Physicians' values and physician-value neutrality

For years articles have decried the lack of empathy in physicians' relationships with patients. In addition to being empathetic, physicians are called upon to assume the posture of value neutrality, i.e., not imposing one's values when dealing with patients. Empathy is clearly an expression of deeply held values; even the language used to define it is value-laden. Physicians are consistently called upon to exhibit traits which are expressions of their underlying values. However, if proponents of value-neutrality are to be taken literally one must not impose any of one's values on one's patients. But then one wonders how empathy could ever be expressed; further, it is hard to imagine what a truly value neutral physician would be like. It is time we recognize that any relationship between two persons requires the expression of values from both parties. These values help shape that relationship and define its further history. Physicians are not excluded from this process just because they consider themselves professionals. Divulging personal values to patients is both more honest and more in keeping with the concepts of justice, beneficence, non maleficence, and autonomy than to feign value-neutrality. A presentation of some type statement of values is timely and would give patients an idea of where a physician stands on a myriad of issues. Rather than being value-neutral, value non-neutrality seems a more right and reasonable posture for physicians to assume.     

A behavioral assessment scale for attention deficit disorder in brazilian children based on DSM-IIIR criteria

A teacher scale based on DSM-III-R diagnostic criteria for attention deficit hyperactivity disorder (ADHD) was developed for the behavioral assessment of children in Brazil. A total of 2, 082 children (782 males and 1,300 females) with a mean age of 11.2 years who were attending a public school in the greater Rio de Janeiro area were the subjects of this study. Two factors (Hyperactivity-Impulsivity and Inattention) were extracted from a principal-factor analysis conducted on the data, and the factor structure of the scale was found to be stable. Ratings of boys were higher than ratings of girls, and younger children had higher ratings than older children for both factors. Test-retest reliability for each item of the scale ranged from .56 to .70. The data are discussed in view of current controversies in the factor structure of teacher ratings of DSM-III-R ADHD symptoms.This research was supported by FINEP (42.88.0138.00) and FUNPENE. GNOB is the recipient of a CNPq Research Career Development Award (30.0197/82). RCAP was supported by a CNPq fellowship (82.2151/87). The authors are grateful to Rosely V. Magalhaes and Angela S. Guedes for assistance in data analysis with the SAS and SPSS packages. The authors wish to thank the school staff and teachers who participated in the study. This work was presented at the Fifteenth European Conference of the International Neuropsychological Society, Portugal, 1993.     

Effects of surface texture on weight perception when lifting objects with a precision grip

In this paper, we show that, when lifting an object using a precision grip with the distal pads of the thumb and index finger at its sides, the perceived weight depends on the object’s surface texture. The smoother the surface texture, the greater the perceived weight. We suggest that a smoother object is judged to be heavier because the grip force, normal to the surface, required to prevent it from slipping is greater. The possibility of there being an influence of surface texture per se is excluded by a second experiment that employed a variant of the precision grip in which the thumb supports the weight of the object from underneath. With the grip oriented in this way, there is no need to match grip force to surface texture and, under these conditions, there is no effect of surface texture on weight perception. In the first two experiments, the test and comparison weights were lifted successively by the same hand. In a third experiment, the effect of surface texture was replicated for sequential lifts made with separate hands. Thus, the effect is not restricted to comparisons made with the same hand.     

Use of a computer-controlled firearms training simulator in perception response time experiments

This paper describes the use of a custom-configured computer-controlled firearms training simulator to measure perception response (reaction) time (RT) to a stimulus in which the degree of threat presented is a manipulable variable across trials. The computer records the number of frames of videotape traversed between the point of presentation of the threat in the video stimulus and the point at which the subject responds by drawing the firearm. For the purposes of data analysis, these frame-count measures are converted to RT measurements. Example data are presented that capture perception RT at both thedraw-stimulus and thefire-stimulus points in situations for which either only one threat or more than one threat exists. Other elements, such as degree of threat and accuracy of response, provide additional data.     

Mindless reading: Eye-movement characteristics are similar in scanning letter strings and reading texts

The purpose of the present study was to compare the oculomotor behavior of readers scanning meaningful and meaningless materials. Four conditions were used—a normal-text-reading control condition, and three experimental conditions in which the amount of linguistic processing was reduced, either by presenting the subjects with repeated letter strings or by asking the subjects to search for a target letter in texts or letter strings. The results show that global eye-movement characteristics (such as saccade size and fixation duration), as well as local characteristics (such as word-skipping rate, landing site, refixation probability, and refixation position), are very similar in the four conditions. The finding that the eyes are capable of generating an autonomous oculomotor scanning strategy in the absence of any linguistic information to process argues in favor of the idea that such predetermined oculomotor strategies might be an important determinant of eye movements in reading.     

Accreditation Standards for University and College Counseling Centers

The accreditation standards outlined in the article are used by the International Association of Counseling Services, Inc., as the basis for the formal accreditation of college and university counseling programs throughout the United States and Canada. They reflect the program elements and practice standards that are deemed essential in a counseling center that provides high-quality services to students.     

Visual slow brain potentials in children with attention deficit disorder

Using a two-stimulus reaction time paradigm, with two separate reward conditions (contingent and noncontingent), we compared slow wave brain potentials (ERPs) in 144 children with attention deficit disorder (ADD) and 30 normal control children. This article reviews the findings during the 900 msec visual warning stimulus. As we had expected, based on ERP work of Forth and Hare (1989) and Raine, Venables and Williams (1990), and on previous work from our own laboratory, the group differences were found in the negative slow wave portions of the ERP complex during the contingent reward condition but not during the noncontingent condition. Aggressive hyperactive subjects with attention deficit disorder (ADDHA) were discriminated from nonaggressive subjects (including control subjects) during the contingent reward condition in the following ways: (1) greater fronto-central negativity (640–900 msec slow wave) and (2) greater right parietal than left parietal negativity (430–750 msec slow wave). All ADD subgroups, when compared to control (CONTR) subjects, showed greater slow wave negativity (700–900 msec) at the midline occipital electrode site during the contingent reward condition. This could be explained in part as an IQ effect on ERPs reflecting the IQ difference between the ADD subgroups and the controls. These slow wave findings seem to relate to attentional problems of these children. They are discussed in terms of a psychobiological model of inhibition/disinhibition and appetitive activation.     

A Playroom Observation Procedure to Assess Children with Mental Retardation and ADHD

Forty-two children (ages 6 to 12 years old) with moderate mental retardation to borderline intellectual functioning were studied in a laboratory playroom setting to determine whether children identified as ADHD (attention deficit hyperactivity disorder) or controls differed on activity and attentional measures. Children with ADHD were further divided into ADHD + conduct problems (ADHD + CD) and ADHD-only subgroups (with an ADHD-combined group comprising children of both subgroups). An interval recording system was used to code observations of independent play and a restricted academic task. Results indicated that the ADHD-combined group was significantly more vocal and engaged in a significantly greater number of toy changes than controls during independent play. Significant group differences were also noted during the restricted academic task, with the ADHD-combined and ADHD + CD groups more off-task and engaging in a greater number of toy touches than controls. Discriminant analyses found independent play measures to predict group membership in 70 percent of cases (ADHD-combined vs. controls), but in only 64 percent of cases using measures from the restricted academic task. No significant findings resulted when the ADHD subjects were further divided into two subgroups. Despite some inconsistent findings, such laboratory-based observations may be of value in the diagnosis of ADHD in children with moderate mental retardation to borderline intellectual functioning.