Sample size determinations for the two rater kappa statistic

This paper gives a method for determining a sample size that will achieve a prespecified bound on confidence interval width for the interrater agreement measure,. The same results can be used when a prespecified power is desired for testing hypotheses about the value of kappa. An example from the literature is used to illustrate the methods proposed here.     

Personal Versus Vocational Focus in Career Counseling: A Retrospective Outcome Study

In this archival study the authors sought to determine the relationship, if any, between counseling outcomes and the topical focus in career counseling. Twenty-two counselors saw 46 adult clients at a community-based clinic for an average of eight sessions. Counseling outcome and topical focus (the extent to which the actual content of counseling sessions reflected relatively more vocationally or personally focused topics) were assessed from follow-up questionnaires to former career clients and from trained raters' evaluations of the counselors' written progress notes. Results showed that, from the counselors' perspective, outcomes were better when the focus of the sessions was relatively more vocational than personal and when relatively more interviews were held. Client satisfaction, on the other hand, was predictable only from the counselor's level of experience. Satisfaction with occupational status was not associated with any of the client, counselor, or treatment factors. Discussion focuses on the contribution of the results to career counseling practice and on the feasibility and validity of retrospective, archival research.     

An experimental analysis of the civil commitment recommendations of psychologists and psychiatrists

Legal and nonlegal factors influencing the civil commitment recommendations of psychologists and psychiatrists separately and as a whole were investigated using an experimental design. One hundred and seventy-six psychologists and psychiatrists made recommendations for or against commitment for a series of clinical vignettes wherein the five facets of commitment criterion, legal committability, clinical treatability, alternative resources and presence of psychosis were systematically varied. Results revealed that all facets contributed independently and in combination to the commitment decisions of participants as a whole. It was concluded that mental health professionals may utilize a variety of types of information, beyond the relevant legal criteria, in making actual decisions to initiate civil commitments.     

From front line to home front: a study of secondary traumatization.

While the long-term effects of combat trauma on veterans have been studied extensively, its impact on veterans' wives has yet to be investigated. This study examined the implications of combat-induced psychopathology--wartime combat stress reaction (CSR) and current posttraumatic stress disorder (PTSD)--in a sample of 205 wives of Israeli combat veterans of the 1982 Lebanon war. Results show that both CSR and PTSD were associated with increased psychiatric symptoms in the wives. In addition, current PTSD was particularly found to contribute to impaired social relations among veterans' wives in a broad range of contexts, from inner feelings of loneliness, through impaired marital and family relations, and extending to the wider social network. Implications of these findings for treatment and further research are discussed.     

Altruism in surgery of AIDS patients

There is usually a long period of time between infection with the AIDS virus and manifestation of symptoms. Asymptomatic patients often would benefit from elective surgery for diseases such as arthritis which are unrelated to their infection. The surgeons' decisions to accept the risks to themselves, their spouses, and their operating teams in order to relieve pain and suffering appear to be based upon two covenants; one concerns their role within the doctor-patient relationship, and the other concerns their relationship to what they see as the ultimate meaning in life.     

Validity of the Threat Index.

The validity of the Threat Index was examined in a study of 42 students and 15 HIV+ clients. When completing the Threat Index, subjects rate the self and death on 30 bipolar adjectives. A count is made of the number of times the same adjective poles are used to describe the self and death. Uses of the same poles are called matches, while uses of different poles are called splits. The Threat Index is based on the assumption that splits indicate threat. Analysis showed that neither splits nor matches were usually threatening and that neither was necessary or sufficient for the experience of threat. These results did not support the validity of the Threat Index.