Self-reinforcement and recall: Differential deficits in depressed and nondepressed psychiatric inpatients.

16 depressed and 12 nondepressed psychiatric inpatients and 19 nondepressed hospital employees (18–60 yrs old) were administered the Beck Depression Inventory, Hamilton Rating Scale for Depression, and a verbal recognition task. Ss' administration and recall of self-reinforcements and self-punishments were assessed. As predicted, depressed Ss administered fewer self-reinforcements and a greater number of self-punishments than hospital employees; however, they did not differ on either of these measures from nondepressed patients. In terms of recall, depressed patients recalled giving themselves fewer reinforcements and a greater number of punishments than was actually the case. Whereas a low rate of self-reinforcement may be characteristic of global psychopathology, deficits in the recall of self-reinforcement and self-punishment were specific to depression. Results are discussed with reference to both cognitive and self-reinforcement conceptualizations of depression. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mortality in geriatric psychiatric inpatients

OBJECTIVE: To report current information about invasive pneumococcal infections, capsular types and antimicrobial resistance in Canada. DESIGN: Retrospective analysis. SETTING: Canada. PATIENTS: A total of 976 patients from whom Streptococcus pneumoniae was isolated from blood or cerebrospinal fluid between Jan. 1, 1992, and Dec. 31, 1995. OUTCOME MEASURES: Capsular type and antimicrobial susceptibility. RESULTS: Twenty types accounted for 90.8% of the isolates from patients over 5 years of age; all but type 15A are covered by the currently available 23-valent vaccine. Nine types accounted for 92% of the isolates recovered from children 5 years and less. Reduced susceptibility to penicillin was found in 7.8% of the collection and was associated with types 6B, 9V and 19A. Full resistance to penicillin was observed most frequently during 1995 and was associated with type 9V. Rates of reduced susceptibility over one 12-month period were 19.5% for trimethoprim-sulfamethoxazole and 4.5% or less for each of cefotaxime, ceftriaxone, chloramphenicol, erythromycin, ofloxacin and tetracycline. CONCLUSIONS: Over 90% of invasive pneumococcal infections are covered by the currently available vaccines (for people over 2 years of age) and the pneumococcal protein-polysaccharide conjugate vaccines under development for young children. The high frequency of antimicrobial resistance observed requires more complete investigation and confirmation; however, taken from a global perspective, it supports the need to develop better control strategies, including greater use of new and existing vaccines.     

Social problem-solving deficits and hopelessness, depression, and suicidal risk in college students and psychiatric inpatients

The Social Problem-Solving Inventory-Revised was used to examine the relations between problem-solving abilities and hopelessness, depression, and suicidal risk in three different samples: undergraduate college students, general psychiatric inpatients, and suicidal psychiatric inpatients. A similar pattern of results was found in both college students and psychiatric patients: a negative problem orientation was most highly correlated with all three criterion variables, followed by either a positive problem orientation or an avoidance problem-solving style. Rational problem-solving skills emerged as an important predictor variable in the suicidal psychiatric sample. Support was found for a prediction model of suicidal risk that includes problem-solving deficits and hopelessness, with partial support being found for including depression in the model as well.     

Stability of MMPI configurations for psychiatric inpatients.

Investigated the stability of Minnesota Multiphasic Personality Inventory (MMPI) code types. Ss were 405 psychiatric patients (mean age 37 yrs) who had completed 2 valid MMPIs and some of whom had been rated twice on the Brief Psychiatric Rating Scale. Test–retest agreements for high-point, low-point, and 2-point codes were 42.72%, 43.95%, and 27.65%, respectively. Code types were somewhat more stable when scales in the codes had more extreme scores initially and when scores on the scales in the codes were considerably different from other scales in the profile. When MMPIs were classified as neurotic, psychotic, or characterological according to 2-point codes, many of the 2-point codes that changed from test to retest remained within the same diagnostic categories. For a subsample of 72 Ss, behavioral ratings of psychosis were compared with stability and change in 2-point code types. Results suggest that at least some changes in code types over time may be associated with meaningful behavioral changes. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interventions for cognitive deficits in brain-injured adults.

