Improving fairness in coverage decisions: performance expectations for quality improvement

Patients and physicians often perceive the current health care system to be unfair, in part because of the ways in which coverage decisions appear to be made. To address this problem the Ethical Force Program, a collaborative effort to create quality improvement tools for ethics in health care, has developed five content areas specifying ethical criteria for fair health care benefits design and administration. Each content area includes concrete recommendations and measurable expectations for performance improvement, which can be used by those organizations involved in the design and administration of health benefits packages, such as purchasers, health plans, benefits consultants, and practitioner groups.     

Scientific Meetings of The American Institute for Psychoanalysis

Conference Report

Scientific Meetings of The American Institute for Psychoanalysis     

The team halo effect: why teams are not blamed for their failures

In this study, the existence of the team halo effect, the phenomenon that teams tend not to be blamed for their failures, is documented. With 2 studies using both real teams and controlled scenarios, the authors found evidence that the nature of the causal attribution processes used to diagnose failure scenarios leads to individuals being more likely to be identified as the cause of team failure than the team as a collective. Team schema development, as indexed by team experience, influences this effect, with individuals who have more team experience being less likely to show the team halo effect     

Power and Psychological Well-Being in Late Adolescent Romantic Relationships

Using Olsen and Cromwell's (1975) three facetsof interpersonal power (power in resources, process, andoutcomes), we examined the balance of power in lateadolescent romantic relationships and the associations between interpersonal power, adolescents'self-esteem, and depression. Participants were 61adolescent couples who were primarily European-American(90% of girls and 93% of boys), with the remainder being comprised of approximately 2-3% each of NativeAmerican, Asian, African American, and Hispanicindividuals. We assessed power in terms of access toemotional resources, control during video-tapedinteraction, and control over decision-making. Overall,couples were more likely to be described by themselvesand by independent observers as egalitarian, with themajority of couples equally contributing emotional resources, sharing power in interaction, andsharing decision-making responsibility. However,romantic relationships characterized by inequality inthe contribution of emotional resources and indecisionmaking were associated with greater psychologicalsymptomatology, especially for females.     

FDG-PET analysis and findings in amnesia resulting from hypoxia

The assumptions underlying neuroimaging, and problems in its analysis and interpretation, are commonly underestimated in neuropsychology. The ways in which fluoro-deoxy-glucose (FDG) positron emission tomography (PET) data can be analysed are discussed. PET findings from four patients who had suffered severe amnesia, following episodes of acute hypoxia, are presented. These patients had shown evidence of medial temporal (hippocampal and parahippocampal) atrophy on MRI brain scans. The PET data were analysed in several different ways. The converging findings were that the patients showed bilateral thalamic hypometabolism, and there was also evidence of retrosplenial hypometabolism bilaterally. Cognitively, these patients performed most like other patients with medial temporal lesions, but the results indicate that structural lesions can have distal metabolic effects on structures elsewhere. These findings are interpreted in the light of neuroanatomical observations concerning parallel projections between medial temporal lobe structures and the thalamus, some of which pass via the retrosplenium.     

Undermining the Undermining Effect of Reward on Sustained Interest1

Sometimes, without recourse to controlling rewards, it is difficult to secure desirable behaviors. Yet, much work has demonstrated the damaging effect that such rewards can have on subsequent independent interest in the reward-induced behavior. Therefore, one who feels required to use controlling rewards to increase desirable action in another faces a dilemma: Failing to employ the rewards means foregoing the desired conduct in the immediate situation, hut applying them risks undermining the other's long-term interest in the conduct. We tested a technique designed to avoid this dilemma by (a) providing a controlling reward to obtain the desired action, but (b) then attributing the action to an abiding trait of the actor. Using this technique, we were able to reverse the damaging impact of a controlling reward on children's motivation to write well.     

