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Biomedical subjects

E D Wish

Publications and source records attributed to E D Wish.

27 records · Page 2Linked to original sources
PubMed1977

Reliability of psychiatric diagnosis. I. A methodological review.

This article reviews some methodological aspects of studies of diagnostic reliability in psychiatry. We define and discuss the concept of interrater reliability and review some of the ways in which the design of the reliability study can influence the results. Three basic methodological issues are raised, including: importance of structured interviews and objective diagnostic criteria, the importance of a test/retest vs an interviewer/observer design, and the calculation of reliability in a way that takes chance agreement into account.

Attitude of Health Personnel↗
PubMed1976

Reassessing the goal of drug education: diversity of preference among teachers and students.

Most of the proponents of drug education assume that the primary objective of such programs is to deter student drug use. To test this assumption, administrators, students and teachers from six public school districts were surveyed about what they thought the primary role of the school should be. While most administrators and teachers thought that the school's role should be limited to developing responsible attitudes or providing drug information, students selected a more diverse set of objectives for the schools. The policy implications of these findings are discussed.

Attitude↗
PubMedDate not supplied

Therapeutic community treatment for substance abusers with antisocial personality disorder.

This study compared treatment outcomes of substance abusers with and without antisocial personality disorder (APD) randomly assigned to two therapeutic communities, differing primarily in length of inpatient and outpatient treatment. We hypothesized that APD clients would be less likely to complete treatment, more likely to test positive for drugs and recidivate at follow-up, and that APD clients in the Standard program would have more favorable outcomes than those in the Abbreviated Inpatient program, because of the Standard program's longer inpatient treatment. Self-reports and objective measures of criminal activity and substance abuse were collected at pre- and posttreatment interviews. APD clients were as likely to complete treatment as other clients, and they exhibited the same patterns of reduced drug use and recidivism as did non-APD clients. Treatment program attended was unrelated to outcomes. Substance abusers diagnosed with APD can benefit from treatment in a therapeutic community combined with outpatient care.

Adolescent↗
PubMedDate not supplied

A comparison of saliva testing to urinalysis in an arrestee population.

Past studies have concluded that individuals under criminal justice supervision often underreport their recent use of illicit drugs. To address this underreporting, objective biological measures, such as urine, saliva, and hair testing, have been used to gain better estimates of illegal drug use. While urinalysis is generally recognized as the reference standard, a method recently introduced in nonlaboratory settings for ascertaining drug use-saliva testing-may offer an alternative to urinalysis. To date, however, no studies have compared saliva testing to urinalysis among criminal justice populations. In the current study, urine and saliva specimens were collected from 114 adult arrestees interviewed as part of Maryland's Substance Abuse Need for Treatment among Arrestees (SANTA) project. With urinalysis as the reference standard, analysis of the saliva test results indicated sensitivity of 100% and specificity of 99% for cocaine and sensitivity of 88% and specificity of 100% for heroin. For marijuana, however, the saliva results indicated a sensitivity of only 5%. Anecdotal reports from the field suggest that saliva may have some advantages over urine because of the ease of collection, invulnerability to adulteration, and minimal personal invasiveness. These findings suggest that a more comprehensive study to evaluate the efficacy of saliva testing in field research may be warranted.

Adult↗
PubMedDate not supplied

U.S. drug policy in the 1990s: insights from new data from arrestees.

What has been overlooked in recent years, and what the new findings presented in this paper indicate, is that even as there has been a welcome and dramatic drop in middle-class and causal drug use in the United States, revealed by the National Household Survey and the High School Senior Survey, there remains a stubborn hard core of drug use in criminals. Data from the newly established Drug Use Forecasting (DUF) program suggest that the arrestee population contains many of the frequent users of cocaine in the United States. These arrestees are part of a deviant segment of the population having multiple behavioral, vocational, and educational deficits. The danger exists that as drug use declines in the middle class, this residual group of dysfunctional drug users will become a national scapegoat subject to extremely harsh societal reactions, or alternatively, be neglected and "written off" by the larger society. A more humane alternative is to take advantage of the access to these persons that the criminal justice system affords to address their drug use and associated problems.

Cocaine↗