Trauma, sport, and malignant cerebral edema

Sudden cerebral swelling and death secondary to craniocerebral trauma has been noted in children and young adults. This is due to an increase in intracerebral blood, either secondary to an increase in cerebral blood volume or a redistribution of intracranial blood from the pial to the intraparenchymal vessels. Sequential craniocerebral trauma has been associated with the syndrome of "malignant cerebral edema"; the possibility of a "compliance compromised brain" has been suggested as the cause. The additional possibility of asymptomatic encephalitis leading to a compliance compromised brain and malignant cerebral edema is discussed.     

Adolescents' capacities to provide voluntary informed consent

Minors' capacities to provide a valid informed consent for the treatment of medical and psychological disorders are contingent in part on the determination of whether they can make voluntary treatment decisions. The gravity of a medical dilemma and the nature of parental influence are two factors hypothesized to effect and perhaps compromise the voluntariness of treatment decisions made by adolescents. In the present study 40 14- and 15-year-old subjects were asked to note their conviction for treatment decisions they had made in response to hypothetical medical dilemmas in which parental influence varied. It was found that adolescents making treatment decisions are generally deferent to parental influence, although they are more likely to resist parental influence when the consequences of the decision have serious implications for the hypothetical adolescent's health.This investigation was supported in part by a grant from the American Psychology-Law Society/ Division 41 of the American Psychological Association, whose assistance is gratefully acknowledged. Gratitude is also extended to the Albemarle County School District, the Blue Ridge School. and St. Anne's-Belfield for their kind cooperation. The authors wish to thank William Gardner, Jeanne Smith, and Edith Lawrence for their work on behalf of this project. Special recognition is due to Lois A. Weithorn for her guidance and support of this research endeavor.     

Factor similarity of the Conflict Tactics Scales across samples,spouses, and sites: Issues and implications

Wide variations in prevalence estimates of marital aggression point to the absence of a uniform and adequate definition of marital aggression. To focus on the construct validity of Straus' (1979) Conflict Tactics Scales, the most frequently used measure of marital aggression, two studies were conducted. Based on responses to the Conflict Tactics Scales, two consistent factors (viz. Physical and Psychological Aggression) emerged in separate samples of 187 couples seeking therapy for marital problems, and 398 nonclinic couples in beginning marriages. The factor structure was consistent across clinic and nonclinic samples, sex, geographical sites, time, and socioeconomic status. Implications for the measurement of interspousal physical aggression are raised (e.g., mild, moderate, and severe aggression load on the same factor) and appropriate directions for further research on the construct validity of the Conflict Tactics Scales are suggested (e.g., conducting similar factor analyses on aggressive couples).     

Ideology and performance: service delivery in a community mental health center

This study examines the relationships between ideology and service delivery performance in an established community mental health center which is beginning major structural changes. Ideological pluralism among several separate and internally-cohesive units within one organization led to diversity in staff productivity. The implications of ideological pluralism for planned organizational change, policy implementation and administration are explored.