Gender and sexual minorities (GSM) experience considerably worse health outcomes than heterosexual and cisgender people, yet no comprehensive understanding of GSM health exists due to a dearth of research. GSM leaders in Dallas expressed need for a community needs assessment of GSM health. In response to this call, the Center for Psychosocial Health Research conducted a needs assessment of gender and sexual minority health in Dallas (35 interviews, 6 focus groups). Competency was one area highlighted and shared across existing research. Thus, the current study explored how competency impacts gender and sexual minorities' experience of health care in Dallas. We utilized a consensual qualitative research approach to analyze competency-related contents. The meaning and implications of emerging core ideas were explored. These findings were also used to develop a survey instrument.

To date, traditional behavioral interventions have done little to reduce the prevalence and transmission of HIV among African American men who have sex with men (AAMSM), a highly at risk group. Some researchers theorize that the lack of success may be because these interventions do not address contextual factors among AAMSM. Community-based participatory research (CBPR) is one approach to research with the potential to lead to effective interventions in the future. CBPR is a collaborative, mixed-methods and multidisciplinary, approach to scientific inquiry, which is conducted with, and within, the community. The current study follows the CBPR approach to engage and develop a relationship with the African American communities in the Dallas/Fort Worth Metroplex. Contextual issues were discussed in order to identify emerging themes regarding HIV health related issues among AAMSM to provide the groundwork for continued CBPR research and future interventions with AAMSM in the Dallas/Fort Worth Metroplex. To accomplish this goal, researchers began the CBPR process by conducting interviews and focus groups with a sample of approximately 62 (34 from key informant interviews, 28 from focus groups [gender balanced]) AIDS service organization leaders and workers, advocates, medical doctors and community members with first-hand knowledge of HIV health issues in …

Utilizing a sample of community-residing older adults, this pretest-posttest design evaluated the short term (approximately 1 week) impact on everyday functioning of Stress Inoculation (SI) training, a cognitive-behavioral intervention that is essentially a coping skills enhancement program. The targets of training were anxiety and concern about being able to successfully perform everyday living tasks. The training program was contrasted with a no contact (waiting list) control. In an effort to maximize the practical aspects of this study, the assessment battery included the use of two ecologically valid measures of everyday problem solving skills (one self-rated and one interviewer-rated). Also included were a measure of everyday intelligence widely used in gerontological research, two measures of self-efficacy, a geriatric depression scale, a state-trait anxiety scale, and a self-report measure of failures in perception, memory, and motor function. The results suggest that Stress Inoculation training is an effective intervention for improving everyday competence but that personal perceptions of self-efficacy and the emotional states of anxiety and depression mediate treatment effects. In general, only persons with lower levels of self-efficacy and higher levels of anxiety and/or depression saw improvement in their cognitive performance following SI training.

Little research has addressed the degree to which domestic violence is mutual and whether patterns are stable across women's relationships. Studies that exist have conflicting results. This study addressed these issues and the effects of sustaining past violence on women's expressions of violence in their current relationship. Archival data from a sample of severely psychologically abused community women (N = 92) and a sample of low-income community women (N = 836) were analyzed. Results showed the presence of mutual violence in women's current relationships which was not related to past partners' violence. Results regarding the stability of violence are weak, but indicate that the frequency and severity of violence across relationships sustained by women does not decrease across relationships. Overall, results supported the hypothesis that violence is mutual in the relationships of community women, although specific patterns may differ by ethnicity.

The purpose of the current study was to examine Dutton's (1992) model of moderating and mediating variables which may impact the relationship of violence from an intimate partner with the development of posttraumatic stress disorder (PTSD) symptoms. This model was tested within three ethnic groups (African American, n = 303, Euro-American, n = 271, and Mexican American, n = 260), of low income, community women in serious, long-term relationships. The importance of the differences and similarities observed are discussed within a framework of the PTSD as well as domestic violence literature.

Ninety-nine African-American undergraduates, at a historically Black college, completed the African American Acculturation Scale to compare fraternity/sorority members with independents' participation in Black cultural traditions versus dominant White society. Greek members were hypothesized to be more traditional, because these organizations represent ethnic enclaves, have duplicate institutions, and communicate ethnic socialization; findings did not support this, but reasons for joining did. They were more superstitious in their beliefs than nonmembers, likely related to pledgeship and initiation rituals. Validity data on the new measure were provided. Why participants join fraternities, why they like/dislike them, and what purposes they serve was also examined.

Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) are often reported as experiencing more stress than parents of normal children. The bulk of this research has been conducted primarily on a Caucasian population, however, providing little information regarding multicultural aspects of parenting stress. Research has also been lacking in attention given to the stress related to parenting a child with internalizing disorders. The purpose of this study was 1) to compare parenting stress reported by mothers of children with ADHD to parenting stress reported by mothers of children with depressive disorders, and 2) to compare parenting stress as reported by Caucasian, African American, and Hispanic mothers. Results indicated that mothers of ADHD children experienced more parenting stress related only to their children's hyperactive and distracting behaviors. Contrary to previous research, Caucasian mothers reported significantly more overall and parent-related parenting stress than African American mothers.

The purpose of this study was to examine the cognitive and emotional functioning of neglected, physically abused, and clinical control children between six and thirteen years of age who were referred for testing at the Dallas Child Guidance Clinic.

Upper limb deficiencies in children may be the result of trauma, disease, or congenital problems. Although biomechanical losses are the primary problem associated with a limb deficiency, the loss of such an obvious body part has cosmetic and psychosocial implications as well. Fitting a child with a prosthesis typically is the treatment chosen by families. Presently, there are three types of prostheses available for pediatric amputees, including passive, cable-operated, and myoelectric arms, but the myoelectric appears to be the most popular choice of children and their families. However, there is growing concern among clinicians that, despite its advanced technological capabilities, the myoelectric prosthesis is chosen for aesthetic rather than functional reasons. It is difficult, then, to justify the expense of fitting a myoelectric prosthesis when a more inexpensive prosthesis, or none at all, would be a more appropriate prescription. The question of when to prescribe a myoelectric prosthesis for a pediatric patient remains one of the most controversial questions in the field of prosthetics today due to this cost/benefit issue. In this study, the researcher examined psychological factors that may influence whether or not a child will wear a prosthesis and how that prosthesis will be used. Thirty prosthetics patients …

The objective of the present study was to evaluate the relationship between a set of cofactors and severity of cognitive impairment, to determine if there were any factors which significantly predicted more severe neurocognitive deficits in persons with AIDS. Twenty-four male volunteers recruited from community groups and physician referrals participated. Subjects completed several self-report questionnaires eliciting information regarding demographics and risk factor variables, in addition to a comprehensive battery of neuropsychological tests. A severity of cognitive impairment summary score was computed for each subject, reflecting both the number of impaired tests and their distance in the impaired direction from normative data. Neither CD4 count, number of months since diagnosis of AIDS, number of AIDS-related illnesses, number of recent stressors, history of head injury/LOC, history of substance use, current or past psychiatric disorder, history of learning disability nor history of other medical illness were found to be significantly related to severity of cognitive impairment in this sample, after controlling for the effects of age, level of education, estimated premorbid IQ and mood status. However, no reliable conclusions could be drawn from this study because the small sample size resulted in an unacceptably low level of statistical power for the desired regression …

Although much research has examined the impact of life stress and the subsequent development of health symptoms, most of this research has been done with White middle class adults. Similar to the adult research, life stress research with children and adolescents has focused on White middle class individuals. The present study expands the knowledge about the stress process in ethnic/racial adolescents while controlling for the effects of SES. A sample population consisting of 103 Black students, 129 Hispanic students, and 105 White students was compared with respect to stressful events experienced, coping strategies, and social support. Students from a wide range of socioeconomic backgrounds were included within each ethnic/racial group studied. After experimentally and statistically controlling for the effects of socioeconomic status, significant differences were observed. Black and Hispanic students reported receiving higher levels of Enacted Social Support (actual support) than White students. Contrary to what has been previous suggested, Black and Hispanic students reported having experienced fewer stressful life events than White students. Other ethnic/racial group differences that emerged included differences in ways in which specific patterns of moderator variables served to enhance the relationship between life stress and psychological symptomatology.

Clinical depression is characterized by alterations in thoughts, judgment, cognition and social behavior. This study focuses on non-optimal views of self and significant others that are proposed to underlie many of these alterations. Perceptions of self and significant others were elicited using the Role Construct Repertory Grid (Kelly, 1955a). Participants included depressed outpatients with high levels of trait anxiety (n = 27), depressed outpatients with lower levels of trait anxiety (n = 29) and a control group of never-depressed volunteers (n = 28). Consistent with prediction, significant group differences were found for negative self perception, discrepancies between actual self and self goals, alienation from significant others, and inconsistencies in self image. Results provided partial support for the self discrepancy theory of emotionality (Higgins, 1987). Among depressed patients, higher levels of anxiety were associated with increased self negativity and greater discrepancies between actual self and self goals. Increased levels of depression were associated with more alienation from significant others and more consistency in self image. Depressed patients' judgments of self and others were altered from optimal ratios, as predicted by the theory of interpersonal judgment (LeFebvre, LeFebvre & Adams-Webber, 1986). Findings have theoretical and clinical importance for the understanding and treatment …

