Commentary: Writing About Clients: Ethical and Professional Issues in Clinical Case Reports

From the standpoint of a former journal editor and long‐time professional, this commentary challenges the direction of the profession as demonstrated in this special section. The ongoing creation of more and more ethical constraints not only harms the profession but also loses sight of fundamental ethical principles.     

Self-Knowledge of Personality: Do People Know Themselves?

The intuition that we have privileged and unrestricted access to ourselves – that we inevitably know who we are, how we feel, what we do, and what we think – is very compelling. Here, we review three types of evidence about the accuracy of self-perceptions of personality and conclude that the glass is neither full nor empty. First, studies comparing self-perceptions of personality to objective criteria suggest that self-perceptions are at least tethered to reality – people are not completely clueless about how they behave, but they are also far from perfect. Second, studies examining how well people’s self-perceptions agree with others’ perceptions of them suggest that people’s self-views are not completely out of synch with how they are seen by those who know them best, but they are also far from identical. Third, studies examining whether people know the impressions they make on others suggest that people do have some glimmer of insight into the fact that others see them differently than they see themselves but there is still a great deal people do not know about how others see them. The findings from all three approaches point to the conclusion that self-knowledge exists but leaves something to be desired. The status of people’s self-knowledge about their own personality has vast implications both for our conception of ourselves as rational agents and for the methods of psychological inquiry.     

Ratings of Orally Presented Verbal Expressions of Probability by a Heterogeneous Sample

Verbal expressions of probability are used in daily conversations, physician-physician and physician-patient communications, and questionnaire and interview responses. To assess the degree of agreement among English-speaking Australian adults in allocating numerical probabilities to these verbal expressions of probability, 966 interviewees provided estimates for 60 isolated expressions of probability and a sequence of seven items placed in a sequence. Means and median scores appeared to be consistent with common sense and with findings from other countries. Mirror-imaged terms were neither symmetrical nor equidistant, with the means and medians for the positive terms being closer to the mid-points of the scale than the means and medians of the negative terms. Items in a sequence of probability terms showed greater symmetry and less variability than isolated expressions. For most items, there was an unacceptably high level of within-subject and between-subject variability. Although subjects with higher levels of education and/ or mathematics education showed less variability, these factors accounted for very little of the variance. The greater variability in Australian results relative to those reported elsewhere was partly attributed to the use of interviews rather than questionnaires. There were no particular stems that yielded greater consistency. It was concluded that the use of these expressions leads to very imprecise communication.     

Prediction of early social and academic adjustment of children from the inner city

Investigated predictors of five measures of early school adjustment for an ethnically diverse cohort of 683 inner-city kindergartners and first graders. Data from 2 consecutive years were collected from teachers, school records, and children. A multiple-regression preduction model significantly explained children's competence behavior, problem behavior, reading achievement, mathematics achievement, and school absences. Prior adjustment and sociodemographic factors explained a majority of the variance in adjustment. Perceived quality of parent involvement was signifcantly related (in the expected direction) to all five outcomes. Exposure to life events was significantly associated in the expected direction with competence behavior, problem behavior, and school absences but not with reading and mathematics achievement. Together, parent involvement and life-event variables explained as much as 12% of the variance in adjustment independent of sociodemographic and prior adjustment factors. The role of family and school factors in the adjustment of children at risk is discussed [corrected].     

Parenting stress among families of children with attention deficit hyperactivity disorder

Prior research has shown that parenting stress levels can be quite high among families of children with attention deficit hyperactivity disorder (ADHD). This study investigated the degree to which such stress was related not only to the child's ADHD, but also to various other child, parent, and family-environment circumstances. Multimethod assessments were conducted on 104 clinic-referred children with ADHD. Data collected from these subjects were entered into hierarchical multiple-regression analyses, utilizing the Parenting Stress Index as the criterion. The results showed that child and parent characteristics accounted for a substantial portion of the variance in overall parenting stress. The child's oppositional-defiant behavior and maternal psychopathology were especially potent predictors. The severity of the child's ADHD, the child's health status, and maternal health status also emerged as significant predictors. These findings are discussed in terms of their impact upon the clinical management of children with ADHD.The authors are grateful to Mary Maher and Paula Nevins for their assistance in collecting and coding the data. The authors would also like to thank Dr. Kenneth Fletcher for his helpful comments regarding the statistical analyses.     

Single and combined effects of methylphenidate and behavior therapy on the classroom performance of children with attention-deficit hyperactivity disorder

Twenty-four boys with attention deficit-hyperactivity disorder (ADHD) participating in an intensive summer treatment program each received b.i.d. placebo and two doses of methylphenidate (MPH, 0.3 mg/kg and 0.6 mg/kg) crossed with two classroom settings: a behavior modification classroom including a token economy system, time out and daily home report card, and a regular classroom setting not using these procedures. Dependent variables included classroom observations of on-task and disruptive behavior, academic work completion and accuracy, and daily self-ratings of performance. Both MPH and behavior modification alone significantly improved children's classroom behavior, but only MPH improved children's academic productivity and accuracy. Singly, behavior therapy and 0.3 mg/kg PMH produced roughly equivalent improvements in classroom behavior. Further, the combination of behavior therapy and 0.3 mg/kg MPH resulted in maximal behavioral improvements, which were nearly identical to those obtained with 0.6 mg/kg MPH alone.The authors gratefully acknowledge the assistance of Patricia Donovan, Michelle Berry, Mary Ingram, Patricia Wells, Beth Gnagy, Karen Greenslade, Mary Hamilton, and the entire staff of the Western Psychiatric Institute and Clinic ADHD Summer Treatment Program.