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1.
This article describes the use of the NIMH prospective life-charting methodology (NIMH LCM-p) in the context of a formal double-blind, clinical trial and provides preliminary evidence of its reliability and validity. Subjects included in this report were 30 outpatients with bipolar I and II disorder who completed the first 2 years of a long-term maintenance study: 1 year on carbamazepine or lithium and a crossover to the other in the second year. The LCM-p follows the same types of guidelines and principles utilized in the previously described retrospective life-chart process, allowing for continuity of illness assessment prior and subsequent to study entry. In the LCM-p, daily ratings of severity of mood symptoms based on the degree of associated functional incapacity, provide a more detailed topography of manic and depressive fluctuations. Inter-rater reliability was examined by comparing the severity of daily LCM-p ratings assigned by two raters. In order to assess the validity, we correlated the LCM-p ratings with well-standardized scales, including Hamilton and Beck Depression Ratings, Young Mania Ratings and the Global Assessment Scale (GAS). The Kappa scores for inter-rater reliability demonstrated significant and satisfactory strength of agreement with no fall off over 14 days prior to the rating interview. Strong correlations were found: (1) between the LCM-p average severity for depression rating and the mean Hamilton Depression Rating (r = 0.86, p < .001), and the Beck Depression Inventory (r = 0.73, p < .001); 2) between the LCM-p average severity for mania rating and the Young Mania Rating Scale (r = 0.61, p < .001); and (3) between the LCM-p average severity and the GAS (r = -0.81, p < .001). These preliminary data suggest the reliability and validity of the NIMH-LCM-p in assessing manic and depressive episode severity. It also provides a useful continuous daily measure of affective illness-related symptom fluctuations that allows for detailed prospective assessment of frequency and pattern of illness, treatment response, and continuity with retrospective life chart assessments.  相似文献   

2.
Studied the relationship between an unstructured global rating of severity of illness and structured ratings of individual symptoms (e.g., Brief Psychiatric Rating Scale) in 278 25-60 yr old depressed women. Correlational analyses revealed that patients rated as more severely ill were those showing psychomotor retardation, depressive delusions, agitation, guilt, initial insomnia, hopelessness, suicidal tendencies, verbal complaint of depressed feelings and observed appearance of depression, and less short-term reactivity of mood. Findings suggest that patients showing greater severity on the core symptoms of depression and more characteristics of psychotic or endogenous depression are perceived as more ill. A multiple regression equation derived from 30 symptoms accounted for 56% of variance in the global scale. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

3.
To assess the accuracy of relatives' recollections of patients' terminal illness 71 out of 77 caring relatives were re-interviewed about 4 months after they and the patients had given regular interviews throughout care. Current and retrospective ratings of problems and feelings have been compared for agreement, using the kappa index. Several volunteered symptoms showed poor agreement, notably pain, anorexia and depression (kappa = 0.03-0.21), but vomiting, dyspnoea and immobility ratings agreed moderately well (kappa = 0.43-0.68). Current ratings from patients' and relatives' were always in better agreement with each other than with the relatives retrospective ratings. Bias sometimes altered apparent prevalence; pain was described as more severe in retrospect, but weakness, malaise, depression and relatives' stress were under-rated later. Ratings of "discomfort only" became less common for all symptoms retrospectively. The regular current assessments of patients' and relatives' emotional state also agreed only slightly with relatives' follow-up accounts of depression but somewhat better for anxiety. Patients stated knowledge of diagnosis, awareness and acceptance of dying matched the relatives' retrospective assessments moderately well (kappa = 0.70, 0.50 and 0.41). This study and other available evidence indicate that relatives' retrospective reports of terminal illness, measured against current ratings, are moderately reliable for some items but can vary or be potentially misleading over other aspects, including pain. This could affect evaluations of care.  相似文献   

