Relative Value Units: Using the New “Currency” for Measuring Clinical Productivity in a Productivity/Incentive Plan

This paper presents an overview of a productivity/incentive plan for faculty in an academic medicine center's department of behavioral medicine and psychiatry. The model utilizes the Resource-Based Relative Value Scale (RBRVS) for its measurement of clinical productivity. The paper provides an introduction to RBRVS terminology and how the RBRVS system was developed. The productivity/incentive plan developed for the Department of Behavioral Medicine and Psychiatry, West Virginia University School of Medicine, Morgantown, is described. The advantages and limitations of utilizing Relative Value Units (RVUs) in a productivity model are discussed. The paper may provide helpful insights to those charged with developing productivity/incentive plans at other academic health science centers.     

珠心算的心理机制实验研究述评

本文回顾了近年来有关珠心算心理机制的实验研究,指出该方面的研究主要是通过采用”专家一新手“对比的研究方法,探索珠心算训练对记忆广度、记忆的迁移、加工方式及左右脑功能的影响。     

掩蔽刺激的空间参考框架对视觉表象旋转的影响

本实验通过将具有参考框架信息的前置刺激改为掩蔽刺激,进一步探讨参考框架的变化和表象旋转的过程。结果表明：１、因掩蔽刺激而引起的主观参考框架的产生是瞬间完成的,而不是由原先直立的参考框架经过连续旋转后形成的。２、显示了倾斜字母的加工不完全是整体表象的线性旋转过程,而可能是整字一成分的混合加工过程。     

Evaluation of a sexual abuse prevention program for adults with mental retardation.

Programs to teach sexual abuse prevention skills to persons with mental retardation have rarely been evaluated empirically, and typical evaluations are limited to assessment of the participants' knowledge rather than their performance of specific skills. In the present study, 6 adult women with mental retardation were trained in sexual abuse prevention, and performance was assessed using four separate measures: pretests and posttests of knowledge, verbal report, role play, and naturalistic probes. All women learned the skills but failed to exhibit them to criterion during the probes. We discuss the implications for further training and assessment of sexual abuse prevention skills.     

IDENTIFICATION AND VALIDATION OF CRITICAL CONVERSATIONAL SOCIAL SKILLS

In this study, we used a four-step social validation process to identify and validate critical skill components that constitute high school students' conversational behavior. The four steps were nominating target behaviors, establishing a normative range of performance, manipulating simulations of behavioral dimensions, and comparing ratings of judges to levels of performance on those behavioral dimensions. Multiple measures, both quantitative and qualitative, suggested that the rate and percentage of time initiating and responding verbally, the percentage of time attending, and the percentage of time not engaging in distracting motor behavior related to favorable ratings by a wide variety of 60 judges. Findings are discussed in relation to the utility of the multistep social validation process and the identification of critical social skill components as targets of interventions.     

Neuroticism,coping and change in MCMI-II clinical syndromes: test of a mediator model

The aim of the study was to examine prospectively whether coping mediated the relation between Neuroticism and change in different clinical mental syndromes. Assessments were conducted with 154 former psychiatric outpatients six and seven years after their initial contact with an outpatient clinic. Dispositional coping mediated the relation between Neuroticism and change in four of the nine clinical scales of the Millon Clinical Multiaxial Inventory (MCMI-II) (Millon, 1987). High Neuroticism led to coping strategies of disengagement and the venting of emotions and to a lack of problem-focused coping, which in turn translated into a relative increase on the MCMI-II scales. The mediator model of coping was found to apply to the MCMI-II scales "somatoform disorder’, ‘dysthymia’, ‘alcohol dependence’ and ‘thought disorder’. Results are discussed under the perspective of an integration of the positions of the transactional theory of stress and personality psychology. .     

