Factor structure of the Treatment Evaluation Inventory: Implications for measurement of treatment acceptability

The Treatment Evaluation Inventory (TEI), a frequently used measure of treatment acceptability, was used by 164 undergraduates to rate the acceptability of each of the following treatments: differential reinforcement of other behavior, exclusionary time-out, overcorrection, medical restraint, contingent electric shock, and physical restraint. TEI ratings of each treatment type were grouped separately, variance-covariance matrices were formed and compared, and data were subjected to factor analysis. The results indicated that the factor structure of the TEI varied with the treatment it was used to evaluate. Item analysis of the TEI indicated a high degree of internal consistency, although item-total correlations varied between rated treatments. The findings suggest that although the TEI is a reliable instrument, sensitive assessment of the treatment acceptability construct probably requires multidimensional measurement.     

跨期选择的变易程度正向预测中华文化圈国民的自评扛疫成效：亚非欧美大洋洲18国跨国研究

跨期选择是对不同时间点的得失的权衡与选择。伊索寓言《蚂蚁和蚱蜢》假借群居型昆虫的跨期选择偏爱暗喻投资未来的慢策略比只顾眼前的快策略更利于生存。用跨期选择领域通用的语言解读这一寓言便是：选择大而迟选项的蚂蚁比选择小而早选项的蚱蜢更可能扛过严冬而生存下来。为了探索何种跨期选择策略更有助于我们扛过疫情,本研究调查了亚非欧美大洋洲这5大洲18个国家共计26355名受测者对混合得失双结果的跨期选择偏爱,测量了人们平时和疫时跨期选择偏爱的变易程度(2类变易的程度指标),以及人们自评的扛疫成效。跨文化比较结果的主要发现是：不同通货的选择变易程度(指标1)和不同时期的选择变易程度(指标2)能联合预测中国/新加坡文化圈国民的自评扛疫成效;不同时期的选择变易程度(指标2)也可以单独预测印度/马来西亚/菲律宾/尼日利亚文化圈国民的自评扛疫成效;这2类选择偏爱变易的程度指标不能预测其他文化圈国民的自评扛疫成效(或者预测方向和假设相反)。基于易经“穷则变,变则通”的要旨和跨国比较的发现,我们认为：面临历史危机时善于变通的特长抑或成就了中华民族特有的竞争优势;在应对危机时,与中国文化距离越相近的国家或民族抑或也能...     

Effectiveness of School-Based Mental Health Services for Children: A 10-Year Research Review

A review of the literature from 1985 to 1995 on school-based mental health services for children was conducted using a computerized data-base search. Of the 5,046 references initially identified, 228 were program evaluations. Three inclusion criteria were applied to those studies: use of random assignment to the intervention; inclusion of a control group; and use of standardized outcome measures. Only 16 studies met these criteria. Three types of interventions were found to have empirical support for their effectiveness, although some of the evidence was mixed: cognitive-behavioral therapy, social skills training, and teacher consultation. The studies are discussed with reference to the sample, targeted problem, implementation, and types of outcomes assessed, using a comprehensive model of outcome domains, called the SFCES model. Future studies of school-based mental health services should (a) investigate the effectiveness of these interventions with a wider range of children's psychiatric disorders; (b) broaden the range of outcomes to include variables related to service placements and family perspectives; (c) examine the combined effectiveness of these empirically-validated interventions; and (d) evaluate the impact of these services when linked to home-based interventions.     

Termination of Mental Health Services for Children

In this paper, we examine the termination of children's mental health services. Analyses were based on the 901 families in the Fort Bragg Evaluation Project who participated at Wave 1 and Wave 2 six months later. The project compared a full continuum of care provided at a demonstration site with traditional care at two comparison sites. The results showed that in most cases families and providers were partners in decisions to terminate treatment. About half of the clients self-terminated or were terminated solely at the discretion of the provider. Providers tended to play a more dominant role in terminating restrictive services; families played a more central role in terminating outpatient care. Regardless of initial psychopathology, children in single-headed households, whose parents were dissatisfied with services, did not expect their child to cooperate with treatment and did not expect treatment to help their child, were more likely to terminate care than others. While the Demonstration site had significantly fewer terminations, the sites did not differ with regard to the reasons for termination, who participated in termination decisions, or the factors that affected the likelihood to terminate care. Of most interest, mental health outcomes among children who had terminated all care did not vary by reasons for termination or by who participated in the termination decision.     

