JCAH standards for accreditation of community mental health service programs: Implications for the practice of psychology.

The Joint Commission on Accreditation of Hospitals (JCAH) has recently developed standards for the accreditation of community mental health centers (CMHCs). A review of these standards and the Balanced Service System reveals little that could be considered restrictive of the practice of psychology in CMHC settings. Unlike JCAH accreditation of hospitals and psychiatric facilities, the CMHC standards do not endorse the view that patient care be the ultimate responsibility of the physician. Although the standards were developed with no formal involvement from organizations representing psychologists, they do reflect contemporary psychological thought in the area of effective delivery of mental health services. Given the heavy consumer orientation and accountability focus emphasized in the standards, the present article maintains that JCAH accreditation could be an appropriate criterion for CMHC eligibility for national health insurance reimbursement. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Islet amyloid polypeptide in patients with pancreatic cancer and diabetes

Population-based psychiatric admission rates vary across geographic areas, but reasons for this variation are unknown. Insofar as Community Mental Health Centers (CMHCs) provide outpatient services that may deter the need for hospitalization, the presence and structural characteristics of CMHCs may have an impact on a population's psychiatric admission rates. This study uses small area analysis to examine how general hospital psychiatric admission rates are associated with CMHC characteristics. Based on a survey of all CMHCs in Iowa and corresponding small area variation data, it was found that population admission rates were higher in areas closer to the CMHC and lower in outlying catchment areas, adjusting for age, sex, and urban/rural differences in populations. There was little evidence that differences in staffing and service variables influenced admission rates, although greater CMHC staff coverage by social workers and psychiatric residents was associated with lower admission rates. The results suggest that CMHCs do not lower an area's hospitalization rate, and in fact, the presence of CMHCs may promote a "supplier-induced demand" phenomenon of higher admissions.     

Research selection bias and the prevalence of depressive disorders in psychiatric facilities.

Applied a statistical technique to correct for selection bias in estimating the prevalence of depressive disorders in community mental health centers (CMHCs). Approximately 243 Ss completed the screening instruments at 2 CMHCs. Results indicate that the prevalence of depression in total CMHC populations may approach 44% rather than the 25% derived from a censored sample. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving program evaluation: Comparison of intervention strategies.

A national study of two intervention strategies to improve evaluation was conducted in 131 community mental health centers (CMHCs) in nineteen states. Four randomly assigned comparison groups were compared by means of pre- and postintervention data from telephone interviews and mailed questionnaires. The intervention strategies—both based on theories of collaboration and ownership but differing with respect to the nature and timing of the activities—were shown to increase actual and planned use of an evaluation resource book. Possible future research on these intervention strategies is discussed in light of the changing role of program evaluation in CMHCs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Task, social structure, and social process in the Community Mental Health Center movement.

Applies a sociopsychological approach to social systems to examine the Community Mental Health Center (CMHC) movement. The interrelated concepts of task(s), social structure, and social process help to explicate the overwhelming emphasis on direct clinical service at the cost of indirect service. The historical evolution of the task mandate and the professional and organizational structures of the CMHCs are traced to their legislative origins. Nonrational aspects of the social process during the 1960s contributed to an illusion of radical social change, despite the actual ongoing predominance of the clinical approach. By considering possible future directions of the CMHC, the advantages of a sociopsychological approach in providing a conceptual base for the integration of direct and indirect services are described. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Community clinic treatment of depressed youth: Benchmarking usual care against CBT clinical trials.

This study used a benchmarking strategy to evaluate the effectiveness of community psychotherapy for depressed youth relative to evidence-based treatment in clinical trials. Symptom trajectories of depressed youth treated in community mental health centers (CMHCs) were compared with trajectories of youth treated with cognitive-behavioral therapy (CBT) in clinical trials. Overall, outcomes of CMHC youth more closely resembled those of control condition youth than youth treated with CBT. Within the CMHC sample, ethnic minority status and low therapy dose were related to worse outcomes. However, when outcomes for Caucasian youth and youth receiving longer term services were examined, the CMHC sample still performed more poorly than youth treated with CBT. The findings support the value of developing, testing, and exporting effective therapies for depressed youth to community clinic settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of alternative aging process on the fracture and interfacial properties of particulate Al2O3-reinforced Al (6061) metal matrix composite

The effects of different aging processes on ductility, fracture, and interfacial properties in particulate Al₂O₃-reinforced Al (6061) metal-matrix composite (MMCs) were studied. Tensile tests based on relevant ASTM standards were performed to investigate the mechanical responses of specimens under different heat-treatment conditions. Scanning electron microscopy (SEM), field-emission SEM (FESEM), and transmission electron microscopy (TEM) studies were carried out to correlate fracture mechanism(s) with microstructural features. Based on the experimental results, the overall effect of heat treatment on tensile properties is similar to that in the monolithic alloy, however, the rate of recovery in fracture-related properties, such as elongation to fracture, is lower in the overaged condition for the MMC samples. To explain this “low” recovery behavior of overaged MMCs, the following observations have been taken into account: (1) a shift of the materials’ behavior from particle fracture to interface (or near-interface) debonding fracture, when moving from the underaged to overaged regime, and (2) more frequent observations of interfacial reaction products (spinel) on the fracture surface of overaged specimens. The presence/formation of spinel phase at the interface was recognized as the main cause of this behavior. Although spinel products mainly form during material processing, they may continue to form in the solid state as well. As a result, the surface morphology of the spinel phase in the underaged specimens is different from that in the overaged specimens.     

