New assessment systems for residential treatment,management, research,and evaluation: A symposium

An introduction and overview are presented to new observational assessment systems for ongoing assessment and monitoring of both staff and resident (client or patient) functioning in residential treatment programs for emotionally disturbed and mentally retarded adults.Preparation of articles and the research and development on which the articles are based was supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health, and by grants from the Joyce Foundation and the Illinois Department of Mental Health and Developmental Disabilities.A symposium presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979.     

Systems use to objectify program evaluation,clinical, and management decisions

The utility of the observational assessment systems at different levels — from local clinical to systemwide management — is outlined. An overview is provided of TSBC information applied to individualized problem identification and programming/monitoring, discharge and competency determinations, and both absolute and comparative program evaluation. The utility of SRIC information for prgoramming/monitoring and for staff training and evaluation is outlined in addition to the applied uses of the information of the assessment systems in combination. Once implemented, the continuous data from the systems allow for empirically based self-corrective improvements in the quality of mental health services while automatically providing a basis for legal documentation and accurate cost/effectiveness comparisons of mental health programs.Preparation of this article and the research and development on which the article is based were supported, in part, by Public Health Service Grants MH-15553 and MH-25464 from the National Institute of Mental Health, and by grants from The Joyce Foundation and the Illinois Department of Mental Health and Developmental Disabilities.Presented at the 87th Annual Meetings of the American Psychological Association, New York City, September 1979, as part of a symposium on New assessment systems for residential treatment, management, research, and evaluation.     

Numerical taxonomy of aphasia

Two hundred consecutively seen aphasics, 142 of them with infarcts, were examined by tests of fluency, comprehension, repetition, naming, and information content. The language scores were subjected to a minimum variance clustering algorithm separately for the total and for the infarct groups. The latter generated 10 clusters on a dendrogram. Attribute analysis of each cluster provided a clinically meaningful profile of language performance for these groups. The degree of correlation of most computer generated clusters with clinically recognized groups was high, and the homogeneity of some of the clusters is striking. An exception appears to be “conduction aphasia,” which is bimodally distributed. One of these clusters, with high fluency and low comprehension scores, was renamed “afferent conduction” aphasia, and the other, with lower fluency and higher comprehension, was renamed “efferent conduction” aphasia. The Principal Components Analysis was used to evaluate the discriminatory value of language characteristics, and the Nearest Neighbor Network Analysis was used to evaluate the significance of clustering. The dendrogram for all aphasics showed a less specific and less homogenous six clusters.     

Generalization effects of social skills training in chronic schizophrenics: An experimental analysis

Social skills training was administered to three (one male and two female) chronic schizophrenic patients in a Partial Hospitalization Service. Treatment consisted of instructions. feedback and modeling, and was administered in 25. 26 and 31 sessions, respectively, for the three patients. Target behaviors were identified for each patient based on his/her responses to role-played interactions involving male and female partners in situations requiring commendatory or hostile assertion. Five to seven target behaviors were selected for each subject and were treated sequentially in a multiple baseline format. Skills training was highly successful for the two female patients but was only partially effective for the male patient. Two forms of generalization measures were included, indicating that the effects of training generalized from trained to untrained, and trained to novel role-played interactions. Follow-up assessments for the two female patients indicated that most of the effects persisted over 8–10-week post-treatment periods.     

Infants’ behavioral styles in joint attention situations and parents’ socio-economic status

In this study the eco-cultural model of parenting (Keller, H. (2007). Cultures of infancy. Mahwah, NJ: Erlbaum) was applied to the study of joint attention behavior of children from families with different socio-economic status (SES). It was hypothesized that infants’ early communication styles would differ with SES reflecting more independent or interdependent interactions with their caregivers. It was also hypothesized that infants would use the same types of behaviors whether they have declarative or imperative communication goals. The Early Social Communication Scales (ESCS, Mundy et al., 2003) was administered to 103 typically developing infants of 12 months (approximately half of them siblings of children with autism). A factor analysis, yielding four behavioral factors, namely pointing, eye contact, actions and following points, confirmed the hypothesis that infants use behaviors consistently across situations independent of their communicative intent. MANOVAs (comprising parental education and income) revealed that higher SES infants showed actions more frequently in the ESCS whereas lower SES infants followed experimenter's points more frequently. The results are discussed in the context of presumably differing socialization goals for infants and the divergent contribution of parental education and income that seem to have additive contribution to some factors (actions, following points) but divergent contributions to others (pointing, eye contact).     

Changing the Criminal Justice System Response to Sexual Assault: An Empirical Study of a Participatory Action Research Project

In jurisdictions throughout the United States, thousands of sexual assault kits (SAKs; also known as a “rape kits”) have not been submitted by the police for forensic DNA testing. DNA evidence may be helpful to sexual assault investigations and prosecutions by identifying perpetrators, revealing serial offenders through DNA matches across cases, and exonerating those who have been wrongly accused. This paper describes a longitudinal action research project conducted in Detroit, Michigan after that city discovered approximately 11,000 untested sexual assault kits in a police department storage facility. We conducted a root cause analysis to examine individual, organizational, community, and societal factors that contributed to the development of the rape kit backlog in Detroit. Based on those findings, we implemented and evaluated structural changes to increase staffing, promote kit testing, and retrain police and prosecutors so that cases could be reopened for investigation and prosecution. As we conducted this work, we also studied how this action research project impacted the Detroit criminal justice system. Participating in this project changed stakeholders’ attitudes about the utility of research to address community problems, the usefulness of DNA evidence in sexual assault cases, and the impact of trauma on survivors. The results led to new protocols for SAK testing and police investigations, and new state legislation mandating SAK forensic DNA testing.     

Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

初中生友谊质量与孤独感的变化轨迹:一项多元潜变量增长模型分析

为考察初中生友谊质量与孤独感的变化轨迹及两者间的关系,采用关系网络问卷、孤独感量表对西安市的875名初中生（M=12.73±0.18;男生494名）进行三年追踪测量,使用多元潜变量增长模型进行分析。结果发现：（1）初中三年,中学生的友谊质量逐渐提高,孤独感水平逐渐下降;（2）初一时的友谊质量和孤独感水平存在显著的个体差异,初中三年期间二者的发展速度也存在个体差异;（3）初一时的友谊质量可显著预测初一时的孤独感水平（β=-1.77,p<0.001）及随后的发展速度（β=0.20,p<0.05）;（4）男生的孤独感水平初始值高于女生,友谊质量的初始值则低于女生;高SES个体孤独感的起始值高于低SES个体。本研究结果揭示了初中三年期间个体友谊质量与孤独感的动态变化关系及友谊质量对孤独感的预测作用,对改善青少年孤独感的现状有一定的现实指导意义。