Inter-rater and test-retest reliability of the Revised Diagnostic Interview for Borderlines

The baseline inter-rater reliability, test-retest reliability, follow-up inter-rater reliability, and follow-up longitudinal reliability (interrater reliability between generations of raters) of borderline symptoms and the diagnosis of borderline personality disorder (BPD) were assessed using the Revised Diagnostic Interview for Borderlines (DIB-R). Excellent kappa s (> .75) were found in each of these reliability substudies for the diagnosis of BPD itself. Excellent kappa s were also found in each of the three inter-rater reliability substudies for the vast majority of borderline symptoms assessed by the DIB-R. Test-retest reliability for these symptoms was somewhat lower but still very good. More specifically, one-third of the BPD symptoms assessed had a kappa in the excellent range and the remaining two-thirds had a kappa in the fair-good range (.57-.73). The dimensional reliability of BPD symptom areas was somewhat higher than for categorical measures of the subsyndromal phenomenology of BPD. More specifically, all five dimensional measures of borderline psychopathology had intraclass correlation coefficients in the excellent range for all four reliability substudies. Taken together, the results of this study suggest that both the borderline diagnosis and the symptoms of BPD can be diagnosed reliably when using the DIB-R. They also suggest that excellent reliability, once achieved, can be maintained over time for both the syndromal and subsyndromal phenomenology of BPD.     

Concordant Spiritual Orientations as a Factor in Physician--Patient Spiritual Discussions: A Qualitative Study

Objectives: To understand the impact of physicians and patients religious/spiritual orientation on discussions of spiritual issues. Methods: We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Results: Respondents expressed that similar belief systems facilitate patient–physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Conclusions: Our respondents view spirituality similarly to other aspects of the physician–patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions.     

Individual differences in susceptibility to experimentally induced phantom sensations

We investigated individual differences in susceptibility to two vibration-induced phantom illusions, i.e. illusory arm extension and nose prolongation (“Pinocchio illusion”). Vibration was applied to the biceps brachii tendon of 32 healthy participants. Susceptibility to the illusions was quantified by vividness ratings and by ratings of the amount of illusory position changes of the arm and illusory shape changes of the nose. Participants also completed the Perceptual Aberration (PA) and the Need for Cognition (NFC) inventories. PA reflects the frequency of spontaneously experienced body schema alterations and NFC a person's tendency to cognitively structure experiences. PA was positively correlated with participants’ susceptibility to illusory arm extension and, exclusively for men, also to nose elongation. A high NFC was weakly associated with a high susceptibility for the Pinocchio illusion. By inference, these findings indicate a physiological basis of PA and a cognitive mediation of experimentally induced phantom sensations.     

Perceiving while acting: action affects perception

In two experiments we studied how motor responses affect stimulus encoding when stimuli and responses are functionally unrelated and merely overlap in time. Such R-S effects across S-R assignments have been reported by Schubö, Aschersleben, and Prinz (2001), who found that stimulus encoding was affected by concurrent response execution in the sense of a contrast (i.e., emphasizing differences). The present study aimed at elucidating the mechanisms underlying this effect. Experiment 1 studied the time course of the R-S effect. Contrast was only obtained for short intertrial intervals (ITIs). With long ITIs contrast turned into assimilation (i.e., emphasizing similarities). Experiment 2 excluded an interpretation of the assimilation effect in terms of motor repetition. Our findings support the notion of a shared representational domain for perception and action control, and suggest that contrast between stimulus and response codes emerges when two S-R assignments compete with each other in perception. When perceptual competition is over, assimilation emerges in memory.     

Index of suspicion: feeling not believing

Throughout the U.S., state laws require professionals who work with children to report cases of suspected child abuse to child protection services. Both practically and conceptually, however, significant problems arise from a lack of clarity regarding the threshold that has been set for reporting. Specifically, there is no consensus as to what constitutes reasonable suspicion, and little direction for how mandated reporters should gauge their legal and professional responsibilities when they harbor suspicion. In this paper we outline the context of the problem, discuss the nature and scope of its conceptual underpinnings, and offer recommendations for moving towards a concrete, practical solution.     

When development and learning decrease memory. Evidence against category-based induction in children

Inductive inference is crucial for learning: If one learns that a cat has a particular biological property, one could expand this knowledge to other cats. We argue that young children perform induction on the basis of similarity of compared entities, whereas adults may induce on the basis of category information. If different processes underlie induction at different points in development, young children and adults would form different memory traces during induction, and would subsequently have different memory accuracy. Experiment 1 demonstrates that after performing an induction task, 5-year-olds exhibit more accurate memory than adults. Experiment 2 indicates that after 5-year-olds are trained to perform induction in an adultlike manner, their memory accuracy drops to the level of adults. These results, indicating that sometimes 5-year-olds exhibit better memory than adults, support the claim that, unlike adults, young children perform similarity-based rather than category-based induction.     

Senior capstone design and ethics: A bridge to the professional world

A senior level capstone design experience has been developed and offered with a particular emphasis on many of the professional issues raised in Accreditation Board for Engineering and Technology (ABET) Engineering Criterion IV. The course has sought to develop student awareness of the ethical foundation of the engineering profession, the global and societal framework within which engineers practice, and the environmental impact on engineering. The capstone design course also focused upon improving the technical communications skills of the graduating senior class with both extensive instruction in writing and multiple workshops dealing with the art of making an effective oral presentation. The effectiveness of the design course was assessed using Kirkpatrick’s model for evaluating training programs. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.