HIV/AIDS risks among Native American drug users: key findings from focus group interviews and implications for intervention strategies.

A multisite study funded through the National Institute on Drug Abuse and the Office of Research on Minority Health was conducted in 1996 to determine the HIV/AIDS prevention needs of Native American out-of-treatment drug users. In an effort to recommend directions for HIV/AIDS prevention programming, one component of this study entailed conducting a series of focus groups at each of four sites: Anchorage, Alaska; Denver, Colorado; Flagstaff, Arizona; and Tucson, Arizona. While some site differences were noted, several consistent thematic findings were revealed across all locations. Specifically, focus group members strongly recommended directly involving key members of the Native American community in conducting outreach and intervention activities, involving Native people as the sources of information, and utilizing local and tribally relevant forms of delivering the message. Other consistent themes included getting messages to smaller communities to prevent the potential "annihilation" of tribes, educating youth, and linking alcohol prevention education to HIV/AIDS education. Findings from this study support the idea that future HIV/AIDS prevention programs must take into account subgroup and individual level differences among Native American drug users.

Use of the Iowa Self-Assessment Inventory with older hospitalized patients.

This study examined the utility of the Iowa Self-Assessment Inventory (ISAI) as a multidimensional screening tool for older adults in the acute care hospital setting. A sample of 98 patients age 60 and older were administered the ISAI, the Short Geriatric Depression Scale, and the Mini-Mental State Examination. The findings suggest the ISAI is useful for screening for depression but does not detect differences in cognition. However, qualitative data and literature review support the continued search for a holistic, humanistic screening tool to increase the quality and effectiveness of patient care.

Unmet treatment needs of drug users in Alaska: correlates and societal costs.

This study assessed the unmet treatment needs of drug users in Anchorage, Alaska. It revealed that almost half of the drug users who desire treatment cannot secure it, largely for external reasons. The primary barrier to treatment was lack of availability of treatment slots, followed by excessive treatment costs and restrictive admission criteria. Unlike other studies, this investigation did not suggest that members of ethnic minority groups, women, and parenting women were disproportionately disadvantaged with regard to ability to secure treatment. However, substance abusers who also met criteria for a co-morbid psychiatric diagnosis other than substance abuse or dependence had more difficulty than their non-co-morbid peers in finding available treatment slots. Social, legal, and medical costs incurred by unsuccessful treatment seekers are outlined and suggest significant cost, as well as perpetuation of intergenerational cycles of violence and substance use.

Southcentral Foundation--Dena A Coy: a model program for the treatment of pregnant substance-abusing women.

This article discusses the societal implications of substance abuse by pregnant women and women of child-bearing age and reviews their treatment needs as documented in the literature. It then provides a treatment model for pregnant women, using the Southcentral Foundation-Dena A Coy Residential Treatment Program as a model program. It outlines a number of components that are critical to successful substance abuse treatment of these women; specifically, medical interventions, social service provision, educational/vocational services, psychoeducational programs, psychotherapy, substance abuse interventions, and family preservation and involvement. These components are superimposed on a therapeutic community model that stresses gender and cultural relevance, as well as supportive structure and direction.

Personality correlates of homophobia.

This study explored the relationship between homophobia and several personality traits (empathy, religiosity, and coping style) in the context of respondents' gender and age. The sample consisted of 714 college students who responded to the Homophobia Attitude Scale (HAS) and personality trait scales. Results revealed that women endorsed fewer homophobic attitudes, beliefs, and behaviors than men and that age was negatively correlated with homophobia. Empathic concern and perspective taking were significantly correlated with lower overall homophobic attitudes, less affect discomfort in regard to gays, and less likelihood to abridge the human rights of gays. Religiosity was significantly correlated with more biased beliefs about the origins of homophobia, greater affective discomfort around gays, less endorsement of human rights for gays, and greater homophobia. Use of denial and isolation as coping styles were positively related to homophobia and use of turning against style was negatively correlated.

Comparison of recent graduates of clinical versus counseling psychology programs.

Recent graduates from clinical (N = 65) and counseling (N = 64) psychology programs were surveyed to assess similarities and differences of aspects of their programs and job-related activity. Results revealed only minor differences. Counseling psychologists were more likely to provide group therapy, career counseling and assessment, public lectures and workshops, to have more knowledge of the Strong Interest Inventory, to be more likely to work in university counseling centers, and to endorse humanistic theoretical orientations. Clinical psychologists were more likely to work in medical school settings, to ascribe human behavior to internal states rather than to social causes, and to have greater knowledge of the Rorschach. However, the similarities between the two specialities relative to work setting, theoretical orientation, service, research, and teaching activities, far outweighed these minor differences. Implications of these findings are placed in the context of previous research that has suggested the possible merger of the two specialities.

The psychological repercussions of the sociocultural oppression of Alaska Native peoples.

