Beyond enmeshment: evidence for the independence of intrusiveness and closeness-caregiving in married couples.

In a 1996 article on family theory, we (Green & Werner) proposed that family enmeshment should not be equated with high cohesion and that the construct of enmeshment fails to discriminate between two distinct relationship processes: Closeness-caregiving and intrusiveness. In this study, our model of these two independent dimensions of family connectedness was tested by assessing spouses from 264 couples, using the California Inventory for Family Assessment (CIFA). The CIFA scales showed acceptable reliability. Significant interspouse validity correlations also were obtained. As predicted by our theory, factor analyses distinguished dimensions of intrusiveness (blurring of boundaries) from dimensions of closeness-caregiving (such as warmth and nurturance). On all but two factors, behaviors of only one spouse (but not of both) had interpretable loadings. That is, in most areas, the two spouses' behaviors did not load together to form meaningful factors. The latter finding suggests that family systems theory--with its central notion of reciprocally contingent behaviors between family members--may be useful in understanding only a few dimensions of spouses' behavior (such as reciprocal aggression) whereas personality-in-context theories may be better for understanding most other dimensions (such as warmth and nurturance).

Factors in Chinese marital process: relationship to marital adjustment.

This research examined the applicability, in Taiwan Chinese groups, of western approaches to conceptualizing and assessing aspects of martial relations. Chinese translations of American measures of marital adjustment (the Marital Adjustment Test) and marital process (the California Inventory for Family Assessment, measuring respondents' perceptions of their spouses' behavior) were developed to study a Taiwan Chinese sample of husbands and wives (N = 104 in Taiwan and N = 54 in the United States). These translations were found to be reliable and for the most part to relate as expected. In accordance with Green and Werner's (1996) reconceptualization of the cohesion-enmeshment domain, factor analytic results yielded independent dimensions consistent with the western constructs of intrusiveness and closeness-caregiving. Results also suggested aspects of marital process that may distinguish Taiwan Chinese marriages from those among western cultures. These findings were interpreted with reference to the impact of modernization on Chinese marital relations.

Intrusiveness and closeness-caregiving: rethinking the concept of family "Enmeshment".

This article analyzes the concepts of "enmeshment" and "cohesion" and their entanglement in the field of family therapy. Early theories in this area were concerned primarily with processes of self/other differentiation. More recent theories have favored spatial metaphors that emphasize closeness-distance. We contend that self/ other differentiation and closeness-distance are different classes of behavior and that their linkage in the literature has obscured useful distinctions. Our analysis reveals two separate dimensions that clinicians and researchers should consider: Intrusiveness (including coercive control, separation anxiety, possessiveness/jealousy, emotional reactivity, and projective mystification); and Closeness-Caregiving (including warmth, time together, nurturance, physical intimacy, and consistency). We give definitions of these constructs and briefly examine their clinical and gender-related implications.

A Q-Sort measure of beliefs about abortion.

PIP: Debate over the availability and use of induced abortion continues in the US. The author introduces a Q-sort procedure for assessing beliefs about abortion and presents results from its application. The measure permits the assessment of reactions to a fuller list of beliefs than has been employed in many previous studies, while being person-centered instead of more variable-centered with regard to the analyses of reactions to the abortion issue. 119 university respondents of mean age 19.6 years in a range of 18-46 years from an introductory psychology class sorted 41 items, derived in part from open-ended responses of a large community sample, into a seven-category forced distribution. 55.5% of the sample was male. Cluster analysis of respondents' sorts yielded two types reflecting pro-life orientations toward the issue and two representing pro- choice orientations. Significant differences were found among the types on eight scales of the California Psychological Inventory, including scales assessing interpersonal effectiveness, intellectual competence, and flexibility. The types did not, however, differ on scales assessing respondents' orientation toward norms. These results demonstrate the strong feasibility and utility of employing the Abortion Beliefs Q-Sort in additional studies on the issue.^ieng

An MMPI typology of cocaine abusers.

