Training Psychologists for a Future in Evolving Health Care Delivery Systems: Building a Better Boulder Model

Recent and dramatic changes in the demand for and reimbursement of psychological services and expertise in health care delivery systems have radical implications for the preparation of psychologists at the predoctoral, internship, and postdoctoral levels. In order to respond to these changes effectively and advance the profession, training programs must realize the expanded and potential role of psychological expertise in evolving health care delivery systems. In this paper, we review several limitations and unfortunate consequences of traditional training programs that have confined the scope of research and practice to the realm of mental health. We propose that future psychologists be recognized and trained from a broader perspective as behavioral scientists, prepared to operate at the highest levels of health care delivery systems. Specific recommendations for training and education are discussed.     

Phase Transitions and Critical Fluctuations in Rhythmic Coordination of Ipsilateral Hand and Foot

Four subjects performed rhythmic movements of the ankle and the wrist in time with an auditory metronome, in two modes of coordination, antiphase and in-phase. The forearm was placed in either a prone or a supine position. When movements were prepared in the antiphase mode, spontaneous transitions to the in-phase mode, or to phase wandering were observed as metronome frequency was increased. When prepared in the in-phase mode, transitions between in-phase modes or to phase wandering were occasionally observed. Predicted signature features of nonequilbrium phase transitions were noted, including loss of stability and critical fluctuations. The stability of the movement patterns was determined by spatial (dependent upon the direction of movement) rather than anatomical (dependent on the coupling of specific muscle groups) constraints. The position of the forearm had no consistent bearing upon the variability of the phase relations between the limbs, the frequency of phase transitions, or the time of onset of transitions. These results are discussed with reference to the coordination dynamics (e.g., multistability, loss of stability) of multijoint movements.     

Behavioral Correlates of Self-Appraised Problem-Solving Ability: Problem-Solving Skills and Health-Compromising Behaviors

According to the revised social problem-solving model, problem solving skills should be associated with cognitive and behavioral attempts to solve or prevent personal problems. We reasoned that the Approach-Avoidance scale on the Problem-Solving Inventory (PSI; Heppner, 1988) measures problem-solving skills as defined in the model, and predicted that scores on this factor would be predictive of health-compromising behaviors among 96 undergraduate students. An aspect of the problem-orientation component would be predictive of global health perceptions. Ineffective problem-solving skills were associated with greater alcohol intake over a 2-week period, and with more sedentary leisure behavior on retrospective and prospective measures. Perceived control over emotions was predictive of health perceptions, as hypothesized. However, elements of problem solving were unrelated to tobacco use, illicit drug use, and exercise behaviors.     

Locus of control, personal control, and the counselling of children with learning and/or behaviour problems

It is widely claimed that locus of control represents an important focus for the counselling of children with learning and/or behaviour difficulties. But the concept is widely misunderstood and often confused with other important control-related constructs. The meaning of a number of key constructs is clarified. An approach to counselling is advocated which recognises the heuristic and therapeutic value of employing these in a discrete, yet integrated fashion.     

Extreme Social Isolation, Use of Community-Based Senior Support Services, and Mortality Among African American Elderly Women

The effect of extreme social isolation and use of community-based senior services on longevity was examined in a national sample of African American elderly women (ages 55–96). Consistent with previous research on the social integration/mortality link, African American elderly women who were extremely socially isolated were hypothesized to have a higher 5-year mortality rate. It was also hypothesized that use of community senior services would be negatively associated with 5-year mortality. Results of logistic regression analysis controlling for age, education, income, and health status found that extremely socially isolated African American elderly women were three times more likely than the nonisolated women to die within the 5-year period from the initial survey. Use of community senior services did not have a relationship on mortality. Results are discussed in terms of directions for future research and intervention.     

M.T.S.: An adaptable microcomputer-based testing system

An Apple II + computer-based human testing system is described. The system, which was developed using the Pascal language, provides library units of low-level procedures to rapidly access a clock, collect responses, control video output, control a touch-sensitive monitor, and display high-resolution graphics. Built-in hardware and software checks provide a high degree of system reliability. Use of easily altered text files for control of trials within a task and inclusion of and ordering of tasks within a session allows the system to be readily adapted.     

Seclusion rates and patient census in a maximum security hospital

Seclusion incidents were studied irr an undercrowded maximum security hospital where seclusion is used in response to episodes of violent or disruptive behavior. Population-based seclusion rates for days with an above-mean census were compared with those for days with a below-mean census. Contrary to expectations derived from studies of overcrowded prisons, the total seclusion rate was higher under low census conditions. Although the seclusion rate for parasuicide incidents was higher under high census conditions, seclusion rates for battery, assault, and disorderly conduct incidents were each higher under low census conditions. These findings are interpreted as indicating that correctional officers observe a smaller proportion of battery, assault, and disorderly conduct incidents under high census conditions. Such underdetection must be taken into account, along with underreporting, in studies of intrainstitutional incidents.