Impact of behavioral knowledge on job stress and the perception of system impediments to behavioral care.
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Adult↗
Biomedical subjects
D C Donat
Publications and source records attributed to D C Donat.
Personality and recovery: integrating personality assessment data to facilitate the recovery process.
The relatively enduring and persistent nature of personality traits means that they will likely continue to impact the course of psychiatric recovery after Axis I symptoms are stabilized. These traits can significantly impact the choices that recovering persons make and the quality of interpersonal relationships with care providers who are trying to facilitate the recovery process. Despite this, they are often inadequately assessed and considered in providing psychiatric care. This manuscript reviews the common combinations of personality traits that have emerged across a variety of clinical samples. The implications of these personality features for the provision of care in an inpatient setting to facilitate recovery are discussed.
Convalescence↗
Impact of a mandatory behavioral consultation on seclusion/restraint utilization in a psychiatric hospital.
Despite demonstrations of the utility and cost effectiveness of behavioral methods for improving care for people with psychiatric impairments, they are seldom employed effectively in inpatient settings. This study evaluated the impact of an administrative procedure to effect a behavioral consultation for cases of high seclusion/restraint utilization. Seclusion/restraint use for the 53 cases was reviewed for a time period of 6 months before and 6 months after development of a behavioral treatment plan resulting from this procedure. The data revealed a 62% reduction in seclusion/restraint use after development of an approved plan. There was also a reversal in serial trend from increasing use during the months prior to plan development to decreasing use during months after plan development. The procedure is described and implications of the results for clinicians and administrators of psychiatric inpatient programs are discussed.
Behavior Therapy↗
Personality traits and psychiatric rehospitalization: a two-year follow-up.
This study followed 188 people with psychiatric impairments for 2 years after their discharge from a public psychiatric facility to assess the impact of personality traits on rehospitalization. A Cox regression analysis revealed a significant relation between the pattern of personality traits and psychiatric rehospitalization. The significant relation was retained after age, sex, race, education. Axis I diagnosis, subscale scores on the Brief Symptom Inventory, Methods of Coping Scale, Level of Expressed Emotion Scale, and scores on the alcohol and drug dependence scales of the MCMI-II were included in a stepwise inclusion analysis. The implications of these results for the assessment and treatment of people with psychiatric impairments are discussed.
Adolescent↗
Empirically derived personality subtypes of public psychiatric patients: effect on self-reported symptoms, coping inclinations, and evaluation of expressed emotion in caregivers.
Personality scales on the Millon Clinical Multiaxial Inventory-II (MCMI-II) for 195 psychiatric inpatients (93 men and 102 women) in a public facility were cluster analyzed to develop an empirical subtyping according to personality traits. Subjects also completed the Brief Symptom Inventory (BSI), Methods of Coping Scale (MOC), and the Level of Expressed Emotion Scale (LEE). The five personality subtypes that emerged were consistent across two clustering methods (K-means and complete linkage). Subtypes members differed on subscales of the BSI, MOC, and LEE. Results support the relevance of personality traits and disorders in assessing psychopathology in psychiatric patients. Results also support the relevance of subtyping these patients according to MCMI-II results.
Adaptation, Psychological↗
MCMI differences between alcoholics and cocaine abusers: effect of age, sex, and race.
Samples of alcohol-dependent-only subjects (n = 164), cocaine-dependent-only subjects (n = 63), and subjects dependent on multiple substances, including alcohol and cocaine (n = 103), were administered the Millon Clinical Multiaxial Inventory (MCMI) as part of a routine clinical evaluation. The alcohol-only group was older (M = 38.7 years) and had a higher percentage of White subjects than other groups. The multiple-use (60%) group also had a higher percentage of White subjects than the cocaine only group (38%) and a higher percentage of male subjects (81%) than the alcohol-only group (67%). Although the MCMI characteristics of each diagnostic group paralleled previous findings, few MCMI differences were found after controlling for age, sex, and race effects. The implications of these results for treatment development are discussed.
Adult↗
Hospital-based multidisciplinary training in the care of seriously mentally ill patients.
A four-week training program at a state hospital in Virginia familiarized undergraduate and graduate students in medicine, occupational therapy, pharmacy, psychiatric nursing, psychology, and social work with the range of care for chronic mentally ill patients. Designed to improve the training of mental health professionals and recruit mental health professionals to work in public mental health settings, the program included lectures, group discussions, field trips to community-based treatment and rehabilitation facilities, and supervised clinical experiences. Students who participated in the program reported being less discouraged about working with chronic mentally ill patients and more likely to choose careers in public psychiatric settings.
Acute Disease↗
Personality characteristics of alcohol dependent inpatients: relationship of MCMI subtypes to self-reported drinking behavior.
Recent cluster analytic research with alcoholic inpatients has demonstrated the existence of several Millon Clinical Multiaxial Inventory (MCMI) clusters that appear to be consistent across different subject samples. The validity of these data would be strengthened by a statistical demonstration of the similarity of attained clusters across studies--a demonstration of concordance of subject classification across different clustering techniques on the same data set- and the inclusion of external, independent measures against which to evaluate the predictive validity of the cluster typology. We found a high level of concordance in subject classification across different clustering methods on the same data set and a high level of agreement with cluster typologies attained in previous studies. Subsequent multivariate analyses employing independent scales measuring various aspects of alcohol use confirmed differences among cluster members on perceived benefits of alcohol use and deleterious effects of alcohol use. The prominent differences in alcohol use along with a rationale for their development are discussed.
Adolescent↗
An inventory to measure knowledge of behavioral methods with inpatient adults.
A 44-item multiple choice inventory designed to assess the knowledge of hospital staff in the use of behavioral methods with adult psychiatric inpatients is described. Data are presented to demonstrate adequate internal consistency, temporal stability and validity. Potential uses and limitations of the inventory are discussed.
Adult↗
Semantic and visual memory after alcohol abuse.
This study compared the relative performance of 40 patients (M age = 31.7) with a history of alcohol abuse on tasks of short-term semantic and visual memory. Performance on the visual memory tasks was impaired significantly relative to the semantic memory task in a within-subjects analysis of variance. Semantic memory was unimpaired. This result is consistent with previous results obtained on tests of intelligence despite the added requirement of encoding, storing, and retrieving data inherent in the memory tasks. This result provides support for the contention that visuospatial and visuomotor skills evince primary residual impairment secondary to the abuse of alcohol. The significance of this result, in light of previous research, is discussed.
Adult↗
Altercations among institutionalized psychogeriatric patients.
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Aged↗
Psychophysiological discriminants of depression at rest and in response to stress.
Examined heart rate, skin conductance, and finger pulse amplitude at rest and in response to stress in a group of 10 chronically depressed Ss and a closely matched set of controls. While all physiological channels revealed a significant main effect attributable to the conditions of rest, anticipation of stress, and stress, only the skin conductance channel revealed a significant group effect. No significant interaction effect was revealed for any of the channels. The results indicate that skin conductance level may have some potential in assessing the level of depression in clients and that attempts to control directly skin conductance level, as in biofeedback, may prove to be a useful adjunct in the treatment of depression with the characteristics employed in this study.
Adolescent↗