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This study examined the observed summertime ozone production efficiency (OPE) and background ozone ([O3]) concentration at two rural sites in New York State, Pinnacle State Park (PSP) in Addison, NY, and Whiteface Mountain Summit (WFMS) in Wilmington, NY. Observed summertime OPEs and their relationship to oxides of nitrogen concentrations ([NOx]) were assessed during photochemically active periods at PSP and WFMS from 2000 to 2017 and 2015–2017, respectively. The summertime OPE increased in response to [NOx] reductions at PSP, consistent with a NOx‐sensitive regime for O3 production. At PSP, the summertime OPE increased from approximately 5–7 parts per billion per parts per billion (ppb ppb−1) in 2000–2009 to approximately 13 ppb ppb−1 in 2012–2017, and the median [NOx] concentration during photochemically productive periods decreased from about 0.60 ppb in 2000–2005 to about 0.23 ppb in 2012–2017. At WFMS, the summertime OPE was approximately 18 ppb ppb−1 in 2015–2017, and the median [NOx] concentration during photochemically active periods from 2015 to 2017 was about 0.21 ppb. The higher WFMS summertime OPE is consistent for a site characterized by lower [NOx] concentrations. The summertime background [O3] concentration at PSP and WFMS was approximately 31–33 ppb for the analysis period, indicating that both sites were likely affected by similar regional emission sources. Key Points: Ozone production efficiency at a rural New York State site over an 18‐year period increased in response to oxides of nitrogen reductionsOzone production efficiency was higher at the more remote site with lower oxides of nitrogen concentrationsSimilar summertime background ozone concentrations were observed for both sites [ABSTRACT FROM AUTHOR]

Recent laboratory chamber studies indicate a significant role for highly oxidized low-volatility organics in new particle formation (NPF), but the actual role of these highly oxidized low-volatility organics in atmospheric NPF remains uncertain. Here, particle size distributions (PSDs) measured in nine forest areas in North America are used to characterize the occurrence and intensity of NPF and to evaluate model simulations using an empirical formulation in which formation rate is a function of the concentrations of sulfuric acid and low-volatility organics from alpha-pinene oxidation (Nucl-Org), and using an ion-mediated nucleation mechanism (excluding organics) (Nucl-IMN). On average, NPF occurred on ∼70% of days during March for the four forest sites with springtime PSD measurements, while NPF occurred on only ∼10% of days in July for all nine forest sites. Both Nucl-Org and Nucl-IMN schemes capture the observed high frequency of NPF in spring, but the Nucl-Org scheme significantly overpredicts while the Nucl-IMN scheme slightly underpredicts NPF and particle number concentrations in summer. Statistical analyses of observed and simulated ultrafine particle number concentrations and frequency of NPF events indicate that the scheme without organics agrees better overall with observations. The two schemes predict quite different nucleation rates (including their spatial patterns), concentrations of cloud condensation nuclei, and aerosol first indirect radiative forcing in North America, highlighting the need to reduce NPF uncertainties in regional and global earth system models. [ABSTRACT FROM AUTHOR]

Recent laboratory chamber studies indicate a significant role for highly oxidized low volatility organics in new particle formation (NPF) but the actual role of these highly oxidized low volatility organics in atmospheric NPF remains uncertain. Here, particle size distributions (PSDs) measured in nine forest areas in North America are used to characterize the occurrence and intensity of NPF and to evaluate model simulations using an empirical formulation in which formation rate is a function of the concentrations of sulfuric acid and low volatility organics from alpha-pinene oxidation (Nucl-Org), and using an ion-mediated nucleation mechanism (excluding organics; Nucl-IMN). On average, NPF occurred on ~70% of days during March for the four forest sites with springtime PSD measurements, while NPF occurred on only ~10% of days in July for all nine forest sites. Both Nucl-Org and Nucl-IMN schemes capture the observed high frequency of NPF in spring, but the Nucl-Org scheme significantly over-predicts while the Nucl-IMN scheme slightly under-predicts NPF and particle number concentrations in summer. Statistical analyses of observed and simulated ultrafine particle number concentrations and frequency of NPF events indicate that the scheme without organics agrees better overall with observations. The two schemes predict quite different nucleation rates (including their spatial patterns), concentrations of cloud condensation nuclei, and aerosol first indirect radiative forcing in North America, highlighting the need to reduce NPF uncertainties in regional and global earth system models. [ABSTRACT FROM AUTHOR]

