Validity of the Medical Model for Mental Illness.

This is a comment to Allen S. Mariner's article in the American Psychologist (1967, 22, 271-281). The article, in which the psychiatrist held the medical model to be invalid in the treatment of the mentally ill be made a part of the record of the Committee hearing that asked that Medicare be amended to cover psychologists' fees independent of medical supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anosognosia and denial: Their relationship to coping and depression in acquired brain injury.

Objective: To evaluate relations among denial, anosognosia, coping strategies, and depression in persons with brain injury. Study Design: Correlational. Setting: A Midwest residential, post-acute brain injury rehabilitation center. Participants: Twenty-seven adults with brain injury. Measures: Clinician's Rating Scale for Evaluating Impaired Self-Awareness and Denial of Disability After Brain Injury, COPE, Beck Depression Inventory-I. Results: Denial and anosognosia were related and co-occurred. Use of process coping strategies was associated with greater use of problem-focused coping strategies. Higher levels of denial were associated with greater use of avoidant coping strategies, and greater use of these coping strategies was related to higher levels of depression. Conclusions: Individuals primarily in denial and individuals primarily anosognosic differ in the coping strategies they institute. Avoidant coping strategies are used more frequently by individuals in denial, and use of these strategies is associated with higher levels of clinical depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stages of Change Among Chinese People With Mental Illness: A Preliminary Study.

Objective: To determine the effect of self-efficacy and outcome expectancy on the readiness for rehabilitation among Chinese people with mental illness. Participants: Fifty-eight men and 62 women with chronic mental illness. Outcome Measures: Change Assessment Questionnaire for People With Severe and Persistent Mental Illness, Task-Specific Self-Efficacy Scale for People With Mental Illness, and Outcome-Expectancy Scale for People With Mental Illness. Results: Chinese people with mental illness can be meaningfully classified into 4 stages of change (SOC) groups: precontemplation, contemplation, ambivalent-conforming, and action-maintenance. SOCs are related to self-efficacy in interpersonal, symptoms management, and help-seeking skills as well as expectations about the benefit of social and coping skills. Conclusion: The SOC concept is useful for tailoring culturally sensitive psychiatric rehabilitation interventions for Chinese people with mental illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Reminiscence and Stage of Illness in Schizophrenia": Erratum.

Reports an error in the original article by J. Higgins and S. A. Mednick (Journal of Abnormal Psychology, 1963, 66[4], 314-317). On page 317, the third line of the right-hand column should read: phrenics were .46 and .50, respectively. (The following abstract of this article originally appeared in record 1963-08191-001.) When given a repetitive inverse alphabet printing task to perform for 5 min. of massed practice, Early Stage schizophrenics (N=16) displayed a greater degree of improvement in performance (reminiscence) after a 2-min. rest than did Advanced Stage schizophrenics (N = 16). Early Stage and Advanced Stage schizophrenia were defined in terms of a theory of schizophrenia which postulates differential levels of arousal as characteristic of the stages of the disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Foreword: Values in psychotherapy.

Contends that the glory of psychotherapists' "tree of psychology" is that its roots are absolutely philosophical and, therefore, limitless in scope and devoid of absolute proofs. The trunk of this tree is a solid and substantial store of scientific and empirical data. The branches bear a multitude of flowers, many of which are not quite substantial; not made to endure the critical climate of a questioning world. Ultimately, however, these flowers contain the germinating factor, that which allows human knowledge the possibility of continued growth and rejuvenation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Putting Outcome Measurement in Context: A Rehabilitation Psychology Perspective.

This article provides an overview of topics related to health care measurement as applied to medical rehabilitation. Described are conceptual models of health outcome measurement in rehabilitation and their utility for researchers and clinicians, the application of contemporary measurement approaches to rehabilitation outcome measurement, and accrediting organizations' efforts to implement performance indicators for rehabilitation. The discussion situates participation as a key interest of rehabilitation psychologists and other stakeholders. Reviewed are examples of instruments designed to operationalize participation, advances in measurement theory, and methods that allow outcome indicators to be measured more accurately and easily, including item response theory. This introduction concludes by considering how public disclosure of outcomes can help consumers make more informed choices and help accrediting organizations' efforts to promote outcome disclosure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From Theory to Application and Back Again: Implications of Research on Medical Expertise for Psychological Theory.

