The Role of Schools in Outcomes for Youth: Implications for Children's Mental Health Services Research

We explore the role of schools in children's mental health services research. Recent literature has suggested that schools play an important role in delivering services to children and adolescents with emotional and behavioral problems. Research in services research, though, has taken a fairly narrow view of which dimensions of school environments are relevant for inclusion in studies. We suggest that a broader view of school environments is appropriate and potentially beneficial to the field. Using Bronfenbrenner's ecological model as a guide, we conceptualize schools as microsystems. Such an approach suggests that all aspects of school environments (treatment as well as non-treatment) are likely to influence many of the outcomes that children's mental health services research frequently targets (e.g., behavioral problems, problematic peer relationships, academic achievement, school attendance). We review literature from a variety of disciplines to suggest relevant features of schools, with particular attention to the role of peer dynamics within schools. We conclude with implications of this expanded conceptualization of schools for children's mental health services research.     

Applying Utilization Management Principles to a Comprehensive Service System for Children with Emotional and Behavioral Disorders and Their Families: A Feasibility Study

The Comprehensive Services Act for At Risk Youth and Families of Virginia (CSA), is a service, funding, and organizational reform initiative designed to improve the provision of child centered and family focused services within a community setting. We conducted this study in order to assess the feasibility of applying utilization management principles to the CSA in order to improve the appropriateness, quality, and cost effectiveness of this service delivery system. Data were gathered through focus groups, surveys, clinical profiling, and analysis of costs, and service utilization. While overall program costs increased since inception of the program, the costs per child served rose less than the rate of inflation. CSA appeared to be serving children with a high degree of emotional and behavioral difficulties. There was considerable variation among localities in placement patterns. A majority of survey and focus group respondents were willing to consider the application of utilization management principles to the CSA as long as decision making remained within localities. We concluded that there is a constructive role for utilization management approaches to improve the appropriateness and quality of services as well as enhancing efficiency in child mental health.     

A Comparison of Three Methods of Teaching Skin Self-Examinations

Skin self-examinations are essential for the early identification and treatment of skin cancers. However, little is known about the most effective methods for teaching skin cancer detection and skin self-examination. This study compared three skin cancer education methods that are commonly used in the primary care setting: viewing a videotape, reading brochures, and one-on-one instruction from a nurse practitioner. One hundred forty-three young adults were randomly assigned to one of the four conditions (educational intervention or wait list) and completed measures of skin cancer knowledge, ability to visually discriminate cancerous versus noncancerous skin growths, and behavioral ability to perform a skin self-examination immediately (Time 1) and 3 weeks (Time 2) after the educational intervention. Results showed that participants across all educational interventions had significantly higher skin cancer knowledge compared to those in the wait-list control group, and these knowledge scores were maintained for 3 weeks. Participants in the brochure condition scored significantly higher than participants in all other conditions on an observational measure of skin self-examination. Demographic variables, such as gender and ethnicity, were not found to be related to performance on any of the dependent measures. These findings provide preliminary evidence that knowledge of skin cancer may be enhanced through a variety of educational techniques and that written materials (e.g., brochures) may represent the minimal intervention level necessary for teaching adults how to perform thorough skin self-examinations.     

A History of the Association of Medical School Psychologists

While psychologists have been active faculty members in medical schools for over 85 years, they lacked organization on the national level until 1981. This history traces the background of psychology's involvement in medical schools, landmark events that affected the discipline, and progress since formal organization has occurred. Office of the Senior Vice President and Provost     

Faulty Judgment,Expert Opinion,and Decision-Making Capacity

An assessment of decision-making capacity is the accepted procedure for determining when a person is not competent. An inferential gap exists between the criteria for capacity specific abilities and the legal requirements to understand relevant information and appreciate the consequences of a decision. This gap extends to causal influences on a person'scapacity to decide. Using a published case of depression, we illustrate that assessors' uses of diagnostic information is frequently not up to the task of bridging this inferential gap in a justifiable way. We then describe cases of faulty judgement which challenge the understanding of diagnostic causal influences. These cases help to clarify the nature of the expertise required for capacity assessments. In practice, the requirements of decision-making capacity are often abandoned to other considerations due to a lack of requisite expertise. The legal policy supporting decision-making capacity as a means to protective intervention is justified only if the requisite expertise is developed. We propose the requisite expertise to be developed in the long term as a distinct multidisciplinary endeavour.     

