Andrew M. Pomerantz

Investigating the relationships between boredom proneness, paranoia, and self-consciousness

The relationships among boredom proneness, paranoia, and self-consciousness were examined in the present study. Undergraduate students from a Midwestern university (N=107) completed the Boredom Proneness Scale, the Paranoia Scale, and the Self-Consciousness Scale. Pearson correlation coefficients revealed that paranoia was significantly related to boredom proneness, public self-consciousness, private self-consciousness and self-reflectiveness. Due to the magnitude of the correlation coefficients between paranoia and boredom proneness, public self-consciousness, private self-consciousness and self-reflectiveness, a stepwise hierarchical regression analysis was performed to determine which construct was the strongest predictor of paranoia. The results of the stepwise analysis indicated that boredom proneness was the strongest overall predictor of paranoia. Additionally, boredom proneness significantly correlated with private self-consciousness, and self-reflectiveness, but not general self-consciousness nor public self-consciousness. Independent t-tests revealed that male participants had significantly higher paranoia and boredom proneness means than the female participants.

Informed consent revisited: An updated written question format

This article presents an updated version of M. Handelsman and M. Galvins (1988) suggested written format for facilitating informed consent to psychotherapy. Significant changes in the psychotherapy profession during the past 15 years, and the revisions regarding informed consent in the American Psychological Associations (2002a) ethics code, form the rationale for this revision. Like the original, this form is a thorough list of questions that clients have a right to discuss with their psychologists. This revised version, which is intended to be illustrative rather than prescriptive, includes new questions addressing insurance/managed care issues, manualized and evidence-based psychotherapy, and psychopharmacology.

How Does Clients' Method of Payment Influence Psychologists' Diagnostic Decisions?

To what extent does payment method (managed care vs. out of pocket) influence the likelihood that an independent practitioner will assign a Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnosis to a client? When a practitioner does diagnose, how does payment method influence the specific choice of a diagnostic category? Independent practitioners responded to a vignette describing a fictitious client with symptoms of depression or anxiety. In half of the vignettes, the fictitious client intended to pay via managed care; in the other half, the fictitious client intended to pay out of pocket. Payment method had a very significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to receive diagnoses and more likely to receive adjustment disorder diagnoses in particular. We discuss implications involving informed consent and other ethical issues.

The Influence of Payment Method on Psychologists' Diagnostic Decisions Regarding Minimally Impaired Clients

Are psychotherapy clients who pay via health insurance more likely to receive Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM–IV], American Psychiatric Association, 1994) diagnoses than identical clients who pay out of pocket? Previous research (Kielbasa, Pomerantz, Krohn, & Sullivan, 2004) indicates that when psychologists consider a mildly depressed or anxious client, payment method significantly influences diagnostic decisions. This study extends the scope of the previous study to include clients whose symptoms are even less severe. Independent practitioners responded to vignettes of clients whose profiles deliberately included subclinical impairment and a high level of functioning. Half of the participants were told that the clients would pay via managed care; the other half were told that the clients would pay out of pocket. As in the earlier study, payment method had a highly significant impact on diagnosis such that relative to out-of-pocket clients, managed care clients were much more likely to be assigned DSM–IV diagnoses. In addition, a noteworthy percentage of participants assigned diagnoses regardless of payment method. Ethical implications are discussed.

The effect of psychologists’ disclosure of personal religious background on prospective clients

How would prospective clients be influenced by information presented by a psychologist at the outset of therapy regarding the psychologists’ personal religious background? The current study examined this question via five written vignettes in which hypothetical psychologists described themselves in terms of a variety of variables. The five vignettes varied only in the religious affiliation of the psychologist: atheist, Christian, Jewish, Islamic, and no mention of religion. Regarding the self-reported likelihood that participants would see the psychologist, significant differences emerged between various therapist religious affiliations, especially for participants high in religiosity. Overall, results suggest that personal religious background disclosed by a psychologist at the outset of therapy may have a significant effect on the likelihood that a prospective client would choose to see the psychologist. Specifically, participants reported that they were more likely to see psychologists who described themselves as having an affiliation to a major religion than a psychologist described as atheist. This finding was especially true for participants who rated themselves high in religiosity. Clinical implications of these results are discussed.

