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.     

Paranoid character and the intolerance of indifference.

This paper suggests that aspects of paranoid character are structured around fantasies of magical and concrete connectedness to objects; these fantasies serve to avoid the terrors of object inconstancy. The authors describe how these fantasies are expressed in the psychoanalytic situation and explore their relation to common paranoid phenomena. The paranoid person must maintain these fantasies of connectedness at all cost or risk experiencing unbearable indifference between self and object. Paradoxically, the sacrifice of self and object boundaries inherent in these fantasies makes object constancy even more difficult to achieve because of the secondary defensive use of anger mobilized to protect the boundaries of the self.     

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.