Donald J. Smeltzer

First Grade Norms, Factor Analysis and Cross Correlation for Conners, Davids, and Quay-Peterson Behavior Rating Scales

Three behavior rating scales were filled out by teachers for the entire first grades of three public schools, totalling 225 children. Factor analyses on this nonclinical sample yielded different factors from those found previously on clinical samples. The Conners scale showed four factors: hyperkinetic, shy-inept, rebellious-unsocialized, and antisocial-immature. The Quay-Peterson checklist also showed four factors: hyperkinetic, shy-inept, depressed, and dyssocial. The “inattentive” items, which formed a separate factor on older clinical samples, blended into the hyperkinetic factor on this younger normal sample. The whole Davids scale was one clean factor with all loadings above .6 and “impulsiveness” the highest loading. The hyperkinetic factors of both scales correlated highly with each other and with the Davids whole scale. The two shy-inept factors correlated at .82 with each other. Factor analysis of all the items from the 3 scales as if they were one large scale yielded seven factors: hyperkinetic-inattentive, shy, rebellious-unsocialized, antisocial, oversensitive, depressed, and dyssocial. Nonclinical first-grade norms by sex and parent occupational status were derived for all three scales and eight factor sub-scales. These consistently showed advantage for girls and for children of higher occupation parents. Many of these trends were significant at .05. Inspection of the Davids ratings raises questions about the meaning of “average” and suggests that teachers very early dichotomize students into good and poor.

Reliability and Validity of the Psychiatry Resident In-Training Examination

The Psychiatry Resident In-Training Examination (PRTTE) has been produced annually since 1979. On each test from 1980 through 1987, the Kuder-Richardson reliability coefficient for the global score in psychiatry was above .90. This is adequate reliability for making comparisons among individual examinees. The reliability coefficients for the neurology score and psychiatry subscores were lower and correlated with subtest length. Small differences in these scores may reflect measurement error. Mean raw scores showed statistically significant increases across groups of examinees with increasing levels of training completed. This supports the presence of construct validity.

Identity shifts in temporal lobe epilepsy

It has long been suggested that there is an association between epilepsy and psychosis [1]. The psychosis associated with epilepsy may be ictal, postical or interictal, but usually is similar to the psychosis of schizophrenia. In fact, the phrase ‘schizophrenia-like psychosis’ has been used to describe the chronic psychosis of epilepsy. This syndrome, similar to schizophrenia, usually includes symptoms such as disorganized thought, auditory hallucinations and persecutory delusions [2]. It is also well known that patients with temporal lobe epilepsy can experience dissociative symptoms such as depersonalization and fugue [1]. Some cases of dissociative identity disorder have also been found in patients with temporal lobe epilepsy [3]. However, a Medline search found no reported cases of a patient adopting other people’s identities. In this case report, we describe an interesting patient with temporal lobe epilepsy who developed the acute onset of psychosis and dissociative identity symptoms. The unusual feature of this case was that the patient adopted other people’s identities. These identities included her mother, her uncle, and several different doctors.

Serum and red cell folate concentrations in outpatients receiving lithium carbonate.

We measured serum and RBC folate levels in 17 outpatients taking lithium for the prophylaxis of recurrent major affective disorder. In contrast to a previous report, we found no evidence for low folate concentrations or for any significant correlation between folate levels and affective morbidity.

The Judgments of College Students and Jurors Concerning Sanity and Guilt of an Alleged Murderer

Abstract Critics of behavioral research have often argued that studies using college students as Ss suggest conclusions that may be inapplicable to the population at large. The present study investigated this bias by comparing juridic judgments of college students with those of actual veniremen. In part one of the investigation, 160 persons who had just completed duty as trial jurors for a county court were individually presented with a brief written account of a murder trial. Each also received supplementary written information about testimony, systematically varied according to professional training of the expert witness, type of testimony given, and the conclusion stated by the expert. The Ss then estimated, on four-point scales, their probable verdict and opinion on the defendants legal sanity. These same procedures were repeated with the use of 160 undergraduate college students. The results show that the students were consistently more lenient than jurors in the determination of sanity and verdict.

Differential Effect of Amphetamine Optical Isomers on Bender Gestalt Performance of the Minimally Brain Dysfunctioned

As part of a double-blind Latin-square crossover comparison of placebo, dextroamphetamine and levoamphetamine in 31 hyperkinetic minimally brain dysfunctioned children, Bender Gestalt tests were administered. On mean Koppitz error scores, dextroamphetamine showed significant benefit over predrug, placebo, and levoamphetamine. Predrug, placebo, and levoamphetamine Koppitz scores were not significantly different from one another, though all three were significantly worse than dextroamphetamine. Dosages of the two isomers were not significantly different, and behavioral effects were comparable.

Two Years’ Experience with the Psychiatry Resident in-Training Examination

The annual Psychiatry Resident In-Training Examination (PRITE) was developed by a consortium of professional and educational organizations as a service available to residency training programs under policies intended to maximize standardization, minimize data bias, and prevent misuse. It provides a nonthreatening educational experience for residents through standardized administration, feedback to examinees based on comparisons with educational peers, detailed or summarized feedback to training directors, and availability of test questions and reference bibliographies as study aids. Each test resembles the written Psychiatry Board Examination in style, format, and method of administration, but differs in goals, content, method of construction, population tested, feedback provided, and manner in which results are used. Although initially controversial, the PRITE was very well accepted by the residents and training programs that participated in 1979 and 1980.

A survey study of the use electropupillogram in predicting response to psychostimulants

To confirm the conclusions from a previous study supporting the usefulness of electropupillogram (E.P.G.) in predicting clinical response, data from three separate studies with hyperkinetic and learning disabled (L.D.) children treated with stimulants were surveyed. Change in extent of pupillary contraction (E.C.) after a test dose of stimulant as measured by E.P.G. did not correlate significantly with actual clinical rating change (with one exception out of 14 correlations calculated). These negative results are reported with a reservation regarding their validity because of technical difficulties in data collection.

Tutorial Teaching of Psychiatry: Effects on Test Scores, Attitudes, and Career Choices of Medical Students

A tutorial teaching program for medical students, previously found highly effective at Ohio State University (OSU), was adapted for use at the University of South Carolina (USC). Three classes of USC students obtained mean scores well above average on the psychiatry National Board Examination; at OSU a similar trend has persisted for seven consecutive years. Students also reported positive attitudes toward psychiatrists and psychiatry and entered psychiatry residency training at a rate higher than the national average. Tutorial teaching is effective for increasing cognitive knowledge, for promoting positive attitudes, and perhaps for increasing interest in psychiatry as a career choice.

A Personalized Study Program for Medical Students

During a required clinical clerkship in psychiatry, medical students participate in a self-paced Personalized Study Program consisting of: (1) structured reading assignments; (2) private meetings with a tutor; (3) standardized practice quizzes; (4) immediate remedial feedback; (5) optional use of audiovisual materials and attendance at lectures; (6) a written final examination; and (7) continuous monitoring by a faculty committee. National Board Examination scores in psychiatry have dramatically increased, and evaluations by students have been overwhelmingly favorable. An important factor in our success has been the enthusiasm of the tutors, who include full-time and volunteer faculty psychiatrists, residents, and selected medical students.