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A psychogeriatric activity group in a rural community.

Three senior students in occupational therapy and a faculty member collaborated with a community mental health center in implementing and conducting an Outreach Activity Group for socially isolated, psychogeriatric clients residing in an outlying rural community. The students gained experience in five areas: learning the structure, functions, and funding of a community program; identifying the role and function of occupational therapy in community-based mental health; making use of administrative and consultative role functions; leading a group; and, with other health professionals, identifying ways to lessen the problems faced by the psychogeriatric client in the community. The group was helpful in maintaining the psychogeriatric client in the community by promoting self-esteem, self-expression, new interests, constructive use of leisure time, reality testing, interpersonal relationships, and perceptual motor stimulation.

Aged

Irrational beliefs as predictors of adolescent drug abuse and running away.

With a population of 78 residents from a residential drug program and 79 residents from a shelter for runaways, this study examined the Rational Behavior Inventory's ability to predict two forms of adolescent maladjustment--drug use and running away. Specific belief systems were found to be differentially associated with each disorder. In addition, gender differences along two belief dimensions of the RBI were found in the drug abuse population. The importance of belief systems as mediating cognitive factors in both running away and drug use also is discussed.

Adaptation, Psychological

The relationship between psychological differentiation and performance expectation in alcoholics and normals.

Sixty subjects (20 alcoholic inpatients, 20 outpatient alcoholics, and 20 surgical controls from two Veterans Administration hospitals) were tested on field independence-dependence (measured by the Rod-and-Frame Test), realistic/unrealistic self-expectations (on the Level of Aspiration Board), and degree of alcohol dependence (on the Alcohol Dependence Scale). Response bias and current intelligence were controlled. As predicted, alcoholic inpatients were more alcohol dependent than outpatients, both groups of alcoholics were found to be more field dependent and more unrealistic in their self-expectations than controls, and field dependence was related to unrealistic expectations. Patterns of differentiation and expectation were similar in both alcoholic groups. Results support the consistency of differentiation levels within clinical groups and the relationship between field dependence and unrealistic self-expectation.

Achievement

Transcending death during early adulthood: symbolic immortality, death anxiety, and purpose in life.

Robert Jay Lifton has originated a comprehensive theory of development based on the human psychobiological need to symbolize death and life continuity. He calls this condition the sense of symbolic immortality and argues that life is threatened whenever death is not transcended. A Sense of Symbolic Immortality Scale was built and administered to two groups of young adults (N = 136) in order to test the hypothesis that symbolic immortality develops with age (Drolet, 1986). Templer's Death Anxiety Scale and Crumbaugh and Maholick's Purpose in Life Test also were administered. Results show that established adults have a sense of symbolic immortality and a purpose in life significantly stronger than those of young adults. They show a negative relation between death anxiety and purpose in life, while purpose in life correlates highly with the sense of symbolic immortality. Finally, the premise that the sense of symbolic immortality helps cope with the fear of death is supported.

Adaptation, Psychological

Confirmation of the borderline personality within a psychodynamic framework.

Using a psychodynamic framework and an underlying structural configuration, the borderline patient is described. Statistical methods are then used to differentiate this group from both a schizophrenic and a character disorder group of patients. The borderline group emerges as a clear-cut entity characterized by (1) the lack of an integrated self concept, and (2) a particular ego structure consisting of a specific pattern of superficial ego strengths and underlying ego weaknesses.

Adaptation, Psychological

[The programming of cardiac pacemakers--wish and reality].

To test the extent and quality of pacemaker programming, 340 programmable pacemakers were selected out of 1,204 impulse generators removed post-mortem. Their actual program was compared with the nominal parameters when first delivered. 177 (52.1%) of the 340 pacemakers still had the same parameters as on delivery. The multiply programmable impulse generators with telemetry were more frequently programmed (61.2%) than the simple programmable ones (43.0%) or the multiply programmable ones without telemetry (43.7%). Rate was the most frequently programmed parameter, followed by impulse amplitude, sensitivity and impulse duration. Refractory time and hysteresis were only rarely changed from the initial state. Apparently, programmability was not thought to be important enough. Programming without telemetry was seemingly too complicated. The reasons for this attitude should be investigated so that the discrepancy between wishes and reality can be overcome.

Equipment Design

The statistical analysis of matched data in psychiatric research.

Clinical studies in psychiatry frequently involve the analysis of matched pairs, in which each patient is matched with his or her psychiatric clinician. If the response variable of interest is dichotomous, then McNemar's chi 2 test for correlated proportions may be applied to the resulting data. However, this test assumes that the set of matched pairs are statistically independent, an assumption that is violated if some clinicians are matched with more than one patient. In this article we present alternatives to McNemar's test for dealing with this problem.

Humans

Working memory and bias in reasoning across the life span.

Age differences in syllogistic reasoning in relation to crystallized and fluid ability were studied in 278 adults from 19 to 96 years of age. Two reasoning tasks, the evaluation and the construction of conclusions for syllogisms of varying complexity and believability, a vocabulary test, and 3 tasks of working memory were administered. The magnitude of age-related variance on selected reasoning tasks was only partially reduced by statistically controlling measures of both working memory and vocabulary. Additional age-related effects on reasoning were found to be significantly associated with number of mental models and bias produced by conflict between belief and logic. A significant bias was also found toward acceptance of invalid syllogisms as valid, even when contents were abstract. These sources of error in logic are discussed in relation to Johnson-Laird's (1983) theory of mental models and Evan's (1989) account of bias in human reasoning.

Adult

Reality perceptions of television: a comparison of emotionally disturbed, learning disabled, and nonhandicapped children.

The Stony Brook Videotest (SBV), a measure of reality perceptions of television programs and commercials, was administered to 38 emotionally disturbed (ED), 35 learning disabled (LD), and 159 nonhandicapped elementary school children. The ED and LD children scored significantly lower than the comparison group, indicating that ED and LD children are less able to distinguish between reality and fantasy on television. The clinical implications of these findings and possible remedial actions are discussed.

Affective Symptoms

Proficiency testing: now it is a reality.

On January 1, 1994, enrollment in an accredited proficiency testing program became mandatory under the CLIA regulations for physicians performing moderate and high complexity tests in their offices. Physicians not enrolled in programs are in violation of the standard.

Centers for Medicare and Medicaid Services, U.S.