Positive matrix factorization (PMF) was applied to the merged high resolution mass spectra of organic and inorganic aerosols from aerosol mass spectrometer (AMS) measurements to investigate the sources and evolution processes of submicron aerosols in New York City in summer 2009. This new approach is able to study the distribution of organic and inorganic species in different types of aerosols, the acidity of organic aerosol (OA) factors, and the fragment ion patterns related to photochemical processing. In this study, PMF analysis of the unified AMS spectral matrix resolved 8 factors. The hydrocarbon-like OA (HOA) and cooking OA (COA) factors contain negligible amounts of inorganic species. The two factors that are primarily ammonium sulfate (SO4-OA) and ammonium nitrate (NO3-OA), respectively, are overall neutralized. Among all OA factors the organic fraction of SO4-OA shows the highest degree of oxidation (O/C = 0.69). Two semi-volatile oxygenated OA (OOA) factors, i.e., a less oxidized (LO-OOA) and a more oxidized (MO-OOA), were also identified. MO-OOA represents local photochemical products with a diurnal profile exhibiting a pronounced noon peak, consistent with those of formaldehyde (HCHO) and Ox(= O3 +NO2). The NO+/NO+ ion ratio in MO-OOA is much higher than that in NO3-OA and in pure ammonium nitrate, indicating the formation of organic nitrates. The nitrogen-enriched OA (NOA) factor contains ~25% of acidic inorganic salts, suggesting the formation of secondary OA via acid-base reactions of amines. The size distributions of OA factors derived from the size-resolved mass spectra show distinct diurnal evolving behaviors but overall a progressing evolution from smaller to larger particle mode as the oxidation degree of OA increases. Our results demonstrate that PMF analysis of the unified aerosol mass spectral matrix which contains both inorganic and organic aerosol signals may enable the deconvolution of more OA factors and gain more insights into the sources, processes, and chemical characteristics of OA in the atmosphere. [ABSTRACT FROM AUTHOR]

The polyhedral oligomeric silsesquioxane (POSS) additivated polystyrene (PS) based nanocomposites were prepared by melt processing and the structure-properties relationships of the POSS-PS systems were compared to those of the neat PS. In order to investigate the effect of these structural parameters on the final properties of the polymer nanocomposites, five different kinds of POSS samples were used, in particular, POSS with different inorganic cage and with different organic pendent groups. The rheological investigation suggests clearly that the POSS acts as a plasticizer and that the processability of the PS was positively modified. The affinity between the POSS samples and the PS matrix was estimated by the calculated theoretical solubility parameters, considering the Hoy's method and by morphology analysis. Minor difference between the solubility parameter of POSS and the matrix means better compatibility and no aggregation tendency. Furthermore, the POSS loading leads to a decrease of the rigidity, of the glass transition temperature and of the damping factor of the nanocomposite systems. The loading of different POSS molecules with open cage leads to a more pronounced effect on all the investigated properties that the loading of the POSS molecules with closed cage. Moreover, the melt properties are significantly influenced by the type of inorganic framework, by the type of the pendent organic groups and by the interaction between the POSS organic groups and the host matrix, while, the solid state properties appears to be influenced more by the kind of cage. [ABSTRACT FROM AUTHOR]

