Dimensions in the perception of psychiatric patients by hospital staff.

Agreement among psychiatric staff and the dimensions underlying such agreement in the perception of psychiatric patients were investigated using 2 Q-sorts, a Behavior (B) deck and an Interpersonal Characteristics (IC) deck. 11 patients were each rated by 5-8 judges. Mean global agreement (r) about patients ranged from .22 to .52 on the B deck, from .20 to .43 on the IC deck; there were significant differences (p     

Review of The mental hospital. A study of institutional participation in psychiatric illness and treatment.

Reviews the book, The mental hospital. A study of institutional participation in psychiatric illness and treatment by Alfred H. Stanton and Morris S. Schwartz (see record 2005-02933-000). This is a rich and rewarding book. It is a report of research, conducted in collaboration by a psychiatrist and a sociologist, into the social organization of a psychiatric hospital and into the effects of this social organization on the behavior of patients. Although it is primarily intended as a contribution to administrative psychiatry, it is also a major contribution to the general literature of social science and, in particular, to the broad area of personality and social structure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of aggression for an adult diagnosed with schizophrenia at a public psychiatric hospital.

The effectiveness of a behavioral program to treat chronic aggression in an adult male individual diagnosed with schizophrenia at a public psychiatric hospital was evaluated. A behavioral plan was developed to provide the client with positive social interactions, social skills training, and positive reinforcement for prosocial behavior; no negative consequences were implemented. The number of aggressive acts declined with the introduction of the behavioral plan and ultimately remitted even without ongoing reinforcers. This article demonstrates the value of psychological intervention in treating aggression with a treatment-resistant client in an in-patient setting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of psychiatric symptom ratings determined at thirteen timepoints from hospital admission.

Principal factor-varimax factor analyses of the Symptom Rating Scale (SRS) were performed at 13 timepoints over a 4-yr period, both in and out of the hospital, on pooled samples of predominantly chronic schizophrenic patients from 12 VA hospitals (N = 329-1274). 5 symptom factors were found: Uncooperative, Depression-Anxiety, Paranoid Hostility, Deteriorated Thinking, and Unmotivated. The high degree of factor similarity found over time, place (hospital or community), and rater (psychologist or social worker) makes longitudinal comparisons meaningful and makes it possible to use the Admission SRS analysis (N = 1274) as a basis for factor scoring throughout. The findings argue for the robustness of rated psychiatric symptom dimensions over changes in time and setting of the rating and in profession of the rater. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of suicide risk in a psychiatric hospital.

Assessment of suicide risk is a serious responsibility of psychologists. Best practice instructs use of a standardized instrument and clinical interview to evaluate suicide risk. Six instruments used to assess suicide behavior and symptoms of anxiety and depression were examined. The sample was adults receiving acute psychiatric treatment in a public hospital. The study consisted of 2 groups: 25 patients admitted for suicidal behavior and 42 patients admitted for other reasons. Analyses were conducted to discriminate between the 2 groups on study instruments. No single instrument predicted suicide risk without significant error. Standardized assessments must be used as part of a structured clinical interview. Suicide risk should be assessed with all people admitted to the hospital regardless of admissions criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of length of stay out of the hospital for released psychiatric patients.

The scores of 104 consecutively released nongeriatric psychiatric patients on the California Psychological Inventory, the Waco Social Adequacy Scale, Opinions about Mental Illness Scale (administered to relatives also) and background variables were correlated with success or failure in achieving a 9-mo. uninterrupted stay in the community after release. Only the Waco, OMI Authoritarianism, Benevolence, and Social Restrictiveness, and 4 of the background variable correlated significantly (p.     

Residual psychopathology in released psychiatric patients and its relation to readmission.

The degree and type of mental pathology reflected in MMPI scores was surveyed in 147 hospitalized psychiatric patients upon admission and release. Both statistical and clinical assessments of the profiles were made with analyses related to changes during hospitalization and to comparison with normal groups. Results vary depending on method of assessment. A substantial group of profile-pairs are judged as showing improvement at release (75%), while the remainder (25%) show more illness. Statistical analysis shows significant group improvement but exit profiles do not resemble those of normals. Psychotic profile types do not change to resemble neurotic ones with hospital treatment. MMPI change scores seem to anticipate rehospitalization better than evaluation of the patients' exit profile alone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Beliefs about mental illness as a functon of psychiatric status and psychiatric hospitalization.

Beliefs about mental illness were assessed among psychiatric inpatients at a VA hospital, the mental health staff responsible for their treatment, and a group of medical and surgical (control) patients. Results indicated that: (a) Psychiatric and nonpsychiatric patients generally hold similar opinions regarding mental illness. Severely disturbed psychiatric patients, however, view mental illness in more moralistic terms than do "normals." (b) Psychiatric hospitalization is generally accompanied by a change in the patient's beliefs concerning mental illness, toward those held by the staff. (c) Psychiatric patients whose beliefs about mental illness are most strikingly influenced by the staff tend to respond most favorably to treatment, as measured by length of hospital stay and gains in self-esteem during the 1st month of treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The reliability of psychiatric diagnosis: a new look.

"Each of 426 state hospital patients was diagnosed independently by pairs of psychiatrists using official psychiatric nomenclature. Reliability of the schizophrenic diagnosis was indicated by values of γ between .73 and .95, depending on the range of discrimination required. Classification of the diagnosis into 3 major categories—organic, psychotic, and characterological—showed that about four-fifths of such classifications of one psychiatrist were confirmed by another. Agreement with respect to diagnoses of the specific subtype occurred in about only half the cases and was almost absent in cases involving personality pattern-and-trait disorders and the psychoneuroses." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A rationale for psychiatric selection.

