Physical characteristics of residential psychiatric and substance abuse programs: Organizational determinants and patient outcomes

Described the Physical and Architectural Characteristics Inventory (PACI), which assesses the physical characteristics of hospital- and community-based psychiatric and substance abuse residential treatment programs for adults. Developed using data from 94 representative programs, the PACI has 7 dimensions that assess community accessibility, physical features that add convenience, aid recreation, and provide support for patients, and space for patient and staff functions. In comparison to community-based programs (n=63), hospital programs (n=31) had more social-recreational and prosthetic aids, safety features, staff facilities, and space. The PACI dimensions were also related to other organizational features, such as facility ownership and program size and staffing level. Programs with more physical amenities had patients who were more involved in self-initiated and community activities and were more likely to successfully complete the program and be discharged to independent living situations and paid jobs. Programs with more social-recreational and prosthetic aids, space, and access to community resources also had better patient outcomes. In addition, PACI dimensions were related to observers' ratings of facility attractiveness. Potential applications of the PACI and the full inventory of which it is a part are discussed.     

Effects of diagnostic classification systems on clinical hypothesis-generation

In this study it was determined whether (a) classification as opposed to absence of classification has an effect on the quality of clinical hypotheses (b) the DSM-III-R and the CBCL have a different effect on the quality of clinical hypotheses, and (c) the potential difference between the DSM-III-R and the CBCL is moderated by the different number of syndromes identified by these systems. To investigate these questions, an experiment was conducted in which 86 clinicians generated hypotheses for six cases. The clinicians were divided into a DSM-III-R, a CBCL, and a control group. Of the six cases, two were classified by both classification systems as one syndrome, two were classified as one syndrome by the DSM-III-R but as two syndromes by the CBCL, and two were classified as two syndromes by the DSM-III-R but as one syndrome by the CBCL. The quality of the hypotheses was determined by means of four dependent variables selected from an overview of qualitative criteria: explanatory value, redundancy, possibility of operationalization, and specificity. No differences between the CBCL and the control groups were found. The DSM group performed better than the control group regarding explanatory value and redundancy. The DSM-III-R group also scored better than the CBCL group regarding explanatory value, particularly when the number of identified syndromes was two for the CBCL and one for the DSM-III-R.     

Diagnosing posttraumatic stress disorder with the MMPI clinical scales: A review of the literature

A review of the literature resulted in 21 published studies that reported mean MMPI profile patterns for PTSD patients. Of these, six (29%) reported that the mean 8-2 profile pattern significantly differentiated PTSD patients from non-PTSD patients. The majority of studies found additional PTSD profile patterns reflecting nearly all of the MMPI clinical scales. The data indicate some common group profile patterns for inpatient veterans, prisoner's of war, and inpatient veteran substance abusers. The results also support the hypothesis that there is a continuum from inpatient to outpatient and veteran to civilian populations that corresponds with both symptom and stressor severity. It is concluded that although there is some typicality in similar populations, clinicians should expect heterogeneous MMPI profiles from PTSD patients representing a diversity of clinical symptoms and styles.     

Sexual responding of “nonrapists” to aggressive sexual themes: Normative data

The present study presents data relevant to the sexual responding to aggressive cues of a large sample of nonrapist males recruited from the community. Two hundred three subjects received physiological assessment of sexual arousal to heterosexual and rape stimuli. Results indicated that under instructions not to interfere with sexual responding, approximately 80% of the nonrapists would be correctly classified, which was significantly different from chance. However, under instructions to suppress arousal, classification was no better than chance. The rape index was not related to age, socioeconomic status, sexual experience, or amount of arousal shown in the laboratory. However, there was a small but significant relationship to IQ. Overall, the data suggest that for instructions not to interfere with responding, the error rate seen in this larger-scale sample was equivalent to that in previous studies using smaller normative samples and that classification in general is not biased by the subject characteristics measured in this study.Portions of this project were supported by USPHS Grant MH-34030-02 from the Center for the Studies of Crime and Delinquency and by Tennessee Department of Mental Health and Mental Retardation Research Contract ID-0783 to the Department of Psychiatry.     

