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ABSTRACT: The Schwartz Outcome Scale-10 (SOS-10) is a 10-item self-report that measures quality of life and psychological well-being. It is easy to administer and score, and past research has revealed its utility, validity, and reliability with different samples (i.e., clinical and nonclinical) and in different clinical settings (i.e., inpatient, outpatient, nonpsychiatry medical settings). The present study looks to investigate the utility of the SOS-10 in measuring psychological well-being and quality of life with the 28-day inpatient chemical dependency sample. In addition, the current study looks to investigate its ability to be used as a treatment outcome measure for chemical-dependent inpatients. The results revealed that the SOS-10 was associated with aspects of interpersonal dependency and alexithymia in predicted ways. The SOS-10 was positively associated to 'Healthy Dependence' and negatively related to alexithymia and 'Destructive Overdependence' and 'Dysfunctional Detachment.' The results also showed that the SOS-10 showed healthy change from admission to discharge and that this change was paralleled by healthy change in interpersonal dependency and alexithymia. [ABSTRACT FROM AUTHOR]

The Schwartz Outcome Scale-10 (SOS-10) is a 10-item questionnaire that measures the broad domain of psychological well-being and quality of life. The SOS-10 is easy to administer and score. Past research has shown its utility, reliability and validity in different clinical settings (i.e., inpatient, outpatient and non-psychiatry medical settings) and with diverse clinical populations in measuring treatment outcome. The present study looks to extend the construct validity of the SOS-10 to assessing quality of life and psychological health in non-clinical samples as well. The results reveal that the SOS-10 is associated in predicted ways with established measures of attachment, interpersonal distress, alexithymia and the big five model whose construct validity and psychometric soundness has been well documented. The SOS-10 was also associated in predicted ways with ratings of childhood memories and the length of the participants' longest romantic relationship. Copyright (c) 2009 John Wiley & Sons, Ltd.Key Practitioner Message:* The Schwartz Outcome Scale-10 is a measure of overall psychological health and well-being which is cost effective, short, easy to administer and score, and evidences strong psychometric properties. It can be utilized with a number of different populations and in diverse settings. [ABSTRACT FROM AUTHOR]

A functional observational battery and an automated test of motor activity have been developed in this laboratory in response to present and future needs for routine assessment of behavioral function in acute and repeated dose rodent safety assessment studies. Data have been collected for untreated 42–49-day-old animals of both sexes in order to gain information on normal ranges of responses in animals of this age as well as to determine the relative variability of the various test measures. Data will continue to be added to this database, both for animals of this age range and for other age ranges. A validation strategy has been outlined that emphasizes the characterization of behavioral profiles of both pharmacologic agents and chemically related neurotoxins, as well as the importance of determining how well these results translate to those observed in humans exposed to the same test agents. The logistical and economic factors associated with neurobehavioral testing and the importance of intralaboratory standardization are discussed in detail. Both controllable and difficult to control environmental and experimental variables that can affect the outcome of a behavioral study are identified. The problems associated with neurobehavioral data interpretation and the importance of a multisystem approach to interpreting functional changes in the context of toxicology studies are discussed. [ABSTRACT FROM PUBLISHER]

Claudin-18 splice variant 2 (CLDN18.2), a tight junction protein, is a highly cell type-specific antigen that is expressed by differentiated gastric mucosa cells. The expression of CLDN18.2 in gastric mucosa cells may be retained upon malignant transformation and is displayed on the surface of several tumors, including gastric/gastroesophageal junction adenocarcinoma. Zolbetuximab is a genetically engineered, highly purified chimeric (mouse/human IgG1) antibody directed against CLDN18.2. Nausea and vomiting were observed as adverse events of zolbetuximab. To investigate the mechanism of nausea and vomiting in humans, we evaluated emesis (retching and vomiting) and conducted histopathologic assessment in ferrets after the administration of zolbetuximab. Emesis was frequently observed in all ferrets treated with zolbetuximab in the first hour after administration. Histopathologic assessment revealed the surface of the gastric mucosa was the primary site of emesis-associated tissue damage. The effect of antiemetics (dexamethasone, ondansetron, fosaprepitant, and olanzapine) on emesis induced by zolbetuximab was investigated. Fosaprepitant showed suppressive effects on emesis, and use of dexamethasone or concomitant use of fosaprepitant with other antiemetics tended to alleviate gastric tissue damage. The onset of emesis in humans receiving zolbetuximab may be associated with damage in the gastric mucosa, and antiemetics may mitigate gastrointestinal adverse events., Competing Interests: Declaration of competing interest All authors are employees of Astellas Pharma, Inc. or its affiliates., (Copyright © 2024 The Authors. Production and hosting by Elsevier B.V. All rights reserved.)

