A national survey of health care administrators' views on the importance of various chaplain roles

A random sample of hospital administrators throughout the United States was surveyed about their views on the importance of eleven chaplain roles and functions. The 494 respondents fell into three categories: (1) directors of pastoral care departments (N = 132); (2) administrators of hospitals that have a pastoral care department (N = 180); and (3) administrators of hospitals that do not have a pastoral care department (N = 182). All three groups considered all eleven roles to be relatively important, although administrators of hospitals that do not have a pastoral care department gave lower ratings, overall. Meeting the emotional needs of patients and relatives were seen as chaplains most important roles, whereas performing religious rituals and conducting religious services were seen as least important by all three groups. In all but a few instances, the level of importance that administrators assigned to the various roles were positively related to their ratings of their own religiousness and spirituality (r's = .11 to .26, p < .05).     

Describing suicidality: an investigation of qualitative SSF responses

Given the incidence and seriousness of suicidality in clinical practice, the need for new and better ways to assess suicide risk is clear. While there are many published assessment instruments in the literature, survey data suggest that these measure are not widely used. One possible explanation is that current quantitatively developed assessment instruments may fail to capture something essential about the suicidal patient's experience. The current exploratory study examined a range of open ended qualitative written responses made by suicidal outpatients to five assessment prompts from the Suicide Status Form (SSF)--psychological pain, press, perturbation, hopelessness, and self-hate. Two different samples of suicidal outpatients seeking treatment, including suicidal college students (n = 119) and active duty U.S. Air Force personnel (n = 33), provided a wide range of written responses to the five SSF prompts. A qualitative coding manual was developed through a step-by-step methodology; two naive coders were trained to use the coding system and were able to sort all the patients' written responses into the content categories with very high interrater reliability (Kappa > .80). Certain written qualitative responses of the patients were more frequent than others, both within and across the five SSF constructs. Among a range of specific exploratory findings, one general finding was that two thirds of the 636 obtained written responses could be reliably categorized under four major content headings: relational (22%), role responsibilities (20%), self (15%), and unpleasant internal states (10%). Theoretical, research, and clinical implications of the methodology and data are discussed.     

A review of research on chaplains and community-based clergy in the Journal of the American Medical Association, Lancet, and the New England Journal of Medicine: 1998-2000

Based on the content analysis of quantitative research appearing in three medical journals, the authors conclude that, despite the shared ideal of providing spiritual care to patients on the part of physicians and chaplains, there is little attention given in these journals demonstrating and promoting this shared perspective. Suggestions for future research that would focus on this common medicine/religion interface and concern are noted.     

Enhancing the effects of extinction on attention-maintained behavior through noncontingent delivery of attention or stimuli identified via a competing stimulus assessment

Recent research has shown that the noncontingent delivery of competing stimuli can effectively reduce rates of destructive behavior maintained by social-positive reinforcement, even when the contingency for destructive behavior remains intact. It may be useful, therefore, to have a systematic means for predicting which reinforcers do and do not compete successfully with the reinforcer that is maintaining destructive behavior. In the present study, we conducted a brief competing stimulus assessment in which noncontingent access to a variety of tangible stimuli (one toy per trial) was superimposed on a fixed-ratio 1 schedule of attention for destructive behavior for individuals whose behavior was found to be reinforced by attention during a functional analysis. Tangible stimuli that resulted in the lowest rates of destructive behavior and highest percentages of engagement during the competing stimulus assessment were subsequently used in a noncontingent tangible items plus extinction treatment package and were compared to noncontingent attention plus extinction and extinction alone. Results indicated that both treatments resulted in greater reductions in the target behavior than did extinction alone and suggested that the competing stimulus assessment may be helpful in predicting stimuli that can enhance the effects of extinction when noncontingent attention is unavailable. DESCRIPTORS: Attention-maintained problem behavior, competing stimuli, extinction, functional analysis, noncontingent reinforcement     

Demographic characteristics,social competence,and behavior problems in children with gender identity disorder: a cross-national,cross-clinic comparative analysis