Reviews the state of the art with regard to interventions for disturbances in information processing following brain damage. Emphasis is placed on recent advances in techniques and issues vital to establishing such interventions as credible, legitimate types of treatment. Two series of studies are noted, one of which examines the treatment of spatial neglect in right-brain-damaged people and the other of which cites the development of modules for the improvement of different skills impaired in brain-damaged people. Of particular importance are the development of experiences and knowledge around (a) ecologic issues, (b) remediation in different population groups, (c) emotional problems and their management, and (d) development of an articulated theory of rehabilitation. (49 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Plasma concentrations of antipsychotic drugs in psychiatric inpatients

We surveyed a random sample (n = 75) of doctors and dentists at University College Hospital, Ibadan, Nigeria. They were offered anonymous testing for hepatitis B surface antigen (HBsAg), hepatitis Be antigen (HBeAG), antibodies to hepatitis B core antigen (anti-HBc) and to hepatitis C virus (anti-HCV), by enzyme immunoassay. The results suggest a high prevalence of hepatitis B virus (HBV) with a high potential of transmissibility, as well as a high prevalence of HCV infection. The majority of the doctors and dentists use universal precaution for protection against viral hepatitis on < 50% of the occasions when they carry out procedures on their patients. Infection with HBV was associated with type of specialty (surgeons, dentists) and lack of HBV vaccination (p < 0.05). After logistic regression, these factors were independently associated with HBV infection (p < 0.05). Sixty (80%) had not received prior HBV vaccination. Unvaccinated personnel were more likely to be surgeons, dentists, < 37 years of age, and have fewer years of professional activity (p < 0.05). After logistic regression, only fewer years of professional activity remained independently associated with lack of vaccination (p < 0.05). To reduce the occupational exposure of HBV, universal precautions must be rigorously adhered to when the doctors and dentists carry out procedures on their patients, and all health-care workers should be vaccinated with HBV vaccine and the HCV vaccine, when it becomes available.     

MCMI-III as a treatment outcome measure for psychiatric inpatients

The Million Clinical Multiaxial Inventory-III (MCMI-III) recently was introduced to replace and update the MCMI-II. A sample of 97 psychiatric inpatients were administered the MCMI-III shortly following admission, and again 7-10 days later. Changes in the personality and symptom scales generally paralleled those found in previous work with the MCMI-II, although the mean retest interval was considerably shorter than in the earlier study. However, some differences between the two instruments were observed, confirming the need for ongoing cross-validation work on the MCMI-III as an instrument that is distinct from the MCMI-II.     

Computerized medication instruction for psychiatric inpatients admitted for acute care

We studied the efficacy and feasibility of using computer-based instruction to provide medication information to hospitalized patients with acute psychotic conditions. Patients were randomly assigned to receive computer-based (n = 21) or personal instruction (n = 21); for the final analyses the computer group was expanded to include 13 patients from a pilot study. Outcome measures were knowledge retention (indicated by changes in test scores) and compliance with medication regimens after discharge (indicated by telephone follow-up at one week, one month, and three months). The subjects reacted positively to the computer program. Knowledge retention and compliance were similar in the computer and control groups. We conclude that psychiatric inpatients admitted for acute care can participate in, and learn from, computerized medication instruction.     

Longitudinal study of cognitions, life events, and depression in psychiatric inpatients.

Administered the Beck Depression Inventory, Attributional Style Questionnaire, Social Readjustment Rating Scale and an irrational beliefs inventory to 47 psychiatric inpatients (mean age 32 yrs) when they were admitted to the hospital, to 32 of them when they were discharged, and to 20 of them 7 mo later. The study tested the models of depression of A. T. Beck (1972) and of L. Y. Abramson et al (see record 1979-00305-001) that predict that stressful life events interact with certain types of cognitions (irrational beliefs in Beck's model; attributions in the Abramson et al model) to produce clinical depression. Results of multiple regression analysis show that severity of depression was related to irrational beliefs, attributions, the interaction of Attributions and Life Events, and the interaction of Attributions and Session. There was no relationship between depression and the interaction of Irrational Beliefs and Life Events. The Attributions?×?Session interaction indicated that the relationship between attributions and depression changed over the period studied; the relationship between irrational beliefs and depression was stable over time. Attributions and irrational beliefs changed over the period studied, indicating that they are not stable, unchanging aspects of personality. (35 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A medication screening tool for cognitive aging researchers.

