Relational Diagnosis: A Retrospective Synopsis

This article highlights and summarizes efforts that have been made primarily during the past 20 years to bring the significance of relational diagnosis to the attention of the entire mental health community, and either (1) to have dysfunctional relational interactive patterns classified and codified and accepted for inclusion in the Diagnostic and Statistical Manual of Mental Disorders, or (2) if this is not feasible, to have a nosology of relational diagnoses, which have been clearly defined with accompanying risks specified for mental illnesses that might develop, and criteria sets delineated and adequately field tested to warrant and lead to publication of a separate but equal Diagnostic Manual of Relational Disorders and Dysfunctional Interactional Patterns.     

Community perceptions of mental disorders: a Greek perspective

The present cross‐sectional study examines the perceptions of residents of a rural community in Greece pertaining to the interpretation, explanation, treatment and prognosis of various psychological problems. In all, 100 community residents took part. A series of vignettes in combination with both qualitative and quantitative data collection procedures was employed. The findings indicate a variation in the endorsement of interpretations and causal attributions as a function of the type of symptomatology presented. The overt psychotic cases of schizophrenia were more likely to be understood within a genetic explanatory framework while the less overt symptoms of mental disorders were perceived as being indicative of emotional problems triggered by personality and social environmental factors. A preference for psychological methods of treatment was expressed. Copyright © 2006 John Wiley & Sons, Ltd.     

Behavioral testing of anxiety: Issues,diagnosis, and practice

This paper cites certain issues of concern in the area of assessment of anxiety and the anxiety disorders. It attempts to describe, in general terms, the potential of behavioral testing for clarifying these issues and for using these tests to supplement clinical interviews, rating scales, and self-report measures. Moreover, the paper describes a potential compatibility between objective behavioral testing and the most recent (third revision)Diagnostic and Statistical Manual of Mental Disorders.The opinions expressed in this paper are those of the author alone and do not necessarily reflect the position of the National Institute of Mental Health.     

Predictors for relapse and chronicity in eating disorders: A review of follow-up studies

Abstract: Eating disorders have been known to be intractable. Yet, their long-term consequences have received relatively little attention in the literature. In this paper, the outcome and follow-up studies of anorexia nervosa and bulimia are reviewed and the current knowledge of the predictors and correlates of relapse and chronicity in each disorder is summarized. Based on the problems and limitations of the extant studies, suggestions for future research are offered, especially from a developmental perspective, to understand better the mechanisms underlying long-term prognosis and relapse.     

Experimental analysis of academic performance in a classroom setting

We evaluated the effects of specific stimulus prompts on accuracy of academic performance with adolescents who displayed academic problems in a public special education classroom. We conducted analyses of instructional strategies within a multielement design with two students who had mild disabilities. Differential effects of the strategies on reading comprehension were not apparent on demand (independent-level) tasks but were apparent on high-demand (instructional-level) tasks. These results suggested that the application of experimental analysis methodologies to instructional variables may facilitate the identification of stimulus prompts associated with accurate academic performance.     

A comparison of peer verbal responding directed toward adolescents with behavioral disorders and nonhandicapped peers

One of the primary intents of inclusion is the maximization of interaction between persons with and without disabilities. The purpose of this study was to analyze the verbal responding that peers directed toward adolescents with behavioral disorders and, to this effect, several comparisons were made: verbal responding of peers directed toward adolescents with behavioral disorders was compared to verbal responding of peers directed toward regular class adolescents; verbal responding of peers directed toward the same adolescents with behavioral disorders was compared across their self-contained and integrated settings; and verbal responding of peers directed toward adolescents with behavioral disorders in integrated settings was compared to verbal responding of peers directed toward regular class adolescents. Data, collected in real time using portable microcomputers, focused on positive, negative, and neutral social responding and positive, negative, and neutral academic responding. All verbal responding of peers directed toward 14 adolescents with behavioral disorders and 14 regular class peers was recorded. Data were analyzed by group and setting, as well as by social or academic content. Results of the study support inclusion, with high levels of peer responding directed toward adolescents with behavioral disorders in integrated classrooms. Almost all peer responding was positive or neutral in content. Results were discussed as they related to placement of students, social skills training, and previous research.     

