Outcome comparison of patients receiving oral or depot neuroleptic medication.

Three outcome measures of psychiatric treatment were retrospectively compared between two groups of acutely hospitalized psychotic patients who had been prescribed either oral haloperidol (n = 58) or depot haloperidol (n = 95) as the only medication at the time of discharge. There were no significant differences between the groups on demographic variables, including sex, age, and ethnicity. There were no significant differences between the groups on keeping the initial outpatient appointment, in readmission history over a 4-yr. follow-up, or in length of time to subsequent readmission, if any. It appears that there is no benefit in choosing one form of medication over the other from a clinical perspective, as neither appears more clinically efficacious when examined on these outcome variables. However, there is a significant difference in cost of the two forms of the medication in favor of the oral form, making the oral form more favorable if cost is to be minimized.

Dementia and mental retardation markers on the Rey 15-item Visual Memory Test.

This study examined the qualitative errors of repetitions and confabulations on the Rey 15-item Visual Memory Test among 500 psychiatric patients who were divided into groups with (1) low IQ scores, (2) a diagnosis of dementia, and (3) other psychiatric diagnoses. These groups were compared on the presence of confabulated figures and repetitions on the Rey. The low IQ patients had the highest rate for both confabulations (48.2%) and repetitions (43.6%). Demented patients had the next highest rate of confabulations (39.8%) and repetitions (39.8%). The general psychiatric patients had the lowest rates on confabulations (16.2%) and repetitions (26.8%). Chi squared analysis showed that both confabulations and repetitions significantly differentiated these patients of low IQ and demented patients from general psychiatric patients. These results suggest that clinicians who use the Rey 15-item Visual Memory Test and find either confabulated or repeated figures should further explore the possibility that the patient might have low intellectual functioning or dementia.

An outcome survey of psychology residency training program graduates of the University of Texas Houston Medical School.

A survey of 71 graduates of the psychology residency program at The University of Texas Houston Medical School and the Texas Research Institute of Mental Science indicated that two-thirds of the respondents were involved in private practice, conducting primarily individual therapy, with assessment also playing a major role in their practice. Managed care had the effect of placing limits on the numbers of sessions available to patients, reducing income, and increasing paperwork associated with practice. Implications for training during residency are that individual therapy, using focused short-term approaches, and assessment should continue to be the primary clinical experiences for trainees, and that there should also be training in the business aspect of practice, including marketing.

Note on concurrent validation of the personality assessment inventory in law enforcement.

This study compared the Personality Assessment Inventory and MMPI-168 profiles of 9 law enforcement applicants with published MMPI profiles to provide concurrent validation for the use of the Personality Assessment Inventory to assess personality pathology of peace officer applicants. The sample showed subclinical elevations of the Positive Impression and Treatment Rejection scales on the Personality Assessment Inventory and subclinical elevations on the MMPI validity scales of Lie and Correction and the clinical scales of Psychopathic Deviate and Hypomania. The applicants' mean MMPI profile provided concurrent validation for the use of the Personality Assessment Inventory in this decision on fitness to serve.

Comparison of the Shipley Institute of Living Scale and WAIS-R IO scores for a sample of public sector psychiatric inpatients.

This study examined the use of the Shipley Institute of Living Scale as a screening device in an intellectually low functioning psychiatric population of 40 inpatients. Shipley IQ scores were significantly correlated .72 with Full Scale WAIS-R IQ scores. There was no significant difference between the mean IQ scores generated from the two measures. These findings suggest that the Shipley scale may be used in this population despite a caution by the test's publisher that the test should not be used in assessing intellectual functioning in individuals with borderline or lower intelligence.

Trail Making Test norms for psychiatric patients.

The Trail Making Test was administered to a sample of 661 inpatients in a publicly supported psychiatric hospital. The patients' mean IQ of 83.7 (SD = 13.0) was in the low end of the low average range. Multiple regression analysis of the scores showed significant IQ and age components of Trail Making Test scores; however, education and gender differences in performance were not significant once IQ and age were factored into the regression equation. Ability-based norms using time in seconds to completion as the score and IQ as a moderator variable are presented. Such norms allow more appropriate evaluation of the differential cognitive functioning of this population than previously published norms. Normal standard score conversions from raw scores, the intercept, regression weights for IQ and age, and standard error of the regression for both the Trails tasks are provided for individuals desiring to write a program to provide scores corrected for IQ and age.

Psychiatric norms for the Rey 15-item Visual Memory Test.