A Web-based medication screening toll that provides researchers with information about side effects associated with medications commonly used by older participants is described. this tool can be used for research purposes to better separate the effects of normal, healthy aging processes from the deleterious effects often associated with medication usage. Researchers can use this tool, called SMART (Screening Medications: Aging Research Taxonomy), to (a) obtain information pertaining to the cognitive, sensory, and motor side effects associated with specific medications, and (b) screen medications in their research for side effect severity. The Web address for the tool is www.psychology.gatech.edu/SMART. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aggressive and impulsive behavior in military psychiatric inpatients

OBJECTIVE: To investigate the risk of cancer associated with exposure to air pollution among bus drivers and tramway employees. METHODS: A retrospective cohort study of 18,174 bus drivers or tramway employees in Copenhagen in the period 1900-94. Data on employment were obtained from company files. Information on cancer was obtained from the Danish Cancer Registry. RESULTS: Findings showed that bus drivers or tramway employees had an increased risk of all malignant neoplasms (standardised incidence ratio (SIR) 1.24, 95% confidence interval (95% CI) 1.19 to 1.30). The relative risk was significantly increased for both men and women (SIR 1.24, 95% CI 1.19 to 1.30 and 1.28, 1.06 to 1.53, respectively). People employed for < 3 months had no increased risk of cancer (1.04, 0.81 to 1.31). For men who were employed for > 3 months the risk of lung cancer (1.6, 1.5 to 1.8), laryngeal cancer (1.4, 1.0 to 1.9), kidney cancer (1.6, 1.3 to 2.0), bladder cancer (1.4, 1.2 to 1.6), skin cancer (1.1, 1.0 to 1.2), pharyngeal cancer (1.9, 1.2 to 2.8), rectal cancer (1.2, 1.0 to 1.5) and liver cancer (1.6, 1.2 to 2.2) was significantly increased. For women employed for > 3 months the risk of lung cancer was significantly increased (2.6, 1.5 to 4.3). CONCLUSION: This cohort study shows that bus drivers and tramway employees are at an increased risk of developing several types of cancer. This might be due to the exposure to air pollution during working hours or to other risk factors, primarily smoking.     

Self-reported suicidal ideation in adolescent psychiatric inpatients.

In an investigation of the psychosocial correlates of suicidal ideation in adolescent inpatients, the Beck Scale for Suicide Ideation (BSI) was administered to 108 inpatients between 12 and 17 yrs of age who were diagnosed with mixed psychiatric disorders. A series of multiple regression analyses that controlled for gender, ethnicity, age, diagnosis of a mood disorder, and a history of a past suicide attempt were then used to examine the relationships of the Beck Depression Inventory, Anxiety Inventory, and Hopelessness Scale (BHS) with the BSI. Regardless of the series, the BHS contributed unique variance to the explanation of the BSI scores. The results are discussed as supporting the use of the BSI with adolescent inpatients and indicating that hopelessness is related to suicidal ideation when depression is controlled for. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Demonstrating specific cognitive deficits: A psychometric perspective.

Cognitive deficits associated with psychopathology often do not occur in isolation. Consequently, identifying a specific deficit in a disorder requires comparing the magnitude of group differences on theoretically relevant measures with those on control tasks measuring other constructs. L. J. Chapman and J. P. Chapman (1973) noted that common forms of such Group?×?Task interactions are theoretically ambiguous unless performance measures have comparable discriminating power. The principles of psychometric matching for discriminating power developed in the Chapmans' research program are reviewed, and both criticisms and alternative psychometric approaches are evaluated. Psychometric matching can be mindful of threats to the construct validity of measures and frequently remains methodologically necessary. Otherwise, interactions involving measures that vary in sensitivity to individual differences may be misinterpreted as evidence for specific deficits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implications of visual search deficits for cognitive theory.

