Patient distortion in reporting outcome: A procedure for correcting patient outcome scores

Outcome scores that are provided by patient report are routinely used in therapy outcome studies. Despite their popularity they are usually viewed with suspicion since they are assumed to reflect a considerable amount of distortion. Two procedures for estimating patient distortion and for creating corresponding correction factors for outcome scores are presented. When either procedure was used to correct the outcome scores of 34 outpatients from six therapy groups in a process-outcome study, a number of significant correlations emerged where none had existed previously when uncorrected scores had been used. When a third correction procedure based on social desirability was used, significant correlations did not emerge. The findings have implications for correcting patient distortion in both individual and group therapy outcome studies.     

Use of first person pronouns as a function of increased objective self-awareness and performance feedback

A recent integrating formalation in social psychology, the Duval-Wicklund theory of “objective self-awareness,” has the core assumption that attention focused on the self is always aversive and, hence, avoided. While faced with either a TV camera or a mirror, and after they had received false feedback concerning their creativity, 98 undergraduates guessed at the meaning of foreign language pronouns, the unobtrusive dependent measure of the direction of the focus of attention. The standard Duval-Wicklund effect was replicated—more attention to self, that is, more first-person pronouns—in the “camera” or “mirror” than in the “no camera” or “no mirror” conditions. However, within the camera or mirror conditions, avoidance of self-focused attention occurred only after negative feedback.     

A developmental study of facilitation by mnemonic instruction

First- and fourth-grade children, as well as adults, were given mnemonic instructions to image or to verbalize a sentence in order to study either a sentence or a noun pair provided aurally. Uninstructed control subjects also were included at each age level. A test of cued recall evaluated the amount of facilitation by mnemonic instruction in each of the groups. Both types of instruction enhanced children's memory, most notably when verbal pairs served as stimuli. However, whereas first graders under imagery instruction were inferior on pairs relative to sentence stimuli, fourth graders and adults recalled the two stimulus types equivalently. Also, whereas first graders performed at the same level on sentences and pairs under the verbalization instruction, fourth graders were superior on the pairs. These results indicate that greater requirements for subject-generated mediation to some degree penalized the younger subjects and benefited the older ones.     

Inferences about the femininity of competent women and their implications for likability

Male (N=59) and female (N=60) college students were given a written protocol describing a competent, achievement-oriented female stimulus person (SP) with either a masculine or feminine pattern of vocational and avocational interests. Three groups were given a masculine-pattern protocol and one group was given a feminine-pattern one. They were then asked to rate the SP on likability in work and social settings, femininity, and a number of other personal attributes. Two groups given the masculine-pattern protocol were also supplied with the SP's responses to items from a “personality” test answered in a predominantly feminine (Masculine—Feminine SP) or masculine (Masculine-Masculine SP) direction. The remaining groups (Masculine-Neutral and Feminine-Neutral SPs) were given no additional information. In agreement with previous findings, the Masculine-Neutral SP was liked more in social settings than was the Feminine-Neutral one. It was hypothesized and confirmed that the Masculine-Neutral SP would be perceived as similar to the Masculine-Feminine SP in femininity and likability and that both these SPs would be judged to be higher on these characteristics than the Masculine-Masculine. Complex results were obtained from the ratings of other attributes. Overall, they indicated that the Masculine-Feminine SP, in whom femininity was explicitly suggested, received the weakest ratings on a series of achievement-related attributes and the Masculine-Neutral SP the strongest.     

AN EXPERIMENTAL COMPARISON OF A CONTINGENCY MANAGED COURSE WITH LARGE LECTURE METHOD1

Contingency management procedures resembling the Personalized System of Instruction (PSI) were compared with a conventional lecture method in teaching an introductory psychology course. The use of a within-subjects design in which half of the students experienced both teaching conditions made it possible to examine the reliability of test-score differences over time when subjects were balanced over conditions. In the contingency management course, material was broken down into 14 small units, each unit covering about 30 pages of text. Students were assigned to an undergraduate teaching assistant who was encouraged to develop a close working relationship with each of his/her 13 assigned students. Specifically, this meant that the assistant was to call each student by his/her first name, show an interest in the student's quiz performance, help the student understand difficult concepts, and discuss various topics of interest to the student. Each week, the teaching assistant administered up to four different 10-item multiple-choice quizzes over the week's chapter. A modified “Doomsday Contingency” required each student either to achieve a score of 80% on one of the four quizzes or drop the course. Most students passed the quiz during the first session of the week; those not passing were tutored on special areas of weakness. No student was actually forced to leave the course under the Doomsday Contingency. Although quizzes were administered on a group basis, they were scored individually while the student stood near by. In addition to the weekly quiz assignment, students under the contingency management procedures were asked to attend one lecture per week. The contingency management method departed from traditional PSI in that (1) self pacing was minimal, such that students were required to master one unit per week or drop the course, (2) teaching assistants met with students in small groups, and usually gave individual tutoring only to those students who did not pass the quiz on the first attempt, and (3) students were asked to attend one lecture per week. However, it was similar to PSI in that small units of subject matter were assigned and unit mastery was assessed through use of undergraduate assistants who delivered immediate feedback. Students in the conventional lecture group attended three 50-min lectures each week; two of these lectures followed textbook material closely, while the third, which was attended by all students, concerned material only indirectly related to the text. As a result, students in both conditions were exposed to essentially identical material. Students in the lecture condition could also obtain copies of the unit quizzes, although few did so. Course grades were determined by scores on two 45-item multiple-choice hourly exams, each covering half of the semester material (each worth 25%), and by a 90-item final exam over the entire course (worth 50%). These measures also served as the dependent variables. The experimental design employed a crossover technique in which one fourth of the students began with the contingency management method and then switched to lecture method at midsemester, while another fourth began with the lecture method and switched to contingency management. The other students stayed in the same condition throughout the semester, half under contingency management and half under the lecture method. On the last day of class, all students filled out an extensive questionnaire that assessed their opinions and attitudes about the teaching techniques. In addition to allowing for assessment of any progressive effects that the contingency management procedures might have had over time, the crossover design also permitted students to make meaningful comparisons of the two teaching methods, since half of the students experienced both methods in the same course. Although average test performance was only slightly higher under the contingency management condition, this difference occurred on each exam and was statistically reliable in each case. Further, the method did not interact with time, as it produced about a three-item advantage per half semester. On each of the three exams, teaching method accounted for between 5 and 8% of the total variance in test scores. Finally, attitude measures indicated that students experiencing half a semester of the contingency management procedures preferred them to the lecture technique, but that only those students with a full semester of contingency management rated the course significantly better than students in the full semester lecture course.     

