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Extant measures of spirituality-religiosity, not developed specifically with substance abuse treatment populations in mind, may not be culturally appropriate in regard to either: (1) the 12-step “culture” found in many treatment programs; or (2) racial-ethnic minority populations overrepresented in publicly funded programs. A 40-item four-dimensional measure was developed, which differentiates “religiosity” (religious practices) from “spirituality” (an individual's relationships with God/higher power, others, and self). Instrument development involved: qualitative focus groups with individuals in seven diverse Texas treatment programs; quantitative exploratory and confirmatory (CFA) analyses to test the four-factor model conducted using data from 237 diverse clients in treatment programs in Tennessee and Virginia. Confirmatory analyses indicate acceptable fit indices (>0.90) for the four-factor model, and acceptable reliability estimates for all subdimensions (≥0.70) provide further support for the measures. Results support the potential usefulness of the measures. [ABSTRACT FROM AUTHOR]

Reliable and valid measures of religiosity and spiritual dimensions appropriate for ethnically diverse groups are needed. I examine the factor structure of the relatively new Fetzer multidimensional measure (Fetzer Institute 1999). Confirmatory factor analyses (CFA) of national data collected in the 1998 General Social Survey are conducted to (1) test the fit of the proposed dimensionality of the Fetzer measure, specifically comparing the Fetzer structure with a simpler single-factor model suggested by preliminary exploratory factor analyses; and (2) evaluate ethnic differences in factor structure of the Fetzer items. Data from 1,201 adults, 1,019 whites and 182 African Americans, are examined to compare the fit of the multidimensional Fetzer model against an alternative single-factor (“unitary spirituality”) model. CFA analyses indicated that only the Fetzer models had acceptable fit indices (NFI and/or NNFI approaching or reaching 0.90). Ethnic differences in loadings, while significant, were not substantively different. These findings suggest that a multidimensional measure like the Fetzer is useful for multiethnic research and that combining the daily spirituality and values/beliefs dimensions into a single factor provides a simpler model overall (compared to the Fetzer model separating these dimensions out) while providing acceptable fit. [ABSTRACT FROM AUTHOR]

The present study examined career pathways and current work patterns for 110 graduates of an internship program. Results show that the group trained after 1980 went into private practice more rapidly than those trained prior to 1980. Both groups do extensive psychological testing. Implications are discussed. [ABSTRACT FROM AUTHOR]

An integrated model of change in knowledge, highlighting the role of technologic and organisational paradigms and the activities of professional and extra-professional groups, is used to clarify the historical development of psychiatry and to account for current specialty choice trends. American psychiatry and medicine stem from disparate scientific/philosophical roots. A review of events leading to the establishment of psychiatry as a medical specialty indicates that the merger of psychiatry and neurology may have stemmed as much from professional competition as from technological or paradigmatic convergence. Recent perceived declines in the choice of psychiatry as a medical specialty are examined in light of this sociology of knowledge perspective. Declining choice of psychiatry as a specialty reflects both underlying paradigmatic conflicts with medicine as well as declining federal support for psychiatric training. Solutions proposed for the perceived problem within psychiatry are designed to solidify ties with medicine, increase political power and prestige, and retain federal support. [ABSTRACT FROM AUTHOR]

Data from a community sample of 1,784 Anglo, African-American, and Mexican-American adults were examined to assess: (I) the nature and magnitude of observed racial/ethnic and acculturation level differences in depression, (2) the relative contribution of sociodemographic and psychosocial factors (fatalism and religiosity) to observed differences, and (3) the joint effects of fatalism and religiosity as sociocultural resources with regard to depression in differing racial/ethnic and acculturation level subgroups. Analyses indicate the most dramatic differences in depression among males- African Americans were roughly similar to Anglos and levels of depression were significantly higher among the least acculturated Mexican Americans relative to Anglos, even after statistical controls. Acculturation level differences among Mexican-American females were explained by statistical controls. Lower levels of depression among more highly acculturated than among less acculturated Mexican Americans provide little support for a simplistic stress formulation of acculturation. Rather, the interplay of acculturation, Fatalism, and religiosity supports a more complex cultural marginality model, emphasizing the consistency of attitudinal elements and language use as facilitators or inhibitors of assimilation into Anglo culture. Both those who successfully acculturate and those who are most insulated in traditional culture appear least depressed from this perspective. [ABSTRACT FROM AUTHOR]

Data from random samples of 645 rural White respondents, 398 rural Black respondents, and 700 urban residents of Nashville, Tennessee (375 White, 326 Black participants), are presented that address urbanicity and race differences in depressive symptoms, psychophysiologic symptoms, and general well-being. After demographic controls, significant urban-rural differences were found only on depressive symptoms, with greater distress in rural areas. Black participants had significantly higher depression scores than White respondents, though race differences were reversed on psychophysiologic symptoms and general well-being. Interaction effects were striking. Urban-rural differences were specific to Black participants - rural Black residents had higher depressive symptom scores than urban Black residents. These differences were reversed on psychophysiologic symptoms and well-being. Race differences were specific to the rural sample; rural Black respondents manifested more depressive symptoms than did rural White participants, though rural White residents had more psychophysiologic symptoms and lower well-being. These findings withstood further controls for migration/length of residence. Implications of these findings for stress models of urbanicity and race differences are considered. [ABSTRACT FROM AUTHOR]