Attention demands of movements as a function of their duration and velocity

The attention demands of initiating and controlling discrete movements were examined as a function of their movement time (MT) and average movement velocity. Experiment 1 showed that the attention required to execute a movement decreased as MT decreased, although Experiment 2 through independently manipulating MT and movement velocity, revealed that movement velocity is the key determiner of attention demands rather than MT. The attention demands of preparing a high velocity movement are greater than during its execution with the reverse being the case for relatively slow velocity movements. The results are compatible with the view that it is the initiation of error corrections that are attention demanding (Keele 1973).     

Sensitivity of 5- and 7-month-old infants to pictorial depth information

An Ames (1951, Psychological Monographs, 65(1, Whole No. 324)) static trapezoidal window, under monocular view, was used to test young infants' responsiveness to pictorial depth. When adults view this display monocularly with the smaller side of the window rotated toward them, they report that the orientation of the display becomes ambiguous: When the head is moved, the window may appear to be in the fronto-parallel plane or either side may appear closer. The 7-month-olds we tested appeared to experience a similar ambiguity; they reached to the near side of the rotated trapezoidal window with significantly less consistency or directedness than infants in a control group tested with a rotated object that lacked pictorial depth information. When 5-month-olds were tested, however, they reached with equal consistency to the closer side of the trapezoidal window and of the control display, apparently uninfluenced by the pictorial depth information available in the trapezoidal window. Thus, sensitivity to the pictorial information for depth that is present in the trapezoidal window appears to develop after the age of 22 weeks.     

An observational case study of failure in social problem-solving

An observationally based assessment of social problem-solving skill was contrasted with more traditional testing methods. A preschool child with low social success was chosen for a demonstration profile analysis. The relative frequencies of the social goals, strategies, and targets shown by this child during free play were plotted in relation to that of his same-sex peer group. Parallel profiles of his relative success with specific goals, strategies, and targets were also constructed and compared to relevant group means and standard deviations. Specific social problem-solving strengths and weaknesses were identified from these profiles, using both intra- and interindividual analyses. The benefits and limitations of this approach for measurement and treatment of social problem-solving deficits were discussed.     

Adolescents' perceptions of friends' and parents' attitudes to sex and sexual risk-taking

This study investigated the association between adolescents' perceptions of parental and peer attitudes towards sexuality and AIDS precautions, and the risky sexual behaviours of 1008 sexually active, heterosexual undergraduate students aged 17-20 years. Students were asked to rate the extent to which their mothers, fathers and friends would agree or disagree with 16 statements reflecting support of the adolescent engaging in sexual behaviour and using sexual precautions, including precautions against AIDS. The adolescents also indicated whether they were sexually active and their level of condom use in both ‘regular’ (or steady) and ‘casual’ relationships. Results indicated that adolescents perceived their parents as non-liberal in their sexual attitudes and relatively unlikely to discuss sex or precautions with them. Parents were viewed as more accepting of their sons' sexual behaviours than of their daughters'. Adolescents believed that peers were more likely to discuss sexuality and precautions than parents, and were more liberal in their sexual attitudes. Adolescent sexual risk-taking was related to the perceived attitudes of significant others in ways which varied across gender and type of relationship. Implications for interventions are discussed.     

Interpersonal problem solving: An intervention program for preschool children

The purpose of the present study was to evaluate the effectiveness of an intervention program designed to train preschool children in interpersonal problem solving skills. Forty preschool age children were randomly assigned to an experimental or control group. Experimental subjects were trained in interpersonal problem solving skills for ten weeks, four days per week, for a total of 10–13 hours. Problem-solving skills were assessed at pretest, posttest, and three months after training was completed. Seventy-eight percent of the children who participated in pretest and posttest were tested at follow-up. Results indicated that the experimental group, compared to the control group, showed a significant increase in both cognitive—verbal and behavioral interpersonal problem-solving skills from pretest to posttest and that these changes were maintained at follow-up testing. Discussion focuses on suggestions for future research and implications for applied settings.