Replication and extension of a model predicting response to psilocybin.

BACKGROUND: Recent research demonstrated the potential of psychedelic drugs as treatment for depression and death-related anxiety and as an enhancement for well-being. While generally positive, responses to psychedelic drugs can vary according to traits, setting, and mental state (set) before and during ingestion. Most earlier models explain minimal response variation, primarily related to dosage and trust, but a recent study found that states of surrender and preoccupation at the time of ingestion explained substantial variance in mystical and adverse psilocybin experiences. OBJECTIVES: The current study sought to replicate the previous model, extend the model with additional predictors, and examine the role of mystical experience on positive change. METHOD: A hierarchical regression model was created with crowdsourced retrospective data from 183 individuals who had self-administered psilocybin in the past year. Scales explored mental states before, during, and after psilocybin ingestion, relying on open-ended memory prompts at each juncture to trigger recollections. Controlled drug administration was not employed. RESULTS: This study replicated the previous model, finding a state of surrender before ingestion a key predictor of optimal experience and preoccupation a key predictor of adverse experience. Additional predictors added to the explanatory power for optimal and adverse experience. The model supported the importance of mystical experiences to long-term change. CONCLUSION: Mental states of surrender or preoccupation at the time of ingestion explain variance in mystical or adverse psilocybin experiences, and mystical experiences relate to long-term positive change. The capacity to recognize this optimal preparatory mental state may benefit therapeutic use of psilocybin in clinical settings.

Measuring continuity of elders' posthospital care.

Continuity of care is a critical component of quality patient care, yet the paucity of reliable and valid measures of continuity of care make it difficult to ascertain the extent to which continuity has been achieved. The purpose of this article is to describe the development of an instrument to measure continuity of care that incorporates the perspectives of elders hospitalized for a chronic illness and their family caregivers. The instrument was used, and its reliability and validity examined, in a series of studies related to elders' posthospital transition. Elders in the studies ranged in age from 55 to 94 years. The findings supported content and construct validity, internal consistency reliability, and ability to detect changes in the same subjects at different points in time for the care management and services subscales. With further refinement, the continuity of provider and conflicting information subscales might also facilitate assessment of care continuity.

Testing a model of family caregivers' perceptions of elder behavior two weeks posthospitalization on caregiver response and health.

The purpose of this study was to examine the effect of family caregivers' perceptions of elders' behaviors on caregiver burden and health while controlling for other factors often associated with burden. The model tested included the following concepts: elders' health, caregivers' perceptions of elder behaviors, caregiving involvement, coping, discrepancy in social support, caregiver response and caregiver health. Data for the analyses were obtained from a longitudinal study of 346 elder/caregiver dyads in which the elders had been hospitalized for acute episodes of chronic conditions. The sample for these analyses consisted of a subset of 118 dyads from the longitudinal project. A structural equation approach using the computer software Linear Structural Relations (LISREL) was used in analyzing the data. The findings indicated that the data fit reasonably well with some of the general patterns hypothesized in the model; the Goodness of Fit Index was 0.85 and the Tucker-Lewis Fit index, .88. More important than overall fit were specific relationships. Caregivers' perception of elders' behaviors was directly linked with caregiving response two weeks postdischarge; caregiver response directly linked with caregiver health at two weeks postdischarge but not at two months postdischarge. The findings provide support for Lazarus and Folkman's theory that appraisal of the situation influences response.

Testing a model for posthospital transition of family caregivers for elderly persons.

The purpose of this study was to test a model of factors influencing family caregivers' responses and health outcomes during the 2-month period following an elder's discharge from the hospital for acute episodes of chronic illness. The elder's average age was 72.3 years. The average age of caregivers, 63% of whom were spouses of the elder, was 61 years. A longitudinal design was used for this study. Data were collected from 346 elder/caregiver dyads the day before discharge and at 2 weeks and 2 months postdischarge. Structural equation analysis was used to evaluate the conceptual model. The findings suggest that the model fits the data with an overall Goodness of Fit Index of .80.

Symptom Questionnaire anxiety and depression scales: reliability and validity.

Many instruments have been developed with college students and used primarily with students or younger adults. Thus, researchers face challenges in selecting measures of psychological state that are valid and reliable for use with elders. This article describes a measure of psychological state, the Symptom Questionnaire; provides information about its reliability and validity; and details the steps used to evaluate reliability and validity of its anxiety and depression scales for elders hospitalized for an acute episode of a chronic condition. The findings suggest that a short version of the Symptom Questionnaire, consisting of the depression and anxiety scales, is valid and reliable for elders. The findings also revealed small differences between the means of data collected using the short version and those obtained using the full instrument.

Educating students with mild disabilities in general education classrooms: Minnesota alternatives.