The Social Cognition and Object Relations Scale-Global (SCORS-G) has been used increasingly in multimethod psychological assessment contexts as a framework for eliciting personality information from narrative data collection techniques, the most popular of which is the Thematic Apperception Test (TAT). Although research on the reliability and validity of the SCORS system has evolved over the last decade, there are numerous psychometric and procedural shortcomings (and corresponding ethical issues) that should be considered when applying this methodology to the TAT in clinical and research settings. Chief among these concerns is a lack of normative benchmarking, variability in TAT card batteries that are administered across contexts (which limit generalization and direct research comparisons), ambiguous reliability and validity evidence (and lack of incremental validity), and redundancy in published studies (i.e., versions of the same data/samples presented repeatedly across research). There is also a dearth of information about how SCORS-G data are influenced by factors such as culture, language, cognitive functioning, and other variables that may impact narrative output, word count, and richness (and subsequent interpretation and clinical decision making). The review concludes with a discussion of the ethical implications of using the SCORS-G in clinical practice, and recommendation for a moratorium on its use until minimum psychometric standards can be established and greater clarity is achieved surrounding its use with diverse and vulnerable populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Objective: The goal of the study is to quantify the reduction in the cases of influenza and how this decrease in incidence correlates with the execution of masking requirements in public as well as social distancing., Methods: Influenza statistics were collected from Northwell Health, a 23-hospital system located throughout New York State. Positive influenza results were collected representing the 2018-2019 Flu season, 2019-2020 Flu season, and compared to the 2020-2021 Flu season, which corresponded to the mask mandates and social distancing measures implemented in NYS., Results: Our data showed a dramatic decrease in influenza rates during the 2020-2021 Flu season, which corresponded to NYS's strict social distancing and mask requirements during the pandemic. This shows a steep decline correlating with the implementation of public health mandates directed at decreasing the spread of aerosolized particles between members of the population., Conclusion: Our data show a significant decrease in the number of positive influenza tests during the same period of time when COVID-19 social distancing and mask-wearing requirements were in effect., Competing Interests: Conflict of interest The authors do not have any conflicts of interest and this project was not supported by grant funding., (© 2023 Greater Baltimore Medical Center.)

Abstract: Research shows that the subscales of the Relationship Profile Test (RPT) are related to adult attachment. Gender differences have been implicated, but findings are inconsistent in terms of replication. A limited amount of research has been conducted on ethnic differences in the context of interpersonal dependency. This study aims to bridge the gap in the literature in terms of using the RPT to predict attachment styles and to assess gender and ethnic group differences in RPT scores. Four samples from various treatment settings were combined to yield a heterogeneous group of ethnically diverse men and women (N = 470) with a mean age of 31.96. No gender differences were observed; however, ethnic differences were noted, with the RPT scales predicting unique variance in secure and insecure attachment styles. This study evidences the incremental validity of the RPT scales when predicting adult attachment style with consideration of ethnic group differences, which can help inform the treatment and assessment process., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Palliative medicine can be essential in helping to align patients' goals of care with their treatment team. Referrals for palliative medicine are more advantageous when initiated in the emergency department as this is the first point of contact for seriously ill patients being admitted to the hospital. This paper highlights a quality improvement project initiated to address knowledge gaps in palliative medicine with emergency department (ED) staff and to increase referrals for palliative medicine from the ED. The palliative medicine staff held an in-service training with the ED staff which focused on defining palliative medicine and the importance of early consults when the patient presents in the ED. Palliative medicine staff also highlighted the differences between palliative medicine and hospice care, when and how to initiate a consult for palliative medicine, as well as how to contact the palliative medicine division. The results showed that after this educational intervention the number of palliative medicine consults increased three-fold. Before the educational intervention, monthly averages for palliative medicine were 6 and after rose to 18.9 per month.

