How does clients' method of payment influence psychologists' diagnostic decisions?

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues.     

Therapeutic reactance in a depressed client sample: a comparison of two measures

The impact of client variables on psychotherapy is of both theoretical and practical importance. Reactance--the premise that individuals seek to maintain control over personal freedoms when threatened by a perceived loss thereof--has been shown to have an impact on the effectiveness of therapeutic interventions. Developing an effective means of quantitatively assessing this characteristic prior to treatment could facilitate treatment planning and maximize treatment outcome. The present study compared two paper-and-pencil measures of reactance: the Therapeutic Reactance Scale (TRS) and Resistance Potential (RP). Ninety-eight men and women diagnosed with depression completed both measures. The TRS and RP failed to correlate despite their presumed ability to measure the same construct. The RP exhibited extremely poor internal consistency, calling into question results that have been based on this measure. The TRS results provided evidence of convergent, divergent, and construct validity for this instrument.     

“Paging Dr. Lauben! Dr. Gustav Lauben!”: Some Questions about Individualism and Competence

In several works, Frege argues that content is objective (i.e., thethoughts we entertain and communicate, and the senses of which theyare composed, are public, not private, property). There are, however,some remarks in the Fregean corpus that are in tension with this view.This paper is centered on an investigation of the most notorious andextreme such passage: the `Dr. Lauben example, from Frege (1918). Aprincipal aim is to attain more clarity on the evident tension withinFreges views on content, between this dominant objectivism and someelements that seem to run counter to it, via developing an understandingof the `Dr. Lauben example. Then I will argue that this interpretation goes some way toward undermining some prevalent contemporary viewsabout language. Based on the advice of Dr. Lauben, I will argue againsta certain understanding of the causal-historical theory of reference –more specifically, of the phenomenon of deferential uses of linguisticexpressions – upon which these views are premised, and I will drawout some morals that pertain to individualism and competence.     

The Prophylactic Mastectomy Dilemma: A Support Group for Women at High Genetic Risk for Breast Cancer

The goal of this pilot study was to test the usefulness of a six session psychoeducational support group for women at high genetic risk for breast cancer who were considering prophylactic mastectomy. The themes of the group sessions included overestimation of and anxiety about risk; desire for hard data; the emotional impact of watching a mother die of breast cancer; concerns about spouse reactions; self- and body image; the decision-making process; and confusion over whom to trust in decision making. Both the participants and the multidisciplinary leaders concluded that as a supplement to individual counseling, a support group is a beneficial and cost-effective treatment modality. Recommendations for the optimal format for such a group are described.     

“From natural function to indeterminate content”

In his recent bookExplaining Behavior, Fred Dretske has outlined a naturalized theory of intentionality. Several philosophers, including Dretske himself, view his theory as lending credence to the claim that mental state content should be construed widely. In this paper I argue that careful analysis of his theory reveals that this view is mistaken. In Dretske's theory, the notion of the function of a state plays a central role in the determination of content. It will be my contention that this notion of function cannot be used in Dretske's theory to distinguish between the wide construal of the content of an intentional state and the narrow or individualistic construal. This inability of his notion of function to discriminate between wide content and individualistic content undermines any claim that Dretske's theory endorses wide content. Instead, we are lead to the conclusion that Dretske's theory entails pervasive content indeterminacy.     

The provision of advocacy services to women leaving abusive partners: An examination of short-term effects

Examined the short-term impact of providing advocacy services to women leaving battered women's shelters. The study employed a true longitudinal experimental design. Women in the advocacy condition received intensive one-on-one services with trained paraprofessional advocates. Advocates assisted women in accessing needed community resources. Women in the control condition received no additional postshelter services. Findings corroborated earlier research suggesting that battered women lack many resources necessary for independent living and that working with advocates produced greater effectiveness in accessing needed resources. Ongoing research will examine the long-term impact on life satisfaction, future victimization, and living arrangements.     

The GABA/benzodiazepine receptor complex in the central amygdalar nucleus and stress ulcers in rats

The effects of bilateral microinjections of chlordiazepoxide and GABA into the central amygdalar nucleus on gastric ulcer formation induced by cold-restraint were examined in chronically implanted Wistar rats. Higher doses of chlordiazepoxide (20 and 30 micrograms/amygdala) significantly reduced stress ulcer development, whereas a lower dose (2.5 micrograms) produced a nonsignificant increase in ulcer severity. A similar dose/response pattern was observed following GABA administration. The benzodiazepine receptor antagonist Ro15-1788, applied to the amygdala, abolished the protective effects of both chlordiazepoxide and GABA. In addition, when Ro15-1788 (10 micrograms) was injected into the amygdala by itself, it aggravated the gastric stress pathology. However, a lower dose (5 micrograms) had an attenuating effect, opposite to the pattern of effects produced by chlordiazepoxide and GABA. The role of the amygdalar GABA-benzodiazepine receptor complex in stressful conditions is discussed.     

Confirmatory factor analysis of the group environment questionnaire with co-acting sports

To assess whether the Group Environment Questionnaire is applicable to athletes in co-acting sports such as track and field, the factor structure of the Group Environment Questionnaire among a heterogeneous sample of 199 co-acting team sport athletes was investigated. A confirmatory factor analysis did not support the hypothesized four-factor model. A subsequent exploratory factor analysis yielded two independent factors that had no interpretable pattern of the four Group Environment Questionnaire factors within them. While this finding requires replication and confirmation, the four-factor model of the Group Environment Questionnaire does not appear to be as valid for co-acting sports as for interacting sports.