Pediatric–Psychology Partnership for Abuse Prevention

Intimate partner violence (IPV) is a significant, albeit underreported and underidentified, public health problem that requires the informed and coordinated efforts of the health care system for appropriate recognition and intervention. In addition, health disparities are seen in the incidence, prevalence, and burden of IPV among specific population groups in the United States. Pediatric–Psychology Partnership for Abuse Prevention is a graduate psychology education training project focused on developing an integrated primary health-care based workforce that is culturally sensitive and competent in the identification and remediation of IPV. In addition, this project aimed to increase the number of health service psychologists from diverse backgrounds who are culturally competent and aware of health disparities. The training included clinical psychology trainees and pediatric residents working together in an ambulatory pediatric health care setting. Project methods, outcomes, and implications for predoctoral clinical psychology training programs are described.     

The false consensus effect: A meta-analysis of 115 hypothesis tests

False consensus refers to an egocentric bias that occurs when people estimate consensus for their own behaviors. Specifically, the false consensus hypothesis holds that people who engage in a given behavior will estimate that behavior to be more common than it is estimated to be by people who engage in alternative behaviors. A meta-analysis was conducted upon 115 tests of this hypothesis. The combined effects of the tests of the false consensus hypothesis were highly statistically significant and of moderate magnitude. Further, the 115 tests of false consensus appear to be relatively heterogeneous in terms of significance levels and effect sizes. Correlational analyses and focused comparisons indicate that the false consensus effect does not appear to be influenced by the generality of the reference population, nor by the difference between alternative choices in actual consensus. However, the significance and magnitude of the false consensus effect was significantly predicted by the number of behavioral choices/estimates subjects had to make, and the sequence of measurement of choices and estimates. These patterns of results are interpreted as being inconsistent with the self-presentational, motivational explanation for the false consensus effect.     

Blood donor development: Effects of personality, motivational and situational variables

The present study examined the relative importance of the aversiveness of the donation procedure, donor motives and donor personality characteristics in the blood donors' decision to donate. One hundred and eighty-six blood donors and 106 nondonors took part in this retrospective study. Participants were asked to complete a number of personality measures, and two questionnaires assessing their motives for donating and the aversiveness of their most recent donation experience. Results indicated that both the aversiveness of the donation procedure and the donor's motivation exert considerable influence upon the donors' decision to return and donate again. Additionally, the donors' experience of physical discomfort and fearfulness about the donation procedure made the major contributions to the donation's aversiveness. The results also revealed that significant differences exist among nondonor, ex-donor, irregular and regular donor groups on several personality characteristics, on their motives for donating, and on the components comprising the aversiveness of the donation procedure. A blood donor decision model is presented incorporating the influence of motivational, situational and dispositional factors in the individual's development into a regular donor.     

Acute effects of alcohol on cardiovascular reactivity to stress in college-age Type A (coronary prone) individuals

Healthy college-age males and females classified as Type A or Type B were randomly assigned to an alcohol (N=24) or a no-alcohol condition (N=24). Subjects were exposed to a verbal stress quiz while blood pressure, heart rate, peripheral vascular response (PVR), and self-reported anxiety indices were monitored. Results indicated that alcohol effected a reduction in resting levels of systolic blood pressure and a tonic reduction in the peripheral vascular response. Alcohol attenuated the systolic blood pressure, heart rate, and PVR to stress and efffected a decrease in anxiety following the Stressor. When analyzed relative to the participants' drinking experience, data indicated that the strongest stress-modulating effect of alcohol was evidenced by Type A subjects who have been identified as long-term drinkers. During recovery from stress Type A subjects identified as short-term drinkers maintained high levels of PVR. Types A and B subjects who did not ingest alcohol evidenced high PVR levels during stress. The findings are discussed in terms of the protective action of moderate chronic alcohol use on cardiovascular disease risk reduction in persons evidencing the coronary-prone behavior pattern.     

Students' self-ratings of stress in medical school: a replication across 20 months

We replicated the essential results of a prior study on the capacity of the BAROMAS scales to reflect stress in medical school as perceived by students. As before, subjective stress was high at the start of medical school, and when facing the exams prerequisite to entry into clinical clerkships. On most measures, stress was lowest when the second year began (i.e. after having passed the first). Once again, most test-retest reliabilities (significant rs ranged from 0.24 to 0.66 for confidence ratings at 12- and 20-months after entry) were moderate.     

