To stay or to go, to speak or stay silent, to act or not to act: moral distress as experienced by psychologists

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice.     

Psychometric evaluation of the restructured clinical scales of the MMPI-2

Conceptual overlap and heterogeneity have long been noted as weaknesses of the Minnesota Multiphasic Personality Inventory's clinical scales. Restructured clinical (RC) scales recently were developed to address these concerns (A. Tellegen et al., 2003). The authors evaluated the psychometric properties of the RC scales in psychology clinic clients (N=285) and military veterans (N=567). The RC scales were as internally consistent as the clinical scales and correlated strongly with their original counterparts (except for RC3/Hysteria). They also were less intercorrelated, produced conceptually clearer relations with measures of personality and psychopathology, and yielded somewhat greater incremental utility than the clinical scales. Thus, the RC scales demonstrated several psychometric strengths while utilizing 60% fewer items, but the 2 sets of scales cannot be used interchangeably. Interpretive considerations are discussed.     

Metabolic and endocrine disturbances in psychiatric disorders: a multidisciplinary approach to appropriate atypical antipsychotic utilization

Patients with psychiatric disorders have an increased rate of cardiovascular morbidity and mortality compared with the general population. Metabolic issues such as weight gain, dyslipidemia, diabetes mellitus, diabetic ketoacidosis,and pancreatitis have been reported with the use of antipsychotic agents. Although atypical antipsychotics have not been linked directly to the development of metabolic syndrome, these medications have been shown to increase risk factors that can lead to metabolic and endocrine disturbances. Therefore, clinicians should provide ongoing monitoring for patients who are being treated for psychiatric disorders with these agents. According to the 2004 Consensus Report on Antipsychotics, screening measures should include baseline and follow-up monitoring of personal/family histories, weight (body mass index), waist circumference, blood pressure, fasting plasma glucose, and fasting lipid profile.     

The role of a language scale for infant and preschool assessment

The PLS-4 (Preschool Language Scale, 4th edition) is a psychometrically sound instrument constructed to assess language skills in children from birth to 6 years 11 months. It is a useful diagnostic and research tool that can be used to identify current comprehension and expressive language skills and can measure changes in language skills over time. The test is individually administered and includes tasks that assess skills in the areas of preverbal behaviors, as well as linguistic skills in the areas of semantics, morphology, syntax, integrative language skills, and preliteracy skills. Extensive reliability and validity evidence are presented. The test has been used extensively in research examining language development of young children from different home environments, children with identified medical conditions, and children participating in a variety of habilitation and intervention programs. Both the previous edition (PLS-3) and the new PLS-4 English and Spanish editions are used extensively in clinical, medical, and research settings to examine developmental language patterns of infants, toddlers, and preschoolers.     

Toward a taxonomy of attention shifting: Individual differences in fMRI during multiple shift types

Although task switching is often considered one of the fundamental abilities underlying executive functioning and general intelligence, there is little evidence that switching is a unitary construct and little evidence regarding the relationship between brain activity and switching performance. We examined individual differences in multiple types of attention shifting in order to determine whether behavioral performance and fMRI activity are correlated across different types of shifting. The participants (n=39) switched between objects and attributes both when stimuli were perceptually available (external) and when stimuli were stored in memory (internal). We found that there were more switchrelated activations in many regions associated with executive control—including the dorsolateral and medial prefrontal and parietal cortices—when behavioral switch costs were higher (poor performance). Conversely, activation in the ventromedial prefrontal cortex (VMPFC) and the rostral anterior cingulate was consistently correlated with good performance, suggesting a general role for these areas in efficient attention shifting. We discuss these findings in terms of a model of cognitive-emotional interaction in attention shifting, in which reward-related signals in the VMPFC guide efficient selection of tasks in the lateral prefrontal and parietal cortices.     