It is argued that demographic factors alone fail to account for public attitudes toward mental illness. Medical and moral lay images of mental illness provide a knowledge base from which tolerance arises. Path analysis of data obtained from 713 rural Tennessee adults indicated low tolerance among those endorsing either lay image. Demographic background variables exerted no direct effects upon tolerance-these effects were mediated by lay images. Comparison of these data with research on attitudes toward alcoholism brings into question the relevance of attributed responsibility for different types of deviant behavior. Finally, the study raises questions regarding the assumption that greater knowledge and understanding will necessarily yield greater tolerance of deviance. [ABSTRACT FROM AUTHOR]

This study examines the possible stress-buffering properties of personal competence and social support with regard to depressive symptoms. The hypothesis examined was that individuals lacking both internal and external resources would manifest higher levels of symptoms as a result of increasing number of life events than would individuals possessing such resources. Further, variation by gender was considered. Data on depressive symptoms (CES-D Scale), personal competence, social support, and life events were obtained in a 70-minute interview with randomly selected samples of white married adults (n = 965) from rural counties of Tennessee, Oklahoma, and Ohio. Analyses indicated both the main and buffering effects of personal competence and social support for the total sample. However, these effects varied by sex. While personal competence and life events had consistent main effects for both married males and females—individuals with more stress or lower levels of competence had higher levels of symptoms—effects of social support were more pervasive among the females. Finally, personal competence appeared to have a greater buffering effect than the presence of social support alone. There was also an unanticipated tendency for greater vulnerability to stressors among individuals (particularly males) under conditions of low competence and high support. [ABSTRACT FROM AUTHOR]

This study of 200 adults receiving outpatient services in rural Middle Tennessee was conducted to provide data on the validity of the CES-D as a measure of depressive symptomatology. Specifically, the study sought to determine the CES-D's ability to discriminate between outpatients and a sample of community residents, between patient groups reflecting different diagnostic classifications and levels of problem severity, and based upon such comparisons, to select cutting points on the CES-D which would indicate levels of depressive symptomatology which denote a need for services. The data indicated that the CES-D distinguished (t) between patients and nonpatients, (2) among various patient groups, and (3) among depressed patients with varying levels of problem severity. Further, the study cites the utility of new cutting points of 17 and 23 to provide an estimate of "possible" and "probable" caseness within the community. The study provides support for the utility of the CES-D in determining levels of depressive symptomatology in the population. [ABSTRACT FROM AUTHOR]

The relationship between race and psychiatric impairment was examined with regard to three measures of psychiatric status. Data on the Health Opinion Survey, the Center for Epidemiologic Studies-Depression Scale, and the General Weil-Being Schedule collected on a rural Tennessee sample (n = 713) indicated a significant zero-order relationship between race and impairment only for the depression index. No race differences were, obtained when controls for SES-related variables were instituted. The data support the recent suggestion that higher levels of impairment among blacks may be an artifact of social class standing. [ABSTRACT FROM AUTHOR]

This household survey of 713 adults residing in nine rural Middle Tennessee counties was conducted to estimate the prevalence of psychiatric impairment in the rural population, to determine which groups in the population are characterized by higher levels of impairment, and to assess the validity of three indices of psychiatric impairment (HOS, CES-D, and GWB). The data indicate that approximately 12% of the rural population may be impaired and that impairment is most likely among females, the divorced, widowed, or separated, and those in lower socioeconomic strata. While depression was more common among the young, physical and psychosomatic complaints were more common among older respondents. Further, respondents classified as impaired by the indices tended to view themselves as having "substantial" or "major" problems and were likely to feel that they might require professional help. While the GWB appeared to discriminate between users and nonusers of services, the other indices were less effective as predictors of service utilization. [ABSTRACT FROM AUTHOR]

A discussion of experimental research as practical action applies the ethnomethodological critique to research in experimental social psychology. While research on demand characteristics may meet some of the ethnomethodological criticisms, it may not provide a set of exemplars around which the practical activity of experimentation can be organized. "Stooge detection" is a practical problem often faced by experimenters. My data suggest that stooge detection may, in certain circumstances, he a member's strategy for dealing with a problematic experimental setting. This view has implications for notions of experimental "bias." [ABSTRACT FROM AUTHOR]

In this article the author the discusses the importance of assessing the efficacy of treatment fidelity in the evaluation of public health interventions. He is critical on the continued issue on treatment fidelity and suggests the use of theory to improve interventions, based on the article by Belinda Borelli which focuses on assessing public health interventions. Also investigates is the relevance of treatment fidelity to behavioral interventions.