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.     

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.     

Technique and countertransference in Freud's analysis of the Rat Man

Freud's records of his treatment of the Rat Man constitute a unique document in the history of psychoanalysis. Through the years different analysts have used these records to support different theories about analytic technique. Certain non-interpretive interventions of Freud's have especially aroused their interest, and many reasons have been put forward to "explain" Freud's behavior. One reason never yet advanced and documented is that a countertransference tension may have been involved in one of these instances. This is surprising, since countertransference is a necessary part of every analysis. Evidence is presented that Freud's behavior may indeed have been under the sway of countertransference. Some recently discovered details concerning his early life are discussed as constituting a plausible background for ths countertransference enactment.     

A note on accepting the null hypothesis: problems with respect to the mass-spring and pulse-step models of movement control

Models are sometimes developed on the premise that there are no differences between two or more conditions regardless of experimental manipulation. This article argues that unless a very sensitive experiment (or series of experiments) was conducted, such conclusions are often premature. Design and statistical factors such as alpha level, variability, sample size, and treatment effect are all determinants of the sensitivity of the experiment. It is sometimes the case that an experiment produces differences between means and yet the null hypothesis is not rejected because of high variability within experimental conditions or because too few subjects were used. Unless the probability of detecting a difference between groups is known, it would seem unwise to conclude that no difference exists. Judgment on the model should be suspended. Examples are taken from the mass-spring and pulse-step models fro voluntary movement control to illustrate the problem.     

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.     

A strategic assessment of deliberate self-harm

This paper describes how patients are interviewed in the context of a general hospital after they have been involved in an episode of self-harm. The interview schedule is structured upon the principles of brief therapy, and uses the 'neutral' approach of the Milan Team (Weakland 1974; Palazzoli et al. 1980). The schedule provides information for referring on and has proved to be 'therapeutic' in itself. The method of interviewing has been used in other hospital contexts with families where a member has been referred 'in a crisis' threatening, or indicating suicidal behaviour. It is suggested that the identification of who is involved systemically is of paramount importance, and that this may not involve 'the family' but significant others in the social network. The important systemic involvement of the general practitioner is recognized.     

Examining awareness of privilege among midwestern college students: An analysis of race/ethnicity,gender, and religion

Dominant group members often are not aware of the privileges they benefit from due to their dominant group membership. Yet individuals are members of multiple groups and may simultaneously occupy multiple categories of dominance and marginality, raising the question of how different group memberships work in concert to facilitate or inhibit awareness of multiple forms of privilege. Examining awareness of privilege is important as awareness may be linked to action to dismantle systems of privilege that maintain oppression and inequality. Grounded in intersectional scholarship, in this study we examined how occupying intersecting categories of race/ethnicity, gender, and religion corresponded to an awareness of White, male, and Christian privilege. In a sample of 2321 Midwestern college students, we demonstrated that students from marginalized groups broadly reported greater awareness of all forms of privilege than students from dominant groups, and the difference between marginalized and dominant groups was most pronounced when the specific group category (e.g., gender) aligned with the type of privilege (e.g., male privilege). We also tested interactions among race/ethnicity, gender, and religion, only finding an interaction between race/ethnicity and religion for awareness of White and male privilege. These findings helped to clarify that multiple group memberships tended to contribute to awareness as multiple main effects rather than as multiplicative. Finally, we examined mean differences among the eight intersected groups to explore similarities and differences among groups in awareness of all types of privilege. Taken together, these findings quantitatively demonstrate the ways in which group memberships work together to contribute to awareness of multiple forms of privilege. We discuss study limitations and implications for community psychology research and practice.     

Insights into computational thinking from think-aloud interviews: A systematic review

This systematic review examines 35 empirical studies featuring the use of think-aloud interviews in computational thinking (CT) research. Findings show that think-aloud interviews (1) are typically conducted in Computer Science classrooms and with K-12 students; (2) are usually combined with other exploratory CT assessment tools; (3) have the potential to benefit learners with special needs and identify the competency gaps through involving diverse participants; (4) are conducted in the absence of cognitive models and standard procedures; and (5) display insufficient definitional and methodological rigor. Theoretically, this review presents a systematic assessment about the application of think-aloud interviews in CT studies and identifies the limitations in existing CT-related think-aloud studies. Practically, this review serves as a reference for studying the cognitive processes during CT problem-solving and provides suggestions for CT researchers who intend to incorporate think-aloud interviews in their studies.