Comorbidity between and within childhood externalizing and internalizing disorders: reflections and directions

The term and concept of lcomorbidity has been mired in controversy, although there is little question that the existence of covariation among psychiatric diagnoses poses significant challenges to current models of psychiatric classification and diagnosis. The papers in this Special Section underscore a number of important issues relevant to the comorbidity between and within childhood externalizing and internalizing disorders, and illustrate both methodological and substantive reasons for such comorbidity. Weiss, Susser, and Catron's distinction among common, broad-band specific, and narrow-band specific features provides a helpful framework for understanding the comorbidity of childhood externalizing and internalizing disorders (B, Weiss, K. Susser, & T. Catron, 1998). Hierarchical models of psychopathology help to dissolve the distinction between splitters and lumpers and point to variables that may elucidate the etiology of externalizing and internalizing disorders.     

大学生心理压力感量表编制理论及其信、效度研究

本研究在对心理压力感理论维度分析的基础上,编制了大学生心理压力感量表。量表的因素分析结果表明：(1)大学生心理压力主要有两方面,一是个人自身压力包括家庭压力、适应压力、健康压力、恋爱压力、自卑压力和挫折压力：一是社会环境压力包括人际压力、择业压力、情绪压力、学校环境压力和学业压力。(2)通过信、效度检验,大学生心理压力感量表的理论维度结构合理,具有良好的信度,达到心理测量学的相关要求。(3)心理压力感量表的各维度对大学生的心理健康水平具有良好的预测作用,可以作为评估大学生心理压力水平的有效测量工具。     

Response to Difficult Patients in Group Analysis: The Personification of I:A/M

The author focuses on the application of Hopper's proposal of an additional basic assumption (I:A/M) using a model of clinicians' theories: bridging theory, psychological theory, and clinical theory (Michels, 1999). This paper will describe the potential for advances in understanding particular group formations seen in clinical practice and other settings.     

教师心理素质的隐含研究

本研究旨在运用隐含研究方法揭示教帅应具备的心理素质及其结构。为此,本研究进行了一个预备测试与3个正式测试。研究结果表明：①创造性,责任感,教育效能感等21项特性是教师重要的心理品质;②在这些心理品质中,客观公正性、移情性、角色认同、有恒性、监控陛、责任感、非权势等11项心理品质被教师、家长、学生共同认定为最重要最基本的心理品质;③人们心目中教师心理品质由工作动因,工作行为、行为调控三个维度构成的;④综合三项测试结果,本研究认为教师心理素质是由3个维度、10项基本特性构成的。此外,文章还分析了这一结论与以前研究结果的关系及隐含研究方法对于该项研究的适用性。     

The Motivations to Volunteer: Theoretical and Practical Considerations

Why do significant numbers of people engage in the unpaid helping activities known as volunteerism? Drawing on functional theorizing about the reasons, purposes, and motivations underlying human behavior, we have identified six personal and social functions potentially served by volunteering. In addition to developing an inventory to assess these motivational functions, our program of research has explored the role of motivation in the processes of volunteerism, especially decisions about becoming a volunteer in the first place and decisions about continuing to volunteer.     

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.     

Comorbidity in schizophrenia: A prognostic study of personality disorders in recovered and non-recovered schizophrenia patients

Symptoms and outcome in schizophrenia are heterogeneous. Part of the variation in outcome might be due to the coexistence of other forms of psychopathology. In the present study the prevalence of personality disorders in a group of recovered and non-recovered schizophrenia patients was focused to examine the prognostic implications of comorbidity for the outcome of the disorder. The results showed no significant differences in prevalence of personality disorders in the two groups at first admission to the hospital, but the difference at the time of interview was close to significance. Emotional and conduct difficulties in adolescence were significantly more prevalent in the non-recovered group. Schizoid features and emotional and conduct disorders in childhood were also more often reported among the non-recovered subjects. The results confirm that comorbidity contributes to the variation in outcome for schizophrenia patients, but does not confirm its prognostic significance.     

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.     

A case study of behavioral assessment and treatment of insect phobia

We assessed the academic performance of a 14-year-old boy with insect phobia in the context of feared stimuli. The dependent measure was math calculation rate across three conditions that varied therapist statements about the presence of crickets and the actual presence of live crickets. Subsequent treatment consisted of graduated exposure and contingent rewards for math problem completion. Assessment results indicated that the boy's performance was consistently low in the presence of live crickets but not when he was spuriously informed that crickets were present (the primary referral concern). Treatment results indicated no effect from exposure alone and a dramatic effect when exposure was combined with contingent rewards.     

Issues in diagnosing anxiety disorders

Research progress in the anxiety disorders is predicated on a useful classification system. In this paper, we review the reliability and validity data for theDiagnostic and Statistical Manual of Mental Disorders, 3rd ed. (DSM-III) anxiety disorders and discuss the salient issues associated with both the conceptualization of anxiety disorders and the diagnostic criteria offered in the DSM-III. It is concluded that the diagnostic reliability for these disorders is, overall, satisfactory. A dearth of validity data, however, hinders progress in both the diagnosis and the treatment of the anxiety disorders. Nevertheless, the DSM-III work group has proposed several changes in the diagnostic criteria for the anxiety disorders. We find some of these proposed changes helpful in that they clarify current diagnostic criteria; changes in diagnostic criteria that alter the basic classification schema, however, seem to be premature.Preparation of this paper was supported in part by MIMH Research Grant 1368.On sabbatical leave from Indiana State University.