Multiaxial taxonomy of fibromyalgia syndrome patients

Pain, disability, and depression are present in various degrees in patients with fibromyalgia syndrome. Cluster analysis was used in this research to ascertain the existence of subgroups of patients in a fibromyalgia sample based on these variables. Two clusters were defined: one characterized by high levels of pain, disability, and depression (n=51) and another characterized by low levels of pain, disability, and depression (n=67). Multivariate analysis of variance (MANOVA) confirmed differences between clusters on these health status factors and a second MANOVA revealed that the subgroup with a poorer health status reported greater passive coping, helplessness, and stress, and less satisfaction with social support, than the subgroup with better health status. Logistic regression indicated that the best discriminator of subgroup membership was helplessness. These results suggest that different approaches to patient management, particularly intervention strategies aimed at reducing helplessness, may be beneficial for patients with high levels of pain, disability, and depression.     

Individualized behavior therapy for alcoholics: a third year independent double-blind follow-up.

An independently conducted double-blind study providing third year follow-up data for 53 of 70 male alcoholics who served as subjects in an experiment evaluating “Individualized Behavior Therapy (IBT)” techniques is reported. In the original study, subjects were initially assigned to either a controlled drinking or non-drinking (abstinence) treatment goal, and were then randomly assigned to either an experimental group receiving IBT or a control group receiving conventional state hospital treatment oriented towards abstinence. Previously reported results showed that IBT subjects functioned significantly better than control subjects throughout the first year of follow-up. Second year follow-up results found that IBT subjects treated with a controlled drinking goal functioned significantly better than their respective control subjects on a variety of measures, including drinking behavior. Differences between IBT subjects treated with a non-drinking goal and their control subjects did not retain statistical significance during the second year of follow-up. The independently determined follow-up data showed that during the third post-treatment year, subjects in the experimental groups generally functioned better than their respective control subjects. Comparison of the controlled drinking experimental group with its control group showed the significantly better functioning of subjects in the experimental condition on a number of drinking and other life functioning measures. Comparison of the non-drinking groups indicated only one possible difference on the drinking related measures involving a trend for subjects in the experimental condition to abstain more than those in the non-drinker control group. On other life functioning measures, however, subjects in the non-drinking experimental condition showed consistent improvement over their respective control subjects. Both of the controlled drinking groups reported more controlled drinking days than the non-drinking groups throughout the third year follow-up period.     

Habit reversal vs. negative practice treatment of nailbiting

A previous study of the habit reversal treatment of nailbiting was extended by using more subjects (97) and a comparison with an alternative method (negative practice). Negative practice reduced nailbiting episodes by about 60% whereas habit reversal reduced nailbiting episodes by about 99% throughout the 5-month follow-up.     

Do medical decision analyses' largest gains grow from the smallest trees?

Some decision analysts recommend reserving their models for careful, complete study of complex problems. Others believe simple problem analyses provide the greatest gains. To clarify these issues, I tested: (1) whether simple published analyses compared to complex ones, produced results as non-intuitive; and (2) whether non-intuitiveness represented analytic gain (or equivalently, intuitive loss). Very limited data also examined (3) the gain from adding model intricacy for a given problem vs. selecting more complex problems for analysis. To assess two non-intuitiveness measures, 75 subjects (33 physicians and 42) non-physicians stated their intuitive preferences in 40 (22 published and 18 unpublished) medical dilemmas. For both physicians and non-physicians, simpler models (those with lees than 30 terminal branches in the decision tree) had about one third the non-intuitiveness of more complex ones. Three tests also supported the premise that analyses outperform intuition, therefore that on average the formers' non-intuitiveness reflects less analytic gain. In addition, for different models of the same problem, tree complexity did not correlate with gain. Thus, simpler trees may not generally gain less because they inadequately describe problems. Instead, simpler analyses may represent simpler problems, with more similar intuitive and formal solutions. If so, these findings may help us avoid some costly but unnecessary simple analyses.     

Future Well-Being Among People Who Attempt Suicide and Survive: Research Recommendations

Over 48,000 people died by suicide in 2018 in the United States, and more than 25 times that number attempted suicide. Research on suicide has focused much more on risk factors and adverse outcomes than on protective factors and more healthy functioning. Consequently, little is known regarding relatively positive long-term psychological adaptation among people who attempt suicide and survive. We recommend inquiry into the phenomenon of long-term well-being after nonfatal suicide attempts, and we explain how this inquiry complements traditional risk research by (a) providing a more comprehensive understanding of the sequelae of suicide attempts, (b) identifying protective factors for potential use in interventions and prevention, and (c) contributing to knowledge and public education that reduce the stigma associated with suicide-related behaviors.     

多时点结果跨期选择的决策效应及其心理机制

多时点结果跨期选择涉及两个及两个以上多个时点结果的权衡, 正日益成为跨期选择的研究重点。现有研究主要从两时点结果和序列结果两方面深入探讨了多时点结果跨期选择中的诸多决策效应, 包括：隐藏的零效应、象征效应、额外金额效应、前端金额效应以及序列效应, 并运用序列模型和权衡模型对上述决策效应进行阐释。未来还应深入探索同时涉及损益结果混合的多时点结果跨期选择, 运用决策过程追踪技术揭示决策效应的过程机制。