The 15-item Visual Memory Test was proposed by Rey in 1964 as a measure of malingering of visual memory. Among psychiatric patients the task has a significant cognitive component, with IQ accounting for 37% of the variance in scores (r = .60). Any interpretation of scores on this task should be ability-based. Such ability-based norms are provided in this study of psychiatric patients (N = 300). Use of a single cut-off score to indicate malingering or any other interpretation is inappropriate given the psychometric properties of the task. In the assessment of immediate visual memory the task has some utility, which is greatly enhanced with the use of ability-based norms.

Students' knowledge of AIDS and sexual risk behavior.

College students appear to be knowledgeable of the methods of transmission and risks of the AIDS virus. However, the reality of susceptibility to infection does not seem to have altered their conduct. In a study of 19 heterosexual college students, knowledge and intention do not appear to be good predictors of sexual behavior. Young people appear to continue high-risk sexual behavior even while knowledgeable of the risks of AIDS.

Self-efficacy among hospitalized mentally ill patients.

General self-efficacy and social self-efficacy were measured in a psychiatric inpatient population of 105 and compared with Sherer's 477 college students. Patients have lower self-efficacy than college students. A small but significant correlation of .38 was noted between general self-efficacy and social self-efficacy. Age was related to general self-efficacy but not social self-efficacy in this population.

Methadone patients' opinions on legalization of drugs.

Clear differences in the attitudes of 1,226 adults in a Gallup survey and 130 patients in 4 methadone treatment programs were observed. Patients were more permissive on legalization of use of and education about drugs than the adult sample.

Some comments on the Peschels' model of biologically-based brain disease.

The model of treatment of mental disorders described by Peschel and Peschel (1990) raises the problem of medical patriarchy. The model does not consider the marked impact of cognition, volition, and affect on the physical realm. While a model of treatment based on a psychological matriarchy is no better, a model of training in health promotion with an appropriate balance of the physical, mental, and spiritual aspects of life gives more hope of training professionals who can see the larger picture of their patients' lives and a better record of success than presently exists.

The role of Addington v Texas on involuntary civil commitment.

The United States Supreme Court in 1979 set the standard for involuntary commitment. This decision, styled Addington v Texas, raised the burden of proof required to commit persons from the usual civil burden of proof of "preponderance of the evidence" to "clear and convincing" evidence. There was no reduction in the rates of commitment as a result of the decision. The proportion of patients committed in Texas grew in almost linear fashion during the years 1972-1986. Various economic, sociological, and treatment factors may have more influence on commitment of patients than does a court decision.

Self-esteem and stress as factors in abuse of children.

A comparison of stress and self-esteem as made between a group of 23 couples in treatment who had abused their children and 23 control couples who were matched for age, race, sex, education, and occupation. Stress was measured by the Recent Life Changes Questionnaire. Self-esteem was measured by a synthesis of 38 items selected by mental health professionals from the Clarke Parent/Child Relations Questionnaire and the Self-description and Mate Description Form. Analysis of variance showed that couples who had abused their children had significantly greater stress than control couples. However, there was no significant difference between the groups on the measure of self-esteem. There was also no interaction effect of stress with self-esteem on abuse. While it seems well established that stress is a major contributor in child abuse, the interaction of stress with personality factors of parents who abuse their children remains uncertain.

The modulation of oxygen toxicity by intermittent exposure.

Intermittent delivery of hyperbaric O2 protects animals from pulmonary and central nervous system toxicity: more total O2 time can be tolerated if interrupted by short periods of low O2. Little is known about the mechanisms or optimization of systematically varied intermittency. Survival time was recorded in groups of 16 awake guinea pigs (239 +/- 23(SD) g) exposed to continuous O2 at 2.8 ATA or to one of six different schedules of O2 delivered with periodic air (PO2 = 0.588 ATA) interruptions. The survival curves had a lag time (11-14 hr of O2 time depending on the intermittency schedule) with a rapid loss of animals thereafter. Data were analyzed with risk models linking the probability of death to the accumulation of a putative toxic substance, X1. A model in which X1 accumulated in proportion to the PO2 and disappeared by first-order decay during periods of low O2 exposure was modified to include an effective rate constant for changes in X1: dX1/dt = a.PO2 + K1.(PO2 - Os).X1. First-order kinetics operated when PO2 was below the oxygen set point (Os), but the rate constant reversed sign to become a self-amplifying system when PO2 was above Os. This model achieved an excellent fit as judged by goodness-of-fit statistics while a simpler one did not. Our analysis suggests that the accumulation of toxicity does not correspond to a stable linear toxic process, but requires one in which a toxic process grows autocatalytically.