Expert evidence by psychologists: Sometimes problematic and often premature

This article provides a critical review of two major types of expert evidence: (a) clinical assessments, and (b) generalizations drawn from psychological research. Strong arguments both for and against both types of testimony have been offered by legal experts and psychologists. These arguments are evaluated and the conclusion is drawn that there are two fundamental problems for psychologists in the role of expert. First, the types of assessments clinicians are asked to make (e.g., concerning the accused's mental state at the time of committing the offense) may exceed the capacity of the discipline; such assessments are problematic. Second, the research foundation that psychologists employ in court does not always apply to the court situation in the way experts imply; the application of laboratory research findings to real world contexts is sometimes premature. The article concludes with an admonition that psychologists should adopt a more conservative response to requests to provide expert evidence.     

Relationship of racial stressors to blood pressure responses and anger expression in black college students

The physiological effects of racism, as a stressor, were examined as they related to blood pressure (BP) and anger experiences in Black college students. Current research has failed to consider the stressful effects of racism as a factor contributing to the higher incidence of essential hypertension among Blacks. Twenty-seven Black college students viewed three excerpts showing racist situations involving Blacks; anger-provoking, nonracist situations; and neutral situations. After each scene, BP was taken, and a mood checklist was administered. The Framingham Anger Scale and the Anger Expression Scale were administered. Analyses revealed that BP significantly increased during the presentation of racist stimuli but not of anger-provoking or neutral stimuli. Self-reports of state anger, as measured by the mood checklist, were significant for both the anger-provoking and racist stimuli. BP scores were significantly correlated to the two trait anger measures. Exposure to racist stimuli was associated with BP increases among Blacks. Such cumulative exposure to racism may have important implications for the etiology of essential hypertension.     

The written summary in group psychotherapy revisited

This paper addresses the use of the weekly written summary with patients in group psychotherapy. In an effort to stimulate group process and effect cotherapist communication, the authors instituted this group recording in an ongoing psychodynamically oriented mixed adult group. While the utilization of this device did, in fact, stimulate the group process and became an important part of the group's life, the therapists additionally saw significant effects upon their working alliance. These included increased focused dialogue upon group dynamics, more purposeful planning for group interventions, and heightened awareness of the significance of interventions in the group.Ms. Bosman-Clark is formerly Clinical Instructor, Department of Psychiatry, Baylor College of Medicine.     

Countering perfectionism in research on clinical practice I: Surveying rationality changes after a single intensive ret intervention

The failure of controlled experimental research on therapy out-come to produce findings of clinical as well as statistical significance seems at least partly due to irrational, perfectionistic, beliefs about how research can be used to infer causes of therapeutic change. Irrational beliefs about controlled experimental designs and about incomplete sampling, in particular, appear to prevent appropriate consideration of probatively valuable quasi-experimental research. Models of more rational alternatives are identified, and an example of the functional advantages of adopting these rational beliefs is explicated. The example demonstrates that single-shot pre-post survey data from self-selected catch-as-catch-can samples can permit legitimate, but not absolutely certain, conclusions about the efficacy and efficiency of RET.Albert Ellis, Ph.D. is executive director of the Institute for Rational-Emotive Therapy in New York City.     

Automated data collection using bar code

Using bar code technology to automate data collection provides a rapid and reliable alternative to paper-and-pencil tracking or keyboard entry into pocket or laptop computer. An array of bar code symbols is printed on a data menu, with a unique symbol corresponding to each possible observation. Bar code symbols are scanned using hand-held readers, which record the event, log the observation time, and store data for transfer to a personal computer. Advantages of the bar code monitoring system include: (1) ease of use by staff with minimal technical training, (2) reduced data entry errors and increased entry speed, (3) reliable portable operation, and (4) low-cost hardware. While the bar code system described here is used for behavioral monitoring in a residential treatment setting for the developmentally disabled, with minimal modification this system can be adapted for use in a wide variety of research and clinical applications.     

Dental phobias and anxieties: evidence for conditioning processes in the acquisition and modulation of a learned fear

The present study investigated some of the factors which differentiate individuals with dental anxieties and phobias from those without such fears. In particular, two questions were addressed: (i) What differentiates subjects who have never been anxious about dental treatment from subjects who at some time have been anxious? and (ii) What factors lead to subjects changing their attitudes either from anxious to relaxed or from relaxed to anxious? The results suggest that the factors which influence the acquisition and modulation of dental anxieties are consistent with the associative and representational processes portrayed in contemporary models of human conditioning. Subjects who reported never having had anxieties about dental treatment were less likely to have had a painful dental treatment than subjects who did report an anxiety. Subjects who did report a painful dental experience but did not acquire anxiety reported a history of dental treatment favourable to the operation of latent inhibition. Subjects who reported that they were good at enduring pain were more likely to report a longer interval between their very first dental treatment and their first painful dental treatment. Under some conditions in which latent inhibition should have precluded the acquisition of a dental fear, an anxiety appeared to be acquired because a very painful experience had attenuated the latent inhibition process. Subjects whose dental anxiety did not remit reported significantly more painful and traumatic dental experiences than subjects whose anxiety did remit.     

A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.     

Adolescent suicide attempters presenting to a pediatric facility

This study profiles the characteristics of adolescent suicide attempters and the treatment they received in a pediatric emergency room (ER). A retrospective chart review of 4,072 adolescents seen in the ER at a children's hospital (CH) from July 1984 to June 1985 was undertaken. Twenty-seven adolescents who had deliberately injured themselves were identified. The average age was 14 years 7 months (range 11-19 years). Fifty-two percent of the patients were white and 78% were female. Ingestion was the most common method (78%), followed by attempted hanging (11%), and wrist laceration (7%). After evaluation by a pediatrician in the ER, 30% of the patients were treated and released, 11% were transferred directly to a psychiatric hospital, and 59% were admitted to the CH, with an average hospital stay of 1.88 days. Once hospitalized, consultations from psychiatry (81%), social service (50%), psychology (19%), and neurology (6%) were obtained. At the time of discharge from either the ER or CH, the patients had a variety of plans for ongoing care, with 52% being referred to outpatient counseling, 37% being transferred to a psychiatric hospital, and 11% having no documented plan for ongoing care. These results demonstrate that the evaluation of suicidal adolescents cared for in a pediatric facility may be episodic and suggest the need for a comprehensive program to approach the problem.