Issues of the mental health of arctic and subarctic Alaska Natives are explored. Their sociopolitical history is described to familiarize psychologists with the special circumstances of several groups of peoples in Alaska that have been ignored in psychological literature. This history demonstrates how intervention by European Americans in Alaska has prompted a self-alienation of Native peoples that has contributed to exorbitant suicide rates, increasing levels of addiction, high rates of interpersonal violence, and high teenage pregnancy. These developments are contrasted with traditional lifestyles. Recommendations are made about the role of psychology in the facilitation of the recovery process of Alaska Native peoples.

Publication productivity of clinical and counseling psychologists.

Compared the research productivity of clinical versus counseling psychologists and found surprisingly few differences. A serendipitous finding was low productivity across the board and a question was raised about the success of the scientist-practitioner model in both clinical and counseling psychology doctoral programs in instilling a research/publication ethic among professional (as opposed to experimental, social, etc.) psychologists.

Comparison of PhD programs in clinical and counseling psychology.

This survey of training directors of all APA-accredited PhD programs in clinical and in counseling psychology explored differences in curricula, program characteristics, predoctoral internships, and postdoctoral placements between the two programs. Minor differences emerged between the two types of programs with regard to curricular emphases, but these differences are far outweighed by similarities. Implications are discussed and support provided for the conclusion that a merger of the two specialties may be possible and desirable.

Faking the MMPI-2: utility of the Subtle-Obvious scales.

We explored the effect of different subject response sets on the profile configuration of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the utility of traditional validity, Back F, and Subtle-Obvious scales in detecting response set. College students were administered the MMPI-2 under one of three response sets; faking good, faking bad, or standard report. Results revealed significant differences across the three response set groups on all clinical, content, validity, obvious, and two of the five subtle scales in the expected direction. Additionally, respondents in the faking conditions produced consistent T-score patterns and significant O-S differences on the Subtle-Obvious scales. Examination of these subtle-obvious patterns may offer clinicians valuable information regarding profile validity beyond that offered by the traditional validity and Back F scales.

Substance use, mental health, and health in Alaska: emphasis on Alaska Native peoples.

It has always been a problem in Alaska to obtain a compilation of accurate and current data with regard to mental health, health, and substance abuse. This paper was designed to pull together different sources of data to present a comprehensive perspective on the substance use, mental health, and health problems facing Alaskans today. The article summarizes the most current substance abuse, mental health, and health data available for the State of Alaska from public, academic, and institutional sources. It emphasizes data relevant to Alaska Native groups, calling for improved efforts in the future to collect data according to ethnicity and gender. The data presented identify a number of significant substance use and mental health problems that are prevalent in Alaska, providing geographic and ethnic data wherever available.

The relationship of death anxiety with age and psychosocial maturity.

For this study, 194 respondents completed a biographical data sheet, the Templer (1970) Death Anxiety Scale and the Constantinople (1973) Inventory of Psychosocial Development to help assess the relationship among death anxiety, age, and psychosocial maturity. Findings showed that psychosocial maturity was a better predictor of death anxiety than age was. However, both variables were significantly negatively correlated with death anxiety, revealing that as psychosocial maturity and age increase, death anxiety decreases.

Concurrent validity of the MMPI-2 feminine gender role (GF) and masculine gender role (GM) scales.

Since the development of the revised Minnesota Multiphasic Personality Inventory (MMPI-2; Butcher, Dahlstrom, Graham, Tellege, & Kaemmer, 1989), no independent studies have been conducted to validate the new GF and GM scales, the only published study being based on the original standardization sample. To determine the concurrent validity of these scales, our study correlated GF and GM with scores obtained from the Bem Sex-Role Inventory, the Sex Role Behavior Scale, and the Sex Role Identity Scale. Because the sex-role literature has suggested numerous personality correlates of masculinity and femininity, the 16-PF was included to assess this dimension of the new scales, as well as measures of social desirability. Results revealed the GF and GM scales to have low internal consistency and low concurrent validity with established sex-role measures. Relative to construct validity, their patterns of correlation with personality measures suggest that GF and GM are more related to personality traits of interpersonal potency and sensitivity, respectively, than to masculinity and femininity. Overall, although the data yielded by these new scales provide additional information over Scale 5, they do not appear to hold as much promise as hoped for.

Sex role conflict, social desirability, and eating-disorder attitudes and behaviors.

The relationship of conflict between sex role ideology and sex role orientation with eating-disorder behaviors and attitudes was examined. American participants were 321 female college students who completed the Bem Sex Role Inventory (Bem, 1974), Sex Role Ideology Scale (Kalin & Tilby, 1978), and Eating Disorders Inventory (EDI; Garner, Olmsted, & Polivy, 1983). The results indicated that conflict between ideology and self-perception had little effect on responses to the Inventory. Instead, students with higher levels of self-rated social desirability and lower levels of masculinity reported higher prevalence of eating-disorder behaviors and attitudes. Analyses of sex role orientation data revealed that participants categorized as undifferentiated had the most pathological responses to the EDI. Overall, the results suggested that social desirability and masculinity, more than sex role orientation or conflict, are strongly related to eating-disorder behavior, perhaps because of a third mediating factor.

