The multi-attitude suicide tendency scale: further validation with adolescent psychiatric inpatients.

The present study was designed to examine the construct validity and psychometric properties of the Multi-Attitude Suicide Tendency Scale in adolescent psychiatric inpatients. This new scale has four subscales: attraction to life, repulsion by life, attraction to death, and repulsion by death. Confirmatory factor analysis of the scale items provided support for the fit of the 28-item, four-factor model. Results of logistic regression analyses revealed that high scores on the repulsion by life and the attraction to death subscales were useful in assessing the risk for suicide attempts. Results of the hierarchical regression analysis showed that high repulsion by life and low attraction to life subscale scores contributed to the prediction of scores on the suicide probability scale. We also examined gender differences on the four subscales and the psychological correlates of each subscale.

The economic cost of infertility-related services: an examination of the Massachusetts infertility insurance mandate.

OBJECTIVE: To examine the costs and outcomes of infertility-related services in Massachusetts during a time of expanded use of assisted reproductive technology (ART). DESIGN: Cost data were obtained from the Massachusetts Department of Insurance Rate-Setting Commission and 9 large group insurance plans for the period 1986-1993. Utilization and success rates of ART were examined, and the cost per live delivery with the use of ART in 1993 was estimated. SETTING: The state of Massachusetts, in which access to infertility-related services has been mandated by law since 1989. PATIENT(S): The study population consisted of 8 large health maintenance organization plans and the Blue Cross/Blue Shield indemnity plan. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Per capita infertility-related expenditures, infertility-related expenditures as a percentage of total expenditures, live deliveries per initiated ART cycle, and cost per live delivery. RESULT(S): Expenditures for infertility services increased at a rate similar to or slower than inflation during the years 1988-1992. Increases were slowest in health maintenance organizations, probably as a result of provider arrangements. Infertility services accounted for 0.41% of total expenditures within the indemnity plan in 1993 (approximately $1.71 per contract-month). Examination of ART utilization showed no evidence of overutilization by patients with a low chance of success. The cost per live delivery with the use of ART in 1993 was $59,484. CONCLUSION(S): Mandated infertility coverage was associated with increased use of ART but not with excessive increases in consumer cost for infertility insurance coverage.

Validation of the Multi-Attitude Suicide Tendency scale in adolescent samples.

The present study extended research on the factor structure and psychometric properties of the Multi-Attitude Suicide Tendency scale (MAST). A mixed sample of 215 adolescents, aged 15 to 18 years, participated in the study. Exploratory principal-components analysis of the 30 MAST items provided support for the four-factor structure of the scale: attraction toward and repulsion by life and death. The MAST subscales showed satisfactory levels of internal consistency. Specific and subset of the MAST subscales were identified for differentiating among adolescents who differed in degrees of psychopathology and suicidal behavior. Correlational and regression analyses examined the relations among the MAST subscales and self-report measures of suicidal behavior, social desirability, and general psychopathology. Limitations and suggestions for future research are discussed.

Social information processing in aggressive and depressed children.

Social information processing patterns of children who were identified as being aggressive or depressed, both, or neither were compared in order to address the issue of specificity and to explore whether children who are comorbid show a unique processing style. Subjects were 220 children in the third through sixth grade. Peer nomination and teacher ratings were used to assess level of aggression, and the Children's Depression Inventory was used to measure level of depression. Aggressive children showed a hostile attributional bias, were more likely to report that they would engage in aggressive behavior, and indicated that aggression would be easy for them. Depressed children similarly showed a hostile attributional bias, although they were more likely to attribute negative situations to internal, stable, and global causes. Depressed children also reported that they would be less likely to use assertive responses and that they expected that assertive behavior would lead to more negative and fewer positive outcomes. Children who were comorbid generally showed patterns similar to both aggressive and depressed children.