Interparent agreement on the Personality Inventory for Children: Are substantial correlations sufficient?

Mothers' and fathers' responses on the Personality Inventory for Children (PIC) were compared for 360 clinic-referred children and adolescents. Interparent agreement was measured by several different indices. Correlations between parental pairs of scale T-scores derived from each parent averaged .66 for 13 of the profile scales; 9 of the scales exceeded this value. In contrast, mothers and fathers agreed in the classification of the presence of clinical significance an average of 77% of the time across these 13 scales, and pairs of parental PIC profiles contained an average of 3 scales in disagreement. The type of index used to measure interparent agreement was found to affect the results. The discussion examines the nature of interparent disagreement and addresses the implications regarding the use of fathers as informants on this instrument.This article is based on Thomas A. Hulbert's master's thesis. The authors extend their appreciation to James Orisell and Dena Mussaff for their assistance in data preparation and analysis.     

Pupillary responses to syntactic ambiguity of sentences

Pupillary responses have proven to be reliable physiological correlates of cognitive effort in a variety of tasks, including language processing. To investigate the relation between psychological and syntactic complexity 20 syntactically ambiguous sentences, balanced for bias, were presented to 16 subjects, while their pupil size was continuously measured. These sentences could be read as verb oriented (syntactically more complex) or object oriented (syntactically less complex). Principal components analysis of pupillary movements revealed that verb-oriented readings, resulted in greater pupillary dilations than object-oriented readings, indicating that syntactically more complex sentences, as determined via a formal grammar, require greater cognitive effort in processing. This is viewed as further evidence for the notion that syntactic and psychological complexity are related. High- and low-bias sentences did not induce comparable differences in pupillary movements, indicating that the "multiple meaning theory" may have to be modified.     

Impact of a preventive social problem solving intervention on children's coping with middle-school stressors

Children receiving 1 year or 1/2 year of a preventive social problem solving program in elementary school were compared with each other and with a no-treatment group upon entry into middle school. One year of training was significantly related to reductions in the severity of a variety of middle-school stressors. Most importantly, a clear mediating role for social problem solving (SPS) skills was found. Children lacking in SPS skills were more likely to experience intense stressors; however, possessing the skills was not necessarily predictive of adjustment to stressors. The results are discussed in terms of the implications of this asymmetry and the strong support given to the value of social problem solving as a preventive intervention for children.     

The right to refuse treatment: Paradox,pendulum and the quality of care

This clinical and theoretical overview of the right to refuse treatment will address some of the themes that have dominated this area of interface between psychiatry and the law, and have, perhaps, obscured the real concern of the right to refuse treatment question; i.e., the issue of quality of care. Central themes include factors present in the medicolegal context and recent events, origin of the concept of the right to treatment, the separation of confinement from treatment, and the changing models of vicarious decision making. This review also addresses judicial conceptualizations of treatment, including the concept of quarantine, judicial risk-aversiveness, and judicial fantasies of drug action. Some possible directions for the future are also examined.     

Narrative unity and clinical judgment

Alasdair MacIntyre's recent thinking both about the concept of a practice and the existence of narrative unity in human life raises important questions about how we should view clinical medicine today. Is it possible for clinical medicine to pursue patient well-being in a society (allegedly) afflicted with what he calls ‘modernity’? Here it is argued that MacIntyre's pessimistic view of the individual in contemporary society makes his call for patient autonomy in the clinical setting pointless. Finally, recent work in gerontology is cited to make three points: first, MacIntyre's pessimism about us is too extreme; second, the concept of a ‘fictionalized’ personal history is closer to reality than either MacIntyre's notion of narrative unity or the ideas of his imagined opponent (Sartre); and finally, we should not expect clinical medicine to produce patient well-being, when this is understood narratively.     

The physician's influence on patients' choices

Although the traditional physician ethic sees nothing objectionable about the doctor's influence over patients, superficial conceptions of the patient's right to self-determination imply that this influence may be manipulative. On the contrary, there are several different lines of argument which can reconcile self-determination with the physician's influence. Nevertheless, drawing the boundaries between legitimate methods of persuasion, and manipulation or coercion sometimes proves difficult.     

Duration of negative practice and the reduction of leg pounding of a traumatically brain-injured adult

This study evaluated the relative efficacy of long (1 minute) and short (15 seconds) durations of negative practice for reducing self-stimulatory leg pounding of a traumatically brain-injured adult. In individual social skill training classes, long negative practice and short negative practice were administered concurrently in an alternating treatments design. Generalization of treatment effects outside of training sessions was assessed during the client's lunch period. The results revealed that both durations of negative practice were equally effective in reducing leg pounding during training sessions. However, the effects of training did not generalize to settings in which the practice contingency was not enforced. Pounding was more frequent and negative practice somewhat less effective during periods of high social stimulation.     

Evidence for disparity change as the primary stimulus for stereoscopic processing

Subjects were able to respond to a lens-induced stereoscopic slant more quickly and more accurately when it was imposed on only part of a surface rather than on the whole surface. This shows that the presence of a stereoscopic boundary, where disparity is discontinuous, increases the efficiency of stereoscopic processing. This finding is not consistent with many current models of stereopsis.