Sex and marital status in relation to the treatment and outcome of alcoholic patients

This article focuses on gender and marital status differences in the treatment process, posttreatment experiences, and outcome of 332 alcoholic patients and explores the utility of several sex-role models in explaining the observed findings. Among men patients, being married is related to better treatment outcome, but the marital status difference is negligible among women patients. Participation in group therapy is related to better outcome for men relative to women; exposure to educational materials on alcoholism is associated with better outcome of women relative to men. Men and women patients also differ in the way in which their perceptions of the treatment environment are related to outcome. After discharge, unmarried women and married men are most likely to receive aftercare outpatient treatment, which is also related to better outcome among men patients. The findings underscore the importance of gender and marital status factors and of patient-program congruence effects in the treatment outcome of alcoholic patients.This research was supported in part by NIAAA Grant AAO2863 and by Vetrans Administration Medical Research Funds. The authors wish to thank Ruth Lederman for her valuable assistance with data analyses, and John Finney and Deborah Shields for helpful comments on earlier drafts.     

The development and validation of computer self-efficacy and outcome expectancy scales in a nonvolitional context

Computer self-efficacy and outcome expectancy scales were developed using 306 responses to a questionnaire distributed by a national mail survey to end users of computer systems in a variety of functional business areas. Confirmatory factor analysis using a structural equations approach was used to develop three scales. The scales were found to demonstrate satisfactory psychometric properties. The reliability coefficients for these scales were as follows: .85 for computer self-efficacy; .88 for work-related outcome expectancy; and .89 for personal outcome expectancy. The scales provide a strong foundation from which to refine the measurement of computer self-efficacy and outcome expectancy. From these refinements, empirical models that include self-efficacy and outcome expectancy as determinants of information technology acceptance at the individual level of analysis can be improved.     

Morality and Adult Attachment Style as Predictors of Psychotherapy Process and Outcome Expectations

This study examined whether moral foundations and adult attachment style predict expectations for counseling. Hierarchical regression models were used to analyze self‐report questionnaires of 963 participants. Moral foundations related to harm–care, fairness–reciprocity, and authority–respect were significantly positively related to both process and outcome counseling expectations. Adult attachment anxiety was positively related to outcome expectations, whereas adult attachment avoidance was negatively related to process and outcome expectations. Moral foundations and adult attachment style are important predictors of therapy process and outcome expectations. Implications for practitioners and future research are discussed.     

Effect of a signalled delay between an action and outcome on human judgement of causality

Three experiments examined the influence of a stimulus inserted between an action (pressing the space bar of a computer) and an associated delayed outcome (a triangle lighting up on the screen) on ratings of the causal effectiveness of that action. In Experiment 1, subjects rated an action that produced an outcome immediately as more causally effective than an action that produced a delayed outcome. The rating of the causal effectiveness of an action that produced a delayed outcome in which the delay was filled by a stimulus was higher than the rating of actions that produced the outcome after an unsignalled delay. In Experiment 2, the effect of a stimulus presented uncorrelated with the action or the outcome was examined and found not to enhance the rating of causal effectiveness of an action that produced a delayed outcome. In Experiment 3, the degree of correlation between the stimulus and the consequence was examined. Ratings of the causal effectiveness of the action were greater the higher percentage of delay intervals that were signalled.     

Interactional justice and the fair process effect: The role of outcome uncertainty

This paper reconciles the inconsistent findings on the interactive effect of interactional justice and social comparison information on outcome evaluation. We distinguish two different effects of interactional justice and examine outcome uncertainty as a qualifying factor. Three hundred and fifty-seven undergraduates participated in a scenario experiment. It is found that, due to the functional quality effect, interactional justice significantly influences outcome evaluation, regardless of the social comparison information that is available, in situations of low outcome uncertainty. However, due to the fair process effect, interactional justice, as with procedural justice, interacts with social comparison information to influence outcome evaluation in situations of high outcome uncertainty. Implications for comparison referents and social comparison motives in social justice research are discussed.     

