Modeling psychiatric patients' treatment decision making

Decision-making processes of psychiatric inpatients were assessed at admission and prior to discharge, and compared to hospital staff members using a paired comparison paradigm in which subjects chose between hypothetical antipsychotic medications. Multidimensional analyses of binary choice matrices revealed that all subjects based decisions on the risks and benefits of medication, and weighted risks and benefits in roughly equal proportions. Hospital staff demonstrated greater internal consistency in their decisions than the inpatient sample at both time points. For newly admitted inpatients, severity of psychiatric symptoms and nonverbal intelligence were related to internal consistency of decision making, and behavioral indices of medication compliance predicted relative weighting of risks and benefits. For predischarge and comparison samples, verbal intelligence and treatment preferences predicted both outcome measures. Reliance on verbal reports of decision making may be misleading when assessing competence in acutely impaired psychiatric patients.     

A Comparison of Chinese and US College Students’ Crime and Crime Control Views

While there is a growing trend to look at criminal justice issues from an international perspective, there has been little literature examining differences in views of crime, criminals, punishment, and treatment between the citizens of the People’s Republic of China and the United States of America. Using data from 524 students at a large university in China and 484 students from a large public university in the USA this study found that, while US respondents were more likely to agree that crime was high in their country, Chinese respondents were more likely to feel that crime was the most serious social problem facing their society. Chinese respondents were more supportive of the death penalty for serious crimes but also were more supportive of rehabilitation of offenders in general. In addition, the study found similarities between students from the two countries in their views. The reasons behind the differences and similarities were explored.

Relinquishing custody as a requisite for receiving services for children with serious emotional disorders

A review of the literature was conducted to assess the extent and nature of the practice of requiring parents to transfer custody in order to receive public funding for intensive services needed by their child/adolescent who had a serious emotional disorder. The review focused on the legal and policy basis of this practice as well as its social and psychological impact on child and family. We conclude that the practice of transfer of custody as a requirement for receiving financial aid occurs in a majority of states, though the actual extent of this practice is not known. The major factor influencing the use of transfer of custody appears to be the absence of an appropriate and adequate system of services for children and adolescents with serious emotional disorders. We recommend that the practice of requiring custody transfer for the sole purpose of receiving services be abolished and offer several suggestions for improving acess to services.Preparation of this article was supported in part by the National Institute of Mental Health (NIMH) under contract no. 89MF761903. The authors are grateful to John Burke and Kelly Kelleher of the Division of Biometry and Applied Sciences, NIMH for their assistance on this project. Laurie Flynn, Executive Director for the National Alliance for the Mentally Ill, was very helpful during the informative stage of the project. Barbara Friesen, Director of the Research and Training Center at Portland State University, gave us useful guidance throughout the project. We thank Stephen Hill, Consultant to the National Governors' Association, for his help. We are grateful to Amy Hewitt and Carol Ishler for their assistance in preparing this report. We also would like to acknowledge several individuals who assisted us with research reported in this article. We are grateful to Governor Richard F. Celeste of Ohio for his letter of support for the state survey of custody transfer practices. We appreciate the efforts on behalf of this survey by staff from the State of Ohio, particularly Jean Ellen Stevens, Administrative Assistant to the Director of the Department of Mental Health. Margraret McNally assisted in the compilation of data for both surveys.     

Patterns of influence and response in abusing and nonabusing families

Behaviors of influence and response during a conflict negotiation task were examined in eight physically child abusing, substance abusing families in which the father was the primary abuser and eight demographically matched nonabusing families. Abusing fathers displayed more coercive patterns of influencing behavior and more negative patterns of response to other family members, including both mothers and children. Fewer differences were observed between mothers in the abusing and nonabusing families or in the children's behavior; however, mothers in the abusing families criticized their husbands more and abused children exhibited less agreement and more criticism toward their fathers. In support of Patterson's theory, abusing families exhibited relatively more reciprocated sequences of criticism and relatively fewer reciprocated sequences of agreement as compared to nonabusing families. Findings are discussed in terms of their implications for understanding interaction in child abusing families.