This article reports two major data collection efforts conducted during successive years. Study 1 examined the relationship between the school effectiveness variables identified in the Minnesota Educational Effectiveness Project (MEEP), and the attitudes and achievement of students in 31 MEEP schools. Study 2, which focused on 11 of the Study 1 schools, compared the instructional programs provided to students with mild disabilities in three integrated programs in these 11 schools, with those provided by conventional resource "pull-out" programs in three other schools. We not only contrasted program characteristics, but analyzed differences between program characteristics and cognitive and affective outcomes. Results do not provide a strong basis for concluding that general efforts at school improvement will provide the framework for improved outcomes among low-achieving students.

Using structured controversy to promote ethical decision making.

This article describes the use of structured controversy as an educational strategy for helping students learn content and skills needed for dealing with difficult ethical situations that arise during the practice of nursing. Structured controversy, an innovative technique that encourages learners to deal with conflict constructively, is described, and research validating its benefits is reviewed. A comprehensive description of how structured controversy was operationalized, using the issue of whether or not to give nutrition and hydration to a dying patient, is included to provide other nursing educators with an illustration of how this strategy can be applied.

Structure of adaptive behavior in samples with and without mental retardation.

The structure of adaptive behavior as a function of age and status of handicap was investigated in two samples with mental retardation and five samples without retardation. Exploratory factor analysis of the subscale scores from a comprehensive, nationally standardized measure of adaptive behavior (Scales of Independent Behavior) revealed a large Adaptive or Personal Independence dimension. Although not consistently identified in all samples, secondary Academic, Personal Responsibility, and Community/Vocational dimensions were also identified. Possible differences were identified in the structure of adaptive behavior as a function of age.

The relation between popularity and achievement: a longitudinal test of the lateral transmission of value hypothesis.

Data from a longitudinal study of school desegregation were used to examine the relation between normative social influence processes and academic achievement in order to test theoretical models of how school desegregation produces benefit. Subjects were white, Mexican-American, and black elementary school children who were measured once prior to and twice after desegregation of their schools. For all groups, analyses using structural equation techniques showed that, contrary to the lateral transmission of values hypothesis, which views social influence processes as shaping academic achievement, "causal influence" did not flow from social acceptance to academic achievement; instead, achievement appeared to affect subsequent social acceptance.

Roles of attribution, affect, and cognitive interference in test anxiety.

The impact of performance outcome, task difficulty, and level of test anxiety on attributional accounts for performance and achievement-related affect was explored. Subjects high and low in test anxiety (Sarason, 1972) worked on tasks of varying difficulty, evaluated their own performance, and then responded to two types of attribution items, inventories of major affective reactions (Izard, 1972), and a measure of cognitive interference (Sarason and Stoops, 1978). Meaningful attributional accounts were uncovered; in particular, performance outcome and task difficulty had independent effects on subjects' attributional judgments. Cognitive interference was implicated as a factor contributing to the attributional predispositions of persons differing in test anxiety, and it was a major determinant of affective reactions. In addition, subjects' affective responses were predictably associated with their perceived performance outcome, their level of test anxiety, the difficulty of the task, and subjects' attributional accounts of the factors influencing their performance. Results are discussed in terms of the cognitive components and phenomenological experience of test anxiety and the consequent impact anxiety may have on achievement-related behavior.

Concomitant appearance of antibodies to two viruses in cerebrospinal fluid of an infant with acute encephalitis.

Acute encephalitis developed in a 5 1/2-month-old infant with a previous history of uncomplicated measles at 4 months of age. The patient survived his acute illness with resultant severe neurological sequelae. The serum complement fixing antibody titer for herpes simplex virus in the early phase of the illness was less than 1:4, and increased significantly to 1:64 in the convalescent phase. Antibody was also demonstrated in the cerebrospinal fluid. Antimeasles antibody was found in the cerebrospinal fluid in the early convalescent stage and remained at a detectable level for at least 1 month. Moreover, at least 71% of the total protein in the cerebrospinal fluid was IgG. Although brain biopsy for viral isolation was not performed, the most probable diagnosis was herpes simplex virus encephalitis, and the concomitant appearance of measles antibody in the cerebrospinal fluid may have been due to leakage of measles antibody from the blood into the cerebrospinal fluid due to disturbance of the blood-brain barrier.

A simple method for the measurement of low levels of serum IgE.

A simple method for the estimation of low serum IgE levels is presented. Radioimmunoassay often gives falsely high values because of the presence of non-specific factors in the serum when an excessive amount of serum is used in order to measure low serum IgE levels. Therefore the serum sample has to be diluted to minimize the influence of the non-specific factors and the lowest IgE level measurable in the serum is about 5 u/ml. In this study, pretreatment of the serum with cellulose powder was found to remove the non-specific factors that yield falsely high values. These factors were adsorbed almost completely onto cellulose powder when the serum IgE level was less than 100 u/ml. Thus, low serum IgE levels could be determined by radioimmunoassay using a sufficient amount of serum pretreated by cellulose powder. The lowest serum IgE level measurable by this method was as low as 0.5 u/ml and the low IgE level in neonatal serum could be determined with sufficient accuracy. By this method the geometric level of IgE in cord serum was 2.45 u/ml with a +/- 2 standard deviations range of 1.04 to 5.80 u/ml.