理论思维、工程思维、评价思维的界定与联系——谈对缺血性脑血管病临床实践若干问题的思考

理论思维是力求逻辑自恰、规避自相矛盾;工程思维是对逻辑地发现的属性进行非逻辑的复合;评价思维是虚体思维和筹划因素相分离所导致的思维方式。理论思维的成果必须通过工程思维付诸实践,评价思维是对实践的结果进行评价,评价的结果是对工程思维或/和理论思维的成果进行反思。对缺血性脑血管病实践中的理论思维、工程思维和评价思维的界定与相互联系进行探讨。     

A Reverse Outcome Bias: The Influence of Multiple Reference Points on the Evaluation of Outcomes and Decisions

Two experiments examined the influence of multiple reference points on the evaluation of outcomes and decisions that lead to those outcomes. Norm theory is applied as a conceptual framework for understanding the conditions under which alternative norms may be evoked by the decision context and how they are subsequently used as reference points in the evaluation process. Of primary interest, in these studies, was how an outcome is evaluated when two reference points, the status quo and an evoked alternative, provide conflicting information about the "goodness" of the outcome (the outcome is good from the perspective of one reference point and bad from the perspective of the other). A gambling paradigm, based on regret theory, is employed to address these questions. We find that an alternative outcome is more likely to be evoked as a reference point when: (1) it is certain that another choice would have led to the alternative outcome; (2) a social comparison other receives the alternative outcome; and (3) the alternative outcome is in a different evaluative domain than the outcome received (i.e., is negative when the outcome received is positive). When these conditions hold, and the alternative outcome is used as a reference point for evaluation, the evaluations which result are quite counterintuitive: winners are rated as more regretful over their choices than losers are considered to be less satisfied with their outcomes than losers, and are rated as having made poorer quality decision than losers, who made the same choice! The latter finding represents a complete reversal of the outcome bias often observed in judgments of decisions made under uncertainty.     

Outcome of aggression affects processing and can legitimise subsequent aggression: Influence of trait aggressiveness

The present study investigated differences in processing times between positive and negative outcomes to an aggressive reaction to provocation. The effects of outcome, sex, trait aggressiveness and current mood on subsequent subject‐generated material were also examined. Fifty subjects read stories line by line on a computer screen. Reading time for the key sentence describing a positive or negative outcome to an aggressive reaction to provocation was recorded and subjects wrote a continuing sentence to half the stories. Subjects took less time to process the negative outcome. The positive outcome resulted in more subject‐generated aggression than the negative outcome. There were few sex differences but men wrote more aggressive endings than women for the stories containing physical aggression. Trait aggressiveness was correlated with producing more aggressive content in the continuing sentence for both outcomes. Feeling peaceful was correlated with producing prosocial material to neutral stories. Subjects therefore expect a negative outcome to aggressive behaviour. Reading stories which present a positive outcome to aggression increases the accessibility of aggressive cognitions. Subjects high in trait aggressiveness are not inhibited by a negative outcome. Aggr. Behav. 30:284–297, 2004. © 2004 Wiley‐Liss, Inc.     

Parallel goal-directed and habitual control of human drug-seeking: implications for dependence vulnerability

Dual-process theories of learning and addiction propose that whereas freely elected drug/reward-seeking is goal-directed in being mediated by the expected value of the outcome, cue-elicited drug/reward-seeking is habitual in being elicited directly by antecedent stimuli, without retrieving a representation of outcome value. To substantiate this claim, the current study conducted a human devaluation-transfer procedure in which young adult smokers were first trained on a concurrent choice task to earn tobacco and chocolate points before one outcome was devalued by specific satiety or health warnings against consumption of that outcome. When choice was again tested in extinction, the selective reduction in performance of the action associated with the devalued outcome indicated that choice was controlled by an expectation of outcome value, that is, was goal-directed. Moreover, the presentation of tobacco and chocolate cues enhanced selection of the response associated with that outcome, indicating that transfer was also mediated by the retrieval of the outcome representation. Paradoxically, however, the magnitude of this transfer effect was unaffected by devaluation, indicating that the stimulus retrieved a representation of outcome identity but not current incentive value. Individual differences in tobacco dependence in the young adult sample were associated with tobacco preference in the concurrent choice task but not with the devaluation or transfer effects. These data accord with dual-process theories in suggesting that drug/reward-seeking are mediated by goal-directed and habitual controllers under freely elected and cued conditions, respectively, and that initial uptake of drug use is associated with hyper-valuation of the drug as an outcome of goal-directed drug-seeking rather than with accelerated habit formation.     