4.
5.
To see whether adolescents view parent–child relationships more like their parents or more like outsiders, 41 mother–father–adolescent child triads were videotaped interacting over two tasks. Each family member then viewed both interactions and rated levels of anxiety, dominance, involvement, and friendliness, for each interactant. These same interactions were also watched and rated by another mother–father–adolescent triad (outsider family) who did not know the family. These interactions were then rated by a trained observer. For ratings of anxiety, dominance, involvement, and friendliness, analyses involved comparisons (a) between the insider and outsider families ratings, on correlations between insider family members and outsider family members with the trained observer, and (b) comparisons among the three types of observers. Ratings by members of the outsider family were generally more negative than those by members of the insider family. Ratings of self tended to be more objective than ratings of other family members. Ratings by the trained observer were more highly correlated with those of the outsider family, although differences between the means showed that trained observers used a similar metric to the insider family. The importance of looking at patterns of ratings as well as mean differences is emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

6.
Investigated psychiatric symptomatology, self-concept, locus of control, and daily events in persons with a history of exposure to mixtures of organic solvents. Exposed Ss were more likely than controls to report depression, anxiety, fatigue, confusion, and somatic concerns, which in turn were associated with certain exposure-related variables (e.g., cacosmia). There were no differences between the groups in self-concept, locus of control, or ratings of daily hassles and uplifts. Exposed persons may be able to accurately identify what they perceive as changes that are due to the exposure (e.g., anxiety) without attributing these specific adverse outcomes to dispositional variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

7.
Examined the concept of shyness and its measurement by collecting and analyzing data in 3 phases: (1) the revision and continued development of a measure of shyness, the Social Reticence Scale (SRS), which was designed by W. H. Jones and D. Russell (see record 1983-09411-001); (2) a psychometric comparison among 5 measures of shyness; and (3) an examination of the factor structure underlying the construct of shyness. Phase 1 assessed the reliability (n?=?252 college students) and validity (n?=?164 college students) of the SRS, including ratings of videotaped monologs and ratings by significant others. Phase 2, using 1,213 Ss (aged 15–25 yrs), compared the 5 shyness measures with one another on indices of internal consistency and with other relevant measures of emotionality, personality, relationships, and behavior. Items from the 5 shyness measures were combined in a factor analysis in Phase 3, and the resulting factors were correlated with the self-report and rating data obtained in Phase 2. Results confirmed that the shyness measures were valid, reliable, and empirically distinct from measures of related constructs. Behavioral validity was observed for several of the shyness scales. Additional analyses suggested that 3 interpretable factors underlie responses to the shyness scale—Social Avoidance and Distress, Social Facility, and Fear of High Status Others—but provided little support for drawing conceptual distinctions among types of shyness. (57 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

8.
This study examined the utility of the domain assessment measures used in the final 2 years at Newcastle medical school in predicting performance ratings in the first year of postgraduate training (internship). Performance ratings were obtained from the clinical supervisors of two graduating classes of the University of Newcastle medical students during their five terms of internship. Three or more ratings were obtained from 57% of interns. Univariate analysis indicated that scores for three of the five domains (professional skills; identification, prevention and management of illness; self-directed learning) were significantly positively correlated with intern performance ratings. Multivariate analysis indicated that only the domain assessing identification, prevention and management of illness was predictive of higher intern performance ratings. The results support the notion that there is some value in the domain assessment model used at Newcastle in predicting the performance of junior doctors.  相似文献   

9.
This paper addresses the evidence for the face, construct, and criterion-related validity of the olfactory-limbic/neural sensitization model for multiple chemical sensitivity (MCS). MCS is a poorly-understood, controversial condition in which low levels of environmental chemicals are reported to trigger disabling levels of illness in certain individuals. Neural sensitization processes could generate an endogenous amplification of responsivity to exogenous substances, thereby providing a plausible explanation for the apparent lack of a classical toxicological dose-response relationship in MCS. Convergent data from both survey and psychophysiological studies of MCS patients and of persons from the community without MCS, but who report elevated frequency of illness from chemical odors (cacosmics), support the involvement of the limbic system and the sensitizability of cacosmics, as predicted by the model. Recent studies show that cacosmics do sensitize their heart rate, blood pressure, and plasma beta-endorphin responses to repeated exposures to a novel laboratory procedure involving dietary manipulations over time. Cacosmia may represent a pathological form of neural plasticity. Taken together, the model and the available evidence suggest the need for more intensive investigation of MCS from the standpoint of possible neurobiological mechanisms affecting cognitive, emotional, and somatic functions.  相似文献   

