The MMPI and clinical diagnosis: a comparison of classification system outcomes with discharge diagnoses

This study examined the agreement or congruence rate between clinical-discharge diagnoses rendered by a psychiatrist, and admission and discharge MMPI-derived diagnoses from four diagnostic classification systems that have been developed for the MMPI. The four classification systems included a simple high-point code based on the most elevated clinical scale in the profile, the Henrichs revision of the Meehl-Dahlstrom rules, the Goldberg equations, and a system developed by Lachar. Subjects consisted of 150 patients selected from a larger pool of patients who had completed a 9-week adult residential treatment program. Overall, this study yielded modest hit rates between 26% and 34% for MMPI-derived diagnoses and psychiatric diagnoses across the various classification systems. In addition, stability of MMPI-based diagnoses from admission to discharge assessments ranged from 48% to 51% depending on the classification system employed. Findings are discussed in terms of their implications for the use of the MMPI in patient diagnosis. It is recommended that the MMPI be used in conjunction with other sources of clinical and test information in deriving clinical diagnoses.     

Effects of Social Demand on Reports of Self-Monitored Blood Glucose in Adolescents with Type 1 Diabetes Mellitus

The purpose of this study was to test the hypothesis that social demand could substantially affect reports of self-monitored blood glucose (BG) in adolescents with insulin-dependent diabetes mellitus. Of 34 patients initially enrolled in the study, 10 were excluded because they did not bring any BG records with them to an outpatient clinic appointment. The remaining 24 patients were randomly assigned to either a low or high social demand condition that provided instructions for monitoring of BG for the week following the appointment. The subjects' BG records were quantified to provide frequency of measurement and mean reported BG for the week prior to and after the clinic visit. Five subjects did not return their BG records for the week following the intervention. The analyses were therefore based on the 19 subjects from whom complete records were obtained. The 12 subjects in the low social demand group and 7 subjects in the high social demand group were equivalent with regard to age, duration of diabetes, socioeconomic status, and glycosylated hemoglobin. Frequency of BG measurement was similar in both groups during both weeks. The mean BG value reported in the week prior to intervention was similar for the groups. However, analyses of the post-intervention BGs revealed that subjects in the low-demand group reported significantly higher BGs compared to pre-intervention and to subjects in the high-demand group. These findings suggest that self-monitoring and reporting of BG is a social behavior that is affected by the demand characteristics of the interpersonal patient-health provider relationship. Because optimal treatment planning for individuals with diabetes requires accurate BG records, care must be taken to interpret them in light of the social demand characteristics associated with clinical assessment.     

A Well-Kept Secret: What Counseling Psychology Can Offer Social Psychology1

Although social psychology has increasingly influenced counseling psychology, the impact that counseling psychology has had or could have on social psychology is less well developed. This paper considers factors that have limited counseling's influence on social psychology. In addition, contributions that counseling can make to social psychology are presented. It is argued that both disciplines have evolved to investigate the behavior of “normal” individuals in social contexts. It is concluded that there is much to be gained by both specialties in a fuller and more comprehensive integration and understanding of the findings and methods of the other.     

Preventing Substance Abuse Among American-Indian Adolescents: A Bicultural Competence Skills Approach

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, American-Indian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.