As of June 15, 2021, from 672,000 to 912,000 deaths have been averted through vaccination of 48% of the US population. Because 52% remain unvaccinated, 728,000 to 988,000 lives remain at risk. These deaths can be spared, and the pandemic stopped in its tracks provided a final national vaccination rate of 84% is achieved. We aim to demonstrate in our analysis the number of lives saved that can be attributed to CV-19 vaccination vs the mortality rate of natural infection seen in unvaccinated individuals. However, time is short given the recent exponential rise of the highly contagious SARS-CoV-2 Delta variant. Delta infection results in a thousand-fold increase in viral load and a transmissibility 2.25x that of the original SARS-CoV-2 strain. Predominance of the Delta variant has already resulted in Covid-19 surges in area with low vaccination rates. An aggressive and timely vaccination campaign is being attempted. We hope our analysis helps convince individuals 'on the fence' that vaccination is essential if the pandemic is to be ended in the United States., Competing Interests: Conflict of interest The authors report no conflicts of interest., (© 2022 Greater Baltimore Medical Center.)

Background: The Accreditation Council of Graduate Medical Education (ACGME) currently requires Internal Medicine (IM) GME programs to incorporate educational opportunities for training and structured experiences in Palliative and Hospice Medicine. Miscomprehension of the differences between palliative medicine and hospice care is a barrier for IM residents ordering palliative consults as many residents may underutilize palliative medicine if a patient is not appropriate for hospice., Objective: This educational performance improvement (PI) project assessed 3 domains, including Medical Knowledge (MK) of palliative versus hospice medicine at baseline and following a single didactic session. Additionally, the number of palliative consults ordered was used as a surrogate for interpersonal and communication skills (ICS) and patient care (PC) domains., Methods: An 8-question survey and 30-minute didactic session were created based upon experientially-determined issues most confusing to IM residents. Participants included 33 IM residents (PGY-1s-3 s) from July 2018 (first cohort) and 32 (PGY-1 s and any PGY-2s-3 s who did not participate in the first cohort) from July 2019 (second cohort)., Results: 65 of a possible 73 residents participated (89% response rate) Pre-test Questions 5, 6, and 8 correct responses were <50% in both cohorts with average scores, respectively, of 43.1%, 35.4%, and 40%. Residents improved on the post-test for Q5, 6, 8 to, respectively, 80%, 86.7%, and 48.3% (t = 7.68, df = 59, p < 001). Correct Q1 responses declined in the first cohort, but clarification for the second cohort improved from pre-test (36.4%) to post-test (65.5%). The total number of palliative consults placed by IM residents increased as well., Conclusions: Baseline MK of palliative versus hospice medicine was <50% on 4/8 questions. A brief educational session significantly improved residents' short-term comprehension and increased the number of palliative consults.

Introduction : Many internal medicine residents struggle to prepare for both the ITE and board test. Most existing resources are simply test question banks that are not linked to existing supporting literature from which they can study. Additionally, program directors are unable to track how much time residents are spending or performing on test preparation. We looked to evaluate the benefit of using this online platform to augment our pulmonary didactics and track time and performance on the pulmonary module and ITE pulmonary section. Method : During the month-long live didactic sessions, residents had free access to the pulmonology NEJM K+ platform. A platform-generated post-test was administered with new questions covering the same key elements, including the level of confidence meta-metric. An anonymous feedback survey was collected to assess the residents' feelings regarding using the NEJM Knowledge+ platform as compared to other prep resources. Results : 44 of 52 residents completed the pre-test. 51/52 completed the month-long didactic sessions and the post-test. Residents' score improvement from % correct pre-test (M = 46.90, SD = 15.31) to % correct post-test (M = 76.29, SD = 18.49) correlated with levels of mastery (t = 9.60, df = 41, p < .001). The % passing improved from 1/44 (2.3%) pre-test to 35/51 (68.6%) post-test, also correlating with levels of mastery. Accurate confidence correlated with improvement from pre to post test score (r = -51, p = .001). Survey feedback was favorable., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.)