消费者产品质量知觉研究

本文探讨了品牌、产地、价格、服务及消费者的知识经验对消费者产品质量知觉的影响。结果表明：１、品牌、产地、服务对消费者的产品质量知觉有显著影响;２、消费者对名牌产品的质量知觉显著高于不知名品牌,对进口产品质量知觉显著高于国产产品,对服务好的产品质量知觉显著高于服务差的产品;３、知识经验丰富的消费者的产品质量知觉易受品牌的影响,而知识经验不足的消费者的产品质量知觉易受价格、服务的影响。     

思维风格测验在大学生中的初步应用

本文介绍了斯腾伯格的心理自我管理理论并使用斯腾伯格所编制的思维风格问卷对大学生的思维风格进行了测量,比较了思维风格在性别、文理科、地域等方面的个体差异,得出了中国大学生在思维风格方面的一些特点;研究了思维风格与一般智力的关系,发现思维风格与智力相关很低,说明思维风格是一种独立于智力的特质;同时对思维风格量表的信、效度及量表的结构进行了探讨。     

AUGMENTING SIMPLIFIED HABIT REVERSAL IN THE TREATMENT OF ORAL-DIGITAL HABITS EXHIBITED BY INDIVIDUALS WITH MENTAL RETARDATION

We investigated whether a simplified habit reversal treatment eliminates fingernail biting and related oral-digital habits exhibited by individuals with mild to moderate mental retardation. Although simplified habit reversal did little to decrease the target behaviors for 3 of 4 participants, simplified habit reversal plus additional treatment procedures decreased the behavior to near-zero levels for all participants. These procedures included remote prompting, remote contingencies involving differential reinforcement plus response cost, and differential reinforcement of nail growth. Limitations of habit reversal for individuals with mental retardation along with directions for future research involving therapist-mediated treatment procedures, particularly those involving remote prompting and remote contingencies, are discussed.     

汉语背景下横纵轴上的心理时间线

采用反应区分范式, 以表示过去和未来的时间词为刺激, 对汉语背景下横、纵两轴上的时间表征情况进行了探讨。结果发现, (1)横、纵轴方向上都出现了STEARC效应; (2)右对角线方向上, 出现了服从横轴的减弱的STEARC效应, 且STEARC效应值呈正态分布。以上结果表明, 汉语背景下既存在从左向右的心理时间线, 也存在从上到下的心理时间线, 两种时间表征同时存在, 且横轴表征倾向于占优势。     

Longitudinal trajectories of bicultural identity integration in recently immigrated Hispanic adolescents: Links with mental health and family functioning

This study examined, in a sample of recently immigrated Hispanic adolescents in Miami and Los Angeles, the extent to which bicultural identity integration (BII; involving the ability to synthesise one's heritage and receiving cultural streams and to identify as a member of both cultures) is best understood as a developmental construct that changes over time or as an individual‐difference construct that is largely stable over time. We were also interested in the extent to which these trajectories predicted mental health and family functioning. Recent‐immigrant 9th graders (N = 302) were assessed 6 times from 9th to 12th grade. Latent class growth analyses using the first 5 timepoints identified 2 trajectory classes—one with lower BII scores over time and another with higher BII scores over time. Higher heritage and US identity at baseline predicted membership in the higher BII class. At the 6th study timepoint, lower BII adolescents reported significantly poorer self‐esteem, optimism, prosocial behaviour and family relationships compared with their higher BII counterparts. These findings are discussed in terms of further research on the over‐time trajectory of biculturalism, and on the need to develop interventions to promote BII as a way of facilitating well‐being and positive family functioning.