Factor structure of the Treatment Evaluation Inventory: Implications for measurement of treatment acceptability

The Treatment Evaluation Inventory (TEI), a frequently used measure of treatment acceptability, was used by 164 undergraduates to rate the acceptability of each of the following treatments: differential reinforcement of other behavior, exclusionary time-out, overcorrection, medical restraint, contingent electric shock, and physical restraint. TEI ratings of each treatment type were grouped separately, variance-covariance matrices were formed and compared, and data were subjected to factor analysis. The results indicated that the factor structure of the TEI varied with the treatment it was used to evaluate. Item analysis of the TEI indicated a high degree of internal consistency, although item-total correlations varied between rated treatments. The findings suggest that although the TEI is a reliable instrument, sensitive assessment of the treatment acceptability construct probably requires multidimensional measurement.     

The design and use of the Bioethics Consultation Form

The emergence of the ethics consultation as a means to resolve moral crises in clinical medicine has revealed the need for a worksheet that would facilitate intake and analysis. The author developed the Bioethics Consultation Form as an attempt to remedy this need. The form is arranged in an outline format and is a useful asset to ethics committee discussions and record keeping. The first section covers basic intake data concerning the patient's medical and personal information, advance directives, and values, as well as the values of the physician and family. After the intake section is completed with the above data, the ethics consultant then turns to the analysis section. This second section allows for (1) the discussion of conflicting values, (2) the identification of priorities, and (3) the elucidation of ethical norms relevant to the case.The Bioethics Consultation Form was adopted by the Patient Care Advisory committee of the Franklin Square Hospital Center in Baltimore, Maryland in 1986. The methodology in the use of the form will be discussed. Further, the potential spectrum of consultative cases that can be analyzed using the form will be highlighted.     

Making peace in gestational conflicts

Mary Anne Warren's claim that there is room for only one person with full and equal rights inside a single human skin ([1], p. 63) calls attention to the vast range of moral conflict engendered by assigning full basic moral rights to fetuses. Thereby, it serves as a goad to thinking about conflicts between pregnant women and their fetuses in a way that emphasizes relationships rather than rights. I sketch out what a care orientation might suggest about resolving gestational conflicts. I also argue that the care orientation, with its commitment to the significance of the partial and the particular, cannot be absorbed within standard, impartialist moral theory.     

Three intensive community-based programs for children and youth with serious emotional disturbance and their families

Systems of care for children with serious emotional disturbance and their families have generally lacked intensive community-based programs. We describe three types of newly established community-based programs in New York State and present a general evaluation plan for determining which programs work for various children and their families. The three community-based programs are Intensive Case Management, Family-Based Treatment, and Family-Centered Intensive Case Management. Process and outcome evaluations are being conducted for each of these programs. These evaluations make use of common intake and termination instruments, based on a minimum data set, standardized assessment instruments, and a common logic model, thus facilitating the comparison of findings across evaluations.     

The social phobia and anxiety inventory: Construct validity

The Social Phobia and Anxiety Inventory (SPAI) is a new instrument composed of social phobia and agoraphobia subscales. The latter scale is used to detect social anxiety that may result from agoraphobia. The SPAI's construct validity was assessed through several procedures. First, confirmatory factor analyses were conducted to validate the existence of the two subscales. Second, exploratory factor analyses examined the underlying structure of the social phobia subscale. Third, a Q factor procedure determined if different anxiety diagnostic groups could be differentiated by their SPAI response pattern. The results confirmed the utility of the two SPAI subscales and identified a number of dimensions contained within the social phobia subscale which differed depending upon the specific subject sample. In addition, the complaints of social phobies appeared more homogeneous than those of an agoraphobic comparison group. The results are discussed in terms of construct validity and the sensitivity of the SPAI to various dimensions of social phobia fears.This study was supported in part by NIMH Grants 41852, 30915, 18269, and 16884.     

HUMANITY IN THE WORLD OF LIFE

Abstract. The position and role of humanity in the world of life is examined in the light of the ontological structure of life itself. This problem is approached by considering the possible units of life representing various modes of life phenomena. I argue that the only meaningful unit of life without interposing some special external conditions is "global life" framed in a star-planet system. Any other possible unit of life exhibited by various kinds of individuals is conditional in the sense that it would leave out an essential part as "co-life." The relationship between human being and the global life should be understood in this general scheme of individual and global life. It is emphasized, however, that human being occupies a unique position in global life in the sense that humanity can promote either a cancerous situation or a healthy higher-order enhancement of the global life.     

TOWARD A NEW RELATION BETWEEN HUMANITY AND NATURE: RECONSTRUCTING T'IEN-JEN-HO-I

Abstract. The traditional Chinese idea of t'ien-jen-ho-i (Heaven and humanity in union) implies that humanity has to live in harmony with nature. As science and technology progress, however, the idea appears increasingly outmoded, and it becomes fashionable to talk about overcoming nature. Ironically, though, the further science reaches the more clearly are its limitations exposed. The exploitation of nature not only endangers many life forms on earth but threatens the very existence of the human species. I propose that a reconstruction of the traditional Chinese idea of T'ien-jen-ho-i will help us envisage a new and salutary relation between humanity and nature.     

HUMANITY IN NATURE: CONSERVING YET CREATING

Abstract. Developing a scientifically grounded philosophy of cosmic evolution, and using the moral norm of completeness as dynamic harmony, this paper argues that humans are a part of nature in both its conserving and emergent aspects. Humans are both material and cultural, instinctual-emotional and rational, creatures and creators, and carriers of stability and change. To ignore any of the multifaceted aspects of humanity in relation to the rest of nature is to commit one of a number of fallacies that are grounded in a dualistic-conquest mentality. Examples of some new developments in philosophy and theology, metaphorical images, and ritual show how to overcome dualism in favor of a dynamic harmony of humanity within nature.     

EFFECTS OF WAIT-TIME AND INTERTRIAL INTERVAL DURATIONS ON LEARNING BY CHILDREN WITH MULTIPLE HANDICAPS

We investigated the influence of teacher wait-time and intertrial interval durations on the performance of 4 multiply handicapped students during instruction in 10 skills. Four experimental conditions were evaluated: long wait-time and long intertrial interval, long wait-time and short intertrial interval, short wait-time and long intertrial interval, and short wait-time and short intertrial interval. Instructors attempted to keep short intervals as close as possible to 1 s and long intervals as close as possible to 10 s for both variables. Results showed that student performance was superior under the long wait-time conditions irrespective of the length of the intertrial interval.