Staff opinions about seclusion and restraint at a state forensic hospital.

OBJECTIVE: The purpose of the study was to obtain staff opinions on the use of seclusion and restraint with acutely psychotic psychiatric patients in a forensic hospital. METHODS: A 40-item questionnaire was distributed to 129 staff members who routinely used these techniques. Descriptive statistics, intercorrelations, and analyses of variance were used to examine patterns of response. RESULTS: Of the 109 respondents, 63 percent favored the use of medications over physical procedures, and 65 percent said that they would order seclusion over restraint if medications could not be used. Responses indicated that staff tended to choose to treat patients as they themselves would want to be treated. Staff with more education, including psychologists and social workers, believed that staff other than physicians should have the authority to write seclusion and restraint orders. Female staff believed that patients experienced seclusion or restraint as positive attention, while male staff believed that it was a negative experience. Staff with more education believed that restraints, seclusion, and medication were overused. CONCLUSIONS: The findings that gender and level of education affect staff's use of physical procedures with acutely psychotic patients have important implications for staff training.

Correlates of the Woodcock-Johnson Reading Comprehension and Kaufman Brief Intelligence Test in a forensic psychiatric population.

Assessing the forensic psychiatric patient remains an ongoing challenge. This study assessed the intellectual status of lower-functioning incarcerated adult males with the Woodcock-Johnson Reading Comprehension subtest and the Kaufman Brief Intelligence Test. The results of this study have led the authors to argue for a broad-based assessment model that focuses on the demands and constraints of the dispositional setting.

A follow-up study of psychiatrically hospitalized adolescents.

The present study analyzes the effects of milieu treatment on 169 teenagers admitted to a midwestern state psychiatric facility. Pre- and post-hospitalization data for both males and females indicate improved functioning in all the areas studied.

Substance use by adolescent psychiatric inpatients and their parents.

The relationship between adolescent psychiatric inpatients' and their parents' drug use was studied using a questionnaire format. The major finding was that there was no systematic relationship. It is hypothesized that due to recent family realignments, adolescents are turning away from their parents and toward peers for their role models in drug use.

Genital herpes. A pervasive psychosocial disorder.

The reports of patients with genital herpes suggest that it is not an awesome physical disability; the more distressing consequences appear to be psychosocial. The symbolic meaning of the disease and its effects on self-esteem and body image have the greatest destructive impact. Patients move through a sequence of adaptational responses remarkably similar to those described for cancer. Of greatest importance is their growing sense of social isolation and their reluctance to initiate relationships with members of the opposite sex.

A comparison of parental and adolescent MMPIs as related to substance use.

Three groups of adolescent psychiatrically hospitalized substance users (minimal, moderate, and heavy) and their parents were compared on the nine standard MMPI scales and the MacAndrew Alcoholism Scale. The results indicated that the adolescent minimal users were more disturbed than the other two user groups. No relationship was found between adolescent and parent substance use. The major finding was that for the adolescent there was a significant relationship between the MacAndrew Scale and the extent of his substance use.

Efficacy of psychiatric inpatient hospitalization for adolescents as measured by pre- and post-MMPI profiles.

The efficacy of inpatient hospitalization on emotionally impaired adolescents was investigated using present and past MMPI data. The results indicated that there is a "flattening of the profile toward normalcy" from time of admission to discharge time. Further statistical analysis revealed that of the 9 clinical MMPI scales, the "Depression" scale showed greatest change toward improvement.

Facilitating oral hygiene in patients with chronic schizophrenia.

Ten patients with chronic schizophrenia and with poor maintenance of dental hygiene were instructed, using a variety of motivational and reinforcement techniques, to improve oral hygiene. Results indicated significant changes in several of the most maladaptive behaviors.

Comparison of the visually evoked response in drug-free chronic schizophrenic patients and normal controls.

