Assessing the efficacy of antidepressants: the transactional paradigm.

Extant pharmacological literature seems to indicate that antidepressants are the most effective treatment for depression. However, there are flaws in the traditional paradigm for evaluating the efficacy of antidepressants. The traditional paradigm in pharmacology has adopted a biologically monistic causal structure, suggesting that the efficacy of antidepressants resides exclusively in biological pathways. The current paradigm in pharmacology has ignored the potential impact of psychological factors associated with the efficacy of antidepressants. This has occurred because psychological effects are seen as being a "paradigmatic anomaly," phenomena that are at odds with the traditional paradigm. Thus, the psychological factors associated with the administration of antidepressants have collectively been labeled as a "placebo effect" and discounted as a potential treatment pathway. However, empirical evidence suggests that the psychological factors, such as the formation of patient expectancies and a therapeutic alliance between physician and patient, increase the efficacy of antidepressants. Consequently, the current paper proposes the adoption of a transactional model that reflects the reciprocal interaction between psychological and biological factors associated with the efficacy of antidepressants.

Follow-up of rapists treated in a forensic psychiatric hospital.

Current research examining the effectiveness of sex offender treatment is encouraging. Despite this optimism, research focusing on men who sexually assault adult women is less optimistic. This study examines the preliminary results of 74 rapists admitted into the Phoenix program, a voluntary sex offender treatment program in a forensic psychiatric hospital. Patients were categorized according to whether they completed treatment or not. Treated rapists (n = 36) reoffended at a substantially lower rate than untreated rapists who were assessed but not treated (n = 38). Statistically significant differences in reoffense rates were found for violent, nonsexual offenses as well as nonviolent, nonsexual offenses. Although nearly twice as many treatment noncompleters reoffended sexually, the difference between the two groups was not statistically significant. Mean follow-up time was well over four years for both groups. The implications of these findings are discussed.

Hand dynamometer: effects of trials and sessions.

12 normal, self-reported dextral subjects (6 men, 6 women) were assessed with a hand dynamometer with 10 trials per hand for 10 consecutive wk. The test-retest reliability of the 10-trial average across the 10 sessions averaged .91 for men and .94 for women for both preferred and nonpreferred hands. Fatigue effects over trials were statistically significant for both sexes and hands except for women's preferred hand. Skill acquisition effects over sessions were only statistically significant for men's nonpreferred and women's preferred hands.

Speech Sounds Perception Test: nonrandom response locations form a logical fallacy in structure.

The response format of the Speech Sounds Perception Test confounds speech perception with irrelevant method variance. To rectify this problem the response format was revised by randomizing the response locations. An empirical comparison of the revised and original forms was undertaken with forensic (n=59) and psychiatric (n=67) samples. The empirical results coupled with the logical problem in the original form indicates that a revision is necessary.

Finger tapping: effects of trials and sessions.

18 normal, self-reported dextral subjects (9 men, 9 women) were assessed with a Halstead Manual Finger Tapping device, with 10 trials per hand for 10 consecutive wk. The test-retest reliability of the 10-trial average between the 10 sessions averaged .94 for men and .86 for women, for both preferred and nonpreferred hands. There were no statistically significant effects of increases in performance over sessions or effects of fatigue over trials for either sex or hand. There were, however, significant increases over trials for men for both preferred and nonpreferred hands.

Superiority of clear-visor safety hat to opaque-visor hat: an evaluation of upper visual-field obstruction.

Three subjects were used to compare superior visual-field threshold for 5 North American industry-standard opaque safety hard hats with a prototype clear translucent-visor safety hard hat and a no-hat baseline condition. Average maximum degrees of superior visual field was equivalent for the clear-visor safety hat and no-hat conditions (52.0 degrees versus 48.3 degrees) but the opaque-visor safety hats resulted in only 15.1 degrees. The opaque safety hats were worse than the clear-visor safety hat and no-hat conditions by, on the average, an order of 3. Analysis indicated that visual-field obstruction is a potential problem for wearers of opaque safety hats. Field research will be required to assess the extent of injuries caused by an impaired superior field of vision when wearing opaque-safety-hat visors. The potential positive effects of the clear-visor safety hat on reduction of accidents also must be determined.

Purdue Pegboard: test-retest estimates.

26 normal, self-reported dextral subjects (12 men, 14 women) were assessed with a Purdue Pegboard 5 times at weekly intervals to evaluate temporal stability and efficacy of lateralization with this test. There was a statistically significant increase in performance over time for men on the right- and left-hand placing subtests and for women on the assemblies subtest. For men/women the test-retest reliability over the 5 sessions averaged .63/.76 for the right-hand, .64/.79 for the left-hand, .67/.81 for both-hands, .81/.83 for assemblies, and .33/.22 for the right/left-hand ratio.

Utility and stability of the basic personality inventory in psychiatric patients with longstanding psychotic disorders in a new psychiatric rehabilitation program over a two-year period.