Three types were found in a cluster analysis of scores on the Minnesota Multiphasic Personality Inventory (MMPI) of 100 men voluntarily presenting for treatment of cocaine abuse. Type 1 (n = 59) had a mean MMPI profile consistent with the hypothesized grouping of persons who self-medicate with cocaine as a means of overcoming depression. The relatively normal mean MMPI profile obtained by Type 2 (n = 37) suggested little indication of significant psychopathology. Type 3's (n = 4) mean MMPI profile suggested either severe disturbance or profile invalidity. Types were found to differ in the nature of drug use, reactions to cocaine, education level, and social class, but not on the scales of the Adjective Check List.

Aspects of consensus in clinical predictions of imminent violence.

This research studied individual differences among psychiatric patients in the extent to which clinical workers agree about the likelihood that the patients will act violently. Predictions of imminent violence proneness for 40 male inpatients made by 35 experienced clinical practitioners were analyzed. As hypothesized, subgroups of patients who elicited high interjudge agreement were found, and admission profiles of these patients were presented. Clinical workers' predictive accuracy was found to be greater when they rated patients who elicited high consensus than for unselected patients or for those who elicited low consensus.

The content of personality inventory items.

Four aspects of the item content of personality inventories were studied: the area of psychological functioning addressed (cognitive, preferences, feelings, behavioral), degree of reference to situational factors, degree of reference to response frequency, and the nature of reference to time. Three judges rated items of the California Psychological Inventory, Eysenck Personality Inventory, Maudsley Personality Inventory, Minnesota Multiphasic Personality Inventory, Jackson Personality Research Form, and Sixteen Personality Factor Questionnaire. Behavioral acts were found infrequently addressed in inventory items, and the other areas of functioning were approximately equally represented. More than half of the items referred to situation characteristics, 39% included the notion of frequency of behavior or experience, and most referred to the present. Rating reliabilities were also presented, and results for individual inventories were compared. Implications for controversies in the field of personality were discussed.

Measuring activism regarding the nuclear arms race.

A 14-item questionnaire measure of activism regarding the nuclear arms race is described. Scale development analyses were conducted on 227 subjects, and internal consistency reliabilities ranged from .56 to .91 for scales assessing four aspects of activism on this issue. High correlations were obtained between these brief scales and corresponding measures derived from a 50-item long form. Responses of five subject groups were also compared: workers in defense industries, participants in a Republican party meeting, graduate students in psychology, religious teachers, and peace activists. Applications of this measure for study of the behavioral component of responses to the nuclear arms race are discussed.

Race, violence, and psychopathology.

The frequency of violent behavior among inpatients on an acute psychiatric unit for veterans was examined. Violent behavior was assessed using a modified Lion scale in 93 white and 24 black consecutively admitted inpatients receiving a fixed dose of neuroleptic. Blacks were significantly less violent according to the Lion scale. Item analysis revealed that whites made more violent threats, committed more violent acts against self, and were more likely to be secluded or restrained. Blacks were less likely to commit multiple acts against others, although the actual numbers of violent episodes were not significantly different. No racial differences were seen in serum neuroleptic level, psychopathology as measured by the BPRS, or admission status. The same racial differences in violence were seen when either schizophrenics alone or paranoid schizophrenics were considered.

Psychiatrists' judgments of dangerousness in patients on an acute care unit.

Statistical analyses suggest that psychiatrists emphasize hostility, agitation, previous assaultiveness, and suspiciousness as factors predictive of violence in psychiatric inpatients. When the actual correlates of violence in these patients are evaluated, a different picture of the assaultive inpatient emerges. Examination of differences between the cues emphasized by clinicians to make their predictions and the empirical correlates of violence suggests ways of improving the accuracy of clinical judgments of inpatients' dangerousness.

Hostile words and assaultive behavior on an acute inpatient psychiatric unit.

