James L. Hedlund

Psychological screening inventory: A comprehensive review

The Psychological Screening Inventory is a relatively brief, easy to administer and score screening instrument that was designed for use by a wide range of professional mental health workers. A comprehensive review of the empirical literature suggests moderate reliability, generally stable factor structure, and adequate validity, particularly for use with college undergraduates, with reformatory and prison inmates, and with psychiatric outpatients.

Computer Generated Diagnosis

A search for more reliable psychiatric diagnosis has been largely responsible for the development of an increasing number of symptom checklists, clinical rating scales, structured or semistructured diagnostic interviews, and computer algorithms to process such information as diagnostic aids. The specific body of literature in the 1950s and 60s which suggested that many clinical judgments could be made with information about relatively few variables, combined in relatively simple ways (see, e.g., Goldberg, 1968), and that actuarial (or “mechanical”) prediction models could virtually replicate many clinical judgments (see, e.g., Meehl, 1954; Sawyer, 1966; Sines, 1970), was also clearly influential in promoting computer diagnosis research.

Computer consultation for emotional crises: An expert system for “non-experts”

Abstract This article describes an expert computerized consultation system for assisting a non-mental-health-expert assess and treat emotional and behavioral emergencies in a remote area. It discusses some of the issues and limitations of this system, and suggests that the intended educational/instructional aspects of expert systems may make them more appropriate for, and potentially better accepted by “non-experts.”

Missouri Actuarial Report System (MARS)

INCE 1966, the Missouri Department of Mental Health (DMH), in collaboration with the University of Missouri, has been developing a comprehensive statewide computerized information system.‘.2 Ten major mental health facilities are connected via remote terminals with high-speed card-readers and line-printers to an IBM 370-155 computer in St. Louis. Approximately fifteen satellite facilities also process data through the terminals of these ten facilities via messenger service and telephone. The system currently processes about 1000 new patients per month, with over 180,000 patients on the data-base. More than 10,000 clinical reports and 30,000 outpatient contacts are processed monthly. Most of the basic clinical forms are automated, including face sheet, mental status checklist, community adjustment scales, psychologic screening tests, and others.” Early in the history of the project, there was considerable interest in the feasibility of classifying individual patients into clinically useful categories, utilizing the large DMH standardized data-base in establishing explicit rules. These rules usually took the form of equations derived by using multivariate statistical techniques. The term “actuarial” in the behavioral science literature has come to mean this process of delineating and using explicit rules to classify individuals or predict their behavior. In this paper, the terms “actuarial rule set” or “rule set” will refer to such rules or equations. The authors’ earliest attempt at actuarial classification involved a list of major diagnostic categories attached to the printout of a computerized mental status report.’ Associated with each category was a probability estimate of the patient’s belonging to that group.” Later, a separate report was developed concerning risks of short versus long length of hospital stay, unauthorized absence from the inpatient service, and harm to self or others.“PX Thereafter, a single report was designed to incorporate all of the above, plus type of psychotropic drug treatment most likely to be prescribed in the Missouri DMH. Entirely new actuarial rule sets were developed, using more sophisticated statistical techniques. After two years of development, the Missouri Actuarial Report System (MARS) became operational. and the creation of a MARS report was “triggered” automatically whenever an admission inpatient mental status report was processed by the computer.

Replicated item level factor structure of the MMPI: Racial and sexual differences

Item-level factor studies of the MMPI date back to the work of Comrey (1957). Surprisingly, there are no extant studies of the items that clinicians use most in the course of daily MMPI interpretive reporting, namely, the 399 x 399 matrix that represents all of the items that comprise the traditional clinical and validity scales. Furthermore, there are no prior studies with adequate Ns that have examined the replicability of MMPI factor structure via available factor comparison techniques (Harman, 1976). In this study, 20,000 MMPIs were factored by the principal components method, followed by Varimax rotations of 6 through 25 factors. The coefficient of congruence was used to compare the factor structures of randomly divided subsamples, as well as males vs. females and Blacks vs. Whites. Differences in factor structure were found, and suggestions are made with regard to the significance of these findings in clinical and applied settings.

Computers in mental health: A national survey

There have been a number of attempts since the mid-1960s to apply computer technology to mental health problems and clinical records (Ulett and Sletten 1971; Crawford, Morgan, and Gianturco 1974). Some of these clinical computer applications have been of relatively limited scope, for special purposes such as automating the scoring and interpretation of psychological screening tests, notably the Minnesota Multiphasic Personality Inventory (MPPI), or computerizing limited aspects of admissions, demographic, or clinical data for case registers, statistical reporting, or research purposes. Only a few automated mental health information systems which process extensive amounts of clinical data have become fully operational. This article summarizes the results of a national survey concerning trends in the development of general mental health information systems. Before beginning, however, it may be helpful to briefly review the types of computer applications which have been demonstrated as clearly feasible.

Computer-supported assessment and consultation for emotional crises in a submarine environment

This is a preliminary report on the development of a computer-assisted consultation program for the assessment and treatment of emotional and behavioral problems on board nuclear submarines. It discusses the early development of a brief structured interview, some of the guiding principles utilized in the development of this consultation system, and rules which relate interview profiles and corpsmen observations to treatment recommendations.

Computers In Mental Health: An Historical Overview And Summary Of Current Status

This paper reviews the development and current status of computer-supported mental health information systems. It describes and provides principal references both for general and for specialized information systems in a wide variety of application areas. It also comments on some of the special problems and emerging directions of computer applications in the mental health field.

Mental Health Information Systems: Some National Trends

Results of a national survey indicate that approximately 90 percent of all state departments of mental health utilize computer support for at least some administrative and clinical functions. Nearly all indicated planning for considerably increased use; very few reported neither current use of computers nor active plans for future use. Both this survey and a similar one concerning community mental health centers indicate extensive development and strong acceptance of computer applications in administrative and documentation areas, in program evaluation, utilization review and research, but rather weak endorsement and proliferation concerning more clinically-oriented computer applications that involve the monitoring of individual patient care, clinical decision making and clinical predictions.