Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

The impact of confederate responsivity on social skills assessment

The current investigation examined the degree to which judges' ratings of skill, anxiety, and attractiveness are influenced by the responsivity of the confederate. High-, medium-, and low-skilled subject-pool groupings, as well as self-referred clinical groups, were exposed to either a moderately or a minimally responsive confederate. Results indicated that subjects were rated as more skillful when interacting with a moderately responsive confederate than when interacting with a minimally responsive confederate. Further, there was a groups × condition interaction for anxiety ratings such that both the high- and the medium-skilled groups appeared more anxious under the minimal condition, whereas the low-skilled and self-referred groups did not. Self-referred subjects received significantly lower attractiveness ratings than did the high- or medium-skilled groups. Implications of these results and future directions for research are discussed.This research is based on a M.S. thesis carried out by the first author under direction of the second author.     

Increasing senior citizen participation in a community-based nutritious meal program

Two experiments were conducted to compare the effects of several prompting and reinforcement procedures on the participation of elderly citizens in a nutritious meal program. Experiment I employed a variation of the multiple-baseline design across three groups of approximately 60 households each. Elderly persons not previously participating in the program were introduced to the following conditions: (1) public service radio announcements for four weeks to advertise the meal program and the availability of free transportation, (2) a home visit that served as a personal invitation and a second prompt for participation, (3) a followup telephone call, and (4) an incentive menu for participation, which was sent through the mail. Results indicated that the home visits and incentives were both effective as recruitment procedures and superior to other conditions; however, incentives proved to be the most cost-effective intervention. Experiment II used a variation of the multi-element design to compare the effects of scheduled activities and incentives in maintaining higher levels of participation by those persons who had attended the meal program at least once in the past, but whose current rate of participation was low. Results showed that activities improved attendance levels somewhat and that incentives substantially increased the number of meal program participants. Data from these experiments thus indicate that relatively inexpensive procedures may be used effectively to increase the extent to which elderly persons make use of potentially beneficial community-based services.     

Effects of stress and retesting on role play tests of social skill

The purpose of this study was to examine the role of stress in performance on role play tests of social skill. Chronic psychiatric patients were tested in a formal videotape studio or in an informal consulting room setting. Motoric and physiological measures were secured. In addition, one-half of the subjects were retested one week later. In contrast to previous studies, results indicated that the assessment was not stressful. The two groups were not different on any measure, and the mean heart rates ranged from only 80 to 84 b.p.m. The effects of retesting were difficult to interpret. There were reductions in motoric indices of anxiety (speech disruptions) but not on physiological indices. Overall, testretest reliability was quite high. The results raise several questions which affect interpretation of many social skills studies in the literature.     

THE UNIT PLAY MANAGER AS FACILITATOR OF PURPOSEFUL ACTIVITIES AMONG INSTITUTIONALIZED PROFOUNDLY AND SEVERELY RETARDED BOYS

Child care workers were trained in specified techniques (play manager routines) in an effort to increase purposeful activity among a group of profoundly and severely retarded institutionalized boys. A system of prompts, increasing the availability of toys and regular staff monitoring, were alternated with normal institutional routines in an ABA reversal design. On the average, activity level increased from 10% to a mean of 70% during treatment conditions. Correspondingly, stereotyped or harmful behaviors decreased from an average of 20% to 70% during treatment.     

Personality factors in dysphoria: A psychometric refinement of beck's Sociotropy-Autonomy Scale

The Sociotropy-Autonomy Scale (SAS) was developed as a means of assessing two cognitive-personality constructs postulated as vulnerability factors in depression (Beck, 1983). While studies have confirmed the validity of the SAS Sociotropy Scale, the construct validity of the Autonomy Scale has not been well supported. The present study was conducted to improve on the measurement of autonomy by generating additional items which were added to the original questionnaire. This 93-item SAS was administered to 485 undergraduates along with the Beck Depression Inventory, Beck Anxiety Inventory, PRF Affiliation and Autonomy Scales, Positive and Negative Emotionality Measures, and Marlowe-Crowne Social Desirability Scale. Four factors labeled Sociotropy, Solitude/Interpersonal Insensitivity, Independence, and Individualistic Achievement emerged from a principal-factor analysis of the SAS item pool. Hierarchical multiple regression analyses indicated that positive emotionality and solitude/interpersonal insensitivity were specifically related to dysphoria, while negative emotionality and sociotropy had significant associations with both anxious and depressed mood states.This research was supported by University of New Brunswick Research Grant 22–51 awarded to the first author.     