Visual analogue scale correlates of musculoskeletal fatigue

Visual analogue scale has been shown to reflect subjective feelings but rarely has it been used for musculoskeletal fatigue so in the present study VAS ratings were used to quantify musculoskeletal fatigue. A total of 20 students underwent a fatigue protocol (M age=21.3 yr., SD= 1.0). A series of randomized external loads at 0, 5, 10, 15, 25, 35, and 50% of the maximum voluntary contraction was generated by the BTE Primus and applied at the distal end of the dominant arm, which was sustained at the 90 degrees forward flexion position. After 60 sec. of force exertion for each loading, the subject marked the scale to reflect their extent of fatigue at the shoulder muscle. Analysis showed fatigue scores were significantly correlated with the percentages of maximum load applied (r =.73, p < or = .01). The correlation between higher external loads (25-50% maximum load) and fatigue scores was .57 (p < or = .01) and that for lower external loads (0-15% maximum load) was .44 (p < or = .01). The validity of using a visual analogue scale as a measure of musculoskeletal fatigue requires further study, particularly for a low load.     

Effects of familiar and unfamiliar asynchronous music on treadmill walking endurance

To assess effects of familiarity of music on treadmill endurance, 15 female undergraduates in sports science performed an incremental treadmill walking task on three separate occasions while listening to Familiar Music, Unfamiliar Music, and White Noise. A repeated-measures analysis of variance indicated that participants walked for significantly longer when accompanied by Familiar and Unfamiliar Music in comparison to White Noise (p<.01). Although participants rated Familiar Music as significantly more motivating than Unfamiliar music (p<.05), no significant differences were found between the two music conditions for treadmill endurance. Heart rates did not appear to be influenced by music during treadmill walking or on completion of the task.     

Interpersonal perception in Japanese and British observers

We compared performance of Japanese and British observers in deciphering images depicting Japanese interpersonal relationships. 201 Japanese and 215 British subjects were assessed by means of a test consisting of 31 photograph problems accompanied by two or three alternative solutions one of which was correct. Japanese subjects outperformed British subjects on the test overall (z = 3.981, p < 0.001). A two-factor ANOVA (culture x gender) was performed for each of the problems. A cultural effect was found in 17 problems. Surprisingly, British subjects outperformed Japanese subjects in 7 of these problems. There was a gender effect in 4 problems and a culture x gender interaction in 6 problems. The results indicate that cultural experience facilitates nonverbal appraisal of interpersonal relationships, but it may sometimes cause specific errors. Differences in the perceptual cues used suggest that British subjects had difficulty reading Japanese facial expressions.     

Handedness and the fringe of consciousness: strong handers ruminate while mixed handers self-reflect

Previous research found that mixed handers (i.e., those that are more ambidextrous) were more likely than strong handers to update their beliefs (Niebauer, Aselage, & Schutte, 2002). It was assumed that this was due to greater degrees of communication between the two cerebral hemispheres in mixed handers. Niebauer and Garvey (2004) made connections between this model of updating beliefs and metacognitive processing. The current work proposes that variations in interhemispheric interaction (as measured by degree of handedness) contribute to differences in consciousness, specifically when consciousness is used in rumination versus the metacognitive task of self-reflection. Using the Rumination-Reflection Questionnaire (Trapnell & Campbell, 1999), predictions were supported such that strong handedness was associated with self-rumination; whereas, mixed handedness was associated with increased self-reflection p values<.01, (N=255). James's (1890) concept of the "fringe of consciousness" is used to make connections between metacognition, updating beliefs, and self-reflection. Several studies are reviewed suggesting that mixed handers experience fringe consciousness to a greater degree than strong handers.     

The Parents Matter! Program Interventions: Content and the Facilitation Process

The Parents Matter! Program (PMP) has developed three interventions for parents of 4th and 5th grade African-American children (9–12 years old). The overarching goal of all three interventions is to provide parents with knowledge, skills, and support for enhancing their efforts to raise healthy children. The interventions are: (1) Enhanced Communication and Parenting (five 2 -hour sessions), (2) Brief Communication and Parenting (single 2 -hour session), and (3) General Health (single 2 -hour session). This article discusses the development of these interventions, presents an overview of the content of each intervention, and discusses issues related to the facilitation/presentation of these interventions.