“Nothing About Me, Without Me”: Participatory Action Research with Self-Help/Mutual Aid Organizations for Psychiatric Consumer/Survivors

Participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors is reviewed. We begin by tracing the origins of and defining both participatory action research and self-help/mutual aid. In so doing, the degree of correspondence between the assumptions/values of participatory action research and those of self-help/mutual aid for psychiatric consumer/survivors is examined. We argue that participatory action research and self-help/mutual aid share four values in common: (a) empowerment, (b) supportive relationships, (c) social change, and (d) learning as an ongoing process. Next, selected examples of participatory action research with psychiatric consumer/survivor-controlled self-help/mutual aid organizations which illustrate these shared values are provided. We conclude with recommendations of how the key values can be promoted in both the methodological and substantive aspects of future participatory action research with self-help/mutual aid organizations for psychiatric consumer/survivors.     

The Timing of Conscious Experience: A Critical Review and Reinterpretation of Libet''s Research

An extended examination of Libet's works led to a comprehensive reinterpretation of his results. According to this reinterpretation, the Minimum Train Duration of electrical brain stimulation should be considered as the time needed to create a brain stimulus efficient for producing conscious sensation and not as a basis for inferring the latency for conscious sensation of peripheral origin. Latency for conscious sensation with brain stimulation may occurafterthe Minimum Train Duration. Backward masking with cortical stimuli suggests a 125–300 ms minimum value for the latency for conscious sensation of threshold skin stimuli. Backward enhancement is not suitable for inferring this latency. For determining temporal relations between stimuli that correspond to subjects' reports, theendof cerebral Minimum Train Duration should be used as reference, rather than its onset. Results of coupling peripheral and cortical stimuli are explained by a latency after the cortical Minimum Train Duration, having roughly the same duration as the latency for supraliminal skin stimuli. Results of coupling peripheral stimuli and stimuli to medial lemniscus (LM) are explained by a shorter LM latency and/or a longer peripheral latency. This interpretation suggests a 230 ms minimum value for the latency for conscious sensation of somatosensory near-threshold stimuli. The backward referral hypothesis, as formulated by Libet, should not be retained. Long readiness potentials preceding spontaneous conscious or nonconscious movements suggest that both kinds of movement are nonconsciously initiated. The validity of Libet's measures of W and M moments (Libet et al., 1983a) is questionable due to problems involving latencies, training, and introspective distinction of W and M. Veto of intended actions may be initially nonconscious but dependent on conscious awareness.     

Parent Satisfaction with Case Managed Systems of Care for Children and Youth with Severe Emotional Disturbance

Case management has emerged as an integral component of current efforts to reform the delivery of mental health services to children and youth with Severe Emotional Disturbance (SED). We examined parental satisfaction with one program's case management system for SED children. In order to validly address parental satisfaction, the program first turned to a group of its parents to develop a satisfaction measure, the Family Satisfaction Survey (FSS). Of the 51 parents who returned an FSS, 74% of the parents were generally satisfied while 26% indicated that they were dissatisfied with their families' case management services. Multivariate regression analyses were employed to examine the role played by client, service, and outcome variables in predicting parental satisfaction. After controlling for child diagnoses, severity of impairment, and levels of psychosocial stress, parent satisfaction with case management services was best predicted by the frequency of monthly contact and fewer days is a psychiatric hospital proportional to length of service. Our results suggest that parent satisfaction is based not only on what case managers do but on how this service impacts SED children's ability to remain at home and in their communities.     

The Client Cultural Competence Inventory: An Instrument for Assessing Cultural Competence in Behavioral Managed Care Organizations

The rapid growth in Behavioral Managed Care Organizations has led to increasing concern about the future availability of culturally competent mental health services for ethnic minorities. Prior efforts to assess cultural competence of mental health services have focused exclusively on agency providers and individual mental health professionals rather than on clients' perceptions of care. We introduce the Client Cultural Competence Inventory, which has several advantages over other cultural competence measures including its (a) lower susceptibility to social desirability bias, (b) ability to assess attitudes concerning a broader range of therapists, providers and plans, and (c) focus on clients rather than the psychiatric community as the central force in determining cultural competence. Preliminary psychometric analyses of the inventory are presented from data gathered in a group of parents with children who are severely emotionally disturbed.