Effects of methylphenidate on acquisition and subsequent performance of successive discrimination reversals.

Abstract

There has been a continued search for methods of care of the aged within home communities ( 3 ) . One such program is the geriatric multi-service unit which offers a broad spectrum of services in the community for the elderly. These services include chemotherapy, individual, group, and family therapy, visiting housekeepers and nurses, and an active outreach program. Often such programs meet resistance in the aged when they are depressed. Zung (5, 6 ) states that depression may be the most common psychopathological disorder among the aged. Some writers link geriatric depression to a loss of narcissistic supplies ( 2 ) and to decreased self-esteem resulting from growing helplessness ( 1 ). Whatever the source of the depression, however, it does lead to loss of interest and motivation which if not treated surely leads to institutionalization. The present study has attempted to make the preliminary assessment of the effectiveness of one geriatric multiservice unit prototype in a large American ciry in reducing self-reported client depression relative to that of a more traditionally oriented senior center. Elderly subjects in a geriatric multi-service (experimental) prototype ( n = 8, M = 67.9) and a senior day care center (control) subjects ( n = 8, M = 69.4) were given preand post-treatment interviews, separated by 2 mo. During the interviews the interviewee completed rhe Zung ( 4 ) Self-rating Depression Scale. The Multi-Service group obtained a pretest M = 52.5, SD = 8.99 and a posttest M = 45.4, SD = 11.16. The control unit obtained a pretest M = 47.5, SD = 11.15 and a posttest M = 49.13, SD = 10.82. Results of a 2 x 2 repeated-measures analysis of variance indicated a significant improvement between the pretest and posttest measures of depression for the multi-service patients (F l , l r = 4.80, P < .05). The multi-service patients also improved significantly more than the senior citrzens as indicated by an interaction of time X treatment ( f i . 1 4 = 12.15, P < .01). Results of a subsequent Duncan's multiple range test supported the analysis of variance. The post-treatment multi-service group mean was significantly lower ( p < .01) than the pre-treatment group mean and the pre-treatment multi-service group mean was significantly higher ( p < .05) than the pre-treatment senior citizen group mean. Although based on a very limited n, the results tend to support the conclusion that the geriatric multi-service unit protorype reduced self-reported client depression more effectively than dld the control unit. While the multi-service unit depression means dropped significantly over the rwo test sessions, the senior citizen unit means tended to increase slightly. The final multi-service group mean tended to be lower than either control mean. It may be noted that findings support ZungVs contention that depression, as measured by the scale is relatively high even in normal aged. The recorded indices very closely approximate the mean index of 48.3, which was the index for normal aged recorded by Zung ( 5 ) . Pending further research, it can be tentatively concluded that a multi-faceted treatment program is more effective in alleviating depression in the aging than is an activities program alone.