Neuropsychological evidence was presented and found to be consistent with Treisman's Feature Integration Theory (FIT). Several studies were reported using groups of patients with unilateral visual neglect, stable patients with known lesion loci, and a single patient with bilateral parietal-occipital lesions. Collectively, the data support a distinction between feature and conjunction search. They also support arguments for the primary role of spatial representation in forming correct conjunctions between features and for individuating objects. Nevertheless, the data do call for some refinements in FIT. The spatial maps involved in feature integration for serial visual search and for the experience of an accurately conjoined object appear to be relatively late. Features are likely to be integrated in the nervous system at sub-threshold levels in early vision (e.g., vl or v2), but it requires supra-threshold spatial knowledge to successfully conjoin features in visual experience (Wojciulik, Robertson & Kanwisher, 1994). The evidence as a whole, however, is consistent with FIT in that spatial information is necessary for controlled visual search and for the accurate conjunction of features in multi-item arrays. In addition, it suggests that explicit access to relatively late spatial information is necessary to correctly conjoin features in the experiences percept. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive deficits and psychiatric rehabilitation outcomes in schizophrenia

Many patients with schizophrenia are characterized by cognitive deficits that limit their ability to benefit from psychiatric rehabilitation interventions. While this suggests that cognitive rehabilitation is important, more needs to be known about which cognitive deficits interfere with which aspects of outcome and functioning before effective interventions are developed. We report data on cognitive predictors of three types of outcome: acquisition and performance of skills in a skills training group; aspects of daily ward functioning; and ability to be discharged from a state hospital. Our data indicate that poorer outcomes in each of these areas are associated with different, but somewhat overlapping, profiles of cognitive deficits. These data are relevant for designing both ward-based and individualized interventions. Integrating traditional psychiatric rehabilitation approaches with targeted cognitive interventions is necessary to maximize the impact of psychiatric rehabilitation services on individuals with chronic schizophrenia.     

Substitution of immediate-release valproic acid for divalproex sodium for adult psychiatric inpatients

In a prospective open-label study, the substitution of immediate-release valproic acid for divalproex sodium was evaluated in the treatment of 47 adult psychiatric inpatients who had been stabilized on divalproex for at least one month. After two weeks, no significant change in Clinical Global Impressions scale (CGI) scores or in seizure frequency occurred, and serum valproate concentrations decreased by 14.4 percent (p=.001). One patient was restarted on divalproex because of gastrointestinal complaints. Among the 19 patients remaining hospitalized at six months, mean CGI scores did not significantly change. Costs were reduced 83 percent; annual savings per patient was approximately $905. These preliminary results suggest that many chronic psychiatric inpatients stabilized on divalproex may be safely switched to valproic acid.     

Deficiencies in the detection of cognitive deficits.

Numerous studies purport to show that cardiopulmonary bypass (CPB) surgery is associated with persistent postoperative cognitive decline. In J. R. Keith et al. (2002), the authors argued that reports of post-CPB cognitive declines have often been quantified using data analysis methods that were based on tenuous assumptions and overlooked problems associated with familywise Type I errors. Four peers who are recognized for their expertise in neuropsychological outcomes research evaluated the arguments developed in the J. R. Keith et al. article, critiqued the study presented in that article, and offered suggestions for how to investigate whether cognitive decline occurs reliably after CPB. In this reply article, the authors respond to the open-peer commentaries made regarding the J. R. Keith et al. study. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blood rituals: Self-cutting in female psychiatric inpatients.

Eight female psychiatric inpatients (aged 18–54 yrs) on a unit specializing in the treatment of dissociative disorders were interviewed in depth about their self-cutting experiences. Self-cutting was correlated with childhood histories of severe abuse and neglect, was not primarily suicidal, and helped patients modulate such overwhelming affects as rage, self-hatred, loneliness, and despair. Implications of the study for theory, research, and clinical practice are discussed. Excerpts from therapy and case illustrations are presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Problems in the measurement of cognitive deficits.

Considers that artifacts cloud the findings in a majority of the studies on differential cognitive deficit because of differences in discriminating power of tasks coupled with generalized deficit of patients. With 2 tests of differing reliability, the test with the higher reliability will yield greater performance deficit for the less able Ss. The advisability, in studies of differential cognitive deficit, is discussed of matching tasks on reliability, shape of the distribution of scores, and mean, variance, and shape of the distribution of item difficulty, using normal Ss alone as a standardization group. Data from a study with 49 severely disturbed schizophrenics and 206 normals is presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)