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This study examined the relation between goal setting and self-efficacy and self-evaluation of interpersonal performance. Twelve dysphoric, 12 socially anxious, and 12 normal undergraduate women participated in videotaped interactions with normal female partners. Measures of goal setting and self-efficacy were obtained prior to the interactions and each member of the dyad evaluated her performance, as well as her partner's performance, immediately after the interaction. Objective observers also rated each partner's performance. The groups did not differ in personal goals or evaluations of their own performance. Observer ratings did not indicate differences in social competence among the three groups. When self-efficacy was considered, dysphoric and socially anxious subjects had larger discrepancies between their goals and efficacy ratings than normal subjects. Although dysphoric and socially anxious individuals did not set perfectionistic goals, they did set higher goals than they believed they could achieve.

In DSM-IV, the revised criteria for PTSD allow for “being exposed to a life-threatening illness,” to now meet the criterion of exposure to an extreme stressor. The present study examined psychosocial adjustment, particularly PTSD symptoms, in 45 cardiac patients 1 week to 3 months after they experienced their first MI. Identification of potential participants proceeded via review of records of patients on the coronary care unit at the University of Massachusetts Medical Center. The results indicated that most patients reported low levels of distress. Using Foa and co-workers’ (1993) PTSD Symptom Scale, 9% of the patients met DSM-III-R criteria for PTSD.

Introduction: Hospital libraries, including ones designed for patient use, share a common history with hospitals in the evolution of health care delivery 1. The library as a component of the early “insane asylum” in the United States is well documented, and many had been established by the mid-nineteenth century. While these libraries certainly existed as a means of recreation for asylum patients, this historical communication will demonstrate they also served as a center for “bibliotherapy,” the use of reading as a means of healing.

An abbreviated breath test for detecting the disulfiram metabolite carbon disulfide (CS2) was evaluated in an analogue investigation of the sensitivity of the test in identifying disulfiram and non-disulfiram intake in a group of 14 alcoholic inpatients.

Disulfiram (250 mg) was administered within an ABAB repeated measures design over a 12-day period with corresponding breath tests administered during morning and afternoon time periods. Dependent measures included spectrophotometric analysis of reacted test samples and visual ratings of sample color.

Results indicated that the test was highly sensitive in discriminating disulfiram administration for the group as a whole, as well as for individual subjects. Moreover, visual ratings were more accurate than spectrophotometric cut-off scores in identifying disulfiram administration.

The test shows considerable promise as a rapid means of assessing disulfiram compliance.

Depression is a common problem among college women, and many of them cope with it on their own (without professional help). Since these naturally occurring episodes of self-controlled behavior are frequent—and sometimes dramatically successful—they were investigated in this study. College women who had coped successfully and unsuccessfully with clinically-significant levels of depression were interviewed about their coping efforts. In contrast to previous research of this type, the present investigation did not identify any clear coping differences between successful and unsuccessful copers. Follow-up interviews indicated that many initially unsuccessful subjects eventually became much less depressed. The implications of these results are discussed, with suggestions for future research.

Reviews an interactional model of depression proposed by J. C. Coyne (see PA, Vols 56:2455 and 61:1146), empirical evaluations of this model, and related research. It is contended that laboratory studies designed to test these interactional models have examined stangers' reactions to depressives and therefore have little relevance to these models, which focus on the interactional processes between a depressed individual and his/her family and friends. It is argued that relevant empirical research is necessary before theoretical conjectures and treatment strategies based on an interactional model are accepted. (27 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)

The utility and construct validity of the Children's Depression Inventory and the youth version of the Center for Epidemiological Studies Depression Scale were examined. No significant grade, sex or race effects were obtained for either measure. Examination of convergent and discriminate validity for these measures revealed high correspondence with self-report measures of related constructs. Children's self-reports corresponded poorly with ratings by teachers or parents. Finally, the utility of recommended cutoff scores for identifying extreme groups of depressed children and adolescents was evaluated. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

The relation between self-efficacy ratings and smoking behavior was explored among 36 people who were trying to quit smoking on their own. Self-efficacy was predictive of smoking outcome, but there was considerable intersubject variability in the strength of the relation between efficacy and smoking behavior. Both efficacy and previous smoking behavior predicted smoking outcome equally well, however.

