This study found few demographic differences between patients completing the program and those defecting from services. Both families completing the program and those discontinuing prematurely rated the overall quality of the program as high. However, lower quality of care was related to increased service attrition even after controlling for the effects of demographic and health parameters. Although a considerable number of patients discontinued services, very few reported that they would not return to the program. The results provide further support for ongoing audit and examination of families' care perceptions in preventing attrition and promoting service recovery.

To examine the relation of illness intrusiveness and illness uncertainty to psychological distress in patients with multiple sclerosis (MS). Study Design: Participants were recruited from regional support groups and local neurologists. Participants completed self-report measures of illness intrusiveness, illness uncertainty, and psychological distress. Disease status was assessed by administration of a mental status exam and an index of ambulation. Participants: The sample included 78 (55 women, 23 men) individuals diagnosed with MS. Main Outcome Measure: The Symptom Checklist-90-Revised Global Severity Index. Results: Hierarchical regression analyses indicated that illness intrusiveness and illness uncertainty independently predicted adjustment problems above and beyond demographic and illness variables. No mediator or moderator relationships were found for illness intrusiveness. Conclusions: Psychological appraisals of illness are salient predictors of adjustment even after statistically controlling for the influence of age, education, and objective indices of physical and cognitive impairment.Multiple sclerosis (MS) is a degenerative neurological disease affecting 150,000 to 350,000 people in the United States and Canada (Anderson et al., 1992;Devins

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The data suggest unusually ambitious, effortful task engagement may contribute to the onset of mild "ordinary" headache. This possibility requires further examination under other controlled conditions as well as in the natural environment.

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Training psychology students to treat patients with serious and persistent mental illness (SPMI) can provide an excellent opportunity for psychologists to help an historically disenfranchised and ignored population. With proper training, psychologists can play an important role in the development, provision, and administration of services to people with SPMI. We outline some of the issues to be considered in developing such a training program for practicum students, discuss the clinical skills and systemic issues that need to be mastered at the graduate level, and delineate the process by which this can be achieved in an inpatient, acute-care setting.

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