The present investigation evaluated sport-related motivational climates by assessing personal and perceived parental goal orientations and perceived parental pressure in children and adolescents. Data were collected from 202 middle-class, racially diverse students, including 43 male and 50 female children aged 12 or below (M age = 10.6) and 51 male and 58 female adolescents aged 13 or above (M age = 14.7), who had participated in a variety of organized sports, and were enrolled in elementary, middle, and high schools of the Dallas (TX) Independent School District. Measures included personal and parental projected versions (mother's and father's) of the Task and Ego Orientation in Sport Questionnaire (TEOSQ), the Sport Parental Pressure Scale (mother's and father's versions), and a background assessment.

This purpose of this study was to investigate and examine the attitudes of therapists who treat HIV-positive (HIV+) clients. Specifically, therapists' perceptions of their own preparedness in dealing with specific issues and emotions of HIV+ clients were examined. Also, therapists' evaluation of their own efficacy of specific therapeutic approaches with HIV+ clients was examined. These therapists' perceptions and evaluations of all their clients in general were compared to their HIV+ clients. Comparisons were also made within the two groups.

Sexual abuse of children has profound negative effects on psychological development. This study examined the effects of sexual abuse on object relations functioning by using the Mutuality of Autonomy Scale (MAS, Urist, 1977) to score Rorschach protocols of 63 abused children and 60 non-abused clinical controls. The hypothesis that abused children would have less developed object relations than their non-abused counterparts was not supported. Neither was the hypothesis that children who experienced greater severity of sexual abuse would exhibit more malevolent object relations. The hypothesis that mean and modal MAS scores would be highly intercorrelated and interchangeable as research variables was supported. Comparisons of this sample to a normative sample are discussed.

The purpose of the present study was to discern a symptom pattern for environmentally ill patients and provide evidence of the uniqueness of the resultant pattern to this population. Patients' environmental exposure was confirmed by the presence of toxins in the blood serum. All patients were administered psychological and physical symptom checklists, the Clinical Analysis Questionnaire, and a standardized intermediate neuropsychological examination. Results indicate a response pattern of symptoms including fatigue, low energy, weakness, poor concentration, poor memory, poor comprehension, headaches, aches and pains, clumsiness, sinus discomfort, mucus, eye problems, restlessness, and present performance inferior to prior level of functioning. Presence of these symptoms, as well as the uniqueness of this symptom pattern was supported by comparisons of the patient and standardization groups on the two standardized tests.

Although many theorists have speculated that chronic pain may be linked to some sort of central neuropsychological integration deficit, a review of the current literature reveals no empirical support for this theory. This study attempts to assess the severity, if any, of neuropsychological deficits in chronic pain subjects by using a neuropsychological screen developed at the University of North Texas. Also, presented are studies of correlations between the UNT Neuropsych-screen and the MMPI. the Dallas Pain Questionnaire (DPQ), the Dallas Pain Drawing CDPD), and time since injury in order to assess any possible relationships. The subjects in this study consist of 100 volunteers. Of these subjects, 74 were patients of the Spinal and Chronic Pain Center at Medical Arts Hospital in Dallas, Texas and represented the clinical population. The remaining 26 subjects were staff volunteers from the hospital . The results of the study indicate significant differences between chronic pain subjects and non-pain subjects across many areas of neuropsychological functioning, as well as other significant correlations among many of the variables. The implications of this study are elaborated upon, in the discussion section, in detail along with limitations and future research directions.

Difficulties developing and maintaining intimate relationships are often attributed to adult children of alcoholics (ACAs). However, the focus of the literature has been on those obtaining psychological treatment and has primarily involved clinical impressions. The purpose of this study was to examine intimacy in the close friendships and love relationships of ACAs. Autonomy and intimacy in respondents' families of origin were also analyzed. Comparisons were made between ACAs currently in (n = 59) and not in (n = 53) therapy, and comparisons who had (n = 48) and had not (n = 77) received therapy. Alcoholics were eliminated. It was hypothesized that ACAs would score significantly lower than comparisons on love and friendship intimacy and autonomy and intimacy in their families of origin. Among the ACAs, those in therapy would score lower than those not in therapy. Hypotheses were tested using MANOVAS. ANOVAs were administered where there were significant differences, and Newman-Keuls contrasts further delineated the divergence. Multiple regression analyses were conducted to obtain explanatory data. The two ACA groups seem to represent distinct populations with those not in therapy failing to report intimacy differences previously ascribed to them. While all of the groups were similar in friendship closeness, only …

