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Biomedical subjects

S Spreat

Publications and source records attributed to S Spreat.

At least 19 recordsLinked to original sources
PubMed1998

Use of psychotropic medications for persons with mental retardation who live in Oklahoma nursing homes.

OBJECTIVE: The study examined the use of psychotropic medications to treat persons with mental retardation living in nursing homes in Oklahoma. METHODS: Data were gathered on all 1,056 individuals funded through the Oklahoma mental retardation service system in 1995 to live in nursing homes. The Developmental Disabilities Quality Assurance Questionnaire was used to assess adaptive behavior, living site conditions, health, use of medications, and other variables. RESULTS: The most frequently used class of psychotropic medications was antipsychotic medication, used by 31.8 percent of subjects. Sixteen percent received anxiolytic medication, and 6.1 percent received antidepressant medication. Stepwise multiple regression analysis indicated that use of antipsychotic medication was marginally predictable (less than 15 percent of the variance was explained) with a linear combination of six variables: mental health problems; violence toward others; adaptive behavior; screaming, yelling, or crying behavior; hyperactivity; and age. CONCLUSIONS: A relatively high percentage of subjects received various forms of psychotropic medications, especially antipsychotics. The presence of behavior problems or mental health problems did not sufficiently explain the high rate of use of antipsychotic medication. The risks of this type of medication and its lower rate of use in group homes raise the question of the appropriateness of placing persons with mental retardation in nursing homes as they are currently conceived.

Adolescent↗
PubMed1997

Use of psychotropic medication in Oklahoma: a statewide survey.

Analysis of statewide survey data revealed that 22.5% of individuals with mental retardation who were served by the Oklahoma mental retardation system were receiving antipsychotic medication. Anxiolytic medications were prescribed for 9.3%, and antidepressants were prescribed for 5.9%. Higher levels of medication use were found in institutional settings and Intermediate Care Facility settings.

Adolescent↗
PubMed1996

Reliability analysis of the motivation assessment scale.

The Motivation Assessment Scale was submitted to several variations of reliability analysis. Internal consistency was found to be superior to interrater reliability. Difference score reliability was insufficient to permit profile analysis.

Adult↗
PubMed1995

A study of the clinical outcome of patients with profound mental retardation gradually withdrawn from chronic neuroleptic medication.

In a naturalistic study of 23 severely and profoundly mentally retarded adult male patients undergoing slow "diagnostic" neuroleptic taper, it was determined that at least 60% could eventually be managed without psychoactive medication. However, many of these demonstrated a remarkably long, but nonetheless transient, period of worsening. This suggests that behavioral deterioration during drug reduction trials does not always indicate a need for chronic neuroleptic maintenance since these behaviors may return to baseline without pharmacological intervention. On the other hand, 40% demonstrated persistent (> 2 years) behavioral worsening. Those individuals who demonstrated persistent deterioration had been generally well controlled on neuroleptics, were somewhat older, and were receiving a higher baseline dose. Most of these persistently worsened subjects currently require some type of psychoactive medication (although only two have been returned to neuroleptics).

Adult↗
PubMed1994

Impact of treatment efficacy and professional affiliation on ratings of treatment acceptability.

Vignette methodology was used to assess factors associated with decisions regarding the acceptability of behavior modification programs. Members (N = 198) of the American Association on Mental Retardation (AAMR) reviewed two vignettes describing proposed treatment plans for individuals who were either aggressive or self-injurious. Nine descriptor variables were nested within each vignette; no two vignettes were exactly the same. The strongest predictor of treatment acceptability was the respondents' own estimates of probable treatment success. Secondary predictors included the restrictiveness of the proposed procedure and whether other procedures had been previously tried. Members of the AAMR Psychology Division tended to be slightly more accepting of behavioral treatments than were members of other divisions.

Adolescent↗
PubMed1989

Obsessive-compulsive disorder in mentally retarded patients.

