J. Ray Hays

Concurrent Validity of the Wechsler Abbreviated Scale of Intelligence and the Kaufman Brief Intelligence Test among Psychiatric Inpatients

This study examined the convergent and discriminant validity of the Wechsler Abbreviated Scale of Intelligence and the Kaufman Brief Intelligence Test for 85 psychiatric inpatients. The correlation between the WASI Full Scale and K-BIT Composite IQ scores was significant (r = .89, p <.001). Multitrait-multimethod analysis of the subtest scores showed that the K-BIT had higher internal consistency for its two subtests but, therefore, less differentiation of cognitive functioning than the brief Wechsler scale, as would be expected due to the larger number and diversity of the latter subtests. Correlations among the Wechsler scale subtests were lower than among those for the K-BIT, so the former may tap different cognitive functions and yield more clinically useful information than the latter. This brief Wechsler scale appears to be a valid screening measure of verbal, performance, and general intellectual ability for use with an inpatient psychiatric population when considerations of the setting or patient preclude administration of a longer measure of intellectual ability.

Psychiatric norms for the Rey 15-item Visual Memory Test.

The 15-item Visual Memory Test was proposed by Rey in 1964 as a measure of malingering of visual memory. Among psychiatric patients the task has a significant cognitive component, with IQ accounting for 37% of the variance in scores (r = .60). Any interpretation of scores on this task should be ability-based. Such ability-based norms are provided in this study of psychiatric patients (N = 300). Use of a single cut-off score to indicate malingering or any other interpretation is inappropriate given the psychometric properties of the task. In the assessment of immediate visual memory the task has some utility, which is greatly enhanced with the use of ability-based norms.

PREDICTION OF READMISSION OF PSYCHIATRIC INPATIENTS

Using demographic and episode-based variables this study attempted to predict which patients would require frequent psychiatric hospitalizations. Records of 943 patients were randomly selected from 14,649 admissions and examined for a 5-yr. period following initial admission. Sex, ethnicity, and age at first admission were not significantly related to readmission. Among the demographic variables, marriage was inversely related to readmission. Involuntary commitment and a longer length of stay at the original admission were associated with a higher rate of readmission. Despite the results being statistically significant, the small covariances of these effects indicate little clinical utility in the prediction of readmission for an individual patient.

Characteristics of Readmitted Psychiatric Inpatients

This study examined sociodemographic, diagnostic, psychological, and episode-based variables in a sample of 130 psychiatric patients admitted to treatment at least twice in a 6-yr. period. Short length of initial hospitalization (r = -.30, p <.01) and younger age on initial admission (r = -.20, p <.05) were significantly correlated with frequent hospital admissions. Scores on four of the subscales of the WAIS-R were significantly correlated with readmission, confirming that patients who have fewer cognitive resources are at risk of frequent admissions. A multiple regression analysis combining variables to predict readmission accounted for only 12% of the common variance (r128 = .34, p <.01), however, indicating that a prediction equation with these variables has limited clinical utility.

Job satisfaction and perceived congruence of attitude between workers and supervisors in a mental health setting.

The Community Mental Health Ideology Scale and Minnesota Satisfaction Questionnaire were administered to the staff of an outpatient treatment facility. Perceived congruence of attitude and job satisfaction including working conditions, pay, agency policy, and other variables were examined. Congruence of attitude between worker and supervisor was positively related to satisfaction with supervisor and agency policy. There were differences among the various disciplinary groups with those workers who had the least education tending to be satisfied in more spheres than those with more education or advanced professional degrees.

Courtroom Observation of Ethnic Representation among Jurors in Harris County, Texas

The ethnic composition of 22 juries in Harris County, Texas was compared with the ethnic composition of the decennial census of the county. Results showed an under-representation of Hispanic members and an over-representation of Euro-American jury members in civil, family law, and criminal trials. African-American members were represented on juries in proportion to their presence in the general population in the county. Whether this misrepresentation reflects selection factors in developing the jury pools, is the result of exercise of peremptory challenges by lawyers, or some other biasing factor is unknown.

Outcome Comparison of Patients Receiving Oral or Depot Neuroleptic Medication

Three outcome measures of psychiatric treatment were retrospectively compared between two groups of acutely hospitalized psychotic patients who had been prescribed either oral haloperidol (n = 58) or depot haloperidol (n = 95) as the only medication at the time of discharge. There were no significant differences between the groups on demographic variables, including sex, age, and ethnicity. There were no significant differences between the groups on keeping the initial outpatient appointment, in readmission history over a 4-yr. follow-up, or in length of time to subsequent readmission, if any. It appears that there is no benefit in choosing one form of medication over the other from a clinical perspective, as neither appears more clinically efficacious when examined on these outcome variables. However, there is a significant difference in cost of the two forms of the medication in favor of the oral form, making the oral form more favorable if cost is to be minimized.

WASI PROFILE VARIABILITY IN A SAMPLE OF PSYCHIATRIC INPATIENTS

This study examined the variability of Wechsler Abbreviated Scale of Intelligence profiles using the subtest range and profile variability index in a sample of 70 psychiatric inpatients. The subtest range and profile variability index were correlated .93 (p < .001), indicating that either measure may be used to assess profile variance. Comparison of profile variability on this abbreviated scale with other Wechsler intelligence scales in similar populations suggests that variability measures are not comparable across the tests.

An Outcome Survey of Psychology Residency Training Program Graduates of the University of Texas Houston Medical School

A survey of 71 graduates of the psychology residency program at The University of Texas Houston Medical School and the Texas Research Institute of Mental Science indicated that two-thirds of the respondents were involved in private practice, conducting primarily individual therapy, with assessment also playing a major role in their practice. Managed care had the effect of placing limits on the numbers of sessions available to patients, reducing income, and increasing paperwork associated with practice. Implications for training during residency are that individual therapy, using focused short-term approaches, and assessment should continue to be the primary clinical experiences for trainees, and that there should also be training in the business aspect of practice, including marketing.