Building and Maintaining Clinical Programs

This paper describes the basic elements of practice development and management within the academic medical setting. These include assessment of the market environment, both in the community and within the medical setting, product development, marketing, budget basics, quality, managed care negotiations, and finding time to do research in a financially-driven health care system.     

Termination of Mental Health Services for Children

In this paper, we examine the termination of children's mental health services. Analyses were based on the 901 families in the Fort Bragg Evaluation Project who participated at Wave 1 and Wave 2 six months later. The project compared a full continuum of care provided at a demonstration site with traditional care at two comparison sites. The results showed that in most cases families and providers were partners in decisions to terminate treatment. About half of the clients self-terminated or were terminated solely at the discretion of the provider. Providers tended to play a more dominant role in terminating restrictive services; families played a more central role in terminating outpatient care. Regardless of initial psychopathology, children in single-headed households, whose parents were dissatisfied with services, did not expect their child to cooperate with treatment and did not expect treatment to help their child, were more likely to terminate care than others. While the Demonstration site had significantly fewer terminations, the sites did not differ with regard to the reasons for termination, who participated in termination decisions, or the factors that affected the likelihood to terminate care. Of most interest, mental health outcomes among children who had terminated all care did not vary by reasons for termination or by who participated in the termination decision.     

The Future of Psychology in Departments of Psychiatry

Health care reform has put increasing pressure on faculty of medical schools to become self-supporting. Opportunities for clinical revenue will decrease, but psychologists who are able to generate research funding will become increasingly competitive, albeit as mercenaries, i.e., capable of paying their own way plus generating a profit to support departmental operations and educational programs. Changes in the health care system signal an end to psychiatry's paternalistic relationship to psychology and present opportunities for psychology proactively to influence its future role in health care. Research, political action, and revised scientific mission, models, and roles represent important strategies in the redefining of psychology as a basic science and major profession in health care.     

Flexibility of Labor, Well-Being, and Stress

After a short introduction into the changing nature of our society and organizations, we outline two kinds of flexibility of labor: qualitative flexibility, that is the degree to which people who work in or for a certain organization can and do perform different tasks, and quantitative flexibility, that is, varying the quantity of personnel and their working hours. Then, the different ways in which we organize our work and organizations are dealt with in terms of quantitative and qualitative flexibility. Next, we survey these ways of organizing on the degree to which they moderate the positive individual outcomes, or individual goals, of work. It can be concluded that quantitatively flexible work, besides some minor positive consequences, may have serious negative consequences for one's well-being, health, and personal development, while qualitative flexibility may have many more advantages, though it may lead to a devastating task overload. Last, we explore some ways to alleviate these negative effects.     

The use of the occupational stress indicator (OSI) in factory workers in China

The purpose of the study was to investigate occupational stress among Chinese factory workers (N=342), from three cities of South East China, using the shortened version of the Occupational Stress Indicator (OSI)-2. The results showed that the reliabilities and predictive validity of the OSI-2 subscales and other subscales used for the study were reasonably high. Quite a high percentage of workers perceived high work pressure. The main sources of stress were intrinsic to the job; and the coping strategies that were most frequently used to tackle stress were “control” methods. In addition, “satisfaction on environmental condition” seemed to be a common predictor for job satisfaction, and mental and physical well-being. The logical relationships between job satisfaction, mental well-being and physical well-being in Chinese workers have provided support to the findings obtained in Western countries.     

时序信息的加工:自动还是控制

从长时记忆的角度出发,以故事的形式为实验材料,对时序信息的加工方式和通道效应进行了研究。结果表明,时序信息的加工存在视听通道效应,通道效应的机制源于记忆,且与加工方式有关。时序信息三个属性的加工方式不同：顺序属性倾向于自动加工;位置属性,就视觉信息来说倾问于自动加工,听觉在有顺序标码情况下倾向于自动加工、而在无顺序标码情况下则是一控制加工过程;间隔特性是一个控制加工过程。     

自由回忆和线索回忆测验中的系列位置效应

本文以96个中国汉字为材料,使用自由回忆和线索回忆测验方法,对20名被试进行6组分测验和最后所有汉字的总测验。发现自由回忆分测验中存在明显的系列位置效应,总测验出现负近因现象;线索回忆分测验也表现出明显的系列位置效应,但最后的总测验没有出现负近因现象。上述结果验证了Bjork和Whitten（1974）提出的顺序或情景理论。     

卡车驾驶员速度估计研究

用速度知觉测试仪,对251名男性卡车驾驶员在四种实验条件下的速度估计准确性进行了测量。结果发现：安全组卡车驾驶员的速度估计准确性优于事故组卡车驾驶员,两者在低速条件下差异不显著,高速条件下差异显著;事故组卡车驾驶员的高估次数高于安全组卡车驾驶员,低速条件下两者不显著.高速条件下差异显著;事故多发组与安全组卡车驾驶员的速度估计准确性在高速及低速长距离条件下差异显著;速度及距离对速度估计准确性有显著影响,且两者之间存在显著的交互作用;年龄对速度估计准确性无显著影响。     

On the dynamics of dying

This study is concerned with dynamic processes that underly the rapid, degenerative changes associated with the “dying” stage of the multicellular organism's life cycle. The interaction between negative and positive feedback cycles is discussed: negative feedback cycles underly the superstability characteristic of health and illness. When negative feedback cycles fade in the dying phase of life, positive feedback cycles, previously held in check by the negative feedback cycles to which they had been coupled, rise explosively, driving physiologic variables from their normal values towards extremes. This results in the rapid downturn that we associate with dying—an accelerating disintegration terminating in death. A medical case history is analyzed.     

Data Smoothing: Prediction of Human Behavior, Detection of Behavioral Patterns, and Monitoring Treatment Effectiveness in Single-Subject Behavioral Studies

Data-smoothing can be particularly useful in predicting human behavior, detecting behavioral patterns, and monitoring treatment effectiveness in highly variable single-subject behavioral experiments that cannot be determined by only visual inspection of their graphs. Using an example from the applied behavior analytic literature, the use of moving-average and exponential data-smoothing aided the detection of the unique behavioral patterns of a child with autism across different treatments. Furthermore, the utility of the data-smoothing procedures to monitor and control the effectiveness of an intervention is discussed. The ease of their calculations suggest use of data-smoothing by behavior analysts whenever the effects of particular interventions are questionable.