Computerized interpretation: Additional issues concerning ethics, standards, and regulation of practice.

Extends J. D. Matarazzo's (see record 1986-19878-001) discussion of computerized clinical psychological testing by discussing legal and licensing considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computerized service delivery in clinical psychology.

Compares the attributes of human clinicians and computer models as a means of examining their compatibility in service delivery. The use of the computer in psychophysiology and biofeedback, interviewing, assessment and diagnosis, and treatment is also reviewed. Economic and ethical considerations in the use of computers, as well as technological and professional obstacles to their adoption, are discussed. Psychologists and other mental health professionals are encouraged to take a more aggressive role in developing, testing, and adopting computerized service-delivery applications. Recommendations are made regarding the need for a detailed empirical analysis of attitudes and patterns of computer use in clinical psychology. (4 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current developments and future directions in computerized personality assessment.

Contends, on the basis of a review of current examples of computer usage in personality assessment, that there is wide acceptance of automated clerical tasks such as test scoring and administration. The computer is also writing narrative interpretive reports from test results. Three proposed strategies (countdown, adaptive typological, and a strategy borrowed from ability testing) for developing computerized adaptive personality tests are described. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using personality tests in preemployment screening: Issues raised in Soroka v. Dayton Hudson Corporation.

Soroka v Dayton Hudson Corporation was the first case in which, on the basis of individuals' right to privacy, the use of psychological tests by a private sector employer was challenged. This article reviews the factual evidence and documentation from the case, discussing a number of technical and professional issues. Test users should consider the potential implications of using tests containing invasive items, and the relevance of personality constructs and evidence of validity for their use in preemployment screening. The legitimacy and legality of clinical personality tests for preemployment screening are questioned and balanced against the utility of such data for the selection or exclusion of job applicants. Finally, the job relevance of personality constructs, technical requirements for job analytic data, the impact of federal guidelines on employment testing, the face validity of items, and assumptions for generalizing across jobs are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

CARE: Bridging the gap between clinicians and computers.

Psychologists and other mental health specialists have yet to capitalize on the enormous potential of computers as "clinical assistants." Many therapeutic uses of computers reflect overly ambitious if not naive uses of these machines, such as providing warmth and understanding to hurting persons. The present authors review previous applications of computers in health care, the nature and scope of computer resistance, the relative merits of people and machines in performing different kinds of tasks, and the ethical–legal issues involved when psychological services are provided by computers. Also presented is a relatively simple algorithm for an automated psychological service delivery system that provides, in response to specified complaint statements, low-level inference evaluations, concrete clinical advice, and modest referral information. The use of this computerized assistance, referral, and evaluation (CARE) system in a college community is described. (33 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's understanding of adoption: Developmental and clinical implications.

Because adopted children are overrepresented in mental health settings, their parents often consult psychologists to help them understand and manage some of the unique developmental and childrearing challenges they commonly face. One of the most frequent issues raised by these parents is talking with their children about adoption. This article provides a developmental framework for helping psychologists understand the way children comprehend adoption and the implications of their adoption knowledge for psychological adjustment. It also provides psychologists with useful guidelines for supporting parents to meet the challenges of discussing adoption with their children. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Computerized testing.

Professionals using computerized testing require substantial training in the principles and procedures of testing and an awareness of the variables that affect test-taking behavior, such as distractions, sensory defects, and motivational level. Legal and ethical considerations involved in the use of automated interpretation services are noted, and the question of the comparability of standard and computerized tests is discussed. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intraoperative automated ST segment analysis: a reliable 'black box'?