Object individuation in young infants: Further evidence with an event-monitoring paradigm

Recent results indicate that, when tested with an event-monitoring task, 7.5- and 9.5-month-olds give evidence that they can individuate objects in different-objects occlusion events – events in which two distinct objects appear successively on either side of an occluder (Wilcox and Baillargeon, in press). The present research sought to confirm and extend these findings. The experiments examined 7.5- and 4.5-month-olds’ ability to correctly interpret a different-objects (ball-box condition) and a same-object (ball-ball condition) occlusion event. The infants in the ball-box condition saw a test event in which a ball disappeared behind the left edge of a screen; after a pause, a box emerged from behind the screen's right edge. For half of the infants (wide-screen event), the screen was wide and could occlude the ball and box simultaneously; for the other infants (narrow-screen event), the screen was narrow and should not have been able to occlude the ball and box at the same time. The infants in the ball-ball condition saw identical wide- and narrow-screen events except that the ball appeared on both sides of the screen. The infants in the ball-box condition looked reliably longer at the narrow- than at the wide-screen event, whereas those in the ball-ball condition tended to look equally at the events. These results suggest that the ball-box infants (a) were led by the featural differences between the ball and box to view them as distinct objects; (b) judged that the ball and box could both be occluded by the wide but not the narrow screen; and (c) were surprised in the narrow-screen event when this judgment was violated. In contrast, the ball-ball infants (a) assumed, based on the featural similarities of the balls that appeared on either side of the screen, that they were one and the same ball, and (b) realized that the ball could be occluded by either the wide or the narrow screen. These results indicate that, by 4.5 months of age, infants are able to use featural information to correctly interpret different-objects and same-object occlusion events. These findings are discussed in the context of the newly-drawn distinction between event-monitoring and event-mapping paradigms (Wilcox and Baillargeon, in press).     

Affective communication differences between distressed and nondistressed mother-adolescent dyads

An assessment technique of having mothers and young adolescents describe in brief written form what they like and dislike about each other was evaluated. Distressed dyads (N=38) produced responses that were rated significantly more negative (Demanding, Personal Attack, Anger and Hostility, Complaining About Unfairness or Disrespect) and less positive (Good Relationship, Appreciation of Other, Complimentary, and Enjoyment) than nondistressed dyads (N=40). Evidence of reliability was reported. Ratings of the written responses correlated significantly with independently obtained codings of taperecorded interactions, thus offering support for validity of the method.The authors wish to thank Diane Follingstad and Peter Kilmann for their comments on an earlier draft.     

The Effects of Numerical and Logical Group Size on Computer-Mediated Idea Generation

A laboratory experiment investigated the effects of numerical group size and logical group size (i.e., group heterogeneity in regard to task demands) on the performance of groups addressing an idea generation task while using computer-mediated communication. Six different numerical group sizes were studied, which ranged from 5 to 10 members. Logical size was manipulated by varying the amount of task-relevant information given to a particular group member. Larger logical group sizes (heterogeneous groups) were induced by distributing unique task-relevant information among group members; smaller logical group sizes (homogeneous groups) were induced by providing all task information to all members. A significant main effect for numerical group size showed that larger groups outperformed smaller groups. Numerical group size interacted with logical group size resulting in greater performance gains for increased numerical group size within heterogeneous groups. Average contributions per group member diminished with increased numerical group size for homogeneous groups and increased for heterogeneous groups.     

Rock Stars in Anti‐Drug‐Abuse Commercials: An Experimental Study of Adolescents' Reactions1

Two studies examined adolescents' perceptions and effectiveness of rock stars in antidrug‐abuse public‐service announcements (PSAs). In the pilot study (N= 24 teenagers), adolescents expected rock musicians, and in particular heavy metal musicians, to be drug users. In our experimental study (N= 78 high school students aged 15 to 16 years), one group was shown 4 PSAs produced by Rock Against Drugs, using rock stars Jon Bon Jovi, Aimee Mann, Gene Simmons, and Belinda Carlysle as spokespersons. The comparison group was shown 4 equivalent PSAs that were created using unknown actors selected for their similarity to the rock stars in terms of age, ethnicity, and gender, but without any reference to rock music. PSA ratings were taken on 4 scales: attractiveness, expertness, trustworthiness, and overall PSA rating. Pretest and posttest measures of drug attitudes supported our hypotheses that countermessages from rock stars denormalize the connection between rock music and drugs, and that adolescents respond more positively to PSAs with rock stars than to PSAs without rock stars.