Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

Praxis makes perfect: Illness as a bridge between biological concepts of disease and social conceptions of health

Analyses of biological concepts of disease and social conceptions of health indicate that they are structurally interdependent. This in turn suggests the need for a bridge theory of illness. The main features of such a theory are an emphasis on the logical properties of value terms, close attention to the features of the experience of illness, and an analysis of this experience as action failure, drawing directly on the internal structure of action. The practical applications of this theory are outlined for a number of problems in each of the three main practical areas, clinical work, teaching and research. In each case the resources of the theory suggest new models and generate new results. The full practical significance of the theory, however, is shown to consist in the way in which it ties together biological and social theories into an integrated picture of the conceptual structure of medicine as a whole. It is argued, finally, that practical efficiency of this kind is a test of theory not only in the philosophy of medicine but also in general philosophy.     

Interpreting canonical correlation analysis through biplots of structure correlations and weights

This paper extends the biplot technique to canonical correlation analysis and redundancy analysis. The plot of structure correlations is shown to the optimal for displaying the pairwise correlations between the variables of the one set and those of the second. The link between multivariate regression and canonical correlation analysis/redundancy analysis is exploited for producing an optimal biplot that displays a matrix of regression coefficients. This plot can be made from the canonical weights of the predictors and the structure correlations of the criterion variables. An example is used to show how the proposed biplots may be interpreted.     

Continuous and discrete latent structure models for item response data

Relations are examined between latent trait and latent class models for item response data. Conditions are given for the two-latent class and two-parameter normal ogive models to agree, and relations between their item parameters are presented. Generalizationss are then made to continuous models with more than one latent trait and discrete models with more than two latent classes, and methods are presented for relating latent class models to factor models for dichotomized variables. Results are illustrated using data from the Law School Admission Test, previously analyzed by several authors.     

Effectiveness of School-Based Mental Health Services for Children: A 10-Year Research Review

A review of the literature from 1985 to 1995 on school-based mental health services for children was conducted using a computerized data-base search. Of the 5,046 references initially identified, 228 were program evaluations. Three inclusion criteria were applied to those studies: use of random assignment to the intervention; inclusion of a control group; and use of standardized outcome measures. Only 16 studies met these criteria. Three types of interventions were found to have empirical support for their effectiveness, although some of the evidence was mixed: cognitive-behavioral therapy, social skills training, and teacher consultation. The studies are discussed with reference to the sample, targeted problem, implementation, and types of outcomes assessed, using a comprehensive model of outcome domains, called the SFCES model. Future studies of school-based mental health services should (a) investigate the effectiveness of these interventions with a wider range of children's psychiatric disorders; (b) broaden the range of outcomes to include variables related to service placements and family perspectives; (c) examine the combined effectiveness of these empirically-validated interventions; and (d) evaluate the impact of these services when linked to home-based interventions.     

Positive and negative self-related goals and subjective well-being: A prospective study

To examine whether having self-related personal goals, or rather whether positive or negative appraisal of them, is associated with subjective well-being, 311 students were asked to complete the Personal Project Analysis (PPA) and revised Beck Depression Inventory, first at the beginning of their studies, and then 2 years later. After 3 years they were asked about the use of mental health services. Two groups of students were identified: (1) those with positive self-projects and (2) those with negative self-projects. The results showed that both positive and negative self-related projects showed stability across a 2-year period, but only negative ones were prospectively predicted by earlier depressive symptomatology. Although neither positive nor negative projects predicted depressive symptomatology, both predicted the use of mental health services.     

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 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.     

追踪作业中几种心理负荷评估指标敏感性的研究

本研究在模拟追踪作业情境下 ,对主任务绩效测定、主观评定和若干生理测量在心理负荷评估中的敏感性进行了实验。实验采用重复测量的被试者内设计 ,2 0名被试 (男女各半 )在六档负荷下分别从事五分钟追踪作业。所选用的指标有追踪作业平均误差距离、追踪警告次数、主观负荷评定、心率、心率变异和血压。结果发现 :1主任务绩效在评估追踪作业心理负荷中具有最高的敏感性 ,主观评定次之 ,心率变化率和心率变异变化率也随负荷变化 ,血压指标随负荷变化的趋势不明显 ;2除血压指标外 ,其余各指标之间均存在明显的相关 ,这提示它们在评估追踪作业心理负荷中具有较大的可靠性。     

计量测验效度的一种方法——测量目标结构空间的实证性因素分析

该文提出了计量测验效度的一种统一方法。首先,根据测量目标由测验编制者提出一组可能的线性拟合模型,拟合模型的集合称作“测量目标结构空间”。然后运用实证性因素分析对各个假设的拟合模型进行多方面的拟合良好性检验。若其中的某一假设模型能最优地拟合预测资料,则该模型中的公共因素的方差总贡献与观测变量的总方差的比就可定义为该测验的效度