Knowledge of the variations of mass concentration, chemical composition and size distributions of submicron aerosols near roadways is of importance for reducing exposure assessment uncertainties in health effects studies. The goal of this study is to deploy and evaluate an Atmospheric Sciences Research Center-Mobile Laboratory (ASRC-ML), equipped with a suite of rapid response instruments for characterization of traffic plumes, adjacent to the Long Island Expressway (LIE) -- a high-traffic highway in the New York City Metropolitan Area. In total, four measurement periods, two in the morning and two in the evening were conducted at a location approximately 30m south of the LIE. The mass concentrations and size distributions of non-refractory submicron aerosol (NR-PM1) species were measured in situ at a time resolution of 1 min by an Aerodyne High-Resolution Time-of-Flight Aerosol Mass Spectrometer, along with rapid measurements (down to 1 Hz) of gaseous pollutants (e.g. HCHO, NO2, NO, O3, and CO2, etc.), black carbon (BC), and particle number concentrations and size distributions. Particulate organics varied dramatically during periods with high traffic influences from the nearby roadway. The variations were mainly observed in the hydrocarbon-like organic aerosol (HOA), a surrogate for primary OA from vehicle emissions. The inorganic species (sulfate, ammonium, and nitrate) and oxygenated OA (OOA) showed much smoother variations indicating minor impacts from traffic emissions. The concentration and chemical composition of NR-PM1 also varied differently on different days depending on meteorology, traffic intensity and vehicle types. Overall, organics dominated the traffic-related NRPM1 composition (>60 %) with HOA accounting for a major fraction of OA. The traffic-influenced organics showed two distinct modes in mass-weighted size distributions, peaking at ~120 nm and 500 nm (vacuum aerodynamic diameter, Dva), respectively. OOA and inorganic species appear to be internally mixed in the accumulation mode peaking at ~500-600 nm. The enhancement of organics in traffic emissions mainly occurred at ultrafine mode dominated by HOA, with little relation to the OOA-dominated accumulation mode. From Fast Mobility Particle Sizer (FMPS) measurements, a large increase in number concentration at ~10 nm (mobility number mean diameter, Dm) was also found due to traffic influence; though these particles typically contribute a minor fraction of total particle mass. The observed rapid variations of aerosol chemistry and microphysics may have significant implications for near-highway air pollution characterization and exposure assessments. [ABSTRACT FROM AUTHOR]

We have investigated an aerosol processing and evolution event from 21-22 July during the summer 2009 Field Intensive Study at Queens College in New York City (NYC). The evolution processes are characterized by three consecutive stages: (1) aerosol wet scavenging, (2) night-time nitrate formation, and (3) photochemical production and evolution of secondary aerosol species. Our results suggest that wet scavenging of aerosol species tends to be strongly related to their hygroscopicities and also mixing states. The scavenging leads to a significant change in bulk aerosol composition and average carbon oxidation state because of scavenging efficiencies in the following order: sulfate > low-volatility oxygenated organic aerosol (LV-OOA) > semi-volatile OOA (SV-OOA) > hydrocarbon-like OA (HOA). The second stage involves a quick formation of nitrate from heterogeneous reactions at nighttime. During the third stage, simultaneous increases of sulfate and SV-OOA were observed shortly after sunrise, indicating secondary aerosol formation. Organic aerosols become highly oxidized in ~ half day as the result of photochemical processing, consistent with previously reported results from the CO-tracer method (OA/1CO). The photochemical reactions appear to progress gradually associated with a transformation of SVOOA to low-volatility species based on the evolution trends of oxygen-to-carbon (O/C) ratio, relationship between f44 (fraction of m/z 44 in OA) and f43 (fraction of m/z 43 in OA), and size evolution of OOA and HOA. Aerosols appear to become more internally mixed during the processing. Our results suggest that functionalization by incorporation of both C and O plays a major role in the early period of OA oxidation (O/C<0.5). Our results also show that photochemical production of LV-OOA during this event is approximately 2-3 h behind of sulfate production, which might explain, sometimes, the lack of correlations between LV-OOA and sulfate, two secondary aerosol species which often exist in internal mixtures over regional scales. [ABSTRACT FROM AUTHOR]