10.
Researchers who study the effects of chronic illness on well siblings have generally focused on individual characteristics and their relationships with psychological adjustment. More recently, researchers suggest that sibling adjustment can be best understood within the context of the family. The purpose of this study was to examine variations in sibling behavioral adjustment in relation to mothers' perceptions of the illness experience and family life. Based on mothers' ratings on the behavior problem scale of the Child Behavior Checklist (CBCL), five siblings considered poorly adjusted and five very well-adjusted siblings were compared with respect to mothers' reports of individual family member's response to illness, illness management, parenting philosophy, presence of other stressors, availability of social supports, and impact of illness on family members and family life. Two major differences were found between mothers who rated healthy siblings either poorly or very well adjusted: (a) effects of illness on the healthy sibling, the ill child, and the marital relationship and (b) perceived controllability of the chronic illness. Devising ways of helping mothers feel confident in managing their child's illness is integral to creating an environment that promotes optimal development of their ill child and the child's siblings.  相似文献   

11.
Using the trait of shyness as an example, the authors showed that (a) it is possible to reliably assess individual differences in the implicitly measured self-concept of personality that (b) are not accessible through traditional explicit self-ratings and (c) increase significantly the prediction of spontaneous behavior in realistic social situations. A total of 139 participants were observed in a shyness-inducing laboratory situation, and they completed an Implicit Association Test (IAT) and explicit self-ratings of shyness. The IAT correlated moderately with the explicit self-ratings and uniquely predicted spontaneous (but not controlled) shy behavior, whereas the explicit ratings uniquely predicted controlled (but not spontaneous) shy behavior (double dissociation). The distinction between spontaneous and controlled behavior was validated in a 2nd study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

12.
Twin studies suggest that parent ratings of temperament exaggerate differences between twins. The present study examined whether such contrast effects also operate for nontwin siblings. The activity level (AL) and shyness of 95 nontwin sibling pairs (ages 3 to 8 years) were assessed via parent ratings and objective measures (actigraph and observer ratings). Siblings showed no resemblance in either parent-rated AL or shyness; however, sibling resemblance for actigraph AL and observer-rated shyness was substantial. Thus, parents do contrast their nontwin siblings when rating these 2 temperament dimensions. Moreover, the importance of sibling differences in temperament to the sibling relationship and differential maternal treatment varied across the different measures of AL and shyness, suggesting that parent perceptions may play a role in these associations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

13.
We asked patients to assess their functional health status by completing the SF-36. Over 2 years, we studied 1,000 patients (average age, 58 years; 50% male; 25% white; 36% diabetic) in three outpatient, staff-assisted hemodialysis units. We used both the eight-scale scores and two-component summary scores to study the relationship between baseline functional health status and clinical outcomes. The physical component summary (PCS) score was as significant a predictor of mortality as was the normalized protein catabolic rate or the delivered Kt/V. Patients with a PCS score below the median for our patients (< 34) were twice as likely to die and 1.5 times more likely to be hospitalized as patients with PCS scores at or above the median score. Either a low PCS score or a low mental component summary (MCS) score correlated with the number of days of hospitalization. While the average dialysis patient has a relatively normal (47 v 50) MCS score and a low (37 v 50) PCS score compared with the normal population, patients who skipped more than two treatments per month tended to have a relatively higher PCS score (judged themselves physically healthier) and a relatively lower MCS score (judged themselves less mentally healthy) than patients who did not skip two or more treatments per month. The prevalence of depression as defined by an MCS score of < or = 42 was approximately 25%. The SF-36 provided a good screening tool for patients at high risk for death, hospitalization, poor attendance, and depression.  相似文献   

14.
Ninety-nine consecutive unmedicated outpatients with a major depressive illness had blood drawn for measurement of serum folate (SF), red cell folate (RCF), and vitamin B12 within 24 hours of completion of ratings of severity of depression at the beginning and ending of a 5-week trial of desmethylimipramine (mean dose = 149.2 mg/day, range = 75-225 mg). As compared with nonresponders, responders had a significantly higher mean SF at baseline (nonresponders = 13.8 nmol/l; responders = 17.7 nmol/l) and RCF showed a significant inverse correlation with severity of depression and a significant positive correlation with age of onset of illness. At week 5, change in severity of depression was significantly correlated with change in RCF, and significantly more responders than nonresponders had an increase in RCF. The possible role of folate status in the regulation of mood and response to treatment is discussed.  相似文献   

