Charles Sheppard

COMBINATION MEDICATIONS IN PSYCHIATRIC TREATMENT: PATTERNS IN A GROUP OF ELDERLY HOSPITAL PATIENTS*

Abstract: The patterns for treatment with combined medications were studied in a group of elderly male (n = 137) and female (n = 432) psychiatric patients housed in the continued‐treatment services of a state hospital. The combination most frequently used was that of an antidepressant agent with a tranquilizing drug (major or minor). Slightly more than half of all combinations of psychoactive agents prescribed for these patients were composed of a tranquilizer and an antidepressent agent.

PERSONALITY CHARACTERISTICS OF URBAN AND SUBURBAN HEROIN ABUSERS: MORE DATA AND ANOTHER REPLY TO SUTKER AND ALLAIN (1973)

Sutker and Allain (1973) suggest that nonincarcerated heroin addicts who are involved in the “street life style” would tend to obtain elevated scores on the Hs, D, Hy and Pd scales of the MMPI. If these findings were cross-validated, then personality descriptions of addicts would have to be modified accordingly. Also, improvement measured by decreases on the Hs and Hy scales soon after entering a drug-free environment may be a result of milieu differences rather than personality change. Four groups of heroin addicts, two hospitalized, urban drug abusers who were free of drug influence at testing (Hospitalized1 and Hospitalized2) were compared with two street addict samples, one from an urban (StreetNARA), the other a suburban (StreetSCNCC) environment. It was hypothesized that both the StreetNARA and StreetSCNCC groups would score significantly higher than the hospitalized groups and that there would be no differences between the hospitalized groups. As was expected, the street samples scored statistically higher on the Hs and Hy scales. However, data for the D and Pd scales failed to cross-validate the Sutker-Allain hypothesis. These data suggest that personality characteristics play a more dominant role in MMPI score elevations than the “street life style.” This contention was also supported by test-retest data on the Hospitalized2 sample measuring the effect of 90 days of hospitalization in a drug-free environment.

Psychological needs of suburban male heroin addicts.

Summary The Edwards Personal Preference Schedule (EPPS), an objective test of Murrays theory of personality development, was completed by 51 male applicants to a county methadone maintenance program. Tests of significance (t) were applied to the suburban heroin addict sample (n = 51) and to the general adult male normative sample (n = 4031) data to determine if they scored differently on the 15 EPPS psychological need constructs. Because of the disproportionate sample sizes, a hypothetical sample (n = 51) was drawn from the normative sample for comparative purposes. Questions raised in these analyses were the following: Do heroin addicts differ in psychological need structure from the general adult male population? What motivates and directs behavior? What are the factors leading to the psychological availability to abusing drugs? What may make addicts resistant to psychotherapy?

Early Cigarette Smoking and Drug Use: Some Comments, Data and Thoughts.

This paper considers some recently reported cigarette smoking and drug-use data which indicate teenage smokers have a greater probability of using or becoming involved with illicit drugs than non-smoking peers. It is suggested that the epidemiological concept of high risk groups be applied to relationship between the use of socially approved substances like tobacco by young people and subsequent drug experiences because it acknowledges the empirical covariance between these events but does not have as strong causal implications as a “stepping stone” notion. By this, it is implied that a person who begins smoking, for example, at age 10 when his reference group will begin at age 15, may be more likely to become involved with substance abuse. Further suggested the decision to use drugs is an individual one which appears to be influenced by a multiplicity of factors as availability, personal needs, values, peer influences, personality characteristics and previous behavioral tendencies.

Comparison of Intercorrelations of Scale Scores from the Opinions about Mental Illness Scale

Intercorrelations among scores on the 5 factorially derived dimensions of the Opinions About Mental Illness Scale (OMI) were computed for 77 female psychiatric attendants at a large state mental hospital. Four rs were significant. However, rs were smaller and, in some cases, directionally different from those in previous studies. Type of institution sampled, temporal factors, and changes in attitude were suggested as possible explanations for these differences in intercorrelations.

Thiothixene, thioridazine, and placebo in male chronic schizophrenic patients

The population of a male chronic schizophrenic ward was selected for treatment with thiothixene (Navane) (35 subjects), thioridazine (Mellaril) (29 subjects), and/or placebo (28 subjects). Medication was administered for seven months. During this period, the maximum daily dosage reached was 55 mg. of thiothixene and 1,100 mg. of thioridazine. Because of the high incidence of untoward effects and the absence of a marked therapeutic effect, daily dosage was titrated to an average of 10 mg. of thiothixene and 200 mg. of thioridazine during the last four months of treatment. On the basis of the fivefold criteria for determining efficacy (statistical comparisons of the behavioral ratings, psychological test data, the number of treatment failures in each medication group, and the incidence of side effects and patient status at the close of the study), thioridazine appeared slightly more effective in the treatment of schizophrenic symptomatology in this series of patients.

Community perception of severity of illness levels of former mental patients: A failure to discriminate

Abstract The data presented here indicated that suburban homeowners did not discriminate among levels of severity when asked to rate the concept, former mental patient, via the semantic differential technique. This lack of individuation of mental patients is interpreted as being consistent with a stereotypic response set and is seen as a demonstration of the depersonalization function of the label of mental illness. Various resistance strategies to community-based programs appear to be consistent with the fear-evoked “threat-recoil cycle” model developed by Rhodes.

RAVENS PROGRESSIVE MATRICES (1938): NORMATIVE DATA ON MALE NARCOTIC ADDICTS

The Ravens Progressive Matrices (RPM), a test of intellectual ability, was administered to 396 male narcotic users. Norms are given, and concepts basic to the validity and reliability of the RPM tested. Significant shifts were found in item order in sets A, B, C, and D. Differences were not considered crucial for each set, which was progressively more difficult than the preceding set; thus the total structure of the test was supported by the sample. The discriminative power of most items ranged from good to excellent. In investigating properties of distractors, answer four was chosen significantly more often than other alternatives as the wrong answer in sets C, D and E identifying the possible operation of a positional distractor. Test-retest reliability, content and concurrent validity coefficients were of the order of .8. Correlation of formal education with RPM was of the order of .2. Previously available normative data on patient samples ae extended and use of the RPM as a measure of intellectual performance relatively free from language and cultural bias is supported.

PERFORMANCE ERRORS ON RAVENS PROGRESSIVE MATRICES ( 1938) BY SOCIOPATHIC AND SCHIZOTYPIC PERSONALITY TYPES

In an attempt to identify the existence of reasoning errors in psychiatric patients, the performance of male narcotic users defined as sociopathic (N = 36) and schizotypic (N = 34) by MMPI profile patterns was analyzed for avoidable errors on the Ravens Progressive Matrices (RPM). An avoidable error was defined as a failure to solve an item whose difficulty level was within the testees range of ability as measured by his performance. Construct validity was defined in terms of the intercorrelations of Ravens centile and item difficulty levels. Parametric and non-parametric tests of significance indicated that the schizotypic group commit significantly more identifiable reasoning errors than the sociopathic group.

Studies with acetylsalicylic acid

In this communication we report an attempt to verify the findings of a previous report comparing the “rtranquilizing and antidepressant” effects of aspirin, an aspirin compound, a mild tranquilizer, and a placebo on 20 volunteer subjects. In a double‐blind, Latin‐square comparison, slightly different from the first design, the “antidepressant” effects of aspirin were verified. Some comments are made on the problems of subject selection in psychopharmacologic studies. The need for further study of the “tranquilizing and antidepressant” effects of aspirin is indicated.