Knowledge of the variations of mass concentration, chemical composition and size distributions of submicron aerosols near roadways is of importance for reducing exposure assessment uncertainties in health effects studies. The goal of this study is to deploy and evaluate an Atmospheric Sciences Research Center-Mobile Laboratory (ASRC-ML), equipped with a suite of rapid response instruments for characterization of traffic plumes, adjacent to the Long Island Expressway (LIE) -- a high-traffic highway in the New York City Metropolitan Area. In total, four measurement periods, two in the morning and two in the evening were conducted at a location approximately 30m south of the LIE. The mass concentrations and size distributions of non-refractory submicron aerosol (NR-PM1) species were measured in situ at a time resolution of 1 min by an Aerodyne High-Resolution Time-of-Flight Aerosol Mass Spectrometer, along with rapid measurements (down to 1Hz) of gaseous pollutants (e.g., HCHO, NO2, NO, O3, and CO2, etc.), black carbon (BC), and particle number concentrations and size distributions. The particulate organics varied dramatically during periods with highest traffic influences from the nearby roadway. The variations were mainly observed in the hydrocarbon-like organic aerosol (HOA), a surrogate for primary OA from vehicle emissions. The inorganic species (sulfate, ammonium, and nitrate) and oxygenated OA (OOA) showed much smoother variations -- with minor impacts from traffic emissions. The concentration and chemical composition of NR-PM1 also varied differently on different days depending on meteorology, traffic intensity and vehicle types. Overall, organics dominated the traffic-related NR-PM1 composition (> 60%) with HOA being the major fraction of OA. The traffic-influenced organics showed two distinct modes in mass-weighted size distributions, peaking at ~ 120 nm and 500 nm (vacuum aerodynamic diameter, Dva ), respectively. OOA and inorganic species appear to be internally mixed in the accumulation mode peaking at ~ 500--600 nm. The enhancement of organics in traffic emissions mainly occurred at ultrafine mode dominated by HOA, with little relation to the OOA-dominated accumulation mode. From Fast Mobility Particle Sizer (FMPS)measurements, a large increase in number concentration at ~10 nm (mobility number mean diameter, Dm) was also found due to traffic influence; though these particles typically contribute a minor fraction of total particle mass. Results here may have significant implications for near-highway air pollution characterization and exposure assessments. Our results suggest that exposure assessments must take into account the rapid variations of aerosol chemistry over short distances near roadways, and also that long-term monitoring of air pollutants throughout the day on different types of days is necessary to accurately gauge exposure to individuals. [ABSTRACT FROM AUTHOR]

Paired nano- and long-tube Scanning Mobility Particle Sizer (SMPS) systems were operated for four different intensive field campaigns in New York State. Two of these campaigns were at Queens College in New York City, during the summer of 2001 and the winter of 2004. The other field campaigns were at rural sites in New York State. The data with the computed diffusion loss corrections for the sampling lines and the SMPS instruments were examined and the combined SMPS data sets for each campaign were obtained. The diffusion corrections significantly affect total number concentrations, and in New York City, affect the mode structure of the size distributions. The relationship between merged and integrated SMPS total number concentrations with the diffusion loss corrections and the CPC number concentrations yield statistically significant increases (closer to 1) in the slope and correlation coefficient compared to the uncorrected values. The measurements are compared to PM2.5 mass concentrations and ion balance indications of aerosol acidity. Analysis of particle growth rate in comparison to other observations can classify the events and illustrate that urban and rural new particle formation and growth are the result of different causes. Periods of low observed PM2.5 mass, high number concentration, and low median diameter due to small fresh particles are associated with primary emissions for the urban sites; and with particle nucleation and growth for the rural sites. The observations of high PM2.5 mass, lower number concentrations, and higher median diameter are mainly due to an enhancement of photochemical reactions leading to condensation processes in relatively aged air. There are statistically different values for the condensation sink (CS) between urban and rural areas. While there is good association (r2 >0.5) between the condensation sink (CS) in the range of 8.35-283.9 nm and PM2.5 mass in the urban areas, there is no discernable association in the rural areas. The average values computed for the CS lie in the range 8.7×10-3-3.5×10-2 s-1. [ABSTRACT FROM AUTHOR]

