Depression in patients with spinal cord injuries: A synthesis of cognitive and somatic processes

Depression in some patients with spinal cord injuries may be clinically significant and, when present, should be treated to decrease morbidity including decreased physical functioning. Depression associated with spinal cord injury (SCI) may be misevaluated, due to (1) nonspecific multifactorial production of depression symptoms and (2) SCI-specific decrease in somatic sensory central nervous system input. The Somatic Suppression Hypothesis suggests that SCI patients have difficulty experiencing any intense emotion because of suppression of physiological arousal. In addition, cognitive processes that may reduce depression in SCI patients include: (1) attribution of somatic symptoms of depression to medical (biological) causes, (2) realistic, positive expectations for physical improvement, and (3) the perception that the disability of the SCI is only minimally related to the patient’s self-care after complete evaluation. Health personnel should accept lack of depression in SCI, and should encourage positive realistic expectations of recovery.     

Toward a therapeutic jurisprudence analysis of medication refusal in the court review model

A therapeutic jurisprudence analysis attempts to discern the role of legal proceedings, lawyers and judges in producing therapeutic or anti-therapeutic consequences. This paper will attempt to use the therapeutic jurisprudence framework to analyze the legal and administrative aspects of court review as it was reported during a one year epidemiologic study of drug refusal. Characteristics of the review process, the effect on patient refusal, and the attitudes of treating psychiatrists are presented. To broaden the clinical context of the administrative findings, selected clinical characteristics of refusing patients, their attitudes toward mental illness, reasons for refusing medication and satisfaction with court review will be described. The discussion attempts to show how the initial administrative study findings may be interpreted in the broader context of their relationship to the achievement of therapeutic outcomes.     

Employment and Roles of Counselors in Employee Assistance Programs

The authors studied employment and roles of master's-level counselors in employee assistance programs (EAPs) and the services offered by different types of EAP organizations. The study focused on programs, workshops and seminars: assessment; counseling; consultation; and evaluation and marketing services offered by EAPs. Master's-level counselors were found to be similar to those with Master's of Social Work (MSW) degrees in employment rate and percentage of EAP staff. Both groups were the most frequently employed and constitute the greatest percentage of the professional mental health staff in EAPs. Also, counselors were found to be involved in all of the service areas studied within each type of EAP. Differences in counselors' roles among EAP types are discussed.     

Interrelationships among students' study activities,self-concept of academic ability,and achievement as a function of characteristics of high-school biology courses

This investigation focused on the interrelationships among students' study activities, students' self-concept of academic ability ratings, students' academic achievement, and instructional practices in 12 high school biology courses. Using a framework derived from a previous investigation, course features were classified into those that appear to (a) place demands on, (b) support, or (c) compensate for student engagement in particular study activities. Students' study activities, self-concept of academic ability ratings, and achievement were measured with experimenter-developed instruments. Results are reported for (a) characteristics of instruments and course features, (b) relationships between central factors of the investigation, and (c) multi-level relationships between course features and student variables. Results at the student level indicated that self-concept of academic ability and, to a lesser extent, students' study activities were positively associated with student achievement. Students' self-concept of academic ability ratings were also linked to students' engagement in generative, proactive study activities. At the course level the supportive practices of providing challenging homework assignments and extensive feedback on student coursework were associated with student engagement in effortful, generative, proactive study activities. The provision of extensive feedback was also associated with high student achievement. Multi-level relationships were analysed using hierarchical linear modelling (HLM) analyses. These analyses revealed, for example, that in courses in which little or no feedback is given on homework assignments, the relationship between achievement and student engagement in diligent effort management activities was enhanced. Other HLM analyses were conducted to examine the mediating role of course features on the relationship between students' self-concept of academic ability and their study activities and achievement. For example, the presence of challenging course demands was associated with an enhancement of the relationship between self-concept of academic ability and achievement whereas the presence of instructor provisions (supports and compensations) designed to reduce course demands was associated with a reduction in this relationship.     

Unitarian validation of a mathematical problem-solving exercise for sales occupations

A content-related test construction strategy was employed as a means of yielding a test with criterion-related evidence of validity. Utilizing a national sample of field sales job incumbents, a group-based job analysis method was developed to identify job requirements. A content validity and concurrent criterion-related study were then conducted. The results demonstrated both content and criterion-related evidence of validity. Differential validity by race or gender was not found. A comparison between minority and non-minority group regression lines found no statistically significant difference between slopes. However, a statistically significant difference between minority and non-minority intercept values was found. The results are discussed in respect to their consistency with other research findings. The significance of the study is addressed in light of the recent Unitarian approach towards the theoretical and practical nature of test validity. It is suggested that practitioners and researchers investigate further the elements of this research effort as guidance for satisfying professional and federal standards.     

Route-finding: A measure of everyday executive functioning in the head-injured adult

This is an ecological test of adaptation in head-injured adults, reporting reliability and validity of the Executive Function Route-finding Task (EFRT; Boyd and Sautter, 1985). A Likert scale was used to rate executive aspects of route-finding such as task formulation, strategy of approach, detection and correction of errors, and dependence on cueing among 31 head-injured young adults within a large rehabilitation facility. The Task has high inter-rater reliability and acceptable concurrent validity with other neuropsychological constructs.     

Offering predictive testing for Huntington disease in a medical genetics clinic: Practical applications

Predictive testing for Huntington disease is presently offered in a select few medical genetics centers in the United States. This is in part due to the labor intensive counseling and psychological testing suggested by the research protocols. We discuss some specific suggestions for establishing programs for Huntington disease predictive testing within pre-existing medical genetics clinics to encourage more centers to offer presymptomatic testing. This will allow more at risk individuals the opportunity to consider predictive testing and cut down the expenses of traveling to the few predictive testing centers that currently exist. The counseling principals will remain similar to those discussed here, even following the identification of the Huntington disease mutation.     

Internalistic foundationalism and the justification of memory belief

In this paper I argue that internalistic foundationalist theories of the justification of memory belief are inadequate. Taking a discussion of John Pollock as a starting point, I argue against any theory that requires a memory belief to be based on a phenomenal state in order to be justified. I then consider another version of internalistic foundationalism and claim that it, too, is open to important objections. Finally, I note that both varieties of foundationalism fail to account for the epistemic status of our justified nonoccurrent beliefs, and hence are drastically incomplete.