The evolution of managed behavioral health care has led to an increased emphasis on reliable and valid assessment of outcomes in clinical practice. The present study evaluated the convergent, divergent, and concurrent validity and sensitivity to change of two widely used measures: Behavior and Symptom Identification Scale (BASIS-32) and Outcome Questionnaire (OQ-45). Comparisons of the two measures revealed that both were sensitive to change over a relatively short inpatient stay. Both measures also showed evidence of convergent and divergent validity of specific subscales, although the total scores of each measure also were highly correlated. Evidence of concurrent validity was suggested by differences between diagnostic groups on specific subscale scores. Together with previous research, these results suggest that the BASIS-32 and OQ-45 can be useful measures for tracking patient functioning over a range of treatment contexts.

The present study examined the frequency and characteristics of panic disorder in children and adolescents who had been referred to a pediatric psychopharmacology clinic. Of the 280 children and adolescents evaluated in this clinic, 35 were diagnosed with panic disorder using a semi-structured clinical interview (K-SADS) and other objective measures. Approximately half of the youngsters with panic disorder also met criteria for the diagnosis of agoraphobia. There was extensive comorbidity between panic disorder and other internalizing and externalizing disorders. Parents reported clinically significant levels of child symptomatology on the CBCL. Teacher-and child-reported symptomatology on the CBCL was within the normal range. At the same time, it was notable that no child had been referred specifically for evaluation or treatment of panic disorder or agoraphobia. Implications for clinical assessment/identification and treatment are discussed.

BACKGROUND: Conduct disorder is considered difficult to treat, but comorbid psychiatric disorders may be a basis for treating some youths with conduct disorder. We sought to identify patterns of comorbid psychiatric diagnoses and psychopathology associated with conduct disorder by reported age-of-onset.

METHODS: Referred children and adolescents, aged 4-17 years old, were clinically evaluated. Ages of onset of CD symptoms (N=53) were ascertained and divided according to DSM-IV criteria as childhood onset (old) or adolescent onset (>or=10 years old).

RESULTS: Childhood-onset conduct disorder was associated with higher rates of ADHD and anxiety disorders, male gender, and perceived and total hostility scores than adolescent-onset conduct disorder. Adolescent-onset was associated with higher rates of PTSD, alcohol and substance use disorders, complex comorbidity (i.e., 6+ diagnoses lifetime), and female gender.

CONCLUSIONS: Understanding age-of-onset-related patterns of comorbidity may facilitate psychiatric treatment planning in children and adolescents with conduct disorder.

This study examined whether youngsters with separation anxiety disorder (SAD) and panic disorder (PD) had experienced more separation-related events than youngsters with SAD (without comorbid PD). We also examined whether age of onset of SAD and comorbidity with other psychological disorders was related to the occurrence of PD. We compared youngsters who were diagnosed with SAD and PD (N=31) with youngsters who were diagnosed with SAD without comorbid PD (N=63) for the number of separation-related events, severity of psychopathology, and parent and child CBCL ratings, age of onset of SAD, and the number of comorbid diagnoses. The findings indicate that youngsters with SAD and PD had a later age of onset of SAD and more extensive psychopathology and functional impairment than youngsters with SAD (without comorbid PD). Contrary to hypothesis, there were no differences between the groups in the occurrence or number of separation-related events.

OBJECTIVE: In children with ADHD who have comorbid disruptive behavior diagnoses distinctions between oppositional defiant disorder (ODD) and conduct disorder (CD) remain unclear. The authors investigate differences between ODD and CD in a large clinical sample of children with ADHD.

METHOD: Consecutively referred and systematically assessed male children and adolescents with either ADHD (n = 65), ADHD with ODD (n = 85), or ADHD with CD (n = 50) were compared using structured diagnostic interviews and parent, teacher, and clinician rating scales.

RESULTS: In children with ADHD, significant differences emerged between ODD and CD in the domains of delinquency, overt aggression, and ADHD symptom severity; ADHD with CD was most severe, followed by ADHD with ODD, and ADHD had the least severe symptoms. Distinctions between ADHD with CD and the other two groups were found for parenting, treatment history, and school variables.

CONCLUSION: Within the limits of a cross-sectional methodology, results support clinically meaningful distinctions between ODD and CD in children with ADHD.

