Psychiatric inpatients' perceptions of written no-suicide agreements: an exploratory study

One hundred thirty-five psychiatric inpatients admitted for suicidal danger were surveyed regarding their views on the benefits/limitations of written no-suicide agreements. A survey instrument developed for this study revealed that these inpatients, for the most part, rated written no-suicide agreements in a positive manner and in ways consistent with clinical opinion expressed in a number of qualitative/expert-opinion articles. Positive views of no-suicide agreements were not materially influenced by social desirability or age, nor were they moderated by gender, presence/absence of Axis II disorders, or admission suicidal danger. However, patient suicide attempt history (no attempts, one attempt, or more than one attempt) exerted a moderating effect on patients' ratings of the helpfulness of these contracts. Multiple attempters viewed written no-suicide agreements as less helpful than those patients with a single or no prior attempts. The methodological problems and generalizability concerns associated with these results are discussed and future research needs are suggested.     

Windowed cross-correlation and peak picking for the analysis of variability in the association between behavioral time series

Cross-correlation and most other longitudinal analyses assume that the association between 2 variables is stationary. Thus, a sample of occasions of measurement is expected to be representative of the association between variables regardless of the time of onset or number of occasions in the sample. The authors propose a method to analyze the association between 2 variables when the assumption of stationarity may not be warranted. The method results in estimates of both the strength of peak association and the time lag when the peak association occurred for a range of starting values of elapsed time from the beginning of an experiment.     

Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms

The purpose of the present study was to examine the potential efficacy, patient acceptability, and feasibility of a novel, cognitive-behavioral therapy (CBT) for adults with attention-deficit hyperactivity disorder (ADHD) who have been stabilized on medications but still show clinically significant symptoms. Thirty-one adults with ADHD and stable psychopharmacology for ADHD were randomized to CBT plus continued psychopharmacology or continued psychopharmacology alone. Assessments included ADHD severity and associated anxiety and depression rated by an independent evaluator (IE) and by self-report. At the outcome assessment, those who were randomized to CBT had lower IE-rated ADHD symptoms (p < .01) and global severity (p < .002), as well as self-reported ADHD symptoms (p < .0001) than those randomized to continued psychopharmacology alone. Those in the CBT group also had lower IE-rated and self-report anxiety (p's < .04), lower IE-rated depression (p < .01), and a trend to have lower self-reported depression (p = .06). CBT continued to show superiority over continued psychopharmacology alone when statistically controlling levels of depression in analyses of core ADHD symptoms. There were significantly more treatment responders among patients who received CBT (56%) compared to those who did not (13%) (p < .02). These data support the hypothesis that CBT for adults with ADHD with residual symptoms is a feasible, acceptable, and potentially efficacious next-step treatment approach, worthy of further testing.     

Prejudice and stereotype maintenance processes: attention, attribution, and individuation

Three experiments examined the relationship between prejudice and processing of stereotypic information. Higher levels of prejudice were associated with greater attention to and more thorough encoding of stereotype-inconsistent than stereotype-consistent behaviors but only when processing capacity was plentiful (Experiments 1 and 3). High-prejudice participants attributed consistent behaviors to internal factors and inconsistent behaviors to external forces (Experiment 2). Together, these results suggest that high-prejudice people attend carefully to inconsistent behaviors to explain them away but only if they have sufficient resources to do so. Results also showed that low-prejudice but not high-prejudice participants formed individuated impressions by integrating the implications of the target's behaviors (i.e., individuating). High levels of prejudice appear to be associated with biased encoding and judgment processes that may serve to maintain stereotypes.     

A confirmatory approach to the factor structure of the Boredom Proneness Scale: evidence for a two-factor short form

We analyzed previous exploratory factor analytic structures on the Boredom Proneness Scale (BPS; Farmer & Sundberg, 1986) using confirmatory factor analysis in structural equation modeling in LISREL 8 (J?reskog & S?rbom, 1993). These analyses indicated that 2 factors were generally consistent across 6 exploratory models. Items that had significant loadings on these two factors (N = 12; 6 for each factor) indicated a lack of Internal Stimulation and External Stimulation. In further analysis on these 12 items using LISREL, we found a much improved fit and provided support for a short form version of the original BPS. We also found the shortened version to be invariant across gender. We discuss implications for the more precise measurement of boredom proneness and the use of the scale in applied settings.     

