Cognitive guidelines for simplifying medical information: Data framing and perception

In this paper, 1 describe psychological guidelines for simplifying medical information — methods to aid the perception and recognition of abnormalities in medical test reports. These techniques resemble natural human editing strategies outlined in prospect theory. The methods pre-edit data as humans do but to reduce human effort. I review empirical studies assessing these techniques and discuss needs for further research.     

The on-line voyeur: Promises and pitfalls of observing electronic interaction

Studies that compare objective data on communication activity to data provided in verbal reports have indicated that verbal report data are not as accurate as one might hope. Researchers of communication have used verbal reports as their primary source of data because it presents a cheap and easy way to collect the data. This paper presents an easy alternative involving the study ofelectronic communication: a method that allows the collection of objective information on electronic communication, thus avoiding the problems associated with self-reports. The paper reviews the available literature on the accuracy of self-reports of communication, presents the instrument used to collect the objective electronic communication data, and discusses some of the difficulties and limitations encountered in implementing a study using the instrument.     

Conversational skills for autistic adolescents: An autistic peer as prompter

In this study, an autistic youth served as peer prompter for three other autistic adolescents. The peer prompter encouraged the other boys to talk about sports, a topic frequently discussed by typical teenagers. A multiple-baseline design across participants was used to assess the effectiveness of the peer-prompting procedure. During baseline, the youth rarely talked about sports, although all three had previously completed a sports-appreciation class and had displayed large pre-to-post gains on a paper-and-pencil test. During intervention, when a peer prompted sports discussions, all three youth engaged in much more sports-related conversation. Generalization measures indicated that: (1) the youth engaged in sports discussions in groups, as well as in the dyads that characterized the training situation; (2) they talked about sports in a setting other than the training setting; (3) they discussed sports with their peers when an unfamiliar teacher was present; and (4) they continued to discuss sports when training tapes and behavioral contracts between the teacher and the peer prompter were withdrawn. Previously, it has been common to use nonhandicapped or less-handicapped peers as tutors; this study demonstrates that an autistic youth may also effectively serve as a prompter who assists his schoolmates in acquiring conversational skills that contribute to their normalization.     

Discrimination of facial expressions of emotion by depressed subjects

A frequent complaint of depressed people concerns their poor interpersonal relationships. Yet, although nonverbal cues are considered of primary importance in interpersonal communication, the major theories of depression focus little attention on nonverbal social perception. The present study investigated the ability of depressed, disturbed control, and normal American adults to make rapid discriminations of facial emotion. We predicted and found that depressed subjects were slower than normal subjects in facial emotion discrimination but were not slower in word category discrimination. These findings suggest that current theories of depression may need to address difficulties with nonverbal information processing. There were also no significant differences between depressed and disturbed control subjects, suggesting that the unique social-behavioral consequences of depression have yet to be identified.     

A controlled comparative investigation of psychological treatments for chronic sleep-onset insomnia

A sample of physician-referred chronic insomniacs was randomly allocated to either progressive relaxation, stimulus control, paradoxical intention, placebo or no treatment conditions. Treatment process and outcome were investigated in terms of mean and standard deviation (night to night variability) measures of sleep pattern and sleep quality. Only active treatments were associated with significant improvement, but the nature of treatment gains varied. In particular, stimulus control improved sleep pattern, whereas relaxation affected perception of sleep quality. All improvements were maintained at 17 month follow-up. Results are discussed with reference to previous research and guidelines are given for clinical practice.     

Anxiety in adolescence and its significance for psychoanalysis

The theme of this paper is the well-known resistance of adolescents to participate in analytic treatment and analysts' reservations about treating adolescents, which is perhaps less well known. Several reasons are discussed: For adolescents, the revival of separational and fusional anxieties during the process of individuation as well as resistance to the analytic setting are held responsible; analysts may lack sufficient awareness of their own adolescence and its resulting anxieties to be able to confront this developmental period. In addition, there are countertransference anxieties that are triggered and kept alive by the behavior of the juvenile patient. The different types of analyst anxieties as well as those of the adolescent under analysis are explained and their significance in the process of individuation and the course of therapy is noted.     

Developmental psychopathology. Current research, issues, and directions

Developmental psychopathology refers to the study of clinical dysfunction in the context of maturational and developmental processes. Although the field encompasses the entire life span, the present focus is on childhood. Special characteristics make the study of childhood dysfunction somewhat unique, including the emergence, evolution, and attenuation of seemingly problematic behaviors over the course of development; the manner in which children are referred for clinical evaluation; and complexities in identifying the appropriate foci for clinical intervention. Notwithstanding these obstacles, recent work has advanced considerably in diagnosis, assessment, and treatment of childhood disorders. The present article highlights recent advances in these areas and promising extensions in current research. Many advances have relied heavily on the extension of paradigms developed in research with adults. Additional research is needed that draws on and integrates conceptual and empirical work from developmental psychology.     

Private-sector care for chronically mentally ill individuals. The more things change, the more they stay the same

Two profit-making industries, nursing homes and board-and-care homes, care for about one million chronic mental patients. This care is primarily custodial and probably not very different from the care patients received in the public sector prior to deinstitutionalization. Moreover, certain characteristics of privately owned facilities encourage poor patient care so as to maximize profit. The problem could be ameliorated if chronic mental patients were strong and informed consumers or if the public sector strongly regulated proprietary care. However, neither of these two conditions now hold. Perhaps the apparent difficulties in significantly improving care for chronically mentally ill individuals despite seemingly major changes in policy reflect a fundamental problem in overall social policy--a reluctance to care for chronically indigent individuals of all kinds.