Follow-up of adolescent trauma victims: a new model of care.

A comprehensive model of service delivery for the rehabilitative care of adolescents with closed head injuries is presented. Our data show that the Glasgow Coma Scale score on hospital admission correlates with the length of time required for follow-up. Adolescents with mild closed head injuries require more follow-up than adults with comparable injuries because of adolescent developmental stages that complicate the recovery process. Anticipatory guidance has helped the patient and family cope with stresses. Finally, we have identified a typical pattern of difficulties during the recovery process including: impaired judgment, reduced attention span, irritability, short-term memory loss, and ongoing memory deficits.

Parent interview findings regarding the impact of cystic fibrosis on families.

An assessment of the impact of cystic fibrosis (CF) was conducted with 43 families. Semistructured parental interviews on family functioning, parent-child interactions, sibling and peer relationships, and medical issues were coded by two independent raters to identify "major," "minor", or "no" problems. Of the 62 questions presented, only 8 were viewed by more than 10% of parents as "major problems." The impact of hospitalization upon parents was the most prevalent "major problem." Parental communication was a "major problem" for 28% of the mothers but for only one father. Ten to 15% of the parents described "major problems" related to: their marital relationship, accepting the illness, feeling they should do more for their child with CF, feeling their other children had been deprived or complained about inattention, or their relationship with the ill child's grandparents. While most families were generally coping successfully, health care professionals should be alert to specific areas of potential problems.

Perceptual span in schizophrenia and affective disorders.

Perceptual span was assessed in schizophrenic, bipolar affective disorder-manic, bipolar affective disorder-depressed, and nonpsychotic inpatients. Both schizophrenics and manics processed less information than depressives, and did not differ from each other. This suggests that reduced span may be a concomitant of psychoses characterized by distractibility and thought disorder, rather than a trait specific to schizophrenia.

Reaction-time crossover in psychiatric outpatients.

Simple reaction time (SRT) was measured in schizophrenic, bipolar affective disorder, and never-psychotic outpatients to determine the specificity of SRT crossover to schizophrenia. A crossover pattern like that reported in other studies was found among the schizophrenics, but the average curve was not different from that of the other groups. Schizophrenics tended to have higher rates of crossover at the 7-second preparatory interval (47% vs. 17%-28%) but not substantially so. These data question the specificity of this behavioral trait to schizophrenics.

Cognitive-behavior therapy for chronically depressed patients. A controlled pilot study.

In a pilot study, 12 chronically depressed outpatients who had been unresponsive to other forms of somatic and psychotherapy were alternately assigned in order of referral either to cognitive-behavior therapy twice weekly for 10 weeks or to a waiting list control condition for 10 weeks (N = 6 per condition). Outcome was evaluated by changes in social skills and depressive affect measured by self-report inventories, independent clinical ratings, and direct behavioral observation. By the end of treatment, the treated group but not the control group had improved significantly in depression, anxiety, and two indices of social skills. At 6-month follow-up, compared to pretreatment, the treated group remained significantly improved in anxiety and the indices of social skills. In our small sample, treated patients did not differ significantly from waiting list controls on any measure of outcome.

Simple reaction time crossover occurs in schizophrenic outpatients.

A crossover pattern similar to that reported for inpatient schizophrenics (e.g., Bellissimo and Steffy 1972) has now been found for outpatients, and its frequency of occurrence in these outpatients is comparable to that reported for hospitalized patients by DeAmicas and Cromwell (1978). The process-reactive construct was unrelated to crossover in the current study, although crossover is found only in process patients in hospitalized samples. The difference in findings may be due to the insensitivity of the particular measure of this concept used here, or to the lack of validity for the construct in samples of chronic patients in the community and in treatment. The present results, together with DeAmicas and Cromwell's (1978) data suggestive of the presence of crossover in nondisturbed first degree relatives of schizophrenics, are consistent with an interpretation of this reaction time phenomenon as a behavioral marker of vulnerability. This hypothesis warrants study in a more extensive series of patients, and from a longitudinal perspective in which behavioral measures and clinical-social functioning variables are tracked across time.