Research directed at an understanding of medical expertise is about 30 years old, and many developments in this literature parallel progress in cognitive psychology. Over the past 15 years or so, this research became much more closely identified with particular psychological theories. Initial forays into medicine were essentially direct applications of methods developed in the psychology lab to the more natural domain of medicine, with varying degrees of success. These attempts were followed by a second wave that took the psychological theories themselves more seriously in a more thoughtful application of psychological methods to the medical domain. I will argue in the present paper that the methods and theories used in the study of medical expertise have advanced to the point that there is some reverse flow and they are providing a unique and valuable perspective on the nature of thinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Item Response Theory and Computerized Adaptive Testing: Implications for Outcomes Measurement in Rehabilitation.

Objective: To evaluate computerized adaptive testing (CAT) measures of rehabilitation outcomes. Study Design: Physical functioning questions were calibrated via item response theory (IRT) and administered with CAT software. Subjects: 485 adults interviewed during postacute care rehabilitation (simulation study) and 26 adults who completed CAT and personal interviews (CAT pilot study). Main Outcome Measures: Patient acceptance and respondent burden, reliability, and discriminant validity. Results: In the simulation study, CAT-based estimates correlated highly (r=.93 and r=.98) with criteria, minimized ceiling and floor effects, and reduced respondent burden while achieving high reliability. Pilot study patients preferred self-administered CAT surveys, and CAT scores discriminated well across severity levels. Conclusions: CAT software has considerable potential to improve physical functioning measurement in rehabilitation settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do-It-Yourself Testing for Mental Illness: Ethical Issues, Concerns, and Recommendations.

Do-it-yourself (DIY) testing for various medical problems has existed for some time and is likely here to stay. However, only relatively recently have such tests been targeted toward mental illness. From the point of view of professional psychology, the development and use of DIY tests for psychological disorders raises numerous ethical issues, including lack of in-person counseling, potential for misuseabuse, and lack of informed consent. In addition, there is currently little government regulation or professional oversight of DIY tests, possibly increasing the chances for unethical practices. This article reviews some currently available DIY tests for mental illness, examining the ethical issues surrounding such tests and making recommendations for the crafting of ethical guidelines for their development and use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conducting Psychological Research in Medical Settings: Challenges, Limitations, and Recommendations for Effectiveness Research.

Efficacy research is insufficient and ineffective in changing practice, despite a large supporting psychotherapy efficacy literature. Concurrently, demand for supporting data and the burden on everyday practice for generating these data is increasing. The disconnect between efficacy and effectiveness is due to a lack of conceptual and methodological tools for testing efficacious procedures in real-world settings, particularly medical contexts. This article articulates the position that effectiveness studies pose more complex questions that require an alteration of conceptual and methodological frames of reference in order to make behavioral services available to the broadest patient base. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

International Classification of Functioning, Disability and Health: An Introduction for Rehabilitation Psychologists.

The International Classification of Functioning, Disability and Health (ICF) represents a new way for rehabilitation psychologists and other health care providers to classify health and functioning. The ICF classifies functioning and disability through the constructs of Body Functions and Structures and Activities and Participation and addresses contextual influences through Environmental and Personal Factors. The ICF and its companion classification, the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, provide a complementary, broad, and meaningful picture of the health of an individual or of entire populations. Research and clinical implementation efforts suggest that the ICF is a useful and meaningful public health tool. The development of the ICF and its universe and scope of application are reviewed. Critical concepts are defined, the structure of the ICF is illustrated, and clinical-research utility are featured in light of the ethical considerations for responsible use by rehabilitation psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rehabilitation psychology and public health: Commonalities, barriers, and bridges.

Purpose: Those in rehabilitation and those in public health have worked to find a place in their respective disciplines. In this article, the author attempts to outline some of the commonalities inherent in the two areas, the barriers to joint work, and the bridges that may be able to allow a more comfortable interaction between the two. Conclusion: Practical realities in modern society have created the need for a closer bond among rehabilitation psychology, disability, and public health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Removing the Shadow of Suspicion: The Effects of Apology Versus Denial for Repairing Competence- Versus Integrity-Based Trust Violations.

Two studies were conducted to examine the implications of an apology versus a denial for repairing trust after an alleged violation. Results reveal that trust was repaired more successfully when mistrusted parties (a) apologized for violations concerning matters of competence but denied culpability for violations concerning matters of integrity, and (b) had apologized for violations when there was subsequent evidence of guilt but had denied culpability for violations when there was subsequent evidence of innocence. Supplementary analyses also revealed that the interactive effects of violation type and violation response on participants' trusting intentions were mediated by their trusting beliefs. Combined, these findings provide needed insight and supporting evidence concerning how trust might be repaired in the aftermath of a violation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking Among Psychiatric Outpatients: Relationship to Substance Use, Diagnosis, and Illness Severity.

