Clients' treatment expectations at a community mental health center

Clients' expectations about mental health care, particularly differences in these expectations as a function of social class, and the relationship of discrepancies between expectations and perceptions to treatment outcome, is examined in this study with 317 Caucasian clients. In contrast to the majority of studies, no differences in treatment expectations relating to clients' social class, sex, or marital status were found. Nor were discrepancies related to course or outcome of therapy. Discussion focuses around explanation and interpretation of these findings. Particularly relevant is the need to determine the extent to which nonusers in the community share the attitudes and expectations of clients.     

A randomized clinical trial of inpatient family intervention: VI. Mediating variables and outcome

In a randomized clinical trial of Inpatient Family Intervention (IFI) for 169 inpatients with schizophrenia, affective disorder, and a residual group of other diagnoses, results suggested significant effects favoring IFI for patients and their families. The treatment effects were limited to females and to two diagnostic groups: chronic schizophrenia patients and the bipolar subgroup of affective disorders.     

Neuroscience, the Person, and God: An Emergentist Account

Strong forms of dualism and eliminative materialism block any significant dialogue between the neurosciences and theology. The present article thus challenges the Sufficiency Thesis, according to which neuroscientific explanations will finally be sufficient to fully explain human behavior. It then explores the various ways in which neuroscientific results and theological interpretations contribute to an overall theory of the person. Supervenience theories, which hold that mental events are dependent on their physical substrata but not reducible to them, are explained. Challenging the determinism of "strong" supervenience, I defend a version of "soft" supervenience that allows for genuine mental causation. This view gives rise in turn to an emergentist theory of the person. Still, I remain a monist: there are many types of properties encountered in the world, although it is only the one nature that bears all these properties. The resulting position, emergentist monism , allows for diversity within the context of the one world. This view is open at the top for theological applications and interpretations while retaining the close link to neuroscientific study and its results. Theology offers an interpretation of the whole world based on a yet higher order of emergence, although the notion of God moves beyond the natural order as a whole. It therefore supplements the natural scientific study of the world without negating it.     

Truth,knowledge, and the standard of proof in criminal law

Could it be right to convict and punish defendants using only statistical evidence? In this paper, I argue that it is not and explain why it would be wrong. This is difficult to do because there is a powerful argument for thinking that we should convict and punish defendants using statistical evidence. It looks as if the relevant cases are cases of decision under risk and it seems we know what we should do in such cases (i.e., maximize expected value). Given some standard assumptions about the values at stake, the case for convicting and punishing using statistical evidence seems solid. In trying to show where this argument goes wrong, I shall argue (against Lockeans, reliabilists, and others) that beliefs supported only by statistical evidence are epistemically defective and (against Enoch, Fisher, and Spectre) that these epistemic considerations should matter to the law. To solve the puzzle about the role of statistical evidence in the law, we need to revise some commonly held assumptions about epistemic value and defend the relevance of epistemology to this practical question.

     

Psychometric characteristics of role-play assessments of social skill in schizophrenia

There is an extensive literature documenting that people with schizophrenia have marked impairments in social role functioning and social skill. One of the most widely employed strategies for assessing social skill has been role-play tests: simulated social interactions that are videotaped for subsequent behavioral coding. There has been considerable discussion of the validity of the approach in the literature, but there has not been adequate consideration of other psychometric characteristics of role-play tests. This paper examines the psychometric characteristics of a representative role-play measure: the Maryland Assessment of Social Competence (MASC). Data from 5 large schizophrenia studies that included the MASC were examined: a study of victimization in women who abuse drugs, a study of health care among people with diabetes, a study of vocational outcomes, a study of social skill among drug abusers, and a clinical trial comparing two antipsychotic medications. Data were examined in terms of five questions: (1) Can role-play scenes be rated reliably? (2) How are role-play ratings distributed across populations? (3) How many and which behaviors should be rated? (4) How many role-play scenes are required? (5) Is role-play behavior temporally stable? Overall, the data suggest that the MASC, and by implication other similar role-play procedures, does have good psychometric properties. However, several things often taken for granted in the literature warrant careful consideration in the design of research using role-play. Implications of the results for design of research are discussed.     

Positive and negative opinion modeling: the influence of another's similarity and dissimilarity

Modeling research that has focused on the effects of observing similar others appears to have underestimated the influence of observing dissimilar others. Two experiments demonstrated that observing a model express liking for a piece of music induced more favorable opinions of the music (positive modeling) when the model was similar to the participant observer in relevant opinions, and more negative opinions (negative modeling) when the model was dissimilar to the participant in relevant opinions. Of note, this pattern was more pronounced when participants also believed their general backgrounds were dissimilar rather than similar to that of the model. Underlying social comparison processes and the mediational role of participants' liking of the model are considered.     

Prototypes and particulars: geometric and experience-dependent spatial categories

People use geometric cues to form spatial categories. This study investigated whether people also use the spatial distribution of exemplars. Adults pointed to remembered locations on a tabletop. In Experiment 1, a target was placed in each geometric category, and the location of targets was varied. Adults' responses were biased away from a midline category boundary toward geometric prototypes located at the centers of left and right categories. Experiment 2 showed that prototype effects were not influenced by cross-category interactions. In Experiment 3, subsets of targets were positioned at different locations within each category. When prototype effects were removed, there was a bias toward the center of the exemplar distribution, suggesting that common categorization processes operate across spatial and object domains.     

Can Temperament Identify Affectively Ill Patients Who Engage in Lethal or Near‐Lethal Suicidal Behavior? A 14‐Year Prospective Study

Among affectively ill patients followed naturalistically for up to 14 years, 36 committed suicide, 120 attempted suicide, and 373 had no recorded suicide attempt. Comparing these three groups on clinical and intake personality revealed that suicide completed within 12 months was predicted by clinical but not personality variables, and suicide beyond 12 months was predicted by newly derived temperament factors, not clinical variables. Attempters and completers shared core characteristics: previous attempts, impulsivity, substance abuse, and psychic turmoil within a cycling/mixed bipolar disorder. Such temperament attributes as impulsivity and assertiveness were the best prospective predictors of completed suicides beyond 12 months with a sensitivity level of 74% and specificity level of 82%.