Mental health services for children. The state of the art.

Throughout this century, people in the United States have been concerned about the serious deficiencies in the mental health care of our children. Despite eloquent needs assessment and recommendations for remediation, most of the unserved needs and deficiencies of our mental-health-care-delivery system remain the same. This article reviews the current status of mental health services to children, youth, and families to highlight the necessity of an integrated system of mental health care. The development of a continuum of care that is coordinated across the mental health and non-mental-health systems that naturally occur in all children's lives has the potential to vastly improve mental health services to children, youth, and families.

Simulation of psychosis on a multiple-choice projective test.

The ability of a new multiple-choice group Rorschach instrument to differentiate 62 undergraduate students asked to simulate psychosis from 75 students and 55 schizophrenics given standard instructions was investigated. For each of 50 responses to miniature inkblots, normals and psychotics chose one of four alternative answers as most descriptive of what the stimulus looked like. Simulators responded as they thought a psychotic or insane person would. As hypothesized, simulators chose significantly more "good form but bizarre wording" responses than normals or psychotics, suggesting that the test is promising as a practical clinical indicator of attempts to simulate psychosis.

The relationship of the WISC-R to academic achievement in a clinical population.

Investigated the validity of the WISC-R as a predictor of academic achievement in a population of emotionally disturbed adolescents (N = 35). Correlations and regression equations were derived between the WISC-R and two standardized measures of academic achievement, the PIAT and Woodcock. Verbal and Full Scale IQ estimates correlated at significant levels with the achievement measures used, and Verbal IQ estimates were the best single predictor of achievement. Performance IQ estimates were the least predictive and, as joint predictors, did not add any unique predictability. In comparison to the PIAT where Verbal IQ estimates were the best predictors, results for the Woodcock show that Verbal and Full Scale estimates make comparably significant predictors. Results support the predictive validity of the WISC-R for a clinical population and the continued use of this instrument in assessment batteries.

Distribution of DSM-II diagnoses in a child psychiatric setting.

While DSM-II contains more diagnostic categories related specifically to children than did the earlier DSM-I, clinical utilization studies of the various categories have not been extensive. The present study reports data on the distribution of diagnoses of childhood disorders and analyzes relationships among several diagnostic categories and subject variables. Results indicate that clinicians are using a wide range of DSM-II diagnoses for childhood disorders, including some which were intended for use with adults as well as those which were designed specifically for children. Transient Situational Disorders and Behavior Disorders are assigned almost equally to two-thirds of the sample. Chi-square analyses revealed a relationship between diagnostic categories and subject variables of age and sex. These data suggest that boys, particularly between the ages of 6 and 13, are more frequently than girls categorized as Behavior Disorder, and that the Transient Situational Disorder category is overutilized for adolescents, both male and female.

Influences of examiner differences on rorschach productivity in children.

Rorschach test protocols for a matched sample of male and female subjects in the child and adolescent age range were scored for total responses. The data were analyzed for evidence of interactions between sex of experimenter and sex and age of subject. Consistent differences in total numbers of responses elicited by different examiners were identified. The productivity of both male and female subjects was found to be significantly more variable for male experimenters than for female experimenters. Alternative explanations for the results include greater structuring of the test situation by female experimenters or greater variability of behavior by male experimenters in relation to different subjects. That these explanations can also account for the sex interactions reported by others is recognized.

Prediction of perceptual defense from experimental stress and susceptibility to stress as indicated by thematic apperception.

The present investigation tested the hypothesis advanced by J. Inglis (1961) that perceptual defense and perceptual vigilance result from an interaction between personality differences and degrees of experimental stress. The design, which controlled for questionable procedures used in previous studies, utilized 32 introverts and 32 extraverts, half male and half female, in an experiment with a visual recognition-task. Results indicated that under low-stress conditions introverts and extraverts identified by their response to a thematic apperception task react to threatening stimuli with perceptual defense and perceptual vigilance, respectively. Under high-stress conditions, type of avoidance activity reverses; extraverts react with perceptual defense and introverts with perceptual vigilance. It was suggested that, when both personality and stress variables are controlled, results of the perceptual defense paradigm are predictable and consistent, in support of Inglis' hypothesis.