Cognitive habilitation in schizophrenia: A theoretical review and model of treatment

Evidence has accumulated for information processing deficits in schizophrenia. The functional significance of these deficits is only beginning to be understood. There are indications that these deficits may respond to intervention. Training on deficient functions has been demonstrated to relate to improvements in performance. A treatment program of cognitive rehabilitation is deduced from the literature and induced from clinical experience. The treatment is designed to impact directly on the information processing deficits of schizophrenic patients and indirectly to ameliorate functional deficits.     

Subclmical depression and role fulfillment in domestic settings: Spurious relationships,imagined problems,or real effects?

Considerable evidence has accumulated in support of the hypothesis that subclinical depression may inhibit role performance in important ways. However, interpersonal stress and marital discord often precede the development of depressive symptomatology and may independently predict deficits in family role functioning. In addition, cognitive theories suggest that persons with subclinical depression may report poor role functioning even in the absence of any real performance deficits. The current research examines the possibility (1) that the effect of depression on the fulfillment of important family roles is attributable to previously unmeasured contextual variables of ongoing interpersonal stress and/or relationship dissatisfaction or, alternatively, (2) that this relationship is the result of depressive distortion associated with self-report of symptoms and performance. Multiple regression analyses of interview data collected from 495 community-dwelling adults found, however, that depression is related to role functioning beyond any spurious effects attributable to interpersonal stress, spousal stress, or marital satisfaction. In addition, the effect of depression persists when collateral reports of role functioning utilized. Accordingly, it appears that subclinical depression is related to decrements in role performance, and this effect is not entirely due to contextual elements or shared method variance between self-report measures.The authors acknowledge research support from Research Grants R01-AA-07250 and R01-AA-07218 from the National Institute on Alcohol Abuse and Alcoholism, Research Grant R01-DA-07417 from the National Institute on Drug Abuse, and National Institutes of Mental Health Grant A-41487-07.     

Distinguishing deviant and non-deviant nurses using the personnel reaction blank

Personnel Reaction Blank (PRB) scores and biographical data were obtained from two groups of registered nurses; a deviant group, represented by those who had official actions taken against their nursing license by the Minnesota Board of Nursing (n=53) and a non-deviant group of nurses (n=79) randomly selected from a broader population. The hypothesis that the deviant group of nurses would exhibit lower PRB scores, on average, compared to the non-deviant group was confirmed. The mean PRB scores for the deviant nurses (m=32.43) were significantly lower (p.01) than for the randomly selected non-deviant nurses (m=35.06). A multiple regression logit analysis showed that in addition to PRB scores, college degree, sex, and household income variables were also significantly related (p.001) to deviant and non-deviant group assignment; nonetheless, PRB significantly differentiated these groups after holding these variables constant.This study is based on the Masters thesis research of the first author. We acknowledge the help of the study subjects who contributed their time and effort.     

Nonsuicidal physically self-damaging acts in adolescents

To determine the frequency and correlates of nonsuicidal physically self-damaging acts in 12–14 year olds, a two stage epidemiologic survey with a self-administered questionnaire (N=3283) followed by a psychiatric interview of a subsample of the adolescents and their parents (N=444) was used. Prevalence estimates of interview validated nonsuicidal physically self-damaging acts were 2.46% in males and 2.79% in females. Significant relationships were found between nonsuicidal physically self-damaging acts and suicidal ideation, major depression and undesirable life events. Data suggest that physically self-damaging acts occur at substantial rates during early adolescence. The strong correlation between nonsuicidal self-destructive acts and both suicidal ideation and major depression clarifies prior conflicting reports in the literature and suggests that a history of self-damaging acts should be taken into consideration when evaluating for possible depression and suicide risk.     

The mormon health traditions: An evolving view of modern medicine

The Mormon church has long been seen as an unusual group in relation to its health practices. But its health traditions and practices go much further than the ban on tobacco, coffee, and alcohol for which it is so well known. Church teachings and influences pervade the entire Mormon existence. This paper briefly discusses these traditions, first by examining their roots in the teachings of its first two prophet/presidents, Joseph Smith and Brigham Young. Then, how these ideas have evolved into the church's current thought is examined; and finally, the church's responses to many modern-day health care issues are presented.The author wishes to thank Dr. John King at Eastern Virginia Medical School in Norfolk, for his assistance and encouragement.     

Sex Roles, Interpersonal Control, and Depression: Who Can Get Their Way?