Personality pathology is conceptualized, in part, as impairments in self and interpersonal functioning. Although most of the research has focused on adult samples, fewer have looked at this relationship in adolescent samples. This paper investigates the relationship between clinician-rated personality prototypes, the Shedler-Westen Assessment Procedure-Prototype Matching Adolescent Version (SWAP-A-P) derived from the SWAP-II-A, and a measure of self and interpersonal functioning, the Social Cognition and Object Relation Scale-Global Rating (SCORS-G). Clinicians rated 66 adolescents hospitalized at a safety net teaching hospital in the northeast. The patient's individual and group therapist rated the patients at discharge using the SWAP-A-P and the SCORS-G at discharge blind to each other's ratings. Results showed that more severe personality pathology was linked with more impairments in self and interpersonal functioning., (© 2020 John Wiley & Sons, Ltd.)

In 2012, Centers for Medicare and Medicaid Services (CMS) announced it would penalize any hospitals that had 30-day readmission rates for heart failure (HF) patients above 20%. Mather Hospital Northwell Health, a community teaching hospital, organized a proactive task force to meet these goals. We describe our hospital-wide Readmission Prevention in Heart Failure (RAP-HF) project. We focused on the following interventions: early identification of patients at risk for readmission, discipline-specific mitigation planning by the interdisciplinary rounding team, enhanced medication education for heart failure patients, education of family/caregivers on medication and heart failure symptoms, facilitation in scheduling of post-discharge follow up visits and hard-wired communication between hospital and post-discharge care providers. We saw a 25.53% decrease in 30-day readmission rates., Competing Interests: No potential conflict of interest was reported by the authors., (© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.)

Newly admitted inpatients in a 28-day chemical dependency rehabilitation unit completed the Personality Assessment Inventory (PAI) at admission and measures of clinical symptomatology (Symptom Checklist-90-Revised) and clinical outcome (Schwartz Outcome Scale-10) at admission and discharge. PAI drug and alcohol scale scores were clinically elevated in this inpatient sample. Modest elevations were found on scales measuring stress, depression, and antisocial and borderline features. Lower scores on most PAI clinical scales were associated with greater symptom reduction and improved psychological well-being, while controlling for pretreatment levels. Multivariate analysis controlling for contributions of clinical scales measuring borderline, depressive, and antisocial traits, as well as pretreatment outcome measures, demonstrated that the PAI Suicidal Ideation and Treatment Rejection scales were significant individual predictors of symptom reduction and improved psychological well-being, respectively, although the treatment scales as a group failed to incrementally contribute to prediction. Overall, the results support the clinical utility of using the PAI to predict clinical improvement among inpatients treated for substance use disorders.

Background: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) created an ABCD tool to assess staging and severity of COPD subgroups that respond to LAMA or LABA with improved quality of life and reduced exacerbations. Our study assesses perception of physicians at five community hospitals towards LAMA use for patients admitted with COPD exacerbations according to the GOLD guidelines and describes the experience at our hospital., Methods: Electronic survey forms regarding LAMA use and the GOLD criteria ABCD for COPD treating physicians were sent to five hospitals. A one-year chart review at our hospital determined prevalent use of a maintenance LAMA or LABA inhaler in patients admitted with acute COPD exacerbation. Currently, our EMR does not require a field for the GOLD ABCD categorization., Results: We obtained a 33% (45/136) response rate. Of these, 63% felt a LAMA to be essential on formulary; 60% were neutral or unlikely to initiate LAMA on admission; 47.7% likely or very likely to start a LAMA during hospitalization; 82% were neutral to very likely to discharge a patient on a LAMA if deemed necessary for maintenance. Of those admitted for acute COPD exacerbations to our hospital, over a third of COPD patients were not on a maintenance LAMA or LABA., Conclusions: Most physicians felt it important to prescribe a maintenance LAMA to COPD patients hospitalized for acute exacerbation. Our hospital's use of LAMA or LABA demonstrates the need to incorporate strategies to encourage appropriate prescribing of these LA inhalers per GOLD guidelines., Competing Interests: This manuscript is original research, has not been previously published and has not been submitted for publication elsewhere while under consideration. Authors declare no conflict of interest with this manuscript., (© 2020 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of Greater Baltimore Medical Center.)