To understand the elevated smoking rates among psychiatric patients, the authors investigated whether psychiatric diagnosis, illness severity, and other substance use predicted smoking status in a diverse sample (N=2,774) of psychiatric outpatients. Results indicated that 61% smoked daily and that 18% smoked heavily. Smoking was related to psychiatric diagnosis and illness severity as well as caffeine consumption and substance abuse. Diagnoses of bipolar disorder, schizoaffective disorder, and schizophrenia were independently related to smoking status, an association that was most pronounced among persons treated at clinics serving more impaired patients. Thus, diagnosis and illness severity contribute to elevated smoking rates, even after controlling for other substance use. Cessation programs are needed to reduce tobacco use in this vulnerable population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The distinction between sympathy and empathy: To call forth a concept, a word is needed.

Discusses the ways in which the terms sympathy and empathy have been used in psychology and suggests that these terms (a) have different historical roots, (b) have been utilized in different research paradigms, and (c) have been involved in different kinds of theorizing. It is suggested that sympathy refers to the heightened awareness of another's plight as something to be alleviated, whereas empathy refers to the attempt of one self-aware self to understand the subjective experiences of another. It is argued that these are different psychological processes and that the differences between them should not be obfuscated. (98 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Proxy Efficacy: Implications for Self-Efficacy and Exercise Intentions in Cardiac Rehabilitation.

Objective: To examine relations among proxy efficacy, exercise self-efficacy, and exercise in cardiac rehabilitation. Participants and Study Design: Twenty-nine cardiac rehabilitation outpatients (24 men and 5 women) enrolled in a 12-week hospital-based program. Measures of proxy efficacy and exercise self-efficacy, obtained in Week 3, were used to predict program attendance and exercise self-efficacy at Week 10. Late program (i.e.. Week 10) exercise self-efficacy and proxy efficacy were also used to predict postprogram exercise intentions. Results: Early program proxy efficacy and attendance predicted late program exercise self-efficacy (adjusted K2 = .71, p     

Burnout Patterns in Rehabilitation: Short-Term Changes in Job Conditions, Personal Resources, and Health.

This longitudinal study reports the patterning of the burnout symptoms and the changes in employees' job conditions, personal resources, and psychological health 4 months after a rehabilitation intervention. The data were gathered by means of questionnaires before and after a rehabilitation period. Four patterns were identified: not burned out (n = 55), exhausted and cynical (n = 36), burned out (n = 26), and low professional efficacy (n = 18). These patterns differed in terms of job resources, personal resources, and depression. There were both positive and negative changes detected in participants' psychological health and job resources at the follow-up. The study shows the importance of identifying different burnout patterns in order to focus rehabilitation activities more effectivel (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responsiveness of Health-Related Quality of Life Outcome Measures in Cardiac Rehabilitation: Comparison of Cardiac Rehabilitation Outcome Measures.

Assessment instruments that are not responsive to change are unsuitable as outcome tools in cardiac rehabilitation because they underestimate the psychosocial benefits of program attendance. Nine questionnaires were assessed for responsiveness with the standardized response mean (SRM). Questionnaires were allocated into 3 batteries, and each battery was completed by cardiac rehabilitation and comparison participants at 2 time points (411 and 375 participants in total, respectively). There was a high degree of variability in the responsiveness of instrument subscales. The positive affect subscale of the Global Mood Scale (J. Denollet, 1993a) was the most responsive (SRM = 0.62). Further information on the comparative responsiveness of psychosocial scales is important to optimize instrument selection for outcome studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the Special Section on the International Classification of Functioning, Disability and Health: Implications for Rehabilitation Psychology.

This introduction to the special section of Rehabilitation Psychology on the International Classification of Functioning, Disability and Health (ICF) previews how implications for rehabilitation psychology are explored through 4 articles, each designed to build on the presentation and discussion of the prior piece: an overview of the ICF classification system; a review of contemporary applications of the ICF to clinical, government, and research uses; an update on clinical implementation efforts and related conceptual issues; and a specific application of the ICF to assistive technology service provision. The special section presents the ICF as a compelling development in the classification of functioning and health in health care service provision and, in particular, rehabilitation psychology practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)