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.     

儿童社会观点采择的发展及其子类型间的差异的研究

对幼儿园大班至小学阶段的４２５名儿童施以认知和情感两类观点采择测验,考察儿童社会观点采择发展的一般趋势以及两类观点采择的发展趋势及水平上的差异。结果发现：６岁左右儿童在准确推断他人观点方面还存在较大困难。６—１０岁左右是儿童社会观点采择能力快速发展的时期。１０岁左右儿童已能根据环境信息较准确推断他人的观点：儿童认知观点采择与情感观点采择能力的发展趋势基本一致,但后者的发展水平极显著地落后于前者。     

Books received

Analytical Psychology
Guggenbühl, Allan., The Incredible Fascination of Violence: Dealing with Aggression and Brutality Among Children.
Bradway, Kay & McCoard, Barbara., Sandplay – Silent Workshop of the Psyche.
Psychoanalysis
Segal, Hanna., Psychoanalysis, Literature and War.
Psychotherapy
White, Andy., Going Mad to Stay Sane – The Psychology of Self-Destructive Behaviour.
Reeve, Gillian & Nesbitt, Jo., The Desperate Woman's Guide to Therapy.
Miscellaneous
Schmidt Neven, Ruth., Emotional Milestones – From Birth to Adulthood: A Psychodynamic Approach.     

Book Reviews

John T. Haworth Work, Leisure and Well-being Owen Hargie The Handbook of Communication Skills Richard Lepsinger and Anntoinette D. Lucia The Art and Science of 360° Feedback Kevin Murphy Individual differences and behavior in organizations     

The Program Environment Scale: Assessing Client Perceptions of Community-Based Programs for the Severely Mentally Ill

The Program Environment Scale (PES) was developed for use with clients of community-based programs for the severely mentally ill. It is intended to fill the gap in available tools for assessing clients' perceptions of program functioning as it affects their quality of life in a program. Formal pretests were conducted with 121 clients at 12 randomly selected programs near Washington, DC. The final field test used a revised form (29 domains; 129 items) with 221 clients in 22 programs selected randomly throughout the U.S., including Clubhouse, day treatment, psychosocial rehabilitation, and social club programs. Twenty-three subscales met at least five of eight psychometric criteria for internal consistency and discriminant validity. A 24th subscale was retained because of its substantive importance. Successful subscales cover program atmosphere and interactions (program cares about me, energy level, friendliness, openness, staff-client and client-client respect, reasonable rules, availability of positive physical contact, protection from bad touch, staff investment in their jobs, and confidentiality), client empowerment/staff-client equality (program and treatment empowerment, egalitarian space use), and service components (support for paid work, work importance, emergency access, family activities, housing, public benefits, community activities, medications, substance abuse, and continuity). Subscale validity is indicated by associations of specific service offerings with scores on scales measuring client perceptions of those services, and by an ability to differentiate among program models (i.e., Clubhouses, day treatment programs, and psychosocial rehabilitation programs look different from each other). Subscale scores were not influenced by client characteristics (gender, race, age, diagnosis, number of hospitalizations, length of time in program). The final scale has 97 items and takes about 25 minutes to complete. The PES succeeds in measuring different aspects of programs as clients perceive them. In the programs we visited, directors felt the PES covers the important things they want to know about how clients perceive their program. The PES should become a useful tool both for researchers interested in how client responses to programs may influence their therapeutic outcomes, and for practitioners interested in improving their clients' program experiences and/or increasing convergence of staff and client views of their program.     

Evidence for the Continuity of Early Problem Behaviors: Application of a Developmental Model

Evidence of the continuity of early problem behaviors in young girls and boys was examined developmentally. Data were gathered on 104 mother-child dyads from low-income families when children were between 1 and 5 years of age. Difficult temperament, aggression, and noncompliance from 12 to 24 months, and externalizing and internalizing problems at 36 and 60 months, were assessed. The results provide evidence for the continuity of early behavioral and emotional problems and support for the early differentiation between internalizing and externalizing problems. Implications of the current findings for prevention efforts are presented.     

考试应付与相关因素的研究

本研究运用测量的方法考察了 1 0 0个大学生考试前后的应付方式以及人格、社会支持等因素对应付方式选择的影响作用。结果发现 ,考试应付与情景变化、人格特点和社会支持等因素有关。其中自尊、外向和低精神质人格特点与解决问题指向应付方式使用相关 ,低掩饰性与悲观人格特点与幻想、发泄、否认的消极应付方式使用相关。社会支持在应付中是一种重要的辅助资源 ,缺乏社会支持资源 ,考试过程中倾向于使用自闭的消极应付方式 ,社会支持资源丰富 ,则倾向于使用寻求社会支持的积极应付方式。     

Parental Perceptions of Child Development Among Low-Income Mexican American Families

Parents' perceptions of child development are influenced by complex interactions among cultural, social, and economic factors. Insights into how parents from culturally diverse societies perceive the development of their children might explain why different cultural groups foster or value the development of different skills in their children. In this study, we explored the perceptions of child development among low income Mexican American parents. A series of ethnographic interviews were conducted with eight Mexican American families who had preschool children. Qualitative data analyses yielded three main themes that were important to these parents: family attitudes and values, changes, and adaptations. For these parents, the development of social attributes in children, that will enable them to function within their own cultural group, was as important as the development of cognitive or motor skills. Service providers, such as school and mental health personnel, should take into account cultural differences in parents' perceptions of the importance of various developmental milestones for their children when suggesting interventions typically used by parents in the dominant culture.     

Assuming a Position: Women and Men as Moral Critics in Their Own War Zone

In their search for an authentic moral self, women and men may at some time in their lives assume a position of resistance. Men are most likely to assume this position in the sphere of war. It is not clear, however, where or when women would be expected to assume such a position or what the nature of that position might be, and how far it could be likened to that of the resisting man. This paper explores the idea that choosing to be a single mother can be a position by and from which women can voice their moral criticism. Such position is comparable to the (known and well-studied) position taken by men who show their moral criticism by refusing to participate in a specific battle during a morally controversial war. The paper begins with an examination of the philosophical and psychological concepts of separate and connected moral positions available to resisting men and women in the spheres of war and family. The conclusions are based on data from two samples of resisters in the spheres of war and the family: 36 soldiers (30 years old on average) who decided to take a stand as selective conscientious objectors (SCOs) during a morally controversial war and 50 (biologically) mature single women (over age 30) who chose to become pregnant and to remain unwed mothers. The conceptual and methodological questions regarding this comparison are discussed.