Measures of fear and anxiety were taken before and after courses in childbirth education and childcare for 42 primiparas in the third trimester of pregnancy. A groups X trial analysis of variance indicated that both kinds of instruction significantly reduced two of three pregnancy-related anxieties, namely, Fears for Baby and Irritability and Tension. Only the childbirth education course (Lamaze method) succeeded in reducing general anxiety level, as measured by the IP AT Anxiety Scale. Anxiety level was found to exert a significant effect on self-ratings of pain during the transition stage of labor. It was concluded that childbirth education can reduce fear and anxiety and that pain perception is enhanced by high anxiety.

This study was designed to determine whether the number and/or types of errors on the Trail Making Test differentiated head-injured and normal control subjects. Errors on Part B were categorized into two types of shifting errors (from number to letter and from letter to number) and two types of sequencing errors (number and letter). Subjects consisted of 133 head-injured patients and 145 normal controls. Analysis showed that the frequency of errors on Parts A and B did not differ significantly between the groups nor did the percentage of subjects making errors. Total shifting and sequencing errors also did not differentiate between the two groups. Although head-injured subjects were more likely than controls to err in shifting from letters to numbers, this finding was of no apparent clinical usefulness. The discriminative value of time scores was confirmed.

Selected military psychologists have been trained and privileged to independently prescribe psychotropic medications. lb explore the attitudes of health care professionals toward prescribing authority, a survey of 395 military psychiatrists, psychologists, primary care physicians, and social workers was conducted. Psychologists, physicians, and social workers supported prescribing privileges and continuation of the training program. Results suggested that support by physicians and social workers is based on improving access to comprehensive mental health care for their patients. Psychologists advocating prescribing privileges at the state level need to pursue the training and licensing authority to prescribe independently. The opposition of organized psychiatry seems assured.The issue of prescribing privileges for psychologists has benefited from extensive reasoned analyses, debate, and practitioner surveys (

Psychologists who acquire prescribing privileges will assume an expanded obligation to address patients' medical (physical) conditions. Development of a training and practice model for prescribing psychologists may be informed by an awareness of how psychiatrists fulfill this obligation. Surveys of psychiatrists indicate that they rarely perform physical or neurological examinations. They typically participate only obliquely in the evaluation of patients presenting with acute behavioral or emotional symptoms suggesting organic illness, and they virtually never treat concomitant medical conditions of their patients. Other than in psychopharmacology, psychiatrists use their residual medical knowledge only indirectly. Findings imply that training for prescribing psychologists can be focused according to their expected clinical activities and that a model of practice emphasizing collaboration with nonpsychiatric physicians is feasible.

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