This study assessed burnout within a large Health Maintenance Organization. Primary care physicians and one psychiatric clinic staff were studied. The Maslach Burnout Inventory was used to develop frequency data in the areas of emotional exhaustion, depersonalization, and personal achievement. Among the primary care physicians, moderate emotional exhaustion, and depersonalization were found. Personal achievement was high. Among the psychiatric staff, high emotional exhaustion and depersonalization were found. Again, personal achievement was high. The entire professional group, with the one exception, was significantly higher in emotional exhaustion, depersonalization, and personal achievement than Maslach's normative sample. Psychiatrists and social workers had significantly higher scores on depersonalization than the primary care physicians or psychologists. High burnout in a Health Maintenance Organization setting suggests that managed health care providers may be more prone to burnout than fee-for-service practitioners. Several suggestions were made for such organizations to help alleviate burnout in their staffs.

Professional psychologists are challenged to determine the appropriate use of interactive computer therapy programs. Although such programs have the potential of enhancing delivery of mental health services and reaching ever broader audiences, they raise serious clinical, legal, ethical, and practical concerns. This article reports on a controlled clinical trial comparing short-term traditional individual therapy with a computer-based intervention overseen by a therapist. Results were favorable and comparable in both conditions, with individual therapy outperforming computerbased therapy on some measures. The practitioner's use of computer-based psychotherapy interventions is discussed and some guidelines offered. Computer technology is changing the face of psychotherapy. Should interactive programs be used as an adjunct to treatments? Should they be recommended for use without other treatment? If so, for what diagnostic groups and with what precautions should they be recommended? Should some clients explicitly be warned against unsupervised interventions? An American Psychological Association task force (Nickelson, 1997) report has cited a minefield of legal, ethical, and financial issues of concern to psychologists interested in these new technologies.

60 deputy sheriffs involved in shooting incidents in the Los Angeles area completed a seven-page survey delineating their reactions to the shooting incident. Data suggest some significant demographic and psychological effects on these officers. 40% were in the Department for 6 to 10 yr., 73% of the shootings involved other police officers, and 91% of the incidents occurred on duty. A variety of psychological reactions were described, e.g., time distortion, sleep difficulties, fear of legal consequences, and various emotional reactions, such as anger, elation, or crying. About 30% of the respondents felt that the shooting incident affected them greatly or a lot, about 33% only moderately and 35% not at all. The emotional responses to shootings appear to be as varied as the individuals involved.

47 Workers' Compensation claimants who had been referred for psychological evaluation were administered the Wechsler Adult Intelligence Scale, the Minnesota Multiphasic Personality Inventory, and the Millon Clinical Multiaxial Inventory. The subjects were divided into four diagnostic groups based on the type of injury claimed: head injury, psychiatric “stress and strain,” low back pain, and miscellaneous. Analysis of variance and discriminant analysis were performed on test data comparing the exclusive diagnostic categories; none of these variables displayed any significant differences. Mean profiles on each personality test were derived for each diagnostic group and showed amazingly similar patterns with interesting clinical elevations. Psychological characteristics displayed by all groups included passive dependence, depression, anxiety, and social introversion. The findings are discussed in terms of the use of these instruments in making differential diagnosis, identification of high-risk individuals for filing insurance claims, and the issue of malingering.

The MMPI Personality Disorder scales, developed by Morey, Waugh, and Blashfield (1985), were validated on an inpatient population by comparing 104 patients' MMPI-PD scores with the MCMI and with DSM-111-R diagnosis. Conservative significance levels were used to ensure more valid conclusions. Schizoid, Avoidant, Dependent, Histrionic, and Narcissistic scales were correlated significantly. Passive-Aggressive, Schizotypal, and Borderline scales did not correlate with corresponding MCMI scales. The MMPI-PD nonoverlapping scales were most effective in predicting diagnosis, specifically the Personality Disorder NOS, Eccentric and Borderline groups. The overlapping scales were not as effective in predicting diagnosis, but best predicted the Eccentric and Borderline groups. This study provides support for the validity of specific scales and circumscribed diagnostic utility for both measures.