EEOC guidance on psychiatric disabilities: many problems, few workable solutions

The EEOC recently issued "Enforcement Guidance" on psychiatric disabilities under the Americans with Disabilities Act. Although the Guidance provides clarification of a few issues involving mental disabilities under the ADA, in most respects the Guidance is problematic. For example, the Guidance suggests that the inability to get along with a supervisor or coworkers may constitute a disability under the ADA, that an employer may have to "accommodate" a disabled employee's misconduct, that an employer cannot require an employee to follow doctor's orders as a condition of employment, and that an employer may be obligated to modify work rules and procedures to accommodate a mentally disabled employee but is prohibited from explaining to coworkers why it is making such modifications. As the EEOC's Guidance exceeds or conflicts with the ADA in some respects and is largely unworkable in many respects, it remains to be seen how many courts will actually follow it.     

Identity development and perceived parental behavior as sources of adolescent egocentrism

Adolescent egocentrism involves heightened self-consciousness and feelings of uniqueness (O. Elkind [1967], Egocentrism in Adolescence, Child Development, Vol. 38, pp. 1025–1034). Some studies have found that adolescent egocentrism is associated with identity development, and other studies have found that egocentrism is associated with perceptions of parental behavior. The purposes of this investigation were to simultaneously examine the associations between these variables (1) to determine whether identity development and perceived parental behavior display separate or overlapping associations with adolescent egocentrism, and (2) to clarify the directions of the relationships between these variables. Four hundred eighteen subjects from 12 to 21 years of age completed established measures of identity development, perceived parental behavior, and egocentrism. Identity development was more strongly and consistently related to egocentrism (egocentric adolescents tended to be identity achieved or to be experiencing an identity crisis), whereas perceived parental behavior accounted for little additional variance. The results also clarify differences between the two primary measures of adolescent egocentrism (the Adolescent Egocentrism Scale and Imaginary Audience Scale).Received his M.Sc. and Ph.D. from the University of Victoria. His main interests are in personality, and social and developmental psychology.     

A review of recent developments affecting COBRA rights

Due to the high cost of health care claims and COBRA's status as remedial legislation, COBRA has generated a significant amount of litigation in recent years. While the early COBRA decisions tended to broaden the law in order to provide a remedy to an otherwise uninsured qualified beneficiary, the recent trend in the case law has been to limit the expansion of COBRA rights based on a narrower construction of the statute. Even so, COBRA still represents a legal minefield for employers. As a result, a careful employer will minimize its exposure by monitoring changes in the law and its interpretation and making appropriate modifications to its COBRA documentation and administration. This article discusses some of the more significant recent changes in the law affecting qualified beneficiaries' COBRA rights--and therefore, employers' exposure.     

The MacArthur Treatment Competence Study. II

This article reports the development and psychometric properties of three standardized and objectively scored measures, the MacArthur Treatment Competence Research Instruments. They were designed to assess abilities related conceptually to four legal standards for competence to consent to treatment: understanding, appreciation, rational manipulation (reasoning), and expressing a choice. Scoring reliability, internal consistency, intertest correlations, and test-retest correlations were examined with data from samples of hospitalized patients with schizophrenia, major depression, and ischemic heart disease, as well as matched non-ill community samples. The results indicate very good interscorer reliability and provide guidance for the use of the instruments and interpretation of their results in future research on patients' decisional abilities in treatment contexts.