Of 283 mildly to profoundly retarded patients, 10 (3.5%) presented with compulsive behavior that significantly interfered with their daily functioning. Compulsions occurred in the context of obvious cerebral dysfunction and in the absence of anxiety or "ego-dystonic" qualities. The interrater reliability of the differential diagnosis between compulsions, stereotypies, and other repetitive behaviors was good (kappa = .82). A severity rating scale for the compulsive behavior yielded total scores with good interrater reliability (intraclass correlation coefficient = .82). Single items that described observable behaviors had good reliability, while inner resistance and subjective distress were not reliably assessed and contributed little to the total score. The authors suggest that the DSM-III-R diagnosis of obsessive-compulsive disorder be considered in mentally retarded patients, despite the absence of recognizable ego dystonic characteristics. Emphasis should be on the behavioral, externally observable components of the disorder, rather than on inner conflicts and anxiety. Such a diagnostic approach may also benefit nonretarded compulsive patients.

Adolescent↗
PubMed1989

Role of Human Rights Committees in the review of restrictive/aversive behavior modification procedures: a national survey.

Public residential facilities were surveyed regarding the roles played by their Human Rights Committees in the review of restrictive/aversive behavior modification procedures. Almost 98% of the responding facilities reported that they had an active Human Rights Committee, with the largest plurality of members being staff members from the facility. Review of restrictive/aversive procedures was a role for over 95% of the committees, even though most committees appeared to lack great degrees of expertise in the clinical use of behavior modification. Other areas of review were discussed.

Behavior Therapy↗
PubMed1987

Developmental growth at Woodhaven Center: an eight year longitudinal study.

Developmental growth of residents of a university operated institution was studied over an eight year period of time. Longterm residents received decreasing benefits over time, although shorter term residents evidenced only linear growth. The ideal duration of services was estimated as approximately three to four years.

Data Collection↗
PubMed1986

Safety indices associated with the use of contingent restraint procedures.

The safety of four general classes of contingent restraint was evaluated in a sample of 231 institutionalized mentally retarded persons. The use of mechanical restraints resulted in a significantly lower injury rate than did personal restraint. The use of restraint in emergency situations was found to be more dangerous than the planned use of such procedures.

Accident Prevention↗
PubMed1985

Client progress toward referral for discharge to the community: an illustration of an evaluation technique.

Data on referral and discharge from a short-term habilitative facility are used to illustrate the "survival analysis" of the rate at which institutionalized mentally retarded persons are released to the community and regression analysis of factors which help predict time to release. These techniques can be used to assess the degree to which habilitative facilities and community agencies achieve their stated goals, to help community agencies plan placement requirements, to compare the progress of various subgroups of clients, and to assess the overall benefit of deinstitutionalization efforts for the entire population at which it is aimed.

Adolescent↗
PubMed1983

A canonical correlation between adaptive and maladaptive aspects of adaptive behavior.

The relationship between the adaptive and the maladaptive aspects of the construct of adaptive behavior was examined by means of a canonical correlation between Part One and Part Two of the AAMD Adaptive Behavior Scale (ABS). The sample consisted of 439 institutionalized mentally retarded persons. Four significant canonical correlations (.68, .49, .39, .28) were derived, three of which were interpretable. The redundancy index was 30 percent with Part One as the criterion and 14 percent with Part Two as the criterion. A redundancy of about 30 percent was calculated. An analysis of the pattern of canonical components suggested that the three major dimensions responsible for the overlap between ABS Parts One and Two are intellectual ability, sociability, and physical ability. An attempt to cross validate these results was made using another sample of 157 mentally retarded persons. Considerable shrinkage was observed on three of the roots.

Adaptation, Psychological↗
PubMed1983

Tolerance for deviance: subjective evaluation of the social validity of the focus of treatment in mental retardation.

Staff members from an American institution, Israeli institutions, and a number of American group homes were asked to rate the social tolerability of 84 types of behavior that reflected either skill deficits or social maladaptation. There was considerable agreement among the three sample groups about the relative rank ordering of the 84 items. Physical violence and socially disgusting behavior were perceived as most intolerable whereas deficits in academic skills were least intolerable. The Israeli sample was uniformly less tolerant than either American sample.

Attitude of Health Personnel↗