The Diagnostic and Statistical Manual of Mental Disorders (5th ed. [ DSM-5 ]; American Psychiatric Association, 2013) introduced the Alternative DSM-5 Model for Personality Disorders (AMPD). Criterion A of the AMPD conceptualizes level of personality functioning (LOPF) in terms of self- and interpersonal functioning. This article describes the development of a short form for the DSM-5 Level of Personality Functioning Questionnaire (DLOPFQ). A sample of 1,279 participants was drawn from community, clinical, and college settings. All participants completed the DLOPFQ full form. The sample was split into a derivation sample ( n  = 640) and a validation sample ( n  = 639). Exploratory factor analysis of the derivation sample data was used to select short-form items. Using the validation sample, confirmatory factor analyses (CFAs) were used to assess fit for proposed item-to-subscale assignments. Short-form subscales had good internal consistency estimates, correlated strongly with full-form subscales, correlated with one another, and were associated with relevant constructs. CFA supported a second-order factor model (i.e., four factors loading onto a higher order LOPF factor). Overall, the DLOPFQ Short Form provides a brief assessment of the constructs measured by the full form. Limitations of the study are reviewed, speculations for improving the measure are discussed, and suggestions for future directions are provided.

The present study aimed to compare personality profiles of alcohol use disorder and opioid use disorder patients in an inpatient chemical dependency rehabilitation unit using a multidimensional personality inventory, the Personality Assessment Inventory (PAI). Ninety-six patients meeting DSM-IV-TR diagnoses for alcohol use or opioid use disorders completed the PAI at admission. Results revealed largely normative patterns across most PAI scales, though alcohol use disorder patients showed clinically elevated scores on Alcohol Problems and Drug Problems, and opioid use disorder patients showed clinical elevations on Antisocial Features, Borderline Features, and Drug Problems. Opioid use disorder patients showed, on average, significantly higher scores than alcohol use disorder patients on Borderline Features, Antisocial Features, Drug Problems, and Suicidal Ideation. Alcohol use disorder patients showed significantly higher scores than opioid use disorder patients only on Alcohol Problems. Discriminant function analysis (DFA) showed discriminability between patient groups using the PAI clinical scales and treatment scales, highlighting higher levels of disturbed functioning among opioid use disorder patients with respect to clinical syndromes, especially borderline features, antisocial features, suicidal ideation, and anxiety. These findings underscore the need to tailor treatment recommendations to distinctive patterns of personality pathology, especially among opioid use disorder patients., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The ability to evaluate patients' level of personality functioning in assessing personality disorders has become increasingly important since the DSM-5 Section III hybrid system of personality disorder assessment was released. One measure developed to assess this criterion is the DSM-5 Levels of Personality Functioning Questionnaire (DLOPFQ; Huprich et al., 2017 ), which assesses individuals' self and other representations in four domains-self-direction, identity, empathy, and intimacy-across two contexts-work or school and relationships. A sample of 140 psychiatric and internal medicine outpatients were administered several questionnaires, including the DLOPFQ. Provider ratings also were obtained for level of functioning and DSM-5 pathological personality traits. Several of the DLOPFQ scales were significantly correlated with self-reported and provider-reported measures of DSM-5 trait domains and levels of functioning, along with self-reported measures of effortful control, overall physical and mental health, and well-being. Certain DLOPFQ scales and subscales were associated with provider ratings of likeability and patient contact with the providers. However, relatively modest validity coefficients, as well as poor discriminant validity of domain scales, indicate further research and measure refinement might be needed. It is concluded that, although further research is necessary, the DLOPFQ could be useful for understanding patients' personality pathology in clinical settings.

With the introduction in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) of a hybrid system of personality disorder assessment, the ability to assess patients' traits, as well as their level of personality functioning, has become increasingly important. To assess this criterion, the DSM-5 Levels of Personality Functioning Questionnaire (DLOPFQ) was developed. The DLOPFQ assesses individuals' self-impairments and other impairments in several domains (self-direction, identity, empathy, and intimacy) and across 2 contexts (work/school and relationships). A sample of 140 psychiatric and medical outpatients was administered the DLOPFQ and several other measures to assess its reliability and construct, incremental, and discriminant validity. The internal consistency and convergence with validation measures yielded generally meaningful and expected results. Several DLOPFQ scales and subscales were significantly correlated with measures of DSM-5 trait domains and levels of personality functioning. DLOPFQ scales also correlated with self-reported ratings of overdependence, detachment, healthy dependency, and overall mental health and well-being. The DLOPFQ also predicted interpersonal and general functioning beyond DSM-5 trait domains. These results support the reliability and validity of the DLOPFQ, which appears to be suitable for clinical use and warrants ongoing study. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The social cognition and object relations scale-global rating method is a clinical rating system assessing 8 domains of self and interpersonal functioning. It can be applied to score numerous forms of narrative data. In this study, we investigate the SCORS-G relationship to measures of alliance and readiness for psychotherapy with an adolescent inpatient sample. Seventy-two psychiatrically hospitalized adolescents were consented and subsequently rated by their individual and group therapist using the SCORS-G. The unit psychiatrist also completed an assessment of patients' readiness for inpatient psychotherapy. The patients completed a self-report of their alliance with the inpatient treatment team as a whole. SCORS-G ratings were positively correlated with assessments of readiness for inpatient psychotherapy and patient-reported alliance. This study further demonstrates the clinical utility of the SCORS-G with adolescents., (Copyright © 2018 John Wiley & Sons, Ltd.)