The adequacy of a role play of a previous event as affected by high and low social anxiety and rehearsal

This study was designed as a preliminary step in evaluating the adequacy of a role play of a previous event. Sixty undergraduate males, high or low in social anxiety, interacted with a female assistant. Two groups of subjects then rehearsed this conversation overtly or covertly, while a third group became involved in a distraction task. Finally, all subjects role played the initial interaction with a second female assistant. Individual Pearson product-moment correlations between the initial and the role-play sessions yielded moderate, but significant correlations for most of the rated behaviors. Canonical correlations for the verbal and for the nonverbal ratings showed the two sessions, as a whole, highly related. Two (high-versus low-social anxiety group) × three (overt, covert, or no rehearsal) analyses of variance were performed on four measures. Significant results were found only for the anxiety group effect and rehearsal group effect on one rating, anxiety behaviors. The implications of the modest individual correlations suggest that estimation of specific levels of behavior is not appropriate from a role play of a previous event. However, the use of such a role play to make global distinctions of relative competence may be appropriate. The results of this study are consonant with earlier studies on role-play assessment.This article is based on a master's thesis completed by the first author in partial fulfillment of the requirements for the Master of Science degree at Ohio University.     

Who drops-out? Do measures of risk to self and to others predict unplanned endings in primary care counselling?

Aims: Unplanned endings, where clients unilaterally end therapy, are of concern for psychological therapy services generally as they raise questions about the appropriateness of the treatment and it's delivery for some clients. Limited available data indicates that those who drop-out often have more severe symptoms at entry, and have poorer clinical outcomes. This raises further questions about risk to self and others for those clients who leave therapy prematurely and how these clients might be identified and kept engaged. Method: This paper uses a large dataset of CORE data collected routinely in a primary care counselling service between 2000 and 2003. Logistic regression was utilised to consider different measures of risk and other client characteristics recorded at assessment to predict drop-out from the service. Results: These indicate that younger age, greater psychological distress at assessment, an addiction problem and greater risk to others, are associated with an unplanned ending. However, no reliable logistic regression model could be produced. This may be partly due to data quality issues or important characteristics not being available in the data. Implications for practice: The paper concludes that counsellors should actively seek to minimise unplanned endings, as amongst them may be represented the more distressed and risky clients referred to primary care counselling.     

Naturalistic Partial Sleep Deprivation Leads to Greater Next-Day Anxiety: The Moderating Role of Baseline Anxiety and Depression

The detrimental effects of insufficient sleep on emotional functioning have been well established. Total sleep deprivation usually leads to increased anxiety and depressive symptoms the following day. However, no study has yet examined the relationships between unmanipulated partial sleep deprivation and next-day symptoms of anxiety and depression in everyday life, which this study sought to characterize. Participants (N = 94) completed daily diary surveys twice per day for 2 weeks without instructions to alter their sleep in any way. Nights of spontaneous, naturally occurring partial sleep deprivation were followed by increased levels of self-reported symptoms of anxious arousal the next day, but were unrelated to next-day symptoms of anhedonic depression or general distress. The relationship between partial sleep deprivation and next-day anxious arousal was found to be moderated by both baseline depressive symptoms and anxiety such that individuals reporting higher levels of depression or anxiety at baseline showed relatively greater increases in symptoms of anxiety following partial sleep deprivation. These results suggest that partial sleep deprivation occurring in everyday life can lead to higher next-day levels of anxious arousal, a relationship that is particularly deleterious for individuals with higher overall levels of anxiety or depressive symptoms.     

Old Fears Die Hard: Return of Public Speaking Fear in a Virtual Reality Procedure

Exposure-based therapy is an effective treatment for social anxiety, but some patients relapse. We used a novel virtual reality procedure to examine spontaneous recovery (i.e., a return of fear over time) and fear renewal (i.e., the return of fear after a context switch) in individuals with fear of public speaking. On Day 1, 32 participants received exposure training before a virtual audience. On Day 8, participants completed a spontaneous recovery phase, followed by a fear renewal test, in which they gave a presentation in front of a new (context switch) or the same audience (no context switch). After exposure, participants exhibited a lower heart rate, subjective distress, negative valence, and arousal. One week later, participants showed spontaneous recovery of heart rate, and the context switch group showed renewal of subjective distress, negative valence, and arousal. Future studies can use this procedure to test interventions aimed at improving long-term exposure effects in individuals with public speaking fear.