EXPERIMENTAL ANALYSIS AND EXTINCTION OF SELF-INJURIOUS ESCAPE BEHAVIOR

Three studies are presented in which environmental correlates of self-injurious behavior were systematically examined and later used as the basis for treatment. In Study 1, 7 developmentally disabled subjects were exposed to a series of conditions designed to identify factors that maintain self-injurious behavior: attention contingent on self-injurious behavior (positive reinforcement), escape from or avoidance of demands contingent on self-injurious behavior (negative reinforcement), alone (automatic reinforcement), and play (control). Results of a multielement design showed that each subject's self-injurious behavior occurred more frequently in the demand condition, suggesting that the behavior served an avoidance or escape function. Six of the 7 subjects participated in Study 2. During educational sessions, “escape extinction” was applied as treatment for their self-injurious behavior in a multiple baseline across subjects design. Results showed noticeable reduction or elimination of self-injurious behavior for each subject and an increase in compliance with instructions in all subjects for whom compliance data were taken. The 7th subject, whose self-injurious behavior during Study 1 occurred in response to medical demands (i.e., physical examinations), participated in Study 3. Treatment was comprised of extinction, as in Study 2, plus reinforcement for tolerance of the examination procedure, and was evaluated in a multiple baseline across settings design. Results showed that the treatment was successful in eliminating self-injurious behavior and that its effects transferred across eight new therapists and three physicians. General implications for the design, interpretation, and uses of assessment studies are discussed.     

Effect of ingestion of smokeless tobacco on motor distal latency of the median nerve

Subjects were 17 men between the ages of 18 and 32 yr. and regular users of smokeless tobacco. Each subject received three treatments consisting of one pouch of Skoal Bandits, one pinch of their regular brand, and a nonnicotine piece of chewing gum. The nervous transmission at the neuromuscular junction in the right thumb was compared before treatment and once every minute for 15 min. after treatment. Repeated-measures analysis of variance indicated a significant increase in the distal latencies for both the brand-name grouping and in the regularly used brand. No such difference was found in a control group when compared to the pretest results. It was concluded that smokeless tobacco ingestion resulted in a delay in the nervous transmission across the neuromuscular junction. This delay was hypothesized to be caused by the enduring binding action of nicotine to the acetylcholine receptor sites, thereby blocking the impulse in some of the faster conducting nerve fibers.     

The unconscious ego-ideal and analytic group psychotherapy

The theoretical position of this paper is that the essential character of the ego-ideal, a part of superego functioning, is unconscious, universal, and functions automatically. Precursors to superego development and ego-ideal formation begin at early preoedipal levels, and derivations in adult behavior contain primitive aspects. Ego-ideal is perfectionistic and impossible to obey;therefore, projection of this phenomenon as well as its activity leads to disappoinment, anger, anxiety, depression and despair. Pseudomoral injunctions frequently rationalize and disguise early primitive aspects of unconscious superego development and ego-ideal formation. These points are illustrated by clinical material, showing the therapeutic action in the group which leads to a modification of this critical, self-defeating aspect of adult functioning.Copyright, 1987, Washington Square Institute for Psychotherapy and Mental Health, which published this paper in No. 14 of the Group Psychotherapy Monograph Series, after the paper had been presented at the Fourteenth Annual Conference of the Group Psychotherapy Department, and presented by invitation at the ninth congress of the International Association of Group Psychotherapy, Zagreb, Yugoslavia, August 1986.Dr. Edwards was formerly an Associate Supervisor and Faculty Member in the Group Department at the Postgraduate Center for Mental Health.     

Variations on a theme

Epstein (1986) has demonstrated that aggregation leads to high correlations which are not spurious but which reflect only stability. He claims that there is no distinction between a demonstration of test-retest reliability and behavioral stability. It is suggested that Epstein has confused personality theory and measurement models and has made the logical fallacy of claiming that high correlation coefficients uniquely reflect stability. Epstein has failed to distinguish clearly between reaction variables and mediating variables and between temporal stability and cross-situational consistency. While high correlation coefficients may reflect stability there is no necessary one-to-one relationship between personality theories and their measurement models nor between reaction variables and mediating variables. The interaction model recognizes that behavior is consistent in the sense of coherence, i.e. a lawful idiographically predictable pattern of behavior. This pattern involves personsituation interactions, and changes over time. Aggregation may obscure these patterns.