The article presents a study which evaluates the use of Hamilton Rating Scale (HRS) for Depression in a general medical in-patient population. HRS was designed to measure the severity of depression in patients already diagnosed as having depressive illness. Here, it was used as part of a comprehensive evaluation of depression in 153 medial in-patients. All the patients had some symptom characteristic of depression as measured by HRS. Though the scores did not match with physician's diagnoses, they correlated as well with scores obtained on the Beck Depression Inventory and with other depressive criteria.

We used the Bond Defense Style and Cloninger Tridimensional Personality questionnaires to assess defense styles and personality dimensions in subjects with anxiety and depressive disorders. When measured against a comparison group, maladaptive defense style scores were significantly higher in those with major depression, panic disorder, generalized anxiety disorder, and social phobia, and higher at a trend level in the subjects with obsessive-compulsive disorder and mixed anxiety and depression. However, there were no differences in adaptive defense style scores between the subjects and the comparison group. The harm avoidance personality dimension scores were significantly higher in subjects with both anxiety and depressive disorders than in the comparison group. The harm avoidance scores correlated positively with the maladaptive defense scores, but negatively with the adaptive defense scores. These findings are discussed in terms of severity of illness, level of functioning, and relationships between Axis I and II disorders.

The State-Trait Anxiety Inventory (STAI) is one of the most widely used scales for the evaluation of anxiety in medical and, to a lesser extent, psychiatric patients. Although there is a relatively large amount of STAI data about anxiety for individuals with a variety of psychiatric disorders, the results of many anxiety studies include only state or trait and many studies have been influenced by comorbidity and by variations in diagnostic criteria used. We studied state and trait anxiety and compared the revised form of the STAI (Form Y) with the original (Form X) to evaluate the anticipated improvement in the measure. In addition, we compared the STAI results with those of another self-report measure (the Symptom Checklist-90 anxiety and depression scales) and also with interviewer-rated measures of anxiety (Hamilton Rating Scale for Anxiety) and depression (Hamilton Rating Scale for Depression). Results indicate that the STAI does not clearly differentiate anxiety disorders from depressive disorders and support the use of multiple tests and of both self-report and interviewer ratings in the evaluation of anxiety and depression in psychiatric patients.

We studied the use of the Symptom Checklist-90 (SCL-90) to differentiate between specific anxiety and depressive disorders and/or their symptoms in 280 patients with 6 DSM-III-R diagnoses: major depression (MD), panic disorder (PD), generalized anxiety disorder (GAD), social phobia (SP), obsessive-compulsive disorder (OCD), and mixed anxiety and depression (MAD). Using a comparison group, we found specific patterns for some of the diagnostic categories. Both the MD and MAD subjects had significantly high paranoid ideation, interpersonal sensitivity, hostility, and psychoticism, as well as high depression subscale scores; those with PD and GAD has the highest anxiety and somatization scores; and those with SP or OCD had a mixed pattern. When ranking the severity of psychopathology, the disorders ordered from most to least were MAD, MD, PD, GAD, SP, and OCD. Subsyndromal levels of symptoms frequently were associated with the various conditions. Use of the SCL-90 subscale helps to enlarge our understanding of the various anxiety and depressive disorders.

We studied Levenson's Internal (I), Powerful Others (P), and Chance (C) locus of control scales in 193 patients with six DSM-III-R diagnoses: Major Depression (MD), Panic Disorder (PD), Generalized Anxiety Disorder (GAD), Social Phobia (SP), Obsessive Compulsive Disorder (OCD), and Mixed Anxiety Depressive Disorder (MAD). Compared to the comparison groups (CG), we found specific patterns for some of the diagnostic categories. There were no significant differences between the I scale scores and of those in the different anxiety and depressive disorder groups and the CG. But, patients with MD, SP, or MAD had significantly higher P scale scores than the CG. Patients with MD, PD, SP, and MAD had higher C scale scores than the CG. The OCD patients had the lowest P and C scale scores of any of the groups and not significantly different than the CG. The findings have some research and clinical implications.

