Feasibility of validating survey self-reports of mental health service use

Survey respondents may inaccurately report mental health service utilization for motivational and cognitive reasons. There is little evidence on accuracy of self-reports of mental health service use, and this evidence suggests that respondents tend to underreport inpatient utilization. This study addressed the question of self-report accuracy by comparing survey data from a large probability sample to data from computerized records of publicly funded mental health services. Few inaccuracies in self-reporting were detected. However, despite the use of data bases that were unusually appropriate for verifying self-reports, several problems limited the feasibility of validation. Suggestions are offered for increasing the feasibility of validation in future studies.     

GENDER DIFFERENCES IN DEPRESSIVE SYMPTOMS

Large community studies of depressive symptomatology provide mixed evidence concerning gender differences. The present paper investigates the effect of the high skewness typically present in distributions of depressive symptom scores on findings of a gender difference in depression. Because of this skewness, a few extreme scores among women (or in any subgroup) can produce a significant between-groups difference in untransformed scores even when the two groups' distributions are otherwise similar. Data from a community survey ( n = 1316) are consistent with this hypothesis. The data also suggest that gender increases depression scores indirectly, rather than directly, for the few women scoring in the extreme upper tail of the distribution. It is concluded that the gender difference in depressive symptoms lacks robustness, and that when it does occur, the effect of gender on depression can be understood as ndirect, i.e., as mediated by gender differences in rate of employment, job status, education, and income.     

TEACHING SAFETY SKILLS TO HIGH SCHOOL STUDENTS WITH MODERATE DISABILITIES

Teaching students with disabilities to respond appropriately to potentially dangerous situations is a useful skill that has received little research attention. This investigation taught 3 students with moderate mental retardation to remove and discard broken materials (plates, glasses) safely from (a) a sink containing dishwater, (b) a countertop, and (c) a floor. A 4th student was instructed on the sink task only. A multicomponent treatment package was used to teach the skills. Simulated materials were used initially and were replaced with broken plates and glasses. A multiple probe design was used to evaluate the effectiveness of the treatment package. The results indicated that the treatment package was effective in teaching the skills. Data were collected 1 week and 1 month following the completion of training, and indicated mixed results. No student was injured during any phase of training. Issues pertinent to teaching safety skills to students with moderate disabilities are discussed.     

Context-dependent variation in social stereotyping 1: The effects of intergroup relations as mediated by social change and frame of reference

During the 1990-1991 Persian Gulf conflict an experiment was conducted with Australian university students (N = 200) to investigate whether the social stereotyping of Americans varied with social contextual manipulations related to the hostilities. The study, conducted in two phases at the start and end of the conflict, examined how the assignment of standard stereotypical traits to Americans was affected (a) by the large-scale social change constituted by the war and (b) by variation in the frame of reference provided by relevant comparison groups. The elicited stereotypes were sensitive to both of these contextual variables, demonstrating significant variation and fluidity. Overall, stereotypes of Americans were relatively negative. They were significantly more negative (a) at the end of the war than at the beginning in the restricted frame (when Australia and Britain were comparison groups) and (b) in the first phase of the conflict when the frame was extended to include Iraq as a comparison group. The findings were in line with expectations derived from self-categorization theory (Turner, 1985) that the social categorization of self and other into ingroup and outgroup is inherently variable, comparative and context-dependent. They question the long-held view of stereotypes as fixed, rigid and resistant to change.     

The psychological present

The present paper compares behavior-analytic and cognitive treatments of the concept of psychological history with regard to its role in current action. Both treatments take the position that the past bears some responsibility for the present, and are thereby obligated to find a means of actualizing the past in the present. Both do so by arguing that the past is brought to bear in the present via the organism. Although the arguments of the two positions differ on this issue, neither provides a complete account. An unconventional treatment of psychological history is proposed, the logic of which is exemplified in anthropological, biological, and psychological perspectives. The unconventional treatment in psychological perspective holds that (a) the organism's interaction with its environment, not the organism itself, changes with experience; and (b) the past interactions of an organism exist as, and only as, the present interactions of that organism. This solution to the problem of psychological history provides obligations and opportunities for analysis that are not available when the more conventional positions of cognitivism and behavior analysis are adopted.     

A biopsychosocial model for treating infertility

With approximately one out of six married couples experiencing infertility, having a basic knowledge of infertility is important to marriage and family therapists. This paper presents important themes that infertile couples often struggle with and stresses the importance of having a biological, psychological, and social understanding of infertility. In addition, the paper suggests possible interventions that family therapists can use in helping infertile couples.     

The process of cognitive therapy: The first dysfunctional thought changes less than the last one

An observant cognitive therapy patient reported that the first dysfunctional thought elicited and treated in homework sessions was more resistant to change than later distorted thoughts. To determine whether this was due to the fact that this thought was elicited first, or to the fact that it was treated first, systematic data were collected from 9 patients in 48 sessions of cognitive therapy. In half of these sessions, dysfunctional thoughts were treated in the order they were elicited; in half of the sessions, they were treated in the reverse order. Results showed that the first dysfunctional thought elicited changed least; there was no effect of order of treatment. Several possible explanations of this finding are offered.     

Mentalism, behavior-behavior relations, and a behavior-analytic view of the purposes of science

In a behavioral view, the purposes of science are primarily prediction and control. To the extent that a scientist embraces both of these as a unified and generally applicable criterion for science, certain philosophical and theoretical practices are counterproductive, including mentalism in both its metaphysical and metatheoretical forms. It is possible and often worthwhile to recast some mentalistic talk into an issue of behavior-behavior relations. When behavior-behavior relations are approached non-mechanistically, however, analysis cannot stop at the level of the relations themselves. Several analytic concepts common in the behavioral community share some of the dangers of mentalism if not employed properly, including such concepts as self-reinforcement, response-produced stimulation, and self-rules.     

Generalization of treatment effects in training public speakers

Three studies compared the efficacy of various treatments for public-speaking incompetence. These effects were evaluated for the target behavior as well as for generalization effects across situations (conversations), settings (different sizes and types of audiences) and time (6-month follow-up). The first study showed that Self-instructional Training, either alone or in combination with other procedures, produced little or no benefits. The second study demonstrated the superiority of a Skills Training program over flooding therapy, while the final study failed to detect any enhancement of treatment benefits for the addition of home-practice to the Skills Training. In the first two studies generalization occurred across the three dimensions (settings, situations and time), while in the final study it was shown that the program was effective for a clinical population as well as recruited volunteers.