Evaluating day-care for chronic psychotics: goal attainment versus symptom-attitude change.
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Bipolar Disorder↗
Biomedical subjects
M W Kahn
Publications and source records attributed to M W Kahn.
The effects of compensation on psychiatric disability.
Psychiatrically impaired veterans who were receiving 100%, partial or no compensation for their psychiatric disabilities were compared on type and level of psychopathology, self-esteem, locus of control and treatment utilization. All groups were highly elevated on measures on measures of psychopathology. There were no differences between groups on psychopathology measures, except that the 100% group scored significantly higher than the uncompensated group on hostility. Differences in locus of control were not found. On 3 of 10 subscales, partially compensated patients reported higher levels of self-esteem than patients in one or both of the other groups. Uncompensated patients required the most hospitalization. Those who were receiving 100% disability compensation required less hospitalization and the number of days they spent in the hospital was significantly reduced following attainment of full compensation.
Adult↗
Drinking patterns and effects: alcoholics in treatment compared to medical outpatients.
Alcoholics in treatment were compared to medical outpatients with regard to their stated drinking patterns and the effects and attractions of drinking. Nineteen percent of the medical outpatients were found to have serious drinking problems and were not included. The alcoholics drank considerably more, were more likely to be daily drinkers, and mainly drank combinations of alcoholic beverages. The controls most frequently drank beer. In all areas of family, vocation, health, and legal difficulties, the alcoholics reported a much higher rate of problems. The alcoholics in high frequencies reported the attractions of drink to be relaxation, forgetting, taste, and mind enhancement; while the controls reported little attraction in any area, but taste most frequently. These findings cross-validated on a second sample.
Adult↗
Psychopathology, treatment outcome and attitude toward mental illness in Mexican American and European patients.
Lower socio-economic European American and Mexican American psychiatric inpatients were compared on degree of psychopathology, response to treatment and attitude toward mental illness and hospitalization. The Mexican American patients were proportionately under-represented, but did not differ from the European Americans in degree of psychopathology at admission nor in response to treatment-both groups showing a high degree of improvement by both MMPI and clinical judgement. However, the Mexican American patients did have a significantly more negative view of hospitalization and treatment, viewing it as controlling and restrictive which may account for their lower proportion in the patient population.
Adult↗
Consistency of field dependence in treated alcoholics.
In accounting for the consistent finding that alcoholics are more field dependent than other groups, research generally supports the predisposition rather than the consequence hypothesis. In this study 32 alcoholics were tested for field dependence with Embedded Figures on admission to and at discharge from a 60-d treatment program. A large and significant drop in the field dependence measure was found, supporting the consequence hypothesis. The pre-posttime period not controlled in other studies, allowing for clearing acute effects and improved nutrition, health, and test motivation, amy account for this change.
Adult↗
Counselor training as a treatment method for alcohol and drug abuse.
Based on the "helper-therapy" principle, a group of predominantly chronic alcohol- and drug-dependent individuals were trained for new careers in alcohol-drug counseling. A 2-month preinternship in alcohol or drug treatment centers served as a screening procedure for motivation and sobriety. Prior to training, measures of personality and self-concept were taken as well as demographic information. A 4-month training course covered broad educational and technical areas, including counseling procedures with participation, and physical conditioning. The 13% who dropped out were compared to the completers and found to differ only in extent of past antisocial history and less certainty about social drinking and abstinence. The pre-post measures of the completers indicated significant improvement in all areas of self-concept and on most of the MMPI scales. A 1-year post follow-up self-report questionnaire revealed that 74% of the respondents were employed, 59% in counseling or related areas. Less than 10% reported moderate regular use of drugs of alcohol, less than 2% heavy usage or addiction. Overall the program appears to have had sustained positive effects.
Alcoholism↗
Wife beating and cultural context: prevalence in an aboriginal and islander community in Northern Australia.
Wife beating is generally condemned in Western society, but may be viewed differently by other cultures. The frequency of battered women in a small urban Australian Aboriginal population was studied through reports of indigenous paraprofessional behavioral health workers of the community. The findings indicated battering was a regular, routine occurrence not only of women referred for mental health problems, but for women of the entire community. The practice seems to have its origin in tribal traditions and is supported by social sanctions, and there are social pressures for women to remain with the men who beat them. It is also currently related to alcohol ingestion and a pervasive jealously and suspicion usually existing between conjugal couples. Intervention strategies should be based on understanding of the cultural context in which the beatings occur.
Australia↗
Faking psychosis on the Rorschach: can expert judges detect malingering?
The susceptibility of the Rorschach to faking of psychological disturbance has been subject to few studies, all of which have significant methodological deficiences. Faking of psychosis was examined in this study by using Rorschach experts as judges to blindly evaluate both faked and actual psychotic protocols. The faked protocols came from role-informed and role-uninformed individuals who were asked to specifically malinger paranoid schizophrenia on the Rorschach. The results indicated that the expert judges were unable to detect the faked psychotic protocols regardless of whether the faker was or was not role-informed. However, significantly more role-informed faked protocols received psychotic designations than both the role-uninformed faked and actual psychotic protocols. Expert clinical judgments o- the Rorschach are apparently very susceptible to faking of serious disturbance.
Adolescent↗
Staff conceptions of patients' attitudes toward mental disorder and hospitalization as compared to patients' and staff's actual attitudes.