Validation of the MMPI-2 Low Self-Esteem Content Scale.

We explored the concurrent validity of the MMPI-2 Low Self-Esteem (LSE) Content scale by asking 216 undergraduate students to complete the Minnesota Multiphasic Personality Inventory-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1991), Harter Adult Self-Perception Profile (Harter, 1986a) and Rosenberg Self-Esteem Scale (Rosenberg, 1965). Results suggest the LSE renders a good assessment of global self-esteem as well as being a measure of three distinct components of self-esteem. These specific subscales, identified by factor analysis, were labeled Ineptitude, Negative Self-Value, and Negative Comparison with Others. The LSE and its subscales produced good internal consistency (alpha and Gutman Split Half) coefficients.

Differences in family of origin functioning among graduate students of different disciplines.

Compared the degree of dysfunction in the family of origin of psychology graduate students to that of graduate students in the disciplines of business, education, engineering, and health sciences. Students were accessed through University of Alaska Anchorage graduate departments. Family background was assessed with the Index of Family Relations (IFR; Hudson, 1990a), the Self-Report Family Inventory (SFI; Beavers, Hampson, & Hulgus, 1990), and relevant demographics obtained from a biographical questionnaire. Results indicated significant differences among the student groups; psychology graduate students demonstrated higher degrees of family dysfunction than students in other disciplines. Implications of these findings for psychology graduate training programs are discussed.

Assessment of fairness in child custody decisions.

Court-appointed child advocates, attorneys, guardians ad litem, and therapists were asked to rate preferred traits for mothers and fathers, and to make custody decisions and abuse likelihood ratings for children in one of two vignettes that varied only as to whether mother or father was described as incompetent to parent without threat of further abuse. Results revealed that this sample of professionals did not hold double standards with respect to attributes important for mothers versus fathers. To the contrary, interpersonal sensitivity traits, traditionally identified as most prevalent among women, were valued equally in mothers and fathers and preferred for both parents to interpersonal potency, traditionally ascribed more readily to men. Further, decisions about custody and placement or abuse likelihood were not affected by any sex-role stereotypes professionals held about parents, nor by professionals' gender or specific occupation. The only factor that affected custody judgments and abuse likelihood ratings was the competence of the parent in question. These findings suggest that biases with regard to gender to gender or traditional sex-role preferences for parents are disappearing among professionals who make important placement decisions in the lives of abused children. Future studies must assess whether these theoretical findings translate into actual behavior in real-life abuse cases for the professional groups represented in this sample.

Blame of victim and perpetrator in rape versus theft.

Variables that may affect attribution of responsibility and blame were explored to assess whether societal stereotypes about rape victims still exist among students in Alaska. In ambiguous crime situations, more blame was attributed to victims and less responsibility to perpetrators if the subjects had traditional views about women's roles. The victims were rated as being more responsible for a theft than for a rape, but the perpetrators were rated as being more responsible for a rape than for a theft. Overall, type of crime affected social judgments. Attitudes toward women affected the attribution of blame, but not fault, in ambiguous crime situations.

Person drawings by transsexual clients, psychiatric clients, and nonclients compared: indicators of sex-typing and pathology.

The drawings by 31 transsexual clients, 61 psychiatric inpatients, and 62 nonclient college students were compared to derive information about whether they differed with regard to sex-typing and psychopathology. Transsexuals did not differ from nonclients or psychiatric patients as far as their conceptualization of masculinity is concerned, nor are they more or less sex-role stereotyped. However, their conceptualization of femininity of women differs significantly from that of the other groups in that transsexuals view women as more feminine than either of the other groups. Finally, transsexuals differed from both nonclients and psychiatric patients in inconsistent patterns across other variables, indicating that they are neither similar to nonpathological controls, nor to psychiatric inpatients. This uniqueness of the transsexual group is discussed in the context of multiple possible interpretations.

Variables affecting length of psychiatric inpatient treatment.

To discover whether variables such as gender, ethnicity, pay code, and diagnostic category affect length of psychiatric inpatient treatment, patient records for a recent 18-month period (January 1988 to June 1989) in a Midwestern teaching hospital setting were examined and statistically analyzed. Variables that emerged as related to length of stay are ethnicity, Axis I diagnosis of adjustment disorder, and presence of any Axis II diagnosis. Comparisons with length of stay statistics from an earlier period (1981) lead to conclusions about inpatient psychiatric services since the implementation of diagnosis related groups. Further, implications of this study's findings are discussed in relation to mental health service delivery.