"Therapist-patient sex as sex abuse: Six scientific, professional, and practical dilemmas in addressing victimization and rehabilitation": Response to Williams's Comment.

Agrees with M. H. Williams's (see record 1991-13292-001) comment on K. S. Pope's (see record 1991-02078-001) article on therapist–patient sexual involvement (TPSI) that evaluations of TPSI research are not well served. Pope addresses Williams's 2 basic propositions: (1) Research on the outcome of TPSI does not, and possibly cannot, meet minimal standards for survey research and (2) psychology has been victimized by those who feel that there must be a data base before sanctions can be applied to therapists involved in TPSI and by those who have used lower standards for research relevant for each ethical guideline and have constrained criticism of research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From trainee impairment to professional competence problems: Seeking new terminology that facilitates effective action.

[Correction Notice: An erratum for this article was reported in Vol 39(4) of Professional Psychology: Research and Practice (see record 2008-10899-013). The APA ethics code standards for issues related to training were incorrectly identified in the last sentence on p. 501 (and continuing on p. 502). The sentence should read as follows: "The 2002 revision of the APA ethics code added standards that address training, including due process conditions for requiring disclosure of personal information when problems arise for trainees (Standard 7.04) as well as standards for mandating individual or group psychotherapy (Standard 7.05)."] Professional psychology has used the term impairment to describe trainees whose behavior does not meet minimum standards of professional competence, despite difficulties with the term that have been identified (L. Forrest, N. Elman, S. Gizara, & T. Vacha-Haase, see record 1999-03998-001), and a few new terms that have been posited. Overlap with definitions of disability and impairment under the Americans With Disabilities Act (1990) create legal risk for training programs continuing to use the term impairment (C. A. Falender, C. J. Collins, & E. P. Shafranske, 2005). In this article, we review this and other problems with impairment, propose new terminology that captures three concepts (problems, professional, and competence), and examine ways in which the new terminology is contextually grounded in emerging trends in psychology (e.g., the competency movement). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"From trainee impairment to professional competence problems: Seeking new terminology that facilitates effective action": Correction to Elman and Forrest (2007).

Reports an error in "From trainee impairment to professional competence problems: Seeking new terminology that facilitates effective action" by Nancy S. Elman and Linda Forrest (Professional Psychology: Research and Practice, 2007[Oct], Vol 38[5], 501-509). The APA ethics code standards for issues related to training were incorrectly identified in the last sentence on p. 501 (and continuing on p. 502). The sentence should read as follows: "The 2002 revision of the APA ethics code added standards that address training, including due process conditions for requiring disclosure of personal information when problems arise for trainees (Standard 7.04) as well as standards for mandating individual or group psychotherapy (Standard 7.05)." (The following abstract of the original article appeared in record 2007-14485-007.) Professional psychology has used the term impairment to describe trainees whose behavior does not meet minimum standards of professional competence, despite difficulties with the term that have been identified (L. Forrest, N. Elman, S. Gizara, & T. Vacha-Haase, see record 1999-03998-001), and a few new terms that have been posited. Overlap with definitions of disability and impairment under the Americans With Disabilities Act (1990) create legal risk for training programs continuing to use the term impairment (C. A. Falender, C. J. Collins, & E. P. Shafranske, 2005). In this article, we review this and other problems with impairment, propose new terminology that captures three concepts (problems, professional, and competence), and examine ways in which the new terminology is contextually grounded in emerging trends in psychology (e.g., the competency movement). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Swedish population reference standards for height, weight and body mass index attained at 6 to 16 years (girls) or 19 years (boys)

Swedish population reference standards for height, weight and body mass index (BMI) attained at 6 to 16 years (girls) or 19 years (boys) are presented. Data were obtained from two independent nationwide samples of Swedish children; one (740 children) born in 1955, the other (2907 children) born in 1967. The weights of the children born in 1955 were adjusted to equal those born in 1967; heights did not differ. These reference standards refer therefore to Swedish children born at around 1970. The observations were fitted by the power transformation, or L, M, S method of Cole and Green. Weights and BMIs were thus normalized and valid SD scores for individuals obtained. Centile charts are given for clinical use. The means of the present, nationwide standards were 1-2 cm and 1-2 kg greater than those of the Solna-based standards currently in use.     

