hospital and observe the course of their marital relationships. The present study included patients meeting criteria for three DSM III DISORDERS (MAjor depressive, bipolar, and schizophrenic) and a normal control sample, all of whom are participants in an ongoing longitudinal study of children at risk for psychopathology (Stony Brook High-Risk Project; Weintraub & Neale, 1984). Marital Adjustment Test (MAT; Locke & Wallace, 1959) scores were collected on patients at entry into the project (Phase I) and at a three year follow-up (Phase II). Course of marriage was defined as negative if the couple's marital adjustment was rated as poor at Phase II or resulted in divorce or separation at Phase II. It was found that only the depressed group differed from the normal group in having significantly worse course of marital relationship; 84% of the depressive couples showed a “negative” course of marital change over time. However, all three patient groups had significantly higher rates of divorce by Phase II. MAT scores at Phase I successfully predicted course of marital relationship for all diagnostic groups. Implications for aftercare of psychiatric inpatients are discussed.     

Casuistry and clinical ethics

For the last century, moral philosophy has stressed theory for the analysis of moral argument and concepts. In the last decade, interest in the ethical issues of health care has stimulated attention to cases and particular instances. This has revealed the gap between ethical theory and practice. This article reviews the history and method of casuistry which for many centuries provided an approach to practical ethics. Its strengths and weaknesses are noted and its potential for contemporary use explored.     

Some aspects of medical ethics from the perspective of bioengineering

The problem of ethics in medical care as seen from the bioengineering results from the almost incredible technological achievements based on scientific research: On the one hand there is inadequate handling of technology and fear on the part of the patient; on the other hand there is admiration on the part of the physicians and the nursing staff. This article will survey the points of criticism concerning ethical behavior and will present and evaluate general problems of mechanization in medical care. General phenomena of human interaction, and especially problems related to medical care, will be discussed. It will be necessary to develop clinical medical technology, aiming primarily at ‘realizing the patient's concern’. After analyzing these concerns, it is necessary for the clinical medical engineer to develop an ‘invisible’ technology. Criteria for such an ‘invisible’ technology (function, design, automatic control, methods of implantation, whether chronic application is necessary) are being demonstrated by particular devices (artifical heart, functional electro-stimulation, diaphragmatic pace-maker).