Come on in, the Water is Fine: Achieving Mainstream Relevance through Integration with Primary Medical Care

Behavior analysis is a generic science, and Skinner's vision for it was that it would become a mainstream force, relevant for most if not all human concerns, major and minor. Clearly his vision has not been realized. Determining why this is the case would require a complex multifactorial analysis. One likely factor is that the majority of its basic science findings have been obtained from the study of rats and pigeons. Another likely factor, one directly addressed by this paper, is that the majority of its applied science findings have been obtained from the study of people in only one tail of the normal distribution. Regardless, those outside the field see the relevance of behavior analysis to general human affairs as very limited. Whether the path behavior analysis is on will lead to widespread perception of mainstream relevance anytime soon seems doubtful. An alternative route would involve integrating it with a field that has already made the trip successfully. A premier example involves primary medical care. This paper argues for the integration of behavior analysis with pediatric primary care, sketches a method for its accomplishment, and uses diurnal enuresis to illustrate the requirements of the method.     

Statistics,data analysis and Psychometrika: Major developments

Approximately 15% of all papers appearing inPsychometrika during the period 1960–1984 have been statistical or data analytic in nature. While these papers cover a very wide range of issues and are technically quite similar to those appearing in other major statistical journals, collectively they possess features which make them identifiablyPsychometrika.     

Analytic philosophy, 1925–69: emergence,management and nature

ABSTRACT

This paper shows that during the first half of the 1960s The Journal of Philosophy quickly moved from publishing work in diverse philosophical traditions to, essentially, only publishing analytic philosophy. Further, the changes at the journal are shown, with the help of previous work on the journals Mind and The Philosophical Review, to be part of a pattern involving generalist philosophy journals in Britain and America during the period 1925–69. The pattern is one in which journals controlled by analytic philosophers systematically promote a form of critical philosophy and marginalize rival approaches to philosophy. This pattern, it is argued, helps to explain the growing dominance of analytic philosophy during the twentieth century and allows characterizing this form of philosophy as, at least during 1925–69, a sectarian form of critical philosophy.     

Implementing Cognitive Behavioral Therapy in Specialty Medical Settings

This article is an introduction to the second issue of a two-part special series on integrating cognitive behavioral therapy (CBT) into medical settings. The first issue focused on integrating CBT into primary care, and this issue focuses on implementing CBT in other specialty medical settings, including cancer treatment, HIV care, and specialized pediatric medical clinics. Models for treatment delivery to improve ease of implementation are also discussed, including telehealth and home-delivered treatment. The six articles in this series provide examples of how to transport CBT techniques that are largely designed for implementation in outpatient mental health settings to specialized medical settings, and discuss unique considerations and recommendations for implementation.     

Le JCR facteur d’impact (IF) et le SCImago Journal Rank Indicator (SJR) des revues françaises : une étude comparative

One of the major functions of academic journals is to contribute to the evaluation of research activities and scientists. Invented more than 50 years ago, the ISI impact factor (IF) became the most important indicator of the quality of journals, in spite of well-known problems and critics such as the over-representation of English-language journals. This is a specific problem for French publishers and scientists; publishing in French is not valorising. Since 2007, the new SCImago Journal Rank Indicator (SJR) offers an alternative to the IF. SJR applies the Google algorithm (PageRank) to the journals of the SCOPUS bibliographic database that indexes more journals than ISI Web of Science. The goal of our study is to compare the two indicators for French academic journals, with three questions: Which is the coverage of French journals by ISI and SCOPUS (title number, scientific disciplines)? Which are the differences of the two indicators IF and SJR for the ranking of French journals? How do they cover the French academic journal publishing market (representativity)? The results of our study of 368 French journals with IF and/or SJR are in favour of the usage of the new indicator, at least as a complement to the IF. (1) Coverage: 166 journals are indexed by ISI (45%), 345 journals are indexed by SCOPUS (94%), 143 journals are indexed by both (39%). 82% of the journals are from STM, 18% are from SS&H. In particular, SCOPUS covers much better the medical and pharmacological sciences. (2) Ranking: The correlation of IF and SJR for the 143 journals with both indicators is high (0.76). The IF better differentiates the journals than the SJR indicator (155 vs. 89 rankings). On the other side, because of the larger source database, more French titles become visible on an international level through SJR than through IF. (3) Representativity: The SJR is more interesting and representative of the French academic journal publishing market than the IF (19% vs. 9%), especially for STM titles (38% vs. 19%), much less for SS&H titles (6% vs. 2%). Nevertheless, ISI (Web of Science) and SCOPUS index journals from only a small part of the French academic publishers (10%–20%). Again, SCOPUS is more representative than the ISI dababase (17% of the publishers vs. 10%). Methodological problems and perspective of a multidimensional evaluation are discussed. Our study compares the ISI impact factor (IF) with the new SJR for 368 French academic journals with IF and/or SJR. The results: The SJR coverage is better than of the IF (94% vs. 45%), especially in medical sciences. The correlation of IF and SJR for journals with both indicators is high (0.76). The IF better differentiates the journals than the SJR indicator (155 vs. 89 rankings). The SJR coverage is more representative of the French academic journal publishing market than ISI/IF (19% vs. 9%), especially for STM titles (38% vs. 19%), less for SS&H titles (6% vs. 2%).     