Sex differences in preadolescent self-disclosure

Both amount and content of self-disclosure may vary with sex role. Both adult and preadolescent females have been reported as engaging in greater amounts of self-disclosure than males; the present study attempted to replicate these findings with preadolescents, and to investigate sex differences in the content of self-disclosure. A self-disclosure questionnaire covering a wide range of subjects was administered to 307 urban children. The sex difference on the total number of items revealed to a friend closely approached significance, with girls showing greater disclosure. When only intimate content items were examined, the sex difference reached clear significance. Content analysis showed that girls were more willing to reveal items related to emotionality, anxiety, and dependence.     

Handedness and sex differences in hemispheric asymmetry

A study was designed to assess the contributions of the factors of sex and familial history to cerebral dominance, where cerebral dominance was inferred from laterality on a dichotic listening task. The 144 subjects were selected from a larger sample on the basis of handedness, sex, and familial history of sinistrality, and tested on a task involving the dichotic presentation of CV syllables. Analysis of the data indicated that in female subjects, the presence of familial sinistrality increased the likelihood that they present atypical left-ear superiorities, while in males the converse was the case. Moreover, there was a significant sex difference overall, such that males were more clearly lateralized than females. A review of other dichotic listening studies provided support for the reliability of this sex difference for dichotic tasks using verbal material. A review of the clinical literature indicated that the hypothesis of a sex difference is at least tenable and merits further investigation. However, the possibility that there is a sex difference in the cognitive strategy used in dichotic listening cannot be ruled out.     

Comorbidity of test anxiety and other anxiety disorders in children

Elementary school children with clinically significant test anxiety, as determined by self-report and a clinical interview, were assessed for the incidence of other fears and anxiety. The results indicated that test-anxious children reported more fears and general worries than their non-test-anxious peers. As expected, the test-anxious children experienced more negative cognitions and subjective distress when taking a test. Furthermore, the fear of negative evaluation was not limited to an actual test, since these children also reported identical symptoms when engaged in a second social-evaluative task. Finally, 60% of the testanxious sample met DSM-III criteria for an anxiety disorder. The results are discussed in terms of the relationship of text anxiety to more complex social-evaluative dysfunctions, more pervasive anxiety conditions, DSM-III anxiety disorders, and the utility of test anxiety as an indicator of the presence of these more pervasive anxiety states.This research is based on a dissertation conducted by the first author under the direction of the second author. Thanks are expressed to Stephen B. Manuck, Scott M. Monroe, Sharon Nelson-LeGall, and Saul Shiffman, who served as committee members. This study was supported in part by National Institute of Mental Health Grants No. 30915 and No. 16804, and a grant to the first author from the Sigma Xi Foundation.     

Cross-domain semantic priming in normal subjects and a prosopagnosic patient

Cross-domain semantic priming of person recognition (from face primes to name targets at 500msecs SOA) is investigated in normal subjects and a brain-injured patient (PH) with a very severe impairment of overt face recognition ability. Experiment 1 demonstrates equivalent semantic priming effects for normal subjects from face primes to name targets (cross-domain priming) and from name primes to name targets (within-domain priming). Experiment 2 demonstrates cross-domain semantic priming effects from face primes that PH cannot recognize overtly. Experiment 3 shows that cross-domain semantic priming effects can be found for normal subjects when target names are repeated across all conditions. This (repeated targets) method is then used in Experiment 4 to establish that PH shows equivalent semantic priming to normal subjects from face primes which he is very poor at identifying overtly and from name primes which he can identify overtly. These findings demonstrate that automatic aspects of face recognition can remain intact even when all sense of overt recognition has been lost.     

Reconsidering the Role of Attitudes in Exercise Behavior: A Decision Theoretic Approach1

Two studies demonstrated that subjective expected utility (SEU) theory predicted interest in, but not adherence to, a weightlifting exercise program. The studies also showed that attitudes were related to adherence for certain individuals. Specifically, attitudes toward not weightlifting were related to the number of days experienced subjects weightlifted. In addition, in Study 1, experienced subjects had more positive attitudes toward weightlifting and more negative attitudes toward not weightlifting than did inexperienced subjects, and the two groups differed on a number of underlying beliefs. Similarly, in Study 2, experienced subjects had more positive attitudes toward weightlifting and differed from inexperienced subjects on a number of underlying beliefs. These results are discussed in terms of their implications for several issues: the usefulness of SEU theory in the exercise domain; the importance of considering attitudes toward alternative courses of action (including inaction) when attempting to predict exercis–or any other–behavior; the need to distinguish between exercise adoption (initiation) and maintenance (adherence); and the importance of Beach's (1982, 1985) distinction between deasion making and decision implementation.