An investigation of the effects of comorbid Axis II pathology on outcome of inpatient treatment for unipolar depression

DSM-based research on comorbidity has suggested thatdepression andpersonality disorder frequently occur together and that the combination of syndromes is associated with a poor response to treatment for depression. The present study was designed to explore the effect of comorbid Axis II pathology for a sample of 45 inpatients who received treatment for major depression. Both categorical and dimensional ratings of personality disorder were used in the statistical analysis. Positive categorical diagnosis of Cluster C (anxious-avoidant) disorder, as well as higher dimensional rating of Cluster A (odd-eccentric) pathology, was predictive of a poor response to treatment (p<.05), as measured by change in pre-post clinical ratings on the Montgomery-Asberg Depression Rating Scale. These results were construed as indicative of a significant Axis II comorbidity effect in the context of an inpatient, multimodal treatment setting for depression. The results also spotlight the influence of techniques of measurement in determining the outcome of statistical analysis.     

HOW FAR SHOULD WE GENERALIZE?

Abstract— A conceptual model based on staffing theory was applied to previously collected survey data from a representative sample of American workers The model links organizational size, workload, work experience variables (felt responsibility and involvement, assessments of work associates), and work outcomes (job satisfaction, work self-esteem, stress symptoms) Path analyses indicated that the model fit data from all waged and salaried workers relatively well When the model was applied to subsamples of new and established employees and of employees from two contrasting occupational groups (professional-technical workers and operative workers), somewhat different patterns emerged The study illustrates the benefits of applying psychological theories across subdisciplines, as well as the limitations of generalizing research findings across different categories of workers We suggest that localized theories and fine-grained analyses of workplace events could help to make research more applicable to work settings     

RESPONSE STYLE AND CROSS-CULTURAL COMPARISONS OF RATING SCALES AMONG EAST ASIAN AND NORTH AMERICAN STUDENTS

Abstract— This report examines cross-cultural differences in response style regarding the use of rating scales Subjects were high school students 944 from Sendai (Japan), 1,357 from Taipei (Taiwan), 687 from Edmonton and Calgary (Canada), and 2,174 from the Minneapolis metropolitan area and Fairfax County, Virginia Responses to fifty-seven 7-point Likert-type scales were analyzed The Japanese and Chinese students were more likely than the two North American groups to use the midpoint on the scales, the U S subjects were more likely than the other three groups to use the extreme values Within each cultural group, endorsement of individualism was positively related to the use of extreme values and negatively related to the use of the midpoint These small, albeit statistically significant, differences in response styles generally did not alter cross-cultural comparisons of item means.     

A classroom demonstration of self-monitoring, reactivity, and interobserver agreement

A brief classroom demonstration designed to introduce students to the concepts of self-monitoring, reactivity, and interobserver agreement is presented. The demonstration provides students with opportunities to monitor their own behavior, record the behavior of others, and calculate interobserver agreement percentages. Results of using the demonstration with students from two classes are presented.     

The role of fairness orientation and supervisor attributions in absence disciplinary decisions

The present study investigated the role of the work value of fairness and attributions regarding the causes of absence in supervisor disciplinary decisions. It was hypothesized that supervisors who valued fairness, and those who made internal attributions regarding the cause of a particular absence incident, render more severe disciplinary decisions than supervisors who value fairness less, and who make external attributions. Furthermore, it was hypothesized that the degree to which supervisors valued fairness moderates the relationship between external attributions and the severity of disciplinary decisions. Using a policy capturing approach, results were consistent with predictions. Implications of the results for research and practice are discussed.     

Stereotyped movement disorder in an adult following acquired brain injury: Effect of environmental stimulation

In the present study, a naturalistic functional analysis procedure was used to assess the effect of environmental stimulation on the stereotypic behavior (body rocking) of an adult whose stereotypy appeared to be induced by an acquired brain injury. Environmental stimulation, operationalized in terms of both physical and social characteristics, resulted in only minimal changes in the occurrence of body rocking. Body rocking occurred in excess of 50% of the observations in all environmental stimulation conditions and in a naturally occurring baseline condition. To our knowledge, this is the first published report of a functional analysis of stereotypy associated with acquired brain injury.     

Case study: Examining the relationship between self-initiations of an individual with disabilities and directive behavior of staff persons in a residential setting

This case study examines the relationship between self-initiations of an adult woman with severe disabilities and the directive behavior of staff persons in a community residential setting. Hypotheses generated from functional assessment procedures indicated that (a) Susan's low self-initiations were very likely related to high directive behavior of staff persons, and (b) infrequent problem behaviors during the morning routine were maintained by escape from repeated staff demands. An intervention was implemented to enable Susan to increase self-initiation in choice and sequence of activities and simultaneously decrease staff directives. Results and discussion focus on the need for a contextual approach for addressing problematic situations and an affirmation of the effectiveness of the positive behavioral support technology for increasing adaptive behaviors in individuals with severe disabilities.     

New directions for the education of clinical psychologists: The primary care setting,the VA's PRIME program,and the in-depth generalist model

As part of this special issue on psychology in primary care settings, we describe the Department of Veterans Affairs' (VA's) new approach to education for practice in the primary care setting and we concurrently address some general issues related to the education of clinical psychologists for practice in this setting. In this article we argue that the primary care psychologist, in parallel with the generalist in medicine, must have a strong generic background in clinical psychology in order to gain the broad range of clinical skills necessary to function effectively as an in-depth generalist (IDG) who is capable of addressing the variety of psychological issues that emerge in the primary care setting. The IDG model of professional practice, which we believe is best suited for primary care/managed care settings, requires extensive training in generic clinical skills and increased time devoted to its implementation at both the predoctoral and the postdoctoral levels.