The Social Cognition and Object Relations Scales-Global Rating Method (SCORS-G) contains 8 scales for coding narrative content. This study explores the factor structure of this measure using college (n = 171), outpatient (n = 239), and inpatient (n = 78) samples. Participants told stories to the Thematic Apperception Test (TAT; Murray, 1943) cards. Stories were transcribed and coded by blind raters using the SCORS-G. Cases were randomly assigned to an exploratory or validation group. Exploratory factor analysis with the exploratory group suggested 2- and 3-factor models. The Emotional Investment in Relationships (EIR) scale did not obtain a primary loading on any factor and was not included in subsequentmodels. After modifications, confirmatory factor analysis indicated good-to-adequate fit for 2- and 3-factor models. Both models showed good fit in the validation group and met criteria for invariance across models. Findings indicated that some SCORS-G scales tap cognitive-structural elements, whereas others assess affective-relational components of narratives. We found mild support separating the affective-relational scales in terms of internal representations for the self and others and relationships. The results reported here indicate that clinicians and researchers can calculate a separate cognitive-structural composite score and an affective-relational composite score when using the SCORS-G to rate TAT stories.

Background: Patient no-shows impede the effectiveness and efficiency of health care services delivery., Objective: To evaluate a 2-phase intervention to reduce no-show rates at an integrated care community health center that incorporates a teaching program for osteopathic family medicine residents., Methods: The Elmont Teaching Health Center (ETHC) is 1 of 5 community-based health centers comprising the Long Island Federally Qualified Health Centers. In August 2015, the ETHC implemented a centerwide No-Show Rates Reduction Initiative divided into an assessment phase and implementation phase. The assessment phase identified reasons most frequently cited by patients for no-shows at the ETHC. The implementation phase, initiated in mid-September, addressed these reasons by focusing on reminder call verification, patient education, personal responses to patient calls, institutional awareness, and integration with multiple departments. To assess the initiative, monthly no-show rates were compared by quarter for 2015 and against rates for the previous year., Results: We recorded 27,826 appointments with 6147 no-shows in 2014 and 31,696 appointments with 5690 no-shows in 2015. No-show rates in the first 3 quarters of 2015 (range, 18.2%-20.0%) were slightly lower than the rates in 2014 (20.1%-23.4%) and then changed by an increasingly wide margin in the last quarter of 2015 (15.3%), leading to a significant year (2014, 2015) by quarter (Q1, Q2, Q3, Q4) interaction (P=.004). Also, the change observed in Q4 in 2015 differed significantly from Q1 (P=.017), Q2 (P=.004), and Q3 (P=.027) in 2015, while Q1, Q2, and Q3 in 2015 did not significantly differ from one another., Conclusion: No-show rates were successfully reduced after a 2-phase intervention was implemented at 1 health center within a larger health care organization. Future directions include dismantling the individual components of the intervention, evaluating the role of patient volumes in no-show rates, assessing patient outcomes (eg, costs, health) in integrative care settings that treat underserved populations, and evaluating family medicine residents' training on continuity of care and no-show rates.

