This study examined the application of the Minnesota Multiphasic Personality Inventory (MMPI) to the assessment of personality and emotional status in neurologic patients. Eighteen specialists in the clinical neurosciences examined the standard MMPI and indicated those items they felt were potentially tapping valid manifestations of neurologic damage or dysfunction. Forty-four items, loading primarily on the Hs, Hy, and Sc scales, were identified. These items were then deleted from the standard MMPI protocols of a heterogeneous group of 115 verified neurologic patients and the protocols rescored in the usual fashion. Corresponding high-points between the original MMPI and the modified version occurred in 46% of the cases. Comparable two-point code types occurred in only 29% of the cases. Taking into account the neurologic content of the MMPI can thus considerably alter the MMPI profile of a neurologic patient. Caution should thus be exercised with regard to the application and literal interpretation of the MMPI in neurologic cases.

Observation is a fundamental skilled nursing intervention. Special observation is an intensified and often prolonged form of this intervention. Depending upon their nature, and the circumstances under which they are carried out, special observations may invoke varying degrees of stress in both the observer and the observed. They may also raise important ethical and significant financial questions. In psychiatry, special observations are usually imposed where a patient is assessed as representing some degree of risk to themselves or others because of their behaviours or potential behaviours. Special observations vary in their degree of intrusiveness and restrictiveness, and may arouse strong emotions in the patient and staff. Patients may be denied privacy for their most intimate needs, and staff may become a focus for patients' acting-out behaviours. Special observations may be medically imposed with minimal consultation with nursing staff, and where there is no nursing and medical staff agreement on their need, nursing staff may at times feel frustrated and powerless to reduce the patients' discomfort with their situation. This paper presents a study into the use of special observations on psychiatric inpatients across a range of clinical settings. The literature on special observations is reviewed, and the findings of an audit into the documentation of special observations is presented and discussed. The study sites comprised two open acute wards, one elderly functionally mentally ill assessment unit which also treats patients with eating disorders, and a secure high dependency unit, which provides rehabilitation within a secure environment for patients with severe and enduring mental illness.

This study examined Minnesota Multiphasic Personality Inventory profile configuration in matched samples of males (n = 77) and females (n = 25) suffering from closed-head injury. For the males, the mean group high-point was the 5c scale; the mean group high-point for the females was the D scale. For the males, the mean group two-point code was the 8-2 configuration; the mean group two-point code for the females was the 2-3 configuration. The males as a group also scored significantly higher than the females on the Sc scale. The D scale was the most frequently elevated clinical scale and high-point for both groups. The overall pattern of findings also suggested a greater predominance of Hs and Hy two-point code types for the females. The results are discussed in terms of the need to pay critical attention to methodological issues in neuropsychological research and practice.

Sources of stress and perceptions of patients' psychosocial adjustment were comparatively examined in the family members of patients who had sustained moderate to severe closed head injury (CHI) or spinal cord injury (SCI). The family members of the patients with CHI reported significantly greater stress in relation to lack of social support, overcommitment, and difficult personality characteristics of the patient. Physical incapacitation of the patient was the principal source of stress that significantly differentiated the family members of the patients with SCI. Family members' perceptions of patients' psychosocial adjustment, as assessed across a broad range of dimensions that included the domestic and social environments, did not differ significantly between the groups. In both groups, the level of personal psychological distress reported by the family members was the most significant and consistent correlate of their perceived stress and perceptions of patients' psychosocial adjustment. The results are discussed In terms of the need to expand the traditional scope of rehabilitative efforts following head and spinal cord injury to directly address family-related issues.

Sources of stress and perceptions of patients' psychosocial adjustment were comparatively examined in the family members of patients who had sustained moderate to severe closed head injury (CHI) or spinal cord injury (SCI). The family members of the patients with CHI reported significantly greater stress in relation to lack of social support, overcommitment, and difficult personality characteristics of the patient. Physical incapacitation of the patient was the principal source of stress that significantly differentiated the family members of the patients with SCI. Family members' perceptions of patients' psychosocial adjustment, as assessed across a broad range of dimensions that included the domestic and social environments, did not differ significantly between the groups. In both groups, the level of personal psychological distress reported by the family members was the most significant and consistent correlate of their perceived stress and perceptions of patients' psychosocial adjustment. The results are discussed In terms of the need to expand the traditional scope of rehabilitative efforts following head and spinal cord injury to directly address family-related issues.