PURPOSE: To review the application of intraoperative computerized ST analysis and its potential impact on postoperative outcomes. SOURCE: Existing anaesthesia and cardiology literature. PRINCIPAL FINDINGS: Computerized ST analysis was introduced into the operating room using exercise electrocardiographic (ECG) systems. In spite of sophisticated algorithms, errors do occur. Downsloping or horizontal ST depression are the classical criteria for ischaemia. Although algorithms have been developed and evaluated in exercise stress testing, only limited evaluation has been carried out in the operating room. This may be a concern since circumstances in the operating room may frequently lead to false positives. Similarly, studies suggest that all myocardial ischaemia may not exhibit ST changes. The diagnostic accuracy of ST depression in exercise stress testing also cannot be assumed in the operating room. Finally, if ST analysis is applied widely, without considering the population or disease prevalence, misdiagnosis may occur. CONCLUSION: Given the number of anaesthetic tasks at-hand, on-line computerized ST analysis in the operating room can be a useful asset. The technology has its problems and should be applied with an understanding of its limitations and potential for errors. It should be applied in the operating room within the context of the population and disease prevalence.     

Hospitals of Developing Countries: Design and Construction Economics

The design and construction of hospitals in the low income regions of developing countries represent a special challenge. Functional requirements must be satisfied, yet at the same time, cost must be reduced to affordable limits. The purpose of this paper is to define the economic and technological considerations that must be observed in the design and construction of these hospitals. In addition, it suggests strategies that could be adopted successfully in those regions. Relevant economic, technological, and sociocultural factors are identified. These provide a background for the hospital operation. The main components of hospital buildings and the most relevant design objectives are discussed. The cost of hospital construction in a developing country (Egypt) is analyzed and major cost items are identified. Means of cost saving are discussed that arrive at strategies for the reduction of initial and running costs. These strategies include the reduction of built areas, the adoption of appropriate construction methods and simple structural systems, the standardization of designs and components, the utilization of natural lighting and ventilation, the adoption of heavy duty materials, and the selection of appropriate electromechanical systems.     

Using new reasoning technology in chemical information systems

Unreliability of numerical data causes difficulties in computer systems for decision-making, risk assessment, and similar activities. Much human judgment is non-numerical and able to make useful evaluations of alternatives under uncertainty. The Logic of Argumentation (LA) offers a basis for computerized support of decision-making in the absence of numerical data, and it is being used in a project on carcinogenic risk assessment, StAR. There are potential applications of LA in other artificial intelligence systems in chemistry, such as for synthesis planning.     

The case against preadoption genetic testing

Adoption professionals and prospective adoptive families have become increasingly interested in obtaining genetic information on children prior to adoption. Predictive genetic testing of apparently healthy children has been urged as a way of generating information about children's future health and assisting families in deciding whether to adopt. Such genetic testing of children, however, raises a host of ethical issues with important implications for adoption policy and practice. The medical and psychosocial benefits and risks of predictive testing provide the context for analyzing the ethics of such testing. Ethical considerations strongly counsel against predictive genetic testing solely for purposes of evaluating a child for adoption.     

Psychologists and technology: A look at the future.

A randomly sampled group of 213 California psychologists were interviewed to assess their use of practice technology and their general attitudes toward technology. Results indicated that (a) nearly 3/4 were using a computer in their practice; however, nearly all uses involved little more than word processing; (b) 1/4 had used a modem to connect to an on-line service (substantially higher than comparable data from business professionals); (c) over 3/4 were using a fax machine in their practice; (d) 1/2 used a pager; (e) 4 out of 10 used a computerized voice mail system, mostly in combination with other messaging systems; (f) few were using computerized assessments; and (g) over half rated themselves as mildly to highly technophobic. Hierarchical multiple regression analyses indicated that technophobia, use of psychological assessment instruments, age, and percentage of managed care clients predicted the use of computer applications. Results are discussed in terms of their practice implications for psychologists (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Landmarks in computer-assisted psychological assessment.

Traces the history, development, and rationale of computer-based psychological test interpretation (CBTI). Developments in computer technology permitted a progression from mail-in services to on-line interactive testing. A taxonomy of CBTI systems is appended, and use of CBTI systems with such tests as the Minnesota Multiphasic Personality Inventory (MMPI), the Sixteen Personality Factor Questionnaire (16PF), and the Rorschach is discussed. Interactive computer-based testing, recurring issues such as ethics and validity, and evaluations of the early systems are also addressed. (76 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Facilitating practice changes in mental health clinics: A guide for implementation development in health care systems.