Walter Bradford Cannon: Pioneer of stress research

Walter Bradford Cannon, M.D., made a significant contribution to psychology and medicine with the discovery of the stress response around 1915, setting the cornerstone for psychosomatic medicine. This brief, introductory article etches out the nature of his contribution and sets the stage for Dr. Bradford Cannon to reflect on his father's important professional contributions and personal life in the following article.     

Estimating rates of chronic fatigue syndrome from a community-based sample: A pilot study

Most of the Chronic Fatigue Syndrome (CFS) epidemiological studies have relied on physicians who refer patients having at least 6 months of chronic fatigue and other symptoms. However, there are a number of potential problems when using this method to derive prevalence statistics. For example, some individuals with CFS might not have the economic resources to access medical care. Other individuals with CFS might be reluctant to use medical personnel, particularly if they have encountered physicians skeptical of the authenticity of their illness. In addition, physicians that are skeptical of the existence of CFS might not identify cases. In the present pilot study, a random community sample (N=1,031) was interviewed by telephone in order to identify and comprehensively evaluate individuals with symptoms of CFS and those who self-report having CFS. Different definitions of CFS were employed, and higher rates (0.2%) of CFS were found than in previous studies. Methodological benefits in using more rigorous epidemiological methods when estimating CFS prevalence rates are discussed. The authors appreciate the generous financial support of the CFIDS Association and Minnan, Inc. We also are grateful for many helpful suggestions provided by Judith A. Richman, William McCready, Wendell Richmond, and Stephen E. Goldston. Finally, we are very thankful to the many undergraduate volunteers who helped us complete this study, and they include Cheryl Stenzel, Georgina DeLa Torre, Vickie Chrisos, Don Banik, Hillary Loeb, Leslie Ramesack, Ellen Diamond, Rob Bleeker, Gib Garza III, Mindy Silverstein, Kadip Sen, Meredith Lombrazo, Brian Miller, Caroline Marsden, Lorraine Whitmore, Stan Gayot, Karen Costakis, and Dave Sobotka.     

Evaluating the vermont system of care: Outcomes associated with community-based wraparound services

Evaluation of innovative community-based interventions is becoming a high priority for child and adolescent mental health service system research. The present study examined outcomes for a sample of Vermont children (N=27) experiencing emotional and behavioral problems and receiving individualized, wraparound services. One year after initiation of wraparound care, incidence of negative behaviors rated as placing a child at risk of removal from the community had decreased significantly, compliance behavior had increased, and a significant decline in Total Problem Behavior scores on the Child Behavior Checklist was observed. In addition, though 70% of the participants had previously required inpatient or residential treatment, 89% were maintained in the community after one year of services, and the total cost of services was less than that of out-of-state residential care. Although further comparative research is needed, this study suggests that for many of these children, wraparound services may be a more efficient intervention than long-term psychiatric hospitalization or residential treatment.     

Outcomes in a System of Care for Youths with Emotional and Behavioral Disorders: An Examination of Differential Change Across Clinical Profiles

We assessed the utility of an empirically-derived classification system for youths with emotional and behavioral disorders in a system of care with a strong representation of juvenile delinquents. Eighty-seven youths served in a system of care were categorized by variables related to past history, current behavioral functioning, and current psychological functioning into four clinical clusters. We evaluated preliminary clinical outcomes after six months of interagency involvement for youths within each cluster and across the four clusters. Results indicated that youths in different clusters improved significantly in need-specific areas. Trends in our data indicated differential change in clinical outcomes across clusters. We discuss our findings within the context of emerging outcomes of youths involved in comprehensive community-based programs and consider implications for outcome research, treatment of juvenile delinquents, and mental health policy.