Les troubles du comportement chez l'enfant et l'adolescent : vers une cohérence des pratiques pluridisciplinaires

Many professionals are involved with the children who present behaviour disorders. One question is “How to develop a medical and psychological care project which involves the child, the family and the school”. In order to respond to that question, four papers with different theoretical approaches will follow in this issue of Pratiques Psychologiques. They present: 1) the different nosological status of behaviour disorders; 2) an example of an analytic work with children and their relatives; 3) a behavioural intervention at school; 4) the problems of treatment access and possibilities of new responses.     

Infant-directed language following a brief behavioral parenting intervention: The importance of language quality

Behavioral parenting interventions decrease early childhood behavior problems and increase positive parenting skills. However, few studies have examined the impact of low intensity interventions for infants at risk for behavior problems on changes in parent language. This study examined the effect of a brief parenting intervention, the Infant Behavior Program, on changes in parent linguistic input and its influence on infant language. Participants were 58 mothers and their12- to 15-month-olds, with elevated levels of behavioral problems. Mothers and their infants were from primarily Hispanic and low-income backgrounds. Mother-infant dyads were randomly assigned to receive the Infant Behavior Program or standard pediatric primary care. Mothers receiving the Infant Behavior Program provided more linguistic input, which indirectly influenced infant language, and suggest targeting infants at risk for behavior problems can have a broader impact on language development.     

Role of Psychologists in Academic Medicine

With an interdisciplinary approach to understanding human psychosocial development and behavior, psychologists in academic medical settings have much to offer in the areas of administration, research, teaching, and service, including in the realm of organizational systems and behavior within medical schools. In these ways, psychologists can play a large role in the fulfillment of the mission of academic medicine and enhance psychology’s stature in the medical school organization. Two case studies are presented that exemplify the varied roles and responsibilities of psychologists in a medical school. To be successful within medical schools, the following generalizable principles are offered: (1) “add value” to the medical school by demonstrating the diverse and relatively unique abilities of psychologists; (2) be flexible and adaptive to the different requirements of medical academic settings; (3) make a concerted effort to work well with medical students, residents, and physicians who may not be well-versed in certain aspects such as rigorous research methodology and statistics; and (4) find a “good match” between one’s strengths, the needs of the medical setting, and the attributes of the M.D. leader. With such an approach, remarkable accomplishments can be made.     

Psychology’s Adaptation to Academic Medical Settings

This introduction provides an overview of the papers that follow. Each paper contributes to the central theme of the issue, psychologists’ adaptation to the realities of academic medical settings. The specific approach of each paper to the shared theme of “adaptation” is described in some detail so the busy reader can go directly to the papers of greatest interest.     

Pediatric Health-Related Quality-of-Life Measurement Technology: Intersections between Science, Managed Care, and Clinical Care

The demand for health care outcomes assessment is increasing, driven by the proliferation of managed care as a form of health care financing. Providers, consumers, and payers can use health care outcomes to improve the efficiency and quality of care, spur performance improvement, and demonstrate accountability. This review introduces health outcomes and focuses on one particular outcome—pediatric health-related quality of life (HRQOL), exemplified by the PedsQL, a brief, practical, reliable, valid, and responsive measure of pediatric HRQOL. HRQOL measurement has the potential, in pediatric clinical practice, to improve assessment, clinical management, and treatment evaluation if practical, conceptual, and empirical challenges are addressed. These issues are discussed and directions for future research are described that would demonstrate the value of HRQOL measurement in pediatric clinical settings.     

An Empirically Supported Framework for Addressing Pediatric Nonalcoholic Fatty Liver Disease in Outpatient Care

In the wake of the pediatric obesity epidemic, the prevalence of nonalcoholic fatty liver disease (NAFLD) has been rising. Standard care for pediatric NAFLD includes dietary and physical activity guidelines, but such recommendations are difficult for families to implement. Clinicians in medical settings may be called upon to address NAFLD; cognitive behavioral techniques that have been effectively used for pediatric obesity are likely applicable. However, given the unique circumstances surrounding NAFLD, it may be helpful also to incorporate community-based and telehealth strategies when assisting families. This treatment development report offers a framework for integrating cognitive behavioral techniques within a community-based, telehealth approach to treating NAFLD within a medical setting. A series of illustrative cases is presented to depict exemplary considerations for implementing this intervention.     