Research is needed to further examine the role of treatment alliance or engagement among child and adolescent patients in inpatient psychiatric settings. In this study, 72 newly admitted patients on an inpatient adolescent psychiatric unit completed measures of symptom severity and treatment alliance. Female patients showed greater symptom severity at both admission and discharge. Residualized gain score analysis showed that male gender predicted greater symptom reduction. Treatment alliance also predicted greater symptom reduction, but only among women. These results suggest that alliance or engagement with acute inpatient psychiatric services may play a more important role among women than men in predicting symptomatic change in severely disturbed adolescents. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

The content of Thematic Apperception Test (TAT) cards can, in some cases, influence how respondents form narratives. This study examines how imagery from select TAT cards affects the narratives of respondents from a nonclinical setting. The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011 ; Westen, Lohr, Silk, Kerber, & Goodrich, 1989) was used to rate narratives. Forty-nine college students provided narratives to 6 TAT cards. Narratives were rated by two expert raters using the SCORS-G. Consistent with prior research, Card 2 exhibited the most pull for adaptive ratings on SCORS-G scales, and 3 BM exhibited the most pull for maladaptive ratings. Findings for other cards were mixed. Although raters were highly reliable, internal consistency estimates were lower than desirable for 6 of the 8 SCORS-G scales. Variance component estimates indicated that card by person interactions accounted for the largest amount of variance in person-level scores. Results and limitations are discussed in light of prior research. We also make suggestions for further lines of research in this area.

The current study investigated the interrater reliability and validity of prototype ratings of 5 common adolescent psychiatric disorders: attention-deficit/hyperactivity disorder, conduct disorder, major depressive disorder, generalized anxiety disorder, and posttraumatic stress disorder. One hundred fifty-seven adolescent inpatient participants consented to participate in this study. We compared ratings from 2 inpatient clinicians, blinded to each other's ratings and patient measures, after their separate initial diagnostic interview to assess interrater reliability. Prototype ratings completed by clinicians after their initial diagnostic interview with adolescent inpatients and outpatients were compared with patient-reported behavior problems and parents' report of their child's behavioral problems. Prototype ratings demonstrated good interrater reliability. Clinicians' prototype ratings showed predicted relationships with patient-reported behavior problems and parent-reported behavior problems. Prototype matching seems to be a possible alternative for psychiatric diagnosis. Prototype ratings showed good interrater reliability based on clinicians unique experiences with the patient (as opposed to video-/audio-recorded material) with no training.

This study assessed the construct validity of the Relationship Profile Test (RPT; Bornstein & Languirand, 2003 ) with a substance abuse sample. One hundred-eight substance abuse patients completed the RPT, Experiences in Close Relationships Scale-Short Form (Wei, Russell, Mallinckrodt, & Vogel, 2007 ), Personality Assessment Inventory (Morey, 1991 ), and Symptom Checklist-90-Revised (Derogatis, 1983 ). Results suggest that the RPT has good construct validity when compared against theoretically related broadband measures of personality, psychopathology, and adult attachment. Overall, health dependency was negatively related to measures of psychopathology and insecure attachment, and overdependence was positively related to measures of psychopathology and attachment anxiety. Many of the predictions regarding RPT detachment and the criterion measures were not supported. Implications of these findings are discussed.

Psychologists in medical settings are frequently tasked with providing comprehensive evaluations of patients with complex medical and psychiatric conditions. In order to achieve these aims, standardized measures of neurocognitive and psychological functioning are often employed to empirically assess a patient's level of functioning across an array of relevant clinical domains. However, less is known about the degree to which cognitive impairment affects a patient's ability to complete these more comprehensive assessments, raising questions about test validity. The current study sought to contribute to this growing body of literature by examining whether neurocognitive functioning is associated with profile validity on the Personality Assessment Inventory (PAI) in both outpatient (N = 321) and inpatient (N = 131) psychiatric settings. In Study 1, results indicate that while multiple cognitive domains are associated with overall profile validity in psychiatric outpatients, attentional impairment specifically was found to be a significant predictor of profile invalidity after accounting for the effects of overall intellectual functioning (accounting for 13% of the variance overall). The magnitude of attentional impairment specifically, and number of impaired cognitive domains more generally, were also found to be meaningfully associated with overall profile validity. Likewise, in Study 2, PAI profile validity was found to be meaningfully associated with gross cognitive impairment on the WMS-IV Brief Cognitive Status Examination (BCSE) in an inpatient psychiatric setting, with almost half of the patients in the most impaired group yielding invalid PAI profiles. The clinical implications of these findings are discussed.