An illustration of multilevel factor analysis

The factor analysis of repeated measures psychiatric data presents interesting challenges for researchers in terms of identifying the latent structure of an assessment instrument. Specifically, repeated measures contain both within and between individual sources of variance. Although a number of techniques exist for separating out these 2 sources of variance, all are problematic. Recently, researchers have proposed that exploratory multilevel factor analysis (MFA) be used to appropriately analyze the latent structure of repeated measures data. The chief objective of this report is to provide a didactic step-by-step guide on how MFA may be applied to psychiatric data. In the discussion, we describe difficulties associated with MFA and consider challenges in factor analyzing life event appraisals in psychiatric samples.     

Item response theory and the measurement of clinical change

An instrument's sensitivity to detect individual-level change is an important consideration for both psychometric and clinical researchers. In this article, we develop a cognitive problems measure and evaluate its sensitivity to detect change from an item response theory (IRT) perspective. After illustrating assumption checking and model fit assessment, we detail 4 features of IRT modeling: (a) the scale information curve and its relation to the bandwidth of measurement precision, (b) the scale response curve and how it is used to link the latent trait metric with the raw score metric, (c) content-based versus norm-based score referencing, and (d) the level of measurement of the latent trait scale. We conclude that IRT offers an informative, alternative framework for understanding an instrument's psychometric properties and recommend that IRT analyses be considered prior to investigations of change, growth, or the effectiveness of clinical interventions.     

Exploring the hand test with medically ill children and adolescents

Pediatric psychologists use the tools of assessment to evaluate the psychological functioning of youth with chronic and acute medical illnesses. This study is an exploration of the use of a performance-based measure, the Hand Test (HT; Wagner, 1983), with pediatric medical patients. A sample of medical inpatients (n = 27) and psychiatric outpatients (n = 24) were administered the HT, a self-report measure, and a parent-report behavior rating scale. Results indicate that the psychiatric group scored higher than the medical group on HT Aggression, Withdrawal, and Pathological scores. The Aggression (d = 0.90) and Pathological (d = 0.80) variables were particularly robust in differentiating between groups, but the Crippled variable did not differ between groups. Hierarchical logistic regression demonstrated the incremental validity of the HT over behavior ratings alone in the classification of clinical groups. Analyses indicated that the HT can add important information in the differentiation of medically ill children from those with psychological disturbance.     

What you see is what you set: sustained inattentional blindness and the capture of awareness

This article reports a theoretical and experimental attempt to relate and contrast 2 traditionally separate research programs: inattentional blindness and attention capture. Inattentional blindness refers to failures to notice unexpected objects and events when attention is otherwise engaged. Attention capture research has traditionally used implicit indices (e.g., response times) to investigate automatic shifts of attention. Because attention capture usually measures performance whereas inattentional blindness measures awareness, the 2 fields have existed side by side with no shared theoretical framework. Here, the authors propose a theoretical unification, adapting several important effects from the attention capture literature to the context of sustained inattentional blindness. Although some stimulus properties can influence noticing of unexpected objects, the most influential factor affecting noticing is a person's own attentional goals. The authors conclude that many--but not all--aspects of attention capture apply to inattentional blindness but that these 2 classes of phenomena remain importantly distinct.     

Types of high self-esteem and prejudice: how implicit self-esteem relates to ethnic discrimination among high explicit self-esteem individuals

There is increasing recognition that high self-esteem is heterogeneous. Recent research suggests that individuals who report having high self-esteem (i.e., have high explicit self-esteem) behave more defensively to the extent that they have relatively low implicit self-esteem. The current studies test whether individuals with high explicit self-esteem are more likely to discriminate ethnically, as a defensive technique, to the extent that they have relatively low implicit self-esteem. The results support this prediction. Among participants with high explicit self-esteem, all of whom were threatened by negative performance feedback, those with relatively low implicit self-esteem recommended a more severe punishment for a Native, but not a White, student who started a fist-fight. In Study 2, this pattern was not apparent for participants with relatively low explicit self-esteem.