Review of a Parent’s Influence on Pediatric Procedural Distress and Recovery

Understanding how parents influence their child’s medical procedures can inform future work to reduce pediatric procedural distress and improve recovery outcomes. Following a pediatric injury or illness diagnosis, the associated medical procedures can be potentially traumatic events that are often painful and distressing and can lead to the child experiencing long-term physical and psychological problems. Children under 6 years old are particularly at risk of illness or injury, yet their pain-related distress during medical procedures is often difficult to manage because of their young developmental level. Parents can also experience ongoing psychological distress following a child’s injury or illness diagnosis. The parent and parenting behavior is one of many risk factors for increased pediatric procedural distress. The impact of parents on pediatric procedural distress is an important yet not well-understood phenomenon. There is some evidence to indicate parents influence their child through their own psychological distress and through parenting behavior. This paper has three purposes: (1) review current empirical research on parent-related risk factors for distressing pediatric medical procedures, and longer-term recovery outcomes; (2) consider and develop existing theories to present a new model for understanding the parent–child distress relationship during medical procedures; and (3) review and make recommendations regarding current assessment tools and developing parenting behavior interventions for reducing pediatric procedural distress.     

Integrating Care for Persons, Not Only Diseases

Integrated care is geared toward enhancing usual care and decision-making for common combinations of medical and mental health conditions, including the behavioral health and behavioral change aspects. Yet even with comprehensive and well-integrated care for health conditions and well-coordinated teamwork in place, some patients do not engage or respond to care in the way clinicians would like or predict. This troubles patients and clinicians alike and may be chalked up informally to things like medical complexity (multiple co-existing conditions), mental health conditions (that complicate care), or simply the case being considered complex or difficult. It also raises the question of how to address person-specific factors that interfere with care of whatever conditions the patient may have, and invites behavioral health clinicians in medical settings to look beyond care of conditions to the care of persons, and to look beyond disease-specific care management protocols to master generic practices of care management across whatever conditions the person may have. This person-centered emphasis is intrinsic to the concept of the “patient-centered medical home” which has burst into animated discussion and demonstration among providers, health plans, government plans, employer purchasers, and professional associations across public and private entities. This represents an opportunity for collaborative care clinicians to help shape the national state of the art in medical home and includes a range of person-oriented (rather than disease-oriented) practices for care management, including working systematically with complex patients and difficult patient–clinician relationships.     

Fake Journals: Their Features and Some Viable Ways to Distinguishing Them

In this paper, we aim to discuss the fake journals and their advertisement and publication techniques. These types of journals mostly start and continue their activities by using the name of some indexed journals and establishing fake websites. The fake journals and publishers, while asking the authors for a significant amount of money for publishing their papers, have no peer-review process, publish the papers without any revision on the fake sites, and put the scientific reputation and prestige of the researchers in jeopardy. In the rest of the paper, we present some viable techniques in order for researchers and students to identify these journals.     

Issues in the identification and long-term management of Munchausen by Proxy Syndrome within a clinical infant service

Munchausen by Proxy Syndrome is a version of Munchausen's Syndrome whereby a parent, usually the mother, simulates or fabricates disease in one or more of her children in order to seek medical attention. Because this disorder is usually identified in pediatric settings, current literature focuses on identification of the syndrome, with little discussion of treatment issues or management strategies other than confrontation of the parent and removal of the child from the home. With the increased availability of infant mental health services, infant clinicians are likely to be called on to evaluate and treat cases of this disorder. This paper reviews the Munchausen by Proxy literature for infant clinicians and describes the identification and long-term management of one Munchausen by Proxy case within the context of an infant home-visiting service. Pertinent issues that emerged included the difficulties inherent in documenting the mother's pathological behavior, the clinical tension between preventing flight from treatment but limiting harmful behavior, the need for a long-term collaborative relationship with a designated pediatrician, and the importance of further education of protective service workers about this syndrome.     

A Functional Analysis of Psychological Terms Redux

In his seminal paper, “An Operational Analysis of Psychological Terms,” Skinner (1945) offered the revolutionary suggestion that, rather than endlessly debating the meanings of psychological terms, psychologists should analyze the variables that control their occurrence as verbal behavior. Skinner''s suggestion reflected the essence of his 1957 book, Verbal Behavior, wherein he argued that the behaviors of which language is composed (i.e., speaking and listening) are controlled by variables found in the social environment (which he called the verbal community), and that analyzing those variables would lead to an understanding of the behaviors. Although Skinner formally introduced his radical approach to language in 1945, it has yet to be fully realized. The result is that psychologists, including behavior analysts, still debate the definitions of terms. In the present paper, I review Skinner''s functional approach to language and describe ways in which behavior analysts have already applied it to traditional psychological terms. I conclude by looking at other current terms in behavior analysis that engender some confusion and encourage behavior analysts to apply a functional analytic approach to their own verbal behavior.     

Ethics in Publishing: Complexity Science and Human Factors Offer Insights to Develop a Just Culture

While ethics in publishing has been increasingly debated, there seems to be a lack of a theoretical framework for making sense of existing rules of behavior as well as for designing, managing and enforcing such rules. This letter argues that systems-oriented disciplines, such as complexity science and human factors, offer insights into new ways of dealing with ethics in publishing. Some examples of insights are presented. Also, a call is made for empirical studies that unveil the context and details of both retracted papers and the process of writing and publishing academic papers. This is expected to shed light on the complexity of the publication system as well as to support the development of a just culture, in which all participants are accountable.