We have examined the numbers and types of symptoms in a sample of 90 patients with generalized anxiety disorder (GAD) and 77 patients with panic disorder (PD) collected from six different sites during the conduct of a multicenter clinical trial. This information was obtained utilizing the Health Questionnaire, a 47-item self-report list of medical symptoms, patterned after the Somatization Disorder section of the Diagnostic Interview Schedule. Although the patients in this sample had a wide variety of medically explained and unexplained physical symptoms, none of them qualified for a diagnosis of somatization disorder by DSM-III-R criteria. GAD and PD patients reported remarkably similar numbers of explained and unexplained medical symptoms. The panoply of somatic symptoms presented by these patients presents a formidable diagnostic challenge for clinicians. These findings suggest that the pattern of overutilization of medical services that is well documented for PD patients may also be found for GAD patients.

The purpose of this study was to determine the utilization of medical specialists by anxiety disorder patients. The setting was a university's clinical outpatient drug trails for anxiety disorders. The participants were subjects identified by advertisement and diagnosed by psychiatric interviews and, in some instances, also by structured interviews. The main outcome measures were the subject responses on a questionnaire listing medical specialists. A total of 94 subjects were surveyed. Primary care physicians (family medicine and internal medicine) were seen more often by panic disorder (PD) subjects than by obsessive-compulsive disorder (OCD) or generalized anxiety disorder (GAD) subjects. Gastroenterologists were seen most frequently by the GAD subjects; dermatologists and cardiologists by the OCD subjects; and otolaryngologists, obstetricians-gynecologists, neurologists, and urologists by the PD subjects. The PD subjects saw more specialists than the subjects with the other disorders. Medical specialists need to increase identification of patients with various anxiety disorders to relieve suffering, improve health care practices, and obtain favorable cost:benefit ratios.

In consulting with anxious medical patients, the psychiatrist needs to consider the possibility of organic disease, differentiate anxiety and depression, and ascertain whether comorbid conditions are present. Guidelines for differential diagnosis are presented. With the anxious patient, treatment goals are to establish rapport, help the patient mobilize intellectual defenses, and enhance self-esteem. Many anxious medical patients will benefit from benzodiazepines, selective serotonin reuptake inhibitors, or doxepin. The therapeutic potential of the consultation is increased by the psychiatrist's meeting with the nursing staff and by a humanistic approach to the patient.

At least 20% of medical patients have anxiety disorders and are in need of treatment, but work with anxious patients is complicated by their distortions and often negative attitudes toward physicians and hospitals. Consultation is complicated by inconsistent referral patterns. Most anxious medical patients accept psychiatric consultation: only 15% to 20% have negative attitudes toward psychiatry. Guidelines for referral are presented.

People with chronic mental illness present complex challenges for the design of health care financing reforms. In this position statement from the committee on psychiatry and community of the Group for the Advancement of Psychiatry, the authors describe chronic and severe mental illnesses as psychiatric illnesses that require acute and ongoing psychiatric assessment and treatment, as chronic medical diseases that require ongoing rehabilitative services, and as persistent disabilities that need ongoing supportive care and social services. Any proposal for health care reform must ensure parity of chronic psychiatric illnesses with other psychiatric conditions. It must also reimburse psychiatric rehabilitation at parity with other medical rehabilitation and provide equal access to and reimbursement for broad ancillary health services that reduce costs and improve quality of life.