Compared ward personnel's (N = 25) conceptions of their patients' attitudes toward mental disorder and hospital atmosphere to the patients' (N = 50) and the personnel's actual attitudes by use of the CPH Factor Scale. Personnel completed the scale as (1) they themselves viewed the hospital; and (2) as they thought their patients viewed it. Patients' views also were obtained. Personnel viewed the hospital in "positive mental health" terms and considered the patients to be significantly less so. In actually, patients were less positive than personnel, but significantly less extreme than they were considered to be by the personnel. This approach suggests a means to provide an index discrepancy in attitude between patient and personnel. Identifying these descrepancies can allow for correction and improved understanding empathy, and patient care.
Adolescent↗
Factors associated with number of treatment interviews of patients from a barrio neighborhood mental health service: a cross-validation.
Demographic and treatment variables were, for a second time, found associated with number of treatment interviews completed by lower socioeconomic patients of a barrio area neighborhood mental health service. Of the eight variables that originally differentiated patients with respect to number of interviews, six remained significant on cross-validation. The longer staying patients were characterized by: young adult age range; disrupted marital status; self-referral; using psychotropic medication; major and secondary problems of anxiety and depression.
Adult↗
How fair is the culture I.Q. test?
If a measure of intelligence is culturally biased it is assumed that disadvantaged individuals will score lower on it than on a less biased instrument. The Cattell purports to be "culture fair" and it was compared to the WISC with a delinquent juvenile population, controlling for both order effects and individual administration. The results reveal consistently lower mean I.Q. scores for the Cattell under all conditions. The Cattell appears to be a more difficult test for this population. It is concluded that considerable caution should be exercised inusing the Cattell as a culture fair method of I.Q. evaluation with underprivileged delinquent youth.
Cultural Deprivation↗
Discriminative effectiveness of the Senior Apperception Test with impaired and nonimpaired elderly persons.
A means was devised of assessing elderly individuals' responses to the Senior Apperception Test (SAT) that would discriminate emotionally-cognitively impaired from nonimpaired. With a matched sample of known impaired and nonimpaired nursing home residents, SAT protocols were scored on four dimensions, and the best discriminating cut-off scores established. Protocols from a second similar matched sample were tested for discriminative effectiveness of previously established criterion scores. Significant discrimination at .01 or better was obtained for all four dimensions in the predicted direction. False positives and false negatives ranged from 7 to 33%. The best predictor score was Interpersonal-relationships, the poorest was mood. This procedure with the SAT appears to be an effective screening method for impairment, and it provides additional useful clinical information.
Affective Symptoms↗
Factors associated with length of treatment in a barrio-neighbourhood mental health service.
Factors which discriminate between lower socio-economic largely Mexican-Americans who continue in treatment for few interviews, from those who continue longer were investigated. Demographic and treatment data were obtained from 356 consecutive cases. The factors which significantly differentiate short from long treatment contact patients were: self-referral, age, marital instability, and complaints of anxiety, depression, social or family incompatibilities. Non-self referral and financial or situation problems characterise the short treatment patient. While there were few Anglos in the sample they were disproportionately high in the long treatment group.
Adult↗
Mental health services by and for Aborigines and Islanders: a follow-up report.
The indigenous behavioural health programme for Aborigine and Islander Community of the Townsville area was belatedly funded and has recently been expanded. An additional group of five behavioural health technicians have been trained to provide broadened services emphasizing alcoholism counselling and community based activities. Evaluation of the programme indicates a considerable increase in the utilization of mental health services by the community as compared to utilization prior to the behavioural health service. Self-referrals account for 40% of the cases. Referrals from the centre's physician and from family account for much of the others. Problems seen are multiple, often both of personal-emotional and of a social service nature. Alcoholism, family-material child-school problems, anxiety and depression were frequent emotional problems. Issues as to whether or not such indigenous programmes should rather deal with social problems or physical health are discussed.
Adolescent↗
Mexican American and European Americal psychopathology and hospital course.
Demographic information, reason for admission, mental status on admission, hospital course variables, and discharge diagnosis were collected for 99 patients admitted consecutively to the psychiatric inpatient unit of a community mental health center serving a low-income population with a large proportion of Mexican-Americans; Patient ethnic distribution reflected that of the catchment area. Although ethnicity, sex, and social class each showed distinct characteristics, when any two of the factors were held constant, only three variables maintained significance, none of which indicated severe, flamboyant psychopathology. This study does not support earlier reports that hospitalized Mexican Americans are more severely disturbed than other ethnic groups.
Attitude to Health↗
Relationships between mental health treatment and medical utilization among low-income Mexican American patients: some preliminary findings.
The hypothesis that medical visits decrease as a function of mental health treatment was tested with a lower socioeconomic Mexican-American population. The number of medical and psychotherapy visits for all patients referred for mental health treatment during a specific period was obtained and analyzed in serveral ways to determine rate of medical visits as a function of psychiatric visits. Results indicated clear rejection of the hypothesis. Medical visits significantly increased rather than decreased. Factors which may account for these findings being opposite of previous studies are discussed and include previous poor medical service availability and socioeconomic differences in populations.
Analysis of Variance↗
Developing a rural mental health service from a base in an academic clinical psychology program.
The development of a Community Mental Health Service for a multiethnic rural area by an academic psychology department clinical program was carried out for the purpose of providing relevant training for grauate students through realistic service functions. The population served was largely lower socioeconomic, and the available resources very limited. The Community Psychology course was used to assist the planning and negotiating for the clinic. Services provided during the first year are summarized. The graduate students' not-too-happy view of the program is presented. The problems and issues raised by this experience, for both training and service, are discussed.
Community Mental Health Services↗
Discriminative effectiveness of two psychiatric screening instruments for a gerontological population.
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Aged↗