Reducing emergency medical service use in patients with chronic psychotic disorders: results from the FAST intervention study

Patients with schizophrenia have disproportionately high rates of emergency medical service use, likely contributing to the high cost this illness places on society. The aim of this study was to examine the impact of a theory-based, behavioral intervention on immediate and long-term use of emergency medical services. Older patients with schizophrenia (n=240) were randomized to receive either a behavioral, skills-building intervention known as Functional Adaptation and Skills Training (FAST) or a time-equivalent attention-control condition (AC). Logistic regression analyses indicated that AC participants were nearly twice as likely to use emergency medical services in general (OR=2.54; p=0.02) and emergency psychiatric services in particular (OR=3.69; p=0.05) during the active intervention phase of the study. However, there were no differences between the interventions in terms of emergency service use during the long-term follow-up phase of the study (i.e., 6-18 months post-baseline). The FAST intervention appears efficacious for reducing the short-term risk of using emergency medical services. However, the long-term efficacy of the FAST intervention appears less clear. Future studies may want to provide more powerful maintenance sessions to encourage continued use of skills in patients' real-world settings.     

Disgust as embodied moral judgment

How, and for whom, does disgust influence moral judgment? In four experiments participants made moral judgments while experiencing extraneous feelings of disgust. Disgust was induced in Experiment 1 by exposure to a bad smell, in Experiment 2 by working in a disgusting room, in Experiment 3 by recalling a physically disgusting experience, and in Experiment 4 through a video induction. In each case, the results showed that disgust can increase the severity of moral judgments relative to controls. Experiment 4 found that disgust had a different effect on moral judgment than did sadness. In addition, Experiments 2-4 showed that the role of disgust in severity of moral judgments depends on participants' sensitivity to their own bodily sensations. Taken together, these data indicate the importance-and specificity-of gut feelings in moral judgments.     

Word length effects are not due to proactive interference

In immediate serial recall short words are better recalled than long words. The word length effect has become pivotal in the development of short-term memory models. The current research tests one explanation of the word length effect; that it is related to proactive interference (PI). We report two experiments in which the relationship is directly tested. In the first experiment we show that word length effects can be observed over the first few trials in an experiment and that the effect shows itself primarily in the number of omissions made. In the second experiment we simultaneously test for PI and word length effects. Strong word length effects were present but there was little evidence for PI influencing either overall levels of recall or the word length effect. In short, no empirical support was found for PI as an explanation of the word length effect.     

Lexicality and phonological similarity: A challenge for the retrieval‐based account of serial recall?

The retrieval‐based account of serial recall () attributes lexicality, phonological similarity, and articulatory suppression effects to a process where long‐term representations are used to reconstruct degraded phonological traces. Two experiments tested this assumption by manipulating these factors in the recall of four‐ and five‐item lists of words and non‐words. Lexicality enhanced item recall (IR), but only affected position accuracy (PA) for five‐item lists under suppression. Phonological similarity influenced both words and non‐words, and produced impaired PA in silent and suppressed conditions. Consistent with the retrieval‐based account, words and non‐words of high word‐likeness appear subject to redintegration. However, some findings, like suppression not reducing the phonological similarity impairment in suppressed conditions, present challenges for the retrieval‐based account and other models of serial recall.     

Is spoken duration a sufficient explanation of the word length effect?

The word length effect is one of the cornerstones of trace decay plus rehearsal models (TDR) of memory. Words of long spoken duration take longer to rehearse than words of short spoken duration and as such suffer more decay and are thus less well recalled. The current experiment manipulates both syllable length and spoken duration within words of fixed syllable length in an aim to test the assumptions of the TDR model. Our procedures produced robust effects of both syllable length and spoken duration in four measures of the time it takes to pronounce the different types of words. Serial recall for the same materials produced robust syllable effects, but no duration effects.     

