John Fracchia

Public Views of Ex-Mental Patients: A Note on Perceived Dangerousness and Unpredictability

The adjectives most strongly attributed to the concept of ex-mental patient by a sample of 30 male and female suburbanites were excitable, strange, tense, strong, uncertain, unsure, unpredictable, convincing, active, and mysterious. In addition, an r of .74 was found between dangerous and unpredictable. These findings may suggest that although the public stereotype of mental patients has undergone positive change since 1960, ex-mental patients still tend to be perceived as potential threat-bearers to the community. Unfounded fears based upon this perception may motivate resistances to community-based treatment programs for this group.

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.

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.

Combination Drug Therapy for the Psychogeriatric Patient: Comparison of Dosage Levels of the Same Psychotropic Drugs, Used Singly and in Combination

The dosage levels for a number of frequently prescribed psychotropic drugs, used singly or in combination, were determined in 902 long‐term psychogeriatric hospital patients. The data failed to support the hypothesis that physicians prescribe lower dosages when combination therapy is used. Rather, the tendency was toward higher dosages under these circumstances.

Personal adjustment and authoritarian attitudes toward the mentally ill.

The relationship between authoritarian attitudes, which reflect the belief that mentally ill persons comprise an inferior class requiring coercive handling, and personal adjustment was examined for 77 female psychiatric aides at a large state mental hospital. Correlations and analysis of variance suggested the lack of a systematic association between the two variables.

Treatment Patterns in Psychiatry: Clinical and Personality Features of Elderly Hospitalized Patients during Milieu, Single-Drug and Multiple-Drug Programs

Psychologic tests and psychiatric ratings for 90 elderly long‐term psychiatric patients showed that those who were treated psychopharmacologically (one or more psychotropic drugs) had personality profiles indicative of less control of impulses and less anxiety binding than did those who received milieu (no‐drug) therapy. Since the three groups of elderly patients tested (no‐drug, one‐drug, multiple‐drugs) did not differ significantly from one another on all measures of intellectual functioning, emotional characteristics and individual psychiatric symptoms, it appears that treatment modes may be mediated more on the basis of reactive personality features than on the basis of clinical differences in basic pathology. Thus, although the patients treated with a single drug or multiple drugs did not manifest different symptom profiles qualitatively or quantitatively, when compared to patients who received no drugs they made their symptoms more apparent to the staff.