7-[3-(1-piperidinyl)propoxy]chromenones as potential atypical antipsychotics. 2. Pharmacological profile of 7-[3-[4-(6-fluoro-1, 2-benzisoxazol-3-yl)-piperidin-1-yl]propoxy]-3-(hydroxymeth yl)chromen -4-one (abaperidone, FI-8602)

A series of novel 7-[3-(1-piperidinyl)propoxy]chromenones was synthesized and tested as potential antipsychotics in several in vitro and in vivo assays. The compounds possessed good affinity for D2 receptors, together with a greater affinity for 5-HT2 receptors, a profile which has been proposed as a model for atypical antipsychotics. Several agents also displayed a high potency in the climbing mice assay on oral administration, suggesting a potent antipsychotic effect as compared to reference standards. Compound 23 was selected for further pharmacological evaluation. Induction of catalepsy and inhibition of stereotypies weaker than standards, along with a lower increase in serum prolactin levels, were indicative of a potential atypical profile for this compound. From these results, 7-[3-[4-(6-fluoro-1, 2-benzisoxazol-3-yl)piperidin-1-yl]propoxy]-3-(hydroxymethyl )chromen- 4-one (23, abaperidone) has been proposed for clinical evaluation in humans as a potential atypical antipsychotic.     

New systems for dental maturity based on seven and four teeth

An updated system for estimating dental maturity is presented. It extends the original system (Demirjian et al., 1973) based on radiographs of 7 teeth by including two extra stages, and by enlarging the standardizing sample to include 2407 boys and 2349 girls. Percentile standards from ages 2-5 to 17-0 years are presented separately for boys and girls. Scoring systems and percentile standards are presented for two different sets of 4 teeth and a comparison of all three systems is made. It is suggested that these systems may measure somewhat different aspects of dental maturity.     

Own versus other standpoints in self-regulation: Developmental antecedents and functional consequences.

An inner audience is an internal representation of other's values, goals, and standards for the self (other standpoint on self). It contrasts with an internal representation of one's own values, goals, and standards for the self (own standpoint on self). Using self-discrepancy theory (E. T. Higgins, see record 1987-34444-001) as a framework to integrate diverse psychological perspectives on this classic distinction, the authors consider the role of own versus other standpoints in self-regulation. They describe developmental shifts and socialization effects on the self-regulatory strength of own and other standpoints. Evidence that individual differences and sex differences in own versus other standpoints for self-regulation relate to different affective and interpersonal vulnerabilities is reviewed. The concepts of identification and introjection are empirically distinguished in a novel way, and therapeutic implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of alanine infusion on glucose production in 'malnourished' African children with falciparum malaria

By US standards, about half of African children are malnourished, although most appear clinically normal. It is possible that precursor supply for gluconeogenesis is limited to a greater extent in these seemingly malnourished African children than in healthy children, consequently limiting glucose production. Since in malaria peripheral glucose utilization is increased, precursor supply could play an even more critical role in maintaining glucose production in African children suffering from falciparum malaria. We studied the effect of alanine infusion (1.5 mg/kg/min) on glucose production (measured by infusion of [6,6-2H2]glucose) and plasma glucose concentration in 10 consecutive children with acute, uncomplicated falciparum malaria. By US standards, six children were below the 10th percentile of weight for height and seven were below the 10th percentile of height for age. Plasma concentrations of alanine increased during alanine infusion from 153 +/- 21 to 468 +/- 39 mumol/l, whereas plasma lactate concentrations did not change (1.4 +/- 0.2 vs. 1.3 +/- 0.2 mmol/l). Plasma glucose concentration and glucose production did not change during alanine infusion: 4.6 +/- 0.3 vs. 4.5 +/- 0.3 mmol/l and 5.8 +/- 0.4 vs. 5.7 +/- 0.3 mg/kg/min, respectively. Gluconeogenic precursor supply is sufficient for maintainance of glucose production in African children with uncomplicated malaria who are malnourished by US standards.     

Effects of reward on intrinsic motivation—Negative, neutral, and positive: Comment on Deci, Koestner, and Ryan (1999).

Comments on the meta-analytic review by E. L. Deci et al (see record 1999-01567-001) concerning the effects of extrinsic rewards on intrinsic motivation. Meta-analyses indicated that rewards increase perceived self-determination and that rewards' effects on intrinsic motivation depend on the performance requirement. Reward for meeting vague performance standards reduced the subsequent choice to carry out the task and did not affect self-reported interest. Reward for meeting absolute performance standards did not affect free choice but increased self-reported interest. Reward for exceeding others increased both free choice and self-reported interest. Applied studies commonly found positive or null relationships between reward and intrinsic motivation. The findings suggest that reward procedures requiring ill-defined or minimal performance convey task triviality, thereby decreasing intrinsic motivation. Reward procedures requiring specific high task performance convey a task's personal or social significance, increasing intrinsic motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dissent from Carver.

Comments on R. P. Carver's (see record 1975-00055-001) article on the psychometric and edumetric dimensions of tests, agreeing that tests used for absolute decisions should meet standards other than those applying in comparative decisions. Disagreement with Carver is cited in the areas of item selection, validity, reliability, and gain scores. (PsycINFO Database Record (c) 2010 APA, all rights reserved)