Citations

The development of a transcultural Web site created by a multidiscplinary committee in a large medical center is described. The purpose of this Web site is to give direct patient caregivers immediate, around-the-clock access to various types of transcultural information that can serve as an aid in the provision of culturally competent care. This article outlines the steps to developing the Web site and provides a description of the types of informational resources available on it.

Dissociative and sexual behaviors were assessed in a sample of 350 children ages 7-18. Four groups were evaluated: a nonpsychiatric comparison sample, a psychiatric sample with no history of sexual abuse, a psychiatric sample with clear evidence of sexual abuse, and another group for whom sexual abuse was likely but not substantiated. All children completed the Trauma Symptom Checklist-Children (TSC-C), and varying numbers completed the Rorschach and MMPI. Parents completed the Child Behavior Checklist (CBC), Child Sexual Behavior Inventory (CSBI), and Child Dissociation Checklist (CDC). Mean differences on the Dissociation and Sexual Concerns subscales of the TSC-C existed between the nonpsychiatric and psychiatric groups. The Dissociation subscale was significantly correlated with MMPI Scale 8 and CDC. Sexual Concerns were significantly related to sexual content on the Rorschach, CBC sex problems, and the CSBI. Duration and nature of abuse significantly contributed over and above age and gender in predicting total score on the Dissociation subscale.

A normative sample of 1,114 children was contrasted with a sample of 620 sexually abused children and 577 psychiatric outpatients on the Child Sexual Behavior Inventory (CSBI), a 38-item behavior checklist assessing sexual behavior in children 2 to 12 years old. The CSBI total score and each individual item differed significantly between the three groups after controlling for age, sex, maternal education, and family income. Sexually abused children exhibited a greater frequency of sexual behaviors than either the normative or psychiatric outpatient samples. Test-retest reliability and interitem correlation were satisfactory. Sexual behavior problems were related to other generic behavior problems. This contributed to the reduced discrimination between psychiatric outpatients and sexually abused children when compared to the normative/sexually abused discrimination.

A sample of 119 consecutively hospitalized adolescents, including 32 sexually abused teenagers, was assessed with the Trauma Symptom Checklist for Children (TSCC). Participants also completed the Beck Depression Inventory, Symptom Checklist-90-Revised (SCL-90-R), Adolescent- Dissociative Experience Scale, Minnesota Multiphasic Personality Inventory (MMPI), Rorschach, and the Family Environment Scale. The reliability and validity of each of the six TSCC scales and four subscales was determined. Analyses suggest that the individual scales are reliable and significantly intercorrelated. Independent measures of depression, anxiety, anger, and dissociation typically correlated significantly with the reference TSCC scales, and in fact, the Posttraumatic Stress subscale significantly discriminated the sexually abused group from the remainder of the sample. These findings suggested that with a psychiatric sample, the TSCC is a valid measure of distress.

This article provides a broad overview of an exploratory thesis designed to enhance an understanding of perturbations and rigidities of psychological functioning a set-point hypothesis of psychological functioning. Historical precedents and parallels with Keesey's set-point theory of obesity are offered. Basic tenets of the hypothesis are detailed, and relevance to clinical behavioral theory is outlined. It is concluded that the set-point hypothesis may provide a framework for conceptualizing clinical cases and optimizing interventions. The thesis appears to be testable; however, the articulation of specific methodologies and research designs must be undertaken before the ultimate usefulness of the set-point hypothesis can be determined.

The purpose of this study was to identify common personality traits in males with traumatic spinal cord injury (SCI). One hundred and five participants with SCI completed the NEO Personality Inventory (NEO-PI). The participants averaged 41.1 years of age and 17.9 years since injury onset. Compared with the NEO-PI normative sample, the SCI sample scored significantly lower on the Conscientiousness factor and the Activity and Assertiveness facet scales. They scored significantly higher on the Excitement-Seeking scale. These results suggest that males with SCI are less determined, have lower energy levels, are socially retiring, and that they tend to seek stimulation. These findings may reflect the contribution of both preinjury personality traits and adaptation to the limitations imposed by SCI.

Two interpretations of the Boston Naming Test (BNT) discontinuation rule of "six consecutive failures" were uncovered in an informal survey. The rigorous interpretation includes correct responses to phonemic cues in the count of failures, whereas the lenient interpretation does not. Using both methods to score the same protocols, BNT final scores were changed in 3% of 655 normal elderly persons and in 31% of 140 patients with Alzheimer's Disease (AD). Among normals, discrepant scores were most often found in persons age 80 years and older, and scores differed by up to 16 points. Among AD patients, discrepant scores did not preferentially occur in any age group, but scores differed by up to 10 points. The clinical impact of BNT scoring differences occasionally can be substantial and warrants attention.

Using the Minnesota Multiphasic Personality Inventory (MMPI), this study investigated preoperative and postoperative emotional and personality adjustment of temporal lobectomy patients from two major epilepsy surgery centers. Temporal lobectomy patients were included only if they were without evidence of lesional pathology on magnetic resonance imaging (MRI; other than evidence of mesial temporal sclerosis), were left-hemisphere language-dominant, and had Wide Range Achievement Test-Revised (WRAT-R) reading achievement standard scores of 70 or higher. The MMPI was completed by 175 patients before and after a temporal lobectomy. There were no significant preoperative differences on any MMPI scale between right temporal (n = 79) and left temporal (n = 96) lobectomy patients. Analysis of MMPI data from one of the surgical centers revealed significant effects for postoperative seizure control. Minimal effects of laterality of seizure onset on preoperative or postoperative psychological adjustment were found. Adequacy of preoperative psychological adjustment and postoperative seizure control have a greater impact on preoperative to postoperative psychological adjustment than side of seizure onset.

This study investigated the psychometric properties of the Mattis Dementia Rating Scale (DRS), including its internal consistency, sensitivity to age and education effects, pattern of change scores, convergent validity and predictive utility. Age and education effects and stability were assessed in a sample of 280 cognitively normal persons over age 55. All other features were assessed in a sample of 274 persons with cognitive impairment, including 221 newly diagnosed dementia patients and 53 patients with mild cognitive impairment. Both samples were drawn from the Mayo Clinic Alzheimer's Disease Patient Registry. Within the normal sample, Pearson correlation coefficients for DRS Total score with age, education and intelligence were all significant, p < .0001; MAYO Full Scale IQ (FSIQ) shared approximately 20% variance with DRS Total score. Internal consistency was greater than .7 for Construction, Conceptualization, Memory, and Total score, greater than .65 for Attention and less than .5 for Initiation and Perseveration. DRS subscales cores for Memory, Attention, and Conceptualization were significantly correlated with appropriate indices from the WAIS-R or Wechsler Memory Scale-Revised, as assessed in the Mayo Older Americans Normative Studies, providing convergent validity for these DRS scales. Importantly, proportional hazards modeling revealed initial DRS Total score to be a significant predictor of longitudinal institutionalization and mortality outcomes.