Thirteen cooperative male drug-free chronic schizophrenic patients, and 11 mentally normal male controls were studied. The VER was recorded from scalp leads O1, O2, Oz, C3 and C4 to combined ear reference (A1--A2). The stimulus was an unpatterned flash of single intensity. Compared to normal controls, there were no consistent differences in wave peak latencies or amplitudes for chronic schizophrenics in any brain area tested. When the chronic schizophrenic patients were separated on the basis of high and low tryptophan uptake, using the Frohman--Gottlieb criteria, the high uptake group exhibited normal VERs while in the occipital regions the low tryptophan uptake group exhibited prolonged latencies and an increased amplitude for wave V when compared to normals. From BPRS scores the high tryptophan subgroup indicated a greater degree of psychopathology than the low tryptophan subgroup. The results obtained do not support an indole hallucinogen hypothesis for process schizophrenia.

Effects of scoring norms on adolescent psychiatric drug users' and nonusers' MMPI profiles.

The present study compared the effects of scoring norms on adolescent psychiatric inpatient drug users' and nonusers' MMPI profiles. The results indicated that regardless of drug usage or nonusage the application of adolescent norms yielded less pathological profiles than did the use of adult norms. A further finding was that Scale O, Social Introversion, is the only clinical scale from differentiated users' from nonusers' profiles.

Evaluation of intellectual, linguistic, and achievement variables in normal, emotionally disturbed, and learning disabled children.

This study addresses itself to developing an abbreviated test battery to assess children presenting learning difficulties in the classroom. Factor analyses of the WISC, ITPA and PIAT revealed that 85% of the total variance of these tests can be accounted for by an abbreviated battery utilizing 12 subtests from the 26 in the total from all three tests. Evidence is presented that the discrepancy between academic achievement and academic aptitude is not as great as expected, in children with apparent underachievement, when careful, reliable measures are used.

Characteristics of drug abusers in an adolescent in-patient psychiatric facility.

Characteristics related to the abuse of drugs in 143 adolescents who had been institutionalized in an inpatient psychiatric facility were investigated. A factor analysis generated the following clusters: (1) multiple drug usage, (2) male narcotics procurement, (3) drug history, (4) prognostic index, (5) family drug usage, (6) entrepreneurial procurement of drugs, and (7) social procurement of drugs. Results also indicated that our patients are coming to us at increasingly younger ages and that patients admitted in 1969 appear more seriously involved in drug abuse than those admitted before or after this time.

A matched-subject comparison of underachievers with normals on intellectual, behavioral, and emotional variables.

Children labeled as underachievers are compared to a matched group functioning normally within the classroom. Factor analyses of the data from several tests reveal that the "normal" children not only have achieved higher academic performance but also have better learning aptitude. The inference may be made that many "underachievers" actually have a low general aptitude when carefully measured.

Relationship between basal body temperature and body activity in a human following a bilateral oophorectomy.

Continuous measures of arm movement activity and basal body temperature were obtained on one female over a total of 149 days, beginning 3 months subsequent to this female's bilateral oophorectomy. Prior to the oophorectomy the subject had been menstruating regularly, and earlier data on this subject had indicated a low-order positive correlation between temperature and activity. The present results found no such correlation, lending support to the notion that at least one index of bodily activity is related to ovarian functioning.

Effects of scoring norms on adolescent psychiatric patients' MMPI profiles.

Effects of employing standard adult and age-appropriate norms on the profile elevation, patterning and classification of adolescent patients' MMPI profiles were examined. More elevated and more often psychotic profiles were obtained with adult norms. Some sex differences were observed, but patient race was not an important source of profile variation.

Comparison of the WISC and WISC-R on a psychiatric adolescent impatient sample.

The present study compared the WISC and WISC-R on a group of psychiatric adolescent inpatients. The results indicated high intercorrelationss between the two test versions but with the correlation linearly related to the changes in content and administration rules of the WISC-R. Analyses of variance indicated that, on the basis of the Full Scale IQ, the WISC is an "easier" test than the WISC-R.