BACKGROUND: This study had two objectives: (1) examine characteristics of aggression in children and adolescents diagnosed with bipolar disorder and (2) determine whether the CBCL pediatric bipolar disorder profile differentiated youngsters with bipolar disorder from youngsters with ADHD.

METHOD: Children and adolescents referred to a pediatric psychopharmacology clinic were systematically evaluated for psychopathology using a psychiatrist-administered diagnostic interview, parent- and teacher-report rating scales assessing the child's behavior, and child-completed self-report scales. In this sample, 27 children and adolescents were diagnosed with bipolar disorder and 249 youngsters were diagnosed with ADHD without co-occurring bipolar disorder. These two groups were compared to determine whether there were significant differences on various measures of psychopathology.

RESULTS: Youngsters diagnosed with bipolar disorder were more verbally aggressive and exhibited higher levels of reactive aggression than youngsters with ADHD without co-occurring bipolar disorder. Youngsters with bipolar disorder also reported higher levels of depressive symptoms than youngsters with ADHD without bipolar disorder. The CBCL pediatric bipolar disorder profile did not accurately identify youngsters diagnosed with bipolar disorder.

CONCLUSIONS: The present findings present a picture of manic youngsters as verbally aggressive and argumentative, who respond with anger when frustrated. Youngsters diagnosed with bipolar disorder and ADHD exhibited significant levels of impulsive behavior and attention problems, but youngsters with bipolar disorder also exhibited significant levels of aggressive behavior and dysphoric mood. Finally, the CBCL pediatric bipolar disorder profile did not accurately identify youngsters who were diagnosed with bipolar disorder.

In this chapter indicators and consequences of substance use are presented, measures commonly used to assess substance use disorder treatment outcomes are described, and challenges and recent developments in this area are pointed out.

Nicotine dependence is a psychiatric disorder characterized by a recurrent, periodic compulsion to use tobacco due to neurophysiological, psychological, and social factors. This disorder has behavioral and physiological characteristics that are similar to those of other addictions, but also unique aspects that require special attention because of its ubiquity on a global scale, its staggering effects on rates of morbidity and mortality, and its high prevalence of psychological comorbidities, including psychiatric disorders. Our chapter focuses on the epidemiology of comorbid nicotine dependence and psychiatric disorders, the underlying biobehavioral mechanisms of comorbidity, cultural factors, psychiatric disorders most often associated with nicotine dependence, and treatment approaches. While there is a need for ongoing studies to more clearly delineate the best treatment interventions for persons with comorbid psychiatric disorders and nicotine dependence, the evidence to date suggests use of all of the medication, behavioral, and peer-support approaches available. Culture changes are needed in mental health and addiction treatment settings to continue to improve access to effective interventions for persons with nicotine dependence and psychological comorbidities.

Research evidence shows that depression is very common among individuals with alcohol dependence, and that the comorbidity between these disorders is considered to be a critical risk factor for suicidal ideation and behavior. Although the etiological mechanisms involved in this comorbidity remain to be deciphered, recent advances have been made in pharmacologic treatment options and in investigations that target the elderly.

Introduction to the Special Issue on: Innovative Interventions for Treating Tobacco Addiction Among Persons With Co-occurring Mental Illness and Addiction: New Approaches to Improve Outcomes.

To analyze national trends in the use of prayer among individuals with depression, we adopted a cross-sectional design with data from the adult Alternative Medicine supplement of the National Health Interview Survey 2002 and 2007. Prayer use and depression were combined into 4 categories: (a) prayed in the past 12 months and depressed; (b) prayed in the past 12 months and not depressed; (c) never prayed but depressed; and (d) never prayed and not depressed. Chi-square tests and multinomial logistic regressions were performed to analyze group differences. All analyses were adjusted for the complex sample design and conducted in SAS-callable SUDAAN. Use of prayer for depression was steady at 6.9 % across time; however, general prayer increased significantly between 2002 and 2007 (40.2 vs. 45.7). Women, aged 50-64, unmarried, with high school education were more likely to use prayer while depressed compared to those who were neither depressed nor prayed. Lifestyle behaviors (e.g. alcohol, smoking, exercise) were also associated with prayer use and depression. Prayer use for depression remained steady with unique relationships occurring among those who smoke, use alcohol, and have irregular exercise. Individuals' use of prayer as a potential complementary treatment for depression suggests that it is critical for mental and physical health treatment providers to be aware of the use of prayer as a coping resource.