Pre‐outcome regret: Widespread and overlooked

Many real‐life decisions (e.g. promises, plans and agreements) involve a time interval between when the decision is made and the main outcome is revealed. Nearly all regret studies focus on anticipated or experienced post‐outcome regret. We argue that regret is also frequently experienced in the pre‐outcome period, and that this ‘pre‐outcome regret’ has other sources than regret experienced after the outcome is known. Regret experienced in the pre‐outcome period has an important function post‐outcome regret (usually) cannot have, namely to motivate the decision maker to reconsider the ongoing decision process and reverse the initial decision. Pre‐outcome regret should for these reasons be distinguished from post‐outcome regret, and studied separately. In two scenario studies, participants were asked to imagine their regret after agreeing to perform an inconvenient task. In both, more regret was reported before than after the event, even when they had imagined a ‘worst case’ outcome. In the third study, participants described a difficult choice from their own life. Again, regret was perceived as higher in the pre‐outcome period than afterwards. In a fourth study, participants reported regret ‘online’ during an economic game (a version of the ultimatum game). They regretted their decisions more before than after they knew the outcome. We conclude that experienced pre‐outcome regret is often stronger than post‐outcome regret, and typically increases during the pre‐outcome period. We suspect that the absence of JDM studies of pre‐outcome regret is a legacy of the dominant gambling metaphor within decision research. Copyright © 2010 John Wiley & Sons, Ltd.     

Perceived Deservingness of Outcomes as a Function of Religious Fundamentalism and Target Responsibility

We examined the perception of deserved outcomes associated with religious fundamentalism (RF). Interviews with videotaped targets varied in target's religiosity, responsibility, and outcome valence (good/bad). Participants either low (LF) or high (HF) on RF formulated an impression of how deserving a target was for a situational outcome. Participants low in RF held targets to be less deserving of a bad outcome than a good one; the HF group showed this to a lesser degree. HFs believed the target was more deserving of a bad outcome than did LFs, even when the target was not responsible for the outcome. Religious fundamentalism is related to attributing greater deservingness of bad outcomes, possibly because of a greater belief in a just world.     

The Impact of Probability and Magnitude of Outcome on Disappointment and Elation

Bell's (1985) disappointment theory postulates that probability and magnitude of outcome affect the intensity of disappointment after undesirable outcomes and that of elation after desirable outcomes. The influence of probability and magnitude of outcome on the intensity of disappointment and elation was examined in five studies. Study 1 (within-subjects design) showed an effect of probability on both disappointment and elation. Study 2 (between-subjects design) showed only an effect of probability on disappointment. Study 3 also relied on a between-subjects design, used a different set of pay-offs, and replicated the findings of Study 2. In Study 4 both probability and magnitude of outcome were systematically varied. Results showed a large effect of probability on disappointment, but only a small effect on elation. Magnitude had a large effect on elation, but only a small effect on disappointment. Study 5 (using a real lottery) replicated the findings of Studies 2 and 3. Overall, these results suggest that experienced disappointment is primarily determined by the probability of the (undesirable) outcome, while elation is primarily determined by the magnitude of the (desirable) outcome. Possible explanations for this asymmetry are proposed, and implications for disappointment theory are briefly outlined.     

Psychometric features related to the acute phase and final outcome of anorexia nervosa

The MMPI responses of a poor and good final outcome group from a follow-up study of anorexia nervosa were compared with responses of a group of anorexic patients in the acute phase. The poor outcome group produced elevated scores in the psychopathological range except on scales 4, 5 and 9. No elevations occurred in the good outcome group and the MMPI thus discriminated significantly between different kinds of final outcome of anorexia nervosa. The profile of the patients in the acute phase at time of testing was not significantly different from the poor outcome group profile. In order to improve the predictive validity of the MMPI related to anorexia nervosa, the paper points to possible directions for further research.     

Conversations With Able-Bodied and Visibly Disabled Strangers An Adversarial Test of Predicted Outcome Value and Uncertainty Reduction Theories

Conversations with visibly disabled strangers entail unequivocally higher uncertainty and relatively more negative predicted outcome values compared to conversations with able-bodied strangers. Contrasting derivations from uncertainty reduction and predicted outcome value theories were tested by comparing observations associated with respondents’ separate conversations with able-bodied and visibly disabled partners. Four hypotheses were cast to favor predicted outcome value interpretations with respect to information seeking, three global features of the respondent's awareness of the partner's behavior, and the association of information seeking with nonverbal affiliative expressiveness and amount of verbal communication. Statistically significant differences in information seeking and awareness of the partner's behavior favored the predicted outcome value interpretation. Implications for predicted outcome value theory and interaction with visibly disabled conversational partners are discussed.     