For more than a decade, health care systems have attempted to implement evidence-based practices and guidelines. These efforts have demonstrated the difficulty in making practice changes in complex systems of care. Many health care systems, including the Department of Veterans Affairs (VA) and state community mental health systems, have made adoption of evidence-based treatments, especially psychotherapies, a priority. Psychologists, as behavioral change experts and clinical leaders, are positioned to aid local implementation efforts but may have limited knowledge of the “implementation science” literature. This article provides a brief introduction to the implementation literature and offers a guide for developing an implementation plan to adopt evidence-based psychotherapies in local health care settings illustrated by a hypothetical example. Challenges to implementation are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Practice guidelines: Not yet ideal.

Efforts to identify empirically supported psychological treatments over the past half century have been strongly influenced by the development of more potent treatments and more effective outcome research methods. Practice guidelines incorporating empirically supported treatments proposed by the Agency for Health Care Policy and Research, the American Psychiatric Association, and the Division of Clinical Psychology of the American Psychological Association are described and critically assessed. Advocates for practice guidelines assert that they promote therapeutic accountability and motivate adoption of the best current practices; critics question their empirical bases, diverse standards of proof, and potential to constrain clinical decision making. These claims are critically examined, and when appropriate, solutions are suggested. It is clear, however, that the one solution that will not work is a return to the preguideline era. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teaching clinical psychology graduate students about traumatic stress studies.

Although clinical psychology graduate seminars in traumatic stress are needed, teaching these courses carries unique challenges and opportunities. This paper describes the rationale, purpose, and process of developing a specialized course in traumatic stress. This course is used as a model for discussing implementation considerations that could be applied in other graduate programs. Course construction, teaching challenges, and potential solutions are presented. In particular, a process for addressing the affective and intellectual integration of material is emphasized. Attempts to assess the quality and outcomes of teaching activities are provided to illustrate future directions for improving trauma-related pedagogy and research that evaluates such pedagogy. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

On the use and misuse of psychological testing in child custody evaluations.

Examined the use of psychological testing in child custody and visitation disputes. It is argued that although psychological testing can play an important role in custody and visitation evaluations, psychologists routinely misuse test data in this type of forensic case. Possible reasons for the misuse of test data are explored in terms of the assumptions and motives of both legal and mental health professionals. Alternatives to traditional psychological testing in custody and visitation cases are examined. Finally, guidelines for responsible and ethical use of psychological testing in custody evaluations are offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy or massage parlor technology? Comments on the Zeiss, Rosen, and Zeiss treatment procedure.

Argues that there are numerous ethical, moral, philosophical, and social psychological issues involved in modern sex therapy. Psychologists have accorded sex therapy a warm reception into the field, but present ethical guidelines are insufficient to protect clients from psychological damage in the form of massive intrusions on privacy and reoriented moral and religious values. Further, the more explicit procedures seem to carry a message to society that "anything goes." The procedure employed by A. M. Zeiss et al (see record 1978-01520-001) is used as a reference point for discussing these issues. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV antibody testing in a teaching hospital: policy versus practice

The cost of HIV antibody testing can be phenomenal. Thus many countries, Ghana included, have adopted policies to guide physicians in making judicious test requests. An analysis of compliance with this policy in a teaching hospital in Ghana, shows that 70% of physician requests meet the stated Ministry of Health guidelines. However, while 84.5% of all test requests which turned positive were within stated guidelines, 48.6% of those turning out negative were not indicated by the policy. The cost of HIV antibody testing could be minimised if clinicians operated within the stated guidelines which make considerations for judicious use of health resources. Compliance with policy also needs evaluating.     

Performance of blacks and whites in computerized versus manual testing environments.

Discusses the problems of research on race and IQ, and describes a study which compared the results of manual and computer testing in judging the performance of blacks and whites. Ss were 10 white and 10 black male high school students. Performance by whites was the same under both procedures. Blacks performed significantly lower in manual tests, but in computerized tests their performance improved and was indistinguishable from that of whites. Theoretical reasons for these findings are discussed. It is felt that the computerized testing procedure circumvents many problems of earlier research. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)