Psychiatric selection procedures are assumed to aid efficient performance and to protect the individual from the consequences of failure. Despite difficulties and shortcomings, "… psychiatric selection is a demonstrably valid and socially useful procedure." Several studies are cited which "… have substantiated the validity of psychiatric selection, demonstrated its value in the military services, shown that it can be established on a sound scientific basis, and indicated that future experimental investigation can hope to increase the range of its application and raise its present level of efficiency." 22 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prognostic scales in schizophrenia.

The case histories of 65 female schizophrenic patients were rated by means of the Phillips, Elgin, and Kantor scales. The reliability of the Phillips and Elgin scales was quite comparable and higher than that of the Kantor. The relationships among the various scales ranged from .52 to .82 for individual raters. However, differences among the scales were observed when "normative" scores were used and the scales appraised in terms of length of hospital stay and marital status. Although scores on all scales appeared to show some relationship to marital status, this relationship was not uniform among the scales. Marital status was also found to relate to length of hospitalization as well as any of the scales. (18 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three Cs in measurement models: Causal indicators, composite indicators, and covariates.

In the last 2 decades attention to causal (and formative) indicators has grown. Accompanying this growth has been the belief that one can classify indicators into 2 categories: effect (reflective) indicators and causal (formative) indicators. We argue that the dichotomous view is too simple. Instead, there are effect indicators and 3 types of variables on which a latent variable depends: causal indicators, composite (formative) indicators, and covariates (the “Three Cs”). Causal indicators have conceptual unity, and their effects on latent variables are structural. Covariates are not concept measures, but are variables to control to avoid bias in estimating the relations between measures and latent variables. Composite (formative) indicators form exact linear combinations of variables that need not share a concept. Their coefficients are weights rather than structural effects, and composites are a matter of convenience. The failure to distinguish the Three Cs has led to confusion and questions, such as, Are causal and formative indicators different names for the same indicator type? Should an equation with causal or formative indicators have an error term? Are the coefficients of causal indicators less stable than effect indicators? Distinguishing between causal and composite indicators and covariates goes a long way toward eliminating this confusion. We emphasize the key role that subject matter expertise plays in making these distinctions. We provide new guidelines for working with these variable types, including identification of models, scaling latent variables, parameter estimation, and validity assessment. A running empirical example on self-perceived health illustrates our major points. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A Correct Diagnosis of a Pseudopatient in an Inpatient Setting.

Rosenhan (1973) reported his data on eight pseudopatients who deliberately feigned auditory hallucinations and subsequently gained admission to 12 psychiatric institutions. From this data he concluded that "sanity" and "insanity" were indistinguishable in the context of a psychiatric hospital. The case study presented here is significant because it fails to conform to the experience of Rosenhan. A pseudopatient was presented for interview at a weekly diagnostic conference in an inpatient setting. He was felt to be "normal" by the interviewer, residents, and other staff at the conference. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prognostic indexes in a military psychiatric population.

Used biographical variables, available at the time of admission to a Navy psychiatric service, to predict the posthospital adjustment of 827 male patients (Navy and Marine Corps personnel) to military life. Predictor variables were combined, using a multiple-regression technique and a simple item-analyzed scale. The latter proved to be slightly, but not significantly, more efficient than the multiple-regression procedure as judged from cross-validity correlations. Variables which were reliable prognostic indicators included (a) occupational specialty, (b) number of children, (c) wife's attitude, (d) solitariness of work, (e) length of service, (f) diagnosis, and (g) recognition for inservice achievements. While improvement on base-rate prediction was not possible, an increase in effectiveness rate for expsychiatric patients could be effected by selecting a high prognosis score as a requirement for returning a patient to duty. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social competence and psychiatric diagnosis.

It was hypothesized that symptoms reflect a patient's social competence or maturity level and that this level is related to the diagnosis he receives. Symptom scales based on empirical relations between symptoms and competence levels were constructed for 3 spheres of functioning: thought, affect, and action. Results obtained with 504 psychiatric patients showed that: (1) placement on each symptom scale was significantly related to diagnosis, and (2) patients who could be rated on all 3 scales showed consistent placement across scales. The latter finding was interpreted as indicating that the maturity dimension is a pervasive one, thus lending further support to the view that maturity plays an important role in the process of diagnosis. (17 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prognostic indicators for cancer. Gastric cancer

The recent shift in the population from patients presenting with gastric cancer to patients presenting with early-stage lesions has led to renewed interest in identifying prognostic factors for this type of tumor. Conveniently for surgeons, prognostic factors can be divided into groups that are assessed preoperatively, intraoperatively, and postoperatively. Despite the explosion of interest in genetic and molecular markers for gastric cancer, the feature best correlated with patient survival continues to be tumor stage at the time of diagnosis.     

Predicting hospitalization of psychiatric outpatients.

"This study constitutes an attempt to devise simple, widely applicable, and maximally precise indices to aid in predicting hospitalization of psychiatric outpatients, as well as to formulate a partial operational definition of the concept, 'latent psychiatric illness'… . Three forms of index were derived, one consisting only of nonpsychometric variables, one consisting only of MMPI signs, and one comprising both nontest and MMPI factors." 24 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)