This study is one of a series of investigations examining the contribution of sex roles to the development of depression within a learned helplessness framework. Utilizing 143 pairs of undergraduate female participants, the present study explored subjects′ abilities to gain and maintain control in an interpersonal context. Interpersonal control was operationalized as successful persuasion in a two-person discussion task, wherein one participant had hidden instructions to be maximally persuasive in discussing a questionnaire about social behavior. The results indicated that less successful persuasion was associated with increases in depressed mood. Furthermore, women with high masculinity and low femininity were able to gain interpersonal control regardless of the sex role of their partner. The results also suggested that high femininity is associated both with giving up control in interpersonal tasks and with increases in depressed mood when one is faced with the task of exerting interpersonal control. The findings were interpreted in terms of the importance of sex role characteristics in learned helplessness and depression.     

The gender role journey measure: Scale development and psychometric evaluation

The Gender Role Journey concept was developed to help women and men explore their gender role changes and transitions. A 34-item Gender Role Journey Measure (GRJM) was conceptualized and developed through empirical methods. The construct validity of the five phases of the gender role journey is assessed. The GRJM and the Personal Attributes Questionnaire (PAQ) were given to a sample of women and men (N=878). The sample was predominantly Caucasian from a mixed ethnic background. Principle factor analysis indicated three meaningful factors: Acceptance of Traditional Gender Roles; Gender Role Ambivalence, Confusion, Anger, and Fear; and Personal-Professional Activism. Moderately high test-retest and internal consistency reliabilities were found for each of the factors. Gender differences and gender by PAQ interactions were found for all three of the factors of the GRJM. Implications for future research, teaching, and workshops are suggested.This article was presented at the 99th convention of the American Psychological Association, San Francisco, California, August 1991. It was supported by a grant from the Research Foundation of the University of Connecticut, Storrs, Connecticut.     

The Use of Psychoendocrine Strategies in Post-Traumatic Stress Disorder1

An overview is presented of a pilot psychoendocrine study of PTSD inpatients in comparison with several subgroups of schizophrenic and affective disorder patients. Using a hormonal profile including Cortisol, norepinephrine, epinephrine, testosterone, and thyroxine, it was found that the mean values for the PTSD group were at or near the extreme end of the range for every hormone measured, i.e., relatively low for Cortisol and high for the remaining hormones. The possible clinical meaning of these findings is considered in the light of prior psychoendocrine research on chronic stress. The hormonal alterations in PTSD appear to be persistent and suggest the possibility of being linked largely to traits or character structure, perhaps particularly to cognitive variables related to defense and coping mechanisms, as reviewed in detail for each hormonal system. There appears to be a potential for a fruitful union between the traumatic stress and psychoendocrine fields and some future strategies for developing and strengthening such a union are suggested.     

Grading the ‘cultural literacy’ project

The essay examines the argument advanced by E.D. Hirsch, Jr., for instituting ‘cultural literacy’ as a fundamental priority of schools. A number of confusions and equivocations in Hirsch's reasoning are identified, and the propensity of his project to indoctrinate is exposed. Among the features of Hirsch's argument shown to be troubling are his shifting construal of ‘language’, his inconsistency about the requirements of cultural literacy, and his uncritical relation to traditional images of the American past and present. The upshot is to raise the question why Hirsch's project has elicited wide support and praise.     

The role of compliance in hypnotic and nonhypnotic analgesia

We modified the standard procedure for administering finger pressure pain in order to assess the extent to which subjects biased their reports of pain reduction when exposed to compliance-inducing instructions. Experiment 1 used only highly hypnotizable subjects and found that compliance-induced reductions in reported pain were about half as large as the reported reductions produced by hypnotic analgesia suggestions. Experiment 2 used low as well as high hypnotizables and administered hypnotic or nonhypnotic analgesia instructions and compliance instructions to the same subjects on separate pain trials. Reported pain reductions produced by hypnotic and nonhypnotic analgesia suggestions and those produced by compliance instructions were substantially and significantly correlated. Furthermore, hypnotizability correlated with compliance-induced reported pain reductions as highly as it correlated with the reported reductions produced by hypnotic analgesia suggestions. Among high hypnotizables (but not low hypnotizables) compliant responding was predicted by social desirability. The findings of both studies indicate that compliance strongly influences the reports of hypnotic and nonhypnotic analgesia proffered by high hypnotizables. The role of compliance in the pain reductions reported by low hypnotizables is less clear-cut.