Substance abuse and the need for money management assistance among psychiatric inpatients.

Patients who mismanage their funds may benefit from financial advice, case management or the involuntary assignment of a payee who restricts direct access to funds. Data from a survey of psychiatric inpatients at four VA hospitals (N = 236) was used to evaluate the relationship between substance abuse and clinician-rated need for money management assistance. Multivariate analytic techniques were used to control for sociodemographic factors and psychopathology. Alcohol and drug use severity both were modestly associated with need for assistance. The effect of substance use severity was greater in patients who were also diagnosed with a major mental illness. Clinicians indicated that 27 patients (11% of the sample) required an involuntary payee and 21 of the 27 (78%) had a Substance Abuse diagnosis. Only drug use severity was significantly associated with need for a payee. These data describe a substantial unmet need for money management assistance in psychiatric inpatients, particularly among those with substance abuse disorders. There is a need to examine the process by which the Social Security and Veterans Benefits Administrations assign payees to determine whether patients with co-morbid substance abuse are not being assigned a payee in spite of their discernible need for one.

Learning and Processes of Associative Mediation.

In the attempt to evaluate product and process views of associative mediation, 80 male and female university students learned paired-associate lists under one of several instructional sets. Those with mediation instructions wrote down associative mediators on cards-with (Intentional) or without (Incidental) instructions to learn the pairs--as pairs were projected onto a daylight screen. Others learned with Standard or Repetition instructions. Incidental mediation instructions were at least equal to Intentional mediation instructions in percent recall and were superior in number of associative mediators produced for normatively linked pairs (p < .05). Production of a mediator was significantly predictive of later recall (p < .001), but mediational instructions may have improved recall even when a rote strategy or no effective strategy was reported. Thus neither the product nor the process view could be rejected; it appeared possible that both types of factor were operating.