This study examined demographic characteristics, social competence, and behavior problems in clinic-referred children with gender identity problems in Toronto, Canada (N = 358), and Utrecht, The Netherlands (N = 130). The Toronto sample was, on average, about a year younger than the Utrecht sample at referral, had a higher percentage of boys, had a higher mean IQ, and was less likely to be living with both parents. On the Child Behavior Checklist (CBCL), both groups showed, on average, clinical range scores in both social competence and behavior problems. A CBCL-derived measure of poor peer relations showed that boys in both clinics had worse ratings than did the girls. A multiple regression analysis showed that poor peer relations were the strongest predictor of behavior problems in both samples. This study—the first cross-national, cross-clinic comparative analysis of children with gender identity disorder—found far more similarities than differences in both social competence and behavior problems. The most salient demographic difference was age at referral. Cross-national differences in factors that might influence referral patterns are discussed.     

A calibration explanation of serial position effects in evaluative judgments

Judges often evaluate stimulus series on dimensions for which no physical scale exists; for example, when judging academic ability in oral examinations. We propose that judges deal with this problem by calibrating an internal judgment scale that maps stimulus input onto available judgment categories. This calibration process implies serial position effects: Judges should initially avoid extreme categories, because using extreme categories reduces judgmental degrees of freedom, thereby increasing the possibility of internal consistency violations. In four experiments, we show that judgments become indeed more extreme later in a series of judgments. Judges evaluated the same good (poor) performances more positive (negative) at the end of a sequence compared to the beginning. Judges’ expertise did not prevent the effect, but allowing end-of-sequence judgments reduced serial position effects. We discuss the implications and possible remedies of these calibration effects on judgment extremity.     

SPSS macros to compare any two fitted values from a regression model

In regression models with first-order terms only, the coefficient for a given variable is typically interpreted as the change in the fitted value of Y for a one-unit increase in that variable, with all other variables held constant. Therefore, each regression coefficient represents the difference between two fitted values of Y. But the coefficients represent only a fraction of the possible fitted value comparisons that might be of interest to researchers. For many fitted value comparisons that are not captured by any of the regression coefficients, common statistical software packages do not provide the standard errors needed to compute confidence intervals or carry out statistical tests—particularly in more complex models that include interactions, polynomial terms, or regression splines. We describe two SPSS macros that implement a matrix algebra method for comparing any two fitted values from a regression model. The !OLScomp and !MLEcomp macros are for use with models fitted via ordinary least squares and maximum likelihood estimation, respectively. The output from the macros includes the standard error of the difference between the two fitted values, a 95% confidence interval for the difference, and a corresponding statistical test with its p-value.     

Group therapy for refugees and torture survivors: treatment model innovations

The paper discusses varieties of group therapies with refugees and torture survivors and the logic behind enhancing traditional group therapies to fit the unique experiences of refugees and torture survivors. It discusses some lessons learned from practice and from empirical research and some recommended adaptations. Finally, it discusses the Center for Torture and Trauma Survivors' therapy group model for torture survivors and describes two of its variants: The Bashal group for African and Somali women and the Bhutanese multi-family therapy group. Group therapies, in this model, extend to community healing. One of the essential and innovative features of the model is that it focuses not only on treating individual psychopathology but also extends to community healing by promoting the development of social clubs and organizations that promote the values and culture of the graduates of the therapy group and the continuation of social support. New graduates from the group join the club and become part of the social advocacy process and of group and community support and healing. This model adds an ecological dimension to the traditional group therapy.     

Trait empathy as a predictor of individual differences in perceived loneliness

Loneliness has been shown to be inversely correlated with empathy in younger adults. The present study extends previous research by investigating the association between empathy and loneliness across the adult lifespan and examining the role of relevant demographic and personality factors. 110 community-dwelling adults (18 to 81 years old) completed the UCLA Loneliness Scale and the Empathy Quotient. Empathy scores were inversely associated with rated loneliness and predicted 8.7% of variance in loneliness scores after accounting for sex, age, relationship status, education, and neuroticism. The Social Skills factor of the Empathy Quotient was the strongest predictor of the association between perceived empathy and loneliness. Previous research is extended by the finding that rated loneliness was inversely associated with empathy scores across the adult lifespan. Underlying this relationship may be negative perceptions of personal social proclivity as a function of difficulty in understanding the mental states of others and high trait neuroticism.