This report analyzes the relationship of hostile verbalizations to assaultive acts committed by 110 male schizophrenic patients on an acute psychiatric unit. It was found that patients who were verbally assaultive and threatening also tended to be physically assaultive. Assaults rarely occurred in the absence of verbal threats or abuse, and 32 per cent of violent patients could be identified on the basis of the occurrence of hostile verbalizations.

Family conflict, psychopathology, and dangerous behavior by schizophrenic inpatients.

Data supporting the hypothesis that history of severe discipline and parental conflict in childhood is related to current violence were obtained in a study of 100 schizophrenic inpatients. In addition to a relation between inpatient violence and degree of schizophrenic symptoms, inpatient assaults and other dangerousness measures were positively and significantly correlated with severity of parental discipline, especially involving the father, and with degree of family conflict, particularly fights between parents and others outside the home.

The context of involuntary commitment on the basis of danger to others: a study of the use of the California 14-day certificate.

This study examines the applications of civil commitment criteria for prolonged (14-day) involuntary hospitalization of individuals judged to be dangerous to others by reason of mental illness. The California Civil Commitment Statute (Lanterman-Petris-Short, LPS) provides for such commitment, after a 72-hour period of observations. For a sample of 71 males on an acute inpatient unit, we examined the relationship between 14-day certification by reason of dangerousness to others (DO) under the LPS and measures of prehospitalization dangerousness, prior legal status, assaultive behavior in hospital, and mental status. The 31 per cent of subjects who were certified as DO were found to have been significantly more often held initially for 72-hour observation on the DO grounds than were patients who were certified for other reasons. However, subjects in the DO group were no different from the contrast groups on ratings of assaultiveness of preadmission behavior and of violent acts while in hospital. The implications of these results for the evaluation of civil commitment proceedings are discussed.

Drift and dangerousness: social class differences between acute schizophrenics and their parents in relation to measures of violence.

Socio-economic differences between schizophrenics on an acute in-patient unit and their parents were studied in relation to indices of dangerousness and of psychiatric status. It was found that, whenever thier class of origin, a large proportion of patients had dropped in occupational attainment, relative to that of their parents, but that patients tended to be higher in education than their parents. Patients who had committed an assaultive act prior to admission were lower in social status than their parents.

Short-term civil commitment and the violent patient.

To explore the specificity of criteria for civil commitment for dangerousness, the authors examined the relationship between civil commitment for dangerousness to others under the California Civil Commitment Statute (the Lanterman-Petris-Short Act) and violent acts and behavioral ratings made immediately after commitment. Using a prospective design they evaluated 84 subjects. The ratings of violent acts for subjects considered dangerous to others were no different than those of a nondangerous control group. The subjects considered dangerous to others, however, differed on several subscales of the Brief Psychiatric Rating Scale. The authors discuss the implications of these results for civil commitment proceedings.

Serum level monitoring of thiothixene in schizophrenia: acute single-dose levels at fixed doses.

After establishing a strong correlation between steady-state thiothixene levels and levels drawn 2.5 hours after a 20-mg test dose, the authors examined the correlation between clinical improvement and serum levels drawn 2.5 hours after a single 20-mg test dose of thiothixene. For 30 male schizophrenic inpatients, improvement on the Brief Psychiatric Rating Scale was significantly correlated with the single test-dose levels. Serum levels were also positively correlated with age, which may explain the tendency of elderly patients to require lower neuroleptic doses and to exhibit a higher incidence of side effects. The results suggest that acute single-dose levels may be useful in predicting clinical response to thiothixene.

Development of a geriatric behavioral self-assessment scale.

Described is the development of a self-rating geriatric behavioral scale modeled after the Sandoz Clinical Assessment-Geriatric (SCAG). This new Self-Assessment Scale-Geriatric (SASG) provides a valid and reliable measure of behavioral pathologic changes for the selective screening of elderly patients who manifest mile to moderate symptoms of dementia. Further use and refinement of this new measuring device are required to confer on it the maximum possible accuracy.