34 long-term psychiatric patients with psychotic-type diagnoses, participating in a Psychiatric Rehabilitation program, completed the Basic Personality Inventory 5 times at 6-mo. intervals. In comparison with normative data, participants had statistically significant (p < .01) higher means at Time 1, indicating greater reported psychopathology on all scales except Interpersonal Problems. Program participants also showed greater impairment than a heterogeneous group of 112 psychiatric patients, with statistically higher means on the scales of Denial, Persecutory Ideas, Thinking Disorder, and Self-depreciation. No statistically significant differences were found for sex, time, or their interaction. Correlations indicated high stability in the scale scores over time. Considerable stability in test scores over time does not indicate lack of program success but reflects stability maintenance goals and processes in patients with longstanding psychotic disorders.

Infanticide of defective newborns: an old midwife's story.

The story of how a midwife many years ago dealt with defective newborns is used to illustrate complete control by a system external to the family. Similarities exist with current public policy concerning the interrelated issues of abortion, neonatal euthanasia, and infanticide in which the family system is often ignored. It is argued that the family's values, expectations, and desires are relevant to the establishment of public policy in this sensitive domain.

Psychopathic and nonpsychopathic inmates differ from normal controls in tolerance levels of electrical stimulation.

With a Tursky electrode applied to the ventral surface of the forearm two samples of inmates (28 psychopaths and 28 nonpsychopaths) were compared to 29 normal controls. No differences were found among the three groups in lower detection thresholds. While there was no difference between the inmate groups in terms of pain tolerance, both inmate groups had a higher tolerance for pain than did the controls. Results do not support previous findings or theories/hypotheses about pain thresholds in psychopathic and nonpsychopathic inmates. Differential learning and experience of pain among inmates, as well as the association among testosterone, dominance, extraversion, and criminality, are suggested to account for the results.

Relationships among clinical and validity scales of the Basic Personality Inventory.

In interpreting the results of a self-report inventory it is important to evaluate the extent to which stylistic distortion may have been operative. This task is complicated because validity measures frequently are confounded with content measures. In order to evaluate the potential utility of the validity measures for the Basic Personality Inventory (BPI) the relationships between validity measures and content scales were evaluated in a sample of 71 inmates. While some validity indices had significant correlations with content scales, other validity indices were relatively independent of the content scales. Recommendations are provided for using the BPI validity scales.

Serum testosterone in violent and nonviolent young offenders.

Single morning serum testosterone samples from 194 15-17 year old male young offenders were compared between subgroups based on violent (n = 75), non-violent (n = 102), and sexual (n = 17) offenses. The violent group had the highest level of testosterone and differed significantly from both the nonviolent and sexual offender groups which were statistically equivalent. The offenders were also classified according to native/metis (n = 68) and Caucasian (n = 126) groups, and the native/metis group had significantly higher testosterone than the Caucasian group. Higher testosterone in the native/metis group may be because this group committed significantly more violent offenses than the Caucasian group. Genetic factors, such as the human leucocyte antigen system, may also be associated with higher testosterone in the native/metis group.

The measurement of intimacy in marriage: the Waring Intimacy Questionnaire.

Developed eight independent content scales to assess components of marital intimacy (Conflict Resolution, Affection, Cohesion, Sexuality, Identity, Compatibility, Autonomy, and Expressiveness). The measures were designed to be relatively free from social desirability and acquiescent responding (N = 248). Test retest and internal consistency reliabilities were high and sexual bias was not indicated.

The factor structure of the Wechsler Adult Intelligence Scale-Revised: one or two but not three factors.

One-, 2-. and 3-factor solutions for the WAIS-R normative samples were examined using principal components analysis with varimax rotations. Factors were examined across age groups by computing congruence coefficients and root mean square differences to determine the equivalence and consistency of factors across age groups. There is strong evidence for the general (g) and 2-factor (verbal and perceptual organization) solutions but noticeably less support for memory/freedom from distractibility in the three-factor solution. Verbal and perceptual organization factors were also attenuated in the three-factor solution. One and 2-factor solutions were essentially equally justifiable but because the 1-factor solution was weighted most heavily with verbal measures, the 2-factor solution may be advantageous because this solution does distinguish between verbal and performance measures.

Stimuli eliciting sexual arousal in genital exhibitionists: a possible clinical application.

The sexually arousing effects of erotic and nonerotic slides were monitored with a penile mercury strain gauge in 14 exhibitionists, 21 normal controls, and 34 nonexhibitionist sex offenders. Responses to 60 slides, constituting 12 distinct categories, were analyzed. The exhibitionists responded sexually to scenes of fully clothed erotically neutral females, whereas the two control groups did not respond to this slide material. No other significant differences were observed between the three groups on the remaining 11 categories. The results support previous reports of sexual arousal in exhibitionists to nonerotic signals from females and are consistent with a hypothesis of exhibitionists displaying culturally unapproved sexual display signals as a consequence of cortical disinhibition.