15.
Perceived, but not actual, control over treatment has been consistently related to better adjustment in chronic illness. This study examined the relationship between actual control over treatment and severity of illness and their influence on depression in a chronically ill population of end-stage renal disease (ESRD) patients. The authors hypothesized that as severity of illness increases, the burden of control over treatment would increase depression. Severity of illness and depression was assessed for 98 ESRD patients. Control over treatment was represented by whether dialysis patients were self-administering treatment (high control) or were receiving treatment from the medical staff (low control). Results indicated that for the most severely ill patients, high control over treatment resulted in poorer adjustment. Furthermore, this effect was due in part to how illness interferes with social relationships in seriously ill, self-care patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

16.
In an initial validation study of the Mutual Psychological Development Questionnaire (MPDQ), a measure of perceived mutuality in close relationships, 345 respondents completed the scale for spouse or partner and friend relationships. Results indicated high interitem reliability. Construct and concurrent validity were demonstrated. MPDQ ratings were correlated with adequacy of social support, relationship satisfaction, and cohesion. Ratings correlated negatively with depression. Low spouse or partner mutuality was predictive of significant depressive symptoms in women but not in men. In a 2nd study, 81 respondents completed the scale at 2 time points. Test–retest reliability was satisfactory, and high interitem consistency was replicated. The substantive meaning of these findings, gender differences, and possible future research applications of the MPDQ are disscussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

17.
Describes a study in which 4,533 male and 639 female faculty members in large and small high school settings rated former students as to their future performance as Marine Corps enlisted men. The ratings were evaluated against a criterion of attrition and pay grade. Validity coefficients were generally low but valid. Ratings made by males were significantly higher in validity than ratings by females. Ratings made in small school settings were more valid than those made in the large school settings. Suggestions are given for modifying the use of these ratings to increase their predictive validity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

18.
Examined the degree to which depression predicted pain and pain behavior by administering the Beck Depression Inventory to 114 male and 93 female low back pain patients (mean age 41.6 yrs). Observations of pain behaviors during physical examination, ratings of pain, and measures of activity level and medication intake were taken on each S. Regression analyses revealed that depression and physical findings were the most important predictors of pain and pain behavior. Although the proportion of variance attributed to depression was modest, it was significant even after controlling for demographic and medical status variables. Ratings of pain severity and use of sedatives/hypnotics were higher among females than males, and depressed Ss were more likely than others to be taking narcotic medications. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

19.
We tested effects of raters' stress on the favorability and dispersion of performance ratings. In all, 120 undergraduates completed either a stressful or an unstressful inbasket exercise, either before or after they saw a videotaped portrayal of a manager's job performance. Then they rated the manager on several performance dimensions. Ratings provided by participants who completed the stressful inbasket showed less dispersion across performance dimensions, but no differences on favorability. Whether participants were stressed before or after viewing the performance videotape made no significant difference in the favorability or dispersion of their ratings. This suggests that stressful experiences affect at least the retrieval stage of information processing and might affect the input stage as well. There was a significant interaction with individual differences in Type A pattern. In the unstressful condition, Type A scores were positively correlated with dispersion (r?=?.32, p?r?=?–.15), but not statistically significant. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

20.
18 male undergraduates with symptoms of depression, anxiety, and unsatisfying interpersonal relationships were seen in brief therapy by professional psychodynamic and experiential therapists. Judges rated audiotapes of early therapy sessions using the Vanderbilt Negative Indicators Scale (VNIS), which consists of 5 subscales representing factors believed to deter therapeutic progress. The hypothesis that negative factors in therapy, as assessed by the VNIS, would be inversely related to outcome was confirmed. The Errors in Technique subscale was the most consistent predictor of outcome. Subscales tapping deficiencies in Patient Qualities and the Patient–Therapist Interaction as well as Global Session Ratings were also related to outcome, although ratings of Therapist Personal Qualities were not. VNIS ratings were more strongly related to the outcome of psychodynamic therapy than experiential therapy and were more often associated with the therapist's and independent clinician's assessments of outcome than the patient's assessment of outcome. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

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