Prevention opportunities in health care settings

Psychologists have an opportunity to offer their expertise at a time when health care settings are beginning to recognize the importance of behaviorally based interventions for improving health and health care. The authors review the changing patterns of health and illness that have led to an increased interest in the role of patient and provider behavior and discuss the many advantages of using health care settings as prevention sites. Examples of successful behaviorally based prevention programs are presented, along with the evidence supporting the cost-effectiveness of such programs. Challenges presented by working in health care settings are described. Throughout, the authors emphasize the multiple opportunities for psychologists' involvement across a wide variety of health care delivery sites.     

The "what" and "where" of object representations in infancy

Four-month-olds' memory for surface feature and location information was tested following brief occlusions. When the target objects were images of female faces or monochromatic asterisks infants showed increased looking times following a change in identity or color but not following a change in location or combinations of feature and location information. When the target objects were images of manipulable toys, the infants showed increased looking times following a change in location but not identity or the binding of location and identity information. This evidence is consistent with the idea that young infants are unable to maintain the information processed separately in both the dorsal and ventral visual streams during occlusions. Our results suggest that it is the target's affordance for action that determines whether the dorsal or ventral information is selectively maintained during occlusion.     

Functional analysis and treatment of verbal perseverations displayed by an adult with autism

The function of perseverative speech for an adult man who had been diagnosed with autism and mental retardation was examined. Results showed that verbal perseverations were maintained by social attention. An intervention consisting of differential reinforcement of appropriate verbal responses and extinction of perseverative verbal responding was effective in decreasing verbal perseverations.     

The effects of presession attention on problem behavior maintained by different reinforcers

The effect of presession attention on the later occurrence of problem behavior was examined with elementary-school children with a range of disabilities. Results of analogue functional analyses suggested an escape function, an attention function, or both. Following the analogue functional analyses, the effects of two antecedent conditions (10-min ignore vs. 10-min attention) were compared on problem behavior in subsequent test conditions. For participants who displayed attention-maintained problem behavior, the test condition involved contingent attention for problem behavior. For participants who displayed escape-maintained problem behavior, the test condition involved contingent escape for problem behavior. Results indicated that participants who displayed attention-maintained problem behavior displayed less problem behavior following presession exposure to attention than when ignored. No such effect was found for presession attention on escape-maintained problem behavior. We discuss matching antecedent-based interventions to the results of functional analysis.     

Infants perceiving and acting on the eyes: tests of an evolutionary hypothesis

It has been hypothesized that an evolutionarily ancient mechanism underlies the ability of human infants to detect and act upon the direction of eye gaze of another human face. However, the evidence from behavioral studies with infants is also consistent with a more domain-general system responsive to the lateral motion of stimuli regardless of whether or not eyes are involved. To address this issue three experiments with 4-month-old infants are reported that utilize a standard face-cueing paradigm. In the first experiment an inverted face was used to investigate whether the motion of the pupils elicits the cueing effect regardless of the surrounding face context. In the second experiment pupil motion and eye gaze direction were opposed, allowing us to assess their relative importance. In a third experiment, a more complex gaze shift sequence allowed us to analyse the importance of beginning with a period of mutual gaze. Overall, the results were consistent with the importance of the perceived direction of motion of pupils. However, to be effective in cueing spatial locations this motion needs to be preceded by a period of direct mutual gaze (eye contact). We suggest that evolution results in information-processing biases that shape and constrain the outcome of individual development to eventually result in adult adaptive specializations.     

A modest proposal: (re)defining unconscious fantasy

The author argues that unconscious fantasy, properly defined, necessarily represents the three-dimensional intersection of wishful thinking (fantasy), veridical perception of the environment (reality), and the naive cognition of childhood. It is proposed that, although attachment theory developed out of the intent to capture the unalloyed reality of dyadic experience, that experience is inextricably entangled with the other two components, wishes and naive cognition, and furthermore, that the behavior of children in the attachment paradigm can only be accounted for by positing the existence of underlying unconscious fantasies. In making these arguments, the author also addresses the development of unconscious fantasies and their relationship to compromise formations and trauma.     

Remembering chosen and assigned options

Recent studies have shown systematic choice-supportive memory for past choices, wherein people tend to overattribute positive features to options they chose and negative features to unchosen options (Mather & Johnson, 2000, Mather, Shafir, & Johnson, 2000). In contrast, the present experiments showed no choice-supportive memory bias for assigned options. Rather than having a general motivation to recall the chosen or the assigned option in a more positive light, people appear to be influenced by heuristics that vary with context: In recalling past choices, people expect the chosen option to contain more positive and fewer negative features than do its competitors. In recalling past assignments, in contrast, people expect the assigned option to be remembered better than the unassigned alternatives. This vividness heuristic leads to systematic misattribution of new features to unassigned alternatives, but not in a manner supportive of the assigned option. Some implications of these findings are discussed.     

Evidence-based treatment of stuttering: V. The art of clinical practice and the future of clinical research

This epilogue summarizes and expands on some of the many points raised in Parts I through IV, emphasizing that evidence-based practice is not in conflict with the "art" of clinical practice but may actually be synonymous. An evidence-based practice framework is also used to suggest some future directions for clinical research in stuttering. EDUCATIONAL OBJECTIVES: The reader will learn about and be able to (1) describe the similarities between evidence-based practice and the art of clinical practice, (2) explain how evidence-based practice provides a structure for future stuttering research, and (3) evaluate the importance of an evidence-based approach to stuttering treatment.     

Inferring the mental processes of other minds

In 4 experiments, the authors examined how several variables influence the quality and quantity of information that people use to make judgments about other people. The results showed that when possible, participants consistently responded appropriately to variables that influenced information that they used to make inferences about other minds. The results also suggested that under circumstances with no opportunity to contrast behavior in different situations, people might not be sensitive to the quality and quantity of information present. The authors interpreted results to mean that under most circumstances, people make inferences in a way that efficiently uses information about the causes of behavior.     

The violent matrix: a study of structural,interpersonal, and intrapersonal violence among a sample of poor women

One goal of this paper is to present an integrated tripartite model of violence, with a focus on structural violence within an oppression paradigm. Using qualitative and quantitative data from 27 women (70% African American and 30% European American) who participated in a national substance abuse treatment demonstration program, we describe a model of violence in which structural violence is presented within a transactional relationship with interpersonal, and intrapersonal violence. We suggest that the effects of structural, interpersonal, and intrapersonal violence are magnified when race and poverty are considered. The second goal of the paper is to present a preliminary test of the new model of violence. Results indicated that different levels and types of violence are interrelated. Implications of these findings for empowering solutions are suggested.