Taking an individualized approach to the assessment of self-efficacy and the prediction of alcoholic relapse

The present study reports on a clinical instrument designed for assessing self-efficacy in alcoholics. In contrast to studies that construct general measures, it was proposed that taking an individualized approach to assessment might offer an effective methodology. Thirty-four alcoholics in an outpatient, behaviorally oriented treatment program participated as subjects. During therapy, an Individualized Self-Efficacy Survey (ISS) was developed for each subject. The ISS was developed by (a) administering the Drinking Patterns Questionnaire (DPQ) to identify important problem areas (e.g., work, children, marital) and specific drinking antecedents and (b) constructing a 15-item scale using each drinker's most important cues. The utility of having clients choose their own items was supported by finding a significant relationship between problem areas identified as important on the DPQ and the areas reported as surrounding relapse. ISS ratings were reflective of efficacy changes during treatment, while posttreatment ISS scores were predictive of subsequent relapse. Situation-specific prediction of relapse was not found. The advantages of this methodology for clinical use are discussed, while general directions for future research are suggested.     

SPEECH PERCEPTION AS A TALKER-CONTINGENT PROCESS

Abstract— To determine how familiarity with a talker's voice affects perception of spoken words, we trained two groups of subjects to recognize a set of voices over a 9-day period One group then identified novel words produced by the same set of talkers at four signal-to-noise ratios Control subjects identified the same words produced by a different set of talkers The results showed that the ability to identify a talker's voice improved intelligibility of novel words produced by that talker The results suggest that speech perception may involve talker-contingent processes whereby perceptual learning of aspects of the vocal source facilitates the subsequent phonetic analysis of the acoustic signal     

The role of theory in treating adolescent substance abuse

The adolescent substance abuser, like adult addicts, is most commonly considered from the perspective of the disease model. The usefulness of the disease model in conceptualizing adolescent substance abuse is questioned, and an alternative view of the topic is set forth. Substance abuse, is regarded as an adaptive aspect of the ongoing interactive processes within the family. The developmental process of the adolescent substance abuser is seen as a functional dynamic in the family's preservation. Three characteristic elements of parental interaction common to the development of adolescent substance abuse are highlighted.An earlier version of this paper was presented at the Texas Association for Marriage and Family Therapy annual conference on January 28, 1993 in Houston Texas.a research associate and director of the Don D. Jackson Archive at the Mental Research Institute, Palo Alto, CA. Authors are listed alphabetically.     

Child abuse: is there a mandate for researchers to report?

During the past 20 years, states have increasingly expanded the lists of individuals who are obligated to report their suspicions of child abuse and neglect. These legal requirements are juxtaposed with ethical considerations in research and professional practice. The ethical issues include the obligation to maintain both confidentiality of information provided by human participants and the safety and protection of these participants. This article reviews the types of state child abuse reporting statutes and outlines the categories of mandated reporters. I develop a model of how individual researchers should approach deciding whether they are mandated reporters of child abuse and neglect.     

Existentialism and postmodernism. Continuities,breaks, and some consequences for medical theory

Since existentialism lost its influence in philosophy in the 1960s, postmodern theory has taken over criticizing basic concepts of western thought. From a postmodern point of view, the main shortcomings of existentialism is that it criticizes traditional unitarian concepts, while re-inventing new unitarian models. Against these unitarian approaches postmodernism holds that the world can only be described in terms of difference. In this article the postmodern program and its differences from existentialism are explained in reference to three concepts of western philosophy: subject, truth, and ethics. Applying these concepts, the relevance of postmodernism for medical theory is illustrated.     

Cognitive function after open-heart surgery: Are postoperative neuropsychological deficits caused by cardiopulmonary bypass?

Despite the many technological developments in arterial perfusion and cardiac surgical procedures, open-heart surgery is still believed to pose a significant risk for cerebral injury. There are several potential causes of brain damage during open-heart surgery, including prolonged or severe arterial hypotension, as well as emboli emanating from the cardiopulmonary bypass circuit or the operative field. This article reviews the available neuropsychological studies of outcome following cardiac valve replacement and coronary artery bypass grafting. Because both procedures are life-saving operations, the research in this area has been quasi-experimental and fraught with methodological problems. Nonetheless, the findings converge to suggest that cognitive dysfunction occurs after open-heart surgery, and that the deficits are attributable, at least in part, to factors specific to the operation or to the patient being maintained on cardiopulmonary bypass. Preliminary findings suggest that embolization is the primary cause of perioperative deficits in uncomplicated operations. Studies have also consistently found preoperative deficits in this population, suggesting that neuropsychological dysfunction is caused by severe chronic cardiac disease as well as open-heart surgery.     

On the scaling of visual space from motion—in response to Pizlo and Salacfa-Golyska

Pizlo and Salack-Golyska (1994) have raised an important question about the validity of the interpretation of experiments reported by Lappin and Love (1992)—based on the fact that alternative cues in the image plane might have supported the shape discriminations in those experiments. The meaning of the hypothesis that visual space may be scaled by congruence under motion is clarified, pertinent evidence is reviewed, and new experimental evidence is reported We conclude that visual space can be metrically scaled by congruence of moving shapes.     

An investigation of the sampling distributions of item discrimination indices

The sampling properties of four item discrimination indices (biserialr, Cook's indexB, theU–L 27 per cent index, and DeltaP) were investigated in order to ascertain their sampling properties when small samples drawn from actual test data rather than constructed data were employed. The empirical results indicated that the mean index values approximated the population values and that values of the standard deviations computed from large sample formulas were good approximations to the standard deviations of the observed distributions based on samples of size 120 or less. Goodness of fit tests comparing the observed distributions with the corresponding distribution of the product-moment correlation coefficient based upon a bivariate normal population indicated that this correlational model was inappropriate for the data. The lack of adequate mathematical models for the sampling distributions of item discrimination indices suggests that one should avoid indices whose only real reason for existence was the simplification of computational procedures.This research reported herein was performed pursuant to a contract (OE-2-10-071) with the United States Office of Education, Department of Health, Education and Welfare.