Ethical Beliefs of Psychotherapists: Scientific Findings

Psychotherapists from the four primary mental health professions (counselors, psychiatrists, psychologists, and social workers) were surveyed regarding the ethicality of 83 psychotherapy-related behaviors. Results indicated a relatively high degree of consensus among psychotherapists of various disciplines regarding their ethical beliefs about the practice of psychotherapy. However, a significant effect for professional group was obtained on ethicality ratings of five psychotherapy behaviors (i.e., unintentionally disclosing confidential information, having clients take tests home, utilizing involuntary hospitalization, addressing a client by his or her first name, and having clients address the therapist by first name) with psychiatrists differing significantly from the other three mental health practitioner groups. The findings from the present study provide a descriptive database to assist practicing psychotherapists, state licensing and ethics boards, and professional organizations in determining what constitutes the ethical practice of psychotherapy.

Beliefs About the Biological (vs. Nonbiological) Origins of Mental Illness and the Stigmatization of People with Mental Illness

The present study focuses on the relationship between an individuals attributions of cause regarding mental illness (i.e., the degree by which psychopathology is perceived as biologically or nonbiologically caused) and resulting stigmatization (particularly social distancing, a form of social rejection). To date, much of the research concerning attributional beliefs and stigma use general terms such as “mental patient” and “psychiatric client,” thereby overlooking the variance apparent between individuals of varying pathology. When specific pathologies have been mentioned, nearly all the research has focused on the diagnoses of schizophrenia, depression, and alcoholism. In this study, one hundred eighteen Midwestern university students were surveyed regarding their attributional beliefs toward mental illness. Regression analysis found that attributional beliefs, both biological and nonbiological, failed to predict social distance. A repeated-measures ANOVA revealed significant variance between conditions; this variance was then investigated with paired-samples t tests. Participants preferred more social distance for the vignettes portraying schizophrenia and alcohol dependence, the latter being the most stigmatized and socially rejected mental illness.

What if prospective clients knew how managed care impacts psychologists' practice and ethics? An exploratory study.

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics (Murphy, DeBernardo, & Shoemaker, 1998) were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioners responses to the managed care survey. Results indicate that when participants were informed of the practitioners views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed.

How Impaired Is Too Impaired? Ratings of Psychologist Impairment by Psychologists in Independent Practice

Although psychologist impairment has received attention from researchers, there is a paucity of empirical data aimed at determining the point at which such impairment necessitates action. The purpose of this study was to provide such empirical data. Members of Division 42 (n = 285) responded to vignettes describing a psychologist whose symptoms of either depression or substance abuse varied across five levels of severity. Results identified specific levels of impairment at which psychologists were deemed too impaired to practice psychotherapy, as well as significant differences between ratings of increasingly severe impairment. Practical and ethical implications of these results are discussed.

The Influence of Length of Marriage and Fidelity Status on Perception of Marital Rape

To what extent does the length of the marriage or the wifes faithfulness to the husband influence the perception of responsibility or trauma in marital rape? In the current study, each participant was presented with one of four marital rape vignettes. The vignettes varied only in the length of the marriage (3 years or 15 years) and the fidelity status of the wife (continuously faithful or involved in an ongoing sexual affair with another man). Results indicate that both length of marriage and fidelity status significantly influence perceptions of marital rape. Specifically, participants assigned greater responsibility for the rape to unfaithful wives than to faithful wives. This finding is particularly salient for wives in long-term marriages as compared to wives in short-term marriages. Additionally, participants perceived rapes within long-term marriages as more traumatic than rapes within short-term marriages.