The problem of assessment and diagnosis of depression in the elderly begins with the definition of depression being indefinite. In this study, the theory of learned helplessness was chosen because of its value in organizing research within a learning theory framework. The Beck Depression Inventory, measures of fluid and crystallized intellectual ability, locus of control, and attribution of success and failure were chosen as variables for an exploratory factor analysis. The purpose of selecting these variables was to assess the cognitive, motivational, and affective components of learned helplessness as they affected the responses of elderly subjects to depression items. Self report measures of income, education, and health, were included to assess the relationship of these variables to depression. A somatic factor was predicted to correlate with an affective factor of depression.

The present study evaluated offender characteristics associated with completion of halfway house placement by the inclusion of additional offender characteristics for analysis in addition to those studied in previous research, the analysis of a large number of representative cases, and the use of statistics allowing clear conclusions upon which to base decision making. Data analysis was done in three steps. The first Step was to identify offender characteristics which were associated with completion in halfway house placement. The second step was to see how accurate the offender characteristics identified were in predicting completion of an offender's halfway house stay. The third step was to identify any possible factors which underlie the offender characteristics identified. Discriminant analyses identified ten offender characteristics which were associated with completion of halfway house placement for 521 male offenders and four offender characteristics which were associated with halfway house completion for the group of 33 female offenders studied. These offender characteristics resulted in 75.38 percent correctly classified cases for the male offender group and 96.9 7 percent correctly classified cases for the group of female offenders. Factor analyses resulted in the identification of four factors for the group of male offenders and two factors for the …

This study investigated the effect of cost-of-escape on helping among children. Forty-four children between the approximate ages of six and twelve served as subjects. The experiment was performed in a natural setting using an ice cream truck. The driver (experimenter) manipulated the cost-of-escape and then had an "accident." The easy-to-escape group received their ice cream before the driver spilled 300 spoons on the ground. The difficult-to-escape group had paid for their ice cream but had not received it before the "accident" occurred. The number of spoons picked up by each condition and the lapse time before a member of each group began to help was recorded. No differences were found between the groups (all ps > .05). Implications for cost-of-escape were discussed.

A comparison of contingent word and phonics drilling exercises on oral reading errors was made and the effects of a work skipping contingency on reading comprehension were examined. Five learning disabled elementary school children served as subjects. Reading comprehension increased from 30 to 50% over baseline, while subjects progressed an average of two years through a reading series. Subjects responded differentially to the two drills on oral reading errors, but the combined effects of the drills produced a 50% average reduction in errors. Pre- and post-tests of reading achievement showed increases in reading grade levels ranging from .8 to 1.5 years during the 10 week, 30 session study. Results supported the efficacy of a behavioral approach to reading remediation.

The objectives of this investigation were to develop, implement, and determine the effects of rational behavior therapy for residents in a retirement community. The question addressed was, "Will rational behavior therapy, relative to a discussion group and control group, exhibit significant changes in level of rational thinking and depression?" Drawing upon a cognitive theory of depression relevant to the aged population and upon rational behavior therapy literature, it was hypothesized that short-term rational behavior therapy intervention would be significantly related to a modification of belief systems and a decrease in depression. The participants were residents of two retirement communities. There were 25 subjects who completed the study through posttest assessment. These subjects were randomly assigned to three groups and assessed at pretest, posttest, and follow-up. The experimental group did not experience the hypothesized significant increase in level of rational thinking and decrease in level of depression. Possible explanations are given for lack of expected effects. Overall, the discussion group had more significant increases in rational thinking than the experimental and control groups.

The Embree/Butler scoring system served as criterion for ascertaining brain dysfunction on the protocols of 100 subjects--50 had been diagnosed by health professionals as having brain dysfunction, and 50 had been diagnosed as having no brain dysfunction. In comparing the hospital's diagnoses with those of the Embree/Butler method, the data strongly supported the hypothesis that the Embree/Butler scoring system did effectively discriminate (chi square of 77.99 < .01) between those with organic brain syndrome (or cerebral dysfunction) and those with psychiatric classification. A point-biserial correlation was used to distinguish the relationship between diagnosis and the score. A cutoff score of above 14 produced the least false-negative or false-positive evaluations.