The Role of Fidelity and Feedback in the Wraparound Approach

Wraparound approaches are being implemented with children in many mental health systems around the country. Evidence for the effectiveness of the wraparound approach, however, is limited. In addition, the degree to which wraparound interventions adhere to the principles of wraparound has rarely been assessed. We examined the influence of adherence to wraparound principles and outcome feedback within the wraparound approach. Children participating in family team meetings were enrolled in a feedback or no feedback condition. Teams receiving feedback were given a brief report regarding outcome progress four times over a three-month period. In addition, adherence to wraparound principles was assessed in the initial team meeting and examined in relationship to outcome at three months and nine months. Although youth in both feedback and non-feedback groups improved with intervention, there were few differences between the groups based on outcome feedback. Similarly, adherence was uniformly high and did not influence the outcome for individual cases. Although the wraparound approach was helpful for youth in our sample, outcome feedback and adherence to wraparound principles had limited influence on these effects.     

工作同盟和领悟对咨询效果的影响

为了解短程咨询中工作同盟和领悟对咨询效果的影响,以12个个案94次会谈为对象,考察工作同盟、领悟分别与会谈效果、治疗效果的关系,并考察二者共同作用于效果的方式。结果表明,咨访双方评定的工作同盟都可以正向预测会谈效果,但不能预测治疗效果;领悟与会谈有效性正相关,领悟正向预测治疗效果;咨询师评定的同盟的三个维度以领悟为中介影响其对会谈效果的评价。     

Outcome expectancies and outcome values as predictors of children's aggression

Social learning theory predicts that outcome expectancies and values should independently predict behavior, but past studies of aggression have failed to test this hypothesis specifically. We asked low–socioeconomic status children to imagine themselves engaging in aggressive behaviors and to rate the likelihood of each of a number of outcomes (outcome expectancies) and to rate how much they cared about those outcomes (outcome values). The relationship between self-reported aggression and outcome expectancies, values, and expectancy by value interactions was assessed. Expectancies, values, and their interactions were differentially related to aggression depending on the specific outcome investigated (e.g., punishment, bad feelings in self or other, prevention of future aggression, and peer respect). Results are discussed in terms of implications for theory and for future research. Aggr. Behav. 24:439–454, 1998. © 1998 Wiley-Liss, Inc.     

Level of alliance, pattern of alliance, and outcome in short-term group therapy

This study investigated the relationships between initial level of alliance, pattern of alliance over sessions, and outcome in a sample of 107 patients who completed short-term group therapy for complicated grief. Both patient-rated alliance and therapist-rated alliance were studied. For patient-rated alliance, both the initial level of alliance and the linear pattern of alliance were directly and significantly related to favorable outcome. For therapist-rated alliance, no significant direct relationships with outcome were found. Instead, significant interaction effects were found. For patients with relatively high initial alliance, the greater the increase in alliance over sessions, the better the outcome. For patients with relatively low initial alliance, the greater the decrease in alliance over sessions, the better the outcome. Explanations for the findings are considered as well as possible clinical implications.     

Predicted Outcome Value and Uncertainty Reduction Theories A Test of Competing Perspectives

This research tests several contrasting predictions from uncertainty reduction and predicted outcome value theories. Pairs of college classmates engaged in initial conversations with one another on the first day of classes. Research participants then reported on each pair's behavior during these conversations and their reactions to their partner and relationship. With few exceptions, predicted outcome value theory proposals were consistently supported by the results of this investigation. However, results failed to support uncertainty reduction theory's original axioms and theorems when predicted outcome value was taken into account. These findings are interpreted as strongly supporting the predicted outcome value perspective and its claim that uncertainty reduction processes are subservient to outcome maximization goals in initial interactions.     

Observers' reactions to genetic testing: the role of hindsight bias and judgements of responsibility

In 3 studies, we examined the effect of birth outcome on observers' reactions to genetic testing. Participants read a scenario in which a woman declined to take a genetic screening test and subsequently gave birth to a child with a genetic disorder (negative outcome) or a healthy child (positive outcome). Retrospective judgments of the likelihood that the child would have a genetic disorder were higher given negative than positive outcome knowledge under conditions of high genetic risk. Moreover, the more likely a negative outcome was perceived to be, the more responsible the mother was held for not taking the genetic screening test. Consistent with Weiner's (1993) theory, responsibility judgments were linked to displeasure and sympathy, with sympathy in turn being related to help judgments.