In May, 1983, when the new University of Louisville teaching hospital was opened under the auspices of Humana Corporation, it became the first university hospital operated by a for-profit corporation. We describe the agreement that launched this venture and summarize the experiences of the Department of Psychiatry and Behavioral Sciences with Humana, Inc., during the past 3 years. We review our impressions of both the positive and negative effects that the for-profit managing style has had thus far on the teaching programs of the Department. Based on our experiences, there are financial and other benefits, but we think that there are also potential dangers for the future of psychiatric education inherent in the administration of a teaching hospital by a for-profit corporation. The "atmosphere of business" that pervades the climate of opinion in the United States in the 1980s and is merely epitomized by the increasing role of enterpreneurial groups in medicine can be antithetical to principles of psychiatry and has implications for psychiatric education in the future. Awareness of these developments is a task for psychiatric education and, when it is possible, comparative studies of residents and their programs in nonprofit and for-profit hospitals should be conducted.

The author reviews the history of consultation-liaison psychiatry from its roots in the 1751 charter of the Pennsylvania Hospital in Philadelphia. The field has evolved through three distinct phases and has currently entered a fourth stage, called the consolidation phase, which is characterized by shrinkage of programs, marked reduction in liaison activities, and anxiety about its validity and future. While the survival of consultation-liaison psychiatry is threatened by inadequate financial resources, the author believes that the increasing demand for C-L psychiatrists will eventually mandate a greater investment in the special expertise they offer.

This study reports the results of a household survey and search of death certificates that show a relationship between depression, anxiety, and subsequent mortality. It is part of an effort to develop practical epidemiologic techniques for continuous assessment of community mental health. Use is made of the population attributable mortality rate, estimated from a comparison of the prevalence of a given factor in life and at death. The study estimated attributable mortality prospectively by following up participants in a mental health survey of Alachua County, Florida, for up to four years. Of eight mental scales examined, five (mood, depression, somatic symptoms of anxiety, the Health Opinion Survey, and selected psychopathologic symptoms) showed significant association of scores with community mortality. The data suggest linkages of mental factors to mortality of an order of magnitude sufficient to warrant consideration of these factors as leading causes of death.

An epidemiologic investigation of the mental needs and services of 1645 respondents, aged 17 to 92 years and living in a representative southeastern county in Florida, revealed that 7.8% of the sample lived in crowded conditions. The crowded respondents scored significantly higher than did the uncrowded on both a depression scale and on the Health Opinion Survey. Associations between crowding and high scores on both scales were strongest among: respondents in the childrearing and middle years of life, blacks at all income levels, whites in the intermediate annual family income range of $6000 to $9999, and especially, females rather than males. Consistently, the crowded black population, and particularly, crowded white women, had much higher scores than did the uncrowded women. A multiple regression analysis showed that three variables--being a female, having a lower income, and crowding--accounted for 16.5% of the variance. The discussion emphasizes that the relationship between crowding and higher scores on indices of emotional distress is quite complicated. In crowded situations, depression may be a costly, semi-adaptive reaction to excessive interpersonal stimulation. Women living in crowded situations appear to be at high risk for depressive illness; their plight brings to mind the classic animal experiments which showed that the maternal behavior of females deteriorated in crowded situations.

The authors describe the establishment of a unit for children that emphasizes the integration of the pediatric model of acute, short-term inpatient care with the psychological and developmental perspective of the psychiatric model. Of the 145 children admitted during the first year, more than 33% manifested aggressive or hyperactive behavior and 25%, depression or suicidal behavior. Eighty-five percent were discharged to their homes or previous residences after an average length of stay of 24 days. The authors suggest that similar units established in children's hospitals or general hospitals could help meet the urgent need for acute inpatient psychiatric care of children in this country.

The authors report data collected on 3674 subjects between 1970 and 1974 as part of an epidemiologic field survey of mental disorder in the southeastern United States, an area which was undergoing rapid sociocultural change. Rates of mental disorder, as measured by the Global Psychopathology Scale, are presented for various sociodemographic groups and are consistent with trends found in previous studies. Analysis of variance and multiple regression techniques are used to explore the relationships among awareness of social change, sociodemographic variables, and psychopathology. Low awareness of change is found to be consistently associated with low psychopathology scores across all socioeconomic groups. The authors postulate a "denial" or "filter" mechanism which may protect particularly vulnerable individuals from the psychic distress accompanying social change.