Health-Related Quality of Life in a Low-Socioeconomic Status Public Rental-Flat Population in Singapore

Health-related quality of life (HRQoL) is a well-established measure of health and general well-being. Socioeconomic status (SES) can affect HRQoL. We sought to determine whether there were differences in HRQoL between low versus higher area-SES flat communities in Singapore. Residents in two integrated public housing precincts comprising of rental-flat blocks (low area-SES neighborhood) and neighboring owner-occupied blocks (higher area-SES neighborhood) were asked to rate their self-perceived HRQoL using the EuroQol Group five dimensions (EQ-5D) instrument. The EQ-5D assesses HRQoL in five domains (mobility, self-care, usual activities, anxiety/mood and pain) and with a global visual analogue scale (EQ-VAS). We evaluated differences in HRQoL between the rental and owner-occupied neighborhoods, and factors associated with anxiety/depression in the rental-flat neighborhood using multivariate logistic regression. The participation rate was 89.1% (634/711). In the owner-occupied neighborhood, 56.7% (216/381) were in full health, compared with 54.2% (137/253) in the rental-flat population (OR = 0.90, 95%CI = 0.66–1.24, p = 0.568). Across the five domains, staying in a rental-flat neighborhood was independently associated with anxiety/depression (adjusted odds ratio [aOR] = 1.79, 95%CI = 1.10–2.92, p = 0.019). In the rental-flat population, having anxiety/depression was independently associated with minority ethnicity, problems with self –care, pain/discomfort, difficulty with healthcare costs, and not being on subsidized primary care (p < 0.05). There was no significant difference on the EQ-VAS between the two neighborhoods (p = 0.627). Staying in a low area-SES neighborhood was associated with more mental health problems. In the rental-flat population, self-reported anxiety/depression was associated with minority ethnicity, physical health problems, and financial disadvantage in healthcare.     

Does neighborhood size really cause the word length effect?

In short-term serial recall, it is well-known that short words are remembered better than long words. This word length effect has been the cornerstone of the working memory model and a benchmark effect that all models of immediate memory should account for. Currently, there is no consensus as to what determines the word length effect. Jalbert and colleagues (Jalbert, Neath, Bireta, & Surprenant, 2011a; Jalbert, Neath, & Surprenant, 2011b) suggested that neighborhood size is one causal factor. In six experiments we systematically examined their suggestion. In Experiment 1, with an immediate serial recall task, multiple word lengths, and a large pool of words controlled for neighborhood size, the typical word length effect was present. In Experiments 2 and 3, with an order reconstruction task and words with either many or few neighbors, we observed the typical word length effect. In Experiment 4 we tested the hypothesis that the previous abolition of the word length effect when neighborhood size was controlled was due to a confounded factor: frequency of orthographic structure. As predicted, we reversed the word length effect when using short words with less frequent orthographic structures than the long words, as was done in both of Jalbert et al.’s studies. In Experiments 5 and 6, we again observed the typical word length effect, even if we controlled for neighborhood size and frequency of orthographic structure. Overall, the results were not consistent with the predictions of Jalbert et al. and clearly showed a large and reliable word length effect after controlling for neighborhood size.     

Children's Perception of Parental Empathy as a Precursor of Children's Empathy in Middle and Late Childhood

The present study investigated the relationship between children's self-concepts and evaluations of parent figures. The subjects were elementary school children (352 males and 280 females; Grades 5 through 10) who came from intact families, divorced families, or families in which one or both parents had died. Significant relationships were obtained between children's self-concept ratings and their evaluations of their natural father and mother for both intact and divorced families. This relationship was not significant, however, for families in which a parent had died. Furthermore, children's self-ratings were not significantly correlated with their evaluations of stepparents.     

Community Mental Health Service Providers' Codes of Ethics and the Standards for Educational and Psychological Testing

This study compared the codes of ethics of 13 professional organizations for community mental health service providers that have been represented at the meetings of the Fair Access Coalition for Testing with the Standards for Educational and Psychological Testing (American Educational Research Association [AERA], American Psychological Association [APA], & National Council on Measurement in Education [NCME], 1985) and all those standards cited in the revised Standards (AERA, APA, & NCME, 1999) that the investigators identified as pertaining to clinical assessment, as these standards apply to test users. The results suggest that only 2 of the codes of ethics address many of the Standards. Implications and recommendations for professional organizations are provided.     

Attending to the big picture: mood and global versus local processing of visual information

Two experiments employed image-based tasks to test the hypothesis that happier moods promote a greater focus on the forest and sadder moods a greater focus on the trees. The hypothesis was based on the idea that in task situations, affective cues may be experienced as task-relevant information, which then influences global versus local attention. Using a serial-reproduction paradigm, Experiment 1 showed that individuals in sad moods were less likely than those in happier moods to use an accessible global concept to guide attempts to reproduce a drawing from memory. Experiment 2 investigated the same hypothesis by assessing the use of global and local attributes to classify geometric